The accuracy of computer-guided piezocision: a prospective clinical pilot study

Computer-guided piezocision can be used to overcome the disadvantages of corticotomy in accelerating orthodontic tooth movement. The aim of this clinical pilot study was to determine the accuracy of this technique. STROBE guidelines were followed. Ten patients were selected and treated. Using new dedicated planning software, the piezocision cuts were properly positioned in virtual models. A surgical guide was designed and printed with slots to guide the scalpel blade first and then the piezoelectric micro-saw. The slots limit the cortical incisions coronally and apically, and also limit the depth of penetration of the piezoelectric micro-saw. The patients underwent CBCT before and immediately after surgery, and the pre- and postoperative images were matched. Using software, the planned piezocisions were compared to the actual piezocisions, and the entry point and depth deviations were measured. Descriptive statistics, kappa statistics, and the t-test were used for the data analysis. The mean deviation at the entry point was 0.67 mm (range 0.06-1.44 mm, standard deviation 0.31). The mean depth deviation was 0.54 mm (range 0.17-0.80 mm, standard deviation 0.21). The limits of the use of computer-guided piezocision are set by the maximum deviation observed; thus a safety distance of 1.5 mm should be considered, which confirms that this innovative technique is clinically applicable.