Abstract
OBJECTIVES: Compare the long-term outcomes of alveolar bone and gingiva between the modified periodontally accelerated osteogenic orthodontics (PAOO) and the mainstream approach. METHODS: This retrospective study included 28 orthodontic patients with bone fenestration and dehiscence in the lower anterior teeth. Fourteen patients were treated with the modified PAOO approach, and 14 patients received the mainstream PAOO treatment. Alveolar bone and gingival conditions were evaluated preoperatively (T0), one week (T1), one year (T2), three years (T3), and five years post-surgery (T4). RESULTS: At T4, the measured change in labial cervical third bone thickness (La-CHBT) of the modified group (0.99; 95% CI: 0.70 to 1.28 mm) was notably greater than that of the control group (0.16; 95% CI: -0.10 to 0.41 mm) (p < 0.001). Additionally, the modified group presented a lower bone graft absorption rate (BGAR) of 0.34 (95% CI: 0.24 to -0.55) versus 0.69 in the control group (95% CI: 0.58 to 0.80; p < 0.001). With respect to the gingival recession (GR), the modified method significantly reduced gingival recession from T0 to T4 (ΔT4 = -0.89; 95% CI: -1.21 to 0.44 mm); however, the GR at T4 in the control group was similar to that of T1 (ΔT4 = -0.14; 95% CI: -0.41 to 0.12 mm). The keratinized gingiva width (KGW) of the modified group increased 2.21 mm (95% CI: 1.52 to 2.91 mm), whereas the change in the control group was 0.11 mm (95% CI: -0.44 to 0.65 mm) (p < 0.001). CONCLUSIONS: In terms of long-term outcomes, the modified method demonstrates superior performance in alveolar bone and gingival augmentation, outperforming the mainstream method. CLINICAL TRIAL NUMBER: Not applicable.