Effect of Alveocentesis on the Rate of Tooth Movement Bushra Naeem Khan, Bushra Naeem Khan, Ulfat Bashir, Owais Durrani Resident in Orthodontic Department, Islamic International Dental Hospital, Islamabad Abstract Introduction: The need to accelerate tooth movement and to decrease orthodontic treatment time has long been the area of research in the field of orthodontics. This study uncovers the modern day techniques in the field of orthodontics to address the issue of prolonged treatment time. Objective: The purpose of the study is to evaluate the effect of microosteoperforations on the rate of tooth movement. Material and Method: This is a randomized control trial in which 30 patients with class II division I were selected. Microosteoperforation side was randomly assigned to 1 side of the maxillary arch at the canine premolar region, and the other side served as the control. By using miniscrews as anchorage, canine retraction was initiated via powerchain. After 4 weeks rate of tooth movement is evaluated. Results: Rate of tooth movement on microosteoperforation side was significantly higher than the control. Rate of tooth movement after micro osteoperforations is 2.04 mm per 4 weeks. Conclusion: The findings of the research successfully aimed to develop a road map for conducting future researches. An increased tooth movement achieved by micro osteoperforation has opened gates for faster and quicker orthodontics. Key Words: Micro-osteoperforations, Canine movement, Accelerated tooth movement Introduction The purpose of orthodontic treatment is to enhance dentofacial functions and esthetics. For years there has been a search of an efficient method that can work expeditiously, accurately and competently to reduce treatment time in fact one of the reasons for adults to defer orthodontic treatment is prolonged treatment time. The biologic response of the tooth is the factor that has control over the rate of tooth movement. But what controls the biologic response of a tooth is still need to be investigated. Orthodontic tooth movement is the response to mechanical stimuli sequenced by bone apposition and resorption at the pressure and tension site respectively. It has been proposed that the rate of tooth movement is dependent on the rate of bone resorption which in turn is influenced by the osteoclastic activity [1,2]. Various methods have been introduced to surge osteoclastic activity in order to accelerate tooth movement. These methods fall in 3 categories. The first one, the biological approach encompasses the local or systemic administration of Interleukin, Prostaglandins, Cyclic adenosine monophosphate and leukotrines [3,4]. The second, physical stimulation which includes direct electric currents, pulsed electromagnetic fields, static magnetic field and low level laser [4]. According to literature these two methods increase the rate of tooth movement 0.3 to 1 fold when compared with the placebo. However these methods are not free of complications. The third, surgical approach consist of interseptal alveolar surgery and corticotomy [5]. A deliberate surgical injury to the cortical bone in order to reduce its resistance to tooth movement is referred as corticotomy. In 2001 Wilcko developed a technique which was called Periodontally Associated Osteogenic Orthodontics (PAOO) in which he added a bioabsosorbable grafting material in the osteomatized bone to enhance healing [6]. Later on, a less invasive technique Piezocision was introduced by Dibart which constitute the incisions on the buccal cortex via piezo surgical knife [7]. These procedures had low patient acceptance due to high morbidity, pain, swelling and being invasive in nature. More recently a new technique called Alveocentesis has been introduced in which Micro perforations were introduced in bone to accelerate bone turnover [8]. Animal studies have shown that by doing micro-osteoperforations (MOPs) on alveolar bone during orthodontic tooth movement accelerates the expression of these inflammatory cytokines, leading to rise in osteoclastic activity and the rate of tooth movement [8]. Teixeira et al. [9] demonstrated that the mice received micro- osteoperforations showed greater tooth movement 0.62 mm in 28 days which is significantly higher than the control group. A study conducted at dental school at Cairo university showed that there is a statistically significant difference (P<0.01) in the rates of anterioposterior movement of the canine in the osteoperforated and non-perforated side [10]. Alikhani et al. [8] concluded that there was 2.3 fold increases in tooth movement after microosteoperforation. MOPs can considerably reduce the density of bone and let safer and faster movement of tooth at the same time augmenting remodeling of alveolus in that particular area [11]. Objective The objective of the study is to evaluate mean tooth movement after alveocentesis. Materials and Methods A randomized single center, single blinded study commenced in the orthodontic department. After the approval of the study by the ethical committee, patients who fulfilled the inclusion criteria and completed the informed consent form were included in the study. A sample of 30 patients was selected. The inclusion and exclusion criteria was Inclusion criteria • Both male and female patients with age of 15- 28 years, • Dental Class II div I cases (Angle’s classification) (annexure attached), • Probing depth < 4 mm in all teeth (measured by CPITN probe). Corresponding author: Bushra Naeem Khan, Resident in Orthodontic Department, Islamic International Dental Hospital, 7th avenue, G-7/4, Islamabad, Tel: +923333751382; E-mail: bushra_nm@hotmail.com 1