Systematic review Does periodontally accelerated osteogenic orthodontics improve orthodontic treatment outcome?
Summary
Background
Periodontally accelerated osteogenic orthodontics (PAOO) can be used to improve periodontal conditions and accelerate tooth movement.
Objective
The aim of this systematic review and meta-analysis was to compare periodontal outcome and treatment duration of patients undergoing PAOO to accelerate orthodontic treatment.
Search method
An electronic search was performed in four electronic databases including Pubmed, EBSCO Cochrane library, CINAHL Complete for randomized clinical trials till November 2017. A hand search was performed on clinicaltrials.gov and Google scholar.
Selection criteria
Randomized
controlled trials reporting periodontal outcomes and treatment duration
of PAOO in adult patients by evaluating treatment duration, root resorption, bone density and pocket depths were included.
Data collection and analysis
Two
authors conducted searches, data extraction and bias assessment with
conflict resolution with a third author. Cochrane's tool for risk of
bias assessment was used for evaluation. A manual search was conducted
for additional studies. A quantitative synthesis of the pooled results
was conducted.
Results
Five
studies were included in the qualitative synthesis and two in the
quantitative synthesis. A total of 56 patients underwent the PAOO
technique; the effects of this therapy were compared with 21 patients
who underwent corticotomy, 9 underwent non-extraction comprehensive orthodontic treatment and 15 underwent fixed mechanotherapy with extractions of first premolars. A random effect model
was used for pocket depths and showed a non-significant difference
between bioactive glass augmented corticotomy and corticotomy alone
(weighted mean difference, −0.03; 95% CI, −0.16, 0.09). Bone density
elucidated a non-significant difference between bioactive glass
augmented corticotomy and corticotomy alone (weighted mean difference,
27.69; 95% CI, −2.29, 57.67). Fixed effect model was used for root
length which revealed a non-significant difference between bioactive
glass augmented corticotomy and corticotomy alone (weighted mean
difference, 0.01; 95% CI, −0.00, 0.02).
Conclusions
Studies
showed significant improvements in periodontal health. Treatment
duration was reduced in patients who underwent PAOO. Root resorption was
not sufficiently evaluated by current literature.
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