Does Alveolar Corticotomy Accelerate Orthodontic Tooth Movement When Retracting Upper Canines? A Split-Mouth Design Randomized Controlled Trial

Purpose: To evaluate the efficacy of alveolar corticotomy on orthodontic tooth movement when retracting upper canines compared with the conventional technique and to evaluate patients' pain and discomfort levels after corticotomy. Materials and Methods: A split-mouth design randomized controlled trial at the Department of Orthodontics (University Al-Baath Dental School) was performed. A total of 30 patients whose orthodontic treatment required canine retraction were included. The predictor variable was the use of corticotomy to facilitate tooth movement. The velocity of space closure was evaluated as the primary outcome variable by measuring the distance between the canine and first molar on each side of the mouth immediately after corticotomy and at 1, 2, 4, 8, and 12 weeks after corticotomy. The levels of pain and discomfort were evaluated as the secondary outcome variables using a questionnaire administered 4 times during the first week after corticotomy. Paired t tests or Wilcoxon matched-pairs signed-rank tests were used to detect significant differences. Results: A total of 30 patients (15 males and 15 females) were recruited with a mean age of 20.04 +/- 3.63 years (range 15 to 24). The space closure velocity after corticotomy was significantly faster on the experimental side than on the control side (x = 0.74 mm/week vs 0.20 mm/week between 1 week after and immediately after corticotomy, respectively; P <.001). The pain encountered during eating was high, with 50% and 30% of patients reporting severe pain at 1 and 3 days postoperatively, respectively. No significant differences were detected between the male and female patients regarding the tooth movement velocity on the experimental side. Conclusions: Alveolar corticotomy increased orthodontic tooth movement and was accompanied by moderate degrees of pain and discomfort. (C) 2014 American Association of Oral and Maxillofacial Surgeons