AOO/Wilckodontics thoughts?

[DrewS]

Does anyone have any experience with Accelerated Osteogenic Orthodontics (AOO), also known as Wilckodontics?

The procedure was explained to me by the dentist/orthodontist/surgeon (same guy) this way: The gums are peeled back above the root and bone and small incisions are made to perforate the bone. Bone grafting powder combined with antibiotics are placed on the incisions, and the gums are reconnected/ reattached with stitches between the teeth. The incisions soften the bone and allow the teeth to move three times as fast as with conventional braces. New bone generates around each tooth's new position, improving the result structurally and cosmetically.

I was assured that the results are exactly the same, maybe better with the surgery due to the new bone growth. Conventional braces use months of pressure from the root pushing on the bone to soften it while the surgery accelerates the bone softening. This is a "minimally invasive" 3-4 hour surgery that would decrease my time in braces from 18-24 months to 4.5-5 months. The swelling is severe for the first week and a half, and chewing solid food is painful for about two months. For me I think it is worth the risk and pain considering the time saved.

Does anyone know what this surgery should cost? It was quoted to me for $3,300.

Any experiences, thoughts, risks I haven't considered, prices you've heard, would be appreciated.

[Sunny]

Here's a web site that you might find helpful - Wilckodontics.

I don't know anyone personally who's had this treatment, but I've read 'personal' stories and most sound positive about the treatment. As long as you're able to cope with the pain/discomfort, swelling and extended periods of not being able to eat solid food, then it sounds like it will be good for you. Treatment time is reduced, although you spend a lot more of your treatment time at appointments, something that needs to be considered if you're working.

There are always risks with surgery, but you need to talk to your orthodontist about these, so you can make an informed decision.

Cost ... more expensive than traditional orthodontic treatment, but I have no idea by how much.

Good luck with your research!

[cellardoor]

wow. i've never heard of this until now, but after reading about, i think i would rather have conventional braces than go through that surgical process. it sounds like a huge ordeal just to save a few months.

[Zoso]

I have no direct experience. However, the article I linked in another thread (http://www.bracesreview.com/forums/n...-grafting.html) suggests that a typical course of treatment (including orthodontic treatment itself) might range in price from $10k - $15k.

That article, by the way, was about research into using autologous bone grafting - using the patient's own bone for the graft - instead of allografting for the procedure, and claimed that this reduced risks. A slightly more detailed version of the story can be seen on the USC PR site, here: Good to the Bone.

From all I've read about it, its adherents feel that PAOO offers not only a greatly reduced treatment time, but also causes less gingival recession, brings a reduced chance of apical root resorption, and can lead to greater stability in the results.

Surgery does indeed bring with it certain risks, but some of those are minimised in PAOO by the fact that the surgical procedure is generally performed in-office, under local anesthesia, rather than requiring the more risky general anesthesia. Probably infection is the most prominent risk, and you should ensure you follow your doc's post-operative instructions carefully.

Generally I'd say that you should question your doctor closely about the risks - both short-term and long-term. For example (and I am speculating here) does PAOO bring with it an increased risk of gum recession in later years? I have no idea, but certainly that is held to be a risk in periodontal regenerative surgery which has certain similarities (and big differences!) to the surgery performed for PAOO. Also, were I you, I'd make sure that your doc is very experienced in this type of treatment.

Good luck.

[mariahfromchicago]

I have heard of that. I have never had any surgery. That whole process sounds scary and painful. I can't imagine consuming only liquids for that long of a time. I would rather go with braces. I agree with cellardoor.

I don't know anyone who has had accelerated orthodontics.

But if that is what you feel is best and going through that whole process is worth cutting your treatment to a short time, go for it!

[vaguelady]

I underwent the Wilckodontics procedure. The braces were applied Sept. 23rd and I had the surgery the next day. The procedure itself is not bad at all, no pain during (except for the local anesthetic shot). I was on a soft foods diet for about four weeks (while the stitches were in). Harder foods would be hard to bite into, but around the four month mark there was no pain or discomfort at all and I was eating anything I wanted. I had regular ortho appointments every two weeks. The worst part of the ordeal were the first 3-4 ortho appointments, very painful - be sure to take advil before. However, as soon as the tech was finished with the "tightening" of the braces, the pain was gone (I have been told with traditional orthodontics you can be in pain afterward for up to a week). I will be debanded on May 11th (less than 8 months of treatment time). If I had gone the traditional route, it would have taken 2.5-3 years. The surgery was $5000 (including follow up appointments, one cleaning at the 6 week mark (after surgery you must use a mouthwash that stains your teeth while the stitches are in place), and one cleaning after the braces come off. My ortho treatment was $4500.

I do not recommend this procedure if you have minimal tooth movement or can use Invisalign. I do recommend this procedure if you have a harder case, want a reduction in time, and have the money to do so (I was able to do a 0% payment plan for my surgery, paid cash for the ortho). Invisalign was not an option for me due to the severity of tooth movement required and I am getting married this year. Feel free to post any questions, I am happy to answer any of them.

To cellardoor - I wasn't merely saving a few months, I was saving a few years.

[Sunny]

Fantastic that your treatment was reduced by so much! It's also great that you recovered from your adjustments so quickly. Most adjustments with traditional treatment are painfree and do not require medication, although some discomfort may be felt by a few patients for few hours, or maybe a day or two, but that's mostly the first couple of adjustments, then they're pain free, unless there's some change in treatment. Of course different people experience discomfort/pain differently, so no true comparison is possible.

Here's to your wedding being a wonderful day and you loving your new bite for the rest of your life!

[DrewS]

I guess I've got quite a big update for you all. I went ahead and had the PAOO/Wilckodontics surgery. I'd be glad to answer any questions people have as well. So far I am extremely pleased with the results and the prospect of cutting my treatment time by 75%.

Brackets were put on the same morning as the surgery, January 8th. That was a Thursday morning, and I took work off Friday as well, but was able to return to work Monday no problem, just a bit swollen in the cheeks and puffy eyes.

A bit about the surgery - they obviously used local anesthesia, but I also had a double dose of sleeping pills (upped one more pill to a triple dose right before the surgery because I was "too coherent") which conked me out for the entire procedure, minus a few moments when the smells were weird. My orthodontist/surgeon is the first in the US to use a laser scalpel, which helps minimize pain and recovery time. The pain was not bad at all. I only used 4 pain killer pills throughout the first two days. I was basically "hung over" and loopy all day after the surgery, though, so if you do the sleeping pill or any other "worry free" medication along with your procedures, you need to have a care-taker.

It hurt to chew for the first week, so I was on a soup/hot cereal diet for that time (luke-warm as to not melt the stitches). Soft foods were fine by the end of the first week, and I was cautiously chewing normal foods by the middle of the second week. As long as I wasn't chewing, there wasn't pain those first few weeks. Honestly, armed with soup I could have gone back to work on Friday. It really wasn't painful.

By the end of the second week my face was almost completely back to normal and the stitches were dissolving from between my teeth. I went in every 2 to 4 weeks to get my elastics changed. I've had the wire changed once so far. Now I go in once every 3 weeks.

I understand it will take 6 to 7 months to complete treatment, and I'm coming up on 4 months. Without the procedure my treatment would have taken 24 months. Costs - braces alone were $6,600, surgery was $3,300 and sleeping pills were $250 (well worth it).

I have pictures of the surgery and my progress, which I'd love to post for you all, but they may be considered graphic. If moderators don't object, I'll post pics in another response.

[DrewS]

I'm having trouble uploading pictures, so I'll have to post links to them (some will show up huge, and some will be on my blog).

Blog post of pictures taken during surgery (slightly graphic):
http://drewcocoon.blogspot.com/2009/...e-surgery.html

Picture right after surgery:
http://3.bp.blogspot.com/_dskx_eUant...Jan+09+003.JPG

One day after surgery:
http://3.bp.blogspot.com/_dskx_eUant...Jan+09+014.JPG

Two days after surgery - Puffy face/cheeks. Should have used two pillows to sleep, as recommended....:
http://1.bp.blogspot.com/_dskx_eUant...y+eyes+002.JPG
http://4.bp.blogspot.com/_dskx_eUant...y+eyes+001.JPG

I look a bit like a drug bust in those pictures...

11 days after surgery, eating normally but cautiously. Stitches are starting to dissolve, but you can see a few left between teeth:
http://4.bp.blogspot.com/_dskx_eUant...n+blog+004.JPG


Sorry to post from my blog. Not trying to self promote, but if you do read it, I hope you enjoy.

[Sunny]

Fantastic that you're so happy with your treatment so far Drew!

It sounds revolting and I can't begin to imagine having that amount of stuff done to my mouth, but you sound very brave, and it sounds like it's been a good decision for you.

Amazing photos and an interesting blog! Good luck with the rest of your treatment.

[PPDI]

I am a periodontist who has had a case referred to me for consultation by an orthodontist. In this case, orthodontic treatment is complete with the exceptio of tooth # 5, which has its buccal root completely outside of the alveolus and surprisingly no gingival recession. There is no contact between the roots of this tooth and the roots of the adjacent teeth. Does anybody have experience using AOO to facilitate tooth movement in this type of case?

[aryan]

did you get the braces off yet?