POPA – Pre Orthodontic Periodontal Augmentation | Dr. Colin Richman
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POPA – Pre Orthodontic Periodontal Augmentation

Conventional orthodontic treatment typically takes between 18 and 24 months to achieve the desired results, and patients with complex cases may find themselves in braces even longer.

Pre-Orthodontic Periodontal Augmentation (POPA) can straighten most patients’ teeth within three to eight months. This option is particularly appealing to adult orthodontic patients who do not want to spend upward of two years sporting a mouth full of appliances.

Younger patients who would prefer to finish their course of orthodontics quickly and get on with their teen years also find POPA to be an attractive alternative.

Comments from our hygienist

POPA puts orthodontics on a fast track by incorporating changes in the structure of surrounding bone to accompany repositioning of the teeth. Traditional orthodontic treatment focuses solely on forces applied to the teeth, while POPA alters the bone in the process, as well, facilitating faster movement.

After the teeth have moved, the surrounding bone will regenerate, solidifying the results.

Dr. Richman is involved in Pre-Orthodontic Periodontal Augmentation (POPA) treatment because the technique requires a preliminary periodontal (gum) surgery to prepare the jawbone for the desired movement. Some alveolar bone material is removed, allowing the teeth to be repositioned quickly as the bone re-mineralizes.

The collaborating orthodontist usually places POPA-specific appliances on the patient’s teeth prior to the surgery. After the surgery is completed, the orthodontist will then adjust the appliances approximately every other week to move the teeth to their desired positions.

Comments from a patient

This initial periodontal (gum) surgery is a straightforward outpatient procedure, and in some cases, it may help patients to avoid more complex and costly orthognathic surgery that repositions the jaw. Most patients can be treated with the POPA method, but you must be evaluated by an orthodontist to ensure that this course of treatment is appropriate for your case.

If you opt for POPA, be sure to ask your periodontist how to prepare for the surgical procedure and what to expect afterward so that you can plan in advance for any necessary adjustments to your typical routine. For example, you should anticipate to spend between seven and 10 days recovering from the surgery.

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Signs and Symptoms of Advanced Dental Disease Including Periodontal (Gum) Disease


Chronic disease anywhere in the body is insidious, thus advanced symptoms may only appear late after significant damage has occurred. Warning signs of advanced dental disease include:

- Redness, tenderness, pain, swollen gums
- Bleeding while brushing, flossing or biting into an apple
- Insufficient long term flossing over a lifetime
- Receding gums, frequently described ‘getting long in the tooth’
- Teeth moving or shifting
- Loose teeth
- Appliances no longer fit comfortably
- Previous history of tooth loss including parents
- History of smoking, diabetes or other metabolic diseases

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