The effectiveness of traditional corticotomy vs flapless corticotomy in miniscrew-supported en-masse retraction of maxillary anterior teeth in patients with Class II Division 1 malocclusion: A single-centered, randomized controlled clinical trial

Khlef, Hanin Nizar; Hajeer, Mohammad Y; Ajaj, Mowaffak A; Heshmeh, Omar; Youssef, Nisreen; Mahaini, Luai

doi:10.1016/j.ajodo.2020.08.008

Cited by 31 publications

(47 citation statements)

References 27 publications

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“…The distal movement was simple due to the suspension of the orthodontic force once the canines arrived at a class I relationship. The results of the current trial are aligned with Khlef et al [ 11 ] study, who noticed that the maxillary first molars were slightly distalized at the end of the retraction stage in both flapless and traditional corticotomy groups with no significant difference between them. In addition, the finding in the FGC group was consistent with that of Tuncer et al [ 31 ], who found that the first molar showed a distal movement.…”

Section: Discussionsupporting

confidence: 86%

“…The upper first premolars were extracted at the onset of orthodontic treatment because the extraction might affect the tooth movement rate [ 31 ]. The mini-screw was used as a direct and indirect anchorage method [ 11 ]. NiTi closed coil springs were utilized for en-masse retraction instead of chain elastic due to their continuous light force [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…A 250 g of force was used during the retraction phase, considered within the physiological range and distributed evenly on the upper anterior teeth [ 30 ]. The retraction phase was started four days after doing the corticotomy [ 11 ], with patients followed up once every two weeks to get the most benefits of the regional acceleration phenomenon (RAP) [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…So, minimally invasive surgical procedures have been suggested and labelled “flapless corticotomies” [ 10 ]. A recent randomized clinical trial by Khlef et al [ 11 ] found that the average en-masse retraction time for the traditional corticotomy group was 3.75 months, versus 4.04 months for the flapless corticotomy group, with no significant difference between both corticotomy techniques. As a result, they concluded that both traditional and flapless corticotomies carried out by piezosurgery effectively accelerated the en-masse retraction of the upper anterior teeth.…”

Section: Introductionmentioning

confidence: 99%

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Is It Possible to Achieve Favorable Accelerated Dental Changes with No Periodontal Complications When Retracting Upper Anterior Teeth Assisted by Flapless Corticotomy Compared to Traditional Corticotomy? A Two-Arm Randomized Controlled Trial

Khlef

Hajeer

2022

The Scientific World Journal

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Objectives. The objective of this trial was to evaluate the dental changes, periodontal health, and tooth vitality in mini-screw-supported en-masse retraction with two corticotomy-based acceleration techniques. Study Design. The sample included 38 adult patients presenting with class II division 1 malocclusion (three males, 35 females; age range between 18 and 30 years), needing the extraction of upper first premolars followed by en-masse retraction. The sample was divided randomly and equally into two groups. Randomization was carried out by random numbers generated by the computer with a 1 : 1 allocation ratio. The allocation concealment was carried out by sequentially numbered, opaque, sealed envelopes. The interventions were traditional corticotomy (TC) versus flapless corticotomy (FC). Mini-screws were inserted between the upper second premolar and first molar, bilaterally. The primary outcome was evaluating dental changes. Secondary outcomes were the periodontal health and pulp vitality of the maxillary teeth. Mann–Whitney U test and two-sample t-test with Bonferroni correction were used to analyze the data. Results. The en-masse retraction rate in the first three months was higher in the TC group than the FC group (1.82, 1.66, and 1.39 mm/month vs 1.60, 1.42, and 1.22 mm/month, respectively) with statistically significant differences ( P < 0.001 , P < 0.001 , P = 0.001 , respectively). The en-masse retraction amount was greater in the TC group than the FC group (6.84 mm vs 6.18 mm, respectively) with statistically significant differences ( P = 0.002 ). There was an increase in the inter-canine and inter-molar widths with a minor distal movement of the upper first molar in the two groups, with no significant differences between them ( P > 0.008 ). The values of gingival, papillary bleeding and plaque indices in the TC group were significantly greater than those in the FC group after performing the corticotomy ( P < 0.001 , P < 0.003 , P = 0.002 , respectively). No gingival recession was found on any of the examined teeth in both groups. All teeth maintained their vitality at all measurement times in both groups. No severe harms were noticed in any group. Conclusions. Both traditional and flapless corticotomy techniques resulted in clinically similar rates of the en-masse retraction of upper anterior teeth, with similar dental changes and no significant periodontal complications or tooth vitality loss. The minimally invasive flapless corticotomy appeared to be a good alternative to the more invasive traditional corticotomy. This trial is registered with https://www.clinicaltrials.gov (Identification code: NCT04847492), retrospectively registered.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is It Possible to Achieve Favorable Accelerated Dental Changes with No Periodontal Complications When Retracting Upper Anterior Teeth Assisted by Flapless Corticotomy Compared to Traditional Corticotomy? A Two-Arm Randomized Controlled Trial

Khlef

Hajeer

2022

The Scientific World Journal

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“…In a recent randomized controlled clinical trial, Khlef at al [ 52 ]. evaluated the efficacy of corticotomies, with and without flaps, which were performed using a piezoelectric knife.…”

Section: Review Of the Literaturementioning

confidence: 99%

Accelerated orthodontic tooth movement: surgical techniques and the regional acceleratory phenomenon

Keser

Naini

2022

Maxillofac Plast Reconstr Surg

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Background Techniques to accelerate tooth movement have been a topic of interest in orthodontics over the past decade. As orthodontic treatment time is linked to potential detrimental effects, such as increased decalcification, dental caries, root resorption, and gingival inflammation, the possibility of reducing treatment time in orthodontics may provide multiple benefits to the patient. Another reason for the surge in interest in accelerated tooth movement has been the increased interest in adult orthodontics. Review This review summarizes the different methods for surgical acceleration of orthodontic tooth movement. It also describes the advantages and limitations of these techniques, including guidance for future investigations. Conclusions Optimization of the described techniques is still required, but some of the techniques appear to offer the potential for accelerating orthodontic tooth movement and improving outcomes in well-selected cases.

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Traditional vs flapless corticotomy

Kumar¹,

Goyal²,

Sharma³

et al. 2021

American Journal of Orthodontics and Dentofacial Orthopedics

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The effectiveness of traditional corticotomy vs flapless corticotomy in miniscrew-supported en-masse retraction of maxillary anterior teeth in patients with Class II Division 1 malocclusion: A single-centered, randomized controlled clinical trial

Cited by 31 publications

References 27 publications

Is It Possible to Achieve Favorable Accelerated Dental Changes with No Periodontal Complications When Retracting Upper Anterior Teeth Assisted by Flapless Corticotomy Compared to Traditional Corticotomy? A Two-Arm Randomized Controlled Trial

Is It Possible to Achieve Favorable Accelerated Dental Changes with No Periodontal Complications When Retracting Upper Anterior Teeth Assisted by Flapless Corticotomy Compared to Traditional Corticotomy? A Two-Arm Randomized Controlled Trial

Accelerated orthodontic tooth movement: surgical techniques and the regional acceleratory phenomenon

Traditional vs flapless corticotomy

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