บทความ
Introduction
With the purpose of enhancing the rate of tooth movement and reducing the adverse side effects which may occur during orthodontic treatment, the regional accelerated phenomenon (RAP) was introduced by Frost in 1983. According to this theory, the recruitment of osteoclasts and osteoblasts during the wound healing process would lead to localized demineralization and remineralization in the alveolar bone and therefore expedite orthodontic tooth movement [1]
Piezocision is a minimally invasive surgical alternative to conventional corticotomies [2]. It is performed by insertion of a piezoelectric knife through a small vertical incision without elevation of a mucoperiosteal flap. The decortication creates a three to four months window of opportunity to 176 M Dent J 2022 August; 42 (2): 175-190. move teeth rapidly through the demineralized bone matrix and can be re-activated by repeated piezocision [3].
Piezocision has been shown to enhance bone healing without causing osteonecrotic damage while preserving root integrity and sparing the soft tissue with its blood supply [4]. Hard tissue or soft tissue grafting can be combined with piezocision via selective tunneling, which allows for the correction of gingival recession and bone deficiencies [5].
Accelerated maxillary canine tooth movement has been observed by several authors who performed piezocision mesial and distal to the canine [5-8]. We hypothesized that the effect of RAP should be more effective if bone injury occurs directly at the alveolar bone of the extraction site.
Therefore, our study chose to evaluate the effect of double piezocision at the maxillary first bicuspid extraction site on the rate of canine retraction. The secondary outcomes assessed in this study included anchorage loss, canine root resorption, as well as pain and discomfort associated with the piezocision procedure. With the advancement of digital images and CBCT, these methods are highly reliable, have fewer distortions, provide precise measurements, and were used to evaluate results to avoid the shortcomings of data collection methods from previous studies.
