Comparison of rate of tooth movement and pain perception during accelerated tooth movement associated with conventional fixed appliances with micro-osteoperforations – a randomised controlled trial

Abstract

Objectives To investigate the influence of micro-osteoperforation (MOP) on rate of orthodontic tooth movement and pain perception with fixed appliances. Design 2 arm parallel randomized controlled trial with an allocation ratio of 1:1. Setting The outpatient department of a dental college. Participants 105 patients were screened, out of which 60 met the inclusion criteria and consented to participate; consisting of 33 females and 27 males requiring en-masse retraction following first premolar extractions. Methods The experimental group consisted of patients bonded with a fixed appliance (Gemini 3M) who received MOP distal to canines throughout the period of retraction every 28 days. These were compared with a control group treated with identical brackets without MOP and were assessed for rate of tooth movement (canine retraction) and pain perception using a Visual Analogue Scale (VAS) of 10 mm. Results Prior to commencement, all baseline parameters were matched between the two groups (p>0.05). A statistically significant increase in rate of tooth movement in the MOP group (p<0.05). Conclusion MOP appears to enhance the rate of tooth movement with no differences in pain perception.

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. All trials reported participants with complete permanent dentition and the mean age ranged from 14 [ 18 ] to 32 [ 20 ] years.…”

Micro-osteoperforations and Its Effect on the Rate of Tooth Movement: A Systematic Review

“…Multiple MOP procedures were performed in various studies to achieve this continued effect of cytokine release after giving MOPs, which showed a constant influence for a month on average. 3,9,17,31 Cramer et al 3 in their split-mouth animal study, however, demonstrated the application of eight MOPs at a depth of 7 mm on seven mature male beagle dogs in the jaw side randomly selected through computerized random number generation for the allocation of experimental and control sides. Contrary to the significant results in many studies, 14,17,28,29 there was not an increase in tooth movement rates due to MOPs.…”

Authors' response

“…After an additional overall quality-of-evidence appraisal across all outcomes, our conclusion that single application micro-osteoperforations have no acceleration effect when observed over a short observation period, was based on only 2 studies 10,11 and the overall quality of the evidence was low. In essence, there is insufficient high-quality evidence to support that micro-osteoperforation is or is not effective for accelerating tooth movement.…”