Accelerated Orthodontic Tooth Movement in Adult Patients by Micro-Perforations of Cortical Bone

Introduction: The objective of this study was to determine whether micro-osteoperforations of cortical bone produce accelerated tooth movement during space closure in adult patients. Methods: Ten healthy adult patients, ages 18 to 37 years old requiring maxillary first premolar extractions participated in this split-mouth study. Temporary Anchorage Devices (TADs) were placed bilaterally for anchorage control. Micro-osteoperforations were performed unilaterally and ipsilateral maxillary canines were distalized using sliding mechanics. Canine retraction rate was measured using: (1) Cone Beam Computed Tomography (CBCT) and (2) Digital models taken before canine distalization at the initiation of the study (T0) and three months later (T1). Results: Mean space closure on the micro-osteoperforation side was 0.44mm less for TAD-Upper canine distal measurement, 0.30mm greater for Upper 2nd premolar mesial to Upper canine distal measurement on CBCT. Space closure on the micro-osteoperforation side was 0.14mm greater for Upper canine Cusp Tip-Upper second premolar Cusp Tip, 0.24mm less for Upper second premolar mesial to Upper canine distal measurement, 0.24mm greater for Upper lateral Midpoint-Upper canine Cusp Tip, 0.18mm greater for Upper molar mesio-palatal Cusp Tip-Upper canine Cusp Tip on digital models. Space closure on the Micro-osteoperforations side was not statistically significant for any variable (t-test p>0.05). Conclusion: Our results indicate that canine retraction is very variable on the experimental side when compared to the control side over the treatment time and the increase in the rate of tooth movement was not significantly different in the overall sample. Further studies are necessary to evaluate the effects of micro-osteoperforations on the rate of tooth movement in the orthodontic treatment of adult patients.