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.

Aim The aim of this study was to evaluate and compare conventional and modified lip repositioning surgical techniques used for management of gummy smile involving hyperactive lip elevator muscles. Methods and Materials. A prospective study was conducted between April 2016 and May 2017. Twenty two adult patients aged 18‐38 years with gummy smile ranging from 4 to 6 mm because of soft tissue disorders were included in the study. All patients were treated in the oral and maxillofacial department at Damascus University. The sample was divided into two groups of 11 patients. The first group was treated by the conventional standard technique, and the second group treated by a modified study technique. The amount of gingival display in full smile was evaluated in both groups following each intervention. Results Both groups exhibited a statistically significant reduction in the measurement of gummy smile at month 1 and 6 postoperatively (P < .05), but there was no significant difference in gingival display at 3 months in either group postoperatively (P > .05). The recent study showed a significant difference in gingival display between 3 and 6 months postoperatively in group 1, but no significant difference in group 2. Conclusion This study showed that the modified technique utilized in treating gummy smile has less relapse after surgery, shows excellent cosmesis and compared to the conventional technique, greater sustainability. Clinical significance The recent increase in demand for an esthetic smile has led to the development a modification of conventional lip repositioning for correcting gummy smile by myotomy of lip elevator muscles. This modified technique offers less relapse and greater stability post‐operatively than the conventional technique.

Investigating the efficacy of Er:YAG laser as a non-invasive particle technique for debonding of failed or malpositioned of porcelain laminated veneers.

In the absence of agreed treatment protocols for OPLs, we recommend CO(2) laser surgery as an effective treatment modality offering precise lesion excision, full histopathological assessment, minimal post-operative morbidity and a 64% disease free clinical outcome. Regular patient follow up is encouraged due to the persistence of field cancerisation effects.

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