Comparison Between Two Methods in the Acceleration of the Retraction of Upper Canines

Damascus University51 enrolled

Overview

Patients at the Orthodontic Department of University of Damascus Dental School will be examined and subjects who meet the inclusion criteria will be included. Then, initial diagnostic records (diagnostic gypsum models, internal and external oral photographs, as well as radiographic images) will be studied to ensure that the selection criteria are accurately matched. The aim of this study is to compare flapless bone cutting by mechanical drills to evaluate the acceleration of the retraction of upper canines versus traditional bone cutting by piezo-surgery in comparison with a control group without bone cutting after extraction of upper first premolars in class II type I patients.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Malocclusion, Angle Class II, Division 1

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 27 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age between 18-27 years * Patients who have malocclusion class II type I and who require first-premolar extraction with: * Dentoalveolar class II type I with ANB between 5 and 9 degrees. * Protrusion between (5-10 mm) * Overbite between (0-4) * Vertical dimension is normal or over the normal range * Mild to moderate crowding * All patients should have complete permanent occlusion on the maxilla * All patients should have normal periodontal tissue and good oral health, which will be assessed by: 1. Depth of the gingival pocket does not exceed 4 mm 2. Plaque index does not exceed 1 3. Gingival index does not exceed 1 Exclusion Criteria: * Patients in which oral surgery under local anesthesia is contraindicated due to medical, psychological, or social reasons. * Patients who have a general health problem that affects dental movement * Patients who have undergone previous orthodontic treatment * Patients with mixed occlusion * Patients who have lost one or more of their teeth since birth or who have one of the permanent teeth extracted (except the third molar) * Patients who have bad oral health or active periodontal disease

Outcomes

Primary Outcomes

Change in Canine Retraction Speed

The rate at which canine is going to be retracted (mm/month) in each group will be calculated. This outcome will be measured by the following steps: 1. Drawing a projection from the upper canine apex to the middle palatal bone line. 2. Drawing a projection from the mesial ending of the third palatal rugae to the middle palatal bone line. 3. Measuring the distance (mm) between the two orthogonal projections. 4. The rate of canine retraction will be measured by dividing the distance between the two orthogonal projections by the time elapsed between assessment times.

Time frame: T1: At the end of alignment (which is expected within 3 months); T2: 1 month after canine retraction; T3: After two months; T4: After 3 months; T5: at the end of canine retraction which is expected within 5 months

Change in Anchorage Loss

Anchorage loss in related the mesial drift of the first molar. This outcome will be measured by drawing two projections from the central groove of the first maxillary molar and the mesial ending of the third palatal rugae to the middle palatal bone line. The mesial migration of the first maxillary molar (mm) will be measured by dividing the distance between the two projections by the time elapsed between assessment times.

Change in Canine Rotation

The angle between the middle palatal bone and the line through the mesial and distal edges of the canine will be measured on each side. The rotation will be assessed by calculating the difference between the angles on two different times. Then, the speed of rotation will be calculated by dividing the rotation angle (degrees) by time that elapsed between assessment times.

Change in Canine Axis

The changes in the canine axis during retraction will be studied by calculating canine angulation (arithmetic mean of the angulation of the right and left upper canine axis with the anterior cranial base plane) on lateral cephalometric radiographs. The difference between the canine angulation on T1 and T2 will be calculated after comparing the two cephalometric using Viewbox version 4.0.0.98.

Time frame: T1: at the end of the alignment stage (which is expected within 3 to 4 months); T2: at the end of the canine retraction stage (which is expected to occur with 4 to five months following the onset of this stage).