Comparison of two micro-osteoperforation protocols using mini-screws on the rate and type of extraction space...

Accelerating orthodontic space closure while minimizing anchorage loss remains a clinical priority. Micro-osteoperforation (MOP) has emerged as a minimally invasive technique to enhance tooth movement. This study aimed to compare the effectiveness of two MOP protocols on the rate and pattern of maxillary extraction space closure.

In this parallel three-arm randomized controlled trial, 30 patients (17-30 years) with 3-4 mm of residual maxillary extraction space were randomly assigned to MOP1, MOP2, or control groups (n = 10 each). All underwent space closure using 0.019" × 0.025" stainless steel archwires and 150 g NiTi closed coil springs. MOP1 involved four perforations (two buccal, two palatal) at the extraction site center; MOP2 included additional perforations mesial and distal to the first molar. MOPs were performed monthly for 3 months. Primary outcome was space closure rate assessed via monthly three-dimensional intraoral scans. Secondary outcomes included angular tipping (PA radiographs) and relative anterior/posterior tooth movement. Statistical analysis used ANOVA, Kruskal-Wallis, and nonparametric post hoc tests (P < 0.05).

Thirty patients (11 males, 19 females) were equally divided into MOP1, MOP2, and control groups. After 3 months, mean space closure was 0.88 mm greater in MOP1 and 0.90 mm greater in MOP2 compared to control. The 0.02 mm difference between MOP1 and MOP2 was clinically negligible. Control showed the greatest tipping, whereas MOP2 had the least. No adverse events were observed.

Monthly application of MOP significantly accelerates space closure and reduces tipping without increasing anchorage loss. The difference between MOP protocols was minimal and clinically negligible.