Mini-implant supported canine retraction with micro-osteoperforation: A split-mouth randomized clinical trial

Effects of Micro-Osteoperforation Depths on Canine Retraction Rate and Root Resorption: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed to compare canine retraction rates and the amounts of root resorption in different depths of micro-osteoperforations (MOPs) during canine retraction in orthodontic patients. Relevant literature was sought using a prespecified search strategy until May 2024. Electronic medical and scientific databases included PubMed/MEDLINE, Scopus, EMBASE, Web of Science, and the Cochrane's Library (clinical trials). The review protocol was registered in Prospero (CRD42024555722). The data were analyzed in terms of mean difference for comparison using a random-effect meta-analysis. A total of 14 randomized controlled trial studies were included. According to the findings of the meta-analysis on MOPs and their impact on the mean rate of canine movement, the MOP groups showed a significantly higher rate compared with the control groups (weighted mean difference = 0.32; 95% confidence interval [CI], 0.24-0.40; p = 0.00 and weighted mean difference = 0.20; 95% CI, 0.01-0.40; p = 0.04) at depths of 2 to 4 and 5 to 7 mm, respectively. Three studies reported no differences in root resorption between the MOP groups and the control groups. Both MOP depths, that is, 2 to 4 and 5 to 7 mm, accelerated canine retraction more than the controls by approximately 0.32 and 0.20 mm/month, respectively. However, both MOP depths presented root resorption during canine retraction that was not different from the controls.

Comparison of efficacy between micro-osteoperforations and alveolar corticotomies on the rate of orthodontic tooth movement: A systematic review and meta-analysis

Micro-osteoperforations and corticotomies are two surgical techniques commonly used to increase the rate of tooth movement. The aim of this systematic review was to respond to the question: Which method used for accelerating orthodontic tooth movement, micro-osteoperforations or alveolar corticotomy, produces a higher rate of tooth movement and present less adverse effects? Searches were performed in the electronic databases of PubMed, Scopus, Cochrane CENTRAL, Web of Science, Lilacs and Science Direct, as well as grey literature (Opengrey), up to March 2024. All the included studies were controlled, randomized clinical trials, cohort, case-control, cross-sectional, and multicentre studies of patients treated with orthodontics and corticotomies or micro-osteoperforations. Cochrane Collaboration risk of bias tool was used for quality assessment. For the quantitative analysis, studies were analyzed with a mixed-effect (random effect) meta-regresion model, with beta coefficients and R2 values, with I2 index and with Q and Egger tests. 31 articles were included for the qualitative analysis and 17 for the quantitative analysis. The rate of tooth movement of the corticotomy was 0.539 mm per month (CI95%: 0.117,0.961) higher than with micro-osteoperforations, being the values statistically significant (p = 0.012) but in a context of strong heterogeneity (89.6%). Adverse effects such as pain, quality of life impact and swelling were reported to be longer and harder after corticotomies. After corticotomy a greater rate of tooth movement has been observed during canine retraction compared to micro-osteoperforations. However, more well-designed randomized clinical trials directly comparing both techniques are needed. REGISTRATION NUMBER: CRD42020156448.

Effectiveness of Surgical and Non-Surgical Techniques for Accelerating Orthodontic Tooth Movement in Fixed Appliances and Aligners: A Systematic Review

Several procedures have been proposed as adjuvant treatments in orthodontics to accelerate orthodontic tooth movement (OTM). This review aimed to evaluate and compare the effectiveness of surgical and non-surgical techniques in accelerating tooth movement, ascertain the influence of different orthodontic appliances on the rate of tooth movement and analyze their clinical applicability as supportive approaches in orthodontic treatment. A bibliographic search was carried out in April 2024 across Pubmed, Scopus, Web of Science, and the Cochrane Library using combinations of keywords and Medical Subject Heading terms relevant to the topic. The search had no time restriction and was limited to studies published in English. A total of 76 articles were included in this systematic review. Corticotomy exhibited the highest acceleration potential among surgical techniques but is highly invasive and associated with considerable pain and discomfort. Among non-surgical techniques, vibration and photobiomodulation (PBM) showed the most promising results due to their non-invasiveness and effectiveness in accelerating tooth movement. This review provides a comprehensive overview of techniques for accelerating OTM. The literature remains limited in involving surgical and non-surgical procedures using orthodontic aligners, highlighting the need for further research. Considering all the pros and cons, PBM appears to be the most promising technique; however, its effectiveness is yet suboptimal. Future efforts should be dedicated to optimizing PBM protocols to stimulate specific remodeling phenomena, ensuring its establishment as a safe, effective, painless, and non-invasive acceleration technique.

The effect of micro-osteoperforation (MOP) in molar distalization treatments: an exploratory systematic review and meta-analysis of RCTs

OBJECTIVE

Molar distalization is a therapeutic approach commonly used for treating Class II malocclusions. However, the extended duration of this treatment often leads to its replacement with alternative methods that offer shorter treatment times. Micro-osteoperforation (MOP) has been introduced as a technique aimed at accelerating tooth movement and reducing treatment duration. The purpose of this study is to evaluate the impact of MOP on molar distalization outcomes to provide evidence for its effective and safe use.

SEARCH METHODS

A comprehensive search was conducted across multiple databases, including MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane's CENTRAL, up to April 2024, without any language or date restrictions.

SELECTION CRITERIA

Only randomized clinical trials (RCTs) that addressed the defined PICO question were included in the analysis. The risk of bias in the included studies was assessed using the Cochrane Risk of Bias 2.0 (RoB 2) tool.

DATA COLLECTION AND ANALYSIS

Relevant data were extracted using custom-designed forms, and a random-effects inverse variance meta-analysis was performed to synthesize the results. The primary outcomes analyzed were the rate and amount of molar distalization, while secondary outcomes included pain levels, root resorption, and periodontal health.

RESULTS

Four RCTs, involving a total of 71 participants, were included in this exploratory review. Most studies were at low or some concerns risk of bias. The meta-analysis revealed no significant differences in the rate or amount of molar distalization between the MOP and control groups (mean difference [MD] = 0.1 mm/month and 0.01 mm, respectively, P > .05). However, the MOP group reported significantly higher pain levels on the day of the procedure (MD = 2, P = .01) on a 10-point visual analog scale (VAS) compared to the control group. This difference in pain perception was no longer significant seven days after the procedure (MD = 0.52, P = .52).

CONCLUSION

While MOP is associated with increased immediate postoperative pain, it does not significantly enhance the efficiency of molar distalization. Therefore, the use of MOP for distalization should be judiciously considered and reserved for cases that involve particularly challenging or prolonged movements, based on the specific needs and characteristics of each patient. Limitations of this review include the small number of available RCTs and variability in MOP protocols, which may limit the generalizability of the findings.

REGISTRATION

The protocol for this systematic review was registered at PROSPERO with the ID CRD42024589482.

Effect of Two Different Penetration Depths of Micro-osteoperforation on the Rate of Orthodontic Tooth Movement: A Prospective Clinical Study

Objective

The objective is to evaluate the effectiveness of two different penetration depths of micro-osteoperforations (MOPs) on the rate of orthodontic tooth movement over 60 days. In addition, the amount of pain and discomfort caused by the MOP was evaluated.

Materials and Methods

A total of 22 patients (18-30 years) who need fixed orthodontic treatment were recruited and randomly assigned into two groups. Randomization for determination of the experimental side and depth of perforations was done using sealed envelopes. On each patient, the other side of the mouth worked as control side with no MOPs. Patients in group 1 (MOP-5) received 3MOPs on the buccal surface of the alveolar bone each at 5 mm depth, whereas patients in group 2 (MOP-7) received 3MOPs on the buccal surface of the alveolar bone each at 7 mm depth. The amount of canine retraction was measured every 30 days at two intervals on both sides of the mouth. Pain perception was measured after 1 h, 24 h, 72 h, 7 days, and 28 days of procedure. MOP-related pain was measured using a visual analog scale. The level of statistical significance was P ≤ 0.05.

Results

The result of the intra-examiner reliability using intraclass correlation coefficient more than 0.97 (P < 0.001), indicating excellent repeatability and reliability of the measurements. The baseline characteristics between groups were similar (P > 0.05). Both the groups demonstrated a significantly higher canine movement than the control group. No significant difference was seen between the MOP-5 and MOP-7 groups (P > 0.05) in terms of canine retraction. Mild-to-moderate pain was experienced only in the first 24 h of the procedure.

Conclusion

Three MOPs with a depth of 5 mm can be performed as an effective method to increase the rate of tooth movement. However, increasing the depth of perforation beyond 5 mm does not additionally enhance tooth movement.

Accelerated Orthodontics: A Descriptive Bibliometric Analysis of the Top 50 Cited Articles from 2012 to 2023

BACKGROUND AND OBJECTIVES

Accelerated orthodontics represents a significant shift in dental practice aimed at reducing treatment times while maintaining optimal patient outcomes. This bibliometric analysis evaluated the research landscape of accelerated orthodontics from 2012 to 2023, focusing on publication trends, citation patterns, influential journals, leading institutions, and key contributors.

MATERIALS AND METHODS

A comprehensive search in Scopus identified 600 relevant articles, with the top 50 most-cited papers encompassing systematic reviews, randomized controlled trials, and experimental studies. Key techniques, such as corticotomy and piezocision, have been frequently highlighted for their effectiveness in expediting tooth movement.

RESULTS

The analysis revealed fluctuating annual scientific outputs, with notable peaks driven by technological advancements and increased patient demand for quicker orthodontic solutions. However, the production of high-impact papers was hindered by delays in citation accumulation and disruptions caused by the COVID-19 pandemic. Keyword analysis identified critical themes, such as orthodontic tooth movement, malocclusion, and demographic factors, while a global collaboration map underscored extensive international research partnerships. Leading journals included the American Journal of Orthodontics and Dentofacial Orthopedics, and prominent institutions such as the University of California at Los Angeles played significant roles in advancing the field.

CONCLUSIONS

This study provides a comprehensive overview of the current state of accelerated orthodontics, emphasizing the need for continued research, particularly RCTs, to further refine and validate accelerated orthodontic techniques and improve clinical outcomes.

Effect of micro-osteoperforations (MOPs) on the rate of en masse orthodontic tooth retraction : A randomized controlled trial

PURPOSE

To evaluate the effect of micro-osteoperforations (MOPs) on the rate of orthodontic tooth movement (OTM) during en masse anterior retraction.

MATERIALS AND METHODS

Twenty patients were randomly allocated into experimental and control group of 10 each. In the control group, en masse retraction was performed with sliding mechanics with a coil spring. In the experimental group after alignment and levelling, MOPs were performed mesially and distally to all six anterior teeth in the interdental cortical region on the labial aspect of both arches. MOPs were performed at the beginning of space closure (T0) and 1 month after beginning of space closure (T1). En masse retraction was performed with sliding mechanics with a coil spring. Measurements were recorded on digital models made from scanned plaster casts at the beginning of space closure (T0) and monthly at each follow-up visit for the next 4 months (T1, T2, T3, T4). The monthly rate of OTM, the overall rate of OTM, and the difference between OTM in the MOP period (T0-T2) and post-MOP (T2-T4) period in the experimental and control group were evaluated. A visual analogue scale (VAS) was used to evaluate patients' pain experience.

RESULTS

The overall rate of OTM was significantly greater in the experimental group for both arches in the MOP period (T0-T2) and also in the post-MOP period (T2-T4) as compared to the control group. Within the experimental group, the rate of OTM in the MOP period was significantly greater than in the post-MOP period, which in turn was greater than that of the control group. The patients reported only mild discomfort for 24 h after performing the MOPs, which then gradually decreased.

CONCLUSIONS

The use of MOPs is effective in increasing the rate of en masse tooth retraction in both the maxillary and the mandibular arch. The rate of tooth movement was greater even in the post-MOP period as compared to the control group.

Bibliometric and visualized analysis of randomized controlled trials in orthodontics between 1991 and 2022

INTRODUCTION

In many evidence-based approaches to orthodontic research, randomized controlled trials (RCTs) represent authoritative evidence to identify rational therapeutics. This study aimed to perform mappings of bibliometric networks on orthodontic RCTs and summarize visual characteristics between 1991 and 2022.

METHODS

The articles were retrieved from the Web of Science Core Collection in October 2022 without an initial time limit. Only orthodontic RCTs were eligible. Some bibliometric tools (HistCite, VOSviewer, SCImago Graphica, and CiteSpace) were applied for visualized analysis. Data such as geography, productive institutions, hot articles, journals, authors, references, and keywords were extracted and summarized for analysis.

RESULTS

A total of 1122 orthodontic RCTs were searched. A total of 3841 authors from 1157 institutions in 65 countries published orthodontic RCTs. The United States (149) was the most prolific country, and the University of Sao Paulo (35) was the most productive institution. The American Journal of Orthodontics and Dentofacial Orthopedics (206) was the most popular journal for scholars. The visualization results of keyword co-occurrence identified 5 clusters: (1) tooth movement and auxiliary measures, (2) appliances and oral health, (3) orthodontic discomfort and symptomatic therapy, (4) periodontal disease in orthodontics and health maintenance, and (5) retention and relapse.

CONCLUSIONS

Over the past 31 years, publications and citations on orthodontic RCTs from the Web of Science Core Collection have increased notably across many countries, authors, and institutions. Recently, there has been a significant increase in the attention to orthodontic RCTs that focus on accelerating tooth movement.

The effect of micro-osteoperforations on the rate of maxillary incisors' retraction in orthodontic space closure: a randomized controlled clinical trial

BACKGROUND

This single-centered randomized controlled clinical trial aimed to evaluate the effectiveness of micro-osteoperforations (MOPs) in accelerating the orthodontic retraction of maxillary incisors.

METHODS

Forty-two patients aged 16-40 were recruited and randomly assigned into two groups, one which underwent MOPs (MOPG) in the buccal and palatal region of all maxillary incisors immediately before the start of retraction and one which did not (CG). Eligibility criteria included the orthodontic need for maxillary first premolars extraction and space closure in two phases. The primary outcome of the study consisted of measuring the rate of space closure and, consequently, the rate of incisors' retraction using digital model superimposition 14 days later and monthly thereafter for the next 4 months. The secondary outcomes included measuring anchorage loss, central incisors' inclination, and root length shortening, analyzed using cone beam computed tomography scans acquired before retraction and 4 months after retraction. Randomization was performed using QuickCalcs software. While clinical blinding was not possible, the image's examinator was blinded.

RESULTS

Twenty-one patients were randomly assigned to each group. However, due to various reasons, a total of 37 patients (17 male and 20 female) were analyzed (mean age: 24.3 ± 8.1 years in the MOPG; 22.2 ± 4.2 years in the CG) during the trial. No statistically significant difference was found between the MOPG and the CG regarding the incisors' retraction measured at different time points at the incisal border (14 days, 0.4 mm vs. 0.5 mm; 1 month, 0.79 mm vs. 0.77 mm; 2 months, 1.47 mm vs. 1.41 mm; 3 months, 2.09 mm vs. 1.88 mm; 4 months, 2.62 mm vs. 2.29 mm) and at the cervical level (14 days, 0.28 mm vs. 0.30 mm; 1 month, 0.41 mm vs. 0.32 mm; 2 months, 0.89 mm vs. 0.61 mm; 3 months, 1.36 mm vs. 1.10 mm; 4 months, 1.73 mm vs. 1.39 mm). Similarly, no statistically significant differences were detected in the space closure, anchorage loss, central incisors' inclination, and radicular length between groups. No adverse effect was observed during the trial.

CONCLUSIONS

MOPs did not accelerate the retraction of the maxillary incisors, nor were they associated with greater incisor inclination or root resorption. Trial registration ClinicalTrials.gov NCT03089996. Registered 24 March 2017- https://clinicaltrials.gov/ct2/show/NCT03089996 .

Convalescing Mandibular Anterior Crowding through Piezocision and the Micro-Osteoperforation Surgical Procedure-A Clinical Comparative Study

BACKGROUND

Minimally invasive periodontic (perio) surgical procedures, piezocision, and micro-osteoperforation are useful techniques for accelerating tooth movement. These techniques also offer advantages in the orthodontic (ortho) and aesthetic domains. This study aimed to evaluate and compare the rates of lower anterior decrowding with piezocision and micro-osteoperforation.

METHODS

This clinical study included 24 patients requiring fixed orthodontic treatments. Two periodontic techniques (piezocision (PZ) and micro-osteoperforation (MOP)) were considered for the orthodontic treatments. Each patient was randomly allocated to either the piezocision (PZ) group or the micro-osteoperforation (MOP) group. The piezocision group received five radiographically guided incisions on the labial surface of the alveolar bone, whereas the micro-osteoperforation group received one to three MOPs each using a mini-implant drill between the six lower anterior teeth, and later, an initial arch wire was ligated to each bracket. Little's irregularity index (LII) was calculated using a digital vernier caliper on study models every four weeks until decrowding was achieved. The difference in the rates of lower anterior crowding between the piezocision and micro-osteoperforation groups was analyzed to determine the statistical significance.

RESULTS

The rates of irregularity index change during decrowding were 4.38 ± 0.61 in the piezocision group and 3.82 ± 0.47 in the micro-osteoperforation group. Piezocision was found to be 1.2 times faster than micro-osteoperforation in terms of the rate of decrowding.

CONCLUSION

The advanced perio-ortho combination technique was advantageous in accelerated decrowding. In comparison to MOP, there was an increase in the rate of decrowding with PZ. Decrowding can be completed quickly with PZ, and it can thus be used to treat crowding effectively in a limited time frame.

Comparison of the effectiveness of piezocision-aided canine retraction augmented with micro-osteoperforation: a randomized controlled trial

OBJECTIVE

To evaluate the effectiveness of micro-osteoperforation (MOP) on the rate of piezocision-aided canine retraction (CR).

MATERIALS AND METHODS

The split-mouth study included 25 participants at the stage of commencing CR. The participants received flapless piezocision bilaterally at T0 (0 months) and MOP only on one side at T3 (3 months). The quadrant that received MOP at T3 served as the intervention, whereas the other quadrant served as the control. The primary outcome was the rate of CR, assessed using digital models. The angular change (AC) of the canine and the change in the buccal cortical bone thickness (BCBT) from before to after CR were also assessed using cone beam computed tomography.

RESULTS

The rate of CR was 0.82 ± 0.39 mm/month in the control quadrant vs 0.75 ± 0.44 mm/month in the intervention quadrant (P > .05). The AC of the canine was 2.00° ± 0.88° in the control quadrant vs 1.98° ± 0.86° in the intervention quadrant (P > .05). The crestal bone gain was 0.50 mm in the control quadrant vs 0.28 mm of bone loss in the intervention quadrant. The bone thickness at a 3-mm height was increased by 0.11 mm in the control quadrant vs a 0.29-mm decrease in the intervention quadrant. The bone thickness at a 6-mm height was decreased by 0.12 mm in the control quadrant vs a 0.15-mm decrease in the intervention quadrant. However, none of the changes or group differences in bone height or thickness were statistically significant (P > .05).

CONCLUSIONS

The periodic activation of a piezocision-aided CR site using MOP had no significant positive effect on the rate of CR, angulation of the canine, or changes in BCBT.

Effect of Mini-implant assisted Micro-osteoperforation on the rate of orthodontic tooth movement-A randomized clinical trial

OBJECTIVE

To evaluate the effectiveness of micro-osteoperforation (MOP) over a 56-day period and to determine the influence of number of perforations on the rate of canine retraction. In addition, the amount of pain and discomfort caused by the MOP was evaluated.

TRIAL DESIGN

A single-center, split-mouth, triple-blind, randomized, controlled trial.

METHODS

22 patients (18-30 years) who need fixed orthodontic treatment were recruited and randomly assigned to MOP1 and MOP2 groups. The recruited patients were divided into two groups with 1:1 allocation ratio. Randomization for the determination of experimental side and number of perforations was done using sealed envelopes. On each patient, the other side of mouth worked as control side with no MOPs. 4 months after first premolar extraction, patients in MOP1 received 3MOPs on the buccal surface of alveolar bone, whereas patients in MOP2 received three buccal and three palatal MOPs in the experimental side. The amount of canine retraction was measured every 28 days at two intervals on both sides of mouth. Pain perception was measured after 1 hr, 24 hr, 72 hr, 7 days, and 28 days of procedure.

RESULTS

Result of the intra-examiner reliability using ICC is more than 0.97 (P < 0.001), indicating excellent repeatability and reliability of the measurements. The baseline characteristics between groups were similar (P > 0.05). A statistically significant difference in the rate of canine retraction on the MOP side was observed at the end of 56 days, amounting to two folds more than that of the control side. No significant difference was seen between MOP1 and MOP2 groups (P > 0.05). Mild-to-moderate pain was experienced only in first 72 hours of procedure.

CONCLUSION

The study recommends that MOP procedure has substantial potential to be used as an adjunct to the routine mechanotherapy for accelerating tooth movement, as it may reduce treatment time by half in the first four weeks after the MOP procedure.

TRIAL REGISTRATION

Clinical trial registry of India (CTRI/2022/12/048181).

The effect of micro-osteoperforation on the rate of tooth movement during the alignment stage in patients with mandibular crowding: a randomised controlled trial

BACKGROUND

Orthodontic treatment is a long process that requires patient cooperation. Risks of side effects such as caries formation, periodontal problems, and root resorption increases as well as problems in patient cooperation arises with longer treatments. Several different techniques were developed that may shorten the treatment time.

OBJECTIVE

The aim of this study was to evaluate the effectiveness of micro-osteoperforations (MOPs) performed during the alignment stage.

TRIAL DESIGN

Randomized controlled trial.

METHODS

Twenty-eight subjects who had crowding in the mandibular arch were included in the study. The first group (4 boys and 10 girls, mean age = 17.21 ± 3.76 years) was treated with MOP (MOP) and the second group (8 boys and 6 girls, mean age = 15.29 ± 1.77 years) was treated without MOP (control). Cephalometric variables, periodontal parameters, Little irregularity index, alignment duration, patient satisfaction, and ease of operation were evaluated. The level of statistical significance was P ≤ 0.05.

RESULTS

Alignment duration was shorter (P = 0.000) in the MOP group (105.57 ± 18.34 days) compared to control group (135.86 ± 15.12 days). Alleviating of the crowding was more in the MOP group, compared to the control group in all time points. The pain level in the MOP group in the first appointment was higher compared to control group (P = 0.002). There was no significant difference between the groups in cephalometric parameters. Higher increases were found for gingival index (P = 0.008) and bleeding index (P = 0.039) in the control group compared to MOP group at the end of treatment.

LIMITATIONS

The study was a single-centre study.

CONCLUSION

Alignment stage was shortened with MOP application. There was no difference between groups for patient satisfaction and pain level except for the first appointment. No difference was observed between the groups regarding cephalometric values. Clinically insignificant inflammation was observed in periodontal tissues for both groups.

REGISTRATION

This study was registered at the Clinical Trials Registry (ClinicalTrials.gov NCT03652454).

Temporary anchorage devices and the forces and effects on the dentition and surrounding structures during orthodontic treatment: a scoping review

BACKGROUND

Temporary anchorage devices (TADs) offer the clinician an immediate temporary source of skeletal anchorage for a range of orthodontic interventions. It is important to understand forces involved in using TADs and the effects on the dentition and surrounding structures, to improve clinical outcomes.

OBJECTIVE

To examine and qualitatively synthesize literature on the forces involved with the use of TADs and the effects on the dentition and surrounding structures in orthodontic tooth movement, to provide better understanding of the complex interactions and the clinical implications.

SEARCH METHODS

Electronic databases searched included: Cochrane Library [including Central Register of Controlled Trials (CENTRAL)], Embase via OVID, Pubmed, and Scopus. Study screening and selection were conducted in duplicate.

SELECTION CRITERIA

Studies selected were clinical studies, simulation studies (computer or laboratory-based), or animal studies with no restriction over gender, age, study type (excluding case reports), or setting. Studies focusing on the forces involved with the use of TADs in orthodontic treatment and their effects on the dentition and surrounding structures were included.

DATA COLLECTION AND ANALYSIS

A data charting form was piloted and refined. Data charting was performed independently and in duplicate. This consisted of key fields with predetermined options and free text. The extracted data were collated, and a narrative synthesis conducted.

RESULTS

The results from 203 included studies were grouped into seven TAD based interventions combining the clinical, simulation, and animal studies. They were: En masse retraction of anterior teeth, intrusion, movement of a single tooth, orthopaedic interventions, distalisation, maxillary expansion and other types. The forces involved with the use of TADs, and their effects on the dentition and surrounding structures, were presented in descriptive and tabular formats.

LIMITATIONS

This review restricted study language to English. Formal appraisal of the quality of evidence is not a required feature of scoping reviews, as per the PRISMA-ScR guidelines, however it was evident that a proportion of clinical studies were of high risk of bias and low quality and therefore any proposed changes the reader may consider to their clinical practice should be contextualized in light of this.

CONCLUSIONS

Across the seven types of TAD based interventions the effects on the dentition and surrounding structures are described providing a better understanding of the complex interactions. A guide to the level and direction of forces in each type of intervention is provided to aid clinicians in achieving high quality outcomes.

IMPLICATIONS

There is a need to validate future FEA simulation studies by comparing to clinical data. It is also recommended that future scoping reviews incorporate a formal critical appraisal of studies to facilitate the translation of the results into clinical practice. Development of a standard set of terms for TADs is recommended to facilitate future research.

REGISTRATION

Registration of a scoping review is not possible with PROSPERO.

FUNDING

None to declare.

Methods of measuring distal canine movement and rotation- A review

This article provides an overview of the various methods for measuring distal canine movement and rotation during retraction. Various databases, including PubMed Central, Science Direct, Wiley Online Library, the Cochrane Library, Textbooks, Google Scholar, and Research Gate, and a manual search up until September 2022, were used to search for various methods of measuring distal canine movement and rotation during retraction. After excluding the duplicate articles, the papers explaining these techniques were included. Four significant techniques were identified. The digital method with 3D superimposition is the safest, most accurate, and most accessible of the methods reviewed.

The transparency of reporting 'harms' encountered with the surgically assisted acceleration of orthodontic tooth movement in the published randomized controlled trials: a meta-epidemiological study

BACKGROUND

Surgical-assisted accelerated orthodontics (SAAO) has become very popular recently. Therefore, this study aimed to investigate the extent to which researchers adhere to Item 19 (harms) of the Consolidated Standards of Reporting Trials (CONSORT) in the published studies in the field of SAAO. In addition, the study evaluated the possible association between harm reporting and the human development index (HDI) of the recruited research sample country, CiteScore-based quartile (CSBQ) of the publishing journal, invasiveness of the surgical intervention (ISI), and the type of orthodontic tooth movement (TOTM). Moreover, it aimed to summarize the different possible harms and complications that maybe encountered in the course of SAAO.

MATERIALS AND METHODS

Electronic searching of six databases was conducted for SAAO-related English RCTs published between January 2000 and April 2022. For the RCTs that did not report harms, information was sought by contacting the corresponding authors. Descriptive statistics of the evaluated variables were performed. The association between 'harm reporting' and the HDI of the research team, the BDRQ of the publication journal, the ISI, and the TOTM were investigated. Binary logistic regression was used, and the odds ratios (ORs) with 95% confidence interval (CIs) of the evaluated variables were obtained. Moreover, the risk of bias of the included RCTs was assessed using the RoB2 tool.

RESULTS

Among the 91 included RCTs, 54 RCTs (59.3%) did not adhere to reporting harm associated with the SAAO. The non-adherence was significantly associated with the ISI (OR 0.16; CI 0.03-0.73; p < 0.018) for invasive methods compared with minimally invasive ones). There was a significant positive correlation between harm reporting and both the CSBQ of the publishing journal and the HDI of the recruited research sample country (p = 0.001, p = 0.003, respectively). On the contrary, a non-significant association was found between harm reporting and the type of OTM (p = 0.695). The incidence of harms associated with SAAO was approximately 17.5%.

LIMITATIONS

Assessment was restricted to English RCTs related to SAAO.

CONCLUSION AND IMPLICATIONS

The adherence to reporting harms in the field of SAAO was deficient. Efforts should be made by authors, peer reviewers, and editors to improve compliance with the CONSORT guidelines regarding harms reporting. Additionally, there is a wide spectrum of harms that could be associated with SAAO that the practitioner should pay attention to and alert the patient to the possibility of their occurrence.

Comparative Evaluation of Effect of Micro-Osteoperforation and Mechanical Vibration on Rate of Orthodontic Tooth Movement in Young Adults With Bimaxillary Protrusion

AIM

To evaluate and compare the rate of orthodontic tooth movement and root resorption by micro-osteoperforation (MOP) and mechanical vibration in young adults with bimaxillary protrusion.

METHOD

Twenty patients having class I bimaxillary protrusion who required all first premolar extraction were allocated into two groups MOP (Group A) and mechanical vibration (Group B), with a 1:1 allocation ratio. After leveling alignment MOP was performed on either side of the arch, and vibration was applied on the contralateral side 20 mins per day. Canines were retracted with nickel-titanium coil springs, and Alginate impressions were taken every four weeks till 4 months.

RESULT

The mean rate of retraction of canines of Group A was more than Group B. There was a statistically significant difference between Group A and Group B. (p=0.0120) Conclusion: The mean rate of retraction of canines treated by MOP was 1.15 mm per 4 weeks, and by mechanical vibration, 0.8mm per 4 weeks.

Substrate Stiffness Regulates the Proliferation and Apoptosis of Periodontal Ligament Cells through Integrin-Linked Kinase ILK

The hallmark of orthodontic tooth movement (OTM) is time-consuming during clinical treatments. The acceleration of OTM through modulating proliferation and apoptosis of periodontal ligament cells (PDLCs) possesses the potential application in clinical treatments. Here, we established an in vitro model with a graded increase in substrate stiffness to investigate the underlying mechanism of proliferation and apoptosis of PDLCs. The role of the integrin-linked kinase (ILK) in response to substrate stiffness was investigated by the depletion model of PDLCs. We found that the proliferation and apoptosis of PDLCs show a stiffness-dependent property with stiffer substrates favoring increased bias at the transcript level. Depleting integrin-linked kinase diluted the correlation between PDLCs behaviors and substrate stiffness. Our results suggest that ILK plays a significant role in modulating PDLC proliferation and apoptosis and can serve as a potential target for accelerating OTM.

Effect of local application of bone morphogenetic protein -2 on experimental tooth movement and biological remodeling in rats

Background: This study attempts to detect the potential effects of local bone morphogenetic protein -2 (BMP-2) on orthodontic tooth movement and periodontal tissue remodeling. Methods: Forty adult SD rats were randomly divided into four groups: blank control group, unilateral injection of BMP-2 on the pressure side or tension side of orthodontic teeth and bilateral injection of BMP-2. Their maxillary first molar was moved by a 30 g constant force closed coil spring. 60 μL of BMP-2 with a concentration of 0.5 μg/mL was injected into each part at a time. In addition, three rats were selected as healthy control rats without any intervention. Fluorescent labeled BMP-2 was used to observe the distribution of exogenous BMP-2 in tissues. Micro-CT was used to measure the microscopic parameters of tooth displacement, trabecular bone and root absorption volume. Three different histological methods were used to observe the changes of tissue remodeling, and then the number of osteoclasts and the content of collagen fibers were calculated. Results: Compared with the blank control group, BMP-2 injection reduced the movement distance and increased the collagen fiber content and bone mass (p < 0.01). There was no significant difference in tooth movement distance, BV/TV ratio and BMD between injection sites in unilateral injection group (p > 0.05). In the case of bilateral injection of BMP-2, the osteogenesis is enhanced. Unilateral injection of BMP-2 did not promote root resorption, but double injection showed root resorption (p < 0.01). Conclusion: Our study does show that the osteogenesis of BMP-2 is dose-dependent rather than site-dependent when a certain amount of BMP-2 is applied around orthodontic teeth. Local application of BMP-2 around orthodontic teeth in an appropriate way can enhance bone mass and tooth anchorage without increasing the risk of root absorption volume. However, high levels of BMP-2 may cause aggressive root resorption. These findings are of great significance, that is, BMP-2 is an effective target for regulating orthodontic tooth movement.

Effect of mini-implant facilitated micro-osteoperforations on the alignment of mandibular anterior crowding: A randomised controlled clinical trial

OBJECTIVE

To assess the effects of mini-implant assisted micro-osteoperforations (MI-MOPs) in the alignment of mandibular anterior teeth, and to explore the intervention's associated pain perception (PP) and root resorption (RR) in adults treated by fixed appliance.

DESIGN

Multicentre, two-arm and single-blinded randomised clinical trial.

SETTING

College of Dentistry, University of Baghdad.

PARTICIPANTS

Adolescents (mean age = 18.97 years) undergoing non-extraction orthodontic therapy for the management of mandibular anterior crowding.

METHODS

A total of 33 participants (mean age = 18.97 years) undergoing non-extraction orthodontic therapy for the management of moderate mandibular anterior crowding were allocated to the experimental (MI-MOPs, n = 17) or control groups (non-MI-MOPs, n = 16). A series of lower study models were obtained at week 4 (T1), week 8 (T2) and week 12 (T3) in the MI-MOPs group and continued to week 16 (T4) and week 20 (T5) in the non-MI-MOPs group, with all models analysed digitally. Periapical radiographs (PA) were taken before commencing treatment (T0) and T3. Participants were asked to complete a 10-point visual analogue scale (VAS) daily during the first week of treatment.

RESULTS

At T0, the mean Little irregularity index (LII) was 5.1 mm (95% confidence interval [CI] = 4.95-5.23) with no statistically significant difference between groups (P = 0.766). At T1, T2 and T3, t-test showed statistically significant differences in the LII (P < 0.05) in favour of the MI-MOPs group; mean differences (MD) were -1.16mm (95% CI = -1.36 to -0.96), -1.77 mm (95% CI = -1.93 to -1.59) and -1.58 mm (95% CI = -1.67 to -1.48), respectively. Mean treatment time from baseline to final alignment was 10.41 weeks (95% CI = 9.92-10.89) in the MI-MOPs group and 16.62 weeks (95% CI = 16.11-17.13) in the non-MI-MOPs groups, which was statistically significant (MD -6.21 mm, 95% CI = -6.88 to -5.53, P < 0.05). Conversely, Mann-Whitney U-test and Wilcoxon signed-rank test showed no significant differences in terms of PP and RR between the groups (P > 0.05). The participants in the MI-MOPs group experienced a higher degree of RR (P < 0.05) secondary to intervention. No other significant adverse events were reported during the trial.

CONCLUSION

This trial found that combining MI-MOPs with non-extraction-based fixed orthodontic therapy in adults mildly shortens the duration of the alignment phase. RR should be monitored throughout the treatment when using MI-MOPs (ClinicalTrials.gov NCT04778241).

Effect of micro-osteoperforations on the rate of orthodontic tooth movement and expression of biomarkers: a randomized controlled clinical trial

INTRODUCTION

Micro-osteoperforation is a minimally invasive technique that has been used to accelerate orthodontic tooth movement and reduce treatment duration. However, literature presents conflicting reports about this technique.

OBJECTIVE

To evaluate the effectiveness of micro-osteoperforations on the rate of canine retraction and expression of biomarkers in gingival crevicular fluid (GCF).

METHODS

This was a randomized clinical trial with split-mouth study design. Thirty adult subjects with age above 18 years (20.32 ± 1.96) who required fixed orthodontic treatment and extraction of maxillary first premolars were enrolled and randomly allocated to either the experimental or control group. Randomization was performed by block randomization method, with a 1:1 allocation ratio. The experimental group received three micro-ostoperforations (MOPs) distal to maxillary canine, using the Lance pilot drill. The retraction of maxillary canine was performed with NiTi coil-spring (150g) in both experimental and control groups. The primary outcome was the evaluation of canine retraction rate, measured on study models from the baseline to 16 weeks of canine retraction. Secondary outcomes were the estimation of alkaline and acid phosphates activity in GCF at 0, 1, 2, 3, and 4 weeks.

RESULTS

There was a statistically significant difference in the rate of canine retraction only after the first 4 weeks. Subsequently there was no statistically significant difference from the eighth to the sixteenth weeks between MOPs and control group. There was a statistically significant difference in alkaline and acid phosphates activity in GCF between MOPs and control groups during the initial 4 weeks of canine retraction.

CONCLUSION

Micro-ostoperforation increased the rate of tooth movement only for the first 4 weeks; thereafter, no effect was observed on the rate of canine retraction during 8, 12 and 16 weeks. A marked increase in biomarker activity in the first month was observed.

A Scoping Review about the Characteristics and Success-Failure Rates of Temporary Anchorage Devices in Orthodontics

This study synthesized the scientific evidence concerning the main characteristics of the Temporary Anchorage Devices (TADs) used in orthodontics and reported the success-failure rates during treatment. For that means, this scoping review collected articles from previous research. A complementary search was carried out in the databases PubMed-MEDLINE, Scopus, LILACS, and EMBASE, focusing on original studies published from 2010 to 2020. We analyzed the main characteristics of the publications. As a result, 103 articles were included. Most of the research was conducted among different groups, who needed TADs principally in the maxilla and an interradicular location between the second premolar and first molar. AbsoAnchor, Dentos Inc., Daegu, Korea, was the most used brand of TADs. The most common characteristics of the devices and biomechanics were a diameter and length of 1.6 mm and 8 mm, a self-drilled system, a closed technique for placement, immediate loading, and forces that ranged between 40 and 800 g. Of the studies, 47.6% showed success rates ≥90%. In conclusion, high success rates were found for TADs, and differences were found according to sociodemographic and clinical variables. The studies showed variability in methodological design, and scientific publications were concentrated in certain countries. We recommend further scientific research on TADs using more standardized designs.

The Effectiveness of Repetition or Multiplicity of Different Surgical and Non-Surgical Procedures Compared to a Single Procedure Application in Accelerating Orthodontic Tooth Movement: A Systematic Review and Meta-Analysis

In this study, we aimed to assess the current scientific evidence concerning the effectiveness of combining two acceleration techniques or repeating an acceleration procedure in comparison with the single application in terms of the speed of the orthodontic tooth movement (OTM). We performed a comprehensive electronic search to retrieve relevant studies on 10 databases. Randomized controlled trials (RCTs) on fixed orthodontic treatment patients who received multiple types of acceleration techniques or underwent a repeated acceleration procedure compared to a single application were included. Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2) was used for assessing the risk of bias of retrieved studies. A total of six RCTs were included in this review. Regarding multiple acceleration methods, it seems that the combination of low-level laser therapy (LLLT) with a surgical technique outperforms the single application of each technique separately. Additionally, the combination of two surgical interventions may have a synergistic effect leading to reduced treatment time compared to the application of a single intervention. Regarding acceleration method repetition, it seems that the re-application of surgical procedures twice is more efficient than the single application. The meta-analysis showed a non-significant difference in the canine retraction rate between the four-weekly micro-osteoperforations (MOPs) (three times of applications) and both the eight-weekly MOPs (two times of applications) [mean difference (MD) = 0.24; 95% CI: -0.2-0.77; p = 0.36], as well as 12-weekly MOPs (two times of applications) (MD = 0.06; 95% CI: -0.14-0.27; p = 0.55). Based on very low evidence, combining two acceleration techniques is superior over a single application in accelerating tooth movement. Again, very low evidence suggests that the efficacy of repetition of surgical procedures twice and three times is similar. Further high-quality RCTs are required to assess the benefit of repeating an acceleration procedure or combining two different methods. In addition, more insight is needed into the possible side effects associated with the repetition or multiplicity of procedures.

The effects of micro-osteoperforation on upper first molar root resorption and bone density after distalization by miniscrew-supported Fast Back appliance in adults: A CBCT randomized controlled trial

OBJECTIVE

To evaluate, primary the effects of Micro-osteoperforation (MOP) on orthodontically induced inflammatory root resorption (OIIRR) of maxillary first molars, and secondary, the density of surrounding alveolar bone during distalization phase with Fast Back distalizer.

MATERIALS AND METHODS

Female patients between 16-20 years of age (University of Mansoura), meeting the criteria, were included between March to September 2019. They were randomly, and equally allocated into control and MOP groups. Both of them underwent distalization with Fast Back distalizer. 3MOPs were applied in the intervention group, distal to the first molars using a 3D printed guide. CBCT images were obtained before and after distalization. Apical root resorption maxillary first molars' roots, and alveolar bone density surrounding them were evaluated using independent-samples t-test. Time of distalization phase was assessed using Mann-Whitney U test. Correlation and partial correlation tests were done between resorption of roots, bone density, and time.

RESULTS

Screening of 50 patients, and exclusion for 30 of them were done. Only 20 subjects underwent the trial to the end. In MOP group, OIIRR of mesiobuccal roots significantly increased (MD=-0.2 (-0.34 to -0.01), P<0.05), and significantly decreased for disto-buccal roots (MD=0.6 (0.45 to 0.72), P<0.001). The second and third layers of bone density decreased significantly in MOP group (MD=116.7 (50.8 to 182.5), MD=560.4 (327.9 to 792.7) respectively, P<0.001). Time for distalization phase was significantly reduced in MOP group (P<0.001).

CONCLUSIONS

MOP decreased OIIRR for nearby distobuccal roots by reduction in surrounding density of bone, and increased OIIRR for the far mesiobuccal roots.

Is Orthodontic Treatment with Microperforations Worth It? A Scoping Review

Malformations of teeth and dental arches can produce functional modifications intermingled with esthetic alterations. Children's rehabilitation may be long, requiring multiple interventions. One of the main challenges of contemporary orthodontics is to reduce treatment time by accelerating orthodontic tooth movements. Among the currently used methods, micro-osteoperforations (MOPs) are flapless, minimally invasive perforations that induce a local trauma to the bone, increase healing capacity, and accelerate dental movements. The use of MOPs in orthodontics is spreading but there are no definite and recognized protocols for their application. This scoping review collected the available evidence in the effect of MOPs during orthodontic therapy as compared to current treatments, to summarize the evidence. The guidelines proposed by PRISMA-ScR were followed: original clinical studies carried out from 2010 to 2021 were retrieved by medical databases combining the terms "micro-osteoperforations" and "accelerated orthodontic tooth movement". From a total of 965 articles, nine were finally selected. The studies' aims, designs, methods, measurements, outcomes, and main findings were very heterogenous, with a duration ranging from 4 weeks to 7 months. This included only Class I malocclusion to any malocclusion. It assessed the effects of MOPs coupled with a variety of orthodontic mechanics on either the retraction of maxillary canines, the distalization of maxillary molars, or the modifications on premolar roots. Mostly, variations in the number, location, and timing of MOPs impeded a global assessment. Overall, most of the studies (six out of nine) reported moderately useful effects of MOPs, one was negative, and only two found significant advantages of MOPs over conventional treatment. The review synthesized the available evidence about MOP applications in orthodontics and identified some important gaps in knowledge that could be starting points for a systematic review of the literature. In conclusion, even if MOPs can accelerate tooth movements, the variety of aims and methods of the published research prevents suggestion of their widespread use.

The effect of micro-osteoperforations on orthodontic space closure investigated over 12 weeks: a split-mouth, randomized controlled clinical trial

OBJECTIVES

To evaluate the effects of minimally invasive micro-osteoperforations (MOPs) on orthodontic tooth movement and pain.

DESIGN

Prospective, split-mouth, randomized controlled trial.

SETTING

Single-centre, university hospital.

METHODS

Twenty subjects requiring maxillary first premolar extractions were included. Right and left sides of the maxilla were randomly allocated into experimental and controls. Space closure was initiated following alignment on 0.20″ stainless steel archwires, using 150 g force, applied by coil springs on power arms. Nance-TPA was used for anchorage. On the experimental side, two 5 mm deep MOPs in vertical alignment on distal aspect of the maxillary canine mid-root region were performed prior to space closure.

OUTCOMES

The primary outcome was the amount of tooth movement during space closure, measured every 4 weeks for 12 weeks (T1, T2, and T3). Secondary outcome was the pain levels related to MOP, measured using Visual Analogue Scale (VAS) questionnaires. Significance was set at P < 0.01.

RANDOMIZATION

Randomization was generated using a randomization table, and allocation was concealed in sequentially numbered, opaque, sealed envelopes.

BLINDING

Blinding was not possible during the experiment but assessor was blinded during outcome assessment.

RESULTS

All subjects completed the study, with tooth movement measurements available for all 20 patients for T0-T2. In three patients, space was closed on one side at T2. The average tooth movement between sides at three intervals (T0-T1, T1-T2, and T2-T3) were not significantly different. Overall difference following 12 weeks (T0-T3) was 0.69 mm higher on the experimental side (P < 0.001). No harms were observed.

LIMITATIONS

Short-term study, cast measurements done with digital callipers.

CONCLUSION

This 12-week randomized split-mouth controlled clinical trial showed two MOPs that are 5 mm deep, applied once prior to space closure, did not create clinically significant increase in maxillary premolar space closure.

PROTOCOL

The protocol was not published before trial commencement.

REGISTRATION

Trial was not registered.

FUNDING

The Australian Society of Orthodontists Foundation for Research and Education.

Biological Anchorage and Canine Orthodontic Movement Rate with a New Technique for Micro-Osteoperforations

Introduction

The differential management of anchorage and the acceleration of tooth movement are some of the current greatest challenges for orthodontists. Diverse techniques and devices to reinforce anchorage and increase the rate of tooth movement have been proposed. Whether micro-osteoperforations (MOPs) can be used for both purposes is currently investigated.

Objectives

To propose and describe a new technique for biological anchorage, which involves six MOPs performed every four weeks, and to present its results in a clinical case of upper premolar extraction. Intervention. In a dental class II patient who met the selection criteria, three MOPs both on the buccal and palatine sides on the intervention side were performed on the extraction area following the protocol described. No MOPs were performed on the control side. The allocation of the intervention was randomised. The MOPs were performed three times at an interval of four weeks. A 0.019 × 0.025-inch stainless steel wire was activated with calibrated NiTi springs. The three-dimensional movement of the first molars and upper canines was evaluated. In addition, the comfort, periodontal status, and canine root resorption of the patient were evaluated.

Results

Clinical and radiographic results suggest that the MOPs had a positive effect in reducing the loss of biological anchorage of the posterior sector and in the rate of canine tooth movement, without damaging changes in the soft and hard tissues.

Conclusion

The proposed protocol involving six MOPs every four weeks improved the behaviour of biological anchorage and increased distalization on the intervention side in this clinical case.

Effects of miniscrew-facilitated micro-osteoperforations on the rate of orthodontic tooth movement : A split-mouth, randomized controlled trial

PURPOSE

The aim of the present split-mouth randomized controlled trial was to evaluate the effects of miniscrew-facilitated micro-osteoperforations (MOPs) on the rate of orthodontic tooth movement during canine retraction.

METHODS

A total of 20 young adult patients (mean age 16.5 years) with the indication for bilateral maxillary first premolar extraction were included in the study. The MOPs were randomly applied to either the right or left side of the mouth with miniscrews (1.5 mm width, 8 mm length) to the extraction area, 28 days apart. The canine distalization continued for 3 months. The closure of the extraction space was measured by using a digital analysis program on the pre- and postdigital study models for both the control and experiment sides.

RESULTS

The mean rate of extraction space closure on the MOP side was 2.51 ± 1.41 mm and on the control side was 2.88 ± 1.32 mm. There was no statistically significant difference between the groups (p > 0.05).

CONCLUSION

Overall, we found that MOPs did not significantly affect the rate of orthodontic tooth movement during canine retraction.

Accelerated orthodontic tooth movement: surgical techniques and the regional acceleratory phenomenon

BACKGROUND

Techniques to accelerate tooth movement have been a topic of interest in orthodontics over the past decade. As orthodontic treatment time is linked to potential detrimental effects, such as increased decalcification, dental caries, root resorption, and gingival inflammation, the possibility of reducing treatment time in orthodontics may provide multiple benefits to the patient. Another reason for the surge in interest in accelerated tooth movement has been the increased interest in adult orthodontics.

REVIEW

This review summarizes the different methods for surgical acceleration of orthodontic tooth movement. It also describes the advantages and limitations of these techniques, including guidance for future investigations.

CONCLUSIONS

Optimization of the described techniques is still required, but some of the techniques appear to offer the potential for accelerating orthodontic tooth movement and improving outcomes in well-selected cases.

Efficacy of micro-osteoperforation of the alveolar bone by using mini-screw for acceleration of maxillary canine retraction in young adult orthodontic patients: A split-mouth randomized clinical trial

AIM

Acceleration of orthodontic tooth movement (OTM) can decrease the rate of complications. This study aimed to assess the efficacy of micro-osteoperforation (MOP) of the alveolar bone for acceleration of OTM by using mini-screws.

MATERIALS AND METHODS

This split-mouth randomized clinical trial evaluated 25 patients (11 females, 14 males, 16-25 years) with class II division I malocclusion who required canine retraction following the extraction of maxillary first premolar. The patients received similar orthodontic treatment at both sides with MOP on one side (MOP group) and no MOP on the other side (control side). Allocation of MOP to the side of jaw was random using Random Allocation Software in 1:1 distribution and equal numbers. Blinding was not applicable. The rate of canine movement was measured monthly for 5 months and considered as the main outcome. The degree of canine tipping was measured at the end of the intervention as the secondary outcome. All measurements were repeated for 12 patients by the two observers and the intra- and inter-examiner correlation coefficients were found to be 0.946 and 0.925, respectively. Data were analysed by paired t-test and repeated measures ANOVA.

RESULTS

Twenty-five patients (11 females, 14 males, 16-25 years) were evaluated. No significant difference was found between the two groups at different time points in the rate of canine movement (P>0.05). The degree of canine tipping in the MOP group was significantly lower than that in the control group (5.34±3.11° versus 7.08±3.70°; P=0.040). Gender had no significant effect on OTM in any group (P>0.05).

CONCLUSIONS

MOP could not accelerate canine retraction but decreased the degree of canine tipping.

Comparison of the effects of horizontal and vertical micro-osteoperforations on the biological response and tooth movement in rabbits

Objective

This study aimed to compare the amount of tooth movement after multiple horizontal (MH) and single vertical (SV) micro-osteoperforations (MOPs), and evaluate the histological changes after orthodontic force application in rabbits.

Methods

The mandibles of 24 white rabbits were subjected to two experimental interventions: MH and SV MOPs. Defect volume of the MOPs between the two groups was kept similar. A force of 100 cN was applied via a coil spring between the incisor teeth and the first premolars. The amount of tooth movement was measured. Differences in the amount of tooth movement and bone variables at three time points and between the two groups were evaluated using repeated-measures analysis of variance.

Results

The first premolar showed a mesial movement of 1.47 mm in the MH group and 1.84 mm in the SV group, which was significantly different at Week 3 (p < 0.05). No significant difference was observed in bone volume and bone fraction between the groups. Tartrate-resistant acidic phosphatase-positive cell count was also significantly greater at Week 3 than at Week 1 in both the SV and MH groups.

Conclusions

The amount of tooth movement showed significant differences between Weeks 1 and 3 in the SV and MH MOP groups, but showed no differences between the two groups. Therefore, SV MOP could be considered an effective tool for enhancing tooth movement, especially for molar distalization, uprighting, and protraction to an edentulous area.

Effectiveness of microosteoperforations in accelerating alignment of maxillary anterior crowding in adults: A randomized controlled clinical trial

INTRODUCTION

This trial aimed to investigate the effectiveness of microosteoperforations (MOPs) in overall time taken for alignment of maxillary anterior crowding and to evaluate the alignment improvement percentage within 6 months between MOPs and control groups.

METHODS

Thirty adult participants (25 females and 5 males; mean age, 22.66 ± 3.27 years) with moderate upper labial segment crowding were randomly assigned into intervention and control groups using block randomization. All participants had first premolar extractions, bonded conventional fixed appliances, and 0.014-in, followed by 0.018-in nickel-titanium archwire placement for initial alignment. The intervention group received a 3-mm deep MOPs procedure under local anesthesia using a Propel device (Propel Ortho Singapore, Pte, Ltd, Winstedt Rd, Singapore) on the labial attached gingivae of maxillary incisors at monthly visits until complete alignment. Little's irregularity index was used to assess the overall changes and measure the change of tooth alignment of the 6 maxillary anterior teeth. Assessor blinding was employed.

RESULTS

There was no statistically significant difference in the median overall alignment duration between MOPs and control groups (139 days [95% confidence interval, 115.32-161.83] vs 143 days [95% confidence interval, 107.12-179.74]; hazard ratio, 0.829; P = 0.467). The MOPs procedure had no significant effect on the alignment duration (P = 0.657) and no overall significant difference in alignment improvement percentage among 2 groups on the basis of time (F = 2.53; P = 0.124). No harm was encountered.

CONCLUSIONS

The application of MOPs is no more effective in accelerating initial orthodontic alignment than conventional treatment.

TRIAL REGISTRATION

This trial was registered at the ISRCTN registry with the study ID ISRCTN15080404.

PROTOCOL

https://doi.org/10.1186/ISRCTN15080404.

FUNDING

This work was supported by the Postgraduate Trust Fund, Faculty of Dentistry, Universiti Teknologi MARA.

Three-dimensional assessment of two different canine retraction techniques: a randomized split-mouth clinical trial

Introduction

The aim of this split-mouth trial was to compare power-arm sliding (PAS) and direct sliding (DS) canine retraction mechanics in terms of speed, rotation, angulation, and anchorage loss.

Methods

Thirty-six class II division 1 patients (20 females, 16 males; mean age, 16.94 ± 3.23) requiring upper first premolar extraction were included in the study. Miniscrews were used as anchorage units, and a retraction force of 150 gr was applied from the power arm on one side and from the bracket on the opposite side by using elastomeric chains. Randomization was achieved by block randomization with a 1:1 allocation ratio either to the right or the left with allocations concealed in opaque, sealed envelopes. Digital models were acquired using an intraoral scanner at the beginning of the retraction (T0), the first month (T1), the second month (T2), and the third month (T3). Before the scans, the archwire was removed, and custom metal jigs were inserted into the vertical slot of the canine brackets to evaluate the canine angulation. The digital models of each patient were separately superimposed with the local best-fit algorithm, and the retraction rate, angulation, rotation, and anchorage loss were measured. The digital measurements were performed using the Geomagic Control X software.

Results

The DS technique’s total retraction rate was higher than that of the PAS technique (2.09 and 1.57, respectively, p = .002). There was, however, no significant difference between the two techniques in terms of angulation, rotation, and anchorage loss. A negative correlation was observed between the retraction rate and age, but it was not statistically significant. No significant difference was observed between the retraction rates of female and male participants in either retraction technique.

Conclusions

For both orthodontists and patients, the DS technique is simpler and more convenient; thus, it is the preferred method for canine retraction.

Trial registration

The trial was not registered.

Protocol

The protocol was not published before the trial commencement.

Comparison of the efficacy of two-time versus one-time micro-osteoperforation on maxillary canine retraction in orthodontic patients: A split-mouth randomized controlled clinical trial

BACKGROUND

Micro-osteoperforation (MOP), a minimally invasive technique for accelerating the rate of orthodontic tooth movement has been research extensively, but with varied clinical results.

OBJECTIVE

To compare the efficacy of one-time versus two-time micro-osteoperforation on the rate of maxillary canine retraction, its influence on anchorage loss, canine angulation and the levels of interleukin (IL-1β) in gingival crevicular fluid (GCF).

MATERIALS AND METHODS

The split-mouth study included 16 patients in which the left and right sides were randomly allocated to the control side (one-time MOP) and experimental side (two-time MOP). MOP was performed on both sides distal to the maxillary canines and canine retraction was carried out using NiTi closed coil springs (150gm) and direct anchorage with miniscrew implants. The second MOP was performed on experimental side one month after the first MOP. The rate of canine movement was assessed using 3D model superimposition over a period of six months. The type of tooth movement, anchorage loss and levels of IL-1β were also evaluated.

RESULTS

Sixteen patients (mean age, 17.87±3.34 years) were analysed for a rate of canine retraction, anchorage loss, and type of tooth movement, while 15 patients were analysed for IL-1β. The rate was significantly higher on two-time MOP side after two months (P<0.001). No statistical difference was found in anchorage loss and controlled tipping of canines was observed. The IL-1β levels immediately after 2^nd MOP were significantly higher than 1^st MOP (P<0.001).

CONCLUSION

The two-time intervention of MOP is more efficacious than one-time MOP in accelerating tooth movement.

Biomechanical and biological responses of periodontium in orthodontic tooth movement: up-date in a new decade

Nowadays, orthodontic treatment has become increasingly popular. However, the biological mechanisms of orthodontic tooth movement (OTM) have not been fully elucidated. We were aiming to summarize the evidences regarding the mechanisms of OTM. Firstly, we introduced the research models as a basis for further discussion of mechanisms. Secondly, we proposed a new hypothesis regarding the primary roles of periodontal ligament cells (PDLCs) and osteocytes involved in OTM mechanisms and summarized the biomechanical and biological responses of the periodontium in OTM through four steps, basically in OTM temporal sequences, as follows: (1) Extracellular mechanobiology of periodontium: biological, mechanical, and material changes of acellular components in periodontium under orthodontic forces were introduced. (2) Cell strain: the sensing, transduction, and regulation of mechanical stimuli in PDLCs and osteocytes. (3) Cell activation and differentiation: the activation and differentiation mechanisms of osteoblast and osteoclast, the force-induced sterile inflammation, and the communication networks consisting of sensors and effectors. (4) Tissue remodeling: the remodeling of bone and periodontal ligament (PDL) in the compression side and tension side responding to mechanical stimuli and root resorption. Lastly, we talked about the clinical implications of the updated OTM mechanisms, regarding optimal orthodontic force (OOF), acceleration of OTM, and prevention of root resorption.

Evaluation of physiodispenser assisted micro-osteoperforation on the rate of tooth movement and associated periodontal tissue status during individual canine retraction in first premolar extraction cases: A split-mouth randomized controlled clinical trial

OBJECTIVE

To assess the rate of tooth movement and the periodontal tissue status over a period of 90 days with and without micro-osteoperforation (MOP).

METHOD

Thirty-three adults of the 19 to 25 age group undergoing labial fixed orthodontic treatment with bilateral maxillary first premolar extraction, requiring individual canine retraction as a part of the treatment plan, were recruited for this split-mouth randomized clinical trial. While performing micro-implant-assisted canine retraction in the maxillary arch, the experimental side received three MOPs each on the mesial and distal aspects of the canine root. The amount of tooth movement was measured clinically at every 15 days interval for 90 days; the periodontal status was assessed clinically (probing depth, relative attachment level) and tomographically (canine root length, alveolar bone level) at the 1st day and 90th day of retraction. The data were subjected to appropriate statistical analyses.

RESULTS

A statistically significant difference in tooth movement on the MOP side was observed in the first 45 days, amounting to 1.5 times more than that of the control side. However, during 45 to 90 days, the difference in the rate of tooth movement between the sides was not statistically significant. Changes in periodontal variables were also insignificant between the sides except for the distal alveolar bone level.

CONCLUSION

An increase in the rate of tooth movement can be achieved without any periodontal adverse effects in the first 45 days of the MOP procedure. The effectiveness of the MOP procedure on the rate of tooth movement gradually declined thereafter.

TRIAL REGISTRATION

CTRI/2019/07/020403.

The effect of single/multiple micro-osteoperforation on the rate of orthodontic tooth movement and its possible complications: A systematic review and meta-analysis

OBJECTIVE

Different surgical and non-surgical approaches have been proposed to accelerate tooth movement and decrease the duration of orthodontic treatments. Recently, less invasive techniques such as micro-osteoperforation (MOP) are becoming more common. Several clinical trials have been performed to analyse the effect of MOP. This systematic review with meta-analyses was done to evaluate the effect of MOP on the rate of orthodontic tooth movement (OTM) and its complications.

MATERIAL AND METHODS

Electronic search was done in PubMed and Cochrane database for studies published until January 2021. Comparative randomized clinical trial studies with 10 or more participants per group were included. The risk of bias (ROB) of the studies was assessed according to the Cochrane Collaborations tool. Meta-analyses were performed to assess the mean difference in tooth movement rate and compare the level of pain between MOP and control groups.

RESULTS

Among a total of 15 included studies, eight studies were at low ROB, while others had unclear ROB. Ten studies evaluated the effect of MOP on OTM rate in canine retraction, and related meta-analysis showed a significant difference between the MOP and control group [SMD=0.42; 95% CI=0.20 to 0.63, P<0.01]. Besides, quantitative analysis showed MOP caused no significant higher anchorage loss [SMD=0.01; 95% CI=-0.15 to 0.13, P=0.89] and pain [SMD=0.54; 95% CI=-0.25 to 1.33, P=0.18].

CONCLUSIONS

Overall, both single and multiple applications of MOP increased the rate of OTM. However, the meta-analysis results of the four studies with low risk of bias showed that there is no significant difference in the rate of tooth movement between MOP and control groups. Besides, it has been shown that MOP did not significantly increase the level of pain, anchorage loss, and periodontal complications.

The effect of different micro-osteoperforation depths on the rate of orthodontic tooth movement: A single-center, single-blind, randomized clinical trial

OBJECTIVE

This study aimed to identify the clinical effectiveness of two different penetration depths of micro-osteoperforations (MOPs) on the rate of orthodontic tooth movement.

METHODS

Twenty-four patients requiring the removal of the upper first premolar teeth were selected and randomly divided into two groups. The control group participants did not undergo MOPs. Participants in the experimental group underwent three MOPs each at 4-mm (MOP-4) and 7-mm (MOP-7) depths, which were randomly and equally performed to either the left or right side distal to the canine. The retraction amount was measured on three-dimensional digital models on the 28th day of retraction. MOP-related pain was measured using a visual analog scale (VAS). Between-group statistical differences in the VAS scores were determined using an independent t-test and those in canine retraction were determined using analysis of variance and posthoc Tukey test.

RESULTS

No significant difference was found between the MOP- 4 (1.22 ± 0.29 mm/month) and MOP-7 (1.29 ± 0.31 mm/month) groups in terms of the canine retraction rate. Moreover, both the groups demonstrated a significantly higher canine movement than the control group (0.88 ± 0.19 mm/ month). MOPs did not significantly affect the mesialization of the posterior teeth (p > 0.05). Moreover, the pain scores in the MOP-4 and MOP-7 groups were similar and showed no statistically significant difference.

CONCLUSIONS

Three MOPs with a depth of 4 mm can be performed as an effective method to increase the rate of tooth movement. However, three MOPs with depths of 4-7 mm does not additionally enhance tooth movement.

Effect of micro-osteoperforations on rate of space closure by mini-implant supported maxillary anterior en-masse retraction: A randomized clinical trial

Background

Micro-osteoperforations is one of the non-invasive surgical techniques used in attempt to accelerate OTM. Conflicting reports on its effectiveness has been reported in the literature.

Objectives

The objectives of this trial were to investigate the effect of micro-osteoperforations on the rate of space closure and on molar anchorage loss during mini-implant supported maxillary anterior en-masse retraction.

Trial design

A single center, parallel arm, randomized controlled trial was conducted.

Method

Sixty, male and female subjects (age range 16-25 years) having Class I bimaxillary protrusion or Class II div 1 malocclusion, who required fixed mechanotherapy with either upper 1st premolar or all four 1st premolar extractions were allocated into two groups using 1:1 allocation ratio. The allocation was done by block randomization method with a block size of 6. In the experimental group, 5 MOPs per side were performed only once just before the en-masse anterior retraction. Mini-screws were placed in order to obtain maximum anchorage. Impressions were taken every month till 4 months and rate of space closure was measured on 3D study models.

Results

Data of 27 subjects in control (attrition ​= ​3) and 28 subjects in experimental group (attrition ​= ​2) were analyzed at the end of this trial. There was a statistically significant increase in the rate of en-masse retraction for the 1st month(p ​= ​0.001,95%CI, 0.17, 0.37 ​mm) but there was no statistically significant difference for the subsequent 2nd (p ​= ​0.450,95%CI,0.13,0.43 ​mm), 3rd(p ​= ​0.204,95%CI,0.23,0.47 ​mm) and 4th month (p ​= ​0.680,95%CI,0.21,0.41 ​mm) between experimental and control groups. There was also no difference (p ​> ​0.05) in molar anchorage loss between both groups at all time intervals.

Conclusion

Micro-osteoperforations (MOPs) did not accelerate the rate of anterior en-masse retraction over a period of 4 months; however, it temporarily increases the rate of retraction only for first month and no affect on molar anchorage.

Trial registration

The trial was registered at www.ctri.nic.in with CTRI No- CTRI/2019/03/018140).

Do orthodontists aim to decrease the duration of fixed appliance treatment?

OBJECTIVES:

The aim of the present study was to investigate the trends in the use of fixed appliance and accelerated orthodontics to decrease the treatment duration. Further, this study aimed to assess the effect of demographic factors on the participant's choice of treatment modality.

METHODS:

This was a cross-sectional study in the form of questionnaire-based online survey especially designed and distributed to 265 orthodontists via email. The questions aimed to collect basic information about the participants and respondents’ choices for decreasing the treatment duration. The data were analyzed according to gender, level of academic education and years of clinical experience using Chi-square test.

RESULTS:

A response rate of 85.2% was reported. Most of the orthodontists aimed to reduce the treatment duration by the biomechanical (66.8%) and surgical approaches (27.4%). The use of sliding mechanics (69.4%) and one-step retraction was more common (66.3%). MBT bracket prescription was more prevalent (51.7%), followed by Roth (41.1%). Conventional brackets were used more than self-ligating brackets, and aesthetic brackets were avoided by one third of the respondents. NiTi wires were the most commonly used wires during the alignment stage (44.2%). However, the effect of gender, years of clinical experience and specialty level of education showed some effects on the use of certain techniques and clinical practice of the respondents.

CONCLUSIONS:

Most of the orthodontists aimed to decrease orthodontic treatment duration by using biomechanical and surgical approaches. Gender and clinical experience to a certain extent affected the participants’ choice during orthodontic treatment.

Comparison of Rate of Canine Retraction and Secondary Outcomes Associated With Conventional Fixed Orthodontic Treatment and Minimally Invasive Techniques (MOPs): A Randomized Control Trial

Introduction:

The objective of the study was to assess the rate of canine retraction and secondary outcomes associated with conventional fixed orthodontic treatment (CFO) and CFO with micro-osteoperforation (CFO + MOP), that is, anchorage loss, root resorption, vitality of tooth, pain and discomfort level during the procedure.

Methods:

A total of 16 patients with Class II Division 1 malocclusion who required upper first premolar extraction with lower non-extraction/single incisor extraction were divided into the test group (MOP) and positive control group (CFO + MOP) for a split-mouth study. Both maxillary canines were retracted with nickel–titanium (NiTi) closed coil springs. Patients were reviewed after 24 hours, 7 days, 28 days, and 4, 8, and 16 weeks to assess the rate of tooth movement, anchorage loss, root resorption, vitality of tooth, pain and discomfort level.

Results:

There was a statistically significant difference in the rate of tooth movement between the CFO and CFO + MOP groups after the first 4 weeks ( P-value = .026), whereas no statistically significant difference was observed at 8, 12, and 16 weeks ( P-value = .33, .99, and .08, respectively). In the CFO group, there was no statistically significant difference in tooth movement between different time intervals ( P-value > .05). There was no significant difference in root resorption between the groups. The pain level was higher in the MOP group in the first 24 hours ( P-value < .05) after the procedure. Later on, the difference in pain level between the groups was not significant ( P-value > .05). The vitality of retracted canines in both groups was healthy.

Conclusion:

The study recommends that the CFO + MOP procedure has substantial potential to be used as an adjunct to the routine mechanotherapy for faster tooth movement, as it may reduce the treatment time by half in the first 4 weeks after the MOP procedure. There are no potential differences in anchorage loss, tipping, vitality, and apical and lateral root resorption between the CFO and CFO + MOP groups. This trial was registered at Clinical Trial Registry, India.

Orthodontists' and patients' perceptions regarding techniques to reduce the orthodontic treatment duration

BACKGROUND

The purpose of this study was to evaluate patients' and orthodontists' perspectives on knowledge of techniques for reducing orthodontic treatment time and acceptance of these techniques.

METHODS

A total of 200 individuals were interviewed and equally divided into two groups: orthodontist group (62 female and 38 male; mean age, 38.07 years) and patient group (52 female and 48 male; mean age, 22.61 years; in the active stage of fixed orthodontic treatment). One questionnaire for each group was administered, including questions about the duration of orthodontic treatment and techniques used for treatment optimization, such as corticotomy, distraction osteogenesis, vibration, and laser therapy. The associations between variables were analyzed by the χ² test at a significance level of 5%.

RESULTS

Among orthodontists, 76% knew at least one technique to reduce the treatment duration, with corticotomy being the most frequently cited (66%); however, only 12% used one or more of these techniques. Laser therapy was the most frequently implemented technique (7%). Regarding the duration of orthodontic treatment, the mean time reported by orthodontists was 19 to 24 months, regardless of the technique or the experience of the orthodontist. Furthermore, 39% of patients expected their treatment to last for more than 24 months, with 50% accepting to undergo further procedures to reduce this duration.

CONCLUSIONS

Patients are willing to undergo additional procedures to reduce the treatment duration and to bear additional costs. However, despite their knowledge, orthodontists do not apply or offer these techniques to the patients.

Three-dimensional assessment of accelerating orthodontic tooth movement-micro-osteoperforations vs piezocision: A randomized, parallel-group and split-mouth controlled clinical trial

OBJECTIVE

To compare the effects of micro-osteoperforations (MOPs) vs piezocision (Piezo) in accelerating orthodontic tooth movement in adults.

SETTING AND SAMPLE POPULATION

In this randomized, single-blinded, parallel-group, split-mouth clinical trial, 24 patients aged 15-40 years were recruited.

SUBJECTS AND METHODS

Patients were randomly allocated into two groups: MOPs and Piezo groups. One side of the maxilla was allocated randomly for treatment with one of these techniques, and the other side was treated conventionally to act as a split-mouth control. The rate of canine retraction was evaluated up to 3 months by three-dimensional digital models using a conventional labial appliance. Root resorption and bone height were evaluated using cone beam computed tomography.

RESULTS

The MOPs and Piezo groups showed a significantly higher rate of tooth movement after 3 months on the experimental sides than the control sides. However, the net movements in the MOPs and Piezo groups did not reveal a higher rate of tooth movement. Similarly, the overall net movement was -0.32 ± 1.14 and -0.55 ± 0.89 mm for MOPs and Piezo, respectively (P = .606). Regarding root resorption, the overall changes in intra- or intergroup comparisons were insignificant. Decreased canine palatal bone height was reported on the experimental side of the Piezo group (P = .015) after 3 months, but the overall changes were insignificant.

CONCLUSIONS

The effect of MOPs and Piezo techniques in accelerating the orthodontic canine retraction was comparable to each other, and to the conventional methods. Neither technique caused root resorption or increased vertical bone loss.

Distribution of mandibular trabeculae bone volume fraction in relation to different MOP intervals for accelerating orthodontic tooth movement

OBJECTIVES

To investigate the effect of micro-osteoperforation (MOP) on the horizontal and vertical distribution of mandibular trabeculae bone volume fraction in relation to different MOP intervals during canine retraction.

MATERIALS AND METHODS

This single-center, single-blinded, prospective randomized split-mouth clinical trial included 30 healthy participants aged 18 years and older, randomized into three groups of different MOP intervals (4, 8, and 12-weekly). Cone beam computed tomography images were taken to assess the bone volume fraction (bone volume over total volume or BV/TV).

RESULTS

BV/TV was significantly reduced (mean difference: 9.79%, standard deviation [SD]: 11.89%; 95% confidence interval [CI]: 4.77, 14.81%; P < .01) and canine retraction increased (mean difference: -1.25 mm/4 mo, SD: 0.79 mm; 95% CI: -1.59, -0.92 mm; P < .01) with MOP, compared to control sites. MOP significantly changed the vertical and horizontal patterns of trabeculae bone with lower values nearer to intervention sites. Only the 4-weekly MOP interval group showed significant decrease in BV/TV (mean difference: 14.73%, SD: 12.88%; 95% CI: 3.96, 25.50%; P = .01) despite significant increase in canine retraction rate for all interval groups. With the use of MOP, BV/TV was found to be inversely correlated to the rate of canine retraction (r = -0.425; P = .04).

CONCLUSIONS

Mandibular trabecular alveolar bone volume fraction was reduced and rate of orthodontic tooth movement increased with MOP, especially in the 4-weekly interval. However, this effect was limited to the immediate interdental region of MOP.

Potential and limitations of orthodontic biomechanics: recognizing the gaps between knowledge and practice

The perennial goals of efficient biomechanics are to obtain more controlled and faster movement and using more discrete appliances. The most recent technological advances have buttressed these goals. Temporary anchorage devices have revolutionized orthodontic practice and loom as a solid cornerstone of orthodontic science, along with the use of light forces, facilitated by "smart" archwires for optimal tooth movement. Accelerated tooth movement with decortication has been successful because of decreasing the resistance of cortical bone but micro-osteoperforation has not matched the same results. Clear aligners and preprogrammed regular or lingual appliances reflect the importance of three-dimensional technology in appliance design based on treatment outcome. These mechanical developments have inched the science closer to the traditional goals, but advances lack regarding their enhancement by biomaterials in a system where the physical stimulus is exerted on the teeth but the expression of tooth displacement is through the biological processes within the surrounding tissues. In this article, present tenets, applications, and advances are explored along with the gaps between knowledge and practice and the possibilities to bridge them. Anchorage control remains the major widely used development but slower is the development of faster noninvasive treatment.

Micro-osteoperforation effectiveness on tooth movement rate and impact on oral health related quality of life

OBJECTIVES

To investigate the effect of micro-osteoperforation (MOP) on the rate of tooth movement (RTM), space closure duration, and oral health-related quality of life (OHRQoL) during completion of anterior retraction in patients undergoing combined orthodontic-surgical treatment after premolar extraction and decompensation with sliding mechanics.

MATERIALS AND METHODS

Twenty-four participants with indications for premolar extractions were randomly allocated to treatment with conventional sliding mechanics (control group; CG) or with to treatment in which three MOPs were performed every activation (experimental group; EG). Dental impressions were taken monthly until space closure was completed and dental casts were converted to three-dimensional models. After the anterior retraction procedure, Oral Health Impact Profile (OHIP-14) questionnaires were filled out at 4 and 72 hours.

RESULTS

Eighteen patients (7 men and 11 women) remained in the trial until space closure was completed (mean follow-up period = 247 days). For full space closure RTM, no significant difference (P = .492) was found between groups (0.614 mm/month for the CG; 0.672 mm/month for the EG). The RTM for different time points, groups, time frames and their interaction were statistically different (P < .05). In multiple correlation analysis, the RTM significantly decreased over time for both groups (P < .05). The OHRQoL scores were significantly higher (worse) for the EG. The psychological, physical and social disabilities, and handicap domains displayed significant differences between the two groups.

CONCLUSION

Use of MOPs did not change the full space closure RTM, while it had a negative impact on OHRQoL.

Osseous evidence behind micro-osteoperforation technique in accelerating orthodontic tooth movement: A 3-month study

INTRODUCTION

The study aimed to investigate the effects of micro-osteoperforations (MOPs) on the mandibular bone volume/tissue volume (BV/TV) ratio changes and the rate of orthodontic tooth movement using cone-beam computed tomography images. Another objective was to evaluate the effects of MOP frequency intervals (4 weeks, 8 weeks, and 12 weeks) on the BV/TV ratio and rate of tooth movement.

METHODS

In 24 participants, 140-200 g of force was applied for mandibular canine retraction. Three MOPs were made according to the scheduled intervals of the 3 different groups: group 1 (MOP 4 weeks), group 2 (MOP 8 weeks), and group 3 (MOP 12 weeks) directly at the mandibular buccal cortical bone of extracted first premolars sites. Cone-beam computed tomography scans were obtained at the 12th week after MOP application. Computed tomography Analyzer software (version 1.11.0.0; Skyscan, Kontich, Belgium) was used to compute the trabecular alveolar BV/TV ratio.

RESULTS

A significant difference was observed in the rate of canine movement between control and MOP. Paired t test analysis showed a significant difference (P = 0.001) in the mean BV/TV ratio between control and MOP sides in all the frequency intervals groups. However, the difference was significant only in group 1 (P = 0.014). A strong negative correlation (r = -0.86) was observed between the rate of canine tooth movement and the BV/TV ratio at the MOP side for group 1 and all frequency intervals together (r = -0.42).

CONCLUSIONS

The rate of orthodontic tooth movement can be accelerated by the MOP technique with frequently repeated MOPs throughout the treatment.