Comparative evaluation of platelet-rich plasma and micro-osteoperforation effect on orthodontic tooth movement rate in class II division 1 patients: A split mouth randomized trial

Abstract

The primary goal of this 2-arm split-mouth randomized clinical trial was to -see whether Platelet-rich plasma (PRP) injection could accelerate the orthodontic teeth movement compared to a micro-osteoperforation (MOP). The secondary purpose was to look at pain perception following MOP and PRP procedures at different time intervals. Of the 50 patients with Class II Division1malocclusion, 100 maxillary quadrants requiring maxillary first premolar extraction were randomly assigned to one of two groups (MOP group and PRP group, n = 50 each). Computer-assisted randomization of two maxillary quadrants of each patient was achieved. Three micro-osteoperforations were performed distal to the canines in the MOP group, and in the other group 0.6 ml of PRP was injected buccally and palatally (0.3 ml on each side) before the initiation of separate canine retractions. The primary outcome was the rate of canine retraction. Secondary outcome was the level of pain experienced by patients during the MOP and PRP procedures. In the MOP group, a small statistically significant difference in the amount of tooth movement was found when comparison was done between baseline and 4 weeks (Mean distance (Md) = â̂’.356, P = .030) and a little more significant between baseline and 8 weeks (Md = â̂’.564, P = .000). The PRP group revealed a significant increase in gingival distance from the baseline to 4 weeks (Md = â̂’.683, P = .005) and from baseline to 8 weeks (Md = â̂’1.205, P = .000); from 4 weeks to 8 weeks, it was a little less significant (Md = â̂’.52200, P = .038). The amount of tooth movement in the PRP group was greater than that in the MOP group. However, the intergroup comparison (MOP and PRP) of tooth movement with an independent t-test showed a difference in favour of PRP but only at 8 weeks ( P = .036) and not significant if we consider the Bonferroni adjustment. The pain experienced during the MOP procedure was a little greater than the pain experienced during the PRP injection ( P = .0473), but the intensity (recorded on the VAS scale) decreased the following day ( P = .2134), further decreasing over the next three days ( P = .6754). In the PRP group, it was found that there was an increased tooth movement mostly from the baseline to 4 weeks. PRP injection have short term effect and diminished through time. It is rather the opposite for the MOP a little more significant between baseline and 8 weeks.