Dental and Medical Problems
2019, vol. 56, nr 4, October-December, p. 385–394
doi: 10.17219/dmp/110432
Publication type: original article
Language: English
License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)
Download citation:
Evaluation of the effectiveness of piezocision-assisted flapless corticotomy in the retraction of four upper incisors: A randomized controlled clinical trial
Ocena skuteczności bezpłatowej piezokortykotomii w retrakcji czterech górnych siekaczy – randomizowane kontrolowane badanie kliniczne
1 Department of Orthodontics, Dental School, University of Damascus, Syria
2 Department of Oral and Maxillofacial Surgery, Dental School, University of Damascus, Syria
Abstract
Background. Comprehensive orthodontic treatment may last for 20–24 months. Reducing the treatment time has become a common demand from both patients and orthodontists. Minimally invasive piezocision is one of the suggested approaches to accelerate the orthodontic tooth movement.
Objectives. The aim of this randomized controlled clinical trial was to assess the effectiveness of the flapless piezocision procedure in accelerating the retraction of upper incisors.
Material and Methods. A single-blinded, parallel-group randomized controlled clinical trial was conducted at the Department of Orthodontics at the University of Damascus Dental School, Syria. The study involved 42 patients (11 males, 31 females) at the age of 16–31 years (mean age: 19.15 years). The patients had class II division I malocclusion and were treated with fixed appliances using the two-step retraction technique. With an allocation ratio of 1:1, the participants were randomly assigned to either the experimental group (n = 21) or the control group (n = 21) using a computer-generated list of random numbers. Allocation was concealed due to the use of sequentially numbered, opaque, sealed envelopes. The primary outcomes were the rate of incisor retraction (RIR) and the time required for retraction. The outcome assessor was blinded.
Results. The data analysis included 20 patients in each group. The rate of incisor retraction significantly increased in the experimental group by 53%, with a significant shortening of the retraction time in the experimental group by 27% (p < 0.001). The rate of anchorage loss was significantly lesser in the experimental group (p < 0.001). Regarding the cephalometric assessment, incisor tipping was significantly greater in the control group than in the experimental group. Skeletal measurements showed insignificant changes following retraction between the 2 groups.
Conclusion. The piezocision procedure was found to be effective in accelerating the retraction of 4 upper incisors, reducing the retraction time, preserving anchorage and enhancing root torque control during retraction.
Key words
acceleration, piezocision, incisor retraction, two-step retraction
Słowa kluczowe
przyspieszenie, dekortykacja przyzębia metodą Piezocision, retrakcja siekaczy, retrakcja dwuetapowa
References (30)
- Mathews DP, Kokich VG. Managing treatment for the orthodontic patient with periodontal problems. Semin Orthod. 1997;3(1):21–38.
- Tsichlaki A, Chin SY, Pandis N, Fleming PS. How long does treatment with fixed orthodontic appliances last? A systematic review. Am J Orthod Dentofacial Orthop. 2016;149(3):308–318.
- Talic NF. Adverse effects of orthodontic treatment: A clinical perspective. Saudi Dent J. 2011;23(2):55–59.
- Pachêco-Pereira C, Pereira JR, Dick BD, Perez A, Flores-Mir C. Factors associated with patient and parent satisfaction after orthodontic treatment: A systematic review. Am J Orthod Dentofacial Orthop. 2015;148(4):652–659.
- Nimeri G, Kau CH, Abou-Kheir NS, Corona R. Acceleration of tooth movement during orthodontic treatment – a frontier in orthodontics. Prog Orthod. 2013;14:42.
- Alfawal AM, Hajeer MY, Ajaj MA, Hamadah O, Brad B. Effectiveness of minimally invasive surgical procedures in the acceleration of tooth movement: A systematic review and meta-analysis. Prog Orthod. 2016;17:33.
- Patterson BM, Dalci O, Darendeliler MA, Papadopoulou AK. Corticotomies and orthodontic tooth movement: A systematic review. J Oral Maxillofac Surg. 2016;74(3):453–473.
- Wilcko MT, Wilcko WM. The Wilckodontics Accelerated Osteogenic Orthodontics (AOO) technique: An overview. Orthotown. 2011;4(6):36–48.
- Al-Naoum F, Hajeer MY, Al-Jundi A. Does alveolar corticotomy accelerate orthodontic tooth movement when retracting upper canines? A split-mouth design randomized controlled trial. J Oral Maxillofac Surg. 2014;72(10):1880–1889.
- AlGhamdi AST. Corticotomy facilitated orthodontics: Review of a technique. Saudi Dent J. 2010;22(1):1–5.
- Charavet C, Lecloux G, Bruwier A, et al. Localized piezoelectric alveolar decortication for orthodontic treatment in adults: A randomized controlled trial. J Dent Res. 2016;95(9):1003–1009.
- Vercellotti T, Podesta A. Orthodontic microsurgery: A new surgically guided technique for dental movement. Int J Periodontics Restorative Dent. 2007;27(4):325–331.
- Dibart S, Sebaoun JD, Surmenian J. Piezocision: A minimally invasive, periodontally accelerated orthodontic tooth movement procedure. Compend Contin Educ Dent. 2009;30(6):342–344,346,348–350.
- Dibart S, Surmenian J, Sebaoun JD, Montesani L. Rapid treatment of Class II malocclusion with piezocision: Two case reports. Int J Periodontics Restorative Dent. 2010;30(5):487–493.
- Gibreal O, Hajeer MY, Brad B. Efficacy of piezocision-based flapless corticotomy in the orthodontic correction of severely crowded lower anterior teeth: A randomized controlled trial. Eur J Orthod. 2019;41(2):188–195.
- Alfawal AMH, Hajeer MY, Ajaj MA, Hamadah O, Brad B. Evaluation of piezocision and laser-assisted flapless corticotomy in the acceleration of canine retraction: A randomized controlled trial. Head Face Med. 2018;14(1):4.
- Tunçer NI, Arman-Özçirpici A, Oduncuoglu BF, Göçmen JS, Kantarci A. Efficiency of piezosurgery technique in miniscrew supported en-masse retraction: A single-centre, randomized controlled trial. Eur J Orthod. 2017;39(6):586–594.
- Proffit WR, Phillips C, Douvartzidis N. A comparison of outcomes of orthodontic and surgical-orthodontic treatment of Class II malocclusion in adults. Am J Orthod Dentofacial Orthop. 1992;101(6):556–565.
- Rizk MZ, Mohammed H, Ismael O, Bearn DR. Effectiveness of en masse versus two-step retraction: A systematic review and meta-analysis. Prog Orthod. 2018;18:41.
- Aksakalli S, Calik B, Kara B, Ezirganli S. Accelerated tooth movement with piezocision and its periodontal-transversal effects in patients with Class II malocclusion. Angle Orthod. 2016;86(1):59–65.
- Al-Sibaie S, Hajeer MY. Assessment of changes following en-masse retraction with mini-implants anchorage compared to two-step retraction with conventional anchorage in patients with class II division 1 malocclusion: A randomized controlled trial. Eur J Orthod. 2014;36(3):275–283.
- Dinçer M, Gülşen A, Türk T. The retraction of upper incisors with the PG retraction system. Eur J Orthod. 2000;22(1):33–41.
- Hoggan BR, Sadowsky C. The use of palatal rugae for the assessment of anteroposterior tooth movements. Am J Orthod Dentofacial Orthop. 2001;119(5):482–488.
- Matsui S, Caputo AA, Chaconas SJ, Kiyomura H. Center of resistance of anterior arch segment. Am J Orthod Dentofacial Orthop. 2000;118(2):171–178.
- Uribe F, Padala S, Allareddy V, Nanda R. Patients’, parents’, and orthodontists’ perceptions of the need for and costs of additional procedures to reduce treatment time. Am J Orthod Dentofacial Orthop. 2014;145(4 Suppl):S65–S73.
- Keser EI, Dibart S. Sequential piezocision: A novel approach to accelerated orthodontic treatment. Am J Orthod Dentofacial Orthop. 2013;144(6):879–889.
- Fischer TJ. Orthodontic treatment acceleration with corticotomy-assisted exposure of palatally impacted canines. Angle Orthod. 2007;77(3):417–420.
- Bhattacharya P, Bhattacharya H, Anjum A, et al. Assessment of corticotomy facilitated tooth movement and changes in alveolar bone thickness – a CT scan study. J Clin Diagn Res. 2014;8(10):ZC26–ZC30.
- Sakthi SV, Vikraman B, Shobana VR, Iyer SK, Krishnaswamy NR. Corticotomy-assisted retraction: An outcome assessment. Indian J Dent Res. 2014;25(6):748–754.
- Khlef HN, Hajeer MY, Ajaj MA, Heshmeh O. En-masse retraction of upper anterior teeth in adult patients with maxillary or bimaxillary dentoalveolar protrusion: A systematic review and meta-analysis. J Contemp Dent Pract. 2019;20(1):113–127.