Effect of micro-osteoperforation on the rate of canine retraction: a split-mouth randomized controlled trial

Amira A Aboalnaga, Mona M Salah Fayed, Noha A El-Ashmawi, Sanaa A Soliman, Amira A Aboalnaga, Mona M Salah Fayed, Noha A El-Ashmawi, Sanaa A Soliman

Abstract

Background: Among the recent modalities introduced to accelerate orthodontic tooth movement (OTM) is micro-osteoperforations (MOPs), in other words, bone puncturing. The aim of this split-mouth trial was to investigate the effects of MOPs on the rate of OTM.

Methods: Eighteen patients requiring bilateral first premolar extraction and upper canine retraction with maximum anchorage were enrolled in this study. Immediately before canine retraction, three MOPs were randomly allocated to either the right or left sides. MOPs were performed using a mini-screw (1.8 mm diameter, 8 mm length) distal to the canine. Canine retraction continued for 4 months. Data were collected from monthly digital models, in addition to pre- and post-retraction maxillary CBCT images. The primary outcomes were the rate of canine retraction per month and the total distance moved by the canines. The secondary outcomes were the effect of MOPs on anchorage loss, canine root resorption, and pain.

Results: The mean rate of canine retraction in both sides was 0.99 ± 0.3 mm/month. The total distance moved by the canine cusp tip was greater in the MOP than the control side (mean difference 0.06 ± 0.7 mm), which was statistically insignificant (P > 0.05(. The total distances moved by the canine center and apex were significantly greater in the MOP than the control side (mean difference 0.37 ± 0.63 mm (P < 0.05) and 0.47 ± 0.56 mm (P < 0.01) respectively). Insignificant differences were detected regarding anchorage loss and root resorption between both sides (P > 0.05). Mild to moderate pain was experienced following the MOP procedure, which rapidly faded away within 1 week.

Conclusions: Micro-osteoperforations were not able to accelerate the rate of canine retraction; however, it seemed to facilitate root movement.

Keywords: Accelerated orthodontics; Canine retraction; Micro-osteoperforation; Tooth movement.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Intra-oral photograph showing the procedure of MOPs using a TAD (note the permanent marks on the vertical segment of the wire guide dividing two thirds of the canine root length into equal thirds, such that one MOP was performed for each third)
Fig. 2
Fig. 2
Landmarks used in digital model assessment. a Upper right canine cusp tip. b MB cusp tip of upper right first molar. c Upper left canine cusp tip. d MB cusp tip of upper right first molar. e Frontal plane
Fig. 3
Fig. 3
Volumetric CBCT views showing a canine retraction measurements; 1: upper right canine cusp tip distance moved (from canine cusp tip to FP), 2: upper right canine center distance moved (from canine center to FP), 3: upper right canine root apex distance moved (from canine root apex to FP). b First molar anchorage loss measurements; 1: mesiobuccal (MB) cusp tip loss of anchorage (from MB cusp tip to FP), 2: Center loss of anchorage (from MB root center to FP), 3: MB root apex loss of anchorage (from MB root apex to FP)
Fig. 4
Fig. 4
The canine CBCT image reoriented to show the maximum canine root length in a the labiolingual cross-section and b the mesiodistal cross-section
Fig. 5
Fig. 5
Time line chart representing the mean distances moved by the upper canines along the study time in the control and MOP sides

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