A clinical comparative evaluation of periodontally accelerated osteogenic orthodontics with piezo and surgical bur: An interdisciplinary approach

Abstract

Context:The orthodontic treatment in adult for the treatment of malocclusion is becoming more common. However, the disadvantages of conventional orthodontics are the time consumed for the treatment (18–24 months), root resorption, and formation of fenestrations and dehiscence. Periodontally accelerated osteogenic orthodontics (PAOO) is a surgical technique resulting in increased alveolar bone width, shorter treatment time, increase posttreatment stability, and decrease amount of apical root resorption.Aim:The aim of the study is to compare the treatment time, root resorption, bone density, and presence/absence of fenestrations and dehiscence after PAOO with surgical bur and PAOO with piezocision.Materials and Methods:Forty participants with bimaxillary protrusion undergoing orthodontic treatment were randomly selected and divided into two groups. Group I: 20 participants selected for PAOO with surgical bur and Group II: 20 participants selected for PAOO with piezocision. Patients were recalled at baseline 3, 6, 9, and 12 months and evaluated for treatment time and bone density, root resorption, and detection of fenestration and dehiscence using cone-beam computerized tomography (CBCT).Results:Participants in Group I had less treatment time compared to Group II. Rate of retraction was 7.07 mm/20.81 weeks and 5.99 mm/28.48 weeks in Group I and Group II, respectively. CBCT showed a statistically significant increase in bone density in both groups, 12 months after the surgery. Root resorption was negligible in Group I (0.34 mm) and in Group II (0.51 mm). CBCT revealed increase in thickness of alveolar bone and coverage of fenestrations and dehiscence.Conclusion:PAOO provides an efficient and stable orthodontic tooth movement.

Piezosurgical corticotomy for rapid orthodontic tooth movement – A case series

“…However, there were some postoperative complications with surgical bur such as root resorption. [ 20 ] Hajji reported similar outcomes in their study. [ 21 ] Chung et al .…”

The transparency of reporting 'harms' encountered with the surgically assisted acceleration of orthodontic tooth movement in the published randomized controlled trials: a meta-epidemiological study

“…The case was managed and the patient was monitored until she returned to her normal condition. Later, she was contacted on the same day and confirmed that she was in good health without any symptoms [ 54 ] The monthly repetition of MOPs caused fear since some patients were afraid and asked to not undergo the perforations [ 41 ] % 2.2% Total n 8 % 8.8% Other harms Numbness n 1 Corticotomy [ 46 ] One patient had numbness in the corner of the upper lip, which lasted for approximately a month and then disappeared after being given nerve repair medication [ 46 ] % 1.1% Hematoma n 2 PAOO [ 53 ], Flapless corticotomy using bur [ 55 ] 3 out of 20 patients in the PAOO with piezocision group experienced hematoma of the chin [ 53 ] One patient developed a significant hematoma in the lower lip while applying flapless corticotomy using bur [ 55 ] % 2.2% Total n 3 % of total 3.3% Total …”

“…Harms that were related to patient-centered outcomes were mentioned in eight papers (8.8%, Table 5 ). These complications had several forms such as postoperative pain [ 41 , 51 , 52 ], discomfort [ 43 , 50 ], swelling (which was reported by the patients themselves and not those observed by the researchers) [ 44 , 50 – 53 ], and in one paper, dizziness and hypotension accompanied by fear of undergoing the surgical intervention [ 41 ]. Also, there was a fear of repeating the surgical intervention [ 54 ].…”

Periodontally accelerated osteogenic orthodontics combined with recombinant human bone morphogenetic protein-2: An outcome assessment

“…In a study by Rajasekaran and Krishna Nayak,[36] mild pain was reported that persisted for 3 days. Thind et al .,[37] observed negligible root resorption when PAOO was performed with a piezosurgical unit and surgical bur.…”