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Objectives To discern the effects of computer-aided design (CAD)/computer-aided manufactured (CAM) customized appliances and piezocision on orthodontic treatment (OT). Materials and Methods The study combined findings from two previously published randomized controlled trials: (1) standard OT vs piezocision-assisted standard OT, and (2) CAD/CAM OT vs piezocision-assisted CAD/CAM OT. Piezocision is a minimally invasive corticotomy surgical procedure used to accelerate orthodontic treatment and CAD/CAM refers to CAD/CAM customized brackets and archwires. The outcomes were the overall treatment time, and the durations of the alignment phase and fine-tuning phase. Clinical and radiological features also were evaluated. Results The combined study included 48 patients with similar baseline characteristics. Compared to the standard treatment, CAD/CAM technology alone significantly decreased the overall median OT time from 543 to 394 days (P < .001) and from 543 to 254 days (P < .0001) when combined with piezocision. Although piezocision significantly reduced the duration of the alignment phase in the mandible and maxilla, CAD/CAM technology considerably shortened the fine-tuning phase. All periodontal and radiographic parameters remained stable from the start to the end of treatment in all groups. Conclusions CAD/CAM technology combined with piezocision accelerates the entire OT process, during the alignment phase for piezocision and during the fine-tuning phase for CAD/CAM, with a global reduction of the overall treatment time of more than 50%.

The aim of this study was to describe a surgical technique that can be used to solve dentofacial deformities in cleft palate patients with maxillary hypoplasia in order to increase maxillary alveolar bone width, without modifying the skeletal base, and therefore, keeping the velopharyngeal function unaltered. Four patients with a history of cleft palate not associated with syndrome and treated under conventional surgical protocol during their childhood, underwent PAOO surgery incorporating L-PRF, followed by an accelerated orthodontic treatment with checkups every two weeks. All patients reached the desired occlusion without modifying their skeletal bases and velopharyngeal function. Orthodontic treatments were finished between 10 and 14 months after surgery without complications. There were no observed complications in the velopharyngeal postsurgical function and an increase in the arch width was achieved in all cases, along with a reduced orthodontic treatment time. The clinical results obtained confirm that PAOO technique is a safe and reliable complement to orthognathic surgery in the surgical treatment of cleft patients. By increasing the perimeter of the maxillary dentoalveolar ridge, the segmentation of the maxilla could be avoided, increasing the post operatory stability of these patients.

Objectives: The purpose of this study was to evaluate the a􀄴itude and perception of orthodontic patients to the duration of orthodontic treatment and the procedures for accelerating orthodontic tooth movement.Methods: This was a cross-sectional analytical study. The study population was made up of patients undergoing fixed appliance orthodontic treatment at the Orthodontic Unit of the Lagos University Teaching Hospital. A convenience sampling technique was used and data collection was via selfadministered questionnaires and an information sheet. The questionnaires assessed patients' knowledge of accelerated orthodontic procedures as well as their perception of orthodontic treatment time and willingness to undergo some accelerated orthodontic treatment procedures. The procedures evaluated included corticotomy, piezocision, micro-osteoperforation, laser therapy, local administration of injections and use of vibrations.Results: One hundred orthodontic patients (n=100, adolescents, 46%; adults, 54%) were surveyed comprising 36 males and 64 females. Most of the participants (88%) had never heard of accelerated orthodontics. A majority of respondents (75%) believed that orthodontic treatment time was too long, and were willing to undergo additional procedures to reduce treatment time (81%). Subjects' willingness to undergo the procedures were inversely proportional to the degree of its invasiveness for all groups, with at least a third of the patients willing to accept a 10% increase in treatment fees for a reduction in treatment time across all techniques surveyed.Conclusion: The orthodontic patients surveyed considered treatment time protracted and were interested in undergoing adjunctive orthodontic procedures to accelerate tooth movement, with a consequent increase in treatment cost. They, however, had a limited knowledge of the different methods of accelerating orthodontic treatment. Key words: Accelerated orthodontics, orthodontic treatment time

Objective To assess the efficiency of low-intensity pulsed ultrasound (LIPUS) and photobiomodulation (PBM) interventions in accelerating orthodontic tooth movement during clear aligner therapy (CAT). Materials and Methods This retrospective study was carried out on the records of 84 subjects who were treated using CAT. Twenty-eight patients were treated using CAT with a daily use of LIPUS for 20 minutes, 28 patients were treated using CAT with a daily use of PBM for 10 minutes, and 28 patients were treated using CAT alone. The total duration of treatment was recorded for all patients. One-way analysis of variance and post hoc Tukey test were used to assess whether there was any significant difference in total treatment duration among the three groups (P < .05). Results The mean treatment durations in days were 719 ± 220, 533 ± 242, and 528 ± 323 for the control, LIPUS, and PBM groups, respectively. The LIPUS group showed a 26% reduction, on average, in treatment duration when compared with the control group, whereas the PBM group showed an average 26.6% reduction in the treatment duration when compared with the control group. The results showed that there were statistically significant differences among the groups (P = .011). Treatment durations were significantly reduced in the LIPUS and PBM groups as compared with the control (P = .027 and P = .023, respectively), with no statistically significant differences between the LIPUS and PBM groups (P = .998). Conclusions Daily use of LIPUS or PBM as adjunctive interventions during CAT could reduce the duration of orthodontic treatment.

To evaluate the preference of young adult patients and their willingness to pay for the different approaches accessible to accelerate orthodontic tooth movement. A cross-sectional survey was conducted in Jeddah, Saudi Arabia from September to December 2019. Young adult orthodontic patients from 18 to 45 years old were interviewed via online survey regarding their perception to the extent of treatment, acceptability of non-invasive (customized appliances and medications) and invasive (surgery) approaches accessible to accelerate orthodontic treatment and increase in fees they were willing to pay. Statistical analyses were performed, and gender difference was calculated at P

Aim To systematically review the comparative differences in the performance and timeliness of conventional orthodontic treatment with that of corticotomy-assisted accelerated orthodontic treatment. Data sources The electronic databases PubMed and Google Scholar were searched from January 2007 to January 2018 in English, with manual searches of reference lists and gray literature. Thirty-six articles were included in the study with inclusion criteria as prospective clinical studies of patients treated with fixed conventional appliance and the intervention was the corticotomy-assisted accelerated orthodontic treatment method. Study selection Two reviewers assessed independently the eligibility of the included articles. One investigator abstracted study design information, intervention details, and harms data from all included studies into a standardized evidence table. The accuracy of these data was checked by the second investigator. We resolved any disagreements through discussion with other authors. Results Different aspects of the corticotomy-assisted accelerated orthodontics treatment method were investigated including risk factors, advantages, and disadvantages as compared to that of conventional orthodontic treatment. Conclusion There is limited available evidence about effectiveness of corticotomy-assisted accelerated orthodontics. Although the current review indicates that the corticotomy-assisted accelerated orthodontic treatment method can fasten the treatment duration by 2.2-3 folds compared to conventional orthodontic treatment, furthermore, the level of evidence needs well-conducted prospective research with big sample size to draw valid conclusions. Clinical significance Orthodontic treatment is a time-consuming process and due to noncompliance of patients, research has found different methods to accelerate the treatment, thus reducing the total treatment duration. Use of accelerated orthodontic techniques is expected to help clinicians in better treatment decisions for noncompliant patients.

Background Discision method may provide an alternative to the piezocision approach in accelerated orthodontic treatment. The purpose of this study was to investigate the efficacy of discision on accelerated orthodontic tooth movement in comparison to the piezocision method in moderate crowding Angle Class I malocclusions. Methods Thirty-five female individuals were included in this clinical study. The participants were classified into three groups as conventional fixed non-extraction orthodontic treatment only (OT, n = 14), piezocision in addition to fixed non-extraction orthodontic treatment (PG, n = 9), and discision in addition to fixed non-extraction orthodontic treatment (DG, n = 12). The piezocisions and discisions were performed 1 week after placement of bonding brackets. The patients were seen at 2–3 week-intervals. Initial Little’s irregularity index scores were recorded from dental casts. Periodontal parameters were measured initially, after the 1-month orthodontic treatment. Probing pocket depth, bleeding on probing, plaque index, and gingival index were recorded. Visual analog scale (VAS) was performed over the first month at different times following the bracket bonding for pain assessment. The total orthodontic treatment duration was noted. Results The duration of orthodontic treatment was statistically decreased in PG and DG compared to OT (P = 0.003). There was no statistical difference between PG and DG in orthodontic treatment duration (P > 0.05). There was no statistical difference between the two experimental groups in terms of VAS and periodontal parameter values (P > 0.05). Conclusions This is the first clinical orthodontic study to assess the effect of discision on the rate of orthodontic tooth movement. Discision is comparable to piezocision in terms of tooth movement acceleration, pain level, and periodontal status. The discision seems to be effective in reducing the time of orthodontic treatment.

Background and objectives: The contemporary demand for an accelerated orthodontic treatment associated with the disadvantage of complicated and difficult surgical procedures and corticotomies. The aim of this study was to evaluate the more conservative orthocision technique as a way for accelerating orthodontic treatment. Methods: Ten patients that matched the inclusion criteria were included in the study, which required orthodontic distalization of canines. The contralateral side of each patient used as a control for the experimental side with vertical incisions and decortication of bone with piezo knife both mesial and distal to the retracted canine after alignment and before starting retraction with power chain on 0.017*0.025 inch stainless steel wire. The pre- and post- treatment photographed cast superimpositions were used to quantify the canine distalization and molar anchorage loss and Muhelmans index was used for evaluating pre- and post- retraction tooth mobility in this study. Results: Statistical analysis showed a highly significant difference between the control side and orthocision side regarding canine distalization distance and time duration and molar anchorage loss. A non-significant result revealed regarding mobility scoring between control and orthocision sides, also a highly significant difference was present between control side and experimental side regarding transverse changes. Conclusions: Orthocision is an effective and a non-invasive way to accelerate orthodontic treatment.

Although pre-surgical orthodontic treatment has been accepted as a necessary process for stable orthognathic correction in the traditional orthognathic approach, recent advances in the application of miniscrews and in the pre-surgical simulation of orthodontic management using dental models have shown that it is possible to perform a surgery-first orthognathic approach without pre-surgical orthodontic treatment. This prospective study investigated the surgical outcomes of patients with diagnosed skeletal class III dentofacial deformities who underwent orthognathic surgery between December 2007 and December 2014. Cephalometric landmark data for patients undergoing the surgery-first approach were analyzed in terms of postoperative changes in vertical and horizontal skeletal pattern, dental pattern, and soft tissue profile. Forty-five consecutive Asian patients with skeletal class III dentofacial deformities who underwent surgery-first orthognathic surgery and 52 patients who underwent conventional two-jaw orthognathic surgery were included. The analysis revealed that the total treatment period for the surgery-first approach averaged 14.6 months, compared with 22.0 months for the orthodontics-first approach. Comparisons between the immediate postoperative and preoperative and between the postoperative and immediate postoperative cephalometric data revealed factors that correlated with the total treatment duration. The surgery-first orthognathic approach can dramatically reduce the total treatment time, with no major complications.

The demand and accessibility of orthodontic care has increased but has also been accompanied by patient requests for shorter treatment times. Longer orthodontic treatment increases the risk of decalcification, gingival recession, and root resorption and so shorter treatment times have multiple advantages as well as appealing to patient's desires. Numerous techniques and materials have been suggested to reduce treatment times but, in most cases, are based upon selected case reports with no prospective clinical trials to validate claims. The present review examines many of the current options purported to accelerate orthodontic tooth movement and the level of evidence presently available. There is some evidence to suggest that low-level laser therapy and a corticotomy involving the raising of a muco-periosteal flap are associated with accelerated orthodontic tooth movement; however, the current level of evidence is low to moderate in quality. For this reason, further research is required before routine application could be recommended.

Doctors and patients attempt to accelerate orthodontic tooth movement with a minimally invasive surgery approach. The purpose of this systematic review was to evaluate the evidence of accelerated tooth movement in minimally invasive surgery and the adverse effects from it. A systematic search of the literature was performed in the electronic databases of PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), Embase, Scopus, Web of Science, Science Direct, and Medline and was complemented by a manual search until February 2019. The inclusion criteria were prospective clinical studies of patients treated with a fixed appliance, and the intervention was accelerated orthodontic treatment with minimally invasive surgery. Nineteen articles (538 participants) were included in the review: 9 studies assessed the rate of upper canine movement; 5 considered the treatment time; 1 evaluated the en masse retraction time; and 4 studied adverse effects. We performed a meta-analysis for the rate of canine movement and treatment time and described the results for the adverse effects in a systematic review. The results of the subgroup analysis according to micro-osteoperforation and piezocision were included in the study. No accelerated tooth movement was found in the micro-osteoperforation group. After flapless corticotomy procedures, increased tooth movement rates were identified by weighted mean differences of 0.63 (95%CI = 0.22, 1.03, P = 0.003) and 0.64 (95% CI, −25 to 1.53; P = 0.16) for 1 and 2 mo, respectively. The mean treatment time was 68.42 d (95% CI, −113.19 to −23.65; P = 0.003) less that than for minimally invasive surgery. Moreover, no significant adverse effect was found. Because of the high heterogeneity of the meta-analysis, the results must be validated by additional large-sample multicenter clinical trials. There is not sufficient evidence to support that the single use of micro-osteoperforation could accelerate tooth movement, and there is only low-quality evidence to prove that flapless corticotomy could accelerate tooth movement.

YouTube™ is the foremost source of videos of all kinds of issues. The aim of this study was to investigate videos related to accelerated orthodontic treatment on YouTube™ in terms of characteristics, content, popularity and viewers’ assessments. Six keywords related to accelerated orthodontic treatment were searched on YouTube™. After sorting by view-count, all 116 videos were evaluated, and the exclusion criteria were defined as: another language than English, unrelated to the topic, poor video quality and duplication. The remaining 80 videos were analyzed for general characteristics, primary purpose, information content, audio-visual quality. Also, viewers’ interaction index, and viewing rate formulas were calculated for each video. The final 80 videos were viewed by users for 177,328 times in total. Most videos were uploaded by an educational institution (n = 40; 50.0%), followed by orthodontists (n = 20; 25.0%). Most of the videos (51.25%) were classified as having excellent general information content, 30.00% were rated as moderate, and 18.75% were rated as poor. The videos generally involved educational content (47.50%), followed by product presentation (20.00%), and then technical details about accelerated orthodontics (11.25%). Only 6.25% of the videos (n = 5) had viewers’ interaction index values of greater than 3.00. Videos with excellent content had significantly higher interaction index values than others (p < 0.001). YouTube™ could be preferred as an important source for patient information about accelerated orthodontics. Reliable informative videos should be uploaded by orthodontists or dental professionals in accelerated orthodontics.

To explore patient-related outcomes measures (PROMs) of piezocision-assisted orthodontic treatment compared to a conventional orthodontic treatment using customized appliance. Twenty-four adult patients requiring orthodontic treatment for mild-to-moderate overcrowding in both jaws were randomly assigned to a test group, treated with a piezocision-assisted orthodontic treatment, or to a control group, where piezocision was not applied. The patient-related outcomes were recorded using a 0–10 visual analog scale (VAS). Daily analgesic consumption and pain level were also recorded following the placement of the orthodontic appliance in both groups and after the piezocision procedure in the test group. Moreover, levels of apprehension and satisfaction were also assessed in both groups. In the piezocision group, over the 7-day period, paracetamol consumption was comparable after the placement of the orthodontic appliance and after the piezocision surgery. Pain levels after the orthodontic and the surgical procedure decreased with time (p

An orthodontic treatment usually involves a long process which often represents an obstacle for patients. To overcome this problem, surgical techniques have been developed to support and accelerate the orthodontic treatment. Two systematic reviews of the literature on clinical research and animal experiments were carried out in order to draw reliable conclusions about the effectiveness of the various surgical techniques. A total of 18 clinical studies and 22 animal experimental studies were analysed. In both reviews of the literature, a study was made of whether the surgical techniques resulted in an accelerated rate of tooth movement and which complications may be observed. In addition, which biological mechanisms take place during surgically facilitated orthodontics was investigated. Both reviews reported accelerated tooth movement with minimal complications after surgical procedures in comparison to conventional orthodontics. An increase in catabolic and anabolic activities was observed. It has to be concluded that based on the quality of the current literature there is still insufficient information for general conclusions and that more standardised prospective research is necessary for a reliable conclusion about the optimal method of treatment.

Accelerated orthodontic treatment is the need of the hour in current scenario as the conventional orthodontics is time taking. Corticotomy assisted orthodontics have been used for years to reduce the treatment duration by reducing the resistance provided by alveolar bone housing. This case report describes the orthodontic treatment combined with the modification in conventional wilkodontic technique in a patient to accelerate tooth movement and shorten the treatment time with an anterior open bite and flared and spaced upper and lower incisors. Firstly plaque control was achieved with supra and subgingival scaling. A modified approach using periodontal access flap followed by vertical bone cuts in the cortical bone from the crest of the alveolar bone margin to 2mm-3mm below the apices of all the anterior teeth extending from upper left canine to upper right canine were performed. These vertical cuts were joined by horizontal cuts apically and flap repositioned. An MBT 0.018 inch appliance was bonded. Orthodontic therapy proceeded with frequent activation of the appliances to retract the incisors every two weeks. The total treatment time was four and half months with active period of two months and no adverse effects were observed at the end of active treatment. The modified decortication technique reduced the treatment time to a considerable extent. The interdental spacing closed and optimum overjet and overbite was achieved.

Piezocision-assisted orthodontic treatment is an innovative, minimally invasive surgical technique designed to help achieve rapid orthodontic tooth movement. Microsurgical interproximal openings are made in the buccal gingivae to let the piezoelectric knife create the bone injury that will lead to transient demineralization and subsequent accelerated tooth movement. When this procedure was first described, cuts were made simultaneously at the maxilla and the mandible. In recent years, the technique has evolved to a more staged approach, with selected areas or segments of the arch demineralized at different times during orthodontic treatment to help achieve specific results. The purpose of this article was to report the use of sequential piezocision in the correction of a Class III malocclusion, in a total treatment time of 8 months.

Indications for orthodontic treatments are in constant augmentation in the adult population. Patients want the shortest possible treatments. Alveolar corticotomies speed up the tooth movement in comparison to conventional orthodontic treatments, therefore decrease treatment duration.This technique consists in the surgical section of cortical bone that leaves the medullar bone uninjured. The biological effects of corticotomies rely on decreasing medullary bone density and increasing bone remodelling activity (RAP regional acceleratory phenomenon).We are currently testing this combined approach of alveolar corticotomies and orthodontic treatments on a pig model with special attention given to potential secondary effects on pulp vitality, dental root morphology and length.We also present here two adult patients with malocclusion cases who underwent alveolar corticotomies as part of their surgical-orthodontic treatments.These experimental and clinical preliminary studies confirm that corticotomy requires a shorter time of orthodontic movement. Our clinical results showed that this technique resolves malocclusion at least twice as fast as conventional orthodontic treatment.No secondary effects of corticotomies on pulp vitality dental root morphology were observed.

Orthodontic treatment in a patient that suffered periodontitis and as a result has a reduced periodontium often requires a combination of several surgical techniques as well as interdisciplinary treatments aimed at achieving optimum results. Objective: To present a treatment with accelerated orthodontics in a patient with severe malocclusion, periodontitis and reduced periodontium to achieve orthodontic treatment success in lesser time and with minimum alteration of periodontal tissues. Methodology: 41 year old female patient, dolichofacial, with a skeletal class II malocclusion, molar class II, canine class II, spacing, convex profi le, incompetent lips, gummy smile, and advanced periodontal loss. Initial orthodonticperiodontal treatment was followed by corticotomy. Periodontal treatment consisted in root planning and scaling as well as oral hygiene instructions. 0.018-slot Roth prescription fi xed appliances were placed in both arches without extractions. Results: At the end of treatment esthetic, occlusal and functional results were achieved. Conclusions: Periodontally compromised patients can be successfully treated by correcting malocclusion when an interdisciplinary approach is used. Key words: Accelerated orthodontics, reduced periodontal tissue.