Localized Piezoelectric Alveolar Decortication for Orthodontic Treatment in Adults

Abstract

This randomized controlled trial aimed to evaluate the benefits and clinical outcomes of piezocision, which is a minimally invasive approach to corticotomy that is used in orthodontic treatments. Twenty-four adult patients presenting with mild overcrowdings were randomly allocated to either a control group that was treated with conventional orthodontics or a test group that received piezo-assisted orthodontics. The piezocisions were performed 1 wk week after the placement of the orthodontic appliances. Neither grafting material nor sutures were used. All patients were followed every 2 wk, and archwires were changed only when they were no longer active. The periods required for the completion of the overall orthodontic treatments were calculated, and the periodontal parameters were evaluated at baseline and at the end of the orthodontic treatment. Patient-centered outcomes were assessed with a visual analog scale; analgesic use following the procedures was also recorded. The patient characteristics were similar between the 2 groups. The overall treatment time was significantly reduced by 43% in the piezocision group as compared with the control group. In both groups, periodontal parameters (i.e., recession depth, pocket depth, plaque index, and papilla bleeding index) remained unchanged between the baseline and treatment completion time points. No increase in root resorption was observed in either group. Scars were observed in 50% of the patients in the piezocision group. Analgesic consumption was similar following orthodontic appliance placement and piezocision surgery. Patient satisfaction was significantly better in the piezocision group than in the control group. In these conditions, the piezocision technique seemed to be effective in accelerating orthodontic tooth movement. No gingival recessions were observed. The risk of residual scars might limit the indications for piezocision in patients with a high smile line (ClinicalTrials.gov NCT02590835).

Efficacy of piezocision on accelerating orthodontic tooth movement: A systematic review

“…In total, 4 studies were included in this review. [14][15][16][17] The kappa score regarding the agreement level was .94, which could serve as the indicator of low interexaminer bias. 20 The details of study inclusion are shown in the PRISMA flow diagram (Figure 1).…”

“…Among the four studies, two were CCTs 14,15 and the other two were RCTs. 16,17 A total of 67 patients were enrolled in this review, with the sample size of individual studies ranging from 10 to 24. The two CCTs 14,15 used split-mouth designs and recruited both adults and adolescents, while the two RCTs 16,17 employed parallel-arm designs and enrolled adults exclusively.…”

“…Sample size calculation was adopted in the 2 RCTs. 16,17 The repeatability of measurements was identified in all included studies. 14-17 …”

“…12 Moreover, several clinical reports have determined the effectiveness of piezocision in accelerating OTM. [13][14][15][16][17] However, the methodological heterogeneity and inconclusive results of these studies could bias the evidence and mislead clinical practice. Therefore, a critical systematic review addressing this topic would be beneficial to clinicians.…”

Methods of accelerating orthodontic tooth movement: A review of contemporary literature

“…[106][107][108] Similar results were obtained during the treatment of mild crowding (a study on 24 patients resulted in a 47% shorter treatment time), orthodontic extrusion of palatally impacted canines (6 patients) and retroinclination of upper incisors with sufficient bone support. [109][110][111] Al-Naoum et al, in a group of 30 patients, obtained an average speed of 0.74 mm/week (compared to 0.2 mm/week on the control side) during retraction of canines. 112 The potential usefulness of corticotomy in the treatment of post-traumatic ankylosis is also worth considering.…”