Class II Div 1 Malocclusion Clinical Trial
Official title:
An Evaluation of the Efficacy of Conventional Corticotomy Versus Flapless Corticotomy in the En-Masse Retraction of Upper Anterior Teeth : A Randomized Controlled Trial
Verified date | August 2018 |
Source | Damascus University |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This study aims to evaluate and compare the skeletal, dental and soft tissue changes, the
levels of pain and discomfort and the effect on periodontal health and teeth vitality
associated to traditional corticotomy and flapless corticotomy in the retraction of upper
anterior teeth.
40 patients requiring extraction of maxillary first premolars and maximum anchorage to
retract the upper anterior teeth will participate in the study. They will be divided randomly
into two groups : flapless corticotomy (20 patients) and traditional corticotomy (20
patients). Pre-retraction, corticotomy will be performed in the maxillary anterior segment.
The skeletal, dental and soft tissue changes will be performed using lateral cephalometric
radiographs which will be obtained pretreatment, pre and post en-masse retraction of the
anterior teeth and we will also use the dental casts to evaluate the dental changes.
Status | Completed |
Enrollment | 20 |
Est. completion date | May 15, 2018 |
Est. primary completion date | August 12, 2017 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 30 Years |
Eligibility |
Inclusion Criteria: - Adult patients with permanent occlusion at age 18-30 years. - Comprehensive medical and dental history ruling out any systemic disease - Not under any systemic medication. - No previous orthodontic treatment - Patients with satisfactory periodontal health and Good oral hygiene - Need to orthodontic treatment with fixed appliances - No congenitally missing teeth except third molars in the maxillary arch - Mild or no anterior crowding in maxillary arch. - Maximum anchorage, with 75% to 100% of space closure of retraction of anterior segment in maxillary arch. - Therapeutic extraction of maxillary first premolars required. - Patients with class ? division 1 (ANB angle =7 degrees) with severe overjet (5-10 mm) - Maximum retraction of the anterior teeth was desired. Exclusion Criteria: - Patients with previous orthodontic treatment. - Patients with severe skeletal dysplasia in all three dimensions. - Patients suffer from systemic diseases or syndromes - Patients on medication for systemic disorders, pregnancy or steroid therapy. - Patients showing any signs of active periodontal disease - Patients with severe crowding (= 3.5 mm) in maxillary arch - Patients with missing or extracted teeth in maxillary arch except third molar. |
Country | Name | City | State |
---|---|---|---|
Syrian Arab Republic | Department of Orthodontics, University of Damascus Dental School | Damascus |
Lead Sponsor | Collaborator |
---|---|
Damascus University |
Syrian Arab Republic,
Al-Sibaie S, Hajeer MY. Assessment of changes following en-masse retraction with mini-implants anchorage compared to two-step retraction with conventional anchorage in patients with class II division 1 malocclusion: a randomized controlled trial. Eur J Orthod. 2014 Jun;36(3):275-83. doi: 10.1093/ejo/cjt046. Epub 2013 Jun 20. — View Citation
Bhattacharya P, Bhattacharya H, Anjum A, Bhandari R, Agarwal DK, Gupta A, Ansar J. Assessment of Corticotomy Facilitated Tooth Movement and Changes in Alveolar Bone Thickness - A CT Scan Study. J Clin Diagn Res. 2014 Oct;8(10):ZC26-30. doi: 10.7860/JCDR/2014/9448.4954. Epub 2014 Oct 20. — View Citation
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Krishnan P, Shetty S, Husain A. An adjunctive minor surgical procedure for increased rate of retraction. J Pharm Bioallied Sci. 2013 Jun;5(Suppl 1):S39-42. doi: 10.4103/0975-7406.113293. — View Citation
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Seo KW, Kwon SY, Kim KA, Park KH, Kim SH, Ahn HW, Nelson G. Displacement pattern of the anterior segment using antero-posterior lingual retractor combined with a palatal plate. Korean J Orthod. 2015 Nov;45(6):289-98. doi: 10.4041/kjod.2015.45.6.289. Epub 2015 Nov 20. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Duration of en-masse retraction of anterior teeth | Assessment will be performed by calculating the months required to achieve complete retraction of the upper anterior teeth (six teeth) through clinical examination. | The months required to compete the retraction procedure will be recorded. Completion of this procedure is expected to be occur within six months in the experimental group and eight months in the control group. | |
Primary | Rate of retraction | Assessment will be performed on study models. The amount of distance being retracted in millimeters will be divided by the duration of retraction in weeks to give an estimation of the retraction rate. | The calculation of the rate of retraction will be done once the retraction procedures has finished. Completion of this procedure is expected to occur within 6 months in the experimental group and 8 months in the control group. | |
Primary | Change in Incisors' positions | Amount of distance being traveled by the retracted anterior teeth is going to be measured on study models taken at monthly intervals until the end of the retraction phase. | T0: 1 day before the beginning of retraction. T1: after 1 month (m) of retraction. T2: after 2 m of retraction. T3: after 3 m. T4: after 4 m. T5: at the end of retraction (expected to be within 6 m in the exp. group and 8 m in the control group) | |
Primary | Change in Molars' positions | Amount of distance being traveled by the first molars and is going to be measured on study models taken at monthly intervals until the end of the retraction phase. | T0: 1 day before the beginning of retraction. T1: after 1 month (m) of retraction. T2: after 2 m of retraction. T3: after 3 m. T4: after 4 m. T5: at the end of retraction (expected to be within 6 m in the exp. group and 8 m in the control group) | |
Primary | Change in the SNA angle | This angle the represents the position of the upper jaw in the cephalometric analysis in the anteroposterior direction. Lateral cephalograms will be taken and this angle is going to be measured in degrees. | The cephalogram will be taken twice, 1 week before the commencement of the retraction and at the completion of retraction. Completion of this procedure is expected to be done within 6 months in the experimental group and 8 months in the control group. | |
Primary | Change in the SNB angle | This angle the represents the position of the lower jaw in the cephalometric analysis in the anteroposterior direction. Lateral cephalograms will be taken and this angle is going to be measured in degrees. | The cephalogram will be taken twice, 1 week before the commencement of the retraction and at the completion of retraction. Completion of this procedure is expected to be done within 6 months in the experimental group and 8 months in the control group. | |
Primary | Change in the ANB angle | This angle the represents the spatial relationship between the upper and lower jaws in the cephalometric analysis in the anteroposterior direction. Lateral cephalograms will be taken and this angle is going to be measured in degrees. | The cephalogram will be taken twice, 1 week before the commencement of the retraction and at the completion of retraction. Completion of this procedure is expected to be done within 6 months in the experimental group and 8 months in the control group. | |
Primary | Change in the SN.GoMe angle | This angle the represents the amount of backward rotation of the lower jaw in the cephalometric analysis. Lateral cephalograms will be taken and this angle is going to be measured in degrees. | The cephalogram will be taken twice, 1 week before the commencement of the retraction and at the completion of retraction. Completion of this procedure is expected to be done within 6 months in the experimental group and 8 months in the control group. | |
Primary | Change in the MM angle | This angle the represents the amount of vertical divergence between the upper and lower jaws in the cephalometric analysis. Lateral cephalograms will be taken and this angle is going to be measured in degrees. | The cephalogram will be taken twice, 1 week before the commencement of the retraction and at the completion of retraction. Completion of this procedure is expected to be done within 6 months in the experimental group and 8 months in the control group. | |
Secondary | Change in the levels of pain and discomfort | Assessment will be performed using questionnaires via visual analog scales (VAS) | Levels of pain will be assessed at : 24 hours following the surgical intervention (T1), one week (T2) , two weeks (T3) and four weeks (T4) following the surgical intervention | |
Secondary | Change in the Plaque index | The plaque index will be used to assess the status of the oral hygiene in these patients. | This will be measured: one day before the commencement of the retraction phase and at the end of the retraction phase which is expected to occur within 6 months in the experimental group and 8 months in the control group. | |
Secondary | Change in the Gingival index | The Gingival index will be used to assess the status of the gingival tissues around the teeth. | This will be measured: one day before the commencement of the retraction phase and at the end of the retraction phase which is expected to occur within 6 months in the experimental group and 8 months in the control group. | |
Secondary | Change in the Bleeding index | The plaque index will be used to assess the status of periodontal tissues and the amount of congestion in the gingival margins around the anterior teeth. | This will be measured: one day before the commencement of the retraction phase and at the end of the retraction phase which is expected to occur within 6 months in the experimental group and 8 months in the control group. | |
Secondary | Gingival Recession | This will be measured in millimeters from the cement-enamel junction to the level of the gingival margin around the six anterior teeth. | Two measurements are required for this calculation: one day before the commencement of the retraction phase and at the end of the retraction phase which is expected to occur within 6 months in the experimental group and 8 months in the control group. | |
Secondary | Change in Tooth Vitality | Tooth vitality will be evaluated for each tooth of the six anterior teeth using Ethyl Chloride applied by a cotton roll. | This will be measured: one day before the commencement of the retraction phase and at the end of the retraction phase which is expected to occur within 6 months in the experimental group and 8 months in the control group. |
Status | Clinical Trial | Phase | |
---|---|---|---|
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