BackgroundTo evaluate the effectiveness of two minimally invasive surgical procedures in the acceleration of canine retraction: piezocision and laser-assisted flapless corticotomy (LAFC).MethodsTrial design: A single-centre randomized controlled trial with a compound design (two-arm parallel-group design and a split-mouth design for each arm).Participants: 36 Class II division I patients (12 males, 24 females; age range: 15 to 27 years) requiring first upper premolars extraction followed by canine retraction.Interventions: piezocision group (PG; n = 18) and laser-assisted flapless corticotomy group (LG; n = 18). A split-mouth design was applied for each group where the flapless surgical intervention was randomly allocated to one side and the other side served as a control side.Outcomes: the rate of canine retraction (primary outcome), anchorage loss and canine rotation, which were assessed at 1, 2, 3 and 4 months following the onset of canine retraction. Also the duration of canine retraction was recorded.Random sequence: Computer-generated random numbers.Allocation concealment: sequentially numbered, opaque, sealed envelopes.Blinding: Single blinded (outcomes’ assessor).ResultsSeventeen patients in each group were enrolled in the statistical analysis. The rate of canine retraction was significantly greater in the experimental side than in the control side in both groups by two-fold in the first month and 1.5-fold in the second month (p < 0.001). Also the overall canine retraction duration was significantly reduced in the experimental side as compared with control side in both groups about 25% (p ≤ 0.001). There were no significant differences between the experimental and the control sides regarding loss of anchorage and upper canine rotation in both groups (p > 0.05). There were no significant differences between the two flapless techniques regarding the studied variables during all evaluation times (p > 0.05).ConclusionsPiezocision and laser-assisted flapless corticotomy appeared to be effective treatment methods for accelerating canine retraction without any significant untoward effect on anchorage or canine rotation during rapid retraction.Trials registrationClinicalTrials.gov (Identifier: NCT02606331).Electronic supplementary materialThe online version of this article (10.1186/s13005-018-0161-9) contains supplementary material, which is available to authorized users.

ObjectiveThe objective of this study was to assess systematically the available scientific evidence relating the efficiency of minimally invasive surgical procedures in accelerating orthodontic tooth movement and the adverse effects associated with these procedures.MethodsElectronic search of these databases CENTRAL, EMBASE, Scopus, PubMed, Web of Science, Google Scholar Beta, Trip, OpenGrey and PQDT OPEN was performed (last updated January 2016). The reference lists of the included studies were hand searched. Unpublished literature and ongoing studies were also checked electronically through ClinicalTrials.gov and (ICTRP). Randomized controlled trials (RCTs) with patients who received minimally invasive surgical procedures combined with fixed orthodontic appliances compared with conventional treatment were included. Cochrane’s risk of bias tool was used to assess risk of bias.ResultsFour RCTs (61 patients) and nine ongoing protocols were included in this review. Only three RCTs were suitable for quantitative synthesis. Higher tooth movement rate was found with the minimally invasive surgical procedures by a weighted mean difference of 0.65 mm for 1 month of canine retraction (WMD = 0.65: 95 % CI (0.54, 0.76), p < 0.001) and by a weighted mean difference 1.41 mm for 2 months (WMD = 1.41: 95 % CI (0.81, 2.01), p < 0.001). No adverse effects associated with these procedures were reported.ConclusionsThere is limited available evidence about the effectiveness of minimally invasive surgically accelerated orthodontics (MISAO). Although the current review indicated that MISAO can help in accelerating canine retraction, further research in this domain should be performed before it can be recommended in everyday clinical practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s40510-016-0146-9) contains supplementary material, which is available to authorized users.

This trial was registered at Clinical Trials.gov (Identifier: NCT02977221).

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Background No randomized controlled trial (RCT) has compared flapless piezocision-assisted corticotomy in the extraction-based orthodontic decrowding of lower anterior teeth with the conventional treatment in terms of pain, discomfort and acceptability. Therefore, the aim of this trial was to compare piezocision-based orthodontic decrowding of lower anterior teeth following premolar-extraction with the conventional orthodontic treatment regarding levels of pain, discomfort, and patients’ satisfaction. Methods A parallel-group RCT was conducted on 34 patients with severely crowded lower anterior teeth. Subjects were randomly allocated to either the experimental (ExpG) or the control group. Piezoelectric corticotomies were performed on the labial surfaces of the alveolar bone in the anterior region in the ExpG. Levels of pain, discomfort, swelling, difficulties of mastication, swallowing and jaws movement limitation were recorded on a Visual Analog Scale (VAS) at 1, 7, 14 and 28 days. In the ExpG, patients were also asked to rate their level of satisfaction following acceleration. Two-sample t tests were employed to detect significant differences. Results No statistically significant differences were found between the two groups at one day following treatment commencement regarding pain, discomfort, difficulties of mastication, swallowing and limitation in jaws movement ( P = 0.082, 0.367, 0.062, 0.446, 0.359; respectively). However, a statistically significant difference was found between the two groups regarding the perception of swelling at the first-day assessment ( P = 0.011). No statistically significant differences were detected between the two groups at 7 days regarding the five previously mentioned variables. There was a drop down to zero level at two weeks and four weeks following treatment onset for all variables. The level of satisfaction in the ExpG had a mean value of 86.47 (±22.47) and all patients were positive towards recommending the surgical intervention to a friend. Conclusions No significant differences in the levels of pain and discomfort were found between the ExpG and the control group for all variables except for the perception of swelling at one day following intervention. Patient-centered outcomes revealed a high level of acceptance and satisfaction with this technique. Trial registration This trial was registered at Clinical Trials.gov (Identifier NCT02975765 ). Electronic supplementary material The online version of this article (10.1186/s12903-019-0758-9) contains supplementary material, which is available to authorized users.

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Background The role of injectable platelet rich fibrin (i-PRF) in orthodontic treatment has not been investigated with focus on its effect on dental and bony periodontal elements. Objective To evaluate the efficacy of i-PRF in bone preservation and prevention of root resorption. Methods A randomized split-mouth controlled trial included 21 patients aged 16–28 years (20.85 ± 3.85), who were treated for Class II malocclusion with the extraction of the maxillary first premolars. Right and left sides were randomly allocated to either experimental treated with i-PRF or control sides. After the leveling and alignment phase, the canines were retracted with 150gm forces. The i-PRF was prepared from the blood of each patient following a precise protocol, then injected immediately before canine retraction on the buccal and palatal aspects of the extraction sites. Localized maxillary cone beam computed tomography scans were taken before and after canine retraction to measure alveolar bone height and thickness and canine root length (indicative of root resorption), and the presence of dehiscence and fenestration. Paired sample t-tests and Wilcoxon signed rank tests were used to compare the changes between groups. Results No statistically significant differences in bone height, bone thickness were found between sides and between pre- and post-retraction period. However, root length was reduced post retraction but did not differ between sides. In both groups, postoperative dehiscence was observed buccally and palatally and fenestrations were recorded on only the buccal aspect. Conclusions I-PRF did not affect bone quality during canine retraction or prevent canine root resorption. I-PRF did not reduce the prevalence of dehiscence and fenestration. Trial registration ClinicalTrials.gov (identifier number: NCT 03399760. 16/01/2018).

Objective: This study aimed to evaluate the epinephrine-containing and norepinephrine-containing local anesthetic solutions on blood glucose levels of type II diabetic patients undergoing dental extractions. Materials and Methods: A total of 60 simple extractions (n=60), performed on teeth of 30 patients with type II diabetes mellitus, were included in the study. The sample was divided according to the used anesthetic solutions into two groups: Group A (lidocaine with epinephrine group; n=30) and Group B (lidocaine with norepinephrine group; n=30). A vasoconstrictor concentration of 1:100,000 was applied in both groups. Consistently with each extraction, blood glucose levels measurements, using portable glucometer, were done three times: immediately before local anesthesia administration, 5 minutes after local anesthesia, and 5 minutes after tooth extraction. Results: The change in blood glucose concentration following the administration of local anesthesia was not statistically significant in both Group A and Group B (P>0.05). No significant change in this parameter was found after teeth extractions in both groups (P>0.05). There were also no significant differences in the glycemic response between Group A and B (P>0.05). Conclusion: Administration of 4 ml of 2% lidocaine with epinephrine 1:100,000 or 2% lidocaine with norepinephrine 1:100,000 in the context of simple dental extraction did not strikingly increase nor decrease the blood glucose levels in patients with type II diabetes. According to the results of this study, both local anesthetics may be used safely in type II diabetics, with no preference for one over the other.