Clinical Trial Details
— Status: Recruiting
Administrative data
NCT number |
NCT04815564 |
Other study ID # |
H48518 |
Secondary ID |
|
Status |
Recruiting |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
August 1, 2022 |
Est. completion date |
July 2026 |
Study information
Verified date |
November 2023 |
Source |
Baylor College of Medicine |
Contact |
Dianne Nguyen |
Phone |
713.798.6694 |
Email |
diannen[@]bcm.edu |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
Misalignment of teeth and jaws (also called malocclusion) is a common life altering problem
facing many individuals with Osteogenesis Imperfecta (OI). The presence of Dentinogenesis
Imperfecta in teeth of OI individuals makes the use of conventional orthodontics in the form
of braces very challenging. Clear aligners are newer form of orthodontic treatment and is
less invasive than braces. Therefore, the aim of our study is to evaluate the efficiency and
safety of using Invisalign clear aligners for orthodontic treatment in individuals with
Osteogenesis Imperfecta. We seek individual with Osteogenesis Imperfecta, with mild to
moderate malocclusion and no prior history of orthodontic treatment. This study will be held
at three sites - McGill University, University of California Los Angeles and National
Institute of Dental and Craniofacial research. This study will for the first time, help
define guidelines for safe and efficient orthodontic treatment using clear aligners in
individuals with Osteogenesis Imperfecta. If successful, this approach can rapidly be
implemented into clinical practice, as the Invisalign system is readily available to
orthodontists.
Description:
Osteogenesis imperfecta (OI) is a heritable connective tissue disorder leading to frequent
fractures and bone deformities. In about 90% of individuals with OI, the disease is caused by
dominant mutations in one of the two genes coding for collagen type I, COL1A1 and COL1A2. The
phenotype of OI ranges widely, which is captured by the Sillence classification of OI into
clinical types I through IV. Individuals who have bone disease that is severe enough to lead
to long-bone deformities, such as bowing of femurs and tibias, are usually diagnosed with OI
type III (severe bone fragility) or IV (moderate bone fragility).
Apart from the well-known features of OI in the extracranial skeleton, OI is frequently
associated with dental and craniofacial issues. These abnormalities are a source of major
concern to patients. Misalignment of the jaws is a common problem in individuals with OI Type
III and IV. Malocclusion associated with OI types III and IV differs markedly from the types
of malocclusion commonly observed in the general population. Malocclusion in the general
population is predominantly class II, however, OI types III and IV are commonly associated
with class III malocclusion. The Invisalign® system (Align Technology, Santa Clara, CA) is a
personalized and FDA-approved (Class II device; 510(k) number: K143630) approach to treat
malocclusion. It involves incrementally moving teeth with a series of removable, custom-made
clear polyurethane trays (aligners) that exert forces on teeth. The aligners are transparent
('clear aligners') and therefore are less visible than traditional braces that are made of
metal. An important consideration in the treatment of patients with OI is that Invisalign
does not require surface etching and cement bonding of metal braces to the tooth surface,
which is difficult in the presence of dentinogenesis imperfecta. In this study, we will
therefore use the Invisalign system to treat malocclusion associated with OI. This study will
directly inform clinical orthodontic practice in an area of unmet clinical need and utilizes
a treatment method that may be immediately implemented.
Individuals who meet the eligibility criteria will be able to enroll in the intervention arm
of the study to undergo orthodontic treatment. Participants who fail to meet the eligibility
criteria will be offered to participate in the study for observation purposes (natural
history arm) without undergoing treatment. Participants in the intervention arm will need to
visit the study site every two months for the study duration (28 months). Initial four months
will involve observation period followed by two years of orthodontic treatment. Participants
in the natural history arm will visit the study site every six months for a period of two
years (4 visits). A complete oral exam, craniofacial evaluation, intra-oral photos,
intra-oral scans, face photos, masticatory test, cone-beam CT and self-reported
questionnaires will be done during the visits.