Short- and long-term potential effects of accelerated osteogenic orthodontic treatment: A systematic review and...

To better understand the potential effects after corticotomy accelerated osteogenic orthodontic treatment (CAOOT).

Systematic review with meta-analysis.

A literature search up to August 2018 was conducted to identify randomized clinical studies (RCTs) on CAOOT reporting periodontal parameters, bone changes, patient-centred and short- and long-term adverse outcomes. A random-effects meta-analysis was performed on various parameters (bone density, buccal bone thickness, anchorage loss, visual analog scale, root resorption and retraction time) to quantify weighted treatment effects.

A total of five split mouth, four parallel arms, one regular RCTs and two prospective CCTs were included (206 patients). Pooled data showed increase in bone thickness by 0.68 mm (95% CI: 1.17, 0.19) and reduced retraction time by 2.80 months (95% CI: -4.17, -1.43). There were statistically insignificant differences for root resorption 0.24 mm (95% CI: -0.49, 0.96), anchorage loss 0.49 mm (95% CI: -1.38, 0.40), worsening of periodontal parameters (gingival index) by 0.30 (95% CI: -0.83, 0.23) and mean increase in bone density of 7.07% on the corticotomy side at 6 months (95% CI: -3.24, 17.38).

Current evidence suggests a very low to low level of certainty (GRADE assessment) in regard to quantified effects after CAOOT. Although CAOOT procedures show insignificant increase in the density following the use of bone graft and anchorage loss, they appear to accelerate the tooth movement during the first few months, to increase the buccal bone thickness and to show good tolerance by the patients; the clinical significance of these changes may be considered questionable.