Piezocision Group Research Articles

The effect of low level laser therapy and piezocision in canine retraction: A prospective randomized split-mouth study

This study evaluated and compared the duration for retraction of maxillary canines in subjects who underwent piezocision and low-level laser therapy.: The study sample consisted of 12 adult patients in a prospective randomized split-mouth study design, requiring therapeutic extraction of bilateral maxillary first premolar and bilateral canine distalization. The subjects were evaluated for 4 months or till the time taken for the maxillary canine to achieve positive contact with the maxillary second premolars bilaterally. Intervention in the form of low-level laser therapy was carried out on one side using a diode laser vis-a viz piezocision on the other side. This was followed by a comparative evaluation of canine retraction due to both the interventions on their respective sides. The LLLT group showed 1.105 times the canine retraction in 4 months as compared to the group subjected to piezocision and the findings are statistically significant (P Value = 0.09) using paired t test . The canine showed a mean distal movement of 3.14mm and 2.84 mm in LLLT and piezocision group respectively. The rate of tooth movement is slightly higher in teeth exposed to LLLT. From the results, we can also infer that there is a constant decline in the rate of tooth movement throughout the duration of the study. With no need for incision and a lesser chance of damage to hard and soft tissue, LLLT appears to be a comparatively attractive option for acceleratory orthodontics.

The effect of piezocision in canine distalization: A prospective split-mouth study

: This study evaluated the duration for distalization of canine and the amount of root resorption with and without piezocision. : The study sample consisted of 15 adult patients in a prospective split-mouth study design, requiring therapeutic extraction of bilateral maxillary first premolar and bilateral canine distalization. The subjects were evaluated for the time taken for the maxillary canine to achieve a positive contact with the maxillary second premolars bilaterally. Intervention in form of piezocision was carried out on one side of the maxillary arch using piezotome vis-a viz the control side. The study further uses pre & post CBCT records to evaluate the amount of blunting of the maxillary canine root apexes bilaterally when distalization was completed. : Duration of canine retraction in the piezocision group was 4.66 ± 0.52 months which is comparatively faster than that of the control group which took almost 5.72 ± 0.65 months. : The study concluded that the use of piezocision in cases of individual maxillary canine retraction results in a shorter duration of maxillary canine distalization and overall treatment time, with no significant difference in root resorption with or without piezocision.

Convalescing Mandibular Anterior Crowding through Piezocision and the Micro-Osteoperforation Surgical Procedure-A Clinical Comparative Study.

Minimally invasive periodontic (perio) surgical procedures, piezocision, and micro-osteoperforation are useful techniques for accelerating tooth movement. These techniques also offer advantages in the orthodontic (ortho) and aesthetic domains. This study aimed to evaluate and compare the rates of lower anterior decrowding with piezocision and micro-osteoperforation. This clinical study included 24 patients requiring fixed orthodontic treatments. Two periodontic techniques (piezocision (PZ) and micro-osteoperforation (MOP)) were considered for the orthodontic treatments. Each patient was randomly allocated to either the piezocision (PZ) group or the micro-osteoperforation (MOP) group. The piezocision group received five radiographically guided incisions on the labial surface of the alveolar bone, whereas the micro-osteoperforation group received one to three MOPs each using a mini-implant drill between the six lower anterior teeth, and later, an initial arch wire was ligated to each bracket. Little's irregularity index (LII) was calculated using a digital vernier caliper on study models every four weeks until decrowding was achieved. The difference in the rates of lower anterior crowding between the piezocision and micro-osteoperforation groups was analyzed to determine the statistical significance. The rates of irregularity index change during decrowding were 4.38 ± 0.61 in the piezocision group and 3.82 ± 0.47 in the micro-osteoperforation group. Piezocision was found to be 1.2 times faster than micro-osteoperforation in terms of the rate of decrowding. The advanced perio-ortho combination technique was advantageous in accelerated decrowding. In comparison to MOP, there was an increase in the rate of decrowding with PZ. Decrowding can be completed quickly with PZ, and it can thus be used to treat crowding effectively in a limited time frame.

Evaluation of Patient-Reported Outcome Measures (PROMs) Associated With the Acceleration of Canine Retraction by Piezosurgery in Comparison With Low-Level Laser Therapy: A Three-Arm Randomized Controlled Clinical Trial.

Background and objectives Recently, both surgical and non-surgical interventions have gained popularity in accelerating orthodontic tooth movement, but there is no randomized controlled trial (RCT) comparing both modalities in terms of patient-reported outcome measures (PROMs) during maxillary canine retraction. Therefore, this trial aimed to assess the PROMs associated with either low-level laser therapy (LLLT) or piezocision-assisted acceleration in the context of maxillary canine retraction. Materials and methods This was a single-blinded, single-center, three-arm RCT. A total of 54 patients (12 males, 42 females, mean age 20.65 ± 2.85) whose treatment needed upper-first-premolar extraction to facilitate canine retraction were enrolled and randomly divided into three groups: piezocision group (PG), LLLT group (LLLTG), and the control group (CG). Standardized questionnaires using a visual analog scale were distributed to patients at five assessment times: 1 (T1), 3 (T2), 7 (T3), 14 (T4), and 28 days following the canine retraction initiation (T5). The patients' pain, discomfort, swelling, chewing difficulty, satisfaction, and acceptance were recorded. Results Regarding pain and discomfort, the levels were significantly lower in the LLLTG during the first two weeks of canine retraction compared to the other two groups (p<0.017). At the same time, these levels were significantly greater in the PG than the CG in the first week of canine retraction (p<0.017). Patients in the PG had a "mild to moderate" perception of swelling at T1 and T2, which was significantly different than that of the other two groups (p<0.001). Regarding chewing difficulty, the levels in the LLLTG were significantly lower than those in PG at the first three assessment times (p<0.017). Patients' satisfaction with canine speed was significantly greater in the intervention groups compared to the CG (p<0.001). In contrast, no statistically significant differences were found between the three groups regarding satisfaction with gum appearance surrounding the canine (p=0.061) and acceptance (p=0.125). Conclusion The LLLT-assisted canine retraction was associated with significantly lower negative patient-reported outcomes during the first two weeks of retraction than piezocision-assisted retraction. However, the levels of pain and discomfort were significantly greater in the piezocision-assisted retraction group than those in the conventional canine retraction group, which in turn were greater than those with the LLLT-assisted canine retraction group during the first week of retraction. Patient satisfaction and acceptance were high with both piezocision and LLLT interventions.

Automated artificial intelligence-based three-dimensional comparison of orthodontic treatment outcomes with and without piezocision surgery.

This study aims to evaluate the influence of the piezocision surgery in the orthodontic biomechanics, as well as in the magnitude and direction of tooth movement in the mandibular arch using novel artificial intelligence (AI)-automated tools. Nineteen patients, who had piezocision performed in the lower arch at the beginning of treatment with the goal of accelerating tooth movement, were compared to 19 patients who did not receive piezocision. Cone beam computed tomography (CBCT) and intraoral scans (IOS) were acquired before and after orthodontic treatment. AI-automated dental tools were used to segment and locate landmarks in dental crowns from IOS and root canals from CBCT scans to quantify 3D tooth movement. Differences in mesial-distal, buccolingual, intrusion and extrusion linear movements, as well as tooth long axis angulation and rotation were compared. The treatment time for the control and experimental groups were 13.2 ± 5.06 and 13 ± 5.52 months respectively (P = .176). Overall, anterior and posterior tooth movement presented similar 3D linear and angular changes in the groups. The piezocision group demonstrated greater (P = .01) mesial long axis angulation of lower right first premolar (4.4 ± 6°) compared with control group (0.02 ± 4.9°), while the mesial rotation was significantly smaller (P = .008) in the experimental group (0.5 ± 7.8°) than in the control (8.5 ± 9.8°) considering the same tooth. The open source-automated dental tools facilitated the clinicians' assessment of piezocision treatment outcomes. The piezocision surgery prior to the orthodontic treatment did not decrease the treatment time and did not influence in the orthodontic biomechanics, leading to similar tooth movements compared to conventional treatment.

Assessment of Dentoalveolar Changes Following Leveling and Alignment of Severely Crowded Upper Anterior Teeth Using Self-Ligating Brackets Alone or With Flapless Piezocision Compared to Traditional Brackets: A Randomized Controlled Clinical Trial.

Introduction Dental crowding is one of the most common types of malocclusions. It can be treated with or without extraction, depending on the severity of the crowding. Extraction-based orthodontic treatments are the preferred treatment option in cases of severe crowding, but they take longer than non-extraction cases. Objective This study aimed to evaluate the dentoalveolar changes following the orthodontic treatment of severely crowded maxillary anterior teeth in adults using self-ligating brackets alone or combined with flapless piezocision. Materials and methods The participants in this study were 63 patients (46 females and 17 males; mean age SD: 19.71 ± 2.74 years) who attended the Department of Orthodontics at the University of Damascus from January 2020 to December 2021. The participants were divided into three groups at random: Group (1): traditional brackets group, Group (2): self-ligating brackets group; and Group (3): self-ligating brackets with flapless piezocision group. Little's Irregularity Index (LII) was measured at five assessment times: before the onset of orthodontic treatment (T0), after one month (T1), after two months (T2), after three months (T3), and at the end of the leveling and alignment phase (T4). The intercanine width (lingual), the intercanine width (cusp), and the canine rotation angle were measured at two assessment times: before the onset of orthodontic treatment (T0) and at the end of the leveling and alignment phase (T4). Results The three studied groups had statistically significant differences in terms of LII during the first three months, and the most significant improvement of LII was in the self-ligating brackets with the piezocision group (P < 0.001). In addition, the intercanine width (cusp) at the end of the leveling and aligning phase revealed greater mean values in both self-ligating brackets groups compared to the traditional brackets group, and the differences were statistically significant (P < 0.001). Otherwise, no statistically significant differences were found at the end of the leveling and aligning phase in the intercanine width (lingual) or the canine rotation angle between the three studied groups (P > 0.05). Conclusion Using self-ligating brackets with flapless piezocision revealed more significant results concerning LII as compared to other groups. Thus, combining these two acceleration methods could get more effective results in aligning severely crowded teeth. Self-ligating brackets, whether used alone or with flapless piezocision, resulted in greater intercanine width at the cusplevel. The type of brackets (traditional or self-ligating) did not affect the canine rotation angle.

Comparison of the effectiveness of piezocision and microosteoperforation in leveling mandibular anterior teeth

The primary aim of this study was to evaluate the effectiveness of piezocision and microosteoperforation (MOP) in accelerating the leveling of mandibular anterior teeth. The secondary aim was to evaluate the changes in periodontal parameters and the differences in patient comfort. Forty-five patients in the study were randomly divided into 3 groups. After bonding mandibular teeth, the patients in the first group (9 girls, 6 boys) underwent piezocision, and the patients in the second group (10 girls, 5 boys) underwent MOP. Patients in the third group (7 girls, 8 boys) comprised the control group. The patients were asked to complete a visual analog scale for pain assessment during the first week of treatment and to complete the Oral Health Impact Profile-14 questionnaire at the end of the week. Little's irregularity index was measured from plaster models taken at the start of the mandibular bonding process, 4 weeks, 8 weeks, 12 weeks, and 16 weeks after the mandibular bonding process. Periodontal parameters were also recorded at baseline and 16 weeks. Our study results showed statistically significantly more orthodontic tooth movement in the piezocision group (mean difference, 7.60 ± 1.55) than in the control group (mean difference, 5.95±1.28) during the total study period (P= 0.015). In the MOP group, no significant difference in the alignment rate was observed at any time compared to the piezocision and control groups (P>0.05). The leveling of mandibular anterior teeth was accelerated by piezocision over 16 weeks, predominantly in the first 12 weeks, whereas MOP had no effect. It was concluded that piezocision is an acceptable procedure and has no destructive effect on the periodontal tissue.

Evaluation of Patient-Centered Outcomes Associated With the Acceleration of Upper Incisor Decrowding Using Self-Ligating Brackets With or Without Piezocision in Comparison With Traditional Brackets: A Three-Arm Randomized Controlled Trial.

IntroductionThe pain and discomfort associated with orthodontic treatment are considered undesirable complications which may negatively affect the patient’s cooperation and reduce the efficiency of orthodontic treatment. This trial aimed to assess patient-centered outcomes in the treatment of class I malocclusion with severe crowding using self-ligating brackets (SLBs) with or without an acceleration procedure (piezocision) compared to the traditional brackets (TBs) in a three-arm trial.Materials and MethodsSixty-six patients (51 females, 15 males; mean age ± SD: 20.08 ± 2.61 years) attending the Department of Orthodontics, the University of Damascus, Damascus (Syria) from April 2019 to October 2020 participated in this study. The patients were randomly allocated to three groups: the TBs s group (n = 22; mean age ± SD: 18.72 ± 2.42), the SLBs group (n = 22; mean age ± SD: 20.48 ± 2.84), and the SLBs with the piezocision group (SLBs+P; n = 22; mean age ± SD: 19.17 ± 2.59). Patient-centered outcomes were assessed using two standardized questionnaires depending on visual analog scales (VAS) for the majority of the questions and a binary scale (Yes/No) for the last two questions in the second questionnaire. The levels of pain, discomfort, swelling, difficulties with mastication, swallowing, and jaw movement restriction were measured at five assessment times: one day (T1), 3 days (T2), 7 days (T3), 14 days (T4), and 28 days (T5) after the beginning of treatment. The satisfaction levels, acceptance to undergo the applied treatment again, and willingness to advise a friend to receive similar treatment were measured at the last assessment time (T5). One-way ANOVA test or its alternative nonparametric test (i.e., Kruskal-Wallis test) was utilized to compare the three groups.ResultsThere were statistically significant differences between the three groups regarding pain, discomfort, swelling, difficulties with mastication, problems with swallowing, and jaw movement restriction during the first three assessment times only (T1, T2, and T3; P < 0.001). The differences were mainly between the SLBs+P group and the other two groups, where the mean values were greater in the SLBs+P group. Otherwise, there were no significant statistical differences between the SLBs and the TBs groups. Concerning patients’ satisfaction with the provided treatment, a statistically significant difference between the three groups was detected after 28 days (T5; P < 0.001). The SLBs+P group showed the lowest mean values, whereas there were no significant differences between the two other groups.ConclusionThe levels of pain and discomfort, swelling, difficulties in mastication and swallowing, and restriction of jaw movement were greater in SLBs with the piezocision group compared to the sole use of SLBs or TBs in the first week only. The patients showed a high level of satisfaction with the applied therapeutic procedures, which means that SLBs alone or in combination with piezocision can be an accepted treatment modality by patients in the acceleration of orthodontic tooth movement.

Efficacy and safety of piezocision in accelerating maxillary anterior teeth en-masse retraction: study protocol for a randomized controlled trial

BackgroundOrthodontic treatment is commonly more time-consuming in adults than in teenagers, especially when it comes to the maxillary en-masse retraction, which may take 9 months or even longer. As to solve this concern, orthodontists have been striving to seek new methods for shortening orthodontic treatment time. Piezocision, as a popular alternative treatment, has been widely used in different types of tooth movement. However, its effect on en-masse retraction of maxillary anterior teeth remains unclear. This randomized controlled trial intends to figure out the role piezocision plays in accelerating en-masse retraction.MethodsThis protocol is designed for a prospective, single-center, assessor-blinded and parallel-group randomized controlled trial. Twenty adult patients aged from 18 to 40 whose orthodontic treatment required bilateral maxillary first premolars extraction will be randomly assigned to the piezocision group and the control group at a ratio of 1:1. The piezocision group will undergo en-masse retraction immediately after the piezo surgery, while the control group will start en-masse retraction directly. Both groups will be followed up every 2 weeks to maintain the retraction force until the end of space closure. The space closing time is set as the primary endpoint. Meanwhile, the secondary endpoints include the change of root length, labial and palatal alveolar bone thickness, vertical bone height, probing depth of maxillary anterior teeth, cephalometric measurements, visual analogue scale, and postoperative satisfaction questionnaire.DiscussionThis study will attempt to provide more convincing evidence to verify whether piezocision will shorten the time of en-masse retraction or not. Distinguished with previous studies, our study has made some innovations in orthodontic procedure and primary outcome measurement, aiming to clarify the efficacy and safety of piezocision-assisted en-masse retraction in Chinese population.Trial registrationChinese Clinical Trial Registry ChiCTR 1900024297. Registered on 5 July 2019

Effect of piezocision procedure in levelling and alignment stage of fixed orthodontic treatment: a randomized clinical trial

This clinical trial compared the time to complete the levelling and alignment stage with flapless piezocision procedure in the treatment of severe maxillary malocclusion with premolar extraction cases. Two-arm parallel group randomized controlled trial was performed at the Orthodontics Unit of Universiti Sains Malaysia, Malaysia. Sixteen patients with severe anterior maxillary crowding (Little’s irregularity index: 7–9 mm) and required bilateral first premolars extraction was recruited. The participants were randomly assigned to a study group according to a simple randomization method using a sealed envelope mentioned about the group name. Both groups were treated with fixed orthodontic appliance using the 0.022-in. slot of McLaughlin Bennett Trevisi prescription brackets. The piezocision group received flapless piezocision corticotomy about 4–5 mm in length and 3 mm depth on the labial mucogingiva between the roots of six anterior teeth. The number of days since treatment started, Little’s irregularity index, gingival recession, pocket depth, pulp vitality, patient perception of the pain and satisfaction level were recorded before the treatment, at about 1 month and 2 months post-treatment, and at the completion of the levelling and alignment stage. The overall time to complete levelling and alignment stage was significantly shorter in the piezocision group than the control group (mean difference = 31.5 days, 95% CI 6.5, 56.5; p = 0.018). Greater reduction in Little’s irregularity index and faster alignment rate in the first 2 months were found in the piezocision group compared to the control group (p < 0.05). No changes in the gingival recession, pocket depth, and pulp vitality in both groups were observed. Patients who received piezocision surgery experienced no or mild pain and were satisfied with the treatment. Flapless piezocision corticotomy is an effective adjunct that shortens treatment time during levelling and alignment stage without any adverse effects on the teeth and surrounding tissues. It is also painless, acceptable and satisfactory to the patients.Trial registration: ACTRN12621001350819.

Comparison of second molar protraction using different timing for piezocision application: A randomized clinical trial.

ABSTRACTObjective: To compare second molar protraction between early, late and no piezocision groups.Material and Methods: Forty subjects with bilaterally extracted mandibular first molars were selected to participate in the study. Subjects were subdivided into two groups: piezocision and no piezocision. The piezocision group was further subdivided into two subgroups: early piezocision (piezocision performed immediately before second molar protraction) and late piezocision (piezocision performed three months after starting molar protraction). In the no piezocision group, molar protraction was done without surgery. The intervention (piezocision group and timing of piezocision/side within group) was randomly allocated using the permuted random block size of 2, with 1:1 allocation ratio. The amount of second molar protraction, duration of space closure and anterior anchorage loss were measured. A repeated measures analysis of variance was conducted to define the differences between the measured variables at the different time intervals. Differences between groups were assessed using ANOVA test.Results: No difference was detected between early and late piezocision groups in the amount of molar protraction at the end of space closure. Duration of complete space closure was 9 and 10 months in the piezocision and no piezocision groups. Anchorage loss was similar between the three studied groups.Conclusions: Early and late piezocision have similar effect and both increased the amount of second molar protraction temporarily in the first 2-3 months after surgery. Duration of mandibular first molar space closure was reduced by one month when piezocision was applied. Anchorage loss was similar in the three groups.

Ability of piezocision to retain orthodontically moved teeth in a goat model: A split-mouth study.

OBJECTIVES:to evaluate the effectiveness of piezocision in enhancing retention when performed after orthodontic tooth movement.METHODS:Four mature goats had their second incisors removed bilaterally. For each goat, the two sides of the mandible were either treated with piezocision or served as a positive control. Using fixed orthodontic appliance, the first and third incisors on each side were approximated and then retained in place for two weeks. Relapse was measured by the amount of space developed between the approximated incisors after six weeks from the end of the retention period. The periodontal ligament of all incisors was assessed histologically with micro computed tomography and regular hematoxylin and eosin staining.RESULTS:A significantly less relapse was observed in the piezocision group than in the control group (p ≤ 0.05). Bone formation occurs in the vicinity and periphery of the periodontal ligament and thus results in the narrowing of the periodontal ligament.CONCLUSION:A protocol of post-orthodontic retention involving piezocision can be promising to enhance stability of orthodontic treatment outcome.

Assessment of the effects of local platelet-rich fibrin injection and piezocision on orthodontic tooth movement during canine distalization

The study aimed to evaluate and compare the effects of local platelet-rich fibrin (PRF) injection and piezocision applications on tooth movement during canine distalization, as well as to evaluate any changes in the periodontal parameters. Twenty-four patients were randomly divided into 2 groups. A randomly selected side of the maxillary arch received either PRF injection (PRF group) or piezocision (piezocision group). The contralateral sides of both groups served as the controls. After piezocision and PRF injection applications, canine distalization was initiated in both groups with a 150g force. Patients were followed every 2weeks for a total 12 of weeks. The following variables were evaluated: cephalometric measurements, the amount of canine distalization, molar mesialization, canine rotation, transversal changes in dental models, and periodontal parameters. The amount of canine distal movement was found to be greater in the experimental sides than in the control sides in both groups at 12weeks (P<0.05). There were no differences in the amount of molar mesialization, canine rotation, or transversal measurements in both groups when compared with the experimental sides with the control sides (P>0.05). There were no differences in the skeletal measurements or periodontal parameters in both groups (P>0.05). In both groups, the maxillary incisors were retroclined and retracted. PRF and piezocision accelerated tooth movement, but there were no differences between the 2 applications in terms of speed, amount, duration of tooth movement, or periodontal parameters during canine distalization.

The effectiveness of surgical adjunctive procedures in the acceleration of orthodontic tooth movement: A systematic review of systematic reviews and meta-analysis.

To identify and evaluate the body of the evidence regarding the effectiveness of surgical adjunctive procedures (SAPs) in accelerating orthodontic tooth movement (OTM). Unrestricted search of three electronic databases and manual search up to 12 June 2020 were undertaken. All systematic reviews of randomised and non-randomised controlled trials that investigate the effectiveness of the SAPs in accelerating OTM were included. Study selection and data extraction were undertaken independently and in duplicate by two reviewers. A random-effects model with a 95% confidence interval (CI) was generated for comparable outcomes. Two reviewers assessed the quality of the included studies using AMSTAR2 and GRADE. Fourteen systematic reviews were included; however, four systematic reviews were assessed quantitatively. Meta-analysis showed that mean difference (MD) of canine retraction rate, for the first month after SAPs, was mild (MD = 0.65 mm/month). Compared to control, micro-osteoperforations (MOPs) statistically but temporally accelerate lower canine retraction and en masse retraction by 0.25 mm/month and 0.31 mm/month, respectively. There was no significant effect (P>0.05) in terms of molar anchorage loss (MAL) between control and MOP groups. Piezocision non-significantly shortens the duration of en masse retraction (4.30 months, P>0.05), but significantly shortens incisors retraction (101.64 days, P<0.001). MAL is mild but significantly less in the piezocision group compared to the control group (MD = 0.53 mm, P=0.03). Low-level evidence showed that SAPs have no significant effect on root resorption or periodontal health; however, piezocision is associated with transient acute inflammation and noticeable scars. Low-level evidence concludes that SAPs accelerate OTMs and reduce treatment duration, but the acceleration is minor and transient. The effect on anchorage loss is variable and technique related. Side effects of SAPs are transient, but some might be aesthetically noticeable. A cost-benefit analysis of SAPs should be considered while making the treatment decision.

Effect of piezocision on molar intrusion in open-bite treatment using a modified MEAW technique.

The aim of this retrospective study was to investigate whether a piezocision technique influences molar intrusion in open-bite cases. In all, 30patients with open-bite malocclusion were assigned to one of two groups: the piezocision groupcomprised 15patients who were treated using curved arches and anterior elastics with the simultaneous combination of piezocision which was performed interdentally in the upper posterior region, while the control group comprised 15patients who were treated with the same treatment mechanics without piezocision. In both groups, after leveling and aligning, upper 0.017 × 0.025 accentuated curve and lower 0.017 × 0.025 reversed curve of Spee NiTi archwires were placed. Anterior vertical elastics were applied between laterals and the canines on both sides. The effects of treatments were investigated on cone-beam computed tomography images acquired before use of elastics and after correction of open-bite. Open-bite closure was achieved in 2.85 ± 0.85 and 4.1 ± 1.58months in the piezocision and control groups, respectively, while total treatment lasted 1.4 ± 0.42 and 1.7 ± 0.43years, respectively. Extrusion of lower posterior teeth (p < 0.05) was observed together with extrusion of incisors and canines (p < 0.001) in the piezocision group, while only incisors and canines were extruded in the control group (p < 0.001). There were no significant differences between the groups (p > 0.05) except significant lower incisor extrusion (p < 0.05) and counter-clockwise rotation of the lower occlusal plane in the piezocision group (p < 0.001). The duration of open-bite correction was significantly shorter in the piezocision group. No molar intrusion was observed in either group. Open bite correction was achieved mainly by extrusion and retrusion of the incisors while maintaining upper molar positions.

Which method is more effective for accelerating canine distalization short term, low-level laser therapy or piezocision? Asplit-mouth study.

This study evaluated and compared the effects of low-level laser therapy (LLLT) and piezocision on the amount of orthodontic tooth movement. Forty maxillary canines from 20patients (mean age, 16.35 ± 1.14years) were evaluated in asplit-mouth design study. Miniscrew-supported canine distalization was performed. Piezocision was applied in the right maxillary canine region, and the left maxillary canines were irradiated with adiode laser (940 nm, 5 J/cm2). LLLT was performed on day0 and days 3, 7, 14, 21, and 28 after the start of canine distalization in the first 4‑week period. Data were evaluated at baseline (T0) and after 4 (T1), 8 (T2), and 12 (T3) weeks. The amount of canine movement was determined from three-dimensional models, and the angulation of canines and first molars was analyzed based on lateral cephalograms. Intragroup and intergroup comparisons of canine distalization were performed for four different time intervals (T0-T1, T1-T2, T2-T3, T0-T3). The canine tooth movement in the T0-T1 period was significantly greater in the LLLT group compared to the piezocision group. No statistically significant differences were observed between the groups for the T1-T2, T2-T3, and T0-T3 periods. The amount of canine distalization in the T0-T1 period was significantly greater than that in the T1-T2 and T2-T3 periods in both groups. Tooth movement during the T1-T2 period was higher than that in the T2-T3 period in the LLLT group. Cephalometric evaluation revealed no statistically significant difference between the groups with respect to canine and first molar angulation. Although laser application seems more effective during the first 4‑week period, considering the 12-week period, the effects of LLLT and piezocision on orthodontic tooth movement during canine distalization were similar.

Evaluation of patient-centered outcomes associated with the acceleration of canine retraction by using minimally invasive surgical procedures: A randomized clinical controlled trial.

Only a few studies in the literature have reported patient-centered outcomes associated with minimally invasive corticotomy, and thus, related scientific evidence is limited. The objective of this study was to evaluate patient-centered outcomes associated with upper canine retraction assisted with piezocision or laser-assisted flapless corticotomy (LAFC). Thirty-two patients (19 females, 13 males) at a mean age of 18.25 ±3.05 years were randomly divided into 2 equal groups: the LAFC group (LG; n = 16) and the piezocision group (PG; n = 16). In each group, the surgical procedure was randomly assigned to one side of the maxillary arch, and the other side served as the control. Standardized questionnaires using the numerical rating scale (NRS) were distributed to all patients during the 1st month after the surgical procedure at 4 time points: 24 h (T1); 3 days (T2); 7 days (T3); and 14 days (T4). The patients' responses were obtained, regarding their feelings of pain, discomfort, swelling, eating difficulty, jaw movement restriction, analgesic consumption, and satisfaction. The levels of pain, discomfort, swelling, and difficulty in chewing were significantly greater at the experimental sides as compared to the control sides only at T1 in both groups (p < 0.05). The levels of pain and discomfort in LG were significantly lower than those in PG only at T1 (p = 0.013 and p = 0.009, respectively) whereas there were no significant differences between the groups regarding swelling, eating difficulty, jaw movement restriction, and analgesic consumption. The patients in both groups reported high levels of satisfaction, with no significant differences. The levels of pain, discomfort, swelling, eating difficulty, and jaw movement restriction were dramatically decreased 1 day after flapless corticotomy treatment in both groups (p < 0.05). Both LAFC and piezocision were associated with high levels of pain, discomfort, swelling, and difficulty in chewing at T1. Laser-assisted flapless corticotomy caused less pain and discomfort than piezocision.

Is Piezocision effective in accelerating orthodontic tooth movement: A systematic review and meta-analysis.

This meta-analysis aimed at critically assessing currently available evidence regarding the overall effectiveness of Piezocision in accelerating orthodontic tooth movement, as well as the adverse effects of this intervention in orthodontic patients. Electronic search of 6 databases and additional manual searches up to April 2019 without restrictions, also update the search was done by 20th November. Randomized controlled trials (RCT) and controlled clinical trials (CCT) reporting piezocision-assisted orthodontics versus conventional orthodontics were included in the review. The data are expressed by mean differences (MD), 95% confidence intervals, fixed-effect model or random-effect model in the meta-analysis in regard to statistical heterogeneity analyses (tau2, and I2). Included randomized studies were assessed for risk of bias using the new Cochrane Risk of Bias tool (ROB.2) and the non-randomized studies were assessed using (ROBINS I) tool. The studies were graded according to the GRADE approach. Fourteen papers for 13 unique trials were included in this systematic review and eight studies were included in the meta-analysis. The meta-analysis showed that the mean difference of the canine retraction rate in the first and second month after piezocision was 0.66 mm/month and 0.48mm/month, respectively. A total canine retraction rate in the first two months after piezocision was statistically significant (0.57 mm/month, p<0.00001), favoring the piezocision group with a high heterogeneity between studies I2 = 69%. For the total treatment time outcome measure, there was a statistically significant difference in the overall treatment time (MD 101.64 Days, 95% CI, 59.24-144.06) favoring the piezocision group. Low quality evidence suggests that piezocision is an effective surgical procedure in accelerating the rate of canine retraction in the first two months and reducing the treatment duration. However, this effect appears to be clinically insignificant. CRD42019136303.

Effect of piezocision on mandibular second molar protraction.

To assess the effects of piezocision on the rate of mandibular second molar protraction. Thirty-one subjects (average age: 22.26 ± 5.63 years) who presented with at least one extracted mandibular first molar were selected to participate in the study. The subjects were subdivided into one of two groups, 22 molars each: group 1, where piezocision was performed immediately before molar protraction and group 2, where molar protraction was performed with no piezocision. Piezocision was performed by making two vertical incisions mesial and distal to the extraction space, and bone cuts were done with a length up to the mucogingival line at a depth of 3 mm. The rate of second molar protraction, duration of space closure, and level of interleukin-1-β (IL-1β) in gingival crevicular fluid (GCF) during the first month of space closure were recorded. During the first 2 months after surgery, the rates of second molar protraction were 1.26 ± 0.12 mm/month and 0.68 ± 0.19 mm/month in the piezocision and no piezocision groups, respectively (P < .001). Duration of lower first molar space closure was 9.61 ± 0.98 months in the piezocision group and 10.87 ± 1.52 months in the no piezocision group (P < .01). The level of IL-1β in GCF was higher in the piezocision group compared to the no piezocision group, up to 1 week after surgery (P = .02). Although piezocision doubled the rate of second molar protraction during the first 2 months after surgery, overall second molar protraction was increased by only 1 month.

Multilevel biological responses following piezocision to accelerate orthodontic tooth movement: A study in rats

AimThe objective of the present study was to explore the alveolar bone tissue response and its dynamic at the tissue, cellular, and molecular levels following a piezocision procedure in a rat model. MethodsSixty rats were randomly allocated to either a control group (conventional orthodontic tooth movement) (TM) or a test group (piezocision-assisted orthodontic tooth movement) (TM+PS). Tissue, cellular, and molecular analyses were performed at 7, 28, and 42 days after the procedures. Orthodontic Tooth Movement (OTM) and Bone Volume Fraction (BVF) were evaluated using Nano-computed tomography. Moreover, histological parameters such as the number of osteoclasts were assessed, and the expression of cytokines involved in the bone turnover was investigated using quantitative reverse transcriptase polymerase chain reaction analysis. ResultsThe OTM was 1.8 times faster in the TM+PS compared with the TM at day 42. A significant decrease in BVF was found in the TM+PS group compared with the TM group at day 7 and day 28, whereas no difference was observed at day 42. The number of osteoclasts was significantly higher in the TM+PS group compared with the TM group at day 7. No difference between the two groups was found in the number of osteoclasts involved in root resorption. RANKL and osteoprotegerin were significantly higher in the piezocision group than in the control group at day 7. ConclusionsIn these conditions, the efficacy of piezocision-assisted alveolar decortication to accelerate tooth movement was demonstrated, and the underlying biological responses at the tissue, cellular and molecular levels were emphasized.