We read with great interest the article “Evaluation of corticotomy-facilitated orthodontics and piezocision in rapid canine retraction” by Abbas et al in the April issue. The article highlighted the advantages of corticotomy and piezocision in reducing the treatment duration of fixed appliance therapy. However, we have a few queries on certain aspects of the study.
The authors looked at patients in the age group of 15 to 25 years. We would like to know whether there were substantive reasons for corticotomy and peizocision at 15 years of age when most of studies had subjects after 19 years of age. What was the mean age of the participants and was it similar in the 2 groups? Did the authors consider this in the outcome analysis?
Did the authors have a reason for using a 0.016 × 0.022-in stainless steel wire for canine retraction in a 0.022-in slot? We wonder whether if a greater dimension wire, such as 0.019 × 0.025 in, had been used, would the canine tipping have been less?
Table I shows that tooth movement was greater between 10 and 12 weeks in the control and experimental groups when compared with other time intervals. (Generally, tooth movement was faster in the later period of the study.) However, the literature reports that tooth movement is faster in the first few weeks to 2 months because of the regional acceleratory phenomenon after corticotomy or peizocision. How do the authors explain the difference between their findings and the literature?
Table II shows that there was an average of 3 mm of molar movement. It is our humble submission that this anchorage loss is self-defeating to the very idea of individual canine retraction enhanced with surgical intervention.
The magnitude of canine tooth movement on the experimental side was generally greater than on the control side; hence, this would have led to inevitable biomechanical problems in space closure and delay in further treatment. We wonder whether this problem could have been circumvented if the authors had used a split-mouth design with corticotomy on one side and piezocision on the other.