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Inpanya P, Chanmanee P, Teerakanok S. Effects of Micro-Osteoperforation Depths on Canine Retraction Rate and Root Resorption: A Systematic Review and Meta-Analysis. Eur J Dent 2025. [PMID: 40315865 DOI: 10.1055/s-0045-1806932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2025] Open
Abstract
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.
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Affiliation(s)
- Potjanakorn Inpanya
- Orthodontic Section, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
| | - Pannapat Chanmanee
- Orthodontic Section, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
| | - Supontep Teerakanok
- Periodontic Section, Department of Conservative Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
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Bisconti F, Eva M, Thevenet E, Zamora-Martinez N. Comparison of efficacy between micro-osteoperforations and alveolar corticotomies on the rate of orthodontic tooth movement: A systematic review and meta-analysis. J Craniomaxillofac Surg 2025; 53:459-475. [PMID: 39870561 DOI: 10.1016/j.jcms.2025.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 12/05/2024] [Accepted: 01/15/2025] [Indexed: 01/29/2025] Open
Abstract
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.
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Affiliation(s)
- Flavia Bisconti
- Universidad Europea de Valencia, Faculty of Health Sciences, Department of Dentistry, Valencia, Spain
| | - Marco Eva
- Universidad Europea de Valencia, Faculty of Health Sciences, Department of Dentistry, Valencia, Spain
| | - Estelle Thevenet
- Universidad Europea de Valencia, Faculty of Health Sciences, Department of Dentistry, Valencia, Spain
| | - Natalia Zamora-Martinez
- Universidad Europea de Valencia, Faculty of Health Sciences, Department of Dentistry, Valencia, Spain; Universidad de Valencia, Faculty of Medicine and Dentistry, Department of Orthodontics, Valencia, Spain.
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Zhou Y, Shao Q, Bie M, Zhang J, Shi H, Kang F. Effect of 3D-printing assisted micro-osteoperforations on the rate of canine retraction: a clinical investigation. BMC Oral Health 2025; 25:605. [PMID: 40254596 PMCID: PMC12010606 DOI: 10.1186/s12903-025-05939-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2024] [Accepted: 04/02/2025] [Indexed: 04/22/2025] Open
Abstract
OBJECTIVES More time is often needed for adult orthodontic patients compared with juvenile counterparts due to lower tissue vitality. In some cases, the prolonged orthodontic treatment may cause a series of problems, such as enamel demineralization, dental caries, periodontitis and root resorption. Therefore, we aimed to accelerate tooth movement to avoid various adverse reactions by 3D-printing assisted micro-osteoperforations (MOPs) in difficult orthodontics cases. METHODS Twenty-eight adult patients (28.3 ± 3.4 years) with slow tooth movement after extraction of bilateral maxillary first premolars were included. The scheme of 3D-printing assisted MOPs was designed to perform bone punctures in the mesial and distal sides of canines. RESULTS The average speed of the retraction of canines was 1.02 ± 0.41 mm per month after MOPs and significantly faster than that before the MOPs, 0.34 ± 0.16 mm per month (P < 0.05). Moreover, the evaluation of side effects including root resorption, periodontal damage did not reach statistical difference and pain level was acceptable generally. CONCLUSION MOPs assisted by 3D-printing could significantly accelerate tooth movement while achieving greater precision, without notably increasing side effects. TRIAL REGISTRATION ChiCTR2100044685, date of registration: 25/03/2021.
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Affiliation(s)
- Yangyifan Zhou
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration & Tongji Research Institute of Stomatology & Department of Department of Oral and Maxillofacial Surgery, Shanghai Tongji Stomatological Hospital and Dental School, Tongji University, No. 399, Middle Yan Chang Road, Shanghai, 200072, China
| | - Qi Shao
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration & Tongji Research Institute of Stomatology & Department of Department of Oral and Maxillofacial Surgery, Shanghai Tongji Stomatological Hospital and Dental School, Tongji University, No. 399, Middle Yan Chang Road, Shanghai, 200072, China
| | - Miaomiao Bie
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration & Tongji Research Institute of Stomatology & Department of Department of Oral and Maxillofacial Surgery, Shanghai Tongji Stomatological Hospital and Dental School, Tongji University, No. 399, Middle Yan Chang Road, Shanghai, 200072, China
| | - Jingju Zhang
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration & Tongji Research Institute of Stomatology & Department of Orthodontics, Shanghai Tongji Stomatological Hospital and Dental School, Tongji University, No. 399, Middle Yan Chang Road, Shanghai, 200072, China
| | - Han Shi
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration & Tongji Research Institute of Stomatology & Department of Orthodontics, Shanghai Tongji Stomatological Hospital and Dental School, Tongji University, No. 399, Middle Yan Chang Road, Shanghai, 200072, China.
| | - Feiwu Kang
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration & Tongji Research Institute of Stomatology & Department of Department of Oral and Maxillofacial Surgery, Shanghai Tongji Stomatological Hospital and Dental School, Tongji University, No. 399, Middle Yan Chang Road, Shanghai, 200072, China.
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Bardideh E, Ghorbani M, Disfani MF, Shafaee H, Mehmani F. The effect of micro-osteoperforation (MOP) in molar distalization treatments: an exploratory systematic review and meta-analysis of RCTs. Eur J Orthod 2025; 47:cjaf004. [PMID: 39969134 DOI: 10.1093/ejo/cjaf004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2025]
Abstract
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.
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Affiliation(s)
- Erfan Bardideh
- Dental Research Center, Orthodontics Department, Mashhad University of Medical Sciences, Vakil Abad Blvd, 9177899191, Mashhad, Iran
| | - Mahsa Ghorbani
- Dental Research Center, Orthodontics Department, Mashhad University of Medical Sciences, Vakil Abad Blvd, 9177899191, Mashhad, Iran
| | | | - Hooman Shafaee
- Dental Research Center, Orthodontics Department, Mashhad University of Medical Sciences, Vakil Abad Blvd, 9177899191, Mashhad, Iran
| | - Fatemeh Mehmani
- Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Tehran Medical Sciences, 9th Neyestan Alley, Pasdaran Ave, 1946853314, Islamic Azad University, Tehran, Iran
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ElSayed HS, El-Beialy AR, Palomo JM, Mostafa YA. Space Closure with Different Appointment Intervals: A Split-mouth Randomized Controlled Trial. Contemp Clin Dent 2024; 15:129-134. [PMID: 39206234 PMCID: PMC11349072 DOI: 10.4103/ccd.ccd_617_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 05/03/2022] [Accepted: 04/11/2024] [Indexed: 09/04/2024] Open
Abstract
Background Canine retraction has been successful with various force systems and retraction techniques. The appointment interval for force reactivation in canine retraction along the archwire is 4-8 weeks. Aims The aim was to evaluate the effect of different reactivation intervals on the rate of space closure. Settings and Design This split-mouth randomized clinical trial recruited 38 patients indicated for the first premolar extraction. Methods Monthly digital models were acquired for 6 months. The first premolars were extracted, and temporary anchorage devices were placed for maximum anchorage control. The canines were retracted using elastomeric chains which were replaced every 2, 4, 6, or 8 weeks. The monthly rate of canine retraction was measured. The time to space closure was calculated. The secondary outcome was the mesial drift of the first molars. Statistical Analysis The Kaplan-Meier survival analysis and the Friedman test evaluated and compared the groups. Results There was no significant difference between the monthly canine retraction rate or the first molar mesial drift between the groups. The mean time to space closure was 5.74 months in the 2-week reactivation group, which was statistically less than the other groups. Conclusions The 2-week reactivation interval may reduce time to space closure. Direct anchorage control with miniscrews limited anchorage loss significantly.
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Affiliation(s)
- Hend Salah ElSayed
- Department of Orthodontics and Pediatric Dentistry, Oral and Dental Research Division, National Research Centre, Giza, Egypt
| | - Amr Ragab El-Beialy
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Juan Martin Palomo
- Case Western Reserve University School of Dental Medicine, Cleveland, OH, USA
| | - Yehya Ahmad Mostafa
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Future University in Egypt, Cairo, Egypt
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Husain S, Sundari S. Comparison of the effectiveness of piezocision-aided canine retraction augmented with micro-osteoperforation: a randomized controlled trial. Angle Orthod 2024; 94:17-24. [PMID: 37839802 DOI: 10.2319/052323-370.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 09/01/2023] [Indexed: 10/17/2023] Open
Abstract
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.
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Singh S, Jain AK, Prasad RR, Sahu A, Priya P, Kumari P. Effect of Mini-implant assisted Micro-osteoperforation on the rate of orthodontic tooth movement-A randomized clinical trial. J Orthod Sci 2023; 12:62. [PMID: 38234639 PMCID: PMC10793843 DOI: 10.4103/jos.jos_18_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/09/2023] [Accepted: 05/29/2023] [Indexed: 01/19/2024] Open
Abstract
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).
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Affiliation(s)
- Shresthaa Singh
- Department of Orthodontics and Dentofacial Orthopedics, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand
| | - Abhay K. Jain
- Department of Orthodontics and Dentofacial Orthopedics, Dental College, RIMS, Ranchi, Jharkhand, India
| | - Raghu R. Prasad
- Department of Orthodontics and Dentofacial Orthopedics, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand
| | - Anshu Sahu
- Department of Orthodontics and Dentofacial Orthopedics, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand
| | - Parul Priya
- Department of Orthodontics and Dentofacial Orthopedics, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand
| | - Priyanka Kumari
- Department of Orthodontics and Dentofacial Orthopedics, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand
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Alfailany DT, Hajeer MY, Al-Bitar MI, Alsino HI, Jaber ST, Brad B, Darwich K. Effectiveness of Flapless Cortico-Alveolar Perforations Using Mechanical Drills Versus Traditional Corticotomy on the Retraction of Maxillary Canines in Class II Division 1 Malocclusion: A Three-Arm Randomized Controlled Clinical Trial. Cureus 2023; 15:e44190. [PMID: 37641723 PMCID: PMC10460508 DOI: 10.7759/cureus.44190] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Both invasive and minimally invasive surgical methods have recently gained popularity in accelerating orthodontic tooth movement. Traditional corticotomy (TC) was one of the first effective invasive surgical techniques in shortening orthodontic treatment time, whereas the flapless cortico-alveolar perforations (FCAPs) technique is a modern minimally invasive method that has recently shown good results in different types of orthodontic tooth movement. Therefore, this study aimed to compare the effectiveness of TC versus FCAPs in maxillary canine retraction when treating Class II division 1 malocclusion patients. MATERIALS AND METHODS This was a single-blinded, single-center, three-arm randomized controlled trial. A total of 51 patients (22 males, 29 females, mean age 20.98 ± 1.95) whose treatment planning included the extraction of maxillary first premolars were enrolled and randomly divided into three groups: the TC group, the FCAPs group, and the control group. The assessed outcomes were the amount of canine retraction, anchorage loss, and canines' rotation, which was evaluated at five-time points till the completion of canine retraction. RESULTS There were statistically significant differences in the amount of canine retraction between the three groups in the first two months (p < 0.001), with greater mean values in the TC group (p < 0.001) in the first month. However, the amount of canine retraction in the FCAPs group was significantly greater in the second month compared to the TC group (p = 0.003) and the control group (p < 0.001). In the first month of canine retraction, anchorage loss, and canine rotation were significantly lesser in the TC and FCAPs groups than in the control group (p < 0.001). On the contrary, the canines' rotation amount after the completion of retraction was greater in the TC group than in the other two groups (p < 0.001). CONCLUSION TC and FCAPs are efficient adjunctive surgical methods for accelerating canine retraction. At the end of the first month, the TC accelerated canine retraction by 59.85% and FCAPs by 44% compared to the conventional retraction. At the end of the second month, the acceleration was less than recorded in the first month (35.44% and 50.20%, respectively). The acceleration effect of the surgical interventions appeared transient and did not last in the following observation period.
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Affiliation(s)
| | - Mohammad Y Hajeer
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, SYR
| | | | - Hallaj I Alsino
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, SYR
| | - Samer T Jaber
- Department of Orthodontics, Faculty of Dentistry, Al-Watanyia Private University, Hama, SYR
| | - Bassel Brad
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Damascus, Damascus, SYR
| | - Khaldoun Darwich
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Damascus, Damascus, SYR
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Mosayebi N, Khademi A, Bagherieh S, Abedi N, Kargarfard M, Tajmiri G, Kouhi M. The effect of micro-osteoperforation on root resorption, pulp vitality, and biological changes of teeth subjected to orthodontic tooth movement: A systematic review study. Dent Res J (Isfahan) 2023; 20:52. [PMID: 37304419 PMCID: PMC10247875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/28/2023] [Accepted: 02/25/2023] [Indexed: 06/13/2023] Open
Abstract
Background These days minimally invasive micro-osteoperforation (MOPs) has accelerated orthodontic tooth movement (OTM). However, there are some conflicting reports about their various impacts; hence, the present systematic review study aimed to evaluate the effect of MOP on root resorption, pulp vitality, and the biological changes of teeth subjected to OTM. Materials and Methods Search in electronic databases of English literature including PubMed, Scopus, Web of sciences, Cochrane, and Google scholar as well as a manual search was performed from 2013 to 2022. Most of the studies included in this article were randomized controlled trials. Results From the total number of 321 found articles, 31 duplicated and 268 irrelevant articles were excluded regarding the defined inclusion and exclusion criteria. Consequently, 22 articles were subjected to the quality assessment process, and finally, 18 articles were selected for the review phase. Root resorption during tooth movement using the MOP approach was reported only in one study. Besides, except for two animal studies, all of the relevant included articles showed that MOPs significantly increased the expression of some inflammatory biomarkers known to recruit osteoclast precursors and increase the number of osteoclast cells. On the other hand, two animal studies showed no differences in osteoclast counts by using MOPs in comparison to their control groups, which was consequently the result of biologic variability between animal and human and also probably the small sample sizes of these two studies. Conclusion In this systematic review, according to the adverse effects of MOP on root resorption, one study showed higher levels of root resorption among patients undergoing MOP. However, this outcome was due to the different methods used to evaluate the effect of MOPs on root resorption. Moreover, a high certainty of evidence supports that MOP causes biological changes and an elevation in cytokines, chemokines, and other biomarkers that stimulates osteoclasts differentiation which in turn accelerate OTM. There was no change in pulp vitality status based on available evidence.
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Affiliation(s)
- Neda Mosayebi
- Department of Orthodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbasali Khademi
- Department of Endodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shervin Bagherieh
- Department of Endodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Niloufar Abedi
- Dental Materials Research Center, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mina Kargarfard
- Department of Orthodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Golnaz Tajmiri
- Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Monireh Kouhi
- Dental Materials Research Center, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Awni KM, Dewachi Z, Al-Hyani OH. Effect of Injectable platelet-rich fibrin (i-PRF) on new bone formation in surgical expansion with mini-screw assisted rapid palatal expander: A dog model study. J Orthod Sci 2023; 12:12. [PMID: 37351391 PMCID: PMC10282521 DOI: 10.4103/jos.jos_56_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/06/2022] [Accepted: 08/19/2022] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVES The objective of the study is to test whether the local injection of i-PRF may affect osteoblast, blood vessels and new bone formation in surgically expanded mid palatal suture using maxillary skeletal expander. MATERIALS AND METHODS Eighteen adult male local breed dogs were divided randomly into three groups: group I (control), includes the expansion with maxillary skeletal expander that was done without corticotomy and i-PRF. Group II, involves the expansion that was done with mid palatal corticotomy but without i-PRF injection. Group III, has the expansion that was done with mid palatal corticotomy and has injection with 2 ml of i-PRF. Each group consisted of 6 dogs which were subdivided into 3 dogs. Three dogs were sacrificed after 15 days and the other 3 dogs were sacrificed after 45 days. The number of osteoblast, blood vessels and new bone formation percentage were statistically analyzed using Sigma plot platform. Mean and standard error, ANOVA and Duncan were performed among the different groups. Values of P ≤ 0.05 were considered significant. RESULTS After expansion, the i-PRF group demonstrated a considerable increase in the amount of new bone in the mid-palatal suture at 15 and 45 days compared with other 2 groups which were indicated by highest percentages of new bone formation (29.30% of 15 days and 76.55% at 45 days) if compared to control group which were (7.72% at 15 days and 22.30% at 45 days). The corticotomy groups were in between, 15.33% and 46.84% respectively. Moreover the number of osteoblasts was higher in corticotomy with i-PRF group on 15 days and decreased on 45 days than the other two groups, while the blood vessels were highest in this group than the other two groups both on 15 and 45 days. CONCLUSION I-PRF enhanced the production of osteoblast, blood vessels, and new bone in the surgically expanded mid palatal suture.
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Affiliation(s)
- Khawla M. Awni
- Department of Orthodontics, College of Dentistry, College of Veterinary Medicine, University of Mosul, Iraq
| | - Zaid Dewachi
- Department of Orthodontics, College of Dentistry, College of Veterinary Medicine, University of Mosul, Iraq
| | - Osama Hazim Al-Hyani
- Department of Surgery and Obstetrics, College of Veterinary Medicine, University of Mosul, Iraq
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Biological Anchorage and Canine Orthodontic Movement Rate with a New Technique for Micro-Osteoperforations. Case Rep Dent 2022; 2022:5469453. [PMID: 35154834 PMCID: PMC8831039 DOI: 10.1155/2022/5469453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/20/2021] [Indexed: 11/18/2022] Open
Abstract
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.
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Bud ES, Bică CI, Păcurar M, Vaida P, Vlasa A, Martha K, Bud A. Observational Study Regarding Possible Side Effects of Miniscrew-Assisted Rapid Palatal Expander (MARPE) with or without the Use of Corticopuncture Therapy. BIOLOGY 2021; 10:biology10030187. [PMID: 33802266 PMCID: PMC8001817 DOI: 10.3390/biology10030187] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 11/20/2022]
Abstract
Simple Summary In this observational study, we evaluated possible complications at the skeletal and dentoalveolar level after palatal split using miniscrew-assisted rapid palatal expansion (MARPE) associated or not with corticopuncture (CP) therapy. The study included 27 patients with maxillary transverse deficiency and unilateral or bilateral cross-bite. Skeletal and dentoalveolar changes were evaluated using cone beam computed tomography (CBCT) images acquired before and after expansion. Changes of the occlusal planes were observed in 10 cases (37%). Maxillary canines tended to show symmetric buccal inclinations relative to the maxillary basal bone. Six patients; 22.22% showed hypertrophy/hyperplasia of the palatal mucosa associated with ulcerations, erythema, itching, and discomfort in the area. Swelling at the mid-palatal suture after split was observed in all cases and was caused by the resultant force. No cases of necrosis of the palatal mucosa were observed. Although occlusal modifications occur after palatal split, especially in unilateral cross-bite cases, these changes can be treated with the help of fixed orthodontic appliances. Abstract The use of maxillary expanders has the effect of distancing the maxillary bones at the level of the median palatal suture. During maxillary expansion, the main resistance forces occur at the zygomatico-maxillary sutures, and not in the median palatal suture, which is the basic principle on which this method is based. In this observational study, we evaluated possible complications at the skeletal and dentoalveolar level after palatal split using miniscrew-assisted rapid palatal expansion (MARPE) associated or not with corticopuncture (CP) therapy. The study included 27 patients with maxillary transverse deficiency and unilateral or bilateral cross-bite. Skeletal and dentoalveolar changes were evaluated using cone beam computed tomography (CBCT) images acquired before and after expansion. The mid-palatal suture was separated in 88.88% of cases, buccal bone height of the alveolar crest had decreased at first molar both at oral and palatal level by approximately 2.07 mm in 40.7% of cases whilst the remaining 59.3% showed insignificant bone loss, with canines exhibiting buccal tipping of 4.10° in 62.5% of cases. Changes of the occlusal planes were observed in 10 cases (37%). Maxillary canines tended to show symmetric buccal inclinations relative to the maxillary basal bone. Six patients; 22.22% showed hypertrophy/hyperplasia of the palatal mucosa associated with ulcerations, erythema, itching, and discomfort in the area. Swelling at the mid-palatal suture after split was observed in all cases and was caused by the resultant force. No cases of necrosis of the palatal mucosa were observed. Although occlusal modifications occur after palatal split, especially in unilateral cross-bite cases, these changes can be treated with the help of fixed orthodontic appliances.
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Affiliation(s)
- Eugen Silviu Bud
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science and Technology George Emil Palade Târgu-Mureș, 38 Gheorghe Marinescu Street, 540139 Târgu Mureș, Romania; (E.S.B.); (C.I.B.); (M.P.); (K.M.); (A.B.)
| | - Cristina Ioana Bică
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science and Technology George Emil Palade Târgu-Mureș, 38 Gheorghe Marinescu Street, 540139 Târgu Mureș, Romania; (E.S.B.); (C.I.B.); (M.P.); (K.M.); (A.B.)
| | - Mariana Păcurar
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science and Technology George Emil Palade Târgu-Mureș, 38 Gheorghe Marinescu Street, 540139 Târgu Mureș, Romania; (E.S.B.); (C.I.B.); (M.P.); (K.M.); (A.B.)
| | - Petru Vaida
- Dudley Group of Hospitals NHS Foundation Trust, Birmingham B18 7QH, UK;
| | - Alexandru Vlasa
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science and Technology George Emil Palade Târgu-Mureș, 38 Gheorghe Marinescu Street, 540139 Târgu Mureș, Romania; (E.S.B.); (C.I.B.); (M.P.); (K.M.); (A.B.)
- Correspondence:
| | - Krisztina Martha
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science and Technology George Emil Palade Târgu-Mureș, 38 Gheorghe Marinescu Street, 540139 Târgu Mureș, Romania; (E.S.B.); (C.I.B.); (M.P.); (K.M.); (A.B.)
| | - Anamaria Bud
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science and Technology George Emil Palade Târgu-Mureș, 38 Gheorghe Marinescu Street, 540139 Târgu Mureș, Romania; (E.S.B.); (C.I.B.); (M.P.); (K.M.); (A.B.)
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Al-Khalifa KS, Baeshen HA. Micro-osteoperforations and Its Effect on the Rate of Tooth Movement: A Systematic Review. Eur J Dent 2021; 15:158-167. [PMID: 32610360 PMCID: PMC7902111 DOI: 10.1055/s-0040-1713955] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Prolonged orthodontic treatments have inconvenienced patients and clinicians alike. Surgically assisted techniques for accelerating orthodontic tooth movement have shown promising results in the literature over the years. The minimally invasive nature of micro-osteoperforations (MOPs), however, for enhanced orthodontic tooth movement has recently gained momentum, with many clinical trials conducted on both animals and humans. An electronic search was performed to extract papers using PubMed, Google Scholar, Scopus, and Web of Science. The keywords that were used included "MOP," "accelerating tooth movement," "orthodontic tooth movement," and "regional acceleratory phenomenon." The studies that met our inclusion criteria were extracted and evaluated in this review. MOPs have been proven time and again, in animal and human studies alike, to increase the rate of orthodontic tooth movement. The application of perforations to cortical bone present in the pathway of teeth, which are specifically to be moved creates transient osteopenia. This reduces the density of the cortical bone, hence speeding up the rate of orthodontic tooth movement. Many techniques have been implemented and perfected to enhance orthodontic tooth movement and shorten the treatment time in the literature. MOPs have proven to be a universally applied, nontechnical, repeatable, and minimally invasive method of accelerating tooth movement, with extremely minimal consequences.
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Affiliation(s)
- Khalifa S. Al-Khalifa
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hosam A. Baeshen
- Department of Orthodontics, College of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Dos Santos CCO, Mecenas P, de Castro Aragón MLS, Normando D. Effects of micro-osteoperforations performed with Propel system on tooth movement, pain/quality of life, anchorage loss, and root resorption: a systematic review and meta-analysis. Prog Orthod 2020; 21:27. [PMID: 32715352 PMCID: PMC7383046 DOI: 10.1186/s40510-020-00326-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/18/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The aim of this systematic review was to evaluate the effect of micro-osteoperforations (MOPs) performed with Propel and other mini-screws on the rate of tooth movement, pain/discomfort, periodontal health, anchorage loss, and root resorption in patients undergoing orthodontic retraction compared to a control group. MATERIALS AND METHODS PubMed, Cochrane, Web of Science, LILACS, Google Scholar, Scopus, and OpenGrey were searched without restriction. A manual search was also carried out. Only randomized clinical trials (RCT) were included. The risk of bias (RoB) was assessed using RoB 2.0 and the certainty of evidence through the GRADE tool. RESULTS Among the twelve RCTs reviewed, five used the Propel system. Overall, the RoB was classified as low (4), moderate (5), and high (3). Two RCTs with moderate and one with a low RoB using the Propel system reported mild increases on rate of tooth movement associated with MOPs. One RCT with a moderate and another with high RoB did not find a significant effect of Propel on orthodontic movement. Regarding tooth movement, a subgroup meta-analysis found no differences between control and Propel movement (95% CI = - 0.01 to 0.75) or other mini-screws (- 0.02 to 0.31) related to rate of tooth movement per month. There was no effect of MOPs on root resorption, periodontal health, anchorage loss, and a mild effect on pain and oral health related to quality of life regardless of mini-screw type. The level of certainty was graded as low for the rate of tooth movement and pain/discomfort, as moderate for anchorage loss, and high for root resorption. CONCLUSION A low certainty of evidence supports that MOPs performed with Propel seem to have no significant effect on the rate of tooth movement. Moreover, this intervention does not seem to cause an increase in root resorption, periodontal heath, pain/discomfort, or anchorage loss. Thus, the Propel system does not appear to produce different results from those observed for other mini-screws.
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Affiliation(s)
| | - Paulo Mecenas
- Post-graduation program of dentistry, Federal University of Pará (UFPA), Rua Augusto Correa 01, Belém, Pará, 66075-110, Brazil
| | | | - David Normando
- Department of Orthodontics, Dental School, Federal University of Pará (UFPA), Belém, Pará, Brazil
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Erratum: The effectiveness of micro-osteoperforations during canine retraction: A three-dimensional randomized clinical trial. J Int Soc Prev Community Dent 2020; 0:0. [PMID: 32269961 PMCID: PMC7133057 DOI: 10.4103/2231-0762.281092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
[This corrects the article DOI: 10.4103/jispcd.JISPCD_233_19.].
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