OBJECTIVE To compare the extent of canine distalization and the transversal changes, postdistalization gingival indices, and mobility scores between patients who were undergoing orthodontic treatment involving upper premolar extraction with (experimental group) or without piezocision. MATERIALS AND METHODS Twenty maxillary canines of 10 patients were evaluated with split mouth design. Pre- and postdistalization dental casts were prepared and scanned with an orthodontic scanner to compare the extent of distalization and transversal changes between the two groups. The pre- and postdistalization gingival indices and mobility scores were also calculated. RESULTS Three-dimensional analysis of the models revealed significant differences in tooth movement (lesser anchorage loss and greater canine distalization) between the experimental and control groups. Furthermore, the distalization time was shortened in the experimental group. There were no differences in the transversal changes, pre- and postdistalization gingival indices, or mobility scores between groups. CONCLUSION Piezocision-assisted distalization accelerates tooth movement, decreases the anchorage loss for posterior teeth, and does not induce any maxillary transversal change. Moreover, piezocision does not have any adverse effects on periodontal health.