Clinical Study Of Accelerating Mandibular Crowding Relieves By Piezocision Assisted Orthodontics And A System Evaluation Of The Effect Of Corticotomies On Orthodontic Tooth Movement

Objective To evaluate the safety and effectiveness of Piezocision,using in the clinical application for orthodontic patients with the lower dentition crowding,and to provide evidence for the popularization and application of piezoelectric in orthodontic treatment.Methods 20 patients(between July 2017 and September 2017)with malocclusion requiring orthodontic treatment in the department of Anhui Provincial Stomatological Hospital with good oral hygiene and periodontal conditions were selected,no systemic disease and local anesthesia contraindications.Divided into experimental group A(10 patients,mean age 18.6 ± 2.3 years old)and control group B(10 patients,mean age 17.9 ± 2.1 years old).All patients need to extract four first premolars.Preoperative CBCT to analyze the mandibular crowding and guide the choice of surgical incision.A comprehensive periodontal examination was performed.The patients with calculus were treated with Ultrasonic scaling.4 first premolars were extracted routinely from the control group.During the second extraction of teeth in the experimental group,Piezocision was performed on the alveolar bone of the mandibular anterior teeth.Visualization pain scale were used for follow-up of postoperative complications such as pain and swelling.One week later,two groups of patients were bonded with 0.022 inch self-ligating Dammon Q brackets appliances.Subjects were followed monthly(every 4 weeks)after the first wire placement.The movement of the teeth was observed until alignment.Record the time for alignment and compare the time required between the two groups.After the alignment,CBCT was taken again.The lengths of 6 teeth in the mandibular anterior teeth area were measured before and after Piezocision to evaluate the root resorption.Results 1.In the experimental group,within one week after the Piezocision,the patient has slight pain and swelling in the surgical area,which did not affect speaking,eating and normal life.After one week,the wound in the surgery area healed without pain and discomfort.2.In Piezocision group,the time needed to relieve the crowding of mandibular dentition was shorter than that of traditional orthontic treatment,the difference was statistically significant,p<0.05.3.The results showed that the root length of the experimental group and the control group had no significant changes(p>0.05),and the difference of root length between the two groups was not statistically significant(p>0.05).Conclusion Compared with traditional orthodontic methods,Piezocision accelerates the alleviating of mandibular crowding and reduces the time of alignment.During the follow-up period,no risk of root resorption was observed.In addition,the Piezocision is relatively minimally invasive,the patient's acceptance of this technique is high and the postoperative adverse reactions are small.Piezocision technology is a safe and effective way to accelerate the movement of orthodontic tooth.Objective To evaluate the effectiveness and safety of corticotomy in accelerating orthodontic tooth movement.Methods According to the standardization of Cochrane Handbook,an electronic search was conducted by two reviewers.Clinical randomized controlled trials concerning the efficacy of corticotomy-accelerated orthodontic were searched in Cochrane,Pub Med,Embase.Literature search,screening,data extraction,and bias analysis was conducted independently by two investigators.Results 8 randomized controlled trials were included in a total of 166 patients.Except for one literature,the rest were obtained significant difference in the speed of tooth movement after the coticotomy.With regard to side-effects,no periodontal damage or root absorption were found.However,due to the different experimental methods,small sample sizes and lack of long-term observation of the shortcoming of the studies,the evidence regarding these conclusions is limited.Conclusion Based on the evidence available for low to moderate quality studies,corticotomy-accelertated orthodontic tooth movement is safe for oral tissues and to a certain extent,corticotomy can produce statistically and clinically meaningful increases in the rate of orthodontic tooth movement.