Osseous evidence behind micro-osteoperforation technique in accelerating orthodontic tooth movement: A 3-month study

Published:August 18, 2020DOI:


      • Canine retraction difference between control and micro-osteoperforation (MOP) was significant.
      • The 4-week group showed a significant difference in bone volume fraction compared with control.
      • Canine retraction and BV/TV ratio at the MOP side were negatively correlated in the 4-week group.
      • The rate of orthodontic tooth movement can be accelerated by using the MOP technique.


      The study aimed to investigate the effects of micro-osteoperforations (MOPs) on the mandibular bone volume/tissue volume (BV/TV) ratio changes and the rate of orthodontic tooth movement using cone-beam computed tomography images. Another objective was to evaluate the effects of MOP frequency intervals (4 weeks, 8 weeks, and 12 weeks) on the BV/TV ratio and rate of tooth movement.


      In 24 participants, 140-200 g of force was applied for mandibular canine retraction. Three MOPs were made according to the scheduled intervals of the 3 different groups: group 1 (MOP 4 weeks), group 2 (MOP 8 weeks), and group 3 (MOP 12 weeks) directly at the mandibular buccal cortical bone of extracted first premolars sites. Cone-beam computed tomography scans were obtained at the 12th week after MOP application. Computed tomography Analyzer software (version; Skyscan, Kontich, Belgium) was used to compute the trabecular alveolar BV/TV ratio.


      A significant difference was observed in the rate of canine movement between control and MOP. Paired t test analysis showed a significant difference (P = 0.001) in the mean BV/TV ratio between control and MOP sides in all the frequency intervals groups. However, the difference was significant only in group 1 (P = 0.014). A strong negative correlation (r = −0.86) was observed between the rate of canine tooth movement and the BV/TV ratio at the MOP side for group 1 and all frequency intervals together (r = −0.42).


      The rate of orthodontic tooth movement can be accelerated by the MOP technique with frequently repeated MOPs throughout the treatment.
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        • Krishnan V.
        • Davidovitch Z.
        Cellular, molecular, and tissue-level reactions to orthodontic force.
        Am J Orthod Dentofacial Orthop. 2006; 129: 469.e1-469.e32
        • Henneman S.
        • Von den Hoff J.W.
        • Maltha J.C.
        Mechanobiology of tooth movement.
        Eur J Orthod. 2008; 30: 299-306
        • Zainal Ariffin S.H.
        • Yamamoto Z.
        • Zainol Abidin I.Z.
        • Megat Abdul Wahab R.
        • Zainal Ariffin Z.
        Cellular and molecular changes in orthodontic tooth movement.
        ScientificWorldJournal. 2011; 11: 1788-1803
        • Cardaropoli D.
        • Gaveglio L.
        The influence of orthodontic movement on periodontal tissues level.
        Semin Orthod. 2007; 13: 234-245
        • Frost H.M.
        The regional accelerated phenomenon.
        Orthop Clin N Am. 1981; 12: 725-726
        • Schilling T.
        • Müller M.
        • Minne H.W.
        • Ziegler R.
        Influence of inflammation-mediated osteopenia on the regional acceleratory phenomenon and the systemic acceleratory phenomenon during healing of a bone defect in the rat.
        Calcif Tissue Int. 1998; 63: 160-166
        • Wilcko W.M.
        • Ferguson D.J.
        • Bouquot J.E.
        • Wilcko M.T.
        Rapid orthodontic decrowding with alveolar augmentation: case report.
        World J Orthod. 2003; 4: 197-205
        • Hsu J.T.
        • Chang H.W.
        • Huang H.L.
        • Yu J.H.
        • Li Y.F.
        • Tu M.G.
        Bone density changes around teeth during orthodontic treatment.
        Clin Oral Investig. 2011; 15: 511-519
        • Yu J.H.
        • Huang H.L.
        • Liu C.F.
        • Wu J.
        • Li Y.F.
        • Tsai M.T.
        • et al.
        Does orthodontic treatment affect the alveolar bone density?.
        Medicine (Baltimore). 2016; 95: e3080
        • Wilcko W.M.
        • Wilcko T.
        • Bouquot J.E.
        • Ferguson D.J.
        Rapid orthodontics with alveolar reshaping: two case reports of decrowding.
        Int J Periodontics Restorative Dent. 2001; 21: 9-19
        • Ren A.
        • Lv T.
        • Kang N.
        • Zhao B.
        • Chen Y.
        • Bai D.
        Rapid orthodontic tooth movement aided by alveolar surgery in beagles.
        Am J Orthod Dentofacial Orthop. 2007; 131: 160.e1-160.e10
        • Iino S.
        • Sakoda S.
        • Ito G.
        • Nishimori T.
        • Ikeda T.
        • Miyawaki S.
        Acceleration of orthodontic tooth movement by alveolar corticotomy in the dog.
        Am J Orthod Dentofacial Orthop. 2007; 131: 448.e1-448.e8
        • Sebaoun J.D.
        • Kantarci A.
        • Turner J.W.
        • Carvalho R.S.
        • Van Dyke T.E.
        • Ferguson D.J.
        Modeling of trabecular bone and lamina dura following selective alveolar decortication in rats.
        J Periodontol. 2008; 79: 1679-1688
        • Wang L.
        • Lee W.
        • Lei D.L.
        • Liu Y.P.
        • Yamashita D.D.
        • Yen S.L.
        Tisssue responses in corticotomy- and osteotomy-assisted tooth movements in rats: histology and immunostaining.
        Am J Orthod Dentofacial Orthop. 2009; 136 (discussion 770-771): 770.e1-770.e11
        • Wilcko M.T.
        • Wilcko W.M.
        • Pulver J.J.
        • Bissada N.F.
        • Bouquot J.E.
        Accelerated osteogenic orthodontics technique: a 1-stage surgically facilitated rapid orthodontic technique with alveolar augmentation.
        J Oral Maxillofac Surg. 2009; 67: 2149-2159
        • Alikhani M.
        • Raptis M.
        • Zoldan B.
        • Sangsuwon C.
        • Lee Y.B.
        • Alyami B.
        • et al.
        Effect of micro-osteoperforations on the rate of tooth movement.
        Am J Orthod Dentofacial Orthop. 2013; 144: 639-648
        • Tsai C.Y.
        • Yang T.K.
        • Hsieh H.Y.
        • Yang L.Y.
        Comparison of the effects of micro-osteoperforation and corticision on the rate of orthodontic tooth movement in rats.
        Angle Orthod. 2016; 86: 558-564
        • Teixeira C.C.
        • Khoo E.
        • Tran J.
        • Chartres I.
        • Liu Y.
        • Thant L.M.
        • et al.
        Cytokine expression and accelerated tooth movement.
        J Dent Res. 2010; 89: 1135-1141
        • Sivarajan S.
        • Doss J.G.
        • Papageorgiou S.N.
        • Cobourne M.T.
        • Wey M.C.
        Mini-implant supported canine retraction with micro-osteoperforation: a split-mouth randomized clinical trial.
        Angle Orthod. 2019; 89: 183-189
        • Sugimori T.
        • Yamaguchi M.
        • Shimizu M.
        • Kikuta J.
        • Hikida T.
        • Hikida M.
        • et al.
        Micro-osteoperforations accelerate orthodontic tooth movement by stimulating periodontal ligament cell cycles.
        Am J Orthod Dentofacial Orthop. 2018; 154: 788-796
        • Alkebsi A.
        • Al-Maaitah E.
        • Al-Shorman H.
        • Abu Alhaija E.
        Three-dimensional assessment of the effect of micro-osteoperforations on the rate of tooth movement during canine retraction in adults with Class II malocclusion: a randomized controlled clinical trial.
        Am J Orthod Dentofacial Orthop. 2018; 153: 771-785
        • Felsenberg D.
        • Boonen S.
        The bone quality framework: determinants of bone strength and their interrelationships, and implications for osteoporosis management.
        Clin Ther. 2005; 27: 1-11
        • Genant H.K.
        • Gordon C.
        • Jiang Y.
        • Link T.M.
        • Hans D.
        • Majumdar S.
        • et al.
        Advanced imaging of the macrostructure and microstructure of bone.
        Horm Res. 2000; 54: 24-30
        • Issever A.S.
        • Link T.M.
        • Kentenich M.
        • Rogalla P.
        • Burghardt A.J.
        • Kazakia G.J.
        • et al.
        Assessment of trabecular bone structure using MDCT: comparison of 64- and 320-slice CT using HR-pQCT as the reference standard.
        Eur Radiol. 2010; 20: 458-468
        • Ibrahim N.
        • Parsa A.
        • Hassan B.
        • van der Stelt P.
        • Wismeijer D.
        Diagnostic imaging of trabecular bone microstructure for oral implants: a literature review.
        Dentomaxillofac Radiol. 2013; 42: 20120075
        • Cheung T.
        • Park J.
        • Lee D.
        • Kim C.
        • Olson J.
        • Javadi S.
        • et al.
        Ability of mini-implant-facilitated micro-osteoperforations to accelerate tooth movement in rats.
        Am J Orthod Dentofacial Orthop. 2016; 150: 958-967
        • Ibrahim N.
        • Parsa A.
        • Hassan B.
        • van der Stelt P.
        • Aartman I.H.
        • Wismeijer D.
        Accuracy of trabecular bone microstructural measurement at planned dental implant sites using cone-beam CT datasets.
        Clin Oral Implants Res. 2014; 25: 941-945
        • González-García R.
        • Monje F.
        The reliability of cone-beam computed tomography to assess bone density at dental implant recipient sites: a histomorphometric analysis by micro-CT.
        Clin Oral Implants Res. 2013; 24: 871-879
        • Van Dessel J.
        • Huang Y.
        • Depypere M.
        • Rubira-Bullen I.
        • Maes F.
        • Jacobs R.
        A comparative evaluation of cone beam CT and micro-CT on trabecular bone structures in the human mandible.
        Dentomaxillofac Radiol. 2013; 42: 20130145
        • Van Dessel J.
        • Nicolielo L.F.
        • Huang Y.
        • Coudyzer W.
        • Salmon B.
        • Lambrichts I.
        • et al.
        Accuracy and reliability of different cone beam computed tomography (CBCT) devices for structural analysis of alveolar bone in comparison with multislice CT and micro-CT.
        Eur J Oral Implantol. 2017; 10: 95-105
        • Giannopoulou C.
        • Dudic A.
        • Pandis N.
        • Kiliaridis S.
        Slow and fast orthodontic tooth movement: an experimental study on humans.
        Eur J Orthod. 2016; 38: 404-408
        • Park H.S.
        • Lee Y.J.
        • Jeong S.H.
        • Kwon T.G.
        Density of the alveolar and basal bones of the maxilla and the mandible.
        Am J Orthod Dentofacial Orthop. 2008; 133: 30-37
        • Parsa A.
        • Ibrahim N.
        • Hassan B.
        • van der Stelt P.
        • Wismeijer D.
        Bone quality evaluation at dental implant site using multislice CT, micro-CT, and cone beam CT.
        Clin Oral Implants Res. 2015; 26: e1-e7
        • Bechara B.
        • McMahan C.A.
        • Moore W.S.
        • Noujeim M.
        • Geha H.
        • Teixeira F.B.
        Contrast-to-noise ratio difference in small field of view cone beam computed tomography machines.
        J Oral Sci. 2012; 54: 227-232

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      • Osseous evidence behind micro-osteoperforation
        American Journal of Orthodontics and Dentofacial OrthopedicsVol. 159Issue 2
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          We read the article reporting osseous evidence behind micro-osteoperforation (MOP) when it was first published online ahead of print (Asif MK, Ibrahim N, Sivarajan S, Heng Khiang Teh N, Chek Wey M. Osseous evidence behind micro-osteoperforation technique in accelerating orthodontic tooth movement: a 3-month study. Am J Orthod Dentofacial Orthop 2020;158:579-86.e1). The study highlighted important aspects related to the acceleration of orthodontic tooth movement. We have some questions regarding the trial and would like the authors to enlighten us regarding the same.
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