Impact of piezocision-assisted orthodontics on root resorption and alveolar bone: a prospective observational study.

OBJECTIVES: To assess the impact of orthodontic treatment combined with piezocision (OT-PC) on root structure and alveolar bone. MATERIALS AND METHODS: Twelve adults were treated with OT-PC. Pre- and post-treatment CBCT examinations evaluated apical root resorption (ARR) and alveolar bone height and thickness changes. Pre- and post-treatment differences were compared using one-sample t test and Wilcoxon signed-rank test. RESULTS: ARRs were generalized and significantly more severe in both anterior sextants compared with posterior sextants. Bone thickness decreased significantly in the maxilla at mid-root and apex areas. The majority of mandibular alveolar bone dehiscences occurred on the buccal aspect at the mid-root level, especially where thickness was less than 0.3 mm. Overall bone height decreased twice as much on the buccal aspect (1.43 mm, P < 0.001) compared with the lingual aspect (0.67 mm, P = 0.001), most significantly in the lower incisors, where the average median loss was 2.10 mm (P = 0.003). CONCLUSION: OT-PC causes minor negative effects on both alveolar bone and root resorption. CLINICAL RELEVANCE: Orthodontic treatment combined with piezocision causes minor negative effects on periodontal support. Nevertheless, mild bone height loss on the buccal aspect of the mandibular teeth and root resorption in both anterior sextants have been detected with this new treatment.

Piezocorticision-assisted orthodontics: Efficiency, safety, and long-term evaluation of the inflammatory process.

OBJECTIVES: The aim of this work was to compare the duration of treatment between orthodontic treatment combined with piezocorticision (OT-PC) and conventional orthodontic treatment (COT), as well as to evaluate the safety, inflammatory process, periodontal health, and soft tissue healing in the OT-PC group. METHODS: Twelve patients were included in each group, and their treatment times were compared for preliminary bracket alignment (PBA) and for overall treatment. In the OT-PC group, the inflammatory process was evaluated by quantifying cytokines in the gingival crevicular fluid. A calibrated examiner measured the probing depth (PD), the distance between the gingival margin and the cementoenamel junction (GM-CEJ), and the clinical attachment level (CAL), before and after OT-PC. The presence of gingival scars was evaluated. Bone and root injuries were assessed with the use of cone-beam computed tomography. RESULTS: The treatment time was significantly reduced in the OT-PC group for PBA in both maxilla (45%; P = 0.001) and mandible (31%; P = 0.023), as well as for overall treatment (52%; P < 0.0001). Although not statistically significant, several inflammatory mediators demonstrated peaks at 3-5 and 16 weeks. There were not significant changes in PD and GM-CEJ after OT-PC treatment, unlike CAL (0.09 ± 0.12 mm; P = 0.024); 47.5% of piezocorticisions caused gingival scars. Only one patient showed no scars. Four cortical bones did not heal completely, and 2 roots had piezoelectric injuries. CONCLUSION: OT-PC was effective at reducing the orthodontic treatment time.

[Accelerated tooth movement by alveolar corticotomy or piezocision]. / Le concept du déplacement dentaire accéléré par corticotomie ou par piézocision.

The relatively recent introduction of corticotomies and piezocision has made it possible for orthodontists to accelerate tooth movement and thereby to shorten the length of orthodontic treatment. Specialists emphasizing a mechanistic concept have been debating the underlying basic biological mechanics of these new therapeutic tools with opposing specialists who support a biological conception. Our analysis of different publications on the subject suggests that the biological explanation, with its emphasis on the Regional Acceleratory Phenomenon (RAP), is correct. However, the majority of studies in this field are not based on the principle of evidence based medicine (EBM).