Effect of Piezoincision on the Rate of Mandibular Molar Mesialization: A Randomised Clinical Trial

Abstract

Background and Aim: The aim of this clinic study was to investigate the effect of piezoincision on the rate of mandibular molar  mesialization using clinical, radiological, and biochemical methods.

Materials and Methods: Twenty-one patients requiring mandibular  first molar extraction and second molar mesialization were included in the study which was designed as split-mouth study. Piezoincision was performed on the buccal surface of alveolar bone following regional alignment to the randomly selected side. 150 g of force was  applied to the second molar teeth using mini-screw-supported anchorage after the piezoincision. Cone beam computed tomography  (CBCT), gingival crevicular fluid (GCF) and digital model records of the patients were obtained. Two- and three-dimensional  measurements were performed and compared on the CBCT images in a study which lasted 24 weeks.

Results: According to the model  analysis, the canine-second molar distance was consistently reduced and a greater decrease was measured on the experimental group (p  < 0.05). Second molar mesial rotations increased in both groups (p < 0.001). Two‑dimensional measurements on CBCT images showed  increased mesial and buccal tipping of second molars in experimental group (p < 0.001). There was a significant increase in mesialization  measurements of experimental group (p < 0.001). Three‑dimensional measurements on the CBCT images showed a decrease of root  length in both groups (p < 0.001), and a greater decrease was found in the experimental group (p < 0.001). When intra‑group changes in  GCF results were examined, it was observed that there was no significant change in osteoprotegerin (OPG) values over time in  experimental group (p = 0.148).

Conclusion: The piezoincision technique provided acceleration of mandibular molar mesialization and  did not cause further damage to the buccal alveolar bone. Piezoincision can be used as a safe method in the mandibular molar region.