Accelerated Canine Retraction by Corticotomy Assisted or Periodontal Distraction

Abstract

Objectives: Canine retraction was accelerated by periodontal distraction or several surgical techniques depending on the concept that the greater surgical injury to alveolar bone, the greater biological response in the form of localized inflammatory reaction and bone remodeling, hence tooth movement acceleration. The present study aimed to compare between certain surgical techniques and periodontal distraction combined with interseptal bone reduction to accelerate canine distalization.Patients and Methods: A randomized split mouth clinical multi-operator study was performed on 30 orthodontic patients aged 15 years and above whose treatment procedures were planned for first premolar extractions and subsequent retraction of canines. Canines were distalized by surgery or distraction on one side and by conventional mechanics on the other side (the control side). Subjects were randomized equally into three canine retraction groups: Group I (multiple-osteoperforation MOPs); Group II (MOPs+corticotomy) and Group III (periodontal distraction). Canine retraction was carried out by power chain applying 150 g of force per side. Total time for complete canine retraction was determined and change in canine angulation was assessed using panoramic radiographs.Results: Regarding the time needed for complete canine retraction for all groups, the experimental side(surgical or distraction) showed a statistically significant lower mean value as compared with the non-surgical side. In other words, less than three months in Group I, about two months in Group II and less than one month in Group III, while more than four months in the conventional retraction side was taken for complete canine retraction. the mean canine angulation changes by degree was (11-15.2-23.2-8.1) degree for group I, II III and conventional group respectively.Conclusion: Canine retraction movement was accelerated effectively by MOPs, corticotomy and periodontal distraction techniques; the fastest of them was the periodontal distraction mechanics. However, it showed more distal tipping and more buccal inclination of the canine than MOPs, corticotomy or conventional canine retraction.