Mini-implant supported canine retraction with micro-osteoperforation: A split-mouth randomized clinical trial.
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ABSTRACT: Objectives
To investigate, using a split-mouth randomized clinical design, the effect of micro-osteoperforation (MOP) on mini-implant supported canine retraction using fixed appliances.Materials and methods
Thirty subjects (seven males and 23 females) with a mean age of 22.2 (3.72) years were randomized into three canine retraction groups: Group 1 (MOP 4-weekly maxilla/8-weekly mandible; n = 10); Group 2 (MOP 8-weekly maxilla/12-weekly mandible; n = 10) and Group 3 (MOP 12-weekly maxilla/4-weekly mandible; n = 10) measured at 4-week intervals over 16 weeks. Subjects also completed pain (5-point Likert scale) and pain impact (Visual Analogue Scale) questionnaires. The primary outcome was the amount of canine retraction over 16 weeks at MOP (experimental) and non-MOP (control) sites.Results
Mean overall canine retraction was 4.16 (1.62) mm with MOP and 3.06 (1.64) mm without. After adjusting for differences between jaws, all MOP groups exhibited significantly higher canine distalization than the control group: 0.89 mm more (95% confidence interval [CI] = 0.19 to 1.59 mm; P = .01) in the MOP-4 group, 1.08 mm more (95% CI = 0.49 to 1.68 mm; P = .001) in the MOP-8 group and 1.33 mm more (95% CI = 0.55 to 2.10 mm; P = .002) in the MOP-12 group. All subjects reported pain associated with MOP with 60% classifying it as moderate and 15% severe. The main impact of this reported pain was related to chewing and speech.Conclusions
MOP can increase overall mini-implant supported canine retraction over a 16-week period of observation but this difference is unlikely to be clinically significant.
SUBMITTER: Sivarajan S
PROVIDER: S-EPMC8120871 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundAmong 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.MethodsEighteen 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.ResultsThe 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.ConclusionsMicro-osteoperforations were not able to accelerate the rate of canine retraction; however, it seemed to facilitate root movement.
| S-EPMC6545296 | biostudies-literature
Project description:OBJECTIVE:The present study aimed to evaluate the effect of MOP over a 3-month period and to determine the influence of the number of perforations on the rate of canine retraction. In addition, the amount of pain and discomfort caused by the MOP method was evaluated. TRIAL DESIGN:A single-center, split-mouth, triple-blind, randomized, controlled trial was conducted. METHODS:The clinical trial was conducted from December 2018 to July 2019 in the Orthodontic Clinic, Shiraz Dental School. Twenty-eight patients (range from16.3 to 35.2?years) who need fixed orthodontic treatment were recruited and randomly assigned to MOP1 and MOP2 groups. In each patient one side of the mouth worked as a control side which received no MOPs. Four?months after first premolars extraction, patients in MOP1 group received 3 MOPs on the buccal surface of alveolar bone in the experimental side to accelerate canine retraction whereas patients in MOP2 group received 3 buccal MOPs and 3 palatal MOPs in the experimental side. The amount of canine retraction was measured every 28?days at three intervals on both sides of the mouth. Pain perception was also measured on the day of MOP procedure and subsequently at 24?h. Randomization was performed using online software RANDOM.ORG; the recruited patients were divided into two parallel groups with a 1:1 allocation ratio then the side of MOPs intervention in each subject was randomly determined with coin tossing. Triple blinding design was employed. RESULTS:The result of the intra-examiner reliability using ICC was 0.97 (P <? 0.001), indicating excellent repeatability and reliability of the measurements. The baseline characteristics between the groups were similar (P >?0.05). There was a significant difference in the rate of canine retraction between the MOP groups and the contralateral control sides, as well as between the MOP1 and MOP2 groups (P <? 0.05). CONCLUSION:The MOP procedure was effective in accelerating orthodontic tooth movement, although the amount of acceleration was not clinically significant in the case of canine retraction. An increase in the number of MOPs resulted in a significant acceleration of the canine retraction. TRIAL REGISTRATION:The trial was registered 30 November 2018 at the Iranian Registry of Clinical Trials (IRCT20181121041713N1).
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Project description:IntroductionIn the majority of orthodontic premolar extraction cases, the canine retraction phase is the most laborious procedure. This randomized clinical trial aimed to assess the effect of single versus repeated micro-osteoperforations (MOPs) during orthodontic canine retraction.MethodsIn this split-mouth study, two equal groups of 18 patients who required maxillary first premolar extractions and fixed orthodontic therapy were randomly assigned (n=9). In Group I, MOPs were only performed once on one site before retraction, whereas in Group II, MOPs were performed on one site repeatedly once a month for four months. In both groups, the contralateral control sites received no MOPs. The canines were retracted using mini-screws and closed-coil nickel-titanium springs. Using the patients' 3D models, the primary outcome measure at four months was the amount of orthodontic canine distal movement. The amount of anchorage loss (AL), degree of molar rotation (MR) and canine rotation (CR), and degree of canine tipping (CT) were measured as the secondary outcomes. The comparison of mean changes in the primary and secondary outcomes between the groups was done using the independent sample t-test (p<0.05).ResultsThe rate of canine retraction, degree of CT, and rotation were not significantly different between the two groups (p>0.05). Additionally, there were no statistically significant variations in the maxillary first MR and the degree of AL (p>0.05).ConclusionsWhen maxillary canine retraction was performed with a single and repeated regimen of MOPs, comparable levels of distal CR and tipping were observed, along with an identical minimal degree of MR and AL.
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Project description:The study aimed to clinically estimate an influence of a 635 nm diode laser on the stability of orthodontic mini-implants, to assess mini-implants loss, and to evaluate a pain level after the treatment. The randomized clinical split-mouth trial included 20 subjects (13 women and 7 men; age: 32.5 ± 6.1 years), 40 implants (RMO, West Colfax Ave., Denver, CO, USA) with a diameter 1.4 mm and length of 10 mm. Mini-implants were placed in the area of the attached gingiva between the second premolar and first molar teeth, 2 mm below the mucogingival junction of both sides of the maxilla. Each implant on the right side (G1, n = 20) of the maxilla was irradiated with a diode laser, and the implants on the opposite side (left, G2, n = 20) were a control group (without laser irradiation). The 635-nm laser parameters; dose: 10 J per point (20 J/cm2), time: 100 s per point, two points (irradiation on a buccal, and a palatal side of the alveolus/implant), the total energy per session 20 J. Laser application protocol: immediately and 3, 6, 9, 12, 15, and 30 days after surgery. The total energy after all therapeutic sessions was 140 J. The implants' stability was measured employing a Periotest device (Periotest Test Value-PTV) immediately and 3, 6, 9, 12, 15, 30, and 60 days after the insertion of the mini-implants. We found significantly higher secondary stability, lower mean PTV (6.18 ± 5.30) and (1.51 ± 2.25), for self-drilling mini-implants (G1, test group) in contrast to the control, G2 group (9.17 ± 8.25) and (5.00 ± 3.24), after 30 (p = 0.0003) and 60 days (p = 0.0000). Moreover, the analysis of the mini-implants stability after 635-nm diode laser application revealed significant higher stability in comparison with none irradiated implants (G2 group) after 3 days. (p = 0.0000) There was no significant difference in pain level measured on the NRS-11 scale on both sides of the maxilla. (p = 0.3665) An important finding was that all inserted mini-implants survived during a two-month observation period. 635-nm diode laser at laser irradiation increases the secondary stability of orthodontic mini-implants.
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Project description:The purpose of this study was (1) to investigate denture satisfaction following the conversion of existing mandibular complete dentures to implant overdentures (IOD) in very old edentulous patients who depend on help for activities of daily living and (2) to evaluate secondary end points, such as functional, structural, nutritional, and patient-centered aspects. For this randomized clinical trial, 2 interforaminal short implants were placed in the intervention group (n = 16, 85.0 ± 6.19 yrs) to retain mandibular IODs; the control group (n = 18, 84.1 ± 5.55 yrs) received conventional relines. During the first year, no implant was lost; however, 2 patients died. IODs proved more stable, and participants in the intervention group demonstrated significantly higher denture satisfaction as well as an increased oral health-related quality of life compared to the control group. Maximum voluntary bite force improved significantly with IODs, yet the chewing efficiency was not different between groups. Masseter muscle thickness increased with IODs, mainly on the preferred chewing side. Body mass index decreased in both groups, but the decline tended to be smaller in the intervention group; blood markers and the Mini Nutritional Assessment did not confirm this tendency. These results indicate that edentulous patients who depend on help for activities of daily living may benefit from IODs even late in life.
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Project description:Objective To compare early implant failure and implant stability of one-stage Hiossen ET III implants with its new hydrophilic (NH) surface, compared with Hiossen ET III implants with the sandblasted and acid-etched (SA) surface at 1-year follow-up.Materials and methods This study was designed as a split-mouth, multicenter randomized controlled trial aimed to compare SA surface implants (SA group) and NH surface, (NH group). Outcomes were implant and prosthetic survival rates, complications, the insertion torque at implant placement, and implant stability quotient (ISQ) values.Results Twenty-nine patients (mean age 59.9 ± 11.3 years) were treated and followed up to 1 year after loading. No patient dropped out. Fifty-eight implants (29 SA group and 29 NH group) were placed. No implants or prostheses failed and no complications were experienced during follow-up. The mean insertion torque was 40.5 ± 3.23 (38.17-41.83) Ncm in the SA group and 40.48 ± 3.49 (38.02-41.98) Ncm in the NH group (p = 0.981). There was a statistically significant difference at the second week (T2) with higher values in the NH group (p = 0.041). Similar results were found in the maxilla (p = 0.045), but not in the mandible (p = 0.362). A positive correlation was found between initial insertion torque and ISQ with higher value in the NH group (0.73 vs. 0.66).Conclusions NH implants are a viable alternative to SA surface, as they seem to avoid the ISQ drop during the bone remodeling phase.
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Project description:Background Many patients suffer from some degree of pain following the surgical procedures of dental implantation. The fear of pain may be one reason for postponing such prosthodontic treatments. Many procedures have been suggested to control post-implantation pain. This trial evaluated the effectiveness of using hyaluronic acid (HA) during dental implantation on patients' perceived pain during the postsurgical soft-tissue healing period. Methodology A split-mouth randomized controlled trial (RCT) was conducted. The trial sample consisted of 22 dental implants in 11 patients (five males and six females). Patients were selected from those attending the Department of Oral Medicine at the Faculty of Dentistry, University of Damascus between February 2021 and May 2022. The implants were performed in similar bone quality and density for each patient as the implants were inserted in the same jaw on both sides to ensure the same physiological conditions. The study sample was divided into two groups. The first group (the experimental group) consisted of 11 implants in which the implant site was drilled, following which HA was placed inside the implant site and on the surrounding bone before the flap was returned and sutured. The second group (the control group) comprised 11 implants following the conventional procedure without applying any material to the implant socket. The main outcome measure was pain perception which was assessed using the visual analog scale (VAS). Patients were asked to record their perceived pain on the first, third, and tenth days. Two-sample t-tests were used to detect significant differences. Results There were statistically significant differences in the mean pain intensity between the experimental and control groups on the first, third, and tenth days (p < 0.05). The mean values of perceived pain in the control group were 5.68, 1.72, and 0.56 on the first, third, and tenth days, respectively. In comparison, the mean values of perceived pain in the experimental group were 4.52, 1.14, and 0.18 on the first, third, and tenth days, respectively. The maximum perceived pain in the control group was 7.5 on the first day following implantation, whereas the maximum value recorded in the experimental group was 6.5. At the third assessment time (i.e., 10 days following the surgical intervention), the mean values were in the very mild category of pain intensity. Conclusions This study showed that applying HA in the implant cavity and on the surrounding bone effectively reduced pain after dental implant surgery in comparison with the control group. Patients had lower mean pain scores at one, three, and ten days following surgery compared to the conventional method. HA is suggested to be an adjunctive method to control postsurgical pain after dental implantation.
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Project description:BackgroundPrevious studies have assessed different aspects concerning the applications of i-PRF in the oral cavity. However, nothing is known regarding patients' perceptions of the injection of autologous platelet-rich fibrin (i-PRF).ObjectivesTo investigate patients' perceptions after injecting platelet-rich fibrin (i-PRF) in the course of retracting upper canines.MethodsTwenty-one patients, whose treatments required extractions of both upper first premolars, were recruited. Extraction side was randomly allocated to the intervention or control sides. After the alignment phase, i-PRF was injected twice with a one-month interval on the buccal and palatal aspects of the extraction sites (intervention side). Patients' perceptions were evaluated with two questionnaires: the first was used to assess the level of pain, discomfort, swelling, eating and swallowing difficulties as well as jaw movement restriction after 1 h (T1), 2 h (T2), 6 h (T3), 24 h (T4) and 48 h (T5) of the second injection; the second questionnaire was used to assess the acceptance of the i-PRF injection and overall satisfaction with this technique at the end of canine retraction phase. Visual Analogue Scale (VAS) was adopted for this purpose. Wilcoxon Signed Rank Test was used to compare between both sides at all time points while Friedman's Test was the selected test for detecting variables' changes over time. Post-hoc Wilcoxon Matched-Pairs Signed-Rank Tests were applied when any of the results were significant. As to the multiplicity of tests, Bonferroni Correction was implemented.ResultsPain and swelling levels were significantly higher on the experimental compared to the control sides at T1, T2, and T3 (P < 0.05), whereas they declined sharply and went back to almost normal values at T4 (after 24 h). At T5 they were 0. Discomfort and difficulty in mastication on intervention sides were significant only at T1 and T2. Pain, swelling, and chewing difficulties were significant (P < 0.001) during the 4 assessed time points. The increase was insignificant regarding swallowing difficulties and jaw movement limitations at all time intervals.ConclusionsInjecting autologous (i-PRF) during orthodontic canine retraction is a well-perceived and well-tolerated method due to the limited discomfort which significantly diminishes 24 h afterwards.Trial's registrationClinicalTrials.gov (Identifier Number: NCT03399422. 16/01/2018).
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Project description:The effectiveness of adjunctive photodynamic treatment (PDT) to non-surgical periodontal therapy has been shown to depend on initial periodontal status. As molar furcation involvement impairs healing response to non-surgical periodontal therapy, the aim of this study was to evaluate the impact of furcation involvement on PDT outcomes. Thirty-six patients suffering from severe chronic periodontitis were included in a 6-month split-mouth randomized clinical trial. PDT applications used the toluidine blue O and a light-emitting diode (LED) with a red spectrum. Repeated PDT applications were performed in addition to non-surgical periodontal treatment at baseline and at 3-months. Pocket probing depth (PPD), plaque index, bleeding on probing, and clinical attachment level were recorded at baseline, and again at 3- and 6-months. Furcation sites of molars were compared to other sites of molars and non-molars. Multilevel analysis showed no PDT effect in molar furcation sites while an additional significant reduction (odds ratio = 0.67) of pockets with PPD > 5 mm in other sites at 3-months was measured. PPD reduction appeared delayed in molar furcation sites treated with PDT. There is no additional apparent benefit to use PDT in molar furcation sites for the reduction of pockets with PPD > 5 mm contrary to other sites.
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Project description:Aim:To compare implant survival rate and marginal bone loss (MBL) of immediately loaded single implants inserted by using ultrasonic implant site preparation (UISP) (test) and conventional rotary instrumentation (control). Methods:Two single implants were inserted for each patient: after randomization, test site was prepared by using an ultrasonic device (Piezosurgery Touch, Mectron, Italy) and control site was prepared by using the drills of the selected implant system (Premium AZT, Sweden & Martina, Italy), until reaching a final diameter of 3?mm in both groups. Identical implants (3.8x11.5?mm) were inserted in all sites at crestal level. Impressions were taken and screwed resin single crowns with platform-switched provisional abutments were delivered with 48 hours. Periapical radiographs were taken at provisional crown insertion (T0), 6 months (T1) and one year (T2) after prosthetic loading to measure MBL. All data were tested for normality and subsequently analyzed by paired samples t-test and forward multiple linear regression. Results:Forty-eight patients were treated in six centers with the insertion of ninety-six implants (48 test; 48 control). Four implants in four patients failed within the first six months of healing (two in test group; two in control group; no difference between groups). Forty patients (age 60.1±10.7 years; 22 female, 18 male) were included in the final analysis. Mean MBL after six months of loading was 1.39±1.03?mm in the test group and 1.42±1.16?mm in the control group (p>0.05) and after one year was 1.92±1.14?mm and 2.14±1.55?mm in test and control, respectively (p>0.05). Conclusions:No differences in survival rate and MBL were demonstrated between UISP and conventional site preparation with rotary instruments in immediately loaded dental implants: UISP, with its characteristics of enhanced surgical control and safety in proximity of delicate structures, may be used as a reliable alternative to the traditional drilling systems.
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