Effect of piezocision corticotomy on en-masse retraction: A randomized controlled trial

Objectives: To compare the amount of en-masse retraction with or without piezocision corticotomy, to assess the type of tooth movement, to evaluate root integrity after retraction, and to record reported pain levels. Materials and Methods: This randomized, controlled clinical trial included 26 orthodontic patients requiring premolar extraction. The patients were divided into two groups: (1) an extraction with piezocision corticotomy group (PCG) and (2) an extraction-only group, which served as the control group (CG). Cone-beam computed tomography images were acquired before and 4 months after the initiation of en-masse retraction utilizing miniscrews. The following variables were assessed: the amount of en-masse retraction, incisor inclination, incisor and canine root resorption, and patient-reported pain. Results: Twelve and 11 participants completed the entire study in the PCG and CG, respectively. The amount of en-masse retraction was significantly greater in the PCG compared to the CG (mean = 4.8 +/- 0.57 mm vs 2.4 +/- 0.33 mm, respectively [P<.001]). There was also significantly less tipping and root resorption of incisors in the PCG (P<.05). The reported pain was significantly higher on the first day in the PCG compared to the CG (P<.001); however, it became similar between the groups after 24 hours. Conclusions: Piezocision corticotomy enhanced the amount of en-masse retraction two times more with less root resorption. However, future studies are required to assess the long-term effects of this technique.