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Background Low-intensity electrical stimulation (LIES) is one of the recent physical techniques employed to accelerate orthodontic tooth movement and reduce treatment time. Objective This trial aimed to assess the effectiveness of the LIES technique in shortening the en-masse retraction time and evaluate skeletal, dental, or soft tissue changes on lateral cephalograms. Methods Young adult patients with a Class II division I malocclusion who visited the Department of Orthodontics at the University of Damascus Faculty of dentistry, between October 2022 and February 2023 and met specific inclusion criteria were included in this two parallel arms randomized controlled trial (RCT). The patients were randomly distributed into: the LIES group and the traditional en-masse retraction (TRAD) group. Computer-generated random numbers were used for the patient assignment. Blinding was performed only during data extraction and analysis. Mini-screws were used for anchorage during the en-masse retraction, and a force of 250 g was applied bilaterally with Nickel-Titanium springs. In the LIES group, each upper anterior tooth received a 15–20 µA electrical stimulation for five uninterrupted hours daily using an intraoral removable electrical stimulation device. The assessed outcomes were the required time for completing the en-masse retraction phase and the skeletal, dental, and soft tissue changes using lateral cephalograms at specific time points (T0: baseline; T1: before en-masse retraction; T2: end of en-masse retraction). Results Out of 127 patients were examined, 36 adult patients were enrolled and entered data analysis with a mean age of 20.91 ± 2.24 years. The en-masse retraction phase in the LIES group took a significantly shorter time than that in the TRAD group by a mean of 2.69 months ( P  < 0.001). Insignificant differences were observed between the two groups in almost all measured variables. In addition, a slight anterior rotation of the mandible was observed in both groups. A greater horizontal retraction of the apices of the upper incisors was seen in the LIES group compared to the TRAD group ( P  = 0.005). Conclusions The LIES shortened the required time for the en-masse retraction of the upper anterior teeth by approximately 30% compared to the traditional method. No significant differences between the two groups were observed in skeletal and soft tissue variables. However, a greater bodily movement of the upper incisors was noted in the LIES group. Registration This trial was retrospectively registered in the Clinical Trials database (ID: NCT06639204) and it was first posted on 15/10/2024.

Enhancement of orthodontic tooth movement (OTM) through local administration of biofunctional molecules has become increasingly significant, particularly for adult patients seeking esthetic and functional improvements. This comprehensive systematic review analyzes the efficacy of various biofunctional molecules in modulating OTM, focusing on the method of administration and its feasibility, especially considering the potential for topical application. A search across multiple databases yielded 36 original articles of experimental human and animal OTM models, which examined biofunctional molecules capable of interfering with the biochemical reactions that cause tooth movement during orthodontic therapy, accelerating the OTM rate through their influence on bone metabolism (Calcitriol, Prostaglandins, Recombinant human Relaxin, RANKL and RANKL expression plasmid, growth factors, PTH, osteocalcin, vitamin C and E, biocompatible reduced graphene oxide, exogenous thyroxine, sclerostin protein, a specific EP4 agonist (ONO-AE1-329), carrageenan, and herbal extracts). The results indicated a variable efficacy in accelerating OTM, with Calcitriol, Prostaglandins (PGE1 and PGE2), RANKL, growth factors, and PTH, among others, showing promising outcomes. PGE1, PGE2, and Calcitriol experiments had statistically significant outcomes in both human and animal studies and, while other molecules underwent only animal testing, they could be validated in the future for human use. Notably, only one of the animal studies explored topical administration, which also suggests a future research direction. This review concluded that while certain biofunctional molecules demonstrated potential for OTM enhancement, the evidence is not definitive. The development of suitable topical formulations for human use could offer a patient-friendly alternative to injections, emphasizing comfort and cost-effectiveness. Future research should focus on overcoming current methodological limitations and advancing translational research to confirm these biomolecules’ efficacy and safety in clinical orthodontic practice.

To investigate the effectiveness of AcceleDent Aura vibrating device on the rate of canine retraction. Thirty-two patients requiring extraction of upper first premolars and canine retraction were randomly allocated with a 1:1 ratio into either no-appliance group or the AcceleDent Aura appliance group. Canine retraction was done applying 150gm of retraction force using NiTi coil springs on 16 × 22 stainless steel archwires. The duration of the study was 4 months. Models were collected and digitized directly after extraction of upper first premolars and at monthly intervals during canine retraction for recording the monthly as well as the total distance moved by the canine. Digitized models were superimposed on the initial model and data were statistically analyzed. Anchorage loss, rotation, tipping, torque and root condition were evaluated using cone beam computed tomography imaging. Pain was evaluated by visual analog scale. No patients were dropped-out during this study. There was no statistically significant difference between both groups regarding the total distance travelled by the canine ( P  = 0.436), as well as the rate of canine retraction per month ( P  = 0.17). Root condition was the same for the two groups. Regarding the pain level, there was no statistically significant difference between the two groups at day 0 ( P  = 0.721), after 24 h ( P  = 0.882), after 72 h ( P  = 0.378) and after 7 days ( P  = 0.964). AcceleDent Aura was not able to accelerate orthodontic tooth movement. Pain level couldn’t be reduced by vibrational force with an AcceleDent device during orthodontic treatment. Root condition was not affected by the vibrational forces.

For a world that is constantly trying to speed up every procedure while obtaining the maximum result, traditional orthodontics have the biological limitation of using light and constant forces that allow tooth movement in a time frame that is only sometimes short. The treatment time could be lengthened if surgical procedures are programmed in the plan. Methods to accelerate tooth movement and reduce the duration of treatment while minimising complications are investigated and reported in the dental literature (e.g., low-level laser therapy, corticotomy, and micro-osteoperforations). This systematic review aims to analyse and summarise the strategies for quickening orthodontic movement during extraction orthodontic treatment, including any potential drawbacks or adverse consequences. The review will evaluate each approach’s effectiveness, safety, and evidence quality, compare their benefits and disadvantages, and analyse the implications for clinical practice and future research. Pubmed, Science Direct, Scopus, and Web of Science were searched using the keywords “acceleration” AND “dental movement” AND “orthodontic” between 1 April 2003 and 1 April 2023. After carefully scanning the study findings, forty-four publications were chosen for the systematic review. Most therapies discussed and provided in the literature seem promising and successful in enhancing orthodontic treatments. The success of operations like corticotomies, piezo-incisions, micro-osteoperforations, osteogenic distraction, low-level laser therapy, the administration of pharmacological treatments, and infiltrations with PRF and PRP were statistically significant and appear to be promising and effective in optimising orthodontic treatments. These strategies expedite treatment and enhance the patient experience, potentially broadening orthodontic appeal and minimising issues like cavities and enamel demineralisation. Further studies, with larger samples and standardised treatment protocols, are needed to investigate the efficacy of these tooth movement acceleration modalities.

A cumulative review with a systematic approach aimed to provide a comparison of studies’ investigating the possible impact of the active form of vitamin D3, calcitriol (CTL), on the tooth movement caused by orthodontic forces (OTM) by evaluating the quality of evidence, based on collating current data from animal model studies, in vivo cell culture studies, and human clinical trials. Methods: A strict systematic review protocol was applied following the application of the International Prospective Register of Systematic Reviews (PROSPERO). A structured search strategy, including main keywords, was defined during detailed search with the application of electronic database systems: Medline/Pubmed, EMBASE, Scopus, Web of Science, and PsycINFO. In addition, a search was carried out with the use of ClinicalTrials.gov search in order to include ongoing or recently completed trials. The Oxford Level of Evidence and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was utilized to critically evaluate the risk of bias and relative quality of studies included. Meta-analysis with the use of RevMan5 software, random effect, and inverted variable method allowed the quantification of cumulative results. Results: Twenty-seven studies were identified which fulfilled inclusion criteria, including two clinical studies. The assessed level of evidence was variable and inconsistent, predominantly being moderate or low due to a significant difference in study design, sample size, and study protocols. Data synthesis rendered from meta-analysis involving various CTL doses demonstrated slight discrepancies in tooth movement between control and experimental groups (mean difference = 0.27; 95% CI: 0.01–0.53, std mean difference = 0.49; 95% CI: 0.09–0.89), as well as relatively moderate heterogenicity. Conclusions: Although it has been suggested that CTL could accelerate OTM in animal studies and clinical context, these scarce data were supported by a low level of evidence and the studies were carried out using inadequate sample size. Well-powered RCT studies would help to overcome the lack of robustness of the research.

Background No randomized controlled trial (RCT) has studied the accuracy of surgical guides used in terms of orthodontic treatment acceleration. Therefore the aim of this trial was to assess computer-guided piezocision-based orthodontic. Materials and methods Thirty-two patients with severely crowded upper anterior teeth were enrolled and randomly allocated to either the experimental group (ExpG) or the control one. Subjects of the ExpG received three-dimensional (3D) guided piezoelectric corticotomies on the buccal alveolar bone of the anterior region. Five piezocision cuts were properly performed between each anterior teeth and the adjacent in virtual models. Surgical guides were designed and 3D-printed with preplanned slots that guide gingival and then piezoelectric incisions. The patients underwent Cone-Beam Computed Tomography CBCT before and immediately after surgery. Thus, Predesigned piezocisions were compared to the actual ones in attempt to measure three dimensional deviations of the applied peizocisions. Results Ninety-six severe maxillary dental crowding were assigned for eligibility, 40 of them met the inclusion criteria. Thirty-two participants were randomly allocated to the trial`s groups. No patient was lost to follow-up neither from the control nor the experimental group. Overall alignment time (OAT) was reduced by 53% in the experimental group compared to the control group. The mean of the 3D deviation of the surgical guide was 0.23 mm (standard deviation 0.19 mm). Conclusion The values of the surgical guide deviation was nearly null, which confirms that this innovative technique is clinically applicable. Furthermore, this technique was impressively effective in accelerating orthodontic tooth movement. Trial registration This trial was registered at The ISRCTN registry (ID: ISRCTN65498676 Registration date: 07/04/2021).

The acceleration of orthodontic tooth movement can be conducted by light-emitting diodes (LEDs) irradiation. The blue-LED provides a photobiomodulation effect by the absorption of photons by cytochrome c oxidase to increase the production of ATP for the metabolic processes of cells involved in bone remodeling. Increased osteoblast during bone formation will be accompanied by increased of alkaline phosphatase (ALP).Twenty-four Cavia cobayas were divided into 4 groups (group I non-irradiated, group II 25 seconds irradiation, group III 30 seconds, and group IV 35 seconds). The orthodontic force was applied to the inter incisor using open coil. The irradiated group was given blue-LED irradiation every day for 7 days. Gingival crevicular fluid was obtained using paper point to evaluate ALP levels on days 0, 3, and 7 using a spectrophotometer (405 nm). The data were statistically analyzed using Anova p<0.05.The results showed that ALP levels in the irradiated group was significantly different with the control. Group III has the highest ALP levels. The ALP levels of all groups increase from days 0, 3, and 7. The conclusion is 25, 30, and 35 seconds irradiation of blue-LED increase ALP levels of the GCF. Thirty seconds irradiation is the optimal time to increase ALP levels. The duration of irradiation from days 0, 3, and 7 increase ALP levels.Experimental article (J Int Dent Med Res 2020; 13(4): 1242-1247)

Background Piezocision is a minimally invasive surgical method aiming to accelerate tooth movement. However, its effect was found to be transient, appertaining to the regional acceleratory phenomenon (RAP). Hence, the aim of the study was to evaluate the effect of single and multiple piezocisions on the rate of orthodontic tooth movement (OTM). Moreover, the impact of both protocols on canine tipping and orthodontically induced inflammatory root resorption (OIIRR) has been assessed. Methods Thirty indicated patients for the therapeutic extraction of maxillary first premolars were enlisted in this split-mouth study, and they were randomly split into two equal groups, each including 15 subjects. In the Single Application Group (SAG), one side of the maxillary arch arbitrarily received a single piezocision before the onset of canine retraction, whereas in the Multiple Application Group (MAG), piezocisions were randomly performed on one side, three times on a monthly basis, over the 12-week study period. The contralateral sides of both groups served as the controls. Canine retraction was carried out bilaterally using nickel-titanium closed-coil springs, delivering 150 g of force, and the rate of tooth movement, as well as canine tipping were evaluated on a monthly basis, over a 3-month period. Cone-bean computed tomography scans were also conducted pre- and post- canine retraction, and OIIRR was assessed using Malmgren Index. Results The reported outcomes revealed a significant increase in the amount of canine retraction, canine tipping, as well as root resorption scores on the experimental sides in both groups SAG and MAG post-retraction ( p  < 0.001). However, upon comparing the experimental sides in both groups, non-significant differences have been observed between them regarding all the assessed outcomes ( p  > 0.05). Conclusions Single and multiple piezocisions effectively accelerate OTM in comparison to conventional orthodontic treatment, with relative outcomes reported by both intervention frequencies. Accordingly, single piezocision is recommended as an adjunct to OTM. Furthermore, significant tooth tipping as well as a significantly higher root resorption risk accompanies both single and multiple piezocision applications in conjunction with OTM. Name of the Registry Clinicaltrials.gov Trial Registration Number NCT05782088 Date of Registration 23/03/2023 “Retrospectively registered”. URL https://clinicaltrials.gov/ct2/show/NCT05782088

Background To evaluate the effectiveness of two minimally invasive surgical procedures in the acceleration of canine retraction: piezocision and laser-assisted flapless corticotomy (LAFC). Methods Trial design: A single-centre randomized controlled trial with a compound design (two-arm parallel-group design and a split-mouth design for each arm). Participants: 36 Class II division I patients (12 males, 24 females; age range: 15 to 27 years) requiring first upper premolars extraction followed by canine retraction. Interventions: piezocision group (PG; n  = 18) and laser-assisted flapless corticotomy group (LG; n  = 18). A split-mouth design was applied for each group where the flapless surgical intervention was randomly allocated to one side and the other side served as a control side. Outcomes: the rate of canine retraction (primary outcome), anchorage loss and canine rotation, which were assessed at 1, 2, 3 and 4 months following the onset of canine retraction. Also the duration of canine retraction was recorded. Random sequence: Computer-generated random numbers. Allocation concealment: sequentially numbered, opaque, sealed envelopes. Blinding: Single blinded (outcomes’ assessor). Results Seventeen patients in each group were enrolled in the statistical analysis. The rate of canine retraction was significantly greater in the experimental side than in the control side in both groups by two-fold in the first month and 1.5-fold in the second month ( p  < 0.001). Also the overall canine retraction duration was significantly reduced in the experimental side as compared with control side in both groups about 25% ( p  ≤ 0.001). There were no significant differences between the experimental and the control sides regarding loss of anchorage and upper canine rotation in both groups ( p  > 0.05). There were no significant differences between the two flapless techniques regarding the studied variables during all evaluation times ( p  > 0.05). Conclusions Piezocision and laser-assisted flapless corticotomy appeared to be effective treatment methods for accelerating canine retraction without any significant untoward effect on anchorage or canine rotation during rapid retraction. Trials registration ClinicalTrials.gov (Identifier: NCT02606331 ).

Background Accelerating orthodontic treatment is crucial in reducing complications such as root resorption, caries, and oral hygiene compromise, especially in adults. Piezocision and corticotomy are surgical techniques that accelerate tooth movement by causing bone remodelling. This study compares and evaluates changes in Interleukin-1β (IL-1β) levels in gingival crevicular fluid (GCF) following piezocision and corticotomy-facilitated orthodontics in adults. Aim To assess and compare IL-1β fluctuations in GCF of adult patients undergoing corticotomy and piezocision-assisted orthodontic treatment. Materials & methods This split-mouth study consisted of 16 adult patients (18–25 years) who needed premolar extractions. One half of the maxilla was randomly assigned for piezocision and the other half for corticotomy. GCF samples were taken from maxillary canines at varying time intervals: pre-treatment (T0), before surgery (T1), and 24 h (T2), 7 days (T3), and 21 days (T4) following surgery. IL-1β concentrations were quantified using an ELISA kit, and statistical analysis was done. Results IL-1β concentrations were highest at 24 h after surgery (T2) in both groups and decreased steadily by day 21 (T4), but were still elevated above pre-treatment levels. IL-1β concentrations were significantly greater in the piezocision group at all time points after surgery than in the corticotomy group ( p  < 0.001), reflecting a more intense inflammatory reaction and greater bone cell metabolism. Conclusion This study suggests that piezocision elicits a more intense biological response than corticotomy, as reflected by higher IL-1β levels in gingival crevicular fluid. While this may indicate a potential for enhanced bone remodelling and accelerated tooth movement, further research is needed to directly correlate cytokine expression with the rate of orthodontic tooth movement.