Comparison of External Apical Root Resorption in Modified Corticotomy-Assisted and Conventionally Retracted Maxillary Canines Using Frictionless T-Loop Mechanics: A Randomized Controlled Clinical Trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Mean Loss of Canine Root Length (mm)
Study Overview
Brief Summary
This randomized controlled clinical trial will compare external apical root resorption in patients undergoing maxillary canine retraction using modified corticotomy-assisted frictionless T-loop mechanics versus conventional frictionless T-loop mechanics. Sixty orthodontic patients requiring extraction of maxillary first premolars will be randomly assigned to two groups. Changes in canine root length will be measured on panoramic radiographs taken before and after retraction to determine the extent of external apical root resorption. The study will evaluate whether modified corticotomy-assisted retraction results in different root resorption outcomes compared to conventional retraction.
Detailed Description
External apical root resorption is a known complication of orthodontic treatment and may be influenced by the magnitude and duration of orthodontic force. Methods that accelerate tooth movement may reduce overall treatment time and potentially influence the extent of root resorption.
Corticotomy-assisted orthodontics is based on the regional acceleratory phenomenon, which enhances bone remodeling and facilitates tooth movement. Modified corticotomy techniques involve limited surgical injury to the cortical bone to stimulate accelerated movement while minimizing postoperative morbidity. Frictionless mechanics using T-loops allow controlled canine retraction with reduced frictional resistance between the bracket and archwire.
This single-center randomized controlled clinical trial will enroll 60 patients aged 12 to 30 years who require bilateral extraction of maxillary first premolars as part of orthodontic treatment. Participants will be randomly allocated in a 1:1 ratio to:
Group A: Modified corticotomy-assisted canine retraction with frictionless T-loop mechanics Group B: Conventional frictionless T-loop canine retraction
All participants will be treated using 0.022 × 0.028-inch preadjusted edgewise appliances. Standardized T-loop activation delivering controlled force will be performed at three-week intervals until canine retraction is completed.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- Single (Outcomes Assessor)
Masking Description
The investigator responsible for measuring root length and width on calibrated OPG radiographs using ViewBox software will be blinded to group allocation. Radiographs will be coded to prevent identification of the intervention group.
Eligibility Criteria
- Ages
- 12 Years to 30 Years (Child, Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Patients aged 12-30 years requiring canine retraction into maxillary first premolar extraction spaces
- •Patients with normal vertical skeletal pattern (mandibular plane angle 32° ± 5°)
- •Patients with healthy periodontium
Exclusion Criteria
- •Syndromic patients
- •Patients with systemic conditions requiring long-term medication affecting orthodontic tooth movement (e.g., NSAIDs, bisphosphonates, anticonvulsants)
- •Mixed dentition cases
- •Patients with pre-existing root resorption
- •Patients who fail to attend scheduled appointments
Arms & Interventions
Modified Corticotomy Assisted Canine Retraction
Description: Participants will undergo modified corticotomy procedure followed by canine retraction using frictionless T-loop mechanics after extraction of maxillary first premolars.
Intervention:
- Procedure: Modified Corticotomy
- Procedure: Frictionless T-loop canine retraction.
Intervention: Modified Corticotomy assisted frictionless canine retraction (Procedure)
Conventional T-loop Canine Retraction
Description: Participants will undergo conventional canine retraction using frictionless T-loop mechanics without any surgical intervention after extraction of maxillary first premolars.
Intervention: Frictionless T-loop canine retraction.
Intervention: Conventional Frictionless Canine retraction (Procedure)
Outcomes
Primary Outcomes
Mean Loss of Canine Root Length (mm)
Time Frame: - Before retraction (baseline) - From baseline to completion of canine retraction (approximately 4-6 months)
External apical root resorption measured as the difference in root length (in millimeters) from canine cusp tip to root apex on calibrated pre-treatment and post-retraction OPG radiographs using ViewBox software.
Secondary Outcomes
- Change in Root Width at Mesial and Distal Apex (mm)(From baseline to completion of canine retraction (approximately 4-6 months))