Comparison of the Effect of Local Platelet Rich Fibrin Injection (i-PRF) and Micro Osteo-Perforations (MOPs) on Orthodontic Tooth Movement during Canine Distalization

Abstract

Background and Aim: Accelerating orthodontic tooth movement is clinically important to reduce prolonged treatment-related complications and improve patient acceptance. This study compared the effect of injectable platelet-rich fibrin (i-PRF) and micro-osteoperforations (MOPs) on the rate of maxillary canine distalization during extraction space closure. Material and Methods: A single-blinded, split-mouth randomized controlled trial was conducted in 32 participants. The mean age was 22.22 ± 5.15 years, with 19 (59.4%) males and 13 (40.6%) females; 18 (56.3%) were aged 21–30 years and 14 (43.8%) were aged 13–20 years. Each participant received i-PRF on one side and MOPs on the contralateral side, based on computer-generated randomization. Canine retraction was performed using miniscrew anchorage and nickel-titanium closed coil springs (150–200 g). Distal canine movement was assessed at 1 month (T1), 2 months (T2), and 3 months (T3). Results: Distal canine movement was significantly greater on the MOP side compared with the i-PRF side at T1 (0.84 ± 0.08 mm vs 0.75 ± 0.24 mm; p = 0.038), T2 (1.90 ± 0.08 mm vs 1.82 ± 0.10 mm; p = 0.001), and T3 (2.77 ± 0.24 mm vs 2.07 ± 0.26 mm; p < 0.001). Females showed greater distalization with MOP at T1–T3 (p ≤ 0.018), while males demonstrated significant differences at T2 (p = 0.020) and T3 (p < 0.001). In the 13–20 years group, MOP superiority was significant at T1 (p = 0.005), T2 (p = 0.008), and T3 (p < 0.001), whereas in the 21–30 years group significance emerged at T2 (p = 0.048) and persisted at T3 (p < 0.001). Conclusion: Micro-osteoperforations produced a higher rate of canine distalization than i-PRF during the study period, with more consistent acceleration across subgroups.