Is Piezocision effective in accelerating orthodontic tooth movement: A systematic review and meta-analysis

Abstract

This meta-analysis aimed at critically assessing currently available evidence regarding the overall effectiveness of Piezocision in accelerating orthodontic tooth movement, as well as the adverse effects of this intervention in orthodontic patients. Search methods Electronic search of 6 databases and additional manual searches up to April 2019 without restrictions, also update the search was done by 20 th November. Selection criteria Randomized controlled trials (RCT) and controlled clinical trials (CCT) reporting piezocisionassisted orthodontics versus conventional orthodontics were included in the review. Data collection and analysis The data are expressed by mean differences (MD), 95% confidence intervals, fixed-effect model or random-effect model in the meta-analysis in regard to statistical heterogeneity analyses (tau 2 , and I 2). Included randomized studies were assessed for risk of bias using the new Cochrane Risk of Bias tool (ROB.2) and the non-randomized studies were assessed using (ROBINS I) tool. The studies were graded according to the GRADE approach. Results Fourteen papers for 13 unique trials were included in this systematic review and eight studies were included in the meta-analysis. The meta-analysis showed that the mean difference of the canine retraction rate in the first and second month after piezocision was 0.66 mm/ month and 0.48mm/month, respectively. A total canine retraction rate in the first two months after piezocision was statistically significant (0.57 mm/month, p<0.00001), favoring the

The effectiveness of surgical adjunctive procedures in the acceleration of orthodontic tooth movement: A systematic review of systematic reviews and meta-analysis

“…This systematic review of systematic reviews included 9 quantitative reviews (systematic review with meta-analysis) (Alfawal et al, 2016;Dab et al, 2019;Fleming et al, 2015;Fu et al, 2019;Kamal et al, 2019;Mheissen et al, 2020;Shahabee et al, 2020;Sivarajan et al, 2020;Zimmo et al, 2018) and Five qualitative reviews (systematic review with narrative-analysis) (Apalimova et al, 2020;Figueiredo et al, 2019;Rekhi et al, 2020;Viwattanatipa and Charnchairerk, 2018;Yi et al, 2017). Eight studies (Alfawal et al, 2016;Fleming et al, 2015;Kamal et al, 2019;Rekhi et al, 2020;Shahabee et al, 2020;Sivarajan et al, 2020;Viwattanatipa and Charnchairerk, 2018;Zimmo et al, 2018) included only randomised controlled trials, while the rest included randomised and non-randomised controlled trials.…”

“…Only one study (Kamal et al, 2019) investigated corticotomy intervention, two studies (Shahabee et al, 2020;Sivarajan et al, 2020) investigated MOPs and two studies (Mheissen et al, 2020;Yi et al, 2017) tested piezocision procedure, while the rest of the reviews studied more than one SAP. All included reviews declared that there is no conflict of interest except one study (Yi et al., 2017) (Table 1).…”

“…PT ( 1) SM ( 2) SM+PT ( 1) CR ( 3 The quality of the included reviews A summary of the quality of the included reviews is given in Table 2. Using AMSTAR 2, two studies (Dab et al, 2019;Fu et al, 2019) were appraised as critically low-quality reviews, seven studies (Alfawal et al, 2016;Apalimova et al, 2020;Kamal et al, 2019;Shahabee et al, 2020;Sivarajan et al, 2020;Zimmo et al, 2018, Yi et al, 2017) were appraised as low-quality reviews and five studies (Fleming et al, 2015;Figueiredo et al, 2019;Mheissen et al, 2020;Rekhi et al, 2020;Viwattanatipa and Charnchairerk, 2018) were appraised as moderate-quality reviews.…”

“…Eight reviews (Alfawal et al, 2016;Figueiredo et al, 2019;Fleming et al, 2015;Kamal et al, 2019;Mheissen et al, 2020;Shahabee et al, 2020;Sivarajan et al, 2020;Viwattanatipa and Charnchairerk, 2018) registered their prior protocols with registration bodies. Four of the included reviews (Alfawal et al, 2016;Dab et al, 2019;Fleming et al, 2015;Mheissen et al, 2020) provided a justification of primary studies exclusion. All studies, except the one by Dab et al (2019) and Apalimova et al (2020), assessed the risk of bias of the primary non-randomised controlled trials using a suitable tool.…”

“…As recycling the same trials in different systematic reviews introduced overlapping in the outcomes, the authors applied the Jadad decision algorithm for choosing the best body of evidence. Hence, only four reviews (Dab et al, 2019;Mheissen et al, 2020;Sivarajan et al, 2020;Zimmo et al, 2018) were included in the meta-analysis of this umbrella review. Three of the included reviews assessed the effectiveness of SAPs (corticotomy (Zimmo et al, 2018), piezocision (Mheissen et al, 2020) and MOPs (Sivarajan et al, 2020)) on OTM, while Dab et al (2019) studied the effect of SAPs on the periodontal indexes and the bone density (Figure 2).…”