Treatment Outcome of Clear Aligner and Traditional Fixed Appliances in Four Premolar Extraction Cases

Damascus University40 enrolled

Overview

Patients with severe crowding requiring the extraction of four premolars will be enrolled in this study. The degree of apical root resorption associated with using the clear aligner technique compared with vestibular fixed appliances in the treatment of severe crowding malocclusion cases requiring the extraction of first premolars will be evaluated using cone beam computed tomography (CBCT) volumes. There are two groups: First group (Experimental): the patients in this group will be treated using clear aligners. Second group (Control): the patients in this group will be treated using fixed appliances.

With the increasing number of young adults requesting esthetic orthodontic treatment, clear aligners have continued to gain widespread use, driven by greater consideration of esthetic aspects and oral health-related quality of life compared to traditional fixed orthodontic appliances. Recently, clear aligners have been used in more complex malocclusion cases that require premolar extraction. Teeth root resorption occurs due to physiological or pathological causes that lead to loss of tooth structure. Apical root resorption (ARR) is a common side effect of orthodontic treatment that requires careful investigation of its location and frequency.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Malocclusion, Class I/II

Eligibility

Sex: ALLMin age: 18 YearsMax age: 25 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adult patients aged 18-25 years. * Class I malocclusion with severe dental crowding. * Tooth size-arch discrepancy more than 6 mm. * No congenitally missing or extracted teeth (except for the wisdom teeth). * No history of previous trauma to the maxillofacial region or surgical interventions. Exclusion Criteria: * Previous orthodontic treatment. * Presence of previously occurred ARR. * Patients with psychological abnormalities or systemic diseases. * Patients with known allergies to latex or plastic materials.

Outcomes

Primary Outcomes

Change in root length

The maximum linear lengths between the root apex and incisal edges (for the anterior teeth) or the cusp tips (for the posterior teeth) will be measured on the cone-beam computed tomography (CBCT) images. Differences between the measurements of each tooth before and after treatment provided the amount of apical root resorption in mm. The variable will be measured for each tooth (from the central incisors to the first molars) and on both jaws.

Time frame: First assessment: one day before the commencement of treatment (i.e., initiating orthodontic tooth movement). Second assessment: one day following the end of treatment (which is expected to occur within 12 to 18 months).