Effectiveness of minimally invasive surgical procedures in the acceleration of tooth movement: a systematic review and meta-analysis

Alaa M H Alfawal, Mohammad Y Hajeer, Mowaffak A Ajaj, Omar Hamadah, Bassel Brad, Alaa M H Alfawal, Mohammad Y Hajeer, Mowaffak A Ajaj, Omar Hamadah, Bassel Brad

Abstract

Objective: The objective of this study was to assess systematically the available scientific evidence relating the efficiency of minimally invasive surgical procedures in accelerating orthodontic tooth movement and the adverse effects associated with these procedures.

Methods: Electronic search of these databases CENTRAL, EMBASE, Scopus, PubMed, Web of Science, Google Scholar Beta, Trip, OpenGrey and PQDT OPEN was performed (last updated January 2016). The reference lists of the included studies were hand searched. Unpublished literature and ongoing studies were also checked electronically through ClinicalTrials.gov and (ICTRP). Randomized controlled trials (RCTs) with patients who received minimally invasive surgical procedures combined with fixed orthodontic appliances compared with conventional treatment were included. Cochrane's risk of bias tool was used to assess risk of bias.

Results: Four RCTs (61 patients) and nine ongoing protocols were included in this review. Only three RCTs were suitable for quantitative synthesis. Higher tooth movement rate was found with the minimally invasive surgical procedures by a weighted mean difference of 0.65 mm for 1 month of canine retraction (WMD = 0.65: 95 % CI (0.54, 0.76), p < 0.001) and by a weighted mean difference 1.41 mm for 2 months (WMD = 1.41: 95 % CI (0.81, 2.01), p < 0.001). No adverse effects associated with these procedures were reported.

Conclusions: There is limited available evidence about the effectiveness of minimally invasive surgically accelerated orthodontics (MISAO). Although the current review indicated that MISAO can help in accelerating canine retraction, further research in this domain should be performed before it can be recommended in everyday clinical practice.

Keywords: Accelerated tooth movement; Corticotomy; Flapless; Minimally invasive; Orthodontics; Surgical.

Figures

Fig. 1
Fig. 1
PRISMA 2009 flow diagram of the included studies
Fig. 2
Fig. 2
Risk of bias summary of RCTs. Low risk of bias (the plus sign); unclear risk of bias (the question mark sign)
Fig. 3
Fig. 3
Overall risk of bias score for each field
Fig. 4
Fig. 4
Forest plot of the comparison between minimally invasive surgical procedures and conventional treatment for the canine retraction amount at 1 month
Fig. 5
Fig. 5
Forest plot of the comparison between minimally invasive surgical procedures and conventional treatment for the canine retraction amount at 2 months

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Source: PubMed

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