Efficiency of piezotome-corticision assisted orthodontics in alleviating mandibular anterior crowding-a randomized clinical trial

Abstract

Objectives: The aim of this clinical trial was to investigate the duration of mandibular-crowding alleviation with piezotome-corticision orthodontics compared with conventional orthodontics.

Design: Single-centre, two-arm parallel group randomized controlled trial.

Setting: Orthodontic clinic at the University of Connecticut.

Ethical approval: The study was approved by the Institutional Review Board (IRB # 12-0147-2).

Subjects and methods: Forty-one adult subjects from a single centre with more than 5mm of mandibular anterior crowding were randomly allocated using block randomization into experimental and control groups. The experimental group received a corticision procedure with a piezotome on the labial aspect of the mandibular incisors in conjunction to a self-ligation fixed orthodontic appliance. The control group received the self-ligation fixed orthodontic appliance and no corticision. Same archwire sequence (0.014 inch followed by 0.014 × 0.025 inch copper-nickel-titanium) was followed for both groups. Mandibular study casts taken every 4-5 weeks were used to assess changes in the irregularity index by blinded outcome assessors.

Outcome measures: The time to alignment was calculated in days.

Results: Twenty-nine subjects (16 experimental and 13 control) completed the study. Overall, no significant difference in the time required to correct mandibular crowding with piezotome-corticision assisted (102.1 ± 34.7 days; 95% CI, 83.6 to 120.6) and conventional orthodontics (112 ± 46.2 days; 95% CI, 84-139.9) was observed. No complications with treatment or unintended consequences were observed on any of the subjects.

Limitations: A high attrition rate.

Conclusions: This randomized clinical trial found no evidence that piezotome-corticision assisted orthodontics was more efficient in alleviating mandibular anterior crowding.

Registration: ClinicalTrials.gov, Identifier: NCT02026258.

Funding: Division of Orthodontics, University of Connecticut.

Conflict of interest: None.