Periodontal distraction is a minimally invasive procedure that has the potential to retract teeth rapidly and dramatically decrease the time required to close extraction sites. Reducing treatment time through accelerated space closure helps to mitigate the iatrogenic side effects associated with prolonged treatment and meet patient demand for faster treatment. The distraction process also shows promise in producing regenerate bone of sufficient quality and quantity for implant placement, but to date no uCT studies exist for confirmation. The biologic implications of periodontal distraction also remain unknown and require further elucidation before clinical acceptance. The purpose of this study is to evaluate whether rapid tooth movements with periodontal distraction cause loss of tooth vitality and whether the regenerate bone meets the restorative guidelines for dental implant placement. Seven dogs were fitted with intraoral distraction devices. On the experimental side, the maxillary 2nd premolars were extracted and the mesial interradicular bone was removed while maintaining the buccal and lingual cortices. A thin layer of bone distal to the 1st premolar was spared. No procedures were performed on the control side. After a 5 to 7-day latency, the 1st premolars were distalized at a rate of 1 mm/day for 6 days. A 3-week consolidation period was observed. Cast and intraoral measurements showed that the experimental teeth moved 4.7 and 4.8 mm, respectively. The rate of tooth movement achieved over the experimental period was 0.8 mm/day. Laser Doppler flowmetry showed pulsatile signals consistent with the heartbeat of each dog, suggesting pulpal vitality. uCT analyses showed slightly less dense and mature bone mesial to the 1st premolar, with complete to almost complete vertical and buccolingual bone fill. Minimal root resorption of the distracted teeth was noted. In conclusion, periodontal distraction accelerates tooth movement without detriment to tooth vitality or the health of the roots. It is capable of moving teeth at a daily rate of 0.8 mm/day and significantly reducing the treatment time in crowded, extraction cases. Moreover, it is a novel approach to produce bone for implant placement in patients with congenitally missing teeth or partially edentulous patients.
