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Biology of the Alveolar Bone : Orthodontic Tissue Regeneration ( OTR )

Today the treatment of adult patients with complex dental problems often requires an interdisciplinary collaboration between different specialties of dental medicine among them frequently orthodontics: interdisciplinary orthodontics. The advancements in material science, biomechanics and in understanding the biology of the alveolar bone led to improved treatments of cases that once seem to be hopeless. The orthodontist, the surgeon and the periodontist work on the same biological substrate: the alveolar bone. Lack of alveolar bone support is probably the most common and challenging dilemma confronting this interdisciplinary team. The paper will discuss and evaluate periodontal lesions like bone dehiscence or fenestration, age-related changes of the bone, the lag time, special biomechanical considerations and the effect of intrusion and extrusion of teeth in patients with periodontal disease. The orthodontic tooth movement, even in vertical or horizontal plane, has a great osteogenic potential. The positive influence of orthodontic tissue regeneration (OTR) on the depth and the breadth of the alveolar bone will be highlighted in various clinical cases. In conclusion interdisciplinary orthodontics can contribute significantly to overcome challenging bone defects in adult patients, joining the new regenerative paradigm of modern dental medicine. Key-Words: interdisciplinary adult orthodontics, bone dehiscence, bone fenestration, bone remodeling, lag time, orthodontic extrusion, premolar distalization, osteogenic potential, regenerative paradigm