ABSTRACT

Objectives

To discern the effects of computer-aided design (CAD)/computer-aided manufactured (CAM) customized appliances and piezocision on orthodontic treatment (OT).

Materials and Methods

The study combined findings from two previously published randomized controlled trials: (1) standard OT vs piezocision-assisted standard OT, and (2) CAD/CAM OT vs piezocision-assisted CAD/CAM OT. Piezocision is a minimally invasive corticotomy surgical procedure used to accelerate orthodontic treatment and CAD/CAM refers to CAD/CAM customized brackets and archwires. The outcomes were the overall treatment time, and the durations of the alignment phase and fine-tuning phase. Clinical and radiological features also were evaluated.

Results

The combined study included 48 patients with similar baseline characteristics. Compared to the standard treatment, CAD/CAM technology alone significantly decreased the overall median OT time from 543 to 394 days (P < .001) and from 543 to 254 days (P < .0001) when combined with piezocision. Although piezocision significantly reduced the duration of the alignment phase in the mandible and maxilla, CAD/CAM technology considerably shortened the fine-tuning phase. All periodontal and radiographic parameters remained stable from the start to the end of treatment in all groups.

Conclusions

CAD/CAM technology combined with piezocision accelerates the entire OT process, during the alignment phase for piezocision and during the fine-tuning phase for CAD/CAM, with a global reduction of the overall treatment time of more than 50%.

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Author notes

a

Associate Professor, Université Côte d'Azur, Laboratoire Microbiologie orale Immunité Santé MICORALIS (Unité Propre de Recherche 7354), Faculté de Chirurgie Dentaire, Centre Hospitalier Universitaire de Nice, Nice, France; and Researcher, Dental Biomaterials Research Unit (d-BRU), University of Liège, Liège, Belgium.

b

Postdoctoral Researcher, Dental Biomaterials Research Unit (d-BRU) and Department of Periodontology, Oral Surgery and Implant Surgery, University Hospital of Liège, Liège, Belgium.

c

Biostatistician, Biostatistics and Medico-Economic Information Department, University Hospital of Liège, Liège, Belgium.

d

Professor Emeritus, Department of Public Health, University of Liège, Liège, Belgium.

e

Professor and Head, Department of Periodontology, Oral Surgery and Implant Surgery, University Hospital of Liège; and Co-Director, Dental Biomaterials Research Unit (d-BRU), University of Liège, Liège, Belgium.