{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:18:36Z","timestamp":1787008716917,"version":"build-2736575974"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,8,19]],"date-time":"2020-08-19T00:00:00Z","timestamp":1597795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,8]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prolonged duration of orthodontic treatment is of great concern and poses risks to the teeth and surrounding tissues. Orthodontic tooth movement can be accelerated by introducing regional insult. Evidence suggests piezocision to be minimally invasive and clinically effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of the present study was to compare the effectiveness of conventional and piezocision-assisted orthodontics in relieving anterior crowding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Search methods<\/jats:title>\n                    <jats:p>Electronic and manual searches were conducted in databases including PubMed, Dental and Oral Science, CINAHL, and Cochrane Central Register of Controlled Trials until April 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Selection criteria<\/jats:title>\n                    <jats:p>Randomized and non-randomized controlled trials were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data collection and analysis<\/jats:title>\n                    <jats:p>Data were extracted independently by two authors from the studies that fulfilled inclusion criteria. The primary outcome assessed was time required for the alleviation of crowding. The secondary outcomes evaluated were pain, root resorption, and periodontal health. The risk of bias in the clinical trials was evaluated according to the Cochrane Collaboration\u2019s tool. Studies having homogenous data were included in the meta-analysis using the RevMan software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Initial search yielded 3018 studies with eight articles meeting the inclusion criteria, six were randomized controlled trials and two were non-randomized controlled trials. Significant differences were found in alignment time between conventional and piezocision-assisted orthodontic treatment. However, gingival health, pain experienced by the patient, and root resorption showed non-significant differences. The forest plot of meta-analysis depicted significant mean difference of \u221246.44; 95 per cent confidence interval (CI) \u221287.95, \u22124.93; P \u2264 0.03 in the alignment time. Difference in pain levels was found to be non-significant (P = 0.78).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations<\/jats:title>\n                    <jats:p>There is a shortage of high-quality randomized controlled trials with a limited sample size and lack of standardization of piezocision protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and implications<\/jats:title>\n                    <jats:p>According to the existing evidence, piezocision is effective in reducing tooth alignment time and alleviating crowding when compared to conventional therapy. Pain levels showed insignificant differences revealed in meta-analysis. Weak evidence suggests that there are no negative effects on periodontal health and root resorption after performing piezocision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p>PROSPERO (CRD42019134398).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejo\/cjaa046","type":"journal-article","created":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T15:12:12Z","timestamp":1594825932000},"page":"360-366","source":"Crossref","is-referenced-by-count":21,"title":["Comparison between conventional and piezocision-assisted orthodontics in relieving anterior crowding: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5403-858X","authenticated-orcid":false,"given":"Erum","family":"Afzal","sequence":"first","affiliation":[{"name":"Section of Dentistry, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mubassar","family":"Fida","sequence":"additional","affiliation":[{"name":"Section of Dentistry, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Durre Shahwar","family":"Malik","sequence":"additional","affiliation":[{"name":"Section of Dentistry, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2598-052X","authenticated-orcid":false,"given":"Sarah","family":"Irfan","sequence":"additional","affiliation":[{"name":"Section of Dentistry, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meisha","family":"Gul","sequence":"additional","affiliation":[{"name":"Department of Operative Dentistry, Bahria University Medical and Dental College, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,8,19]]},"reference":[{"key":"2021060818175476500_CIT0001","doi-asserted-by":"crossref","first-page":"469.e1","DOI":"10.1016\/j.ajodo.2005.10.007","article-title":"Cellular, molecular, and tissue level reactions to orthodontic force","volume":"129","author":"Krishnan","year":"2006","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2021060818175476500_CIT0002","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1111\/j.1601-6343.2009.01444.x","article-title":"RANK\/RANKL\/OPG during orthodontic tooth movement","volume":"12","author":"Yamaguchi","year":"2009","journal-title":"Orthodontics & Craniofacial Research,"},{"key":"2021060818175476500_CIT0003","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.ajodo.2008.09.028","article-title":"Pretreatment characteristics associated with orthodontic treatment duration","volume":"137","author":"Fisher","year":"2010","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2021060818175476500_CIT0004","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.sdentj.2011.01.003","article-title":"Adverse effects of orthodontic treatment: a clinical perspective","volume":"23","author":"Talic","year":"2011","journal-title":"The Saudi Dental Journal,"},{"key":"2021060818175476500_CIT0005","doi-asserted-by":"crossref","first-page":"276.e1","DOI":"10.1016\/j.ajodo.2008.07.011","article-title":"Attractiveness, acceptability, and value of orthodontic appliances","volume":"135","author":"Rosvall","year":"2009","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2021060818175476500_CIT0006","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1590\/2176-9451.19.6.123-133.sar","article-title":"New therapeutic modalities to modulate orthodontic tooth movement","volume":"19","author":"Andrade","year":"2014","journal-title":"Dental Press Journal of Orthodontics,"},{"key":"2021060818175476500_CIT0007","first-page":"35","article-title":"Accelerated orthodontics-a review","volume":"1","author":"Shenava","year":"2014","journal-title":"International Journal of Scientific Study,"},{"key":"2021060818175476500_CIT0008","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2196-1042-14-42","article-title":"Acceleration of tooth movement during orthodontic treatment-a frontier in orthodontics","volume":"14","author":"Nimeri","year":"2013","journal-title":"Progress in Orthodontics,"},{"key":"2021060818175476500_CIT0009","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2174\/1874210601004010159","article-title":"Corticotomy-assisted orthodontic treatment","volume":"4","author":"Hassan","year":"2010","journal-title":"Open Dentistry Journal,"},{"key":"2021060818175476500_CIT0010","doi-asserted-by":"crossref","first-page":"417","DOI":"10.2319\/0003-3219(2007)077[0417:OTAWCE]2.0.CO;2","article-title":"Orthodontic treatment acceleration with corticotomy-assisted exposure of palatally impacted canines","volume":"77","author":"Fischer","year":"2007","journal-title":"The Angle Orthodontist,"},{"key":"2021060818175476500_CIT0011","first-page":"3","article-title":"The regional acceleratory phenomenon","volume":"31","author":"Frost","year":"1983","journal-title":"Henry Ford Hospital Medical Journal,"},{"key":"2021060818175476500_CIT0012","first-page":"9","article-title":"Rapid orthodontics with alveolar reshaping: two case reports of decrowding","volume":"21","author":"Wilcko","year":"2001","journal-title":"The International Journal of Periodontics & Restorative Dentistry,"},{"key":"2021060818175476500_CIT0013","doi-asserted-by":"crossref","first-page":"e54","DOI":"10.4317\/jced.50642","article-title":"Corticotomy-assisted orthodontics","volume":"4","author":"Cano","year":"2012","journal-title":"Journal of Clinical and Experimental Dentistry,"},{"key":"2021060818175476500_CIT0014","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.2147\/PPA.S89095","article-title":"Patients\u2019 acceptance of corticotomy-assisted orthodontics","volume":"9","author":"Zawawi","year":"2015","journal-title":"Patient Preference and Adherence,"},{"key":"2021060818175476500_CIT0015","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1053\/j.sodo.2015.06.003","article-title":"Piezocision\u2122-assisted orthodontics: past, present, and future","volume":"21","author":"Dibart","year":"2015","journal-title":"Seminars in Orthodontics,"},{"key":"2021060818175476500_CIT0016","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1051\/orthodfr\/2011142","article-title":"Accelerated orthodontic treatments with piezocision: a mini\u2013invasive alternative to alveolar corticotomies","volume":"82","author":"Jean-David","year":"2011","journal-title":"Orthodontie Fran\u00e7aise,"},{"key":"2021060818175476500_CIT0017","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s13005-018-0161-9","article-title":"Evaluation of piezocision and laser-assisted flapless corticotomy in the acceleration of canine retraction: a randomized controlled trial","volume":"14","author":"Alfawal","year":"2018","journal-title":"Head & Face Medicine,"},{"key":"2021060818175476500_CIT0018","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1093\/ejo\/cjw091","article-title":"Efficiency of piezotome-corticision assisted orthodontics in alleviating mandibular anterior crowding-a randomized clinical trial","volume":"39","author":"Uribe","year":"2017","journal-title":"European Journal of Orthodontics,"},{"key":"2021060818175476500_CIT0019","doi-asserted-by":"crossref","first-page":"491","DOI":"10.2319\/01191-751.1","article-title":"Efficacy of piezocision on accelerating orthodontic tooth movement: a systematic review","volume":"87","author":"Yi","year":"2017","journal-title":"The Angle Orthodontist,"},{"key":"2021060818175476500_CIT0020","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1001\/jama.2015.3656","article-title":"Preferred reporting items for a systematic review and meta-analysis of individual participant data: the PRISMA-IPD statement","volume":"313","author":"Stewart","year":"2015","journal-title":"Journal of the American Medical Association,"},{"key":"2021060818175476500_CIT0021","doi-asserted-by":"crossref","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane Collaboration\u2019s tool for assessing risk of bias in randomised trials","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ (Clinical Research Ed.),"},{"key":"2021060818175476500_CIT0022","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s40510-018-0244-y","article-title":"Comparison of piezocision and decision methods in orthodontic treatment","volume":"19","author":"Yavuz","year":"2018","journal-title":"Progress in Orthodontics,"},{"key":"2021060818175476500_CIT0023","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1016\/j.ajodo.2018.06.013","article-title":"Piezocorticision-assisted orthodontics: efficiency, safety, and long-term evaluation of the inflammatory process","volume":"155","author":"Strippoli","year":"2019","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2021060818175476500_CIT0024","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1177\/0022034516645066","article-title":"Localized piezoelectric alveolar decortication for orthodontic treatment in adults: a randomized controlled trial","volume":"95","author":"Charavet","year":"2016","journal-title":"Journal of Dental Research,"},{"key":"2021060818175476500_CIT0025","doi-asserted-by":"crossref","first-page":"4355","DOI":"10.1007\/s00784-019-02887-z","article-title":"Patient-reported outcomes measures (PROMs) following a piezocision-assisted versus conventional orthodontic treatments: a randomized controlled trial in adults","volume":"23","author":"Charavet","year":"2019","journal-title":"Clinical Oral Investigations,"},{"key":"2021060818175476500_CIT0026","doi-asserted-by":"crossref","first-page":"e292","DOI":"10.4317\/jced.50822","article-title":"Periodontally accelerated osteogenic orthodontics (PAOO)-a review","volume":"4","author":"Amit","year":"2012","journal-title":"Journal of Clinical and Experimental Dentistry,"},{"key":"2021060818175476500_CIT0027","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.ajodo.2013.01.022","article-title":"Effect of piezopuncture on tooth movement and bone remodeling in dogs","volume":"144","author":"Kim","year":"2013","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2021060818175476500_CIT0028","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1093\/ejo\/cjt057","article-title":"Bone response to buccal tooth movements with and without flapless alveolar decortication","volume":"36","author":"Ruso","year":"2013","journal-title":"European Journal of Orthodontics,"},{"key":"2021060818175476500_CIT0029","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.ejwf.2019.07.002","article-title":"Multilevel biological responses following piezocision to accelerate orthodontic tooth movement: a study in rats","volume":"8","author":"Charavet","year":"2019","journal-title":"Journal of World Federation of Orthodontists,"},{"key":"2021060818175476500_CIT0030","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1093\/ejo\/cjn018","article-title":"Factors affecting the duration of orthodontic treatment: a systematic review","volume":"30","author":"Mavreas","year":"2008","journal-title":"European Journal of Orthodontics,"},{"key":"2021060818175476500_CIT0031","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1093\/ejo\/cjy042","article-title":"Efficacy of piezocision-based flapless corticotomy in the orthodontic correction of severely crowded lower anterior teeth: a randomized controlled trial","volume":"41","author":"Gibreal","year":"2019","journal-title":"European Journal of Orthodontics,"},{"key":"2021060818175476500_CIT0032","volume-title":"Efficiency of Piezotome-Corticision Assisted Orthodontics in Alleviating Mandibular Anterior Crowding\u2014A Randomized Controlled Clinical Trial","author":"Mehr","year":"2013"},{"key":"2021060818175476500_CIT0033","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/s12903-019-0758-9","article-title":"Evaluation of the levels of pain and discomfort of piezocision-assisted flapless corticotomy when treating severely crowded lower anterior teeth: a single-center, randomized controlled clinical trial","volume":"19","author":"Gibreal","year":"2019","journal-title":"BMC Oral Health,"},{"key":"2021060818175476500_CIT0034","first-page":"543","article-title":"Osseous response following resective therapy with piezosurgery","volume":"25","author":"Vercellotti","year":"2005","journal-title":"The International Journal of Periodontics & Restorative Dentistry,"},{"key":"2021060818175476500_CIT0035","first-page":"216","article-title":"Combined surgical and orthodontic management of anterior open bite using corticotomy","volume":"36","author":"Generson","year":"1978","journal-title":"Journal of Oral Surgery,"},{"key":"2021060818175476500_CIT0036","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.ajodo.2015.09.029","article-title":"Evaluation of corticotomy-facilitated orthodontics and piezocision in rapid canine retraction","volume":"149","author":"Abbas","year":"2016","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2021060818175476500_CIT0037","doi-asserted-by":"crossref","first-page":"59","DOI":"10.2319\/012215-49.1","article-title":"Accelerated tooth movement with piezocision and its periodontal-transversal effects in patients with Class II malocclusion","volume":"86","author":"Aksakalli","year":"2016","journal-title":"The Angle Orthodontist,"},{"key":"2021060818175476500_CIT0038","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1093\/ejo\/cjy082","article-title":"Piezocision-assisted orthodontic treatment using CAD\/CAM customized orthodontic appliances: a randomized controlled trial in adults","volume":"41","author":"Charavet","year":"2019","journal-title":"European Journal of Orthodontics,"}],"container-title":["European Journal of Orthodontics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ejo\/article-pdf\/43\/3\/360\/38548221\/cjaa046.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ejo\/article-pdf\/43\/3\/360\/38548221\/cjaa046.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T15:33:30Z","timestamp":1623166410000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejo\/article\/43\/3\/360\/5894256"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,19]]},"references-count":38,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,8,19]]},"published-print":{"date-parts":[[2021,6,8]]}},"URL":"https:\/\/doi.org\/10.1093\/ejo\/cjaa046","relation":{},"ISSN":["0141-5387","1460-2210"],"issn-type":[{"value":"0141-5387","type":"print"},{"value":"1460-2210","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,6,1]]},"published":{"date-parts":[[2020,8,19]]}}}