BACKGROUND: Piezoelectric surgery (PIEZO) uses ultrasonic vibration to cut hard tissue without damaging adjacent soft tissues. Our previous studies indicated that PIEZO enhanced bone turnover compared to a conventional rotary bur (BUR) in rat tibia wounds by inducing the regional acceleratory phenomenon (RAP). PIEZO induced osteocyte apoptosis without damaging blood vessels during Day 1, 3 and 7 of rat tibia healing. We hypothesized that PIEZO increased bone turnover by activation of osteocyte apoptosis with a controlled inflammatory response. This study evaluated early morphological changes in tibial defects caused by either PIEZO or BUR. MATERIALS & METHODS: We created surgical defects in tibia by either PIEZO or BUR in 9–10-week-old Sprague-Dawley rat tibias (n=4). We evaluated tissue responses by using H&E, Masson’s Trichrome and TRAP stains on Day 1, 3 & 7 after surgery. The surgical defect beneath the soft tissue was located using Computed Tomography (CT). RESULTS: On postoperative Day 1, there was no significant blood vessel change or cellular extravasation in the PIEZO group. In contrast the BUR group had extravasation of leukocytes and increased blood vessels' size. On Day3, there was no significant inflammation or morphological changes to blood vessels in the PIEZO group. Empty lacunae adjacent to the defect area suggested osteocyte apoptosis. In the BUR group, blood vessels returned to an average size and the leukocyte population was reduced and bone adjacent to the lesion was unaffected, and intact osteocytes were in the lacunae. On Day 7 there was increased in osteoclastic activity in Piezo compared the BUR group. CONCLUSION: These results suggested that PIEZO induced osteocyte apoptosis, increased bone turnover with a controlled inflammatory response and protected the bone blood vessel network.

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.