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

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          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 Unpublished literature and ongoing studies were also checked electronically through ClinicalTrials.gov and (ICTRP).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.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s40510-016-0146-9) contains supplementary material, which is available to authorized users.

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          Most cited references33

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          Rapid orthodontics with alveolar reshaping: two case reports of decrowding.

          William M Wilcko, D. Ferguson, T Wilcko … (2001)
          Two case reports demonstrate a new orthodontic method that offers short treatment times and the ability to simultaneously reshape and increase the buccolingual thickness of the supporting alveolar bone. A 24-year-old man with a Class I severely crowded malocclusion and an overly constricted maxilla with concomitant posterior crossbites and a 17-year-old female with a Class I moderately to severely crowded malocclusion requested shortened orthodontic treatment times. This new surgery technique included buccal and lingual full-thickness flaps, selective partial decortication of the cortical plates, concomitant bone grafting/augmentation, and primary flap closure. Following the surgery, orthodontic adjustments were made approximately every 2 weeks. From bracketing to debracketing, both cases were completed in approximately 6 months and 2 weeks. Posttreatment evaluation of both patients revealed good results. At approximately 15 months following surgery in one patient, a full-thickness flap was again reflected. Visual examination revealed good maintenance of the height of the alveolar crest and an increased thickness in the buccal bone. The canine and premolars in this area were expanded buccally by more than 3 mm, and yet there had actually been an increase in the buccolingual thickness of the overlying buccal bone. Additionally, a preexisting bony fenestration buccal of the root of the first premolar was covered. Both of these findings lend credence to the incorporation of the bone augmentation procedure into the corticotomy surgery because this made it possible to complete the orthodontic treatment with a more intact periodontium. The rapid expansive tooth movements with no significant apical root resorption may be attributed to the osteoclastic or catabolic phase of the regional acceleratory phenomenon. Instead of bony "block" movement or resorption/apposition, the degree of demineralization/remineralization might be a more accurate explanation of what occurs in the alveolar bone during physiologic tooth movement in these patients.
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            Effect of micro-osteoperforations on the rate of tooth movement.

            B. Lee, Markos Raptis, Sarah Alansari … (2013)
            Our objectives were to study the effect of micro-osteoperforations on the rate of tooth movement and the expression of inflammatory markers. Twenty adults with Class II Division 1 malocclusion were divided into control and experimental groups. The control group did not receive micro-osteoperforations, and the experimental group received micro-osteoperforations on 1 side of the maxilla. Both maxillary canines were retracted, and movement was measured after 28 days. The activity of inflammatory markers was measured in gingival crevicular fluid using an antibody-based protein assay. Pain and discomfort were monitored with a numeric rating scale. Micro-osteoperforations significantly increased the rate of tooth movement by 2.3-fold; this was accompanied by a significant increase in the levels of inflammatory markers. The patients did not report significant pain or discomfort during or after the procedure, or any other complications. Micro-osteoperforation is an effective, comfortable, and safe procedure to accelerate tooth movement and significantly reduce the duration of orthodontic treatment. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
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              The regional acceleratory phenomenon: a review.

              Peter G H Frost (1982)
              Article 0 comments Cited 85 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Alaa M. H. Alfawal: alaa7alfawal@gmail.com
                Mohammad Y. Hajeer:
                ORCID: http://orcid.org/0000-0003-0640-1297
                myhajeer@gmail.com
                Mowaffak A. Ajaj: drajajortho@gmail.com
                Omar Hamadah: omar.hamadah@gmail.com
                Bassel Brad: basselbrad@gmail.com
                Journal
                Journal ID (nlm-ta): Prog Orthod
                Journal ID (iso-abbrev): Prog Orthod
                Title: Progress in Orthodontics
                Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )
                ISSN (Print): 1723-7785
                ISSN (Electronic): 2196-1042
                Publication date (Electronic): 24 October 2016
                Publication date PMC-release: 24 October 2016
                Publication date Collection: 2016
                Volume: 17
                Electronic Location Identifier: 33
                Affiliations
                [1 ]Orthodontics Department, University of Damascus Dental School, Damascus, Syria
                [2 ]Oral Medicine Department, University of Damascus Dental School, Damascus, Syria
                [3 ]Oral and Maxillofacial Surgery Department, University of Damascus Dental School, Damascus, Syria
                Author information
                http://orcid.org/0000-0003-0640-1297
                Article
                Publisher ID: 146
                DOI: 10.1186/s40510-016-0146-9
                PMC ID: 5075528
                PubMed ID: 27696311
                SO-VID: fa433873-fe9d-4760-9b81-e66473fa5b12
                Copyright © © The Author(s). 2016
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Date received : 30 July 2016
                Date accepted : 19 September 2016
                Categories
                Subject: Review
                Custom metadata
                issue-copyright-statement © The Author(s) 2016

                Keywords: orthodontics,accelerated tooth movement,minimally invasive,surgical,flapless,corticotomy
                Data availability:
                Keywords: orthodontics, accelerated tooth movement, minimally invasive, surgical, flapless, corticotomy

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