Alveolar Bone Dehiscence and Fenestration Following Accelerated Maxillary Canine Retraction

Tanta University60 enrolled

Overview

Alveolar bone loss and fenestration are the most prevalent bone defects that often result in root exposure, gingival recession, and potential treatment relapse or failure. These issues present complications in orthodontic therapy. Hence, reducing the length of orthodontic therapy and minimizing the occurrence of these serious complications are highly important for orthodontic patients, particularly adults. platelet-rich plasma (PRP) injection and decortication are two promising methods for accelerated tooth movements. Thus, The aim of this study is to evaluate alveolar bone dehiscence and fenestrations after canine retraction, using alveolar decortication and PRP injection as two methods for accelerating tooth movements.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Fenestration Dehiscence

Interventions

Combined decortication and PRP injectionPROCEDURE

Experimental sides will receive PRP injection after performing decortication. After administration of local anesthesia, two-line flap will be performed from the mesial surface of the maxillary second premolar to the distal surface of the maxillary canine Mucoperiosteal flap will be reflected in the buccal side. Two millimeters of marginal crestal bone will be held intact and using a high-speed drill and a round carbide bur (1mm diameter) under copious saline irrigation, the cortical wall will be penetrated to reach marrow spaces. Multiple perforations (10 holes for standardization) in the cortical bone will be created. The surgical site will then rinsed, and the flap will be repositioned and sutured.

Eligibility

Sex: ALLMin age: 16 YearsMax age: 22 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Age of the patients ranged from 16: 22 years old. 2. Malocclusion that requires extraction of the maxillary first premolar and canine retraction (e.g. class I bimaxillary dentoalveolar protrusion and class II div 1 malocclusion). 3. Maximum anchorage needed for the maxillary arch as a part of the orthodontic treatment plan. 4. Good oral hygiene and periodontal condition. Exclusion Criteria: 1. Medically compromised patients. 2. Severe crowding in the maxillary arch. 3. Chronic intake of NSAIDs or any medication that interfere with OTM. 4. Previous orthodontic treatment.

Outcomes

Primary Outcomes

Alveolar bone dehiscence

Pre- and post- retraction CBCTs will be obtained from patients. Linear measurement (mm) for dehiscence (LM-D) will be defined as the distance between the alveolar crest to the cementoenamel junction of each root (critical point will be set at 2 mm)

Time frame: 4 months

Alveolar bone fenestration

Pre- and post- retraction CBCTs will be obtained from patients. Linear measurement (mm) for fenestration (LM-F) will be recorded when the defect involved only the apical one-third of a root (critical point will be set at 2.2 mm)