**5. Conclusions**

significant pain or discomfort [64]. In line with these findings, it is possible to state that microosteoperforations are easily tolerated by the patients and can be applied to routine clinical use. Orthodontically induced inflammatory root resorption (OIIRR) is included in negative side effects of orthodontic tooth movement as a frequent research subject. Although its etiology and predictors are not fully understood, it is considered to be resulted from complex interaction of individual sensitivity [68], applied mechanics [69, 70], and specific dental predisposition [71]. Orthodontically induced inflammatory root resorption was stated to be related with periodontal ligament remodeling which is a result of the pressure applied to tooth root during tooth movement and removal of hyalinized necrotic tissues after trauma. Excessive pressure that causes ischemic necrosis [72] of periodontal ligament and root resorption related to orthodontic tooth movement is reported to be frequently observed in the areas in which excessive pressure is applied to periodontal ligament [73]. The underlying biological process of both orthodontic tooth movement and root resorption covers local inflammatory response. Animal studies show that many pro-inflammatory cytokines are common in both pathways. Cytokines such as IL-1, TNFα, and chemokines as IL-8 and MCP-1 are known to have significant roles to initiate and ease root resorption process [74]. These inflammatory mediators have significant roles on activation of tooth movement and osteoclast activity [75]. Inhibition of cytokine activity decreases osteoclast and odontoclast rate as well as tooth movement and root resorption [76]. It is known

that accelerated tooth movement techniques increase inflammatory cytokine activation.

experimental groups in terms of root resorption [80].

86 Current Approaches in Orthodontics

In the literature, there are several studies that evaluate the effects of accelerated tooth movement and decortication on root resorption [5]. The cytokines which promote inflammation are also reported to activate cementoclasts which cause root resorption increasing root resorption risk accordingly [77]. On the contrary, there are findings in the literature which state that decortication and demineralization of alveolar bone decrease the pressure toward tooth movement enabling an ease for the movement and decreasing root resorption risk accordingly [12]. It was found out that the effects of tooth movement accelerated via corticotomy on orthodontically induced inflammatory root resorption were similar to conventional orthodontic treatment but it was also reported that periapical radiographies may not be reliable for assessing root resorption in two studies which was carried out by evaluation of periapical radiographies [78, 79]. In an animal study which evaluates the effects of corticotomies on tooth movement, it was found out that there were not any differences between control and

In the literature, there is a limited number of studies which evaluates the effects of microosteoperforations on root resorption. Tsai et al. reported in their study in which they compared the efficiency of micro-osteoperforations and corticisions that root resorption creation risk of minor surgical interventions is lower when compared with conventional orthodontic treatments. The hematoxylin and eosin analysis of the researchers showed that micro-osteoperforation-assisted accelerated tooth movement was resulted in decreased root resorption [11]. Similarly, in the study in which Cheung et al. evaluated effects of microosteoperforations on experimental tooth movement in rats, root resorption was observed on the MOP application side on the samples which were colored with hematoxylin eosin reporting that 3D volumetric analysis did not show any volumetric difference in the root


• Further studies are required for the ideal timing and frequency of the application in order to achieve optimum tooth movement acceleration.

[7] Yamasaki K, Shibata Y, Imai S, Tani Y, Shibasaki Y, Fukuhara T. Clinical application of prostaglandin E1 (PGE1) upon orthodontic tooth movement. American Journal of

Micro-Osteoperforations

89

http://dx.doi.org/10.5772/intechopen.81419

[8] Fujita S, Yamaguchi M, Utsunomiya T, Yamamoto H, Kasai K. Low-energy laser stimulates tooth movement velocity via expression of RANK and RANKL. Orthodontics &

[9] Wilcko MT, Wilcko WM, Bissada NF. An evidence-based analysis of periodontally accelerated orthodontic and osteogenic techniques: A synthesis of scientific perspectives.

[10] Aksakalli S, Calik B, Kara B, Ezirganli S. Accelerated tooth movement with piezocision and its periodontal-transversal effects in patients with Class II malocclusion. The Angle

[11] Tsai CY, Yang TK, Hsieh HY, Yang LY. Comparison of the effects of micro-osteoperforation and corticision on the rate of orthodontic tooth movement in rats. The Angle Orthodontist.

[12] Cheung T, Park J, Lee D, Kim C, Olson J, Javadi S, et al. Ability of mini-implant-facilitated microosteoperforations to accelerate tooth movement in rats. American Journal of Orthodontics

[13] Proffit WR, Fields HW, Sarver DM. Contemporary Orthodontics. 5th ed. St. Louis:

[14] Ren A, Lv T, Kang N, Zhao B, Chen Y, Bai D. Rapid orthodontic tooth movement aided by alveolar surgery in beagles. American Journal of Orthodontics and Dentofacial

[15] Bartzela T, Türp JC, Motschall E, Maltha JC. Medication effects on the rate of orthodontic tooth movement: A systematic literature review. American Journal of Orthodontics and

[16] Sekhavat AR, Mousavizadeh K, Pakshir HR, Aslani FS.Effect of misoprostol, a prostaglandin E1 analog, on orthodontic tooth movement in rats. American Journal of Orthodontics and Dentofacial Orthopedics. 2002;**122**(5):542-547. DOI: 10.1067/mod.2002.126153 [17] Tunçer Nİ, Yılmaz A. Tooth movement acceleretaion techniques. Türk Ortodonti Dergisi.

[18] Shenava S, Nayak K, Bhaskar V, Nayak A. Accelerated orthodontics—A review. Inter-

[19] Nishimura M, Chiba M, Ohashi T, Sato M, Shimizu Y, Igarashi K, et al. Periodontal tissue activation by vibration: Intermittent stimulation by resonance vibration accelerates experimental tooth movement in rats. American Journal of Orthodontics and Dentofacial

Orthopedics. 2008;**133**(4):572-583. DOI: 10.1016/j.ajodo.2006.01.046

Orthopedics. 2007;**131**(2):160.e1-160.10. DOI: 10.1016/j.ajodo.2006.05.029

Dentofacial Orthopedics. 2009;**135**(1):16-26. DOI: 10.1016/j.ajodo.2008.08.016

and Dentofacial Orthopedics. 2016;**150**(6):958-967. DOI: 10.1016/j.ajodo.2016.04.030

Craniofacial Research. 2008;**11**(3):143-155. DOI: 10.1111/j.1601-6343.2008.00423.x

Seminars in Orthodontics. 2008;**14**:305-316. DOI: 10.1053/j.sodo.2008.07.007

Orthodontist. 2016;**86**(1):59-65. DOI: 10.2319/012215-49.1

2016;**86**(4):558-564. DOI: 10.2319/052015-343.1

national Journal of Scientific Study. 2014;**1**(5):35-39

Elsevier Health Sciences; 2014. 278 p

2012;**25**:76-91

Orthodontics. 1984;**85**(6):508-518. DOI: 10.1016/0002-9416(84)90091-5

• Although it is reported that side effects such as pain or root resorption are not observed due to micro-osteoperforations, long-term studies with more samples are required.
