Orthodontic moving teeth are closely related to the health of periodontal support tissues, and the combined periodontal orthodontic treatment is becoming more and more normalized. Inflammation control is the prerequisite for orthodontic treatment in patients with periodontitis. For many adult patients, the long course of treatment and the risk of periodontal tissue damage during orthodontic treatment have gradually attracted the clinicians′ attention. Periodontally accelerated osteogenic orthodontics (PAOO) is one of the surgical strategies by combining selective decortication with alveolar augmentation to promote orthodontic treatment. It is aiming to accelerate the movement of teeth for shortening the treatment course, to increase the bone volume for reshaping the alveolar bone and expanding the range of tooth movement and to reduce the risk of tooth movement beyond the "alveolar bone boundary" during orthodontic treatment. Based on the retrieve and review of current literature, this article will focus on how to design and implement PAOO surgery so as to maximize the effectiveness in clinical practice.