Following selective alveolar decortication as defined by the surgical scarring of the alveolar cortex, severe malocclusions can be orthodontically treated in six months. When combined with bone grafting, this technique also significantly expands the scope of treatment in resolving extreme dental arch crowding or borderline skeletal problems with stable clinical outcomes. The biology of rapid tooth movement after selective alveolar decortication involves a transient decrease in bone density thus creating a local environment of less resistance. Animal studies verify demineralization-remineralization (osteopenia) as the rationale for rapid orthodontics, and it is surmised that the stability of orthodontic outcome is due to increased tissue turnover and increased cortical bone thickness due to the graft. With careful treatment planning and understanding of the biological rationale, the alveolar bone metabolism can be locally manipulated to achieve stable and rapid orthodontic results.

This innovative tissue engineering technique offers the clinician a new tool in the treatment of today’s most demanding adult patients.