Accelerated tooth movement with piezocision and its periodontal-transversal effects in patients with Class II malocclusion (original) (raw)
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Impact of piezocision on orthodontic tooth movement
Korean Journal of Orthodontics, 2021
This study investigated the impact of a single piezocision in the maxillary alveolar process on the speed of tooth movement. The null hypothesis was that the speed of tooth movement will be equal with and without piezocision. Methods: All maxillary molars on one side were moved against the combined incisors in 10 ten-week-old male Wistar rats. Under general anesthesia, a force of 25 cN was applied on either side using a Sentalloy closed coil spring. After placing the orthodontic appliance, vertical corticision was performed using a piezotome under local anesthesia, 2 mm mesial from the mesial root of the first molar on a randomly selected side; the other side served as the control. At the beginning of the treatment, and 2 and 4 weeks later, skull micro-computed tomography was performed. After image reconstruction, the distance between the mesial root of the first molar and the incisive canal, and the length of the mesial root of the first maxillary molar were measured. Moreover, the root resorption score was determined as described by Lu et al. Results: Significantly higher speed of tooth movement was observed on the corticision side; thus, the null hypothesis was rejected. The loss of root length and root resorption score were significantly more pronounced after piezocision than before. A strong correlation was observed between the speed of tooth movement and root resorption on the surgical side, but the control side only showed a weak correlation. Conclusions: Piezocision accelerates orthodontic tooth movement and causes increased root resorption.
The International Journal of Periodontics & Restorative Dentistry
The aim of the present study was to compare the effect of traditional orthodontics and Piezocision-assisted orthodontics on the periodontal status and rate of canine retraction. In a split-mouth study, 20 subjects undergoing orthodontic treatment were selected. Conventional orthodontics was performed on 20 canine sites (control side), and contralateral canines were subjected to Piezocision-assisted orthodontics (experimental side). The experimental side showed statistically significant increase in rate of canine retraction as well as an increase in alveolar bone level in mesial and buccal aspects. Int J
American Journal of Orthodontics and Dentofacial Orthopedics, 2018
The purpose of this split-mouth trial was to investigate the effect of micro-osteoperforations (MOPs) on the rate of tooth movement. Methods: Thirty-two patients (24 female, 8 male; mean age, 19.26 6 2.48 years) who required fixed orthodontic treatment and maxillary first premolar extractions participated in this trial with MOPs randomly allocated to either the right or left sides distal to the maxillary canines. Eligibility criteria included Class II Division 1 malocclusion, healthy periodontal condition, no smoking, and no systemic disease. Miniscrews were used to support anchorage and retract the canines with the aid of closed-coil nickel-titanium springs with 150 g of force. Randomization was accomplished with block randomization with a permuted block size of 2 with a 1:1 allocation ratio to either right or left with allocations concealed in opaque, sealed envelopes. Blinding was used at the data collection and analysis stages. Three MOPs were performed using miniscrews (5 mm depth, 1.5 mm width) on the buccal bone distal to the canines on the randomly selected side. The primary outcome was the rate of canine retraction measured from 3-dimensional digital models superimposed at the rugae area from the baseline to the first, second, and third months. The following secondary outcomes were examined: anchorage loss, canine tipping, canine rotation, root resorption, plaque index, and gingival index. Pain level, pain interference with the patients' daily life, patients' satisfaction with the procedure and degree of ease, willingness to repeat the procedure, and recommendation to others were also evaluated. Results: There was no statistically significant difference in the rates of tooth movement between the MOP and the control sides at all time points (first month: P 5 0.77; mean difference, 0.2 mm; 95% CI, À0.13, 0.18 mm; second month: P 5 0.50; mean difference, À0.08 mm; 95% CI, À0.33, 0.16 mm; third month: P 5 0.76; mean difference, À0.05 mm; 95% CI, À0.40, 0.29 mm). There were also no differences in anchorage loss, rotation, tipping, root resorption, plaque index, periodontal index, and pain perception between the MOP and control sides at any time point (P .0.05). MOPs had no effect on the patients' daily life except for a feeling of swelling on the first day (P 5 0.05). Level of satisfaction and degree of easiness of the procedure were high. A significant percentage of patients were willing to repeat the procedure and recommend it to others. No serious harm was observed. Conclusions: Three MOPs were not effective in accelerating tooth movement at any time point. Other secondary parameters evaluated were not different between the MOP and control sides except for the feeling of swelling on day 1 on the MOP side. Patients were highly satisfied with the MOP procedure, and many considered MOPs an easy procedure and were willing to repeat and recommend it to friends. Registration: This trial was registered at Clinicaltrials.gov with identifier number NCT02473471.
The Angle Orthodontist
Objectives To investigate canine retraction (CR) and anchorage loss (AL) among average facial height (AFH) and high facial height subjects (HFH) with or without piezocision surgery (PS). Materials and Methods This was a split-mouth, randomized clinical trial. Twenty-three females (aged 19.05 ± 2.95 years) who presented with Class II division I malocclusion requiring bilateral maxillary extraction and who fulfilled eligibility criteria were included and categorized into two groups: AFH (12 participants) and HFH (11 participants). Atraumatic extractions were performed 10 weeks following bonding. Before space closure, impressions were taken to fabricate models, which were scanned to generate digital models. Each participant had PS on the randomly assigned side. Space closure was undertaken using 100-g nickel-titanium coil closing springs on 0.019 × 0.025-inch stainless steel archwire. Digital models were collected 6 and 12 weeks post-PS. They were superimposed using reliable reference ...
Sequential piezocision: A novel approach to accelerated orthodontic treatment
American Journal of Orthodontics and Dentofacial Orthopedics, 2013
Piezocision-assisted orthodontic treatment is an innovative, minimally invasive surgical technique designed to help achieve rapid orthodontic tooth movement. Microsurgical interproximal openings are made in the buccal gingivae to let the piezoelectric knife create the bone injury that will lead to transient demineralization and subsequent accelerated tooth movement. When this procedure was first described, cuts were made simultaneously at the maxilla and the mandible. In recent years, the technique has evolved to a more staged approach, with selected areas or segments of the arch demineralized at different times during orthodontic treatment to help achieve specific results. The purpose of this article was to report the use of sequential piezocision in the correction of a Class III malocclusion, in a total treatment time of 8 months.
Objective This meta-analysis aimed at critically assessing currently available evidence regarding the overall effectiveness of Piezocision in accelerating orthodontic tooth movement, as well as the adverse effects of this intervention in orthodontic patients. Search methods Electronic search of 6 databases and additional manual searches up to April 2019 without restrictions, also update the search was done by 20th November. Selection criteria Randomized controlled trials (RCT) and controlled clinical trials (CCT) reporting piezocision- assisted orthodontics versus conventional orthodontics were included in the review. Data collection and analysis The data are expressed by mean differences (MD), 95% confidence intervals, fixed-effect model or random-effect model in the meta-analysis in regard to statistical heterogeneity analyses (tau2, and I2). Included randomized studies were assessed for risk of bias using the new Cochrane Risk of Bias tool (ROB.2) and the non-randomized studies were assessed using (ROBINS I) tool. The studies were graded according to the GRADE approach. Results Fourteen papers for 13 unique trials were included in this systematic review and eight stud- ies were included in the meta-analysis. The meta-analysis showed that the mean difference of the canine retraction rate in the first and second month after piezocision was 0.66 mm/ month and 0.48mm/month, respectively. A total canine retraction rate in the first two months after piezocision was statistically significant (0.57 mm/month, p<0.00001), favoring thepiezocision group with a high heterogeneity between studies I2 = 69%. For the total treat- ment time outcome measure, there was a statistically significant difference in the overall treatment time (MD 101.64 Days, 95% CI, 59.24–144.06) favoring the piezocision group. Conclusions Low quality evidence suggests that piezocision is an effective surgical procedure in acceler- ating the rate of canine retraction in the first two months and reducing the treatment dura- tion. However, this effect appears to be clinically insignificant. Systematic review registration CRD42019136303.
Progress in Orthodontics
Background The aims of this study were to evaluate the efficacy of alveolar corticotomy (AC) and piezocision (PZ) in accelerating maxillary canine retraction, and their effects on multiple bone remodeling expression in gingival crevicular fluid (GCF). A split-mouth, randomized controlled clinical trial was performed at the Department of Orthodontics of Pontifical Catholic University of Minas Gerais, Brazil. Eligibility criteria included orthodontic need for first maxillary premolars extractions, followed by canine retraction. Fifty-one adult patients were recruited and randomly assigned to 3 groups (allocation ratio 1:1:1). Random allocation of surgical or control interventions to each side of the maxillary arch was also conducted: G1 − AC × Control, G2 − PZ × Control, and G3 − AC × PZ. Both the definition of the group and the decision of the experimental or control sides were randomized by the software. Intraoral digital scans were performed before, 7 and 14 days after the beginnin...
Pulp volume changes after piezocision-assisted tooth movement: a randomized clinical trial
2021
Background Orthodontic treatment has some undesirable side effects, such as root resorption and a decrease in the size of the pulp tissue which are relatively associated with the duration of the orthodontic treatment. Piezocision-assisted tooth movement was introduced as a minimally invasive surgical procedure with an aim to shorten orthodontic treatment time. This prospective randomized clinical trial was aimed to compare the pulp volume changes of maxillary anterior teeth after en-masse retraction with or without piezocision-assisted orthodontics. Methods Patients who required orthodontic treatment with bilateral maxillary first premolar extractions and en-masse retraction were recruited. Patients were randomly divided into extraction with piezocision, or only extraction, serving as controls. Pulp volume and root length changes of the maxillary six anterior teeth were measured and compared between the two groups using a 3-Dimensional analytical software. Paired and independent sam...
Biomedical Journal of Scientific & Technical Research, 2018
Introduction: Orthodontics has been advocating extraction as a treatment option for over a Century. Some concerns have been raised regarding dental extractions in orthodontics. Some clinicians suggested that extraction would lead to arch collapse resulting in a narrower arch width. Yet others have reported that extraction treatment to correct malocclusion will not result in arch narrowing compared with similar non extraction protocols. However, it is well accepted that extraction treatment will involve changes in the arch dimensions. Aim of the study: The aim of the current study will be directed to investigate the changes in maxillary dental arch parameters concomitant to maxillary first premolar extraction in orthodontic treatment of Angle Class II dental malocclusion. Materials and methods: This prospective clinical trial was carried out in a two arm parallel design. A group of orthodontic patients with Angle Class II dental malocclusion, Division 1 and 2 (Total N= 17) and divided into two groups division 1 (N=10) and division 2 (N=7). Records were taken before treatment and after extraction and space closure in the maxillary arch. Both groups were compared regarding Arch width, Arch perimeter, Arch length and arch depth. Conclusion: We concluded that there was no significant difference in all pre-treatment readings between Class II division 1 and division 2 groups except for Arch perimeter, Upper incisor angulation and upper incisor tip where they showed a statistically significant difference. Regarding the amount of change between pre and post-extraction measurements in for Class II division 1 there was no significant difference except for arch length, inter-canine width, and arch perimeter. The amount of change between pre and post-extraction measurements in Class II division 2 showed no significant differences.
The Angle Orthodontist
Objectives To assess the effect of piezocision on periodontal tissues and alveolar bone height and to detect lower second molar root resorption in piezocision-assisted mandibular second molar protraction compared to no-piezocision molar protraction. Materials and Methods Twenty-one subjects (four males, 17 females, aged 22.43 ± 2.83 years) who presented with bilateral extraction of lower first molars were included. The patients were divided into two groups; Group 1: Piezocision-assisted molar protraction (right or left side of subjects) in which piezocision was performed immediately before lower second molar protraction and, Group 2: No-piezocision molar protraction in which lower second molar protraction was not surgically assisted. Plaque index (PI), gingival index (GI), periodontal pocket depth (PPD), width of keratinized gingiva (WKG), gingival recession (GR), lower second molar mesial root resorption, alveolar bone height, and mandibular bone height were recorded at T1 (immedia...