September 22, 2021

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Is Patented Bone Acceleration Surgical Therapy right for you?

Bone Acceleration Surgical Therapy (BAST) improves the performance of periodontal aligners. It is a wonderful component of the patented Tinnisense Dental Care protocol.

By facilitating tooth movements, BAST usually trims the overall treatment time by months, or when mouth conditions are severe, more than a year is saved.

The goals of BAST are to help tooth movements proceed:

    1. more rapidly (often cuts total time in half)
    2. with greater efficiency and predictably
    3. when teeth are stagnant or not progressing as expected
    4. less invasively

BAST is the least invasive corticotomy that can be provided by a dentist, orthodontist, oral surgeon, or periodontist.

A bone acceleration surgery (alveocentesis) is a proven method to expedite movements of teeth.1   Special orthodontic devices make holes in the gums and bone via micro-osteoperforation surgeries (MOPS).2  MOPS are considered somewhat aggressive because slight amounts of bone are removed from each area penetrated. Perforations of the bone and its subsequent removal elicit reactions called regional acceleration phenomena (RAP). Those stimulations enable physiologic processes to occur which increase the rate of bone reformulation.3  While each RAP is unique, they’re all based on the same concept; mild traumas to the bone help the body’s healing response, which is highly desirable.4

One of the reasons why BAST was awarded a milestone patent was that it advanced the state-of-the-art for a dental corticotomy. BAST is the only available corticotomy which doesn’t diminish the overall density of the jaws — no bone is permanently removed! That gives enormous piece of mind to and is highly welcomed by patients, clinicians, and surgeons.

Another appreciated benefit is the relatively rapid recovery time. Other corticotomies are infrequently done a second time because the initial surgical experience along, with the prolonged healing time, dissuade patients from having it again.

A testament to BAST’s efficacy and relative gentleness is that more than a third of the patients have received BAST on more than one occasion.

Advantages of BAST over similar methods

    1. Sterile saline is used to help cool the areas being treated. This follows the protocol with many oral and maxillofacial surgeries and every dental implant surgery. Other corticotomies do not use sterile saline.

    2. Gentle, blunted burs instead of sharp, pointed ones reduce the likelihood of an errant jab.

    3. Bone is redistributed, not removed. The density of the maxilla (top jaw) and mandible (bottom jaw) are not reduced, they remain unchanged.

    4. There is no need for a bone graft. Since some dental corticotomies remove so much bone from the jaws that a surgery to add replacement bone is part of that procedure.

    5. Even though BAST is considered a minimally invasive or nano-invasive procedure, the nominal and brief bone traumas are still sufficient to trigger the desired healing responses and growth stimulation.

    6. Moderate discomfort/pain for the first 24 hours post-treatment is common. Symptoms beyond the first 48 hours are typically mild and often resolve by the 4th day.

Patients like this novel treatment because:

    1. It’s fast – less time is spent in the dental chair.
    2. Recovery time is short, there’s less discomfort, and is a powerful motivator.
    3. Teeth move more quickly so progress is evident every month.
    4. It’s a great motivator that helps encourage compliance.

Potential consequences of BAST:

    1. Gum tissues around the treatment areas can become inflamed or infected.
    2. The root, periodontal ligament (soft tissue between the tooth and bone), nerve, incisal sinus or maxillary sinus can be inadvertently damaged by an errant poke from the drill.
    3. Lingering effects of the local anesthetic can lead to unintentional biting of the cheek, lips, or tongue.

 

While these consequences are uncommon, rare, or merely theoretical, patients should be aware of them before they grant their consent for the procedure. The clinician should be prepared to act with prudence should one of these consequences arise.

This was minutes after BAST was completed. Holes were poked through the gums into the bone. The red spots (where the bleeding has just about stopped) are minimally invasive micro-penetrations of the gum.

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 where the penetrations and vibration occurred have faded)

Patient did not experience any discomfort or peculiar sensations the day following the procedure.

Her comment: “within days, the teeth started ‘flying’”, moving much quicker than prior to the procedure.

FAQ

Whether an additional BAST would be beneficial is based upon how much movement is still expected. Treatment receives a boost for 3-4 months. When significant changes are still needed, there’s a greater likelihood of benefitting from a second or third treatment.

 

It has been reported that the high fees for each corticotomy, acceleration therapy, MOPS, Wilckodontics, or RAP has dissuaded patients from opting for them.

I do not charge a separate fee for BAST — it’s bundled and included in the comprehensive treatment fee (along with retainers and oral antiseptic therapy [teeth whitening]).

That’s because BAST is such a game changer. When combined with periodontal aligners and enamel replacement to form the essential components of the Divign Dental Care protocol, conditions classified as untreatable with aligners are treated successfully and in a reasonable time frame with aligners. That efficiency and positive patient feedback allows the time and cost savings to be passed along to my patients (Manhattan and Bronx, NY offices). It’s a true win-win situation.

Since it’s development in 2018, more than 50 patients have received more than 400 quadrants of care during more than 100 BAST sessions.

 

Summary

Bone Acceleration Surgical Therapy is a valuable option for those considering or already undergoing periodontal clear aligner treatment. The minimally invasive procedure is fast and cost effective. Expect to obtain highly satisfying and lasting results.

More News and Dental Articles from Dr. Elliot Davis.

Additional Patent Issued to Dr. Davis

See Information about Patent #11,173,014 — “Minimally Invasive Method to Enhance Tooth Movement Velocity”

  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
  3. Teixeira 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

An Update

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.

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