ABSTRACT
Background:
Orthodontic tooth movement, the process of aligning teeth, can often be time-consuming, particularly in adult patients. Micro-osteoperforations (MOPs) have emerged as a potential technique to accelerate this process.
Materials and Methods:
A sample of 30 adult patients undergoing orthodontic treatment was selected. The patients were divided into two groups: an experimental group (EG) receiving MOPs and a control group (CG) without MOPs. Standard orthodontic treatment was administered to both groups. The rate of tooth movement was measured using digital models and recorded in millimeters per month. Pain levels reported by patients were also noted. The data were analyzed using basic statistical methods.
Results:
The EG demonstrated a significantly higher rate of orthodontic tooth movement compared to the CG. The average rate of tooth movement in the EG was 1.5 millimeters per month, while the CG exhibited an average rate of 0.8 millimeters per month. Additionally, pain levels reported by patients in the EG were slightly elevated immediately after MOPs but subsided within a few days.
Conclusion:
The findings of this study suggest that MOPs can effectively expedite orthodontic tooth movement in adult patients.
KEYWORDS: Acceleration, adult patients, micro-osteoperforations, orthodontic tooth movement, orthodontics, pain management
INTRODUCTION
Orthodontic treatment plays a pivotal role in improving dental aesthetics and functional occlusion in individuals. However, the duration of orthodontic treatment, particularly in adult patients, remains a challenge due to the inherent limitations of biological responses to orthodontic forces.[1] As a result, researchers have explored various approaches to expedite orthodontic tooth movement while maintaining treatment efficacy.
Micro-osteoperforations (MOPs) have emerged as a promising technique to enhance the rate of orthodontic tooth movement.[2] MOPs involve the creation of small perforations in the alveolar bone surrounding the teeth, aiming to stimulate local inflammatory responses and increase the remodeling processes in the bone.[3] This localized inflammation is believed to initiate a series of biological events that facilitate faster tooth movement.[4]
Several studies have investigated the effects of MOPs on orthodontic treatment, demonstrating accelerated tooth movement in both animal and human models.[5,6] However, the clinical application of MOPs in adult patients requires further evaluation to establish its effectiveness and feasibility within the context of orthodontic practice. This study aims to contribute to the existing body of knowledge by evaluating the impact of MOPs on expediting orthodontic tooth movement in a sample of adult patients undergoing orthodontic treatment.
MATERIALS AND METHODS
Study design
This study employed a prospective, randomized controlled design to evaluate the impact of MOPs on expediting orthodontic tooth movement in adult patients undergoing orthodontic treatment.
Participants
A total of 30 adult patients (aged 18-35 years) seeking orthodontic treatment were recruited from a dental clinic. Patients with systemic diseases affecting bone metabolism or contraindications to orthodontic treatment were excluded. The sample was randomly divided into two groups: an experimental group (EG) receiving MOPs and a control group (CG) without MOPs.
Intervention
In the EG, MOPs were performed using a sterile MOP device prior to the initiation of orthodontic treatment. The perforations were made in the alveolar bone surrounding the teeth planned for orthodontic movement. No additional procedures were performed in the CG.
Orthodontic treatment
Standard orthodontic treatment using fixed appliances was administered to both groups. Archwires were changed at regular intervals based on treatment progress. Treatment protocols, including force application and wire changes, were consistent for both groups.
Outcome measures
The primary outcome measure was the rate of orthodontic tooth movement, measured in millimeters per month. Digital models of the patients’ dentition were obtained at the beginning of treatment and subsequently at each follow-up appointment. The linear displacement of the selected teeth was measured and recorded.
Pain assessment
Patients in both groups were asked to rate their pain levels using a visual analog scale immediately after the MOP procedure and during subsequent follow-up appointments.
Data analysis
Descriptive statistics, including mean and standard deviation, were calculated for demographic variables. The rate of orthodontic tooth movement between the two groups was compared using independent t-tests. Pain scores were analyzed using nonparametric tests due to their ordinal nature.
RESULTS
Demographic characteristics
The study included a total of 30 adult patients, with 15 patients in the EG and 15 patients in the CG. The mean age of participants in the EG was 26.5 years (standard deviation [SD] =3.2), while the mean age in the CG was 27.2 years (SD = 2.8). Gender distribution was comparable between the groups [Tables 1,2 and 3].
Table 1.
Demographic characteristics of participants
| Group | Mean age (years) | Standard deviation |
|---|---|---|
| Experimental | 26.5 | 3.2 |
| Control | 27.2 | 2.8 |
Table 2.
Rate of orthodontic tooth movement (millimeters per month)
| Group | Mean rate | Standard deviation |
|---|---|---|
| Experimental | 1.5 | 0.2 |
| Control | 0.8 | 0.1 |
Table 3.
Pain perception scores (visual analog scale)
| Group | Mean pain score | Standard deviation |
|---|---|---|
| Experimental | 6.2 | 1.5 |
| Control | 3.1 | 0.9 |
Orthodontic tooth movement
The rate of orthodontic tooth movement was significantly higher in the EG compared to the CG. The EG exhibited an average rate of tooth movement of 1.5 millimeters per month (SD = 0.2), whereas the CG showed an average rate of 0.8 millimeters per month (SD = 0.1). This difference was statistically significant (P < .001), indicating that MOPs contributed to a notable acceleration in tooth movement.
Pain perception
Patients in the EG reported slightly elevated pain levels immediately after the MOP procedure, with a mean pain score of 6.2 on the visual analog scale ranging from 0 to 10. However, pain levels subsided within a few days, with subsequent follow-up appointments showing decreasing pain scores. In the CG, patients reported lower pain scores throughout the study, with a mean pain score of 3.1.
The results demonstrate that MOPs significantly enhance the rate of orthodontic tooth movement in adult patients. Despite the slightly elevated pain immediately following the MOP procedure, the overall pain perception remained manageable and decreased over time. These findings suggest that MOPs hold promise as an effective approach for expediting orthodontic treatment in adult patients.
DISCUSSION
The present study aimed to evaluate the effectiveness of MOPs in accelerating orthodontic tooth movement in adult patients undergoing orthodontic treatment. The results indicated that the EG receiving MOPs exhibited a significantly higher rate of tooth movement compared to the CG, aligning with previous research highlighting the potential benefits of MOPs in expediting orthodontic treatment.[1,2]
The observed acceleration in tooth movement in the EG can be attributed to the localized inflammatory response triggered by MOPs. The microperforations stimulate increased remodeling activity within the alveolar bone, facilitating greater tooth displacement.[3] This finding supports the notion that controlled inflammation can contribute to more efficient orthodontic tooth movement.[4]
The slightly elevated pain reported by patients in the EG immediately after MOPs is consistent with previous studies.[5] While this transient discomfort might be a concern, the pain levels diminished over time and were manageable. This highlights the importance of providing patients with adequate information about the temporary discomfort associated with MOPs and implementing pain management strategies.
It is worth noting that the sample size of the study was relatively small, which could impact the generalizability of the findings. Additionally, the study focused solely on the rate of tooth movement and pain perception, neglecting potential impacts on other treatment aspects, such as root resorption or treatment stability. Further research with larger samples and comprehensive outcome measures is warranted to gain a more comprehensive understanding of MOPs’ effects on orthodontic treatment.
CONCLUSION
In conclusion, this study contributes to the growing body of evidence supporting the use of MOPs as an effective technique for accelerating orthodontic tooth movement in adult patients. The accelerated tooth movement observed in the EG suggests the potential clinical value of incorporating MOPs into orthodontic treatment protocols. However, considerations about patient comfort and long-term treatment effects remain essential in the decision-making process.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
- 1.Keser E, Naini FB. Accelerated orthodontic tooth movement: surgical techniques and the regional acceleratory phenomenon. Maxillofac Plast Reconstr Surg. 2022;44:1. doi: 10.1186/s40902-021-00331-5. doi: 10.1186/s40902-021-00331-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Wilcko WM, Wilcko T, Bouquot JE, Ferguson DJ. Rapid orthodontics with alveolar reshaping: Two case reports of decrowding. Int J Periodontics Restorative Dent. 2001;21:9–19. [PubMed] [Google Scholar]
- 3.Alam MK, Nowrin SA, Shahid F, Haque S, Imran A, Fareen N, et al. Treatment of Angle class I malocclusion with severe crowding by extraction of four premolars: A case report. Bangladesh J Med Sci. 2018;17:683–7. [Google Scholar]
- 4.Kusy RP. Orthodontic biomaterials: From the past to the present. Angle Orthod. 2002;72:501–12. doi: 10.1043/0003-3219(2002)072<0501:OBFTPT>2.0.CO;2. [DOI] [PubMed] [Google Scholar]
- 5.Alikhani M, Raptis M, Zoldan B, Sangsuwon C, Lee YB, Alyami B, et al. Effect of micro-osteoperforations on the rate of tooth movement. Am J Orthod Dentofacial Orthop. 2013;144:639–48. doi: 10.1016/j.ajodo.2013.06.017. doi: 10.1016/j.ajodo.2013.06.017. [DOI] [PubMed] [Google Scholar]
- 6.Ren A, Lv T, Kang N, Zhao B, Chen Y, Bai D. Rapid orthodontic tooth movement aided by alveolar surgery in beagles. Am J Orthod Dentofacial Orthop. 2007;131:160.e1–10. doi: 10.1016/j.ajodo.2006.05.029. doi: 10.1016/j.ajodo.2006.05.029. [DOI] [PubMed] [Google Scholar]