Accelerated Orthodontic Tooth Movement in Adult Patients by Micro-perforations of Cortical Bone

Abstract

Introduction: The objective of this study was to determine whether micro-osteoperforation of the cortical bone produces accelerated tooth movement during space closure in adult patients. Methods: Ten healthy adult patients, ages 18 to 44 years old with a malocclusion requiring maxillary first premolar extractions participated in this split-mouth study. Temporary Anchorage Devices (TADs) were placed bilaterally for anchorage control in the maxilla. Micro-osteoperforations were performed unilaterally apical to the extractions site and maxillary canines were distalized using sliding mechanics. Canine retraction rate was measured using: (1) Cone Beam Computed Tomography (CBCT) and (2) Digital models taken before canine distalization at the initiation of the study (T0) and three months later (T2). Results: Each of the research subjects showed varied amount of canine retraction into the extraction space. For the two measurements performed on the initial and final CBCTs, the mean of all patient measurements on the experimental side was 0.44mm less than control for "TAD-U3D" and 0.30mm greater than control for "U5M-U3D". For the four measurements performed on the initial and final digital models, the mean of all patient measurements on the experimental side was 0.14mm greater than control for "U3 Cusp Tip- U5 Cusp Tip", 0.24mm less than control for "U5M-U3D", 0.24mm greater than control for "U2 Midpoint- U3 Cusp Tip", and 0.18mm greater than control for "U6 MP Cusp Tip- U3 Cusp Tip". Statistical analysis showed that the amount of canine retraction on the experimental side was not significant when compared with the control side for any of the six measured variables (P>0.05). Conclusion: Our results indicate that 50% of subjects showed faster canine retraction rate on the experimental side when compared to control, however, this difference was not statistically significant. Further studies are necessary to evaluate the effects of micro-osteoperforations on the rate of tooth movement in the orthodontic treatment of adult patients.