Substantial evidence associating orthodontic crowding with the 'shrinking human jaws", from the anthropological perspective, is available. The consequence of this malady is that gingival recession, orthodontic relapse, less favorable esthetic results, and root resorption are common iatrogenic complications, frequently associated with orthodontically treated patients. These complicating factors may occur either in the short term or many years following treatment. Of course these problems are present in the non-orthodontic patients as well.
Today, procedures exist which predictably minimize these problems. I have created the acronym (POPA), Pre Orthodontic Periodontal Augmentation, or (PRPA), Pre Restorative Periodontal Augmentation, to describe a modification of the original Periodontally Accelerated Osteogenic Orthodontic Procedure (PAOO). The POPA procedure is less invasive and seems to offer the same advantages seen with the typical PAOO procedure. We are also providing POPA therapy to younger patients, almost prior to the initiation of orthodontic treatment, when it is determined that there is a risk for future gingival recession. These augmentation procedures are also being provided to non-orthodontic patients prior to the onset of substantial restorative endeavors.
Essentially, POPA is an augmentation procedure provided for teeth demonstrating periodontal dehiscences, fenestrations and a thin phenotype. A secondary benefit of POPA, for the orthodontic patient, is that teeth move quicker due to the RAP effect and tooth movement through thin cortical bony plates (e.g. B point, occurs more readily).
