By Josh Brower, DDS, MIAMDI, FAASDI U sing (RAP) regional accelerated phenomenon to decrease treatment time or allow treatment that wasn’t feasible before to become acceptable now to the patient. Taught and brought to the orthodontic community by Dr. Willian Wilcko and Dr. Thomas Wilcko, a periodontist and orthodontist. Regional accelerated phenomenon in Wilckodontics relates to corticotomy assisted orthodontics to speed up move-ment by 3-4 times. Surgery is limited to the cortical portion of the bone and increases the tissue reorganization and healing by a quick burst of mediating factors that greatly speed up soft and hard tissue remodeling. Depletion of calcium and diminished bone density allows for rapid tooth movement. Bone graft material is placed over the corticotomy is completed to fill in the gaps created during the surgery and slowly fill in the bone as the teeth shift to the final location. Two sectional case reports are shown here with discussion below each figure. Case 1: Supererupted Molar Intrusion The photo on the left shows a supererupted second molar not allowing prosthetic space for restoration of the lower arch and creating a periodontal defect between the adjacent molar. The photo on the right shows immedi-ate post surgery on the day of prior to bonding buccal tubes in place. (Fig. 1, Courtesy of Dr. Samuel Lee) Sectional bonding placed buccal and lingual on each molar with Nickel Titanium arch wires were then placed. Composite bonding stops the sectional archwires from coming loose. Note the bend in the Niti archwire in the top left photo. (Fig. 2, Courtesy of Dr. Samuel Lee) In 4 months note the complete intrusion with only the force of the adjacent molar as anchorage. Restorative space was created and the opposing prosthetic used. (Fig.3, Courtesy of Dr. Samuel Lee) Fig. 1 8 Winter 2016 JAOS
Journal of the American Orthodontic Society Winter 2016: Page 8
