Evaluation of the Effects of Micro-osteoperforation and Injectable Platelet-rich Fibrin on the External Root Resorption: A Split-mouth Prospective Study

Aim: To evaluate and compare the effects of micro-osteoperforations (MOPs) and injectable platelet-rich fibrin (I-PRF) on external apical root resorption (EARR) during maxillary canine retraction using a split-mouth prospective study design.Materials and methods: Twenty orthodontic patients (mean age 22.8 ± 2.7 years) who required first premolar extractions bilaterally were recruited.In each subject, one quadrant was randomly assigned to MOP and the contralateral quadrant to I-PRF.All patients underwent fixed appliance therapy with a pre-adjusted edgewise system, and maxillary canines were retracted with NiTi closed-coil springs delivering 150 gm of force.Micro-osteoperforations were performed at the initiation of retraction, whereas I-PRF was injected monthly.To measure changes in root length, cone-beam computed tomography (CBCT) images of the patients were taken both prior to and following full canine retraction (T0 and T1, respectively).Statistical analysis was completed using unpaired and paired t-tests (p < 0.05).Results: Both groups demonstrated significant root length reduction after retraction (p < 0.05).The mean EARR in the MOP group was 1.21 ± 0.25 mm, while the I-PRF group showed 1.00 ± 0.10 mm of resorption.Despite the MOP group's somewhat higher resorption, there were no clinically noteworthy distinctions between the two categories (p > 0.05).Conclusion: Micro-osteoperforations and I-PRF are both effective adjuncts for facilitating orthodontic tooth movement (OTM); however, both approaches are associated with measurable root resorption.There is no statistically significant difference observed between the two techniques in terms of minimizing EARR.Clinical significance: While MOPs and I-PRF can shorten treatment duration, clinicians should remain cautious of their potential to induce root resorption.Injectable PRF may offer additional biological benefits owing to its regenerative properties, but long-term studies with larger samples should be done before definitive clinical recommendations are suggested.