Comparing Labial and Lingual Orthodontic Appliances on Root Resorption and Bone Height

Not Applicable

Completed

• Conditions: Crowding of Anterior Maxillary Teeth; Crowding of Anterior Mandibular Teeth
• Interventions: Procedure: Lingual brackets; Procedure: Buccal brackets

• Registration Number: NCT06401369
• Lead Sponsor: Damascus University

Brief Summary

Patients who have moderate crowding that could be treated on a non-extraction will be treated in this study. The apical root resorption and alveolar bone height of the lingual and labial fixed appliances will be assessed. All patients will receive a cone-beam computed tomography (CBCT) scan at two different times (T0: Before treatment, T1: After treatment).

There are two groups: The first group (Experimental): The patients in this group will be treated using Lingual Fixed Orthodontic Appliances. The second group (Control): The patients in this group will be treated using Labial Fixed Orthodontic Appliances.

Detailed Description

Recently, the therapeutic results of lingual orthodontics have become similar to those produced by labial orthodontics. However, lingual appliances act differently. The application of force near the center of resistance and the distance between the lingual brackets leads to an increase in friction and, thus, an increase in the force applied during treatment. In addition, the contact of the lower incisors with the brackets of the upper incisors in the lingual technique can lead to the intrusion of these incisors. Therefore, these factors can be potential risks for apical root resorption and alveolar bone height in lingual orthodontics.

2D radiographs may not accurately depict the true amount of root resorption due to magnification errors and difficulties in obtaining repeatable images. Besides, conventional two-dimensional radiographs cannot accurately assess alveolar bone height in the anterior region. CBCT has proven to be valuable in diagnosing root resorption due to its capability to produce distortion-free images, as well as its ability to maintain a high level of reproducibility despite changes in tooth positions after treatment, with high sensitivity and specificity. On the other hand, the use of CBCT allows for an evaluation of alveolar bone height in the anterior region with high accuracy and precision.

Study Timeline

• Study Start: 2022-03-10
• Primary Completion: 2022-06-15
• Study Completion: 2023-09-15
• Status Verified: 2024-05
• Study First Submitted: 2024-05-02
• Study First Submitted QC: 2024-05-02
• Last Update Submitted: 2024-05-02
• Study First Posted: 2024-05-06
• Last Update Posted: 2024-05-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

1. Class I molar and canine relationships on both sides.
2. Moderate crowding of both arches of about 4 to 6 mm treated on a non-extraction basis.
3. Age from 18 to 25 years.
4. The presence of permanent dentition (except third molars).

Exclusion Criteria

1. The existence of craniofacial syndromes, cleft lip and/or palate (soft and/or hard).
2. Skeletal or dental crossbite.
3. Patients with missing teeth or periodontal diseases.
4. Previous orthodontic treatment.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
The lingual fixed orthodontic group (LA)	Lingual brackets	This group received treatment with lingual brackets with 0.018-inch slots (DTC Orthodontics, Hangzhou, China) applied with the aid of a special, indirect bonding technique, the "Modified HIRO® Technique." Individual lingual archwires (Forestadent®, Germany) were also used.
The labial fixed orthodontic group (BA)	Buccal brackets	Patients in this group received treatment with labial appliances with 0.018-inch slots (American Orthodontics brackets, Mini Master series, MBT prescription) directly bonded on both arches. Prefabricated archwires (American Orthodontics, Sheboygan, WI, USA) were also used.

Primary Outcome Measures

Name	Time	Method
Change in tooth lengths	T0: one day before the commencement of treatment. T1: one day following the end of treatment	Axial, coronal, and sagittal planes of the CBCT images will be reoriented to be perpendicular to the long axis of each tooth under assessment. The distances were measured as follows.; Central and lateral incisors: from incisal edge to apex (sagittal section). Canines: from cusp tip to apex (sagittal section). Single-rooted premolar: from vestibular cusp tip to apex (sagittal section). Two-rooted premolar: from vestibular cusp tip to apex (sagittal section) and lingual cusp tip to apex (coronal section).; Upper molars: from the mesiolingual cusp tip to the apex of the lingual root of the molar (coronal section), from the mesobuccal cusp tip to the apex of the mesobuccal root of the molar (sagittal section), from distobuccal cusp tip to the apex of distobuccal root of molar (sagittal section).
Change in the alveolar bone height	T0: one day before the commencement of treatment. T1: one day following the end of treatment	The CBCT images were redirected according to the long axis of each tooth as given previously.; The distance between the cementoenamel junction and the crest of the alveolar bone was measured in the sagittal plane for central and lateral incisors, while in the coronal plane for canines. For the premolars and first molars, the distance between the cementoenamel junction and the crest of the alveolar bone was measured in the coronal plane.

Trial Locations

Locations (1)

Department of Orthodontics, Faculty of Dentistry, University of Damsacus; 🇸🇾 Damascus, Syrian Arab Republic