Corticotomies have been used to assist orthodontic treatment since the late 18th century. This review describes and compares different surgical techniques available to accelerate tooth movement: PAOO™, Corticision, Piezocision™ and Propel. All of the approaches described accelerate orthodontic tooth movement and may protect against root resorption. PAOO™ and Piezocision™ offer the option of bone and soft tissue grafting at time of surgery. Corticision, Piezocision™ and Propel are considered minimally invasive procedures thanks to the flapless approach, but the use of the mallet in Corticision could constitute a trauma for the patient. The piezoelectric knife creates a more intense Regional Accelleratory Phenomenon (RAP) at the site of injury due to the effect of high frequency vibrations. This suggests that Piezocision™ could create a greater effect on bone remodeling, hence producing faster tooth movement and extended RAP. The lack of randomized controlled clinical trials makes an effective comparison between these techniques difficult and future studies are needed to better evaluate the outcomes of each of these.

BACKGROUND: Accelerating orthodontic treatment is a priority for clinicians and patients aiming to reduce treatment duration and associated discomforts. This systematic literature review assesses the current evidence regarding the efficacy of surgically assisted acceleration techniques in orthodontics. MATERIALS AND METHODS: In November 2021, an extensive search was conducted across EMBASE, Cochrane, and PubMed databases, yielding a total of 2,022 articles. After application of selection criteria and full text analysis the articles for review, were narrowed down to a total of 26 entries. These studies included Piezocision, Propel, Micro-osteoperforations (MOP), Periodontally Assisted Osteogenic Orthodontics (PAOO), and laser-assisted techniques as interventions. RESULTS: The scrutinized literature revealed that 75% of articles on Piezocision reported a favorable impact on treatment time, whereas MOP was found effective in half of the related articles. The Propel system was deemed beneficial in only 25% of the studies examined. In contrast, both articles evaluating PAOO unanimously found it to be an effective method for accelerating orthodontic tooth movement. CONCLUSION: Our review indicates a significant variance in the success rates of surgically assisted orthodontic acceleration methods, with Piezocision and PAOO displaying the highest efficacy, 1.5-2x faster than control groups. Risk of bias assessment revealed moderate to high risk across our selected studies, with the most common issues including lack of blinding of participants and assessors as well as inconsistent reporting of outcomes.