الفهرس 
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Abstract
The average timing of comprehensive orthodontic treatment ranges between two to three years. The long duration of active treatment increases the risks of periodontal diseases, decay of teeth due to carious defects, external root resorbtion of teeth subjected to orthodontic forces and white patching of teeth. The extended time of active treatment results in decrease in the patient compliance. Various modalities are used to quicken orthodontic displacement of teeth and decrease the interval of active displacement of teeth including surgical interventions (corticotomy , micro-osteo perforation and piezocissions), and physical acceleration methods (electric current and LASER).
Piezocision is surgical method of acceleration of orthodontic tooth movement that is less invasive than conventional corticotomy. Low level energy Laser (LLEL) is an effective method of bio-stimulationand acceleration of orthodontic tooth movement.
The previously mentioned data encouraged us to design this study aiming to compare between efficiency of piezocision as a non-invasive surgical technique for acceleration of orthodontic tooth movement and Low level energy Laser as an efficient method of bio-stimulation and acceleration of orthodontic tooth movement.
This study included twenty female patients divided onto two parallel groups (each group contained 10 patients).
group A: Half arch study design where the first side was control side and the other side was treated with piezocisions.
group B: Split mouth study design where one of the sides was control side and the other side was treated with Low level energy Laser.
Prior orthodontic treatment all patients were instructed to go to an oral surgeon to provide minimally traumatic surgical extraction for the first bi-cuspid. Orthodontic treatment was then started till complete achievement of levelling and alignment phase and being able to insert 0.017 x 0.025 stainless steel arch wire into the brackets of the Maxillary teeth passively.
All patients obtained CBCT images prior canine retraction phase. Absolute anchorage was obtained using Mini-screws that were put in place between 1st molar and 2nd bi-cuspids above canine retraction forces were applied to eliminate any loss of anchorage unit.
Canine retraction was perfomed as follows:
In Control sides of both groups, canine retraction was performed directly using Nickle-Titanium closing coil spring anchored on the mini-screw.
While in piezocisions sides piezocisions were performed in addition to the standard canine retraction using closing Ni-Ti coil spring anchored to mini-screw.
In Low level energy Laser sides, bio-stimulation mode was used to perform Laser application in addition to the standard canine retraction using Ni-Ti closing coil spring anchored to mini-screw.
This study extended for three months where direct intra-oral measurements were taken every two weeks targeting the assessment of the rate of canine retraction.
Post-intervention CBCTs were taken for all patients in order to compare these results with the pre-intervention CBCTs to assess the speed of canine movement, type of obtained tooth movement and amount anchorage loss.
The analysis of the obtained data showed significant statistical differences between the speed of displacement of cuspid in the acceleration methods sides and the control sides as follow; the piezocision showed intensification in the speed of cuspid movement by 1.3-fold compared to the non accelerated side while the Low level energy Laser group showed faster the speed of cuspid displacement by 1.48 fold when seen in relation to the non accelerated side.
Conclusions
1. Both piezocisions and Low level energy Laser techniques were proven to hasten the speed of canine movement during orthodontic treatment.
2. Low level energy Laser technique was capable of hastening the amount of cuspid displacement more than piezocisions by 1.1 fold when compared to the standard canine retraction technique.
3. Canine retraction in all used interventions was accompanied by some degree of distal crown tipping which did not differ significantly between the different interventions.
4. No statistically significant molar mesial movement as no anchorage loss was as a result of usage of mini-screws as a direct anchorage tool for canine retraction.