Effect of mini-screw-facilitated micro-osteoperforation on the rate of orthodontic tooth movement: a single-center, split-mouth, randomized, controlled trial

Abstract

Objective: The present study aimed to evaluate the effect of MOP over a 3-month period and to determine the influence of the number of perforations on the rate of canine retraction. In addition, the amount of pain and discomfort caused by the MOP method was evaluated. Trial design: A single-center, split-mouth, triple-blind, randomized, controlled trial was conducted. Methods: The clinical trial was conducted from December 2018 to July 2019 in the Orthodontic Clinic, Shiraz Dental School. Twenty-eight patients (range from16.3 to 35.2 years) who need fixed orthodontic treatment were recruited and randomly assigned to MOP1 and MOP2 groups. In each patient one side of the mouth worked as a control side which received no MOPs. Four months after first premolars extraction, patients in MOP1 group received 3 MOPs on the buccal surface of alveolar bone in the experimental side to accelerate canine retraction whereas patients in MOP2 group received 3 buccal MOPs and 3 palatal MOPs in the experimental side. The amount of canine retraction was measured every 28 days at three intervals on both sides of the mouth. Pain perception was also measured on the day of MOP procedure and subsequently at 24 h. Randomization was performed using online software RANDOM.ORG; the recruited patients were divided into two parallel groups with a 1:1 allocation ratio then the side of MOPs intervention in each subject was randomly determined with coin tossing. Triple blinding design was employed. Results: The result of the intra-examiner reliability using ICC was 0.97 (P < 0.001), indicating excellent repeatability and reliability of the measurements. The baseline characteristics between the groups were similar (P > 0.05). There was a significant difference in the rate of canine retraction between the MOP groups and the contralateral control sides, as well as between the MOP1 and MOP2 groups (P < 0.05). Conclusion: The MOP procedure was effective in accelerating orthodontic tooth movement, although the amount of acceleration was not clinically significant in the case of canine retraction. An increase in the number of MOPs resulted in a significant acceleration of the canine retraction. Trial registration: The trial was registered 30 November 2018 at the Iranian Registry of Clinical Trials (IRCT20181121 041713N1).

Effects of micro-osteoperforations performed with Propel system on tooth movement, pain/quality of life, anchorage loss, and root resorption: a systematic review and meta-analysis

“…Five studies [ 12 , 13 , 19 , 20 , 25 ] using the Excellerator instrument (Propel Orthodontics—Ossining, NY, USA) evaluated the effects of MOPs on the rate of tooth movement in orthodontic retraction compared to a control group without MOPs; also, seven RCTs [ 14 , 15 , 18 , 26 – 29 ] using other mini-screws performed the same evaluation.…”

“…Among eight studies which analyzed the pain associated with the interventions [ 12 – 15 , 20 , 25 , 28 , 29 ], one evaluated the impact on the daily routine of patients [ 14 ] and three studies evaluated the presence of root resorption [ 14 , 15 , 28 ]. None used the Propel system.…”

“…Eight RCTs [ 12 , 14 , 15 , 20 , 26 – 29 ] used the split-mouth model and four [ 13 , 18 , 19 , 25 ] utilized the two-arm parallel groups. The sample sizes ranged from 8 [ 28 ] to 60 [ 25 ] patients.…”

“…Regarding the type of brackets, one study used self-ligating Roth system 0.022″ [ 19 ], eight studies used MBT 0.022″ [ 12 – 14 , 18 , 25 , 26 , 28 , 29 ], two used Roth prescription 0.022″ [ 15 , 27 ], and one study used Standard edgewise 0.022″ [ 20 ]. Concerning the canine retraction, eight RCTs [ 12 , 14 , 15 , 18 – 20 , 28 , 29 ] used mini-screws as anchorage devices and NiTi springs with strength levels between 100 and 150 g, one used mini-screws and chain elastic for retraction with forces between 140 and 200 g [ 26 ], two used conventional anchorage and NiTi springs [ 13 , 27 ], and one study used transpalatal bars and tie back mechanics [ 25 ].…”

“…Regarding the number of perforations, all five Propel studies [ 12 , 13 , 19 , 20 , 25 ] and six other investigations [ 14 , 15 , 18 , 26 , 28 , 29 ] were performed with three and one study with two perforations [ 27 ]. The depth of perforation ranged from 1 mm [ 29 ] to 8 mm [ 15 ]; also some studies reported 2 to 3 mm [ 12 , 13 , 25 – 27 ], 3 to 4 mm [ 14 ], 5 mm [ 18 , 20 ], and 5 to 7 mm [ 19 , 28 ] of depth. Thus, depth perforation among studies examining the Propel system ranged from 2-3 mm [ 12 , 13 , 25 ] to 7 mm [ 19 ].…”