Comparative Assessment of Maxillary Canine Retraction With and Without Piezocision - A Randomized Clinical Trial"

Intraoral impressions with alginate will be taken at the start of treatment and plaster casts will be obtained by using ortho plaster. Separators will be passed mesial and distal to first molars to create space for band placement. After 7-10 days bands will be cemented on first molars. Pre- adjusted edgewise brackets with 0.022 in-slot Roth appliance will be bonded on teeth according to the treatment plan. Extractions will be done according to the treatment plan and piezocision will be carried out after levelling and alignment.

This will be a split mouth study with one side receiving piezocision (experimental) and the other side acting as control, after random allocation. Randomization will be done by simple randomization method in which experimental side will be randomly allocated to the patient and opposite side of the same patient will act as control. First patient will have piezocision on right side and 2nd patient will have piezocision on left side, 3rd patient will have piezocision on right side and 4th patient will have piezocision on left side and so on. After extraction of maxillary first premolars, piezocision will be performed on experimental side whereas the opposite side will be taken as control. Piezocision will be performed under local anesthesia by giving two vertical interproximal incisions on mesiobuccal & distobuccal line angles of canine on experimental side 2mm below the interdental papilla with piezo electrical knife without flap reflection. Piezoelectric incisions of the cortical alveolar bone will then be made with piezotome. The incisions will be sutured with non resorbable 4-0 black silk with the interrupted suture technique. After piezocision canine retraction will be carried out by either continuous mechanics, sectional mechanics or sliding mechanics depending on the treatment plan. Mechanics will be same on left and right side of the patient and mean retraction will be measured at four time intervals. T0 at the start of canine retraction, T1 at 4 weeks, T2 at 8 weeks and T3 at 12 weeks after piezocision.

Alginate impressions will be taken at T0, T1, T2 and T3. The anteroposterior crown tip movements of the canines will be assessed on scanned cast at 4 time points (T0-T3). A cast showing the reference lines, the midpalatine raphe (MPR) and the rugae line (RL) formed by a projection from the most medial point on the third right rugae. The distance between the cusp tip of the canine and the rugae line used to measure the anteroposterior canine movement is dc.