This clinical study used CBCT images to investigate the alveolar bone changes and root resorption in unilateral buccally displaced maxillary canines and adjacent teeth before and after orthodontic traction of unilateral BDMCs. The CBCT images will also be used to compare these changes to the normal contralateral side. The study outcome is to compare the 3-D changes in the alveolar bone and dental roots between the 2 interventional techniques (segmentalT-loop and piggyback NiTi traction) methods.
Buccally displaced eruptions of permanent maxillary canines occur in 0.8% to 5.2% of orthodontic cases. Patients are often motivated to request orthodontic treatment when they have crowded teeth and maxillary canines that come in buccally erupted. The treatment of BDMC is challenging due to the limited labial alveolar bone and the potential risks of root resorption, bone loss, and gingival recession due to the movement of long and bulge roots, necessitating bodily movement with light and constant orthodontic force. The previous studies focused only on comparisons of root resorption, bone loss, and periodontal health before and after impacted canine traction. The previous studies on BDMC mainly included case reports that looked at various orthodontic traction methods. To our knowledge, no randomized clinical trial has been done to study the 3- D changes in the alveolar bone and root length after orthodontic traction of BDMCs.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
40
Firstly, only the BDMC will be bonded with a preadjusted edgewise bracket from the 0.022-in-slot MBT system and cementing the trans palatal arch. Canine traction will be carried out by ligating the segmental T loop of 0.016×0.022 TMA wire on the BDMC and inserting the other end of the T loop in the maxillary first permanent molar tube. The segmented T loop will be activated by 2 mm per month and tightened posteriorly to the tube of the first permanent molar for approximately 3 months to move the canine. Once the BDMC is in the proper site in the maxillary arch, all teeth in both maxillary and mandibular arches will be bonded with preadjusted edgewise brackets from the 0.022-in-slot MBT system. Leveling and alignment will start with engaging 0.014-in NiTi arch wires in both arches.
All teeth in both maxillary and mandibular arches will be bonded with preadjusted edgewise brackets from the 0.022- in-slot MBT system. Leveling and alignment will start with engaging 0.014-in NiTi arch wires in both arches, bypassing maxillary BDMC. The arch wire sequence will include 0.014-in NiTi, 0.016-inch NiTi, 0.016x0.022-inch NiTi. After the arches are properly aligned, the piggyback technique will be used on the maxillary arch, and the arch wire size will be increased to 0.016 x 0.016-inch stainless15 steel for the maxillary arch and ligating the accessory 0.012-inch NiTi round for BDMC traction.
Mean Change in the Alveolar Bone Thickness
The mean change in the alveolar bone thickness will be measured in millimeters (mm) using CBCT scans.
Time frame: From baseline (before orthodontic traction) to the completion of orthodontic traction (an average of 8 months)
Mean Change in the Alveolar Bone Height
Alveolar bone height measured in millimeters (mm) using CBCT.
Time frame: Baseline and Month 8
Mean Change in Root Resorption
The rate of external root resorption in mm measured using CBCT scans.
Time frame: Baseline and Month 8
Difference Between Two groups in Alveolar Bone Dimension Changes
Measuring the mean change in alveolar bone dimension (mm) between Segmental T loop and Piggyback Orthodontic traction techniques using CBCT.
Time frame: Month 8 after the completion of canine traction.
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