Is Bone Acceleration Surgical Therapy right for you?
Bone Acceleration can often be a wonderful aid for arch reformulation therapy (ART) which uses periodontal aligners (e.g., Invisalign®) to reposition the teeth and reshape the supporting bone. The purpose of bone acceleration surgical therapy is to coax the bone to move more quickly than it would without intervention, which facilitates tooth movements.
The goals of bone acceleration surgical therapy (BAST) are to help tooth movements proceed:
with greater efficiency
when they had been lagging or not progressing properly
in a manner that the time needed for the Active Phase of ART is cut in half (or more)
One type of bone acceleration surgery is alveocentesis (micro-osteoperforations).1 Treatments which use a Propel® orthodontic surgical device refer to the process as Micro-osteoperforation Surgery (MOPS).2 MOPS are some of the least invasive of the regional acceleration phenomena (RAP).3 Healing due to RAP refers to complex physiologic processes with increase the rate of bone reformulation. While each RAP is unique, these procedures are based on the same concept; that one can induce mild traumas to the bone which are significant enough to trigger the body’s healing response. That stimulation will expedite the highly desired remodeling process of the bone and gum.4
Advantages of BAST over similar methods:
sterile water is used to help cool the areas being treated(identical to the protocol incorporated into every dental implant surgery and standard in many oral and maxillofacial surgeries)
gentle, round-shaped burs are used instead of sharp, pointed ones (safer because an errant placement is far less likely)
patients report little discomfort the day of treatment and rarely report any symptoms 48 hours later
Dr. Chad Johnson performs a wide array of sophisticated services at Veranda Dentistry in Pleasant Hill, Iowa. I had previously treated many patients with the most popular orthodontic bone surgery device before I started to use the less invasive bone acceleration method. It quickly became self-evident that this technique was going to be a relief to both me and my patients.
Dr. Johnson shared his specific observations. Patients like the newer treatment because:
they spend less time in the chair
recovery time is shorter
they have less discomfort
teeth moved at the same rate or faster with the newer, more progressive bone acceleration method
the technique is dentally gentle and intuitive
- gum tissues around the treatment areas can become inflamed or infected
Potential consequences of BAST:
gum tissues around the treatment areas can become inflamed or infected
a portion of a bur or injection needle can break
the root, periodontal ligament (soft tissue between the tooth and bone), nerve, incisal sinus or maxillary sinus can be inadvertently damaged by an errantly guided drill
While these are uncommon, rare or merely theoretical occurrences, patients should be aware of them before granting their consent to the procedure. The clinician should also be prepared to act with prudence should one of these consequences arise.
This was minutes after BAST was completed. The holes were poked through the gums.
The red spots (where the bleeding has just about stopped) show the location of the minimally invasive micro-penetrations.
The clear dental composite
bumps on the teeth are another method to facilitate the progress of sequential periodontal aligners.
- 5 days after BAST (notice the red spots have faded)
Patient did not experience any discomfort or peculiar sensations the day after the procedure.
Her teeth started flying, moving much quicker than she had expected.
Does the procedure ever have to be repeated
Usually, it does. But, it really depends on how much correction is required. The more changes that the mouth needs to undergo, the greater the likelihood the treatment will need to be repeated a second, third or fourth time.
How much does it cost?
The fee for the procedure varies widely. Some clinicians charge a fee for each bone acceleration therapy, MOPS or RAP session. Others charge a single acceleration fee for the entire course of treatment, regardless of the number sessions that will need to be rendered.
A few, like me, do not charge for bone acceleration –it’s included in the comprehensive treatment fee. Here’s my quote:
Bone acceleration surgical therapy has been a game changer. When combined with ART, it’s allowed me to treat patients previously deemed untreatable. Because it’s so efficient, predictable and dentally gentle, I can prudently and confidently pass on those savings to my patients here in New York (Manhattan and Bronx).
The bottom line: expect the fee to range from $0 – $1,500 over the course of a periodontal aligner, an orthodontic aligner or a traditional orthodontic therapy.
Bone acceleration therapy is a worthwhile and wonderful option for those considering or already undergoing arch reformulation therapy or orthodontic treatment. It’s fast, inexpensive or free. Expect to obtain highly satisfying and lasting results.
Elliot Davis, DDS ([email protected])
1 Nicozisis J. Accelerated Orthodontics With Alveocentesis. Princeton Orthodontics. Clin Orthod. 2012;19:1–4.
2 Alikhani M, Raptis M, Zoldan B, Sangsuwon C, Lee Y, Alyami B, Corpodian C, Barrera L, Alansari S, Khoo E, Teixeira C. Effect of micro-osteoperforations on the rate of tooth movement. Am J Orthod Dentofacial Orthop. 2013;144:639-48
3Teixeira CC, Khoo E, Tran J, Chartres I, Liu Y, Thant LM, Khabensky I, Gart LP, Cisneros G, Alikhani M. Cytokine expression and accelerated tooth movement. J Dent Res. 2010;89:1135–1141.
4 Camacho AD, Velásquez Cujar SA. Dental movement acceleration: Literature review by an alternative scientific evidence method. World J Methodol. Sep 26, 2014; 4(3): 151-162
On January 1, 2018, a new CDT 2018 Dental Procedures Codes entry (D7297 – Corticotomy – four or more teeth or tooth spaces, per quadrant) will officially recognize BAST and similar procedures.