Malocclusion; Displaced Teeth
Conditions
Keywords
Buccally Displaced Maxillary Canines, Alveolar Bone Changes, Root Resorption, Orthodontic Treatment
Brief summary
This clinical study used CBCT images to investigate the alveolar bone changes and root resorption in unilateral buccally displaced maxillary canines and adjacent teeth before and after orthodontic traction of unilateral BDMCs. The CBCT images will also be used to compare these changes to the normal contralateral side. The study outcome is to compare the 3-D changes in the alveolar bone and dental roots between the 2 interventional techniques (segmentalT-loop and piggyback NiTi traction) methods.
Detailed description
Buccally displaced eruptions of permanent maxillary canines occur in 0.8% to 5.2% of orthodontic cases. Patients are often motivated to request orthodontic treatment when they have crowded teeth and maxillary canines that come in buccally erupted. The treatment of BDMC is challenging due to the limited labial alveolar bone and the potential risks of root resorption, bone loss, and gingival recession due to the movement of long and bulge roots, necessitating bodily movement with light and constant orthodontic force. The previous studies focused only on comparisons of root resorption, bone loss, and periodontal health before and after impacted canine traction. The previous studies on BDMC mainly included case reports that looked at various orthodontic traction methods. To our knowledge, no randomized clinical trial has been done to study the 3- D changes in the alveolar bone and root length after orthodontic traction of BDMCs.
Interventions
DEVICEPiggyback double wire
All teeth in both maxillary and mandibular arches will be bonded with preadjusted edgewise brackets from the 0.022- in-slot MBT system. Leveling and alignment will start with engaging 0.014-in NiTi arch wires in both arches, bypassing maxillary BDMC. The arch wire sequence will include 0.014-in NiTi, 0.016-inch NiTi, 0.016x0.022-inch NiTi. After the arches are properly aligned, the piggyback technique will be used on the maxillary arch, and the arch wire size will be increased to 0.016 x 0.016-inch stainless15 steel for the maxillary arch and ligating the accessory 0.012-inch NiTi round for BDMC traction.
DEVICET-loop
Firstly, only the BDMC will be bonded with a preadjusted edgewise bracket from the 0.022-in-slot MBT system and cementing the trans palatal arch. Canine traction will be carried out by ligating the segmental T loop of 0.016×0.022 TMA wire on the BDMC and inserting the other end of the T loop in the maxillary first permanent molar tube. The segmented T loop will be activated by 2 mm per month and tightened posteriorly to the tube of the first permanent molar for approximately 3 months to move the canine. Once the BDMC is in the proper site in the maxillary arch, all teeth in both maxillary and mandibular arches will be bonded with preadjusted edgewise brackets from the 0.022-in-slot MBT system. Leveling and alignment will start with engaging 0.014-in NiTi arch wires in both arches.
Sponsors
Sana'a University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Masking description
This clinical trial will use a randomized design with equal allocation in a 1:1 ratio, blinding, and paralleling two groups.Computer-generated random sequencing using Microsoft Office Excel will performed. Opaque sealed envelopes will be used for allocation concealment. Blinding of the participants and operator will not possible because of the nature of the study. Blinding of the result evaluation will be done through data concealment during assessment.
Intervention model description
This clinical trial will use a randomized design with equal allocation in a 1:1 ratio, blinding, and paralleling two groups. The study will compare the treatment outcomes between the segmental T-loop and the piggyback double wire traction techniques. The study will use CBCT images to evaluate the 3-D changes in the alveolar bone and root length of the unilateral BDMCs and adjacent teeth before and after orthodontic traction and compare them with the normal contralateral canines and adjacent teeth.
Eligibility
Sex/Gender
ALL
Age
12 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Yemeni ethnic patients. * Presence of unilateral BDMC. * The presence of a properly positioned and normally erupted contralateral canine. * Mild to moderate crowding. * The need for fixed orthodontic treatment. * No sagittal discrepancy
Exclusion criteria
* History of severe facial trauma. * Previous orthodontic treatment. * Presence of bilateral BDMC. * Presence of developmental dental anomalies. * Presence of facial syndromes and bone metabolism disease.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean Change in the Alveolar Bone Thickness | From baseline (before orthodontic traction) to the completion of orthodontic traction (an average of 8 months) | The mean change in the alveolar bone thickness will be measured in millimeters (mm) using CBCT scans. |
| Mean Change in the Alveolar Bone Height | Baseline and Month 8 | Alveolar bone height measured in millimeters (mm) using CBCT. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mean Change in Root Resorption | Baseline and Month 8 | The rate of external root resorption in mm measured using CBCT scans. |
| Difference Between Two groups in Alveolar Bone Dimension Changes | Month 8 after the completion of canine traction. | Measuring the mean change in alveolar bone dimension (mm) between Segmental T loop and Piggyback Orthodontic traction techniques using CBCT. |
Countries
Yemen
Contacts
CONTACTMohammed A Al-Hababy, MSc
CONTACTFuad Luft Almutareb, Prf.
PRINCIPAL_INVESTIGATORMohammed A Al-Hababy, MSc
Sana'a University
Outcome results
None listed