YIJOM-3115; No of Pages 4 Please cite this article in press as: Cassetta M, et al. Minimally invasive corticotomy in orthodontics: a new technique using a CAD/ CAM surgical template, Int J Oral Maxillofac Surg (2015), http://dx.doi.org/10.1016/j.ijom.2015.02.020 Technical Note Orthognathic Surgery Minimally invasive corticotomy in orthodontics: a new technique using a CAD/CAM surgical template M. Cassetta, S. Pandolfi, M. Giansanti: Minimally invasive corticotomy in orthodontics: a new technique using a CAD/CAM surgical template. Int. J. Oral Maxillofac. Surg. 2015; xxx: xxx–xxx. # 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. M. Cassetta, S. Pandolfi, M. Giansanti Department of Oral and Maxillofacial Sciences, ‘‘Sapienza’’ University of Rome, Rome, Italy Abstract. Accelerating orthodontic tooth movement is a topical issue. Despite the different techniques described in the literature, the corticotomy is the only effective and safe means of accelerating orthodontic tooth movement. Although effective, the corticotomy presents significant postoperative discomfort. The aggressive nature of these particular methods, related to the elevation of mucoperiosteal flaps and to the length of the surgery, has resulted in reluctance to proceed with this technique among both patients and the dental community. To overcome the disadvantages of the corticotomy, this technical note describes an innovative, minimally invasive, flapless procedure combining piezoelectric surgical cortical micro-incisions with the use of a 3D Printed CAD/CAM surgical guide. Key words: corticotomy; orthodontics; CAD/ CAM; minimally invasive; surgical template; 3D Printer. Accepted for publication 25 February 2015 The mean duration of fixed orthodontic treatment poses a high risk of caries, external root resorption, and decreasing patient compliance. 1 Accelerating ortho- dontic tooth movement, with the result- ing shortened treatment duration, is therefore a topical issue. 1 Despite the different techniques described in the literature, the corticotomy is the only effective and safe means of accelerating orthodontic tooth movement; however, there are few published reports on this subject. 2 It has been suggested that the biological basis of accelerated orthodon- tic tooth movement is mediated by a regional acceleratory phenomenon. 3 The hypothesis is that the corticotomy can lead to intensified osteoclastic activ- ity, resulting in osteopaenia and in- creased bone remodeling. 3 The corticotomy used in accelerating orthodontic tooth movement, also termed corticotomy-assisted orthodontic treatment (CAOT), 2 consists of small perforations on the alveolar bones along the way by which the tooth would be moved. Although effective, CAOT pre- sents significant postoperative discom- fort. 1 The aggressive nature of these particular methods, related to the eleva- tion of mucoperiosteal flaps and to the length of the surgery, has resulted in reluctance to proceed with this technique among both patients and the dental com- munity. 4 Initially the cortical incisions were performed using a bone bur, which Int. J. Oral Maxillofac. Surg. 2015; xxx: xxx–xxx http://dx.doi.org/10.1016/j.ijom.2015.02.020, available online at http://www.sciencedirect.com 0901-5027/000001+04 # 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.