Micro-osteoperforation (MOP) has gained attention as a minimally invasive technique to speed up orthodontic tooth movement. But how effective is it in practice—particularly when used to distalise molars?
A recent exploratory systematic review and meta-analysis of randomised controlled trials (RCTs) set out to answer this question. The aim: to determine whether MOP can truly accelerate molar distalisation and whether it should be used routinely in clinical orthodontics.
Read on for our expert summary.
What Is MOP and Why Use It?
MOP involves creating small perforations in the alveolar bone to stimulate an inflammatory response, which is thought to increase bone remodelling and accelerate tooth movement. It’s often promoted as a quicker, less invasive alternative to procedures like corticotomy.
But does the research support these claims?
What the Review Looked At
A team of researchers conducted a comprehensive systematic literature search across multiple databases, including MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane’s CENTRAL, up to April 2024.
After screening 3,617 articles, four RCTs involving 71 adult participants were included in the review. These studies specifically examined the effects of MOP on molar distalisation, with a focus on the following clinical outcomes:
- The rate and amount of molar movement
- Pain levels, measured using the Visual Analog Scale (VAS)
- Root resorption
- Periodontal health
The quality of each study was assessed using the Cochrane Risk of Bias 2.0 tool.
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Key Findings
The meta-analysis revealed no significant difference in the rate or overall amount of maxillary molar distalisation between the MOP and control groups.
- The mean difference in movement rate was just 0.1 mm/month
- The total amount of movement differed by only 0.01 mm
These findings suggest that MOP does not substantially accelerate or enhance molar distalisation.
However, pain levels were significantly higher in the MOP group on the day of the procedure. Patients reported a 2-point increase in VAS scores compared to controls.
One study also reported a slight but statistically significant reduction in root length (0.2 mm) in the MOP group, indicating a mild risk of root resorption. Overall, however, periodontal health appeared unaffected across the included studies.
Should You Use MOP in Practice?
The review concluded that while MOP continues to show promise in theory, current evidence does not support its routine use for molar distalisation.
Given that MOP does not significantly increase the rate or amount of tooth movement—and may be associated with increased pain and a potential risk of root resorption—it may not offer meaningful benefits in most clinical cases.
However, MOP could still be considered in select scenarios, particularly:
- In patients with slow or resistant tooth movement (e.g., high bone density)
- Where a less invasive alternative to corticotomy is desirable
In these cases, MOP might still be a useful adjunct—but further high-quality studies are needed.
Limitations of the Study
As an exploratory review, the findings are limited by the small number of included studies and participants. Only four RCTs with 71 patients were analysed, which restricts the generalisability of the conclusions.
Further research with larger sample sizes and long-term follow-up is needed to better assess the risks and potential benefits of MOP in different orthodontic contexts..
About Dr. Jamal
Dr. Jamal Giri is an orthodontist and associate professor at B.P. Koirala Institute of Health Sciences in Nepal. He obtained his orthodontic training from the Institute of Medicine, Tribhuvan University, Nepal, in 2014.
Currently pursuing a PhD at the University of Adelaide, Dr. Jamal’s research focuses on the genetic and environmental factors influencing malocclusion development. He also holds a postgraduate certificate in clinical education from the University of Edinburgh and a master’s in medical education from the University of Nottingham.
Dr. Jamal teaches on the Diploma in Orthodontics and Dentofacial Orthopaedics at the London Dental Institute.
Reference
Bardideh E, Ghorbani M, Disfani MF, Shafaee H, Mehmani F. The effect of micro-osteoperforation (MOP) in molar distalization treatments: an exploratory systematic review and meta-analysis of RCTs. European Journal of Orthodontics. 2025;47(2):cjaf004.
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