Effect of Flapless Laser Corticotomy on Maxillary Canine Retraction: a Systematic Review and Meta-Analysis

This systematic review study aims to evaluate the effectiveness of flapless laser corticotomy in accelerating canine distalization during extraction-based orthodontic treatment.

Present systematic review followed PRISMA guidelines and was registered at the PROSPERO database (CRD420251055675). Literature searches were conducted across PubMed, The Cochrane Library, ScienceDirect, Web of Science databases. The search included human studies, which measured canine distalization rate, published in English up to August 31, 2025, with no time restriction. The quality of the studies was assessed using the Cochrane risk of bias tool (RoB 2.0) and the statistical examination was done using the Review Manager (RevMan).

Seven split-mouth randomized controlled trial studies with 103 patients were included, of which four studies with 55 patients were suitable for quantitative analysis. Flapless laser corticotomy significantly accelerated canine distalization in the first month (MD = 0.83; 95% CI = 0.3 to 1.35, where MD indicates mean difference and CI - 95% confidence interval, P = 0.002) and second month (MD = 0.44; 95% CI = 0.09 to 0.79; P = 0.01), despite high heterogeneity. No significant differences were found in the third (MD = 0.03; 95% CI = -0.18 to 0.24; P = 0.79) or fourth month (MD = -0.04; 95% CI = -0.13 to 0.05; P = 0.37).

The results proved flapless laser corticotomy as an effective method to increase canine distalization speed during the first two months of the treatment. However, more trials with bigger sample sizes should be performed to validate its clinical effectiveness.