Comparing the Effectiveness of Surgical Techniques for Accelerating Orthodontic Movement: A Systematic Review

Various surgical procedures have been proposed in orthodontics to accelerate tooth movement, aiming to reduce treatment time and improve patient outcomes. These surgical procedures include corticotomy (CO/TC), piezocision (PZ), flapless corticotomy (FC), periodontally accelerated osteogenic orthodontics (PAOO), and micro-osteoperforations (MOPs). This systematic review aimed to determine if one surgical technique for accelerating tooth movement in orthodontics is more effective than others in accelerating orthodontic movement or reducing treatment time. The study adhered to PRISMA guidelines and searched PubMed and Scopus for randomised clinical trials (RCTs) comparing two or more surgical techniques to facilitate orthodontic movement. The Cochrane Risk of Bias tool (RoB 2.0) was used to assess the risk of bias in the randomised trials. Thirteen RCTs were included in the systematic review. Only four studies reported a statistically significant difference between the tested surgical techniques. Specifically, Abbas found a higher rate of canine displacement with CO versus PZ, Chandra reported a shorter treatment duration with PAOO versus CO, Fernandes showed a higher rate of canine retraction with CO versus PZ, and Khlef's 2022 study statistically reported a higher rate of mass retraction with traditional corticotomy (TC) versus FC, though the author questioned its clinical significance. This lack of significant difference was supported by eight other studies, and in Bahammam et al., p-values was not calculated. The review concluded that no major differences emerged between the various surgical techniques in increasing tooth displacement. In most studies, the procedures appeared valid and comparable in accelerating tooth movement, with no clinically significant differences in efficacy or side effects.