Efficiency of piezosurgery technique in miniscrew supported en-masse retraction: a single-centre, randomized controlled trial

Nilüfer Irem Tunçer, Ayça Arman-Özçirpici, Bahar Füsun Oduncuoglu, Jülide Sedef Göçmen, Alpdogan Kantarci
European Journal of Orthodontics 2017 November 30, 39 (6): 586-594

Background: Piezoelectric surgery is a newly introduced technique for rapid tooth movement. However, the efficiency of this technique has not been investigated on en-masse retraction cases yet.

Objective: To investigate the efficiency of piezosurgery technique in accelerating miniscrew supported en-masse retraction and study the biological tissue response. In addition, to show if this technique induces a difference in dental, skeletal and soft tissue changes on lateral cephalograms, and in canine and molar rotations, besides intercanine and intermolar widths on dental casts.

Design, setting, participants: We conducted a randomized, single-centred, parallel-group, controlled trial, requiring upper right and left first premolar extractions on 30 patients above the minimum age of 14 years at the beginning of retraction.

Interventions: Piezosurgery-assisted versus conventional en-masse retraction anchored from miniscrews placed between second premolars and first molars, bilaterally.

Outcomes: The main outcome was the en-masse retraction rate. Secondary outcomes were gingival crevicular fluid (GCF) volume and GCF content of receptor activator of nuclear factor κβ ligand (RANKL), changes regarding cephalometric and dental cast variables, and miniscrew success rates.

Randomization: Accomplished with opaque, sealed envelopes.

Blinding: Applicable for data assessment only.

Recruitment: Commenced in February 2013 and ended in October 2014.

Results: Thirty-one patients were included in the study and divided into 2 groups of piezosurgery (n = 16) and control (n = 15). After 9.3 months of follow-up, no statistically significant difference was observed between groups for neither retraction rates (P = 0.958) nor GCF parameters (P > 0.05). Changes in lateral cephalometric and dental cast variables, and miniscrew success rates did not show significant differences either.

Conclusion: Based on the results of this study, piezosurgery technique was found to be ineffective in accelerating en-masse retraction, and promoting a difference in the studied GCF parameters, skeletal and dental variables.

Registration: The trial was not registered.

Protocol: The full protocol of this PhD thesis study can be accessed from

Funding: This work was supported by Başkent University Research Fund. No conflict of interest was declared.


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