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Effects of micro-osteoperforations on intraoral miniscrew anchored maxillary molar distalization

A randomized clinical trial

Effekte von Mikroosteoperforationen auf die minischraubenunterstützte molare Distalisierung im Oberkiefer

Eine randomisierte klinische Studie

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie volume 81, pages 126–141 (2020)Cite this article

Abstract

Purpose

The aim was to study the effects of micro-osteoperforations (MOPs) on miniscrew-supported maxillary molar distalization.

Methods

As part of a single center, split-mouth, randomized clinical trial, 20 eligible subjects were randomly recruited from patients who had applied to the orthodontics department of a university dental hospital. In the experimental group, subjects were randomized to receive MOPs to either the left or right maxillary molar region (n = 10). The control group (n = 10) and the contralateral sides of the experimental group (n = 10) did not receive any MOPs. In both groups, distalization of the maxillary molars was performed by miniscrew-supported distalization appliances. Using 3D models, maxillary molar distalization at 3, 6, 9, and 12 weeks was measured. Pain, discomfort, eating difficulty, and speech problem levels were assessed using a visual analog scale (VAS 0–10). Periodontal evaluations were performed.

Results

In all, 18 subjects completed the study. The mean amount of tooth movement was significantly greater on the MOP side compared to contralateral side of the experimental group at all time points. After 12 weeks, the maxillary molars on the MOP side moved 1.17-fold more than those on the contralateral side. No significant differences were found regarding amount of tooth movement between the control group and the MOP and contralateral sides of the experimental group. The rates of tooth movement in the MOP sides of the experimental group, contralateral sides of the experimental group, and the control group were 0.029, 0.025, and 0.028 mm/day, respectively. Pain VAS scores after intervention were significantly increased on the MOP side compared with the contralateral side of the experimental group but not at any other time point. No differences in periodontal scores between the groups were observed.

Conclusions

A 1.17-fold increase in the rate of tooth movement in the MOP group compared with the contralateral side was recorded. However the accelerating effect of MOPs was lower than expected. The mean pain level was statistically greater in the MOP group compared to the contralateral side only on the first day of application.

Zusammenfassung

Zielsetzung

Ziel war es, die Auswirkungen von Mikroosteoperforationen (MOPs) auf die mit Minischrauben unterstützte Molarendistalisierung im Oberkiefer zu untersuchen.

Methoden

Im Rahmen einer randomisierten klinischen Split-mouth‑, Single-center-Studie wurden 20 geeignete Probanden zufällig aus den Patienten rekrutiert, die sich an der kieferorthopädischen Abteilung einer Universitätszahnklinik vorgestellt hatten. In der Versuchsgruppe erhielten die Probanden MOPs, randomisiert entweder in der linken oder der rechten oberen Molarenregion (n = 10). Die Kontrollgruppe (n = 10) und die kontralateralen Seiten der Versuchsgruppe (n = 10) erhielten keine MOPs. In beiden Gruppen wurde die Distalisierung der Oberkiefermolaren mit Hilfe von minischraubengestützten Distalisierungsgeräten durchgeführt. Anhand von 3‑D-Modellen wurde die maxilläre Molarendistalisierung nach 3, 6, 9 und 12 Wochen gemessen. Schmerz, Beschwerden, Ess- und Sprechstörungen wurden unter Verwendung einer visuellen Analogskala (VAS 0-10) erfasst. Es wurden Zahnfleischuntersuchungen durchgeführt.

Ergebnisse

Insgesamt haben 18 Probanden die Studie abgeschlossen. Der mittlere Betrag der Zahnbewegung war zu allen Zeitpunkten auf der MOP-Seite signifikant höher als auf der kontralateralen Seite der Versuchsgruppe. Nach 12 Wochen hatten sich die Oberkiefermolaren auf der MOP-Seite 1,17-mal mehr bewegt als die auf der kontralateralen Seite. Es wurden keine signifikanten Unterschiede bezüglich des Ausmaßes der Zahnbewegung zwischen der Kontrollgruppe und der MOP sowie den kontralateralen Seiten der Versuchsgruppe festgestellt. Die Zahnbewegungen in der MOP-Gruppe, den kontralateralen Seiten der Versuchsgruppe und der Kontrollgruppe lagen jeweils bei 0,029, 0,025 und 0,028 mm/Tag. Die Schmerz-VAS-Werte waren auf der MOP-Seite im Vergleich zur kontralateralen Seite der Versuchsgruppe postinterventionell signifikant erhöht, jedoch zu keinem anderen Zeitpunkt. Zwischen den Gruppen wurden keine Unterschiede in den Parodontalwerten beobachtet.

Schlussfolgerungen

Es wurde ein 1,17-facher Zuwachs der Geschwindigkeit der Zahnbewegung in der MOP-Gruppe im Vergleich zur kontralateralen Seite festgestellt. Die beschleunigende Wirkung der MOPs war jedoch geringer als erwartet. Das mittlere Schmerzniveau war in der MOP-Gruppe statistisch höher als auf der kontralateralen Seite nur am ersten Tag der Anwendung.

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Funding

This study was funded by the Near East University Scientific Research Projects Coordination Unit (SAG-2016-2-028).

Author information

Authors and Affiliations

  1. Department of Orthodontics, School of Dentistry, Near East University, Nicosia, Northern Cyprus

    Kemal Gulduren DDS & Ulas Oz

  2. Department of Periodontology, School of Dentistry, Near East University, Nicosia, Northern Cyprus

    Hayriye Tumer

Authors
  1. Kemal Gulduren DDS
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  2. Hayriye Tumer
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  3. Ulas Oz
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Corresponding author

Correspondence to Kemal Gulduren DDS.

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Conflict of interest

K. Gulduren, H. Tumer and U. Oz declare that they have no competing interests.

Ethical standards

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee (Near East University Ethics Review Board—YDU/2017/43-358) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Gulduren, K., Tumer, H. & Oz, U. Effects of micro-osteoperforations on intraoral miniscrew anchored maxillary molar distalization. J Orofac Orthop 81, 126–141 (2020). https://doi.org/10.1007/s00056-019-00207-4

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  • DOI: https://doi.org/10.1007/s00056-019-00207-4

Keywords

  • Adults
  • Accelerated tooth movement
  • Tooth distalization
  • Humans
  • Treatment outcome

Schlüsselwörter

  • Erwachsene
  • Beschleunigte Zahnbewegung
  • Zahndistalisierung
  • Menschen
  • Behandlungsergebnis