Crowding of Anterior Maxillary Teeth
Conditions
Brief summary
Mandibular incisor crowding is a frequent issue that prompts many adults to seek orthodontic treatment. The treatment may enhance patients' quality of life, facilitate dental plaque control, and improve the quality of periodontal tissue. However, this treatment is accompanied by several side effects, including resorption of the apical portion of the teeth. Platelet-rich concentrates, such as injectable platelet-rich fibrin, have been shown to have positive effects on both soft- and hard-tissue healing. They may serve as a beneficial self-derived material to prevent this complication.
Detailed description
In recent years, increasing attention has been directed toward biologically driven approaches to modulate tissue responses during orthodontic treatment and minimize adverse effects, such as root resorption. Platelet-rich fibrin (PRF), a second-generation autologous platelet concentrate, has emerged as a promising biomaterial due to its high concentration of platelets, leukocytes, and a fibrin matrix that allows gradual release of multiple growth factors, including platelet-derived growth factor (PDGF), transforming growth factor-β (TGF-β), vascular endothelial growth factor (VEGF), and insulin-like growth factor (IGF). However, in 2014, injectable platelet-rich fibrin (I-PRF), which is similar to PRF, was introduced in France by Choukroun, using non-glass tubes and adjusting the centrifugal force. Just like traditional PRF, i-PRF contains high levels of growth factors, stem cells, leukocytes, and cytokines. These growth factors play a crucial role in angiogenesis, tissue regeneration, modulation of inflammation, and bone remodeling, all of which are central processes in orthodontic tooth movement and periodontal healing.
Interventions
PROCEDURE4-time i-PRF injection group
I-PRF will be injected in 4 sessions at 28-day intervals. The injection will administered submucosally in the buccal region of the lower incisors, using 2 ml of i-PRF per session (0.5 ml per incisor). Orthodontic wires will be sequenced until they reach 0.019×0.025-inch stainless steel.
PROCEDURESaline injection
Saline serum will be injected in 4 sessions at 28-day intervals. The injection will be administered submucosally in the buccal region of the lower incisors, using 2 ml of i-PRF per session (0.5 ml per incisor). Orthodontic wires will be sequenced until they reach 0.019×0.025-inch stainless steel.
Sponsors
Damascus University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
17 Years to 25 Years
Healthy volunteers
No
Inclusion criteria
* Adult patients aged between 17 and 28 years * Class I malocclusion with moderate crowding (4-6 mm) according to Little's Irregularity Index (LII) * Normal or inclination for mandibular incisors * Complete permanent teeth.
Exclusion criteria
* Previous orthodontic treatment, * Poor oral hygiene, * Severe skeletal discrepancy, * The presence of coagulation disorders or being under anticoagulant treatment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in root length | First assessment time: one day before the commencement of treatment. Second assessment time: within one week following the leveling and alignment stage (The stage is expected to finish within 4 to six months after the beginning of treatment) | Root resorption (i.e., change in root length) will be measured by calculating the difference in the full linear length of each incisor (incisal edge to the apex) between two assessment times (in millimeters) using CBCT images. |
Countries
Syria
Contacts
PRINCIPAL_INVESTIGATORMohammad I. Idris, DDS
Faculty of Dentistry, University of Damascus
STUDY_DIRECTORAhmad S. Burhan, DDS MSc PhD
Faculty of Dentistry, University of Damascus
STUDY_CHAIRMohammad Y Hajeer, DDS MSc PhD
Faculty of Dentistry, University of Damascus
Outcome results
None listed