A P S Gil1, O L Haas2, I Méndez-Manjón3, J Masiá-Gridilla4, A Valls-Ontañón4, F Hernández-Alfaro4, R Guijarro-Martínez4. 1. Institute of Maxillofacial Surgery, (Director: Prof. F. Hernández-Alfaro, MD, DDS, PhD, FEBOMS. Staff surgeons: Dr. R. Guijarro-Martínez, Dr. A. Valls-Ontañón, Dr. J. Masià-Gridilla. Staff dentist: I. Méndez-Manjón. Research fellows: Dr. A. Paredes, Dr. OL Haas Jr.), Teknon Medical Center, Barcelona, Spain; Department of Oral and Maxillofacial Surgery, (Chair: Prof. F. Hernández-Alfaro, MD, DDS, PhD, FEBOMS. Assistant professors: Dr. R. Guijarro-Martínez, Dr. A. Valls-Ontañón, Dr. J. Masià-Gridilla. PhD Student: Dr. A. Paredes), Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain. Electronic address: ariane.psgil@gmail.com. 2. Institute of Maxillofacial Surgery, (Director: Prof. F. Hernández-Alfaro, MD, DDS, PhD, FEBOMS. Staff surgeons: Dr. R. Guijarro-Martínez, Dr. A. Valls-Ontañón, Dr. J. Masià-Gridilla. Staff dentist: I. Méndez-Manjón. Research fellows: Dr. A. Paredes, Dr. OL Haas Jr.), Teknon Medical Center, Barcelona, Spain; Department of Oral and Maxillofacial Surgery, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil. 3. Institute of Maxillofacial Surgery, (Director: Prof. F. Hernández-Alfaro, MD, DDS, PhD, FEBOMS. Staff surgeons: Dr. R. Guijarro-Martínez, Dr. A. Valls-Ontañón, Dr. J. Masià-Gridilla. Staff dentist: I. Méndez-Manjón. Research fellows: Dr. A. Paredes, Dr. OL Haas Jr.), Teknon Medical Center, Barcelona, Spain. 4. Institute of Maxillofacial Surgery, (Director: Prof. F. Hernández-Alfaro, MD, DDS, PhD, FEBOMS. Staff surgeons: Dr. R. Guijarro-Martínez, Dr. A. Valls-Ontañón, Dr. J. Masià-Gridilla. Staff dentist: I. Méndez-Manjón. Research fellows: Dr. A. Paredes, Dr. OL Haas Jr.), Teknon Medical Center, Barcelona, Spain; Department of Oral and Maxillofacial Surgery, (Chair: Prof. F. Hernández-Alfaro, MD, DDS, PhD, FEBOMS. Assistant professors: Dr. R. Guijarro-Martínez, Dr. A. Valls-Ontañón, Dr. J. Masià-Gridilla. PhD Student: Dr. A. Paredes), Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.
Abstract
INTRODUCTION: It has been suggested that alveolar corticotomies may accelerate tooth movement, broaden the scope of malocclusion types that can be treated orthodontically, decrease the need for extractions, and support long-term stability. Several techniques have been proposed, although the indications, ideal design and technical characteristics, potential complications, and objective clinician and patient satisfaction remain unclear. This systematic review aimed to provide scientific support to validate alveolar corticotomies as a reliable approach to accelerated orthodontics. MATERIAL & METHODS: A literature search was conducted using MEDLINE (via PubMed), Cochrane, and EMBASE electronic databases until December, 2016. Articles written in any language other than English, Spanish, French, German, and Portuguese were excluded. Randomized controlled trials, controlled clinical trials, and case series involving healthy adult patients, with a sample size of at least 5 patients, and using alveolar corticotomy techniques were included. Two reviewers extracted the data independently. RESULTS: Three randomized clinical trials, 2 prospective randomized clinical trials, 6 case series and 1 randomized controlled split-mouth study were included. No clinical trials were retrieved. Mean total treatment time in corticotomy-facilitated orthodontic cases was 8.85 months (range, 4-20 months); control groups treatment duration was 16.4 months (range, 7.8-28.3 months). Complications such as pain, swelling, and dentin hypersensitivity were reported. Few studies mentioned patient/clinician satisfaction. The faster and less invasive procedures appeared to be well tolerated. However, the methodological quality of the selected studies was low, with only low to moderate scientific evidence. CONCLUSIONS: Corticotomy-facilitated orthodontics resulted in decreased treatment time. Few complications and low morbidity were found. More solid evidence-based research is required to support these results.
INTRODUCTION: It has been suggested that alveolar corticotomies may accelerate tooth movement, broaden the scope of malocclusion types that can be treated orthodontically, decrease the need for extractions, and support long-term stability. Several techniques have been proposed, although the indications, ideal design and technical characteristics, potential complications, and objective clinician and patient satisfaction remain unclear. This systematic review aimed to provide scientific support to validate alveolar corticotomies as a reliable approach to accelerated orthodontics. MATERIAL & METHODS: A literature search was conducted using MEDLINE (via PubMed), Cochrane, and EMBASE electronic databases until December, 2016. Articles written in any language other than English, Spanish, French, German, and Portuguese were excluded. Randomized controlled trials, controlled clinical trials, and case series involving healthy adult patients, with a sample size of at least 5 patients, and using alveolar corticotomy techniques were included. Two reviewers extracted the data independently. RESULTS: Three randomized clinical trials, 2 prospective randomized clinical trials, 6 case series and 1 randomized controlled split-mouth study were included. No clinical trials were retrieved. Mean total treatment time in corticotomy-facilitated orthodontic cases was 8.85 months (range, 4-20 months); control groups treatment duration was 16.4 months (range, 7.8-28.3 months). Complications such as pain, swelling, and dentin hypersensitivity were reported. Few studies mentioned patient/clinician satisfaction. The faster and less invasive procedures appeared to be well tolerated. However, the methodological quality of the selected studies was low, with only low to moderate scientific evidence. CONCLUSIONS: Corticotomy-facilitated orthodontics resulted in decreased treatment time. Few complications and low morbidity were found. More solid evidence-based research is required to support these results.