Abstract
BackgroundOrthodontic treatment may result in undesirable side effects, such as root resorption and a decrease in the size of the pulp tissue which could be associated with the duration of the orthodontic treatment. Piezocision-assisted tooth movement was introduced as a minimally invasive surgical procedure 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.MethodsPatients 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 sample t-tests were used to compare within and between groups. Bivariate correlation was done between the mean change in pulp volume and its corresponding root length. The significance level was set at α = 0.05.ResultsA total of 23 patients were included, 12 in the piezocision, and 11 in the control group. At the end of the en-masse retraction phase, (mean = 122.74 ± 3.06 days) pulp volume was significantly decreased in all six anterior teeth in both groups (P < 0.01). The decrease in pulp volume was not statistically different between both groups, (P > 0.05). There was a statistically significant but moderate correlation only between the pulp volume change of the right canine and its root length, r = 0.44, P = 0.034.ConclusionsThe effect of piezocision-assisted orthodontic tooth movement on the pulp volume was comparable to the conventional orthodontic treatment. The degree of change in pulp volume does not appear to be related to the amount of root resorption.Trial registration NCT03180151. Registered December 25, 2016, retrospectively registered, https://clinicaltrials.gov/ct2/show/record/NCT03180151.
Highlights
Orthodontic treatment may result in undesirable side effects, such as root resorption and a decrease in the size of the pulp tissue which could be associated with the duration of the orthodontic treatment
Tissues that are affected by orthodontic force application include the periodontal tissues, root length, and the pulp tissues [1,2,3,4]
Changes that occurred in the dental pulp as a result of orthodontic forces were observed in the form of pulpal aging and disruption of the odontoblastic layer at various locations [13]
Summary
Orthodontic treatment may result in undesirable side effects, such as root resorption and a decrease in the size of the pulp tissue which could be associated with the duration of the orthodontic treatment. Piezocisionassisted tooth movement was introduced as a minimally invasive surgical procedure to shorten orthodontic treat‐ ment 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. Human pulpal response to orthodontic forces after 5 and 10 days showed a significant increase in angiogenesis and the degree of the pulpal response and was found to be dependent on the force applied [6] These changes ranged from a minor alteration in the pulp vasculature to a decrease in respiration rate of the tissue, vacuolization of odontoblasts, apoptosis, alteration of alkaline phosphatase level and tissue damage aspiration [14]. A recent study investigated the effect of forces applied by the rapid palatal expansion appliance on pulp volume [9]. They found a decrease in pulp volume at the end of the expansion
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