Micro-osteo perforation effects as an intervention on canine retraction

Abstract

ObjectiveTo evaluate the rate of canine retraction, mesial movement of molar and pain perception in maxillary first premolar extraction patients with or without flapless cortical perforations (FCPs).MethodsThirty adult patients with class II div I malocclusion were randomly allocated with the help of SPSS software to either perforation or conventional group for carrying out this randomized parallel group-controlled trial in 1:1 ratio. Maxillary first premolars were extracted and after canine retraction, distance between the tip of the canine and midpoint of incisal edge and the distance between the cervical midpoints on the height of contour of respective cinguli was measured. Also, mesial movement of molar and pain perception were assessed in both groups. Three bilateral cortical FCP of 1.5 mm diameter were made in the perforation group. Data were analyzed with the help of SPSS software with an intention-to-treat the FCP approach.ResultsSignificant canine retraction in patients with FCP (mean retraction of 6.68 ± 0.60 [measured at crown tip level] and 5.97 ± 0.71 mm [measured at mid cervical level]) was revealed, while patients with conventional mechanics had mean retraction of 2.54 ± 0.49 and 2.33 ± 0.46 mm. Mesial movement of molar also showed significant difference (FCP = 0.48 ± 0.11 mm and Conventional = 0.65 ± 0.19 mm). Pain perception in control group was significantly lower in day 1 and 2.ConclusionFCPs are an effective method of accelerating the rate of canine retractions by 2–3 fold of tooth movement, however, pain perception was high in day 1 and 2.

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.…”

“…One Propel study assessed the implications on quality of life [ 19 ]. Five studies, including one Propel [ 13 ], evaluated the occurrence of anchorage loss [ 13 – 15 , 18 , 28 ]. Two studies without Propel assessed the periodontal health associated to MOPs [ 14 , 28 ].…”

“…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 ].…”

“…Propel (Propel Orthodontics, Ossining, NY) is a 1.4-mm surgical stainless steel mini-screw implant attached to a driver to create MOPs, which according to the company has a design to accelerate the rate of tooth movement [ 11 ]. Although, some studies have used this system to perform MOPs and reported a 2–3-fold increase in rate of movement [ 12 , 13 ]. Nevertheless, MOPs using conventional mini-screws following a methodology similar to the Propel system reported no impact on tooth movement [ 14 , 15 ].…”