Pacific Coast Society of Orthodontists Bulletin Summer 2019 - 43

Case Report

Dr. Thomas S. Shipley
Thomas S. Shipley, DMD, MS,
received his bachelor's of science
degree in business management
from Brigham Young University
and went on to earn his doctorate
from the University of Kentucky
College of Dentistry. Dr. Shipley
completed a master's program in
orthodontics at West Virginia University and maintains a full-time
orthodontic practice in Peoria,
Arizona. He is an Adjunct Professor
of Orthodontics at The Arizona
School of Dentistry & Oral Health,
Postgraduate Orthodontic Program. Dr. Shipley is a Diplomate of
the American Board of Orthodontics and a member of the American
Association of Orthodontists, the
American Dental Association, the
Pacific Coast Society of Orthodontists, and the Arizona Dental
Association.
In addition to publishing several
orthodontic case reports and original research articles, Dr. Shipley is
Invisalign Faculty and a Certified
Teacher for Larry Andrew's 6 Elements Orthodontic Philosophy. He
is a clinical advisory board member
for Propel Orthodontics, Henry
Schein Orthodontics, and Orthoscience. Dr. Shipley has lectured
extensively, giving more than 300
lectures nationally and internationally.

Summer 2019

PCSO Bulletin

Figure 14. Final condylar positions
from experiments to clinical practice. APOS Trends
Orthod 2017;7:6-11.

Editor's Comments
Dr. Shipley elegantly described how an adult
patient was treated efficiently in four and a half
months with clear aligners, augmented by the
MOPs. It is obvious that we were not able to
compare the efficiency of different treatment
modalities on the same patient (for example, using fixed appliances vs. the approach Dr. Shipley
presented here), as we could not treat the same
malocclusion twice. Regarding the effectiveness
of MOPs, while some evidence is emerging in
the literature, there is still some controversy.
Alkebsi et al1 found that three MOPs (3 to 4 mm
depth with a 1.5 mm × 6 mm miniscrew) were
not effective on canine retraction during a threemonth observation, but Sivarajan et al2 found
that canines could be retracted on average by
0.89 mm to 1.33 mm more than those in a group
that did not receive MOPs treatment (2 to 3
mm depth with a 1.6 mm × 6 mm miniscrew)
over a 16-week period. Keep in mind, the 95%
confidence intervals provided in this split-mouth
randomized clinical trial ranged from 0.55 mm to
2.10 mm for the intervention group, which had

the best results of 1.33 mm more canine retraction in roughly three months. Hence, when we
recommend MOPs or other modalities that claim
to "accelerate" tooth movement or shorten overall treatment time, patients should be informed
that there have been significant variations
in the effectiveness among patients with the
treatment. By far, there is a lack of evidence that
MOP effectively reduces the overall treatment
time. Dr. Shipley cited one study by Choi et al. in
this case report, but there is definitely a need for
further studies.
References
1. Alkebsi A, Al-Maiitah E, Al-Shorman H, Abu
Alhaija E. Three-dimensional assessment
of the effect of micro-osteoperforations on
the rate of tooth movement during canine
retraction in adults with Class II malocclusion: A randomized controlled clinical trial.
Am J Orthod Dentofacial Orthop 2018;152:771-
785.
2. Sivarajan S, Doss JG, Papageorgiou SN,
Cobourne MT, Wey MC. Mini-implant supported canine retraction with micro-osteoperforation: A split-mouth randomized clinical trial.
Angle Orthod 2019;89:183-189.

Pacific Coast Society of Orthodontists Bulletin Summer 2019

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Summer 2019