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Effect of Micro-Osteoperforations on Orthodontic Tooth Movement: A Systematic Review and Meta-Analysis.

Ali Heidari1, Sepideh Mojiri1, Masood Azarbayjani1

  • 1School of Dentistry, Islamic Azad University (Khorasgan Branch), Isfahan, Iran.

International Dental Journal
|April 29, 2026
PubMed
Summary

Micro-osteoperforations (MOPs) can significantly accelerate orthodontic tooth movement. Repeating MOPs every four weeks appears most effective, with minimal risk of adverse effects like root resorption.

Keywords:
Accelerated orthodontics, Anterior crowding, Treatment durationBone remodelling, Alveolar boneOrthodontic appliances, Randomized controlled trials

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Area of Science:

  • Orthodontics
  • Periodontology
  • Biomaterials Science

Background:

  • Micro-osteoperforations (MOPs) are proposed to speed up orthodontic treatment, but their efficacy and safety are debated.
  • Assessing MOPs' clinical effectiveness and safety is crucial for optimizing orthodontic treatment protocols.

Purpose of the Study:

  • To systematically evaluate the effectiveness and safety of micro-osteoperforations (MOPs) in accelerating orthodontic tooth movement.
  • To identify optimal application protocols for MOPs through subgroup and meta-regression analyses.

Main Methods:

  • A systematic literature search was performed across major databases (PubMed, Embase, Scopus, Cochrane CENTRAL) and grey literature.
  • Random-effects meta-analysis synthesized data from 39 randomized controlled trials (1025 participants).
  • GRADE framework assessed the certainty of evidence.

Main Results:

  • MOPs demonstrated a substantial acceleratory effect (SMD = 1.66).
  • Repeating MOPs every 4 weeks was associated with ~0.54 mm cumulative movement.
  • No clear evidence of increased root resorption or periodontal deterioration was observed; pain was minimal.

Conclusions:

  • Moderate-certainty evidence supports MOPs, particularly repeating shallow buccal perforations every 4 weeks, for accelerated tooth movement.
  • Heterogeneity necessitates cautious interpretation of the effect's magnitude.