Surgically Facilitated Orthodontic Therapy

Comorbidities that negatively impact orthodontic (malocclusion), periodontal (periodontitis, deficient dentoalveolar bone volume, mucogingival), and prosthetic (structural integrity compromise from caries, attrition, and erosion) conditions can affect the general health of the patient. In addition, emerging data highlights the importance of undiagnosed airway volume deficiencies and sleep-disordered breathing conditions in the adult and pediatric population. Deficiencies in dentoalveolar bone and discrepancies in alveoloskeletal relationships can impact the volume of hard and soft tissue structures of the periodontium and decrease oral cavity volume. Contemporary interdisciplinary dentofacial therapy (IDT) is a key process for addressing the comprehensive problems of patients based on etiology, homeostasis, and sustainability of physiologically sound outcomes. These provide the patient with sustainable esthetics and function. Surgically facilitated orthodontic therapy (SFOT) uses corticotomies and dentoalveolar bone decortication to stimulate the regional acceleratory phenomenon and upregulate bone remodeling and tooth movement as a part of orthodontic decompensation. It also generally includes guided periodontal tissue regeneration and/or dentoalveolar bone augmentation via particulate bone grafting. SFOT enhances the dentoalveolar bone phenotype and augments the orthodontic boundary conditions as well as expanding orthodontic treatment opportunities for challenging malocclusion cases. SFOT as a part of IDT is demanding and requires extensive attention and communication among all team members. This chapter focuses on the role of SFOT as an integral component of contemporary IDT to enhance and facilitate highly predictable and sustainable outcomes.