Three-dimensional Assessment for the Possible Synergetic Effect of Micro-osteoperforation and Injectable Platelet-rich Fibrin on the Rate of Maxillary Canine Retraction :A Split-mouth Randomized Controlled Clinical Trial

Abstract

Three-dimensional Assessment of the Possible Synergetic Effect of Micro-osteoperforations and Injectable Platelet-rich Fibrin on the Rate of Maxillary Canine Retraction: A Split-mouth Randomized Controlled Clinical Trial Abstract This prospective split mouth randomized controlled clinical trial aimed primarily to assess the combined effect of micro-osteoperforations (MOPs) and injectable platelet-rich fibrin (i-PRF) on the rate of maxillary canine retraction. Additionally, it explored the side effects of the related rotation, tipping, vertical movements, root length and the presence of alveolar bony defects as dehiscence or fenestration. Twenty-five adults’ patients (19 females and 6 males, mean age, 20.47±4.1 years) exhibiting class II division 1 malocclusion with bilateral class II canines that required a therapeutic maxillary 1st premolars extraction were enrolled. Randomly selected side of maxillary arch received either MOPs with i-PRF (Experimental side), the contralateral side received only MOPs and served as (Control side). Canine retraction with absolute anchorage utilizing a minis-crews was initiated for both groups via a NiTi close coil springs with 150 g of force per side. The rate of maxillary canine retraction was measured every 4 weeks over a 24 weeks follow-up period (T0{before canine retraction} – T6{ after 24weeks}). Additionally, canine rotation, tipping, intrusion/extrusion, root length, alveolar boney defects were evaluated using cone-beam computed tomography (CBCT) before and after retraction at two- time points (T0 and T6). The independent t-test was used to compare between two sides while the t-test for paired samples and repeated measure of variance was used for the comparisons between stages from T0-T6. The p value was set at 0.05. The study findings revealed that, the rate of maxillary canine retraction was significantly different between the experimental and control side, with an over rate of 1.25±0.28 and 0.75 ±0.1 mm/month, respectively. This significant faster rate occurred at T1-T2 and at T4-T5 time points. Canine tipping was also greater in the experimental side, at 3.89 ±0.19º than in the control side, at 1.80±0.12º. No significant differences were found in maxillary canine rotation, extrusion or intrusion, root length and alveolar bony defects including fenestration and dehiscence. The study concluded that combination of MOPs and i-PRF proved to have a synergetic effect to enhance the acceleration of orthodontic tooth movement during maxillary canine retraction within the first 8 weeks (2 months) from their application, but also with a significant tipping movement.