Non-Cochrane · intervention · PM42222474
Micro-osteoperforation for accelerating orthodontic tooth movement: a meta-analysis of short-term efficacy, safety, and optimal application parameters.
Ching Shu-Hong, Wang Xiaozhe, Li Danyang, et al. · Frontiers in dental medicine · 2026 · PubMed · doi:10.3389/fdmed.2026.1814419
Findings
29 findings
| Population | ||||
|---|---|---|---|---|
| Orthodontic patients receiving fixed appliance treatment (ages 16 to 30 years) | MOPs adjunctive to orthodontic treatment (all protocols) | Conventional orthodontic treatment without MOPs | Postoperative pain | Pain scores were significantly higher with MOPs on the day of surgery and the difference diminished at later time points; 8 RCTs; not pooled Very low Downgraded: risk of bias, inconsistency 8 studies |
| Orthodontic patients receiving fixed appliance treatment (ages 16 to 30 years) | MOPs adjunctive to orthodontic treatment (all protocols) | Conventional orthodontic treatment without MOPs | Quality of life | Quality of life (OHIP-14 or VAS) was affected mainly in the first three postoperative days; no long-term impact; 3 RCTs; not pooled Very low Downgraded: risk of bias, inconsistency 3 studies |
| Orthodontic patients receiving fixed appliance treatment (ages 16 to 30 years) | MOPs adjunctive to orthodontic treatment (all protocols) | Conventional orthodontic treatment without MOPs | Periodontal parameters | Periodontal parameters reported in 4 RCTs; mild, transient effects (for example slight increase in probing depth); not pooled Very low Downgraded: risk of bias, inconsistency 4 studies |
| Orthodontic patients receiving fixed appliance treatment (ages 16 to 30 years) | MOPs adjunctive to orthodontic treatment (all protocols) | Conventional orthodontic treatment without MOPs | Anchorage loss (molar mesial movement) | Anchorage loss (molar mesial movement) did not differ significantly between MOPs and control groups in the 3 RCTs reporting it; not pooled Low Downgraded: imprecision 3 studies |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Micro-osteoperforation (MOPs) adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Total orthodontic tooth movement distance (mm) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Overall | MD 0.67 [0.45, 0.88] Moderate Downgraded: risk of bias, inconsistency 14 studies · 484 participants |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Micro-osteoperforation (MOPs) adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Monthly orthodontic tooth movement rate (mm/month) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Overall | MD 0.20 [0.13, 0.26] Moderate Downgraded: risk of bias, inconsistency 14 studies · 484 participants |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Micro-osteoperforation (MOPs) adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Root resorption (change in root length, mm) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Overall | MD 0.19 [-0.14, 0.51] Low Downgraded: imprecision 4 studies · 172 participants |
| Orthodontic patients receiving fixed orthodontic treatment, maxillary teeth | Micro-osteoperforation (MOPs) adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Monthly orthodontic tooth movement rate (mm/month) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Perforation location: maxillary | MD 0.17 [0.11, 0.24] GRADE not reported 12 studies · 427 participants |
| Orthodontic patients receiving fixed orthodontic treatment, maxillary teeth | Micro-osteoperforation (MOPs) adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Root resorption (change in root length, mm) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Perforation location: maxillary | MD 0.18 [-0.13, 0.50] GRADE not reported Studies not reported |
| Orthodontic patients receiving fixed orthodontic treatment, maxillary teeth | Micro-osteoperforation (MOPs) adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Total orthodontic tooth movement distance (mm) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Perforation location: maxillary | MD 0.63 [0.41, 0.85] GRADE not reported 12 studies · 427 participants |
| Orthodontic patients receiving fixed orthodontic treatment, mandibular teeth | Micro-osteoperforation (MOPs) adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Total orthodontic tooth movement distance (mm) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Perforation location: mandibular | MD 2.19 [-0.03, 4.41] GRADE not reported 4 studies · 107 participants |
| Orthodontic patients receiving fixed orthodontic treatment, mandibular teeth | Micro-osteoperforation (MOPs) adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Root resorption (change in root length, mm) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Perforation location: mandibular | MD 0.15 [-0.15, 0.44] GRADE not reported Studies not reported |
| Orthodontic patients receiving fixed orthodontic treatment, mandibular teeth | Micro-osteoperforation (MOPs) adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Monthly orthodontic tooth movement rate (mm/month) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Perforation location: mandibular | MD 0.47 [0.22, 0.71] GRADE not reported 4 studies · 107 participants |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Single (one-time) micro-osteoperforation application adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Total orthodontic tooth movement distance (mm) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Perforation frequency: one-time MOPs | MD 0.61 [0.45, 0.77] GRADE not reported 8 studies · 315 participants |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Single (one-time) micro-osteoperforation application adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Monthly orthodontic tooth movement rate (mm/month) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Perforation frequency: one-time MOPs | MD 0.20 [0.11, 0.28] GRADE not reported 8 studies · 315 participants |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Multiple (repeated) micro-osteoperforation applications adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Total orthodontic tooth movement distance (mm) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Perforation frequency: multiple MOPs | MD 1.17 [0.21, 2.13] GRADE not reported 6 studies · 169 participants |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Multiple (repeated) micro-osteoperforation applications adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Monthly orthodontic tooth movement rate (mm/month) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Perforation frequency: multiple MOPs | MD 0.22 [0.01, 0.43] GRADE not reported 6 studies · 169 participants |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Micro-osteoperforation with the Propel device adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Monthly orthodontic tooth movement rate (mm/month) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Instrument: Propel | MD 0.26 [0.09, 0.43] GRADE not reported 7 studies |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Micro-osteoperforation with the Propel device adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Total orthodontic tooth movement distance (mm) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Instrument: Propel | MD 1.21 [0.54, 1.87] GRADE not reported 7 studies |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Micro-osteoperforation with other instruments (mini-implants, miniscrews, micromotor) adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Total orthodontic tooth movement distance (mm) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Instrument: other instruments | MD 0.55 [0.29, 0.80] GRADE not reported 7 studies |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Micro-osteoperforation with other instruments (mini-implants, miniscrews, micromotor) adjunctive to fixed orthodontic treatment | Conventional orthodontic treatment without MOPs | Monthly orthodontic tooth movement rate (mm/month) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Instrument: other instruments | MD 0.14 [0.07, 0.20] GRADE not reported 7 studies |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Single (one-time) micro-osteoperforation application adjunctive to fixed orthodontic treatment, maxillary teeth | Conventional orthodontic treatment without MOPs | Monthly orthodontic tooth movement rate (mm/month) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Frequency and location: one-time MOPs, maxillary | MD 0.20 [0.12, 0.29] GRADE not reported Studies not reported |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Single (one-time) micro-osteoperforation application adjunctive to fixed orthodontic treatment, maxillary teeth | Conventional orthodontic treatment without MOPs | Total orthodontic tooth movement distance (mm) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Frequency and location: one-time MOPs, maxillary | MD 0.62 [0.45, 0.79] GRADE not reported Studies not reported |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Single (one-time) micro-osteoperforation application adjunctive to fixed orthodontic treatment, mandibular teeth | Conventional orthodontic treatment without MOPs | Monthly orthodontic tooth movement rate (mm/month) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Frequency and location: one-time MOPs, mandibular | MD 0.19 [0.11, 0.28] GRADE not reported Studies not reported |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Single (one-time) micro-osteoperforation application adjunctive to fixed orthodontic treatment, mandibular teeth | Conventional orthodontic treatment without MOPs | Total orthodontic tooth movement distance (mm) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Frequency and location: one-time MOPs, mandibular | MD 0.60 [0.44, 0.76] GRADE not reported Studies not reported |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Multiple (repeated) micro-osteoperforation applications adjunctive to fixed orthodontic treatment, maxillary teeth | Conventional orthodontic treatment without MOPs | Monthly orthodontic tooth movement rate (mm/month) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Frequency and location: multiple MOPs, maxillary | MD 0.20 [0.03, 0.36] GRADE not reported Studies not reported |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Multiple (repeated) micro-osteoperforation applications adjunctive to fixed orthodontic treatment, maxillary teeth | Conventional orthodontic treatment without MOPs | Total orthodontic tooth movement distance (mm) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Frequency and location: multiple MOPs, maxillary | MD 0.91 [0.23, 1.59] GRADE not reported Studies not reported |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Multiple (repeated) micro-osteoperforation applications adjunctive to fixed orthodontic treatment, mandibular teeth | Conventional orthodontic treatment without MOPs | Monthly orthodontic tooth movement rate (mm/month) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Frequency and location: multiple MOPs, mandibular | MD 0.23 [-0.04, 0.50] GRADE not reported Studies not reported |
| Orthodontic patients (aged 16 to 30 years) receiving fixed orthodontic treatment | Multiple (repeated) micro-osteoperforation applications adjunctive to fixed orthodontic treatment, mandibular teeth | Conventional orthodontic treatment without MOPs | Total orthodontic tooth movement distance (mm) Follow-up 1 to 7.6 months across included trials · Orthodontic treatment · Frequency and location: multiple MOPs, mandibular | MD 1.28 [0.06, 2.50] GRADE not reported Studies not reported |
Included primary studies 16
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Kumar 2024 Effect of micro-osteoperforations (MOPs) on the rate of en masse orthodontic tooth retraction : A randomized controlled trial. PMID:36018346 | 2024 | 2 other reviews | Total orthodontic tooth movement distance (mm) | not extracted yet |
| Singh 2023 Effect of Mini-implant assisted Micro-osteoperforation on the rate of orthodontic tooth movement-A randomized clinical trial. PMID:38234639 | 2023 | 2 other reviews | Total orthodontic tooth movement distance (mm) | not extracted yet |
| Thomas 2021 Evaluation of physiodispenser assisted micro-osteoperforation on the rate of tooth movement and associated periodontal tissue status… PMID:34112627 | 2021 | 2 other reviews | Total orthodontic tooth movement distance (mm); Root resorption (change in root length, mm) | not extracted yet |
| Babanouri 2020 Effect of mini-screw-facilitated micro-osteoperforation on the rate of orthodontic tooth movement: a single-center, split-mouth,… PMID:32147751 | 2020 | 1 other review | Total orthodontic tooth movement distance (mm) | not extracted yet |
| Fattori 2020 Micro-osteoperforation effectiveness on tooth movement rate and impact on oral health related quality of life. PMID:33378487 | 2020 | 1 other review | Total orthodontic tooth movement distance (mm) | not extracted yet |
| Golshah 2021 Efficacy of micro-osteoperforation of the alveolar bone by using mini-screw for acceleration of maxillary canine retraction in young adult… PMID:34696998 | 2021 | 1 other review | Total orthodontic tooth movement distance (mm) | not extracted yet |
| Gulduren 2020 Effects of micro-osteoperforations on intraoral miniscrew anchored maxillary molar distalization : A randomized clinical trial. PMID:32095922 | 2020 | 1 other review | Total orthodontic tooth movement distance (mm) | not extracted yet |
| Gumus 2023 Effects of miniscrew-facilitated micro-osteoperforations on the rate of orthodontic tooth movement : A split-mouth, randomized controlled… PMID:35024875 | 2023 | 1 other review | Total orthodontic tooth movement distance (mm) | not extracted yet |
| Kilinc 2023 Comparison of the effectiveness of piezocision and microosteoperforation in leveling mandibular anterior teeth. PMID:36517376 | 2023 | 1 other review | Total orthodontic tooth movement distance (mm) | not extracted yet |
| Li 2022 The effect of micro-osteoperforations on orthodontic space closure investigated over 12 weeks: a split-mouth, randomized controlled… PMID:35134142 | 2022 | 1 other review | Total orthodontic tooth movement distance (mm) | not extracted yet |
| Mordente 2024 The effect of micro-osteoperforations on the rate of maxillary incisors' retraction in orthodontic space closure: a randomized controlled… PMID:38342823 | 2024 | 1 other review | Total orthodontic tooth movement distance (mm) | not extracted yet |
| Raghav 2021 Effect of micro-osteoperforations on rate of space closure by mini-implant supported maxillary anterior en-masse retraction: A randomized… PMID:33598396 | 2021 | 1 other review | Total orthodontic tooth movement distance (mm) | not extracted yet |
| Sahin 2023 The effect of micro-osteoperforation on the rate of tooth movement during the alignment stage in patients with mandibular crowding: a… PMID:37167078 | 2023 | 1 other review | Total orthodontic tooth movement distance (mm); Root resorption (change in root length, mm) | not extracted yet |
| Shahrin 2021 Effect of micro-osteoperforations on external apical root resorption: A randomized controlled trial. PMID:33678624 | 2021 | 1 other review | not stated | not extracted yet |
| Chandorikar 2023 Impact of micro-osteoperforations on root resorption and alveolar bone in en-masse retraction in young adults: A CBCT randomized… PMID:36502787 | 2023 | this review only | Root resorption (change in root length, mm) | not extracted yet |
| Yadav 2025 A comparative assessment of orthodontically induced root resorption and alveolar bone changes in adolescent orthodontic patients… PMID:40888938 | 2025 | this review only | Total orthodontic tooth movement distance (mm); Root resorption (change in root length, mm) | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Orthodontic patients receiving fixed orthodontic treatment with normal root shapes; no prior orthodontics, systemic disorders, smoking, pregnancy or periodontal disease | 459 participants aged 16 to 30 years in 16 RCTs (40 lost to follow-up) |
| Intervention | Micro-osteoperforation (MOPs) as the main intervention technique | MOPs (1 to 5 perforations, 3 to 7 mm deep, 1.5 to 2 mm wide); 7 studies used the Propel device; multiple MOPs in 8 RCTs |
| Comparison | Traditional conventional orthodontics (no MOPs) | Traditional orthodontic treatment without MOPs (non-MOPs group) |
| Outcomes | Primary: distance and rate of tooth movement; secondary: root resorption, anchorage changes, periodontal conditions, pain, quality of life | Tooth movement distance and rate (14 RCTs); root resorption (4 RCTs); anchorage loss (3 RCTs); periodontal parameters (4 RCTs); pain and quality of life (8 RCTs) |
| Study designs | Randomized controlled trials; English-language articles with full text | 16 RCTs published 2020 to 2025, 8 of them split-mouth designs |
| Timing | Not specified | Follow-up 1 to 7.6 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Yes | no |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |