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.
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).
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.
The benefit of piezocision-assisted orthodontic treatment seems to be relevant from a patient perspective.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
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
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
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
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
Frost HM (1983) The regional acceleratory phenomenon: a review. Henry Ford Hospital Medical Journal 31(1):3–9
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
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
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
Kim SJ, Park YG, Kang SG (2009) Effects of corticision on paradental remodeling in orthodontic tooth movement. The Angle Orthodontist 79(2):284–291
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
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
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
Park YG (2016) Corticision: a flapless procedure to accelerate tooth movement. Frontiers of Oral Biology 18:109–117
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
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
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
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
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
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
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
Ni Riordain R, Wiriyakijja P (2017) Patient reported outcome and experience measures of oral disease in oral medicine. Br Dent J 223(9):713
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Keser EI, Dibart S (2011) Piezocision-assisted Invisalign treatment. Compendium of Continuing Education in Dentistry (Jamesburg, NJ : 1995) 32(2):46–48 50–1
Zawawi KH (2015) Patients’ acceptance of corticotomy-assisted orthodontics. Patient Preference and Adherence 9:1153–1158
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
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
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
Ritter PL, Gonzalez VM, Laurent DD, Lorig KR (2006) Measurement of pain using the visual numeric scale. J Rheumatol 33(3):574–580
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
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.
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).
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.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
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
- Accelerated orthodontic treatment
- Patient-reported outcome measures (PROMs)
- Pain level