Abstract
Data sources
the Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, LILACS, metaRegister of Controlled Trials, ClinicalTrials.gov and the World Health Organisation (WHO) International Clinical Trials Registry Platform.
Study selection
Randomised controlled trials (RCTs) evaluating the effect of surgical adjunctive procedures for accelerating tooth movement compared with conventional treatment (no surgical adjunctive procedure).
Data extraction and synthesis
Two reviewers independently abstracted data and assessed risk of bias.
Results
Four randomised trials involving 57 patients were included. All four studies had unclear risk of bias. Interventions evaluated were corticotomies to facilitate orthodontic space closure or alignment of an ectopic maxillary canine, with the effect of repeated surgical procedures assessed in one of these studies. Tooth movement was found to be slightly quicker with surgically assisted orthodontics in comparison with conventional treatment over periods of one month (MD 0.61 mm; 95% CI 0.49 to 0.72; P value < 0.001) and three months (MD 2.03 mm, 95% CI 1.52 to 2.54; P value < 0.001). No information on adverse events was reported in the included studies.
Conclusions
This review found that there is limited research concerning the effectiveness of surgical interventions to accelerate orthodontic treatment, with no studies directly assessing our prespecified primary outcome. The available evidence is of low quality, which indicates that further research is likely to change the estimate of the effect. Based on measured outcomes in the short-term, these procedures do appear to show promise as a means of accelerating tooth movement. It is therefore possible that these procedures may prove useful; however, further prospective research comprising assessment of the entirety of treatment with longer follow-up is required to confirm any possible benefit.
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Authors and Affiliations
Additional information
Address for correspondence: Luisa Fernandez Mauleffinch, Managing Editor, Cochrane Oral Health Group, School of Dentistry, The University of Manchester, JR Moore Building, Oxford Road, Manchester, M13 9PL, UK. E-mail: luisa.fernandez@manchester.ac.uk
Fleming PS, Fedorowicz Z, Johal A, El-Angbawi A, Pandis N. Surgical adjunctive procedures for accelerating orthodontic treatment. Cochrane Database Syst Rev 2015; Issue 6. Art. No. CD010572. DOI: 10.1002/14651858.CD010572.pub2.
This paper is based on a Cochrane Review published in the Cochrane Library 2015, issue 6 (see www.thecochranelibrary.com for information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and the Cochrane Library should be consulted for the most recent version of the review.
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Flores-Mir, C. Limited research on surgical interventions to accelerate orthodontic treatment. Evid Based Dent 16, 88–89 (2015). https://doi.org/10.1038/sj.ebd.6401120
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DOI: https://doi.org/10.1038/sj.ebd.6401120
