Manipal University College Malaysia, Jalan Batu Hampar, Bukit Baru, 75150, Melaka, Malaysia.
Orthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.
Sci Rep. 2022 Apr 14;12(1):6230. doi: 10.1038/s41598-022-09851-0.
This clinical trial compared the time to complete the levelling and alignment stage with flapless piezocision procedure in the treatment of severe maxillary malocclusion with premolar extraction cases. Two-arm parallel group randomized controlled trial was performed at the Orthodontics Unit of Universiti Sains Malaysia, Malaysia. Sixteen patients with severe anterior maxillary crowding (Little's irregularity index: 7-9 mm) and required bilateral first premolars extraction was recruited. The participants were randomly assigned to a study group according to a simple randomization method using a sealed envelope mentioned about the group name. Both groups were treated with fixed orthodontic appliance using the 0.022-in. slot of McLaughlin Bennett Trevisi prescription brackets. The piezocision group received flapless piezocision corticotomy about 4-5 mm in length and 3 mm depth on the labial mucogingiva between the roots of six anterior teeth. The number of days since treatment started, Little's irregularity index, gingival recession, pocket depth, pulp vitality, patient perception of the pain and satisfaction level were recorded before the treatment, at about 1 month and 2 months post-treatment, and at the completion of the levelling and alignment stage. The overall time to complete levelling and alignment stage was significantly shorter in the piezocision group than the control group (mean difference = 31.5 days, 95% CI 6.5, 56.5; p = 0.018). Greater reduction in Little's irregularity index and faster alignment rate in the first 2 months were found in the piezocision group compared to the control group (p < 0.05). No changes in the gingival recession, pocket depth, and pulp vitality in both groups were observed. Patients who received piezocision surgery experienced no or mild pain and were satisfied with the treatment. Flapless piezocision corticotomy is an effective adjunct that shortens treatment time during levelling and alignment stage without any adverse effects on the teeth and surrounding tissues. It is also painless, acceptable and satisfactory to the patients.Trial registration: ACTRN12621001350819.
这项临床试验比较了无瓣超声骨刀去骨劈开术与传统有瓣去骨劈开术在治疗伴有前磨牙拔除的严重上颌前突畸形中的整平阶段时间。该研究在马来西亚理科大学正畸科进行了一项双臂平行组随机对照试验。共招募了 16 名患有严重上前牙拥挤（Little 不调指数：7-9mm）并需要双侧第一前磨牙拔除的患者。采用信封随机分组方法将患者随机分为研究组和对照组。两组均采用 0.022 英寸槽的 McLaughlin Bennett Trevisi 方丝弓托槽固定矫治器治疗。超声骨刀组在上颌六前牙唇侧龈颊沟内行无瓣超声骨刀皮质切开术，长度约 4-5mm，深度 3mm。记录治疗开始后的天数、Little 不调指数、牙龈退缩、牙周袋深度、牙髓活力、患者疼痛感知和满意度，以及治疗后约 1 个月和 2 个月、整平阶段完成时。与对照组相比，超声骨刀组完成整平阶段的总时间明显更短（平均差值=31.5 天，95%CI6.5，56.5；p=0.018）。与对照组相比，超声骨刀组在前 2 个月的 Little 不调指数减小更多，排齐速度更快（p<0.05）。两组的牙龈退缩、牙周袋深度和牙髓活力均无变化。接受超声骨刀手术的患者无或轻度疼痛，对治疗满意。无瓣超声骨刀皮质切开术是一种有效的辅助手段，可缩短整平阶段的治疗时间，且对牙齿和周围组织无不良影响。它还无痛、可接受且令患者满意。试验注册：ACTRN12621001350819。
