Patient-reported outcomes measures (PROMs) following a piezocision-assisted versus conventional orthodontic treatments: a randomized controlled trial in adults

Abstract

Objective

To explore patient-related outcomes measures (PROMs) of piezocision-assisted orthodontic treatment compared to a conventional orthodontic treatment using customized appliance.

Materials and methods

Twenty-four adult patients requiring orthodontic treatment for mild-to-moderate overcrowding in both jaws were randomly assigned to a test group, treated with a piezocision-assisted orthodontic treatment, or to a control group, where piezocision was not applied. The patient-related outcomes were recorded using a 0–10 visual analog scale (VAS). Daily analgesic consumption and pain level were also recorded following the placement of the orthodontic appliance in both groups and after the piezocision procedure in the test group. Moreover, levels of apprehension and satisfaction were also assessed in both groups.

Results

In the piezocision group, over the 7-day period, paracetamol consumption was comparable after the placement of the orthodontic appliance and after the piezocision surgery. Pain levels after the orthodontic and the surgical procedure decreased with time (p < 0.0001) but remained globally higher after piezocision (p = 0.0056). Significantly, more patients of the piezocision group reported that they would undergo the treatment again (p = 0.033) and that they greatly appreciated the duration of treatment (p = 0.0008). However, the level of apprehension was significantly higher in the piezocision group compared to the test group (p = 0.012).

Conclusions

Although, the degree of apprehension before the surgery and higher pain level in the piezocision group, PROMs emphasized similar pain killer consumption in both group and revealed high acceptance and satisfaction with piezocision approach.

Clinical relevance

The benefit of piezocision-assisted orthodontic treatment seems to be relevant from a patient perspective.

Trial registration

NCT03406130

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

References

  1. 1.

    Yi J, Xiao J, Li H, Li Y, Li X, Zhao Z (2017) Effectiveness of adjunctive interventions for accelerating orthodontic tooth movement: a systematic review of systematic reviews. J Oral Rehabil 44(8):636–654

    Article  Google Scholar 

  2. 2.

    Kole H (1959) Surgical operations on the alveolar ridge to correct occlusal abnormalities. Oral Surgery, Oral Medicine, and Oral Pathology 12(5):515–529 concl

    Article  Google Scholar 

  3. 3.

    Kole H (1959) Surgical operations on the alveolar ridge to correct occlusal abnormalities. Oral Surgery, Oral Medicine, and Oral Pathology 12(4):413–420 contd

    Article  Google Scholar 

  4. 4.

    Kole H (1959) Surgical operations on the alveolar ridge to correct occlusal abnormalities. Oral Surgery, Oral Medicine, and Oral Pathology 12(3):277–288 contd

    Article  Google Scholar 

  5. 5.

    Frost HM (1983) The regional acceleratory phenomenon: a review. Henry Ford Hospital Medical Journal 31(1):3–9

    PubMed  Google Scholar 

  6. 6.

    Sebaoun JD, Kantarci A, Turner JW, Carvalho RS, Van Dyke TE, Ferguson DJ (2008) Modeling of trabecular bone and lamina dura following selective alveolar decortication in rats. J Periodontol 79(9):1679–1688

    Article  PubMed  PubMed Central  Google Scholar 

  7. 7.

    Baloul SS, Gerstenfeld LC, Morgan EF, Carvalho RS, Van Dyke TE, Kantarci A (2011) Mechanism of action and morphologic changes in the alveolar bone in response to selective alveolar decortication-facilitated tooth movement. American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, its Constituent Societies, and the American Board of Orthodontics 139(4 Suppl):S83–S101

    Article  Google Scholar 

  8. 8.

    Wang L, Lee W, Lei DL, Liu YP, Yamashita DD, Yen SL (2009) Tisssue responses in corticotomy- and osteotomy-assisted tooth movements in rats: histology and immunostaining. American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, its Constituent Societies, and the American Board of Orthodontics 136(6):770.e1–770.11 discussion −1

    Google Scholar 

  9. 9.

    Kim SJ, Park YG, Kang SG (2009) Effects of corticision on paradental remodeling in orthodontic tooth movement. The Angle Orthodontist 79(2):284–291

    Article  Google Scholar 

  10. 10.

    Kim YS, Kim SJ, Yoon HJ, Lee PJ, Moon W, Park YG (2013) Effect of piezopuncture on tooth movement and bone remodeling in dogs. American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, its Constituent Societies, and the American Board of Orthodontics 144(1):23–31

    Article  Google Scholar 

  11. 11.

    Dibart S, Sebaoun JD, Surmenian J (2009) Piezocision: a minimally invasive, periodontally accelerated orthodontic tooth movement procedure. Compend Contin Educ Dent 30(6):342–344 6, 8–50

    PubMed  Google Scholar 

  12. 12.

    Alikhani M, Raptis M, Zoldan B, Sangsuwon C, Lee YB, Alyami B, Corpodian C, Barrera LM, Alansari S, Khoo E, Teixeira C (2013) Effect of micro-osteoperforations on the rate of tooth movement. American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, its Constituent Societies, and the American Board of Orthodontics. 144(5):639–648

    Article  Google Scholar 

  13. 13.

    Park YG (2016) Corticision: a flapless procedure to accelerate tooth movement. Frontiers of Oral Biology 18:109–117

    Article  Google Scholar 

  14. 14.

    Charavet C, Lecloux G, Bruwier A, Vandenberghe B, Le Gall M, Lambert F (2018) Selective piezocision-assisted orthodontic treatment combined with minimally invasive alveolar bone regeneration: a proof-of-concept. Int Orthod 16:652–664

    PubMed  Google Scholar 

  15. 15.

    Charavet C, Lecloux G, Bruwier A, Rompen E, Maes N, Limme M, Lambert F (2016) Localized piezoelectric alveolar decortication for orthodontic treatment in adults: a randomized controlled trial. J Dent Res 95(9):1003–1009

    Article  Google Scholar 

  16. 16.

    Dibart S, Yee C, Surmenian J, Sebaoun JD, Baloul S, Goguet-Surmenian E, Kantarci A (2014) Tissue response during piezocision-assisted tooth movement: a histological study in rats. Eur J Orthod 36(4):457–464

    Article  Google Scholar 

  17. 17.

    Alfawal AMH, Hajeer MY, Ajaj MA, Hamadah O, Brad B (2018) Evaluation of piezocision and laser-assisted flapless corticotomy in the acceleration of canine retraction: a randomized controlled trial. Head Face Med 14(1):4

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Abbas NH, Sabet NE, Hassan IT (2016) Evaluation of corticotomy-facilitated orthodontics and piezocision in rapid canine retraction. American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, its Constituent Societies, and the American Board of Orthodontics. 149(4):473–480

    Article  Google Scholar 

  19. 19.

    Aksakalli S, Calik B, Kara B, Ezirganli S (2016) Accelerated tooth movement with piezocision and its periodontal-transversal effects in patients with class II malocclusion. The Angle Orthodontist. 86(1):59–65

    Article  Google Scholar 

  20. 20.

    Charavet C, Lecloux G, Jackers N, Albert A, Lambert F (2019) Piezocision-assisted orthodontic treatment using CAD/CAM customized orthodontic appliances: a randomized controlled trial in adults. Eur J Orthod

  21. 21.

    Ni Riordain R, Wiriyakijja P (2017) Patient reported outcome and experience measures of oral disease in oral medicine. Br Dent J 223(9):713

    Article  Google Scholar 

  22. 22.

    Marshall S, Haywood K, Fitzpatrick R (2006) Impact of patient-reported outcome measures on routine practice: a structured review. J Eval Clin Pract 12(5):559–568

    Article  Google Scholar 

  23. 23.

    Tan WC, Krishnaswamy G, Ong MM, Lang NP (2014) Patient-reported outcome measures after routine periodontal and implant surgical procedures. J Clin Periodontol 41(6):618–624

    Article  Google Scholar 

  24. 24.

    Fitzpatrick R, Davey C, Buxton MJ, Jones DR (1998) Evaluating patient-based outcome measures for use in clinical trials. Health Technology Assessment (Winchester, England) 2(14):i–iv 1-74

    Google Scholar 

  25. 25.

    Pacheco-Pereira C, Pereira JR, Dick BD, Perez A, Flores-Mir C (2015) Factors associated with patient and parent satisfaction after orthodontic treatment: a systematic review. American Journal of Orthodontics and Dentofacial Orthopedics : official publication of the American Association of Orthodontists, its Constituent Societies, and the American Board of Orthodontics. 148(4):652–659

    Article  Google Scholar 

  26. 26.

    Brown MW, Koroluk L, Ko CC, Zhang K, Chen M, Nguyen T (2015) Effectiveness and efficiency of a CAD/CAM orthodontic bracket system. American Journal of Orthodontics and Dentofacial Orthopedics : official publication of the American Association of Orthodontists, its Constituent Societies, and the American Board of Orthodontics. 148(6):1067–1074

    Article  Google Scholar 

  27. 27.

    Baccetti T, Franchi L, JA MN Jr (2002) An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. The Angle Orthodontist 72(4):316–323

    PubMed  Google Scholar 

  28. 28.

    Wewers ME, Lowe NK (1990) A critical review of visual analogue scales in the measurement of clinical phenomena. Research in Nursing & Health 13(4):227–236

    Article  Google Scholar 

  29. 29.

    Al-Naoum F, Hajeer MY, Al-Jundi A (2014) Does alveolar corticotomy accelerate orthodontic tooth movement when retracting upper canines? A split-mouth design randomized controlled trial. Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons 72(10):1880–1889

    Article  Google Scholar 

  30. 30.

    Strippoli J, Durand R, Schmittbuhl M, Voyer R, Rompre P, Nishio C (2017) Pain and quality of life in patients undergoing guided piezocorticision- assisted orthodontic treatment. Journal of Clinical Orthodontics : JCO 51(12):792–799

    PubMed  Google Scholar 

  31. 31.

    Cannizzaro G, Felice P, Leone M, Checchi V, Esposito M (2011) Flapless versus open flap implant surgery in partially edentulous patients subjected to immediate loading: 1-year results from a split-mouth randomised controlled trial. European Journal of Oral Implantology 4(3):177–188

    PubMed  Google Scholar 

  32. 32.

    Wang F, Huang W, Zhang Z, Wang H, Monje A, Wu Y (2017) Minimally invasive flapless vs. flapped approach for single implant placement: a 2-year randomized controlled clinical trial. Clin Oral Implants Res 28(6):757–764

    Article  Google Scholar 

  33. 33.

    Piersanti L, Dilorenzo M, Monaco G, Marchetti C (2014) Piezosurgery or conventional rotatory instruments for inferior third molar extractions? Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons 72(9):1647–1652

    Article  Google Scholar 

  34. 34.

    Mantovani E, Arduino PG, Schierano G, Ferrero L, Gallesio G, Mozzati M, Russo A, Scully C, Carossa S (2014) A split-mouth randomized clinical trial to evaluate the performance of piezosurgery compared with traditional technique in lower wisdom tooth removal. Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons 72(10):1890–1897

    Article  Google Scholar 

  35. 35.

    Stubinger S, Kuttenberger J, Filippi A, Sader R, Zeilhofer HF (2005) Intraoral piezosurgery: preliminary results of a new technique. Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons 63(9):1283–1287

    Article  Google Scholar 

  36. 36.

    Eli I, Baht R, Kozlovsky A, Simon H (2000) Effect of gender on acute pain prediction and memory in periodontal surgery. Eur J Oral Sci 108(2):99–103

    Article  Google Scholar 

  37. 37.

    Cabbar F, Burdurlu MÇ, Tomruk CÖ (2018) Does giving brief information keep patients calm during different oral surgical procedures? Quintessence Int. 49(10):817–828. https://doi.org/10.3290/j.qi.a40245

  38. 38.

    Keser EI, Dibart S (2013) Sequential piezocision: a novel approach to accelerated orthodontic treatment. American Journal of Orthodontics And Dentofacial orthopedics : Official Publication of the American Association of Orthodontists, its Constituent Societies, and the American Board of Orthodontics 144(6):879–889

    Article  Google Scholar 

  39. 39.

    Keser EI, Dibart S (2011) Piezocision-assisted Invisalign treatment. Compendium of Continuing Education in Dentistry (Jamesburg, NJ : 1995) 32(2):46–48 50–1

    Google Scholar 

  40. 40.

    Zawawi KH (2015) Patients’ acceptance of corticotomy-assisted orthodontics. Patient Preference and Adherence 9:1153–1158

    Article  PubMed  PubMed Central  Google Scholar 

  41. 41.

    Gibreal O, Hajeer MY, Brad B (2018) Efficacy of piezocision-based flapless corticotomy in the orthodontic correction of severely crowded lower anterior teeth: a randomized controlled trial. Eur J Orthod

  42. 42.

    Dibart S, Surmenian J, Sebaoun JD, Montesani L (2010) Rapid treatment of class II malocclusion with piezocision: two case reports. The International Journal of Periodontics & Restorative Dentistry 30(5):487–493

    Google Scholar 

  43. 43.

    Page MG, Katz J, Stinson J, Isaac L, Martin-Pichora AL, Campbell F (2012) Validation of the numerical rating scale for pain intensity and unpleasantness in pediatric acute postoperative pain: sensitivity to change over time. The Journal of Pain : Official Journal of the American Pain Society 13(4):359–369

    Article  Google Scholar 

  44. 44.

    Ritter PL, Gonzalez VM, Laurent DD, Lorig KR (2006) Measurement of pain using the visual numeric scale. J Rheumatol 33(3):574–580

    PubMed  Google Scholar 

  45. 45.

    Deana NF, Zaror C, Sandoval P, Alves N (2017) Effectiveness of low-level laser therapy in reducing orthodontic pain: a systematic review and meta-analysis. Pain Res Manag 2017:8560652

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

The authors wish to express their gratitude to Adelin Albert for their guidance and support. The reviewers are thanked for their significant contribution to improving our publication.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Carole Charavet.

Ethics declarations

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

The randomized controlled trial as a whole received approval of the Ethics Committee of the University Hospital Liege (file number: B707201629875). The study was registered with ClinicalTrails.gov (Identifier: NCT03406130).

Informed consent

All patients were verbally informed of the purpose of the study and they all signed an informed consent form.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Charavet, C., Lecloux, G., Jackers, N. et al. Patient-reported outcomes measures (PROMs) following a piezocision-assisted versus conventional orthodontic treatments: a randomized controlled trial in adults. Clin Oral Invest 23, 4355–4363 (2019). https://doi.org/10.1007/s00784-019-02887-z

Download citation

Keywords

  • Piezocision
  • Piezosurgery
  • Accelerated orthodontic treatment
  • Patient-reported outcome measures (PROMs)
  • Pain level