Mandibular Second Molar Protraction Assisted by Piezocision
Condition: Acceleration of Tooth Movement; Piezocision
Study type: Interventional

Summary: 
      This study was conducted to compare the rate of second molar protraction, level of
      Interleukin1-β in gingival crevicular fluid, periodontal health (gingival index, plaque
      index, and periodontal pocket depth) and perception of pain in patients treated by molar
      protraction with piezocision vs control (no piezocision).
    

Detailed description: 
      Twenty-six subjects (39 Molars) who presented with at least one extracted mandibular first
      molar were selected to participate in the study. The subjects were subdivided into one of 3
      groups as follows: group 1 consisted of 18 molars (13 molars from patients with bilateral
      first molar extraction space and 5 molars from patients with unilateral first molar
      extraction space) where piezocision was performed immediately before molar protraction; group
      2 consisted of 21 molars (13 from patients with bilateral first molar extraction space and 8
      molars from patients with unilateral first molar extraction space) where molar protraction
      was performed with no piezocision; group 3 consisted of 21 molars (group 2 subjects where
      piezocision was carried on after 3 months of molar protraction with no piezocision. After
      reaching 0.019X0.025" SS arch wire, NiTi coil spring was used for space closure (protraction
      force was 150g) attached from the lower second molar hook to the head of the mini-screw.
      Piezocision was performed by making 2 vertical incisions mesial and distal to the extraction
      space. Piezotome was inserted in the incisions previously made and bone cuts were done with a
      length up to mucogingival line and depth of 3 mm.

      Gingival crevicular fluid (GCF) sample was obtained from the mesiogingival side of the lower
      second permanent molar with use of Periopaper. GCF sample was repeated 1 day, 1 week and 4
      weeks after molar protraction with piezocision or with no piezocision. Pain was assessed
      using visual analog scale (VAS). Patients were requested to report the level of pain for 7
      consecutive days.
    

Intervention name(s): Piezocision
Intervention type(s): Procedure
Intervention description(s): Piezocesion was performed by making 2 vertical incisions mesial and distal to the extraction space. Piezotome was inserted in the incisions previously made and bone cuts were done with a length up to mucogingival line and depth of 3 mm.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Three models:-
Split mouth design where piezocision will be performed on the right of left side of the patient in bilateral first molar extraction space subjects.
comparison between 2 groups of subjects; one group where protraction is done with piezocision and the other group where protraction was done with no piezocision.
third part where the same side of space receives the 2 interventions. Molar protraction started with no piezocision for 3 months followed by piezocision and protraction for another 3 months,
Primary purpose: Treatment
Keywords: Piezocision; Temporary anchorage device; molar protraction