Evaluation of the efficacy of laser-assisted flapless corticotomy in accelerating canine retraction: a split-mouth randomized controlled clinical trial

Abstract

Objective: To evaluate the efficacy of laser-assisted flapless corticotomy in the acceleration of canine retraction compared with the conventional technique and to evaluate patients' pain and discomfort levels after corticotomy.

Materials and methods: A single-center randomized controlled trial was conducted on 18 class II division 1 patients (7 males, 11 females; age range: 16 to 24 years) who required the first-upper-premolar extraction followed by canine retraction. A split-mouth design was used in which the Er:YAG laser-assisted flapless corticotomy was randomly allocated to one side, whereas the other side served as the control side. The primary outcome measure was the canine retraction rate which was assessed immediately after laser application, 1, 2, 4, 8, and 12 weeks after laser application. Also, the levels of pain and discomfort during the first week following laser application were assessed. Paired t-tests or Wilcoxon matched-pairs signed-rank tests were used to detect significant differences.

Results: All of the selected eighteen patients entered the statistical analysis stage. Significant differences were observed (P < 0.001) in canine retraction rates between the experimental and control sides at the baseline to 1st-week, 1st- to 2nd-week, 2nd- to 4th-week, and 4th- to 8th-week intervals. No significant difference was found between the two sides at the 8th- to 12th-week interval. A significant reduction was seen in the mean score of pain during eating at all assessment times when compared to the baseline data (P = 0.002 at day 2, P < 0.001 at days 5 and 7).

Conclusion: Er:YAG laser-assisted flapless corticotomy appears to be an effective treatment method for accelerating canine retraction and was accompanied by a mild degree of pain and discomfort.

Trial registration: ClinicalTrials.gov (No.: NCT04316403), retrospectively registered on the 20th of March 2020. URL: https://clinicaltrials.gov/ct2/show/NCT04316403.

Keywords: Acceleration; Canine retraction; Corticotomy; Flapless; Laser-assisted.