Evaluation of Clinical Approaches to Accelerate Orthodontic Tooth Movement
- Conditions
- Orthodontic Tooth Movement
- Interventions
- Procedure: CorticotomyProcedure: PiezocisionProcedure: Micro-osteoperforationsDevice: Control Side
- Registration Number
- NCT03089996
- Lead Sponsor
- Pontifícia Universidade Católica de Minas Gerais
- Brief Summary
This study will compare the techniques of piezocision and alveolar corticotomies in accelerating orthodontic retraction movement of canines. In a second phase, this clinical trial will evaluate the effectiveness of micro-osteoperforations in accelerating the retraction of maxillary incisors.
- Detailed Description
The first phase will consist of a split-mouth study in patients who require the extraction of the first premolars to correct malocclusion. The canine will be retracted using corticotomy and piezocision surgical techniques, as well as without any intervention, being this the control side. In addition, it will be evaluated the inflammatory biomarkers present in the gingival crevicular sulcus during the dental movement, as well as data related to pain and discomfort. The second phase will evaluate the effects of micro-osteoperforations in the retraction of maxillary incisors. The following parameters will be evaluated in the upper arch: anteroposterior incisors and first molars displacement, space closure, inclination and length of central incisors.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 45
- Patient with orthodontic need for bilateral upper first premolar extraction.
- Adequate dento-oral health
- ASA I and ASA II
- Compliance with clinic visits every 2 weeks
- History of periodontal disease
- Smokers
- Altered bone metabolism (e.g., due to anti-resorptive drug, steroid or immunosuppressant use)
- Pregnancy
- Presence of cleft or any syndrome
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Piezocision Control Side Piezocision-assisted canine retraction x Control (split mouth design) Corticotomy Corticotomy Corticotomy-assisted canine retraction x Control (split mouth design) Piezocision x Corticotomy Corticotomy Piezocision-assisted retraction x Corticotomy-assisted retraction (split mouth design) Piezocision Piezocision Piezocision-assisted canine retraction x Control (split mouth design) Corticotomy Control Side Corticotomy-assisted canine retraction x Control (split mouth design) Micro-osteoperforations Micro-osteoperforations Micro-osteoperforations-assisted upper incisors retraction Piezocision x Corticotomy Piezocision Piezocision-assisted retraction x Corticotomy-assisted retraction (split mouth design)
- Primary Outcome Measures
Name Time Method Orthodontic Canine Retraction Rate Up to 6 months The main objective is to evaluate and compare the canine retraction velocity in the different groups. Digital intra-oral scans will be performed (3Shape A / S®, Kopenhagen, Denmark) as registration method, every 14 days, up to 6 months.
Anteroposterior displacement of the upper incisors Up to 4 months The anteroposterior displacement of the upper incisors was assessed on superimposed digital models through the distance of points on the incisal edge and palatal cervical margin of these teeth to a coronal reference plan created on the initial CBCT scan.
Space closure Up to 4 months The space closure was assessed by the distance between the most menial point of the medial surface of the canine to the most distal point of the distal surface of the lateral incisor.
- Secondary Outcome Measures
Name Time Method Changes of the length of the central incisors Up to 4 months The initial and final length of the central incisors were measured by creating a 2D line, passing through the lowest point of the incisal edge and the highest point of the root apex. To perform these measurements, a sagittal cut was used in which the longest length of these teeth was seen.
Duration of the effect of the surgical procedures Up to 6 months The retraction of the canine will be accompanied by up to 6 months after surgery to verify the duration of its effect, if it occurs.
Evaluation of biomarkers Up to 6 months To evaluate the expression of the inflammatory biomarkers present in the gingival crevicular sulcus of the canines to be retracted. At T0, immediately before retraction, and 15 in 15 days.
Patient Pain and discomfort Up to 6 months VAS questionnaire will be used after the surgical procedures, as well after TADs placement, separator placement and premolar extraction. Always 7 days after each procedure.
Changes of the inclination of the central incisors Up to 4 months The initial and final CBCT were superimposed by the "voxel-based method" in the Dolphin Imaging software (Chatsworth, CA, USA), using the cranial base as reference. The inclination of the central incisors was then assessed by means of the angle formed by the long axis of each central incisor in the initial and final CBCT.
First molars anchorage loss Up to 4 months The first molars anchorage loss was assessed on superimposed digital models through the distance of a point on the mesiobuccal cuspid to a coronal reference plan created on the initial CBCT scan.
Trial Locations
- Locations (1)
Pontifícia Universidade Católica de Minas Gerais
🇧🇷Belo Horizonte, MG, Brazil