Correction of Skeletal Class II Malocclusion – An Accelerated Osteogenic Orthodontic Approach

Selective alveolar decortication and periodontal augmentation with a bone graft were the two procedures used for the correction of the skeletal Class II malocclusion in the case reported. A 25-year-old male patient presented with a skeletal Class II malocclusion with increased bi-maxillary dentoalveolar protrusion, increased overjet, deep bite and imbricated & rotated mandibular incisors with bilateral presence of supernumerary teeth in the maxillary right and left premolar region. Extraction of the supernumerary tooth in the maxillary right and left premolar region as also the impacted UL5 was done. Pre-adjusted edgewise appliance, Roth’s prescription (0.022 x 0.028-inch slot) was strapped up and a week later full thickness labial and lingual flaps were reflected in the maxillary and mandibular arches. Circumscribed corticotomy cuts were done and subsequently augmented with a bone graft. Orthodontic treatment was commenced immediately after surgery and orthodontic adjustments were carried out every 2 weeks. The entire orthodontic treatment was completed in 9 months. The primary objective was to evaluate whether selective alveolar decortication could accelerate orthodontic tooth movement and reduce the duration of orthodontic treatment. It was observed that regional acceleratory phenomenon, triggered by alveolar decortication was responsible for the rapid correction of the malocclusion and augmentation with the bone graft further provided adequate bone volume for housing the teeth. This combined procedure might probably contribute to the decrease in the possibility of the tell-tale relapse.