Assessment of Piezoelectric Periodontal Surgery Effects on Orthodontic Treatment: a Prospective Pilot Study

NCT02359760 | Completed DMC

• 1 other identifier: UMontreal
• Study Type: interventional
• Target: 14
• Locations: 1 country
• Sites: 1

Brief Summary

INTRODUCTION: Dentoalveolar surgeries such as piezocision, have been developed with the aim to accelerate the tooth movement and therefore reduce the length of orthodontic treatment. Although this surgical technique seems to present several advantages, such as decreased risk of decalcification or orthodontic relapse, its use as a routine practice is not yet recommended. The main purpose of this study is to determine the duration of orthodontic treatment by using the piezocision. The secondary objectives are to evaluate the effect of this surgical technique on bone density, root resorption, osteoclast activity, inflammatory events and pain assessment. MATERIAL AND METHODS: The investigators will conduct a prospective study. The experimental group will consist of 14 adults, subjects from 18 to 40 years-old (10 women, 4 men). The control group will consist of 30 matched patients, who have been already treated in the orthodontic clinic of the University of Montreal. The reliabilities of Intra and Inter assesors will be measured for each doctor. After completion of the surgical guides from CBCT, the Piezocision will be performed the same day of the bracket indirect placement. The surgical procedure will be standardized and did it by the same surgeon. The appointments will be every 2 weeks for 4 months, then every month. The investigators will make an assessment of pain by using a numerical visual scale, during the first 7 days after surgery. Analysis of inflammatory markers (IL-1) and osteoclast activity (RANKL, OPG) will be evaluated from the gingival sulcus fluid collected at day 0, 1, 3, 5, 8, 12, 16 and 24 weeks. At the end of the treatment, the overall quality evaluation of treatment using the "American Board of Orthodontics' grading system" would be realized by two blind external observers to limit bias.

Conditions

Malocclusion

Keywords

Rapid orthodontics; accelerated orthodontics; Piezocision; flapless corticotomies; minimaly invasive

Outcome Measures

Primary Outcomes (1)

• Determine the duration of orthodontic treatment associated with Piezocision

  Assessment of the length of orthodontic treatment following piezocision

  18 months

Secondary Outcomes (8)

• Compare the duration of treatment with the control group

  18 months

• Assess the overall quality of treatment (American Board of Orthodontics' grading system)

  18 months

• Assessment of pain during treatment (numerical visual scale)

  Every days after the surgery durin 7 days and one day after every appointment

• Evaluation of osteoclastic activity (analysis of RANKL and OPG markers by sampling in the gingival fluid with sterile paper points)

  weeks 0, 1, 3, 5, 8, 12, 16, 24

• Evaluation of inflammatory markers (quantification of interleukin-1 (IL-1))

  weeks 0, 1, 3, 5, 8, 12, 16, 24

Study Arms (2)

Piezocision group

EXPERIMENTAL

The experimental group will consist of 14 adults, subjects from 18 to 40 years-old (10 women, 4 men).

Procedure: Piezocision

conventional orthodontics

NO INTERVENTION

The control group will consist of 30 matched patients with the same inclusion and exclusion criteria, who have been already treated by conventional orthodontics in the orthodontic clinic of the University of Montreal.

Interventions

Piezocision PROCEDURE

Flapless corticotomies

Piezocision group

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• normal or low skeletal problem;
• dental relationchip without extraction;
• healthy;
• complete adult teeth;
• very cooperative;
• no plaque;
• no active periodontal disease and no bone loss visible radiographically;
• patient wishing a shorter orthodontic treatment.

You may not qualify if:

• patient regularly taking analgesic and antidepressants.
• patients with alcool abuse problems.
• patient smoking more than 10 cigarettes per day.
• pregnant patient.
• allergy to non-steroidal anti-inflammatory drugs.
• local or systemic Immunodeficiencies.
• uncontrolled systemic disease (For exaemple diabetes, cardiovascular disease).
• coagulation problems or taking anti-coagulants.
• presence of oral infections and periodontal disease uncontrolled active.
• taking intravenous bisphosphonates or taking oral bisphosphonates for more than 4 years.
• taking a long-term corticosteroids.
• antibiotic necessary before any surgery and taking antibiotics within 6 months before surgery

Sponsors & Collaborators

• Université de Montréal: lead

Study Sites (1)

University of Montreal, orthodontic department

Montreal, Quebec, H3V 1H9, Canada

Location

Related Publications (13)

• Brugnami F, Caiazzo A, Dibart S. Lingual orthodontics: accelerated realignment of the "social six" with piezocision. Compend Contin Educ Dent. 2013 Sep;34(8):608-10.

  PMID: 24564613 BACKGROUND

• Dibart S, Sebaoun JD, Surmenian J. Piezocision: a minimally invasive, periodontally accelerated orthodontic tooth movement procedure. Compend Contin Educ Dent. 2009 Jul-Aug;30(6):342-4, 346, 348-50.

  PMID: 19715011 BACKGROUND

• Dibart S, Surmenian J, Sebaoun JD, Montesani L. Rapid treatment of Class II malocclusion with piezocision: two case reports. Int J Periodontics Restorative Dent. 2010 Oct;30(5):487-93.

  PMID: 20814602 BACKGROUND

• Dibart S, Yee C, Surmenian J, Sebaoun JD, Baloul S, Goguet-Surmenian E, Kantarci A. Tissue response during Piezocision-assisted tooth movement: a histological study in rats. Eur J Orthod. 2014 Aug;36(4):457-64. doi: 10.1093/ejo/cjt079. Epub 2013 Nov 19.

  PMID: 24253033 BACKGROUND

• Keser EI, Dibart S. Piezocision-assisted Invisalign treatment. Compend Contin Educ Dent. 2011 Mar;32(2):46-8, 50-1.

  PMID: 21473299 BACKGROUND

• Keser EI, Dibart S. Sequential piezocision: a novel approach to accelerated orthodontic treatment. Am J Orthod Dentofacial Orthop. 2013 Dec;144(6):879-89. doi: 10.1016/j.ajodo.2012.12.014.

  PMID: 24286911 BACKGROUND

• Long H, Pyakurel U, Wang Y, Liao L, Zhou Y, Lai W. Interventions for accelerating orthodontic tooth movement: a systematic review. Angle Orthod. 2013 Jan;83(1):164-71. doi: 10.2319/031512-224.1. Epub 2012 Jun 21.

  PMID: 22720793 BACKGROUND

• Milano F, Dibart S, Montesani L, Guerra L. Computer-guided surgery using the piezocision technique. Int J Periodontics Restorative Dent. 2014 Jul-Aug;34(4):523-9. doi: 10.11607/prd.1741.

  PMID: 25006769 BACKGROUND

• Mathews DP, Kokich VG. Accelerating tooth movement: the case against corticotomy-induced orthodontics. Am J Orthod Dentofacial Orthop. 2013 Jul;144(1):5-13. doi: 10.1016/j.ajodo.2013.04.008. No abstract available.

  PMID: 23810039 BACKGROUND

• Sebaoun JD, Surmenian J, Dibart S. [Accelerated orthodontic treatment with piezocision: a mini-invasive alternative to conventional corticotomies]. Orthod Fr. 2011 Dec;82(4):311-9. doi: 10.1051/orthodfr/2011142. Epub 2011 Nov 23. French.

  PMID: 22105680 BACKGROUND

• Strippoli J, Aknin JJ. [Accelerated tooth movement by alveolar corticotomy or piezocision]. Orthod Fr. 2012 Jun;83(2):155-64. doi: 10.1051/orthodfr/2012015. Epub 2012 Jun 21. French.

  PMID: 22717115 BACKGROUND

• Vercellotti T, Podesta A. Orthodontic microsurgery: a new surgically guided technique for dental movement. Int J Periodontics Restorative Dent. 2007 Aug;27(4):325-31.

  PMID: 17726988 BACKGROUND

• Yamaguchi M. RANK/RANKL/OPG during orthodontic tooth movement. Orthod Craniofac Res. 2009 May;12(2):113-9. doi: 10.1111/j.1601-6343.2009.01444.x.

  PMID: 19419454 BACKGROUND

MeSH Terms

Conditions

Malocclusion

Condition Hierarchy (Ancestors)

Tooth Diseases; Stomatognathic Diseases

Study Officials

• Julien Strippoli, DMD

  University of Montreal, orthodontic department

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Ph.D

Study Record Dates

• First Submitted: February 4, 2015
• First Posted: February 10, 2015
• Study Start: March 1, 2015
• Primary Completion: January 1, 2016
• Study Completion: April 1, 2017
• Last Updated: October 26, 2017

Record last verified: 2017-10

Locations

CA (1)