Surgically Facilitated Orthodontic Therapy (SFOT)

90% of humans have less than 1 millimeter of bone on the front aspects of their natural teeth.1. This increases the risks associated with orthodontic tooth movement. SFOT is an alternative approach that prevents the need for retractive (usually involving extractions) orthodontics and may improve cavity volume and subsequently tongue space. SFOT moves teeth with less risk to bone and gums and can improve the bone volume around the often deficient root structures.
1.Braut V, Bornstein MM, Belser U, Buser D. Thickness of the anterior maxillary facial bone wall- a retrospective radiogaphic study using cone beam tomography. Int J Periodontics Restorative Dent 2011; 31(2):125-131.

Classification of Dentoalveolar Bone Phenotypes
  Classification of Dentoalveolar Bone Phenotypes
Thick-Thick dentoalveolar bone phenotype representations
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Surgically-facilitated orthodontic therapy (SFOT), also known as Periodontally Accelerated Osteogenic Orthodontics (PAOO; i.e. Wilckodontics®) is a revolutionary approach that not only includes the efficient application of forces to the teeth, but also exploits the potential of the surrounding bone to respond to these forces. This orthodontic therapy is said to be “surgically-facilitated” because a periodontal procedure is used to accelerate tooth movement. Dr. Mandelaris is a certified Wilckodontics® surgeon.

To learn more about wilckodontics click here or review these additional clinical case studies.

SFOT works to develop and manipulate the bone structure that supports teeth. This enables the doctors to temporarily “soften” bone so that teeth move more expeditiously in response to the forces exerted upon them by braces or other orthodontic appliances such as Invisalign®. Surgically-facilitated orthodontic therapy enables patients to grow additional bone where need be. This can be especially important for skeletally mature patients, as their bones are no longer in the process of growing and developing like children or teenage patients.

This interdisciplinary approach produces better results for patients. This is because facial bone structure is considered alongside tooth appearance, creating a beautiful, structurally-sound smile with sufficient bone support. Patients who opt for SFOT often have lower incidences of relapse and a decreased chance of root resorption (i.e., root breakdown and eventual loss). Patients also benefit from a shortened orthodontic treatment 50%-60% of the time.

Cross sectional anatomy of an upper central incisor.
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Dr. Mandelaris has developed a forward-looking perspective on SFOT, as it goes hand in hand with the interdisciplinary philosophy of Periodontal Medicine and Surgical Specialists. Dr. Mandelaris is currently working to educate other clinicians on the benefits of collaboration between oral health specialists for SFOT and other types of treatment.

Has extraction of teeth been recommended to you, your child or someone you know going through orthodontia? If so, we encourage you to contact our office for a second opinion. Taking teeth out for orthodontic therapy is irreversible and could devastating long-term consequences on systemic health by reducing oral cavity volume size and possibly predisposing you to sleep apnea problems. Alternative options such as SFOT can help improve your bite, smile, face and long-term periodontal health without taking teeth out.

If you or someone you know has had tooth extraction recommended to accommodate orthodontic therapy, we encourage you to contact us for a second opinion. Please do not have your teeth taken out for orthodontic purposes without getting a second opinion from us.