SURGICALLY FACILITATED ORTHODONTIC THERAPY
Surgically facilitated orthodontic therapy (SFOT) uses corticotomies (bone cuts made through the outer bone layer) and dentoalveolar bone decortication (removal of some of the surface bone) to stimulate the regional healing processes and increase bone remodeling and tooth movement as part of orthodontic treatment. It also generally includes guided tissue periodontal tissue regeneration (helping periodontal/gum health) and/or dentoalveolar augmentation (adding bone in areas of loss). (Compendium, March 2018: Pg 146-149)
We have been providing these treatments proactively for about 10 years. Prior to that we had learned through experience that when we performed jaw surgeries (orthognathic surgery), that it was easier to move the teeth for a period of time after the jaw surgery was performed. At the time, we theorized that this was due to the physiologic and chemical changes in the tissue/bone/teeth as a result of the healing processes that resulted from our making bone cuts to perform these surgeries. Subsequently, this was shown to be true through research. During the healing processes, because of the release of these healing/regeneration factors, the teeth are particularly open to the suggestion of orthodontic movement. There is a limit to this and a properly trained surgeon/orthodontist team is best to carry this treatment out.
The procedure typically involves making small vertical incisions in the gum tissue between the roots of the teeth that are to be moved. Through these small incisions an ultrasonic bone cutting instrument called a piezotome is used to make small cuts just through the outer layer of bone. It is fairly simple as long as you know what you are doing. It is not a painful procedure either. Some slight soreness for a few days, but most people would be back to school or work the next day.
In combination with computer generated orthodontic tooth movement, this procedure can greatly reduce treatment time and effectiveness. Ask you orthodontist if you would benefit form SFOT.
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