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Effect of piezocision on molar intrusion in open-bite treatment using a modified MEAW technique

Wirkung der Piezozision auf die Molarenintrusion bei der Behandlung eines offenen Bisses mittels einer modifizierten MEAW-Technik

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The aim of this retrospective study was to investigate whether a piezocision technique influences molar intrusion in open-bite cases.


In all, 30 patients with open-bite malocclusion were assigned to one of two groups: the piezocision group comprised 15 patients who were treated using curved arches and anterior elastics with the simultaneous combination of piezocision which was performed interdentally in the upper posterior region, while the control group comprised 15 patients who were treated with the same treatment mechanics without piezocision. In both groups, after leveling and aligning, upper 0.017 × 0.025 accentuated curve and lower 0.017 × 0.025 reversed curve of Spee NiTi archwires were placed. Anterior vertical elastics were applied between laterals and the canines on both sides. The effects of treatments were investigated on cone-beam computed tomography images acquired before use of elastics and after correction of open-bite.


Open-bite closure was achieved in 2.85 ± 0.85 and 4.1 ± 1.58 months in the piezocision and control groups, respectively, while total treatment lasted 1.4 ± 0.42 and 1.7 ± 0.43 years, respectively. Extrusion of lower posterior teeth (p < 0.05) was observed together with extrusion of incisors and canines (p < 0.001) in the piezocision group, while only incisors and canines were extruded in the control group (p < 0.001). There were no significant differences between the groups (p > 0.05) except significant lower incisor extrusion (p < 0.05) and counter-clockwise rotation of the lower occlusal plane in the piezocision group (p < 0.001).


The duration of open-bite correction was significantly shorter in the piezocision group. No molar intrusion was observed in either group. Open bite correction was achieved mainly by extrusion and retrusion of the incisors while maintaining upper molar positions.



Ziel dieser retrospektiven Studie war es, zu prüfen, ob eine Piezozisionstechnik die Molarenintrusion bei einem offenen Biss beeinflusst.


Insgesamt 30 Patienten mit einer offenen Bissfehlstellung wurden einer von 2 Gruppen zugeordnet: Die Piezozisionsgruppe umfasste 15 Patienten, die behandelt wurden mit gekrümmten Bögen und anterioren Elastics in Kombination mit gleichzeitiger Piezozision, die interdental im oberen Seitenzahnbereich durchgeführt wurde. Die Kontrollgruppe umfasste 15 Patienten, die mit der gleichen Behandlungsmechanik, aber ohne die Verwendung von Piezozision behandelt wurden. In beiden Gruppen wurden nach Nivellierung und Ausrichtung im Oberkiefer 0,017 × 0,025 akzentuierte NiTi-Spee-Bögen und im Unterkiefer 0,017 × 0,025 umgekehrte Spee-NiTi-Bögen platziert. Anteriore vertikale Elastics wurden zwischen den seitlichen Schneidezähnen und den Eckzähnen auf beiden Seiten angebracht. Die Auswirkungen der Behandlungen wurden auf DVT(digitale Volumentomographie)-Bildern untersucht, die vor dem Einsatz von Elastics und nach der Korrektur des offenen Bisses aufgenommen wurden.


Ein Verschluss des offenen Bisses wurde in 2,85 ± 0,85 Monaten in der Piezozisions- und nach bzw. 4,1 ± 1,58 Monaten in der Kontrollgruppe erreicht, wobei die Gesamtbehandlung 1,4 ± 0,42 bzw. 1,7 ± 0,43 Jahre dauerte. Die Extrusion der unteren Seitenzähne (p < 0,05) wurde zusammen mit der Extrusion der Schneide- und Eckzähne (p < 0,001) in der Piezozisionsgruppe beobachtet, während in der Kontrollgruppe nur die Schneide- und Eckzähne extrudiert wurden (p < 0,001). Es gab keine signifikanten Unterschiede zwischen den Gruppen (p > 0,05), mit Ausnahme der signifikanten Extrusion der unteren Schneidezähne (p < 0,05) und der Drehung der unteren Okklusionsebene gegen den Uhrzeigersinn in der Piezozisionsgruppe (p < 0,001).


Die Dauer der Korrektur des offenen Bisses war in der Piezozisionsgruppe signifikant kürzer. In beiden Gruppen wurde keine molare Intrusion beobachtet. Die Korrektur des offenen Bisses wurde hauptsächlich durch Extrusion und Retrusion der Schneidezähne unter Beibehaltung der oberen Molarenpositionen erreicht.

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Correspondence to Hanife Nuray Yilmaz DDS PhD.

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H.N. Yilmaz, E. Alakus, B. Erdem and N. Kucukkeles declare that they have no competing interests.

Ethical standards

For this article no studies with human participants or animals were performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Marmara University Ethics Committee (approval no. 2019-354). Written informed consent to participate was obtained from the patients or parents in case of minor. Written informed consent for publication was obtained from the patients or parents in case of minor.

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All data generated or analyzed during this study are included in the published article.

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Yilmaz, H.N., Alakus, E., Erdem, B. et al. Effect of piezocision on molar intrusion in open-bite treatment using a modified MEAW technique. J Orofac Orthop 82, 163–174 (2021).

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