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
PubMed ID Author / Year Patient Group Study type (level of evidence) 17465647 Fischer/2007 6 patients between the ages of 11 and 13, presenting with bilateral, palatally impacted canines. Split-Mouth Randomized Controlled Trial Key results For 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	(Orthodontics)
Keywords	Orthodontics, Impacted canine
ID#	2413
Date of submission	02/28/2013
E-mail	cometti@livemail.uthscsa.edu
Author	Peyton Cometti
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Clarence C. Bryk, DDS, MS
Faculty mentor e-mail	brykc@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) None available