Effects of Mini-Screw Implant–Assisted Micro-Osteoperforations Following Placement of Autologous Leukocyte-Platelet-Rich Fibrin on the Rate of Maxillary Canine Retraction and the Expression of Various Biomarkers in Gingival Crevicular Fluid During Comprehensive Orthodontic Treatment: A Split-Mouth Randomized Clinical Trial

The extended period for orthodontic treatment is troublesome for adult patients for aesthetic and social reasons. Thus, orthodontists are constantly looking for ways to accelerate orthodontic tooth movement reducing the treatment duration. Adults show lagging cell mobilisation rates and irregular collagen fiber arrangement and are more prone to periodontal diseases as compared to younger patients. Therefore, shortening the duration of treatment by hastening the tooth movement is challenging for orthodontists. Two types of treatment modalities are available to accelerate the rate of orthodontic tooth movement, i.e., surgical and non-surgical, which can be invasive or non-invasive. Micro-osteoperforations and L-PRF plugs have been used to enhance bone remodeling. The benefits of L-PRF remain for 4 weeks, and micro osteoperforation activates the localised inflammatory pathway, which triggers inflammatory markers leading to osteoclast activation and, ultimately, faster bone remodelling. The sequential use of L-PRF and micro osteoperforations can benefit orthodontic tooth movement. Some studies mentioned the benefits of L-PRF plug and micro osteoperforations on the acceleration of orthodontic tooth movement separately. However, the literature is still lacking in studies that explored the combined effect of micro osteoperforations and L-PRF. Hence, the current research is directed towards evaluating the additional effect of L-PRF and micro osteoperforations on the rate of orthodontic tooth movement and correlating the same with the expression of various biomarkers in GCF during comprehensive orthodontic treatment.