Clinical impact of micro-osteoperforations in contemporary orthodontics

Abstract

Micro-osteoperforations have emerged as a minimally invasive technique aimed at accelerating orthodontic tooth movement by stimulating bone remodeling and localized cellular reactivation. The objective of this study was to analyze the scientific evidence available over the past five years regarding the clinical effectiveness of micro-osteoperforations in orthodontics, with emphasis on their ability to induce cellular reactivation and enhance tooth displacement. A systematic review was conducted following the PRISMA 2020 methodology, using a structured search in the PubMed database, which yielded 47 studies, of which 13 were selected after applying inclusion and exclusion criteria. The included studies comprised randomized clinical trials, experimental studies in humans and animal models, as well as biomechanical simulations. Most investigations reported a significant increase in the rate of tooth movement following the application of micro-osteoperforations, particularly when the procedure was repeated during critical phases of treatment. Additionally, localized biological activation was observed, with no clinically relevant increase in root resorption or adverse periodontal effects. Some studies showed inconclusive results, mainly in complex dental movements or when a single intervention was applied. In conclusion, micro-osteoperforations are an effective and safe tool to optimize the efficiency of orthodontic treatment, especially in adult patients and prolonged clinical cases. The technique effectively addresses the scientific question posed and fulfills the objective of the study, although future research should aim to standardize protocols and explore long-term outcomes.