Corticotomy, Piezocision, and Micro-Osteoperforation versus No Adjunct for Canine Retraction Acceleration – A Systematic Review and Meta-Analysis

AIM: The objective of this study was to evaluate the efficacy and benefit-to-harm relation of conventional corticotomy, piezocision, and micro-osteoperforation in accelerating canine retraction. METHODS: A systematic search was conducted across PubMed, Cochrane Library, Embase, CT.gov, WHO ICTRP, Scopus, Google Scholar, with additional screening using NCT and study identification number. Randomized studies published between 2023 and the 20th February 2025 (last date searched) evaluating surgical interventions for canine retraction acceleration were included. RESULTS: Twenty-eight randomized clinical trials, in qualitative review, reported mild to moderate pain and discomfort, moderate root resorption, and acceptable anchorage loss. Ten randomized clinical trials in meta-analysis showed short term acceleration with piezocision yielding higher first month mean acceleration (0.81 mm, 95%, CI 0.65 to 0.96) than micro-osteoperforation (0.48 mm, 95%, CI 0.32 to 0,65). CONCLUSION: All three interventions resulted in a short-term acceleration of canine retraction, accompanied by mild-to-moderate adverse effects. The acceleration was statistically significant during the first month and provided the greatest clinical benefit when closing canine gaps of 5 mm or less, with only transient effects and minimal anchorage loss.