EFFECTS OF THE INNOVATIVE MINIMALLY INVASIVE METHOD OF ORTHODONTIC TREATMENT ACCELERATION ON THE PERIODONTAL CONDITIONS

Effects of the innovative minimally invasive method of orthodontic treatment acceleration on the periodontal conditions. INTERIM RESULTS OBJECTIVES: The aim of this project is to evaluate effects of the innovative micro-osteoperforations (MOPs) method of orthodontic treatment acceleration on periodontal tissues during teeth alignment provided by clear aligners. MATERIALS AND METHODS: This is a multicenter, parallel-arm, randomized controlled clinical trial. The study was conducted in two clinical centres. Orthodontic patients with Class I and II malocclusion with diastema or with mild to moderate teeth irregularity (1-6 grade of Little’s index) of the lower incisors in a permanent dentition, in absence of craniofacial anomalies were recruited. Study subjects were randomly allocated in one of the following groups: Control Group will receive conventional Invisalign treatment changing trays every 7 days, Test Group receiving MOPs and changing trays every 3 days. Clinical measurement (gingival phenotype, PPD, REC, FMPS and FMBS) were performed at baseline, every 10 aligners and after the end of active orthodontic treatment. Additionally, after the completion of orthodontic treatment all patients received a VAS questionnaire for patients’ satisfaction assessment. Data analysis was performed using JMP software (version 5.01a, SAS). Descriptive statistics of baseline characteristics were calculated and expressed as mean values ± standard deviation (SD). RESULTS: This manuscript reports ad interim results of the RCT.
A total of 10 patients were enrolled, however during the experimental period, 1 patient was lost because of an interruption of the orthodontic treatment, thus a total of 9 subjects (5 males and 4 females; mean age 30.6±10.4 years;) were included in the present study. Two patients represented with diastema and seven with teeth crowding. Five patients were assigned to the test group (4 males and 1 females, mean age 33.2±12.9 years) and four were in the control group (1 male and 3 females, 27.5±6.6 years). After the MOP placement all treated sites healed uneventfully in all subjects assigned to the test group.
All patients presented with FMPS and FMBS lower than 20%, performing acceptable level of patients compliance and from low to moderate risk for the periodontal breakdown. Probing depth never exceeded 4 mm in both groups from T0 to T30 and only few sites were deeper than 3mm.
Total amount of gingival recessions at T30 was almost did not changed copied to the baseline. In two patients after uneventful healing of the mucosa and orthodontic forces application we observed multiple exostosis formation in the area of the MOPs’ placement. Patients who experienced this unwanted effect reported some grade of discomfort, that diminished in time. During further two month of the accelerated orthodontic therapy following the study protocol patients experienced a graduate reduction of exostoses. Conclusions and recommendation for future research. MOPs can be considered as a new minimally invasive, easy-to-use and efficient technique for acceleration of orthodontic tooth movement with improved patient acceptance. If the oral hygiene is kept under control, and timing of the tooth acceleration after procedure is respected- MOPs’ do not lead to the periodontal breakdown. It is important to investigate if there is a correlation between the incidence of gingival recession and periodontal phenotype features in orthodontic patients treated with or without periodontally assisted acceleration, therefore, it is necessary to augment the number of participants in order to validate the statistics. Further studies are required to evaluate the effect of different numbers of MOPs on the rate of tooth movements and to find the ideal timing and frequency of the MOP application in order to achieve optimum tooth movement acceleration.