Root Resorption after Piezocision and Micro-osteoperforations in Canine Retraction: A Systematic Review and Meta-analysis

This systematic review and meta-analysis aimed to compare the amounts of root resorption between micro-osteoperforations (MOPs) and Piezocision during canine distalization in orthodontic treatment. A comprehensive literature search was conducted using databases including PubMed, Web of Science, Scopus, EMBASE, and the Cochrane Library (clinical trials) that covered publications up to June 2025. The review protocol was registered in PROSPERO (CRD420251081429). The treatment outcome was analyzed as continuous data, and the data were aggregated using the weighted mean difference (WMD) along with 95% confidence interval (CI). The effect estimates were pooled using the DerSimonian and Laird random-effects model. A total of six randomized controlled trials were deemed eligible and included in the meta-analysis. According to the findings, the impact of MOPs on root resorption showed no statistically significant difference compared with the control group (WMD = − 0.02; 95% CI: −0.06 to 0.02; p = 0.37). Similarly, the meta-analysis of the impact of Piezocision on root resorption also showed no statistically significant difference compared with the control group (WMD = − 0.41; 95% CI: −0.98 to 0.15; p = 0.15). MOPs and Piezocision did not have any adverse events on root resorption in canine retraction patients.