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Received: 24 June 2021    Revised: 14 July 2021    Accepted: 15 July 2021

DOI: 10.1111/ocr.12519

RESEARCH ARTICLE

The effects of a corticotomy on space closure by molar

protraction using TSADs in patients with missing mandibular
first molars

Jae Hyun Park1,2  | Kyung Wook Kim3 | Nam-­Ki Lee4  | Ja Hyeong Ku5 |

Jaehyun Kim5  | Yoon-­Ah Kook6  | Alex Hung Kuo Chou7 | Yoonji Kim6

1
Postgraduate Orthodontic Program,
Arizona School of Dentistry & Oral Health, Abstract
A.T. Still University, Mesa, AZ, USA Introduction: The purpose of this study was to evaluate the effects of a triangular-­
2
Graduate School of Dentistry, Kyung Hee
shaped corticotomy on the protraction of second and third molars in patients with
University, Seoul, Korea
3
Graduate School of Clinical Dental Science,
missing mandibular first molars.
The Catholic University of Korea, Seoul, Subjects and Methods: The corticotomy and non-­corticotomy groups consisted of
Korea
4
sixteen first molars in fifteen patients (28.6 ± 9.4 years) and nineteen first molars in
Department of Orthodontics, Section
of Dentistry, Seoul National University fifteen patients (26.6 ± 8.4 years), respectively. A triangular-­shaped corticotomy was
Bundang Hospital, Seongnam, Korea performed between the second premolar and molar. Temporary skeletal anchorage
5
Department of Orthodontics, Seoul St.
devices (TSADs) were placed between the first and second premolars in both groups.
Mary’s Hospital, Catholic University of
Korea, Seoul, Korea Mandibular dentition variables were measured on the pre and post-­treatment pano-
6
Department of Orthodontics, College of ramic radiographs and lateral cephalograms. Analysis of covariance was performed.
Medicine, Seoul St. Mary's Hospital, The
Catholic University of Korea, Seoul, Korea Results: The corticotomy group exhibited 2.8  mm more inter-­radicular correction
7
The Catholic University of Korea, Seoul, between the second molar to second premolar roots (P  < .001) and 1.6 mm more
Korea
inter-­radicular distance correction between the third molar to second premolar roots
Correspondence compared to the non-­corticotomy group (P < .01). The corticotomy group required
Yoon-­Ah Kook, Department of
5.5 months less treatment time for space closure (P < .05), but the total treatment
Orthodontics, Seoul St. Mary’s Hospital,
College of Medicine, The Catholic University time was the same for both groups.
of Korea, 222 Banpo-­daero, Seocho-­Gu,
Conclusions: The inter-­radicular distance between the mandibular second premolar
Seoul 06591, Korea.
Email: kook190036@yahoo.com and molar and treatment times for space closure was significantly reduced in the
corticotomy group.

KEYWORDS

inter-­radicular distance, missing mandibular first molars, molar protraction, temporary skeletal
anchorage devices, triangular-­shaped corticotomy

space in the edentulous area is often not completely closed, and

1 |  I NTRO D U C TI O N there is a marked reduction of alveolar bone height in adults.1-­3 In
addition, mandibular molar protraction has difficulties due to the
Orthodontic space closure of a missing molar by protracting the sec- extrusion of the maxillary molars, loss of alveolar bone and a large
ond or third molars can be a viable treatment modality. However, space to close with bodily movement.1,2

Jae Hyun Park and Kyung Wook Kim authors contributed equally to this work

© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Orthod Craniofac Res. 2021;00:1–9.  |

wileyonlinelibrary.com/journal/ocr     1
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2       PARK et al.
Many reports have demonstrated the protraction of mandib-
ular molars using temporary skeletal anchorage devices (TSADs)
with contemporary modalities.4-­10 Roberts et al5,6 used a rigid en-
dosseous implant in the retromolar area for mesial movement of
the lower molars. Baik et al11 reported the lower second and third
molars protraction to successfully close space due to missing first
molars.
There is a consensus that corticotomies induce a regional acceler-
atory phenomenon that accelerates tissue turnover and tooth move-
12-­16
ment and shortens treatment time. In support of this, several
animal studies have demonstrated that a corticotomy enhanced the
rate of tooth movement.17,18 Kook et al19 reported that corticotomy-­
assisted treatment could expedite closure of spaces in atrophied
20
edentulous adult patients. Recently, Arsenina et al showed that a
corticotomy with a splitting alveolar ridge reduced treatment time
and allowed an almost bodily translation of the molars.
To the best of our knowledge, while many studies have reported
space closure by protraction of the second and third molar with
missing first molars1-­3,7,11 few reports have examined the treatment
effects of a triangular-­shaped corticotomy on molar protraction.
Therefore, the purpose of this study was to evaluate the effects
of a triangular-­shaped corticotomy on protraction of second and
third molars using TSADs in patients with missing mandibular first
molars and to compare tooth movement with a corticotomy versus
without a corticotomy.
2 |  M ATE R I A L S A N D M E TH O DS
This retrospective study consisted of 30 patients who underwent
mandibular molar protraction to close the space from 35 missing
first molars at the Department of Orthodontics, Seoul St. Marys’
Dental hospital, from January 2005 to December 2019. Patients
were divided into two groups: 15 patients (28.6  ± 9.4 years) with
16 missing first molars treated with a corticotomy and 15 patients
(26.6 ± 8.4 years) with 19 missing first molars treated without a cor-
ticotomy, the control group (Figure 1 and (Table 1). Inclusion crite-
ria for all groups were (i) missing mandibular first molars, (ii) fully
erupted mandibular second molars, (iii) well-­developed mandibular
third molars, (iv) without failure of miniscrews for molar protraction,
(v) −5° <ANB <6°; −5  mm <overjet < 6  mm; −7  mm <arch length
discrepancy <7 mm; and (vi) no systemic disease or local factors
which could affect tooth movement. The severity of the maloc-
clusions was not significantly different between the two groups
(Table 1). Approval was granted by the institutional review board of
the Catholic University of Korea (KC11RASI0790).
Before space closure with a corticotomy, 0.022-­in slot brack-
ets and bands (Tomy) were placed on the maxillary and mandibular
teeth, including the third molars. The biomechanics are the same
in both groups, which were performed by one operator (KYA). The
procedure used in this study was detailed in a previous report.19
The corticotomy had a triangular-­shaped bone cut 3 mm mesial and
parallel to the periodontal ligament of the second molar in the area
between the second premolars and molars. The triangular-­shaped
corticotomy was approximately 7 mm of the base, and only corti-
cal plates in depth were removed using a no. 7 carbide round bur.
TSADs 8 mm in length and 1.6 mm in diameter (Jeil Medical Co.) was
placed between the first and second premolars in both the corticot-
omy and control groups. Approximately 200 g of orthodontic force
was applied immediately after performing the corticotomy using
NiTi closed coil spring (3 M Unitek) between a hook on the auxiliary
tube of the second molar tube and a TSAD for the protraction of
the second molars (Figure 2). Simultaneously, the second and third
molars were ligated passively with 0.010-­in wire for protracting the
third molars.
Also, miniscrews were placed bilaterally between the maxillary
first and second molars to intrude or avoid extrusion of the max-
illary molars during space closure. The miniscrews were removed
after space closure. The treatment time for space closure, including
levelling and alignment, was calculated from the patients' records.
In addition, total treatment time was measured between pre-­and
post-­treatment.
All measurements on the lateral cephalograms and panoramic
radiographs at pre-­and post-­treatment were blinded. The following
variables on the pre-­and post-­treatment lateral cephalograms were
used (Figure 3A).
• Distance from the buccal cusp tip of the second premolar to the
mesiobuccal cusp tip of the second molar (5C-­7C)
• Distance from the root apex of the second premolar to the mesial
root apex of the second molar (5R-­7R)
• Distance from the buccal cusp tip of the second premolar to the
mesiobuccal cusp tip of the third molar (5C-­8C)
• Distance from the root apex of the second premolar to the mesial
root apex of the third molar (5R-­8R)
• Distance from J to the mesiobuccal cusp tip of the second molar
(J-­7C) J: Intersection point between the anterior border of the
ramus of the mandible and the occlusal plane.
The following variables on the pre-­ and post-­treatment pan-
oramic radiographs were used (Figure 3B,C). Variables 10-­12 were
measured in the second molars.
• Angulation of the occlusal plane to the mandibular plane (OP-­MP)
• Angulation of the second premolar to the mandibular plane (MP-­5)
• Angulation of the second molar to the mandibular plane (MP-­7)
• Angulation of the third molar to the mandibular plane (MP-­8)
• Crown height (CH): the vertical distance between the mesiobuc-
cal cusp tip and cementoenamel junction
• Alveolar bone height (ABH): the vertical distance between the ce-
mentoenamel junction and the alveolar bone ridge
• Root length (RL): the vertical distance between the alveolar bone
ridge and the mesial root apex
The vertical distance was parallel to the long axis of the second
molars. Also, the alveolar bone height was measured only on the
PARK et al.       3|
F I G U R E 1   Panoramic radiographs
before and after space closure (A:
non-­corticotomy, B: with corticotomy)
1. Inter-­radicular distance between the
second premolar and second molar (a)
initial and (b) after space closure, 2. the
angle between the long axis of the second
premolar and second molar (c) initial and
(d) after space closure

TA B L E 1   Patient characteristics

P
Corticotomy group Control group value

Number of third molars (n) 16 19 N/A

a
Age (y)   28.6 ± 9.4 26.6 ± 8.4 .256
Sexb  Male 2 3 .67
Female 13 12
Total 15 15
a
Severity of malocclusion   ANB (°) 3.1 ± 3.1 2.5 ± 2.6 .55
OJ (mm) 2.9 ± 3.0 2.7 ± 2.4 .83
ALD (mm) 1.6 ± 3.4 1.7 ± 3.5 .93
Treatment time for space closure (m)a  20.2 ± 9.3 25.7 ± 8.7 0.039*
Total treatment time (m)a  36.6 ± 10.3 34.7 ± 11.2 0.605

Note: Control group means the non-­corticotomy group.

Abbreviation: ALD, arch length discrepancy.
aIndependent t test was performed.
bFisher's exact test was performed.
*P value < .05.

mesial side of the second molars because alveolar bone loss often The amount of crown and root movement of the protracted
occurs on the mesial surface of the second molars that are tilted due molars was measured on the pre-­and post-­treatment lateral ceph-
to missing first molars. alograms. We measured them along the mandibular occlusal plane
 |
4       PARK et al.
F I G U R E 2   Schematic drawing of a triangular-­shaped
corticotomy (bone cut 3 mm mesial and parallel to the periodontal
ligament of the second molar) after flap surgery, and miniscrew
anchorage was placed between the first and second premolars to
protract the second and third molars
connecting the incisor tip and buccal cusp of the second premolars
(Figure  3A). In the panoramic radiographs, the occlusal plane was
set as a line connecting the incisal edge of the mandibular central
incisors and the buccal cusp of the mandibular second premolars.
The mandibular plane was set as a line tangent to the lower border
of the mandibles (Figure 3B). The crown height registration method
described in a previous study7 was used to correct any variations
in image magnification or distortion between the pre-­and post-­
treatment panoramic radiographs (Figure 3C).
21
The sample size calculation was based on a previous study
used a triangular corticotomy in connection with horizontal tooth
movement variables. It showed that at least 22 samples were re-
quired in total, 11 samples in the experimental and control groups to
identify a Cohen's d effect size of 1.286 units, with an alpha of 0.05
and a beta of 0.2.
One examiner (J-­H-­K ) did all the tracing and measurements on
the radiographs. Ten randomly selected subjects were reprocessed
two weeks later to evaluate intraoperator reliability. The two-­way
mixed intraclass correlation coefficient showed that the measure-
ments were reliable (>0.997).
2.1 | STATISTICAL ANALYSIS
A statistical evaluation was performed using the SAS System for
Windows V 9.4 (SAS Ins.). An independent t test and Fisher's exact
test were performed to compare the patient characteristics between
the corticotomy and non-­corticotomy groups. An independent t test
was used to evaluate the linear and angular measurements at T1
and T2 between the two groups. Analysis of covariance (ANCOVA)
was performed to assess the differences at pre-­and post-­treatment
and the treatment effects between the groups using total treatment
time as a covariance. An independent t test was also used to evalu-
ate the changes in alveolar bone height and root length. In this study,
there were a few patients with protraction of both the right and left
molars, and each molar was analysed and statistically performed as
an independent sample.
3 | R E S U LT S
The treatment time for space closure for the corticotomy group
was 20.2  months compared to 25.7  months for the control
group. The corticotomy group required 5.5  months less treat-
ment time for space closure (P < .05). However, the total treat-
ment time for the corticotomy group was 36.6 months compared
to 34.7 months for the control group, which was no different
(Table 1).
In Table 2, there were no statistical differences between the cor-
ticotomy and the control groups at pretreatment except for MP-­5.
However, there were statistical differences in 5R-­7R, 5C-­8C, 5R-­8R
and MP-­5 between the groups at post-­treatment.
The second premolars in the corticotomy group showed sta-
tistically more angular changes (MP-­5) than those in the control
group, 3.3° vs 1.6°, respectively (P < .05). The angular changes in
the second molars were 12.9° in the corticotomy group and 11.3°
in the control group, not a significant difference. The corticotomy
group showed improved inter-­radicular distance; 2.8 mm more
inter-­r adicular distance correction between the second molar to
second premolar roots (P < .001) and 1.6 mm more inter-­r adicular
distance correction between the third molar to second premolar
roots (P < .01).
that The distance between the third molar and second premolar
crowns decreased by 6.7 mm in the corticotomy group; it decreased
by just 4.4 mm in the control group, so there was 2.3 mm more dis-
tance correction in the corticotomy group (P < .05).
There was an average of 1.52 ± 1.50 mm of root resorption and
0.48 ± 0.87 mm of alveolar bone change in the corticotomy group
compared to 1.96 ± 1.60 mm of root resorption and 0.19 ± 0.44 mm
of alveolar bone change in the control group. However, neither of
these changes was significant (Table 3).
4 | D I S CU S S I O N
Temporary skeletal anchorage can be applied not only for the re-
traction of anterior teeth or intrusion but also for molar protraction
when the first molar is missing. In previous studies, 22,23 corticoto-
mies reportedly accelerated tooth movement and shortened treat-
ment time.
A corticotomy combined with TSADs can facilitate closure of
space when a sound third molar is present, which reduces the need
PARK et al. |
      5

F I G U R E 3   A, Linear measurements in a lateral cephalogram: (1) Horizontal distance from the buccal cusp tip of the second premolar
to the mesiobuccal cusp tip of the second molar (5C-­7C), (2) horizontal distance from the root apex of the second premolar to the mesial
root apex of the second molar (5R-­7R), (3) horizontal distance from the buccal cusp tip of the second premolar to the mesiobuccal cusp
tip of the third molar (5C-­8C), (4) horizontal distance from the root apex of the second premolar to the mesial root apex of the third molar
(5R-­8R), (5) horizontal distance from J to mesiobuccal cusp tip of the second molar (J-­7C) horizontal distance was measured parallel to
the mandibular occlusal plane as a line connecting the incisor tip and buccal cusp of the second premolars. B, Angular measurements on a
panoramic radiograph: (6) The angulation of the occlusal plane to the mandibular plane (OP-­MP), (7) the angulation of the long axis of the
second premolar and mandibular plane (MP-­5), (8) the angulation of the long axis of the second molar and the mandibular plane (MP-­7), (9)
the angulation of the long axis of the third molar and mandibular plane (MP-­8). C, Linear measurements of the second molar on panoramic
radiographs: (10) crown height (CH), (11) alveolar bone height (ABH), (12) root length (RL)

to place a dental implant restoration for a missing mandibular first
molar. Therefore, our study aimed to evaluate the effects of molar
protraction on the corticotomy group compared to that in the con-
trol group.
Regarding the development of the third molar, the roots of the
third molar are not fully developed at 18 years old, which may af-
fect molar protraction. In this study, although patients were aged
(28.6  ± 9.4) and (26.6 ± 8.4), respectively, no patients were in the
corticotomy group and two patients in the control group under
18 years old. Therefore, the patient's age might not affect the out-
come of this study.
In our study, two-­dimensional radiographs, including panoramic
radiographs and lateral cephalograms, were measured. Baik et al24
used panoramic radiographs to measure the distance on the crown
and root level for evaluating mesialization of the mandibular second
molars. In addition, Kim et al7 evaluated root length and alveolar
bone height on panoramic radiographs. Some reports25,26 showed
acceptable reliability with panoramic radiographs. We used the
crown height registration method in our study to minimize magnifi-
cation or distortion in panoramic radiographs.
With the occlusal plane for a reference line, orthodontic treat-
ment with a fixed appliance might affect the vertical position of
 |
6      

TA B L E 2   Linear and angular measurements and changes between the corticotomy and control groups

Pretreatment (T1) Post-­treatment (T2) Changes (T2-­T1)

Corticotomy
Measurement Corticotomy (n = 16) Control (n = 19) Corticotomy (n = 16) Control (n = 19) (n = 16) Control (n = 19)

Mean SD Mean SD P valuea  Mean SD Mean SD P valuea  Mean SD Mean SD P valueb 

Linear
5C-­7C (mm) 13.04 3.52 10.98 2.71 .059 6.46 0.75 6.71 0.76 .339 6.58 3.63 4.27 2.45 .203
5R-­7R (mm) 21.13 3.21 22.26 3.53 .332 10.03 2.87 13.96 2.83 <.001** 11.10 2.71 8.30 3.78 <.001**
5C-­8C (mm) 24.15 3.32 23.42 3.28 .518 17.46 2.77 19.05 1.31 .032* 6.70 3.71 4.37 3.47 .026*
5R-­8R (mm) 32.10 4.56 34.49 3.83 .102 23.04 3.05 27.00 2.78 <.001** 9.06 4.81 7.49 4.14 .001*
J-­7C (mm) 21.89 3.83 23.04 4.54 .429 26.64 3.51 24.92 3.58 .162 4.75 4.48 1.88 3.19 .041*
Angular
MP-­5 (°) 74.62 8.36 67.05 7.51 .008* 77.88 5.85 68.67 7.05 <.001** -­3.26 5.63 -­1.62 4.87 .010*
MP-­7 (°) 106.54 12.39 105.56 6.68 .769 93.66 7.11 94.29 9.83 .831 12.88 8.51 11.27 11.50 .729
MP-­8 (°) 107.80 14.17 108.80 14.32 .838 101.51 10.27 95.38 22.31 .319 6.29 17.73 13.42 24.35 .314
OP (°) 13.22 33.63 11.40 20.68 .307 13.86 33.31 11.14 17.27 .115 0.64 5.61 -­0.27 5.15 .257
OP-­MP (°) 23.24 5.15 25.16 3.62 .205 20.65 5.97 22.64 3.76 .238 2.59 4.68 2.52 3.41 .632

Note: Control group means non-­corticotomy group.

a
Independent t test.
b
analysis of covariance (ANCOVA).
*P value < .05.; **P value < .001.
PARK et al.
PARK et al.
TA B L E 3   Comparison of the changes
in alveolar bone height and root length
between the corticotomy and control Measurement
groups
Δ Alveolar bone height (mm)
Δ Root length (mm)
Note: Control group means the non-­corticotomy group.
a
Independent t test.
the mandibular incisors inducing the change of the occlusal plane.
However, OP (°) had no significant changes during treatment in each
group (Table 2).
To compare the treatment effects between both groups, treat-
ment time was used as a covariance. Because the treatment time is
different for each patient, the amount of tooth movement may be
affected by treatment time. So, it is necessary to control the time
variance to evaluate the corticotomy effect more accurately.
Regarding the horizontal movement of the third molar, previ-
7,24
ous clinical studies showed similar results to those in our study
without a corticotomy, which were 5.0  mm and 5.1  mm of crown
movement, respectively. The corticotomy group revealed a 2.8 mm
decrease in the inter-­radicular distance compared to that of the con-
trol group. Therefore, corticotomy might be a viable treatment op-
tion to improve root movement during space closure.
Regarding the speed of tooth movement, a couple of animal
22,27
studies found that surgical intervention in alveolar bone pro-
duced more significant tooth movement than was seen with an un-
treated extraction socket. Other similar approaches have produced
increased rates of tooth movement in clinical studies. 28-­33 Long
28
et al reported it is a safe and effective way to accelerate tooth
movement. However, Dab et al34 showed an acceleration of tooth
movement only appeared during the first few months. Arsenina
et al20 also showed the mesialization speed of molars was increased
within the first 4.5 months for space closure.
Regarding the length of treatment time, the treatment time
for space closure in the corticotomy group was 20.2 months com-
pared to 25.7  months in the control group, which was a signifi-
cant difference of 5.5  months in our study. On the other hand,
the total treatment time for the corticotomy and control groups
was 36.6  months and 34.7  months. These results suggest that
the treatment time for space closure can be reduced despite no
difference in total treatment time. However, treatment time can
be affected by various factors, including patient compliance, the
complexity of the malocclusion, frequency of the appointments,
and so on. These factors should be considered for evaluating
total treatment time.
Additionally, root resorption and alveolar bone change were
not significant in our study. However, Kim et al7 reported a signif-
icant 0.80  mm of external apical root resorption and 0.56  mm of
alveolar bone loss after protracting mandibular molars when using
miniscrews. Nevertheless, this is a clinically acceptable method for
protracting second molars. In addition, the amount of root resorp-
tion and alveolar bone height change was not clinically relevant in
|
      7
Corticotomy (n = 16) Control (n = 19)
Mean SD Mean SD P valuea 
0.48 0.87 0.19 0.44 .254
−1.52 1.50 −1.96 1.60 .427
patients treated by mesialization of mandibular molars with unilat-
eral second premolar agenesis.35,36
However, when patients present with missing mandibular first
molars with atrophic, narrow alveolar ridges, orthodontic space
closure is challenging. Ostler and Kokich37 reported ridge width de-
creases 25% within three years after extraction, although the rate of
decrease diminished over the next three years.
According to six classifications of an edentulous ridge by Cawood and
Howell,38 corticotomy might not be needed with Class I with dentate, Class
II immediately post-­extraction and Class III. For the efficient application of
corticotomy for protraction of the second and third molars during space
closure, the type of edentulous ridge needs to be considered.
In atrophied alveolar ridges, a previous report demonstrated
corticotomy-­assisted space closure with missing mandibular molars
in adults.14 In our study, we used the triangular-­shaped corticotomy
method in the corticotomy group. However, Kim et al21 studied the
amount of tooth movement relative to different corticotomy designs
in rabbits and found no difference with different corticotomy de-
signs such as triangular or indentation corticotomies. Therefore, our
results could be applied to other types of corticotomy.
For the clinical application for protracting molars, many factors
should be considered. There are anatomic factors, including root
shape and length of the third molars, time after extraction of the
first molars, and patient preference.
A limitation of this study had to measure two-­dimensional ra-
diographs. Therefore, a future study should consider cone-­beam
computer tomography to evaluate the 3-­dimensional tooth move-
ment, bony support and changes at pre-­and post-­treatment with a
triangular-­shaped corticotomy for molar protraction.
5 | CO N C LU S I O N S
This study evaluated the effects of a corticotomy for protraction
of second and third molars in patients with missing mandibular first
molars and compared the tooth movement between corticotomy
and non-­corticotomy groups. We made the following observations:
• The inter-­radicular distance between the mandibular second mo-
lars and the second premolars was significantly reduced in the
corticotomy group
• The corticotomy group required a shorter treatment time for
space closure than the non-­corticotomy group. However, total
treatment time had no significant difference in both groups.
 |
8       PARK et al.
For cases with missing first molars where the third molars sound,
a treatment plan using corticotomy with TSADs for protraction of
the second and third molars should be considered a viable option.
C O N FL I C T S O F I N T E R E S T
All authors have completed and submitted the ICMJE Form for
Disclosure of Potential Conflicts of Interest, and none were reported.
AU T H O R ' S C O N T R I B U T I O N
Jae Hyun Park contributed to data analysis and writing the arti-
cle. Kyung Wook Kim contributed to data collection and writing
the article. Nam-­K i Lee contributed to the statistical analysis and
critical revision of the article. Jaehyun Kim contributed to data
measurement and the statistical analysis. Ja Hyeong Ku contrib-
uted to reviewing the literature. Yoon-­A h Kook contributed to
supervising the overall project and overall responsibility. Alex
Hung Kuo Chou contributed to reviewing the literature and criti-
cal revision of the article. Yoonji Kim contributed to the critical
revision of the article.
DATA AVA I L A B I L I T Y S TAT E M E N T
The data that support the findings of this study are available from
the corresponding author upon reasonable request.
ORCID
Jae Hyun Park  https://orcid.org/0000-0002-3134-6878
Nam-­Ki Lee  https://orcid.org/0000-0003-1505-2551
Jaehyun Kim  https://orcid.org/0000-0002-5618-2961
Yoon-­Ah Kook  https://orcid.org/0000-0001-9969-8645
Yoonji Kim  https://orcid.org/0000-0002-1664-3137
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How to cite this article: Park JH, Kim KW, Lee N-­K , et al. The
effects of a corticotomy on space closure by molar
protraction using TSADs in patients with missing mandibular
first molars. Orthod Craniofac Res. 2021;00:1–­9. https://doi.
org/10.1111/ocr.12519