Evaluating the Efficacy of Micro-Osteoperforations Technique on the Orthodontic Tooth Movement Acceleration in Moderate Mandibular Anterior Crowding Cases Treated With Clear Aligners

Patients with moderate mandibular anterior crowding will be treated in this study. The efficacy of micro-osteoperforations technique by special drill in accelerating orthodontic tooth movement during clear aligners therapy will be assessed along with patient's pain and satisfaction. There are two groups: 1. a group of patients in which participants will be received treatment with the traditional clear aligners technique in addition to a micro-osteoperforations technique. 2. a group of patients in which participants will be received treatment with the traditional clear aligners technique alone

Inclusion Criteria: * Completion of permanent dentition (except third molars) * Moderate crowding (4-6 mm according to Little's index) * Absence of medications intake that interferes with pain perception for at least one week before the beginning of the treatment * Number of aligners ≥ 8 aligners. Exclusion Criteria: * • Systematic diseases that could affect bone and tooth movement and no contraindication avoid oral surgery * Medical conditions that affect tooth movement (Corticosteroid, NSAIDs) * Patients had previous orthodontic treatments * Poor oral hygiene or concurrent periodontal disease