Comparison of efficacy between micro-osteoperforations and alveolar corticotomies on the rate of orthodontic tooth movement: A systematic review and meta-analysis.

Abstract

Micro-osteoperforations and corticotomies are two surgical techniques commonly used to increase the rate of tooth movement. The aim of this systematic review was to respond to the question: Which method used for accelerating orthodontic tooth movement, micro-osteoperforations or alveolar corticotomy, produces a higher rate of tooth movement and present less adverse effects? Searches were performed in the electronic databases of PubMed, Scopus, Cochrane CENTRAL, Web of Science, Lilacs and Science Direct, as well as grey literature (Opengrey), up to March 2024. All the included studies were controlled, randomized clinical trials, cohort, case-control, cross-sectional, and multicentre studies of patients treated with orthodontics and corticotomies or micro-osteoperforations. Cochrane Collaboration risk of bias tool was used for quality assessment. For the quantitative analysis, studies were analyzed with a mixed-effect (random effect) meta-regresion model, with beta coefficients and R2 values, with I2 index and with Q and Egger tests. 31 articles were included for the qualitative analysis and 17 for the quantitative analysis. The rate of tooth movement of the corticotomy was 0.539 mm per month (CI95%: 0.117,0.961) higher than with micro-osteoperforations, being the values statistically significant (p = 0.012) but in a context of strong heterogeneity (89.6%). Adverse effects such as pain, quality of life impact and swelling were reported to be longer and harder after corticotomies. After corticotomy a greater rate of tooth movement has been observed during canine retraction compared to micro-osteoperforations. However, more well-designed randomized clinical trials directly comparing both techniques are needed. REGISTRATION NUMBER: CRD42020156448.