# Acceleration Techniques for Teeth Movements in Extractive Orthodontic Therapy
## 4 Discussion
### Corticotomies
The piezo group employed the OT7 (Mectron(r), Carasco, Italy) piezo tip to produce a vertical groove over the buccal cortex. This study assessed that corticotomy with bur was 1.5-2 times more rapid, whereas piezocision was 1.5 times faster; both are effective therapeutic options [55]. The [PERSON] (2019) RCT study compared piezocision with traditional orthodontics in the mandible in 36 patients [38]. Radiographic-guided micro piezoelectric corticotomies on the labial surfaces of the alveolar bone between the six anterior teeth were performed on patients in the ExGr to accelerate alignment. Compared to traditional therapy, this approach required 59% less TT to correct highly crowded lower anterior teeth [38]. [PERSON] (2015) compared two minimally invasive techniques: in a split-mouth study on ten patients, he performed traditional corticision with a number 15 blade in the mesiobuccal and distobuccal area of the maxillary canines on one side; on the contralateral side, he performed piezocisions of a depth of 3 mm [7]. The superimposition of the 3D models, carried out using the third palatine wrinkle as a reference point revealed approximately twice as fast movement on the piezocision side as on the C Side, especially during the first month of treatment [7]. [PERSON] et al. (2022) evaluated the effectiveness of piezocision compared to conventional orthodontics [58]. The piezocision group completed the levelling and alignment phase substantially faster than the CGr (mean difference = 31.5 days, 95% CI 6.5, 56.5; \(p\) = 0.018). The alignment rate in the piezocision group was quicker in the first two months than in the CGr [58]. The [PERSON] study (2015) compared piezocision and control versus corticotomy and control [23]. They assessed that orthodontics supported via corticotomies are 1.5 to 2 times faster than traditional orthodontics, and piezocision was 1.5 more rapid than conventional orthodontics [23]. Also, [PERSON] (2019) compared piezocision with traditional orthodontics: the ExGr with piezocision significantly improved the rate of incisor retraction by 53%, while the retraction time was significantly reduced by 27% [25]. [PERSON] et al. (2022) used a new technique, with 3D-guided piezo-assisted orthodontic treatment, compared to conventional orthodontic [39]. In ExGr 5, incisions were made in the labial cortical between the anterior teeth. The study revealed an OAT reduced 48% in this group compared to the CGr. Through a slight incision, this procedure might enable the creation of a simple, precise, predictable, and safe localised alveolar decortication. As a result, no harm would be inflicted on any surrounding anatomical structures if a flap was not raised [39]. The RCT study by [PERSON] (2020) that analyses the influence of lasercision on OTM is exciting. Lasercision corticotomy (Er, Cr: YSGG 3.5 W, 30 Hz, 40% air, 80% water) in one maxillary quadrant required 59% less TT to correct highly crowded lower anterior teeth than traditional therapy [49]. [PERSON] (2018) analysed laser-assisted flapless corticotomy (LARC) with ER: YAG laser and piezocision [26]. In both groups, the rate of canine retraction was two-fold higher in the ExGr than in the CGr in the first month and 1.5-fold higher in the second month (\(p<0.001\)). In addition, the total canine retraction time was decreased by nearly 25% in both groups when comparing the experimental and C Sides [26]. [PERSON] (2020) conducted a partial buccal plate corticotomy distal to the lingual vertical and subapical incisions, and the lingual flap was not raised [30]. This technique revealed that the rate of canine retraction on the corticotomy side was substantially greater than on the C Side [30]. The literature [26; 38; 68] confirms the efficacy of corticotomy, which reduces treatment time by 40 per cent; bur corticotomy is 1.5-2 times faster, and piezocision is 1.5 times faster, with both being effective. Piezocision accelerates canine retraction by 1.5 times. Lasercision requires 59% less TT for crowded anterior teeth.