Palatally Impacted Canines Clinical Trial
Official title:
The Efficacy of Surgical Exposure With Alveolar-decortication vs. Conventional Surgical Exposure to Reduce Treatment Time for Orthodontic Alignment of Palatally Impacted Canines
The purpose of this pilot clinical trial is to evaluate whether alveolar-decortication has the potential to reduce orthodontic treatment time following surgical exposure of palatally impacted canines.
Purpose:
Upper permanent canines frequently become impacted (2%), which prevents their normal eruption
(Brin et al, 1986. Ericson and Kurol, 1986). The upper canine may become impacted palatally
(61%) or buccally (4.5%) (Stivaros and Mandall, 2000).
One of the treatment options for impacted canines is to surgically expose the canine tooth
and to align it using orthodontic appliances. A bracket is attached to the tooth at the time
of surgery. The tooth is then aligned using orthodontic forces.
Alveolar-decortication is also referred to as corticotomy-assisted orthodontics (Fischer,
2007). The technique involves exposure of alveolar bone and partial decortication of the
cortical plates followed by primary flap closure.
It is believed that this alternative surgical technique reduces the time taken to
orthodontically align teeth; previous case reports and preliminary studies report reductions
by 28% to 80% in treatment time (Fischer, 2007. Wilcko et al, 2001).
No rigorous clinical trials have been conducted to evaluate the efficacy of
alveolar-decortication to reduce orthodontic treatment times. We plan to evaluate this
technique in patients with palatally impacted canines because a surgical procedure is
necessary anyway to expose the tooth and the additional surgical trauma is minimal.
Aims and objectives:
This study aims to investigate the effect of alveolar-decortication in addition to surgical
exposure, on the time taken to align palatally impacted canines. The alternative surgical
technique will be compared to the conventional surgical exposure, by recording the time taken
to subsequently align the tooth.
The objective is to determine whether the use of alveolar-decortication whilst exposing an
impacted tooth, will lead to a reduction in the time required to align the tooth, and
therefore a reduction in the overall treatment time.
Recruitment and consent:
30 orthodontic patients (n=15 per group), who are awaiting exposure and bonding of a
palatally impacted canine tooth, will be selected from the waiting list at Birmingham Dental
Hospital. Potential participants will be invited to take part in the study; they will be
given verbal and written information. If they are happy to take part, written consent will be
obtained. All patients recruited will be competent and capable of making the decision. For
patients under 16 years of age, parental/legal guardian consent will be obtained. The
patients will be able to withdraw from the study at any time, should they not wish to
continue participating.
Methods:
Participants will be randomly allocated to either the control or test group, at the time of
surgery.
Randomisation will use the method of randomly permuted blocks with variable block size.
Enrolled participants will be assigned a study number at the time of surgery. The envelope
with group assignment will be opened after completion of the surgical exposure (prior to
wound closure). For subjects randomised to the test group, alveolar-decortication will then
be carried out prior to wound closure. While the surgeon cannot be blinded for obvious
reasons, group assignment will not be disclosed to the patient and will not be disclosed to
the orthodontist.
At the time of surgery, 3 intra-oral photographs will be taken of the upper arch, including
the exposed tooth.
Following surgery, the orthodontic treatment will be carried out in the normal way. At
routine appointments, 3 intra-oral photographs will be taken of the upper arch, including the
canine tooth. These photographs will be inserted into a computer programme, and a
stereo-imaging technique will be used to construct a 3-D image, which will allow the velocity
of tooth movement to be calculated.
Impressions will be taken of the upper arch during treatment, the resultant study models can
also be used to calculate velocity of tooth movement. The distance between the tip of the
canine tooth, to the line of the arch will be measured with callipers, at the time of surgery
and also during routine orthodontic appointments.
Inclusion criteria:
Patients at Birmingham Dental Hospital. Patients with a palatally impacted canine, awaiting
surgical exposure. Patients with bilateral impacted canines may be included, in these cases
both canines will be treated using the same surgical technique determined by allocation into
either the test or control group.
Informed consent gained.
Exclusion criteria:
History of periodontal disease. Radiographical evidence of pathology associated with the
impacted canine. Patients already participating in a research study.
;
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
NCT03260829 -
Efficacy of Injectable Vitamin C on Accelerating Canine Movement: A Clinical Study
|
N/A |