Comparison of canine retraction by conventional and corticotomy-facilitated methods

Abstract

OBJECTIVE: The purpose of this split-mouth single-centered, parallel-group, randomized clinical trial was to evaluate the efficiency of corticotomy-facilitated orthodontics in rapid canine retraction. METHODS: The sample consisted of 10 patients (15–25 years old) requiring extraction of the maxillary first premolars with subsequent canine retraction. The patients’ right sides were randomly assigned to either the corticotomy (experimental) or control groups. Corticotomy cuts and perforations were performed and canine retraction was initiated bilaterally with closed-coil nickel-titanium springs that applied 150 g of force. The following variables were examined till the end of canine retraction on both sides: Rate of canine retraction, canine root resorption, and patient perception of the procedure. The rate of canine retraction was assessed every month using study models while root resorption was evaluated using CBCT. Patient`s perception was evaluated using a 100 mm VAS. RESULT: Mean time taken for full completion of canine retraction: 5.7 months (test) and 7.1 months (control). Mean root resorption: 0.53 ± 0.10 (control) and 0.24 mm ± 0.10 (test). Mean VAS scores: 16 ± 3.94 (24 hours) and 2 ± 2.58 (1 week) at control side and 46.50 ± 6.69 (24 hours) and 2 ± 2.58 (1 week) at test. CONCLUSION: There was an overall reduction in the time taken for canine retraction with corticotomy; however, an increase in the rate of canine retraction in the corticotomy-facilitated method was evident only for the first four months, compared to the conventional method. Less root resorption was observed in corticotomy-facilitated method than conventional method. Pain perception was more for corticotomy-facilitated method than conventional method at 24 hours, but similar after one week.

Adverse Effects of Surgically Accelerated Orthodontic Techniques: A Systematic Review

“…Out of the 39 included studies, 33 were RCTs [ 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ], from which 17 had a split-mouth study design [ 34 , 37 , 41 , 45 , 48 , 53 , 55 , 56 , 57 , 58 , 59 , 60 , 62 , 64 , 65 , 66 ] and 6 were CCTs [ 22 , 67 , 68 , 69 , ...…”

“…Twelve studies had identified problems with the randomization practices [ 34 , 35 , 36 , 38 , 39 , 40 , 45 , 48 , 49 , 53 , 55 , 65 ]. Twenty-one of the thirty-three included RCTs with a sufficiently stated randomization process [ 37 , 41 , 42 , 43 , 44 , 46 , 47 , 50 , 51 , 52 , 54 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 66 ]. In these trials, randomization was performed with coin tosses, computer-generated random numbers, block randomization, or identical, opaque, sealed envelopes to prevent selection bias.…”

“…In these trials, randomization was performed with coin tosses, computer-generated random numbers, block randomization, or identical, opaque, sealed envelopes to prevent selection bias. The blinding of outcome assessment (detection bias) was possible in 13 trials [ 29 , 37 , 44 , 45 , 46 , 47 , 48 , 58 , 60 , 61 , 62 , 63 , 66 ]; participants and operators (performance bias) could be blinded from each surgical technique in four studies [ 42 , 43 , 57 , 59 ]. Inadequate reporting was identified and was also associated with deviations from intended interventions and measurement of the outcomes.…”

“…From the total of thirty-three included studies, five articles tested corticotomy [ 34 , 35 , 37 , 67 , 71 ], two examined PAOO [ 38 , 39 ], two studied corticision [ 43 , 44 ], eleven investigated piezocision [ 40 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 68 , 70 ], eight evaluated the accelerated tooth movement with the MOPs technique [ 57 , 59 , 60 , 61 , 62 , 63 , 64 , 69 ], and two trials tested lasercision [ 22 , 66 ]. Two studies compared corticotomy with corticotomy combined with bone graft procedures [ 36 , 42 ], one compared corticision with corticotomy [ 45 ], two compared corticotomy with flapless corticotomy using piezotome (piezocision) [ 46 , 47 ], one evaluated MOPs and corticotomy [ 65 ], two tested both MOPs and piezocision [ 56 , 58 ], and one study evaluated corticotomy, piezocision, and corticotomy versus piezocision [ 41 ].…”

“…The majority of the studies that assessed the adverse effects on root length and possible root resorption suggested that there was no evidence of substantial apical root resorption [ 36 , 39 , 40 , 41 , 42 , 44 , 46 , 49 , 50 , 55 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 68 , 71 ]. One trial assessed the amount of root resorption according to CBCT scans after performing corticotomy [ 37 ]. This study reported a statistically significant decrease in canine root resorption on the corticotomy side compared with the control side ( p < 0.05) [Control: Mean ± SD (mm) = 0.53 ± 0.10, 95% CI (0.47, 0.59), corticotomy: Mean ± SD (mm) = 0.24 ± 0.10, 95% CI (0.12, 0.36)].…”