ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Corticotomy-Assisted Orthodontics May Reduce Treatment Time For Patients With Palatally Impacted Canines
Clinical Question For a patient with a palatally impacted canine, how effective is corticotomy-assisted orthodontics (COA) at accelerating orthodontic tooth movement and shortening treatment time as compared to traditional orthodontic therapy?
Clinical Bottom Line While this study shows favorable results that COA may indeed decrease treatment time and increase orthodontic tooth movement, the small sample size and lack of other studies to corroborate the findings prevent an evidential recommendation for the use of COA over traditional orthodontic therapy in treating patients with palatally impacted canines. More evidence is needed to justify a change in current treatment standards.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 17465647Fischer/20076 patients between the ages of 11 and 13, presenting with bilateral, palatally impacted canines.Split-Mouth Randomized Controlled Trial
Key resultsFor the impacted canines treated with COA, there was a 28-33% reduction in treatment time for all patients. Also, the rate of orthodontic tooth movement was shown to be significantly faster for COA than traditional therapy (p<.001), with average values of 1.06mm/month and 0.75mm/month, respectively. Additionally there was shown to be no significant difference in periodontal probing depth or alveolar bone height between the two treatments, indicating that COA is no more harmful to the periodontium than is traditional treatment.
Evidence Search A PubMed search was conducted using the following terms: "corticotomy" and "impacted canines"
Comments on
The Evidence
The study is a double-blinded randomized controlled trial with adequate patient cooperation and no apparent competing interests. The major flaw of this study is that the sample size was only six patients, making the overall validity and reliability of the results weak. The authors acknowledge that more trials need to be conducted in order to give a more definitive answer about the effectiveness and use of COA.
Applicability The patients included in the study are representative of the typical patient that would present needing treatment for palatally impacted canines. If more evidence supporting the findings of this study is produced, COA could become a recommended treatment option for orthodontists with patients looking to speed up their treatment times.
Specialty/Discipline (Orthodontics)
Keywords Orthodontics, Impacted canine
ID# 2413
Date of submission: 02/28/2013spacer
E-mail cometti@livemail.uthscsa.edu
Author Peyton Cometti
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Clarence C. Bryk, DDS, MS
Faculty mentor/Co-author e-mail brykc@uthscsa.edu
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