Effect of piezocision on root resorption associated with orthodontic force: A microcomputed tomography study

•Piezocision might cause increased root resorption when used with orthodontic forces.•Piezocision-related iatrogenic root damage occurred in 5 of 14 participants.•Piezocision should not be used in areas of close root proximity.

IntroductionThe purpose of this study was to investigate the effect of piezocision on orthodontically induced inflammatory root resorption.MethodsFourteen patients were included in this split-mouth study; 1 side was assigned to piezocision, and the other side served as the control. Vertical corticotomy cuts of 4 to 5 mm in length were performed on either side of each piezocision premolar, and 150-g buccal tipping forces were applied to the premolars. After 4 weeks, the maxillary first premolars were extracted and scanned with microcomputed tomography.ResultsThere was a significantly greater total amount of root resorption seen on the piezocision sides when compared with the control sides (P = 0.029). The piezocision procedure resulted in a 44% average increase in root resorption. In 5 patients, there was noticeable piezocision-related iatrogenic root damage. When that was combined with the orthodontic root resorption found on the piezocision-treated teeth, there was a statistically significant 110% average increase in volumetric root loss when compared with the control side (P = 0.005).ConclusionsThe piezocision procedure that initiates the regional acceleratory phenomenon may increase the iatrogenic root resorption when used in conjunction with orthodontic forces. Piezocision applied close to the roots may cause iatrogenic damage to the neighboring roots and should be used carefully.