Pulp volume changes after piezocision-assisted tooth movement: a randomized clinical trial

Abstract

Background Orthodontic treatment may result in undesirable side effects, such as root resorption and a decrease in the size of the pulp tissue which could be associated with the duration of the orthodontic treatment. Piezocision-assisted tooth movement was introduced as a minimally invasive surgical procedure to shorten orthodontic treatment time. This prospective randomized clinical trial was aimed to compare the pulp volume changes of maxillary anterior teeth after en-masse retraction with or without piezocision-assisted orthodontics. Methods Patients who required orthodontic treatment with bilateral maxillary first premolar extractions and en-masse retraction were recruited. Patients were randomly divided into extraction with piezocision, or only extraction, serving as controls. Pulp volume and root length changes of the maxillary six anterior teeth were measured and compared between the two groups using a 3-Dimensional analytical software. Paired and independent sample t-tests were used to compare within and between groups. Bivariate correlation was done between the mean change in pulp volume and its corresponding root length. The significance level was set at α = 0.05. Results A total of 23 patients were included, 12 in the piezocision, and 11 in the control group. At the end of the en-masse retraction phase, (mean = 122.74 ± 3.06 days) pulp volume was significantly decreased in all six anterior teeth in both groups (P < 0.01). The decrease in pulp volume was not statistically different between both groups, (P > 0.05). There was a statistically significant but moderate correlation only between the pulp volume change of the right canine and its root length, r = 0.44, P = 0.034. Conclusions The effect of piezocision-assisted orthodontic tooth movement on the pulp volume was comparable to the conventional orthodontic treatment. The degree of change in pulp volume does not appear to be related to the amount of root resorption. Trial registration NCT03180151. Registered December 25, 2016, retrospectively registered, https://clinicaltrials.gov/ct2/show/record/NCT03180151.

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

“…Postoperative pain experienced by patients was moderate. The same group of investigators published another study where they evaluated the pulp volume changes after piezocision-assisted tooth movement [ 50 ]. They used two groups of patients requiring orthodontic treatment with bilateral maxillary first premolar extractions and en masse retraction: 1- extraction with piezocision, 2- only extraction.…”

Orthodontic root resorption associated with surgical adjunctive procedures for accelerating tooth movement: a systematic review of randomised controlled trials

“…Following the removal of duplicates, 682 articles were screened by title and abstract and resulted in the acquisition of 99 full-text articles (k = 0.89). Of the full-text articles evaluated against the pre-specified inclusion and exclusion criteria, a total of 13 articles [29][30][31][32][33][34][35][36][37][38][39][40][41] fulfilled the requirements for inclusion in the present systematic review. The inter-reviewer agreement of 0.94 for the inclusion of primary articles indicated almost perfect agreement.…”

“…The included studies [29][30][31][32][33][34][35][36][37][38][39][40][41] were published between 2012 and 2022, with sample sizes ranging from 20 to 52 patients (aged . All studies [29][30][31][32][33][34][35][36][37][38][39][40][41] used either a traditional (surgical bur) corticotomy, piezocisionassisted corticotomy, corticision (using a surgical blade and hammer), or MOPs to accelerate tooth movement. Several studies 29,30,32,33,37,38,41 utilised a splitmouth design, in which the participant was subject to the intervention and control on separate sides of their mouth.…”

“…Several studies 29,30,32,33,37,38,41 utilised a splitmouth design, in which the participant was subject to the intervention and control on separate sides of their mouth. Importantly, there was variance in the diagnostic modality for determining the presence of OIERR: ten of the included studies [29][30][31][33][34][35][36][37]39,41 utilised three-dimensional computed tomography (CT), whereas three studies 32,38,40 used two-dimensional intraoral periapical radiographs (IOPA).…”

“…The mean patient follow-up period across studies was approximately 26 weeks; however, this varied considerably between studies (12-77.9 weeks). [29][30][31][32][33][34][35][36][37][38][39][40][41] A difference between the follow-up period for intervention and control groups was also noted in two studies. 34,40 Table II provides a summary of the characteristics of the included studies, describing the participants, treatment goal, intervention, comparison, outcomes measured and study design (PICOS), sample size and follow-up period.…”