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

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.

Background No randomized controlled trial (RCT) has studied the accuracy of surgical guides used in terms of orthodontic treatment acceleration. Therefore the aim of this trial was to assess computer-guided piezocision-based orthodontic. Materials and methods Thirty-two patients with severely crowded upper anterior teeth were enrolled and randomly allocated to either the experimental group (ExpG) or the control one. Subjects of the ExpG received three-dimensional (3D) guided piezoelectric corticotomies on the buccal alveolar bone of the anterior region. Five piezocision cuts were properly performed between each anterior teeth and the adjacent in virtual models. Surgical guides were designed and 3D-printed with preplanned slots that guide gingival and then piezoelectric incisions. The patients underwent Cone-Beam Computed Tomography CBCT before and immediately after surgery. Thus, Predesigned piezocisions were compared to the actual ones in attempt to measure three dimensional deviations of the applied peizocisions. Results Ninety-six severe maxillary dental crowding were assigned for eligibility, 40 of them met the inclusion criteria. Thirty-two participants were randomly allocated to the trial`s groups. No patient was lost to follow-up neither from the control nor the experimental group. Overall alignment time (OAT) was reduced by 53% in the experimental group compared to the control group. The mean of the 3D deviation of the surgical guide was 0.23 mm (standard deviation 0.19 mm). Conclusion The values of the surgical guide deviation was nearly null, which confirms that this innovative technique is clinically applicable. Furthermore, this technique was impressively effective in accelerating orthodontic tooth movement. Trial registration This trial was registered at The ISRCTN registry (ID: ISRCTN65498676 Registration date: 07/04/2021).

Objective: the aim of this study was to investigate the effects of 3D guided piezocision (a minimally invasive surgical technique) in accelerating orthodontic tooth movements (OTM) since the literature does not provide high-quality evidence to confirm that Piezocision results in significant OTM acceleration. Furthermore, no randomized controlled trial (RCT) has utilized 3D piezo-surgical guides to accelerate severe orthodontic de-crowding.Study design: A Parallel-group randomized controlled trial was conducted on patients with severe mandibular teeth irregularity. Sample size was 34 patients (19 females and 15 males), then subjects were divided into two parallel groups using Minitab® Version 17 software. First group received conventional orthodontic treatment, whereas the second group received 3D- guided piezo-assisted orthodontic one. Little irregularity index (LII) changes were studied using dental cast in four time points before inserting the first archwire (T0), after 1 month of treatment onset  (T1), after 2 months (T2), and at the end of the alignment stage (T3) and the overall alignment time (OAT) required to complete anterior alignment of the mandibular arch was also measured.Results: Ninety-five severe dental crowding patients were evaluated for eligibility, 46 of them fulfilled the inclusion criteria. Thirty-four participants were allocated to the treatment groups randomly. There were no withdrawals during the trial phases. Accordingly, the results of 34 patients were statistically analyzed. OAT was reduced by 48% in the experimental group compared to the control group, with a statistically significant difference between the two groups . Likewise, the time difference between all arch changes was significantly lower when 3D guided piezocision was performed, except for the first arch (T0) and the last arches (T3).Conclusion: Minimally invasive 3D guided Piezocision seems to be a very effective and easy technique in accelerating orthodontic tooth movement.

Background No randomized controlled trial (RCT) has studied the accuracy of surgical guides used in terms of orthodontic treatment acceleration. Therefore the aim of this trial was to assess computer-guided piezocision-based orthodontic. Materials and Methods Thirty-two patients with severely crowded upper anterior teeth were enrolled and randomly allocated to either the experimental group (ExpG) or the control one. Subjects of the ExpG received three-dimensional (3D) guided piezoelectric corticotomies on the buccal alveolar bone of the anterior region. Five piezocision cuts were properly performed between each anterior teeth and the adjacent in virtual models. Surgical guides were designed and 3D-printed with preplanned slots that guide gingival and then piezoelectric incisions. The patients underwent Cone-Beam Computed Tomography CBCT before and immediately after surgery. Thus, Predesigned piezocisions were compared to the actual ones in attempt to measure three dimensional deviations of the applied peizocisions. Results Ninety-six severe maxillary dental crowding were assigned for eligibility, 40 of them met the inclusion criteria. Thirty-two participants were randomly allocated to the trial`s groups. No patient was lost to follow-up neither from the control nor the experimental group. Overall alignment time (OAT) was reduced by 53% in the experimental group compared to the control group. The mean of the 3D deviation of the surgical guide was 0.23mm (standard deviation 0.19mm). Conclusion The values of the surgical guide deviation was nearly null, which confirms that this innovative technique is clinically applicable. Furthermore, this technique was impressively effective in accelerating orthodontic tooth movement. Trial Registration: This trial was registered at The ISRCTN registry (ID: ISRCTN65498676 Registration date: 07/04/2021).