Effectiveness of Flapless Piezocision on Maxillary En-Mass Retraction : A Randiomised Control Trial

Abstract

Introduction: This single-centered, parallel-groups trial aimed to evaluate the efficacy of flapless piezocision in accelerating en-masse retraction on maxilla.

Methods: Thirty two patients with Class I and Class II Division 1 malocclusion aged, 18-25 years, requiring maxillary first premolar extractions, were randomly distributed into 2 groups (n = 16 each): 1 group was treated using flapless piezocision (PCG), and the other group was control group (CG)treated with conventional en-masse retraction with anchorage based on miniscrews placed between maxillary second premolars and first molars bilaterally. Randomization was implemented with lottery method; allocation was concealed in sequentially numbered, opaque, sealed envelopes. The study was single-blinded (outcomes' assessor). The primary outcome was the duration of en-masse.

Results: When comparing pretreatment and progress records, there was significantly more retraction in the PCG than in the CG (P ≤ .001 ). The amount of en-masse retraction was significantly greater in the PCG (mean = 4.6 ± 0.39 mm) than in the CG (mean = 2.46 ± 0.16 mm; P ≤ .001). There was also more extraction space closure in the PCG than in the CG, as measured on the casts (P ≤.001). The rate of space closure per month was almost twice in the PCG than in the CG.

Conclusions: There was a significant difference between the two groups in terms of amount of retraction space closure. The en-masse retraction of maxillary anterior teeth in experimental group resulted in improvements of retraction of maxillary anterior teeth by almost twice of what seen in control group. Within the limitations of this randomized clinical trial, it appears reasonable to conclude that en-masse retraction combined with flapless Piezocision is an effective treatment technique for accelerating tooth movement.