MedPath

Accelerated Mandibular Molar Protraction: Piezocision at the Time of Molar Protraction or Later?

Not Applicable
Completed
Conditions
Orthodontic Appliance
Interventions
Other: Piezocision
Registration Number
NCT04338789
Lead Sponsor
Jordan University of Science and Technology
Brief Summary

This study was conducted to compare the rate of second molar protraction, level of Interleukin1-β in gingival crevicular fluid, periodontal health (gingival index, plaque index, and periodontal pocket depth) and root resorption in patients treated by molar protraction with piezocision performed early at the time of protraction (Group 1), piezocision performed 3 months after molar protraction (Group 2), and no piezocision molar protraction (Group 3).

Detailed Description

Detailed Description: Thirty-five subjects who presented with bilaterally extracted mandibular first molar were selected to participate in the study. The subjects were subdivided into one of 3 groups as follows: group 1 consisted of 20 subjects /20 molars where piezocision was performed immediately before molar protraction; group 2 consisted of 20 subjects/ 20 molars where molar protraction was carried on after 3 months of molar protraction with no piezocision; group 3 consisted of 20 subjects (40 molars) where protraction was carried out with no piezocision.

After reaching 0.019X0.025" SS arch wire, NiTi coil spring was used for space closure (protraction force was 150g) attached from the lower second molar hook to the head of the mini-screw. Piezocision was performed by making 2 vertical incisions mesial and distal to the extraction space. Piezotome was inserted in the incisions previously made and bone cuts were done with a length up to mucogingival line and depth of 3 mm. Gingival crevicular fluid (GCF) sample was obtained from the mesiogingival side of the lower second permanent molar with use of Periopaper. GCF sample was repeated 1 day, 1 week and 4 weeks after molar protraction with piezocision or with no piezocision. Periodontal parameters were measured and lower molar root resorption was assessed using Perapical radiographs.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Age range from 19 to 30 years
  • Bilaterally extracted mandibular first molar (first molar extracted more than one year ago and with a residual extraction space of more than 6 mm).
  • Class 1 malocclusion where molar protraction is indicated.
  • All permanent teeth are present except for the extracted mandibular first molars.
  • Healthy periodontium (gingival index score ≤ 2, plaque index score ≤ 2 and probing depth < 4mm)
Exclusion Criteria
  • Previous orthodontic treatment
  • Any systemic disease
  • Smoker
  • Poor Oral hygiene

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group 1PiezocisionIt consisted of 20 subjects with bilateral first molar extraction space where piezocesion was performed immediately before molar protraction on the left or right side of the patient.
Group 2PiezocisionIt consisted of 20 subjects with bilateral first molar extraction space where piezocesion was performed 3 months after molar protraction with no piezocision on the left or right side of the patient.
Primary Outcome Measures
NameTimeMethod
Changes in the level of of Interleukin1-β4 weeks

Detected in Gingival crevicular fluid (GCF). The periopaper was placed for 60 seconds in the mesiogingival sulcus of the lower second permanent molar and was transferred to an Eppendorf tube containing phosphate buffered saline.

Rate of molar protraction1 year

Measured in mm/month from dental casts

Secondary Outcome Measures
NameTimeMethod
Periodontal parameters (Plaque, gingival health, periodontal pocket depth, alveolar bone height)1 year

Plaque and gingival health are measured using plaque index and gingival index. pocket depth and alveolar height are measured in mm.

Lower molar root resorption1 year

Length of lower second molar roots in mm

© Copyright 2025. All Rights Reserved by MedPath