Three-dimensional assessment of the effect of micro-osteoperforations on the rate of tooth movement during canine retraction in adults with Class II malocclusion: A randomized controlled clinical trial.

Abstract

The purpose of this split-mouth trial was to investigate the effect of micro-osteoperforations (MOPs) on the rate of tooth movement. Thirty-two patients (24 female, 8 male; mean age, 19.26±2.48years) who required fixed orthodontic treatment and maxillary first premolar extractions participated in this trial with MOPs randomly allocated to either the right or left sides distal to the maxillary canines. Eligibility criteria included Class II Division 1 malocclusion, healthy periodontal condition, no smoking, and no systemic disease. Miniscrews were used to support anchorage and retract the canines with the aid of closed-coil nickel-titanium springs with 150g of force. Randomization was accomplished with block randomization with a permuted block size of 2 with a 1:1 allocation ratio to either right or left with allocations concealed in opaque, sealed envelopes. Blinding was used at the data collection and analysis stages. Three MOPs were performed using miniscrews (5mm depth, 1.5mm width) on the buccal bone distal to the canines on the randomly selected side. The primary outcome was the rate of canine retraction measured from 3-dimensional digital models superimposed at the rugae area from the baseline to the first, second, and third months. The following secondary outcomes were examined: anchorage loss, canine tipping, canine rotation, root resorption, plaque index, and gingival index. Pain level, pain interference with the patients' daily life, patients' satisfaction with the procedure and degree of ease, willingness to repeat the procedure, and recommendation to others were also evaluated. There was no statistically significant difference in the rates of tooth movement between the MOP and the control sides at all time points (first month: P=0.77; mean difference, 0.2mm; 95% CI, -0.13, 0.18mm; second month: P=0.50; mean difference, -0.08mm; 95% CI, -0.33, 0.16mm; third month: P=0.76; mean difference, -0.05mm; 95% CI, -0.40, 0.29mm). There were also no differences in anchorage loss, rotation, tipping, root resorption, plaque index, periodontal index, and pain perception between the MOP and control sides at any time point (P>0.05). MOPs had no effect on the patients' daily life except for a feeling of swelling on the first day (P=0.05). Level of satisfaction and degree of easiness of the procedure were high. A significant percentage of patients were willing to repeat the procedure and recommend it to others. No serious harm was observed. Three MOPs were not effective in accelerating tooth movement at any time point. Other secondary parameters evaluated were not different between the MOP and control sides except for the feeling of swelling on day 1 on the MOP side. Patients were highly satisfied with the MOP procedure, and many considered MOPs an easy procedure and were willing to repeat and recommend it to friends. This trial was registered at Clinicaltrials.gov with identifier number NCT02473471. The protocol was not published before trial commencement. This work was supported by Jordanian University of Science and Technology (grant number 20150263). No conflict of interest is declared.