The Impact of Piezocision on the Rate of Orthodontic Tooth Movement

AIM: To assess the efficacy of piezocision in increasing the rate of orthodontic tooth movement compared with conventional orthodontic methods. METHODS: PubMed and ScienceDirect were searched to April 2024 for randomised controlled trials (RCTs) and controlled clinical trials (CCTs) evaluating piezocision adjunctive to orthodontic treatment; a manual search was also performed. Included studies reporting clinical outcomes of tooth movement were analysed. RESULTS: Seventeen publications met the inclusion criteria: four CCTs and thirteen RCTs, comprising 550 participants. Investigated movements included lower anterior alignment, en masse retraction, canine distalisation, overall orthodontic treatment and second molar mesialisation. Across studies ages ranged from 13 to 38 years (mean 20 years). Observation periods varied from 4 to 24 months (mean 4–6 months). Higher rates for all tooth movements were found for piezocision versus conventional treatment. The accelerating effect was most pronounced in the first month and, in some studies, at three months, but the effect was not consistently maintained over longer follow-up and generally diminished with time. The intervention was safe for periodontal tissues and teeth. Effective pain relief for piezocision was generally achieved with a single dose of paracetamol. CONCLUSION: Piezocision corticotomy accelerates orthodontic tooth movement in the early phase. Different piezocision techniques produced variable outcomes, but the number of incisions did not correlate with the rate of tooth movement.