The effects of corticotomy and piezocision in orthodontic canine retraction: a randomized controlled clinical trial

Impact of periodontal microRNAs associated with alveolar bone remodeling during orthodontic tooth movement: a randomized clinical trial

BACKGROUND

Micro-RNAs (miRNAs) have been reported to play an important role during orthodontic tooth movement (OTM) through the regulation of periodontal soft and hard tissue homeostasis and functions. The aim of the present study was to assess the effects of miRNAs on OTM and to evaluate possible predictors that influenced the overall OTM amount at a 3-month follow-up.

METHODS

Through a split-mouth design, 21 healthy patients (mean age 13.2 ± 1.8 years) were enrolled in the present study. Clinical parameters and gingival crevicular fluid (GCF) sampling were performed on both compression and tension sides of a random canine to be distalized (test groups) at baseline and at 1 h, 1 day, 1 month and at 3-month after OTM, while the contralateral canine served as a control group. miRNAs - 7a-3p, -7a-2-3p, -7a-5p, -21-3p, -21-5p, -100-3p, -100-5p, -125b-2-3p, -125b-5p, -200b-3p, and - 200b-5p expression was analyzed using a real-time quantitative polymerase chain reaction (RT-PCR). Data were analyzed to assess miRNAs change following OTM. Spearman test, two-way ANOVA and a multivariate regression model were established to evaluate the correlation among miRNAs and clinical parameters and to explore possible predictors of OTM amount at 3-month follow-up.

RESULTS

At 3-month follow-up, there was an increase of miRNA-7a-2-3p, -21-5p, -100-5p, a decrease of miRNA-125b-5p, 200b-3p and - 200b-5p in the compression side and an increase of miRNA-7a-3p, 100-5p in the tension side (p < 0.05). The two-way ANOVA revealed that OTM determined, on the compression side, a significant upregulation on miRNA-7a-3p (p = 0.017), -7a-2-3p (p = 0.023), -21-5p (p = 0.007), -100-5p (p = 0.025) and a significant downregulation of miRNA-125b-2-3p (p = 0.019) and - 200b-5p (p = 0.017). The multivariate model highlighted that high baseline miRNA-7a2-3p (p = 0.025), -21-5p (p = 0.014), -200b-3p (p = 0.041), young age (p = 0.042), lower bleeding on probing (BOP) (p = 0.021) and miRNA-125b-2-3p (p = 0.021) levels were significant predictors of OTM at 3-month follow-up.

CONCLUSIONS

In the present study, OTM significantly impacted the expression of the miRNAs analyzed, in both the tension and compression side of traction tooth at 3-month follow-up. High baseline miRNA-7a2-3p, -21-5p, -200b-3p, and lower miRNA-125b-2-3p, together with younger age and lower BOP, were significant predictors of OTM amount at 3-month follow-up.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06023433 (retrospectively registered).

Evaluation of stress and displacement of maxillary canine during the single canine retraction in the maxillary first premolar extraction cases- A finite element study

OBJECTIVES

This finite element study aimed to simulate maxillary canine movement during anterior teeth retraction.

MATERIALS AND METHODS

Three methods of maxillary canine movement including miniscrew sliding with high hooks (MSH), miniscrew sliding with low hooks (MSL), and the traditional sliding method (TS) without using miniscrews were simulated using three-dimensional finite element analysis. The initial displacement of the maxillary canine, the maximum principal stress of the periodontal ligament and the Von Mises stress were calculated.

RESULTS

The distolingual tipping movements of the canine were shown in three movement modes. MSH showed a small tendency to lingual tipping movement and a extrusion movement while MSL had the largest lingual inclination. TS demonstrated a tendency toward distolingual torsion displacement. Compressive stress values were mainly concentrated in the range - 0.003 to -0.006 MPa. For tensile stress, the distribution of MSH and MSL was concentrated in the range 0.005 to 0.009 MPa, TS was mainly distributed about 0.003 MPa. Von Mises equivalent stress distribution showed no significant difference.

CONCLUSIONS

The loss of tooth torque was inevitable, irrespective of which method was used to close the extraction space. However, miniscrew application and higher hooks reduced the loss of torque and avoided lingual rotation.

CLINICAL RELEVANCE

This study shows that miniscrew implants with different hooks can better control the movement of the maxillary canines. The non-invasive nature of the finite element analysis and its good simulation of dental stress and instantaneous motion trend have a clinical advantage in the analysis of tooth movement.

Low-level laser therapy, piezocision, or their combination vs. conventional treatment for orthodontic tooth movement : A hierarchical 6-arm split-mouth randomized clinical trial

PURPOSE

The use non-invasive or minimally invasive methods to accelerate orthodontic tooth movements (OTM) is desirable. In this regard, low-level laser therapy (LLLT, photobiomodulation) and piezocision are suggested. However, because the efficacies of these methods remain controversial/inconclusive, we investigated and compared these two methods.

METHODS

Sixty-four quadrants in 32 patients were randomized into three parallel intervention groups of 22, 22, and 20 (6 parallel arms, n = 64 treatment/control sides). Bilateral first premolars were extracted and canine retraction commenced. In each group, one side of the mouth was randomly selected as control, while the other side underwent each of three interventions: LLLT (940 nm, 8 J, 0.5 W, 16 s, 12 sites), piezocision, and "LLLT + piezocision". At the 3rd, 6th, and 9th follow-up weeks, canine retraction and anchorage loss were measured. Data were analyzed statistically (α = 0.05).

RESULTS

After 9 weeks, LLLT, piezocision, and LLLT + piezocision improved canine retraction by 0.51, 1.14, and 1.93 mm, respectively. LLLT accelerated canine retraction (compared to control) by 1.6-, 1.4-, and 1.2-fold in the 3rd, 6th, and 9th week, respectively. These statistics were 2.1-, 1.7-, and 1.5-fold for piezocision and 2.7-, 2.1-, and 1.8-fold for LLLT + piezocision. Compared to controls, each intervention showed significant retraction acceleration (p < 0.05). The effect of LLLT + piezocision was greater than that of isolated piezocision (p < 0.05), which itself was greater than that for isolated LLLT (p < 0.05).

CONCLUSION

All three methods accelerated OTM, with the combination of LLLT + piezocision producing the strongest and LLLT producing the weakest acceleration.

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 .

Comparative Efficacy of Traditional Corticotomy and Flapless Piezotomy in Facilitating Orthodontic Tooth Movement: A Systematic Review and Meta-Analysis

Background and Objectives: This study aimed to perform a meta-analysis comparing the effects of corticotomy and flapless piezocision on accelerated tooth movement. Materials and Methods: A comprehensive search using a combination of controlled vocabulary (MeSH) and free-text terms was undertaken by two reviewers to identify published systematic reviews. Three major electronic databases (Medline via PubMed, Cochrane Database, and Embase) were searched up to 2 June 2023. Results: The results of the meta-analysis showed that the pooled standardized mean difference values of accumulative movement distances for flapless piezocision were 1.43 (95% CI, 0.38 to 2.48; p < 0.01), 1.09 (95% CI, -0.08 to 2.26; p = 0.07), and 0.73 (95% CI, -0.58 to 4.02; p = 0.14). The results of the meta-analysis demonstrated that the pooled SMD values of accumulative movement distances for the corticotomy were 2.76 (95% CI, 0.18 to 5.34; p = 0.04), 1.43 (95% CI, -1.10 to 3.96; p = 0.27), and 4.78 (95% CI, -4.54 to 14.10; p = 0.32). Although the test for overall effectiveness was significant for piezocision and corticotomy, there were no significant differences between piezocision and corticotomy. Conclusions: The study determined that both conventional corticotomy and flapless piezosurgery are effective as adjuncts to orthodontic treatment. Moreover, no significant difference was observed in the short-term effectiveness of canine retraction acceleration between conventional corticotomy and flapless piezocision. While piezocision may be a favorable option for orthodontic treatment, corticotomy can be considered in cases requiring additional procedures such as bone grafting.

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.