Acceleration, Orthodontics, Platelet-Rich Fibrin
Conditions
Keywords
injectable platelets rich fibrin
Brief summary
this clinical trial aims to prove that multiple injections will produce a steady rate of acceleration of orthodontic tooth movement.
Detailed description
Platelet-rich fibrin injection is a second-generation platelet concentrate, prepared from centrifuged blood which is a rich source of platelets, stem cells, and growth factors seven times greater than that released by platelet-rich plasma. It is a simplified procedure with no biochemical manipulation of blood, free from anticoagulants which are known to inhibit wound healing or any gelling agent, and easily usable with a low rate of mistakes during the preparation procedure. A variety of growth factors are released by PRF such as platelet-derived growth factor (PDGF), transforming growth factor β (TGF-β), and vascular endothelial growth factor (VEGF), which play a crucial role in angiogenesis, collagen synthesis, and bone regeneration. Treatment with extraction especially in adult patients may take a longer time due to reported increase in bone density and lower bone regenerative rate. Also, the retraction process to close extraction spaces most of the time is accompanied by bone loss and root resorption as reported in the previous studies. i-PRF can accelerate tooth movement, in addition, prevent tooth retraction undesirable side effects.
Interventions
PROCEDUREInjectable platelet rich fibrin (i-PRF): in acceleration of orthodontic tooth movement
Preparatory phase * Space closure will be done on a 17x25 stainless steel wire * Both molars will be indirectly anchored to the miniscrew * Extend closing coil spring of suitable length from the canine hock to the first molar hock for retraction. * Apply a force of 150gm for each side. The force is measured by a force gauge and activated each visit to keep it constant all over the retraction phase. PRF Injection protocol * The First injection will be 3 weeks before extraction * By the end of the fourth week the patients will be referred for pre-intervention records. Upper arch CBCT will be obtained to take preintervention measurements of the alveolar bone. * At the time of canine retraction patient will receive another injection immediately and an alginate impression will be taken * follow up every month and injection will be repeated month after month with an observational period of 5 months.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Intervention model description
This study is a split-mouth randomized, controlled single-center superiority trial, with two parallel groups with a 1:1 allocation ratio.
Eligibility
Sex/Gender
ALL
Age
16 Years to 24 Years
Healthy volunteers
Yes
Inclusion criteria
* adult patient * Full set of permanent dentition (excluding third molars). * Good oral hygiene * protrusion cases that require extraction of premolars (Bimaxillary protrusion or class II div 1)
Exclusion criteria
* History of previous orthodontic treatment. * Systemic disease or drugs affecting tooth movement. * Smokers * Poor oral health that precludes orthodontic treatment (presence of caries, active white spots, or periodontal diseases) * Severe crowding cases with ectopic erupted canines
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of canine retraction. | 5 months | Rate of orthodontic tooth movement will be measured by calculating the difference in the canine position in mm throughout digital superimposition of consecutive digital models that will be made every four weeks. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 1. Assess bone level between intervention and control side. | bone level will be measured at the beginning of the study (T1) and by the fifth month of the study (T5) | 1\. bone level between intervention and control side will be assessed through pre and post retraction CBCT for the upper arch. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Assess Periodontal health at the injection side. | 5 months | 2\. Assess Periodontal health on the injection side through periodontal charting mainly propping depth. |
Countries
Egypt
Contacts
Primary ContactMohamed M Alkhawaga, BDS
Outcome results
None listed