Impact of micro-osteoperforations on root resorption and alveolar bone in en-masse retraction in young adults: A CBCT randomized controlled clinical trial

BACKGROUND

Micro-osteoperforations (MOPs) as a surgical technique is increasingly being used as a method to enhance orthodontic tooth movement. However, its iatrogenic effects on root and alveolar bone morphology have been less studied.

OBJECTIVE

This parallel-groups single-centered trial aimed to assess the impact of micro-osteoperforations (MOPs) on orthodontically induced inflammatory root resorption (OIIRR) and alveolar bone during en-masse retraction stage of maxillary and mandibular anterior teeth.

METHODS

Fifty-two patients (mean age 21.35±2.2 years) with Class I bi-dentoalveolar protrusion, requiring all 1st premolar extractions and miniscrews for anchorage, were randomly distributed into two groups (n=26 each): MOP group treated using single application of MOP's and control group treated with routine sliding mechanics, for en-masse retraction. The primary outcomes were assessed using CBCT-based measurements.

RESULTS

Anterior teeth in MOP group showed increased mean OIIRR than control group, though the difference was statistically non-significant [maxillary anteriors, MOP group - OIIRR=0.78±0.29mm and control group OIIRR=0.73±0.36mm; mandibular anteriors, MOP group - OIIRR=0.733±0.20mm and control group OIIRR=0.70±0.24mm]. Levander and Malmgren's Index for objective scoring of OIIRR revealed only mild resorption with most teeth in both the groups (47% and 51%, respectively). Lateral incisors showed highest OIIRR followed by central incisors and canines in both groups. Lingual side bone thickness and height decreased significantly, however, the differences between the two groups were non-significant (P>0.05).

CONCLUSION

Within the settings of the current RCT, en-masse retraction when combined with single application of micro-osteoperforations did not pose an increased risk of root resorption or alveolar bone changes compared to routine sliding mechanics.

Comparative effect of micro-osteoperforation and Photo-biomodulation on the rate of maxillary canine retraction: A split mouth randomized clinical trial

INTRODUCTION

The lengthy duration of comprehensive orthodontic treatment has always been a major concern. Various modalities have been proposed to accelerate the orthodontic tooth movement (OTM) with varying degree of success. However, there is limited literature, comparing the efficiency of two commonly used modalities which are relatively simple, safe and comfortable chair-side procedures to accelerate orthodontic tooth movement viz. Photo-biomodulation (PBM) being non-invasive and micro-osteoperforations (MOPs) being minimally invasive. The aim was to evaluate the comparative effect of PBM and MOPs on the rate of orthodontic tooth movement (OTM).

METHODS

In this split mouth study, thirty patients requiring ma-xillary first premolar extraction were randomly allocated for Photo-biomodulation (PBM) on one side and for micro-osteoperforations (MOPs) on other side of maxilla. Separate canine retraction was performed and movement was measured over a three month period.

RESULTS

Micro-osteoperforations (MOPs) significantly increased the rate of maxillary canine retraction by 1.1 fold when compared to the Photo-biomodulation (PBM).The MOPs can successfully reduce the comprehensive fixed orthodontic treatment time by around 9% as compared to PBM.

CONCLUSIONS

Micro-osteoperforation is a more efficient modality of accelerating tooth movement as compared to Photo-biomodulation which can be used in routine orthodontic practice.

Effect of micro-osteoperforations on external apical root resorption: A randomized controlled trial

Objective

This study aimed to investigate the effect of micro-osteoperforations (MOPs) on external apical root resorption (EARR) during the initial orthodontic alignment phase of maxillary anterior crowding.

Methods

Thirty patients (25 females, 5 males; mean age, 22.66 ± 3.27 years) who presented with moderate crowding of the upper labial segment and underwent extraction-based fixed appliance treatment were recruited. They were randomly allocated to receive adjunctive therapy with MOPs (n = 15) or treatment with fixed appliances only (control group; n = 15). EARR was measured from long-cone periapical radiographs taken at the start and the sixth month of treatment. A correction factor for the enlargement difference was used to calculate EARR. Data were analyzed with descriptive statistics and repeated-measures analysis of variance.

Results

The mean root lengths of 168 teeth were measured and showed no statistically significant difference (p > 0.05) after six months of fixed appliance treatment in the MOP (mean difference [MD] = 0.13 mm; 95% confidence interval [CI] = −0.10–0.35) and control group (MD = 0.14 mm; 95% CI = −0.10–0.37). Most of the roots in the MOP and control groups (42.86% and 52.38%, respectively) showed only mild resorption. Less than 8% of the roots in both groups (7.14% in the MOP group and 4.76% in the control group) showed moderate resorption.

Conclusions

Acceleration of orthodontic tooth movement with adjunctive MOPs therapy during the alignment phase does not exacerbate EARR in patients with moderate crowding of the upper labial segment in comparison with controls.

Comparison of orthodontic space closure using micro-osteoperforation and passive self-ligating appliances or conventional fixed appliances

OBJECTIVES

To examine the effect of micro-osteoperforation (MOP) on the space closure rate using passive self-ligating or conventional brackets.

MATERIALS AND METHODS

This was a two-arm parallel randomized controlled trial undertaken at the outpatient department of a dental college. There were 60 participants (30 women and 30 men) who fulfilled the inclusion criteria. Both the study and control groups were subjected to MOPs throughout the period of space closure. MOPs were repeated every 28 days. The experimental group (mean age 19.5 ± 1.66 years) was bonded with passive self-ligating brackets while the control group (mean age 19.9 ± 1.13 years) was bonded with conventional brackets. Both groups were examined and compared for rate of space closure. An evaluation was conducted for both groups until the entire extraction space was closed and confirmed by evaluation of a tight contact between the canine and the second premolar using a piece of dental floss.

RESULTS

Before the initiation of retraction, all initial criteria were similar between the two groups (P > .05). No difference was observed between the two groups in the rate of space closure (P > .05).

CONCLUSIONS

MOP in conjunction with passive self-ligation does not increase the rate of orthodontic space closure when compared with MOP used with conventional brackets.

Evaluation of the Effect of Combined Low Energy Laser Application and Micro-Osteoperforations versus the Effect of Application of Each Technique Separately On the Rate of Orthodontic Tooth Movement

AIM

The study was conducted to evaluate the effect of combined low energy laser application and Micro-Osteoperforations versus the effect of the application of each technique separately on the rate of orthodontic tooth movement.

PATIENTS AND METHODS

Three parallel groups (each group contained 10 patients) were performed; Group A: In which one side was controlled side, and the other side received micro-osteoperforations (MOPs), Group B: In which one side was controlled side, and the other side received low-level laser therapy (LLLT), Group C: In which one side was controlled side, and the other side received both MOPs and LLLT.

RESULTS

Significant statistical differences were obvious in the rate of canine retraction between each intervention and the control sides as following; the MOPs increased the rate of canine retraction by 1.6 fold more than the control side, LLLT increased the rate of canine retraction by 1.3 fold than the control side, and combination of both techniques resulted in an increase in the rate of canine retraction by 1.8 fold more than the control side.

CONCLUSION

Combination of MOPs and LLLT proved to be more efficient regarding increasing the rate of canine retraction than the application of each technique separately.