Alqadasi Basema, Aldhorae Khalid, Halboub Esam, Mahgoub Nasrin, Alnasri Akram, Assiry Ali, Xia Hou Y
Department of Orthodontics, Hospital of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Department of Orthodontics, College of Dentistry, Thamar University, Thamar, Yemen.
J Int Soc Prev Community Dent. 2019 Oct 4;9(6):637-645. doi: 10.4103/jispcd.JISPCD_233_19. eCollection 2019 Nov-Dec.
A major challenge in orthodontics is decreasing treatment time without compromising treatment outcome. The purpose of this split-mouth trial was to evaluate micro-osteoperforations (MOPs) in accelerating orthodontic tooth movement.
Eight patients of both genders were selected, age ranging between 15 and 40 years, with Class II Division 1 malocclusion. The participants in this trial with MOPs were randomly allocated to either the right or the left side, distal to the maxillary canine. First maxillary premolars were extracted as part of the treatment plan on both sides and then canine retraction was applied. Miniscrews were used to support anchorage. MOP side received (three small perforations) placed on the buccal bone, distal to the maxillary canine, on randomly selected side using an automated mini-implant driver and the other side was the control side. Blinding was used at the data collection and analysis stages. The primary outcome was the rate of canine retraction measured with a three-dimensional (3D) digital model from the baseline to the first 2 weeks superimposed at the rugae area from the baseline to the first, second, and third months. The following secondary outcomes were examined: anchorage loss, canine tipping, canine rotation, root resorption, plaque index, and gingival index. Pain level, pain interference with the patients' daily life, patients' satisfaction with the procedure and degree of ease, willingness to repeat the procedure, and recommendation to others were also evaluated.
No statistically significant difference was observed in the rates of tooth movement between the MOP and the control sides at all-time points (first month: = 0.77; mean difference, 0.2 mm; 95% CI, -0.13, 0.18 mm; second month: = 0.50; mean difference, -0.08 mm; 95% CI, -0.33, 0.16 mm; third month: = 0.76; mean difference, -0.05 mm; 95% CI, -0.40, 0.29 mm). There were also no differences in anchorage loss, rotation, tipping, root resorption, plaque index, periodontal index, and pain perception between the MOP and control sides at any time point ( > 0.05). MOPs had no effect on the patients' daily life except for a feeling of swelling on the first day ( = 0.05). Level of satisfaction and degree of easiness of the procedure were high.
According to our clinical trial, MOPs cannot help in speeding up a canine retraction.
正畸治疗中的一个主要挑战是在不影响治疗效果的前提下缩短治疗时间。本双盲试验的目的是评估微骨穿孔（MOPs）对加速正畸牙齿移动的作用。
选取8例年龄在15至40岁之间的II类1分类错牙合患者，男女不限。本试验中接受MOPs治疗的参与者被随机分配到上颌尖牙远中的右侧或左侧。按照治疗计划，双侧均拔除第一前磨牙，然后进行尖牙后移。使用微型螺钉支抗。在随机选择的一侧，使用自动微型种植体驱动器在上颌尖牙远中的颊侧骨上进行MOPs（三个小穿孔），另一侧作为对照侧。在数据收集和分析阶段采用盲法。主要观察指标是通过三维（3D）数字模型测量从基线到第2周、从基线到第1、2、3个月在上颌皱襞区域叠加后的尖牙后移速率。还检查了以下次要观察指标：支抗丧失、尖牙倾斜、尖牙旋转、牙根吸收、菌斑指数和牙龈指数。还评估了疼痛程度、疼痛对患者日常生活的干扰、患者对该操作的满意度和舒适度、重复该操作的意愿以及向他人推荐的情况。
在所有时间点，MOPs侧与对照侧的牙齿移动速率均无统计学显著差异（第1个月：P = 0.77；平均差异，0.2 mm；95%可信区间，-0.13，0.18 mm；第2个月：P = 0.50；平均差异，-0.08 mm；95%可信区间，-0.33，0.16 mm；第3个月：P = 0.76；平均差异，-0.05 mm；95%可信区间，-0.40，0.29 mm）。在任何时间点，MOPs侧与对照侧在支抗丧失、旋转、倾斜、牙根吸收、菌斑指数、牙周指数和疼痛感知方面也无差异（P > 0.05）。除了第一天有肿胀感外，MOPs对患者的日常生活没有影响（P = 0.05）。患者对该操作的满意度和舒适度较高。
根据我们的临床试验，MOPs无助于加速尖牙后移进程。
