Efficiency of Piezotome-Corticision Assisted Orthodontics

Inclusion criteria: * Adult patients 18 or older * Single arch or double arch treatment * Non-extraction treatment in the mandibular arch * Presence of full complement dentition from first molar to first molar * No spaces in the mandibular arch * Mandibular anterior irregularity index greater than 5 * Patient with healthy periodontium and attachment loss of up to 2mm * The amount of crowding should allow for bracket placement * No therapeutic intervention planned involving intermaxillary or other intraoral or extraoral appliances including elastics, lip bumpers, maxillary expansion appliances, or headgear prior to the complete alignment of mandibular anterior teeth. Exclusion criteria: * Failure to provide oral and written consent to participation * Medical problems that affect tooth movement (Refer to Appendix I) * Presence of primary teeth in the mandibular anterior area * Missing permanent mandibular anterior teeth * Inability to place brackets in the anterior mandibular teeth * Breakage of any of the mandibular anterior brackets that have not been replaced within a week