Clinical evaluation of the effects of transmucosal decortication procedure on the rate of tooth movement

Over the past decade the number of patients, especially adults, who seek orthodontic treatment has been steadily increasing. There is still one main reason of many people avoiding this treatment, which is the long duration. Even if alveolar corticotomy procedures are quite effective in accelerating orthodontic tooth movement, they found to be traumatic and invasive, leading to low acceptance among orthodontic patients. The purpose of this study is to clinically evaluate the effects of transmucosal decortication procedure, performed using manual drill bur device on the rate of tooth movement and to develop a new conservative, minimal invasive approach that may lead to greater acceptance in the community. Nine patients with the age range of 13-23 years, who had been indicated for maxillary first premolar extraction and bilateral maxillary canine distalization were included in the study. Three micro-osteoperforations 3 mm deep were performed through the buccal gingiva between canine and second premolar on experimental sides using handheld drill bur device. Afterwards, bilateral canine distalization was initiated using 150 g Sentalloy close-coil springs, supported with miniscrews as temporary anchorage device. Impressions were taken at the beginning of the canine distalization (T0), 3rd (T1) and 6th week (T2) of the study to obtain dental casts. Canine distalization, molar anchorage loss and canine rotation amounts were measured using the casts. As a result, there were statistically significant difference in the amount of tooth movement between the experimental (1,51±0,44) and control (0,93±0,40) groups (p<0.05). Mesial movement of the molars was 0,11±0,11 mm for the experimental group, and 0,19±0,18 mm for the control group. The difference is statistically significant (p<0.05). There was no statistically significant difference in the amount of distopalatal rotation of canine between the groups at all measurement times (p>0.05). In our study, decortication procedure known as effective in accelerating tooth movement was performed with alternative and minimal invasive technique. As a result, transmucosal decortication procedure made by using manual drill bur device is effective in accelerating orthodontic tooth movement. Key words: Orthodontic tooth movement, corticotomy, accelerated tooth movement