title: Effectiveness of minimally invasive surgical procedures in the acceleration of tooth movement: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The objective of this study was to assess systematically the available scientific evidence relating the efficiency of minimally invasive surgical procedures in accelerating orthodontic tooth movement and the adverse effects associated with these procedures.
  
  
  METHODS
  Electronic search of these databases CENTRAL, EMBASE, Scopus, PubMed, Web of Science, Google Scholar Beta, Trip, OpenGrey and PQDT OPEN was performed (last updated January 2016). The reference lists of the included studies were hand searched. Unpublished literature and ongoing studies were also checked electronically through ClinicalTrials.gov and (ICTRP). Randomized controlled trials (RCTs) with patients who received minimally invasive surgical procedures combined with fixed orthodontic appliances compared with conventional treatment were included. Cochrane's risk of bias tool was used to assess risk of bias.
  
  
  RESULTS
  Four RCTs (61 patients) and nine ongoing protocols were included in this review. Only three RCTs were suitable for quantitative synthesis. Higher tooth movement rate was found with the minimally invasive surgical procedures by a weighted mean difference of 0.65 mm for 1 month of canine retraction (WMD = 0.65: 95 % CI (0.54, 0.76), p < 0.001) and by a weighted mean difference 1.41 mm for 2 months (WMD = 1.41: 95 % CI (0.81, 2.01), p < 0.001). No adverse effects associated with these procedures were reported.
  
  
  CONCLUSIONS
  There is limited available evidence about the effectiveness of minimally invasive surgically accelerated orthodontics (MISAO). Although the current review indicated that MISAO can help in accelerating canine retraction, further research in this domain should be performed before it can be recommended in everyday clinical practice.
authors.affiliation: Orthodontics Department, University of Damascus Dental School, Damascus, Syria.
authors.forename: Alaa M H
authors.initials: AM
authors.lastname: Alfawal
authors.affiliation: Orthodontics Department, University of Damascus Dental School, Damascus, Syria. myhajeer@gmail.com.
authors.forename: Mohammad Y
authors.identifier: http://orcid.org/0000-0003-0640-1297
authors.initials: MY
authors.lastname: Hajeer
authors.affiliation: Orthodontics Department, University of Damascus Dental School, Damascus, Syria.
authors.forename: Mowaffak A
authors.initials: MA
authors.lastname: Ajaj
authors.affiliation: Oral Medicine Department, University of Damascus Dental School, Damascus, Syria.
authors.forename: Omar
authors.initials: O
authors.lastname: Hamadah
authors.affiliation: Oral and Maxillofacial Surgery Department, University of Damascus Dental School, Damascus, Syria.
authors.forename: Bassel
authors.initials: B
authors.lastname: Brad
mesh_terms: D003481:Cuspid; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D014087:Tooth Movement Techniques / Q000379:methods*
keywords: Accelerated tooth movement; Corticotomy; Flapless; Minimally invasive; Orthodontics; Surgical