Effect of mini-implant facilitated micro-osteoperforations on the alignment of mandibular anterior crowding: A randomised controlled clinical trial

Abstract

Objective: To assess the effects of mini-implant assisted micro-osteoperforations (MI-MOPs) in the alignment of mandibular anterior teeth, and to explore the intervention’s associated pain perception (PP) and root resorption (RR) in adults treated by fixed appliance. Design: Multicentre, two-arm and single-blinded randomised clinical trial. Setting: College of Dentistry, University of Baghdad. Participants: Adolescents (mean age = 18.97 years) undergoing non-extraction orthodontic therapy for the management of mandibular anterior crowding. Methods: A total of 33 participants (mean age = 18.97 years) undergoing non-extraction orthodontic therapy for the management of moderate mandibular anterior crowding were allocated to the experimental (MI-MOPs, n = 17) or control groups (non-MI-MOPs, n = 16). A series of lower study models were obtained at week 4 (T1), week 8 (T2) and week 12 (T3) in the MI-MOPs group and continued to week 16 (T4) and week 20 (T5) in the non-MI-MOPs group, with all models analysed digitally. Periapical radiographs (PA) were taken before commencing treatment (T0) and T3. Participants were asked to complete a 10-point visual analogue scale (VAS) daily during the first week of treatment. Results: At T0, the mean Little irregularity index (LII) was 5.1 mm (95% confidence interval [CI] = 4.95–5.23) with no statistically significant difference between groups ( P = 0.766). At T1, T2 and T3, t-test showed statistically significant differences in the LII ( P < 0.05) in favour of the MI-MOPs group; mean differences (MD) were −1.16mm (95% CI = −1.36 to −0.96), −1.77 mm (95% CI = −1.93 to −1.59) and −1.58 mm (95% CI = −1.67 to −1.48), respectively. Mean treatment time from baseline to final alignment was 10.41 weeks (95% CI = 9.92–10.89) in the MI-MOPs group and 16.62 weeks (95% CI = 16.11–17.13) in the non-MI-MOPs groups, which was statistically significant (MD −6.21 mm, 95% CI = −6.88 to −5.53, P < 0.05). Conversely, Mann–Whitney U-test and Wilcoxon signed-rank test showed no significant differences in terms of PP and RR between the groups ( P > 0.05). The participants in the MI-MOPs group experienced a higher degree of RR ( P < 0.05) secondary to intervention. No other significant adverse events were reported during the trial. Conclusion: This trial found that combining MI-MOPs with non-extraction-based fixed orthodontic therapy in adults mildly shortens the duration of the alignment phase. RR should be monitored throughout the treatment when using MI-MOPs (ClinicalTrials.gov NCT04778241).