Evaluation of the Efficacy of 3D-guided Piezosurgery in Accelerating Mandibular Orthodontic Teeth Alignment: A Randomized Controlled Trial in Adults.

Abstract

Objective: the aim of this study was to investigate the effects of 3D guided piezocision (a minimally invasive surgical technique) in accelerating orthodontic tooth movements (OTM) since the literature does not provide high-quality evidence to confirm that Piezocision results in significant OTM acceleration. Furthermore, no randomized controlled trial (RCT) has utilized 3D piezo-surgical guides to accelerate severe orthodontic de-crowding.Study design: A Parallel-group randomized controlled trial was conducted on patients with severe mandibular teeth irregularity. Sample size was 34 patients (19 females and 15 males), then subjects were divided into two parallel groups using Minitab® Version 17 software. First group received conventional orthodontic treatment, whereas the second group received 3D- guided piezo-assisted orthodontic one. Little irregularity index (LII) changes were studied using dental cast in four time points before inserting the first archwire (T0), after 1 month of treatment onset  (T1), after 2 months (T2), and at the end of the alignment stage (T3) and the overall alignment time (OAT) required to complete anterior alignment of the mandibular arch was also measured.Results: Ninety-five severe dental crowding patients were evaluated for eligibility, 46 of them fulfilled the inclusion criteria. Thirty-four participants were allocated to the treatment groups randomly. There were no withdrawals during the trial phases. Accordingly, the results of 34 patients were statistically analyzed. OAT was reduced by 48% in the experimental group compared to the control group, with a statistically significant difference between the two groups . Likewise, the time difference between all arch changes was significantly lower when 3D guided piezocision was performed, except for the first arch (T0) and the last arches (T3).Conclusion: Minimally invasive 3D guided Piezocision seems to be a very effective and easy technique in accelerating orthodontic tooth movement.