# Acceleration Techniques for Teeth Movements in Extractive Orthodontic Therapy  
[PERSON]  
1 Department of Interdisciplinary Medicine, School of Medicine, University of Barr \"[PERSON]\", 70124 Bari, Italy; [EMAIL_ADDRESS] (G.D.); [EMAIL_ADDRESS] (A.P. ); [EMAIL_ADDRESS] (I.E. ); [EMAIL_ADDRESS] (F.V. ); [EMAIL_ADDRESS] (A.A.); [EMAIL_ADDRESS] (S.C.); [EMAIL_ADDRESS] (D.A. ); [EMAIL_ADDRESS] (A.M.C. ); [PERSON]G.M. ); [EMAIL_ADDRESS] (A.D.L. ); [EMAIL_ADDRESS] (A.M.L)  
[PERSON]  
2 Implant Dentistry College of Medicine and Dentistry, Birmingham B4 6 BN, UK; [EMAIL_ADDRESS] 2  
[PERSON]  
Correspondence: [EMAIL_ADDRESS]; Tel. : +39-331-211-1104 224110 224110 2241  
of therapy may discourage some patients from seeking orthodontic intervention and expose patients to possible complications, such as enamel demineralisation, caries, and gingival recession [1; 2; 3]. In recent years, there has been a growing interest in researching methods to accelerate orthodontic tooth movement (OTM) and reduce the duration of treatment. Several approaches have been proposed and studied, including corticotomies, micro-osteoperforations (MOPs), vibration therapy (VT), low-level pulsed light therapy (LLLT), platelet-rich plasma (PRP) and platelet-rich fibrinogen (PRF), drug therapy, and dentoulveolar distraction (DAD). Despite the growing body of literature, there is still no clear consensus on which methods are most effective, safe, and feasible in the clinical setting [4; 5; 6; 7]. This systematic review aims to examine and synthesise the evidence regarding different methods of accelerating OTM in extractive orthodontic treatment. A fixed orthodontic procedure lasts two to three years, and canine retraction is a crucial and time-consuming step in fixed orthodontic treatment for individuals who have had their premolars extracted. The canine retraction process uses traditional techniques at an average rate of 0.5 to 1 mm monthly. As a result, canine retraction alone requires 5 to 9 months and raises the risk of caries, external root resorption, and decreased patient participation. Therefore, making an effort to accelerate OTM and reduce the duration of treatment can be very helpful for improving future orthodontic treatment [8; 9]. This review will evaluate the efficacy, safety, and quality of the evidence for each approach, compare the advantages and disadvantages of the various methods, and discuss the implications for clinical practice and future research. Through this analysis, we aim to provide a solid foundation for orthodontists and researchers to improve orthodontic treatments further and increase patient satisfaction. It is important to note that not all methods are suitable for all patients and should be carefully evaluated and discussed with the orthodontist before proceeding. Some of the most used methods of accelerating OTM include:  
* Corticotomy is the execution of small incisions in the alveolar bone surrounding the teeth to facilitate their movement (Figure 1) [1], using several different techniques (chisel and hammer, piezosurgery, etc.) [4]. The goal is to stimulate local biological response and bone remodelling without damaging the surrounding tissues. * MOPs are small perforations in the alveolar bone around the teeth, obtained using miniscrews or fine needles [8]. The drilling process stimulates the local inflammatory response and accelerates bone remodelling, allowing for faster and more efficient OTM (Figure 1B) [5]. MOPs can be performed safely and with minor patient morbidity, reducing orthodontic TT [8; 10]. * VT devices use low-frequency vibrations to stimulate bone remodelling, reduce TT [11], reduce pain and discomfort, and improve the overall patient experience [6]. Application time is around 20 min per day [12]. * LLLT uses low-level pulsed light to stimulate tissue healing and bone remodelling by penetrating soft tissue without causing thermal damage [13]. This can help reduce  
Figure 1: **(A)** Corticomies; (B) MOPs; (C) combination of both techniques.