Influence of piezotomy and osteoperforation of the alveolar process on the rate of orthodontic tooth movement: a systematic review.

OBJECTIVE: The minimally invasive procedures piezosurgical corticocision and osteoperforation have been advocated as methods to accelerate orthodontic tooth movement and to shorten treatment time, but without large-scale trauma of the periosteum and the bone. The aim of this study was to evaluate if there is evidence supporting these claims based on a systematic review of the literature.

MATERIALS AND METHODS: A search of PubMed and Google Scholar with the combined search terms "piezo*" and "tooth movement" was performed until May 2016. In addition, the keywords "osteoperforation" and "piezopuncture" were searched in both databases. All scientific articles were considered and examined for suitability by two scientists. Disagreements resolved by consensus. The first inclusion criterion was studies with human species. Second inclusion criterion the surgical procedure had to be performed transmucosally and without the elevation of a mucoperiosteal flap. Case series were also considered.

RESULTS: The Google Scholar search delivered 516, the PubMed search 60 references. A total of 36 human trials fulfilling the first inclusion criterion were identified. Among those, in only 13 publications was a transmucosal technique used (12 on piezosurgical corticocision and 1 on osteoperforation). Of the 13 articles, 9 represented case series and only 4 were clinical trials. In all four trials, an acceleration of the orthodontic treatment was reported. However, the extent of the acceleration was inconsistent and in one article it disappeared when assessing the overall orthodontic treatment.

CONCLUSION: Evidence for an acceleration of tooth movement in conjunction with the minimally invasive methods piezosurgical corticocision and osteoperforation of the alveolar process in humans is low.