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Patients at the Orthodontic Department of University of Damascus Dental School will be examined and subjects who meet the inclusion criteria will be included.
Then, initial diagnostic records (diagnostic gypsum models, internal and external oral photographs, as well as radiographic images) will be studied to ensure that the selection criteria are accurately matched.
The aim of this study is to compare flapless bone cutting by mechanical drills to evaluate the acceleration of the retraction of upper canines versus traditional bone cutting by piezo-surgery in comparison with a control group without bone cutting after extraction of upper first premolars in class II type I patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cortico-alveolar perforations | Experimental | Patients will undergo orthodontic treatment plus cortico-alveolar perforations. |
|
| Traditional Corticotomy | Experimental | Patients will undergo orthodontic treatment plus an acceleration procedure employing traditional corticotomy. |
|
| Control | No Intervention | Patients will undergo orthodontic treatment in which canine retraction will be accomplished using the standard sliding mechanism without any acceleration procedures. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cortico-alveolar perforations | Procedure | Mechanical drills will be used on a handpiece |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in Canine Retraction Speed | The rate at which canine is going to be retracted (mm/month) in each group will be calculated. This outcome will be measured by the following steps:
| T1: At the end of alignment (which is expected within 3 months); T2: 1 month after canine retraction; T3: After two months; T4: After 3 months; T5: at the end of canine retraction which is expected within 5 months |
| Change in Anchorage Loss | Anchorage loss in related the mesial drift of the first molar. This outcome will be measured by drawing two projections from the central groove of the first maxillary molar and the mesial ending of the third palatal rugae to the middle palatal bone line. The mesial migration of the first maxillary molar (mm) will be measured by dividing the distance between the two projections by the time elapsed between assessment times. | T1: At the end of alignment (which is expected within 3 months); T2: 1 month after canine retraction; T3: After two months; T4: After 3 months; T5: at the end of canine retraction which is expected within 5 months |
| Change in Canine Rotation | The angle between the middle palatal bone and the line through the mesial and distal edges of the canine will be measured on each side. The rotation will be assessed by calculating the difference between the angles on two different times. Then, the speed of rotation will be calculated by dividing the rotation angle (degrees) by time that elapsed between assessment times. | T1: At the end of alignment (which is expected within 3 months); T2: 1 month after canine retraction; T3: After two months; T4: After 3 months; T5: at the end of canine retraction which is expected within 5 months |
| Change in Canine Axis |
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Inclusion Criteria:
Age between 18-27 years
Patients who have malocclusion class II type I and who require first-premolar extraction with:
Dentoalveolar class II type I with ANB between 5 and 9 degrees.
Protrusion between (5-10 mm)
Overbite between (0-4)
Vertical dimension is normal or over the normal range
Mild to moderate crowding
All patients should have complete permanent occlusion on the maxilla
All patients should have normal periodontal tissue and good oral health, which will be assessed by:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mohammad Al-Bitar, DDS MSc | MSc student at the Orthodontic Department, University of Damascus Dental School, Damascus, Syria | Principal Investigator |
| Mohammad Y Hajeer, DDS MSc PhD | Associate Professor of Orthodontics, University of Damascus Dental School, Damascus, Syria | Study Director |
| Bassel Brad, DDS MSc PhD | Associate Professor of Oral and Maxillofacial Surgery, Oral and Maxillofacial Surgery Department, University of Damascus Dental School, Damascus, SYRIA | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Orthodontic Department, University of Damascus Dental School | Damascus | DM20AM18 | Syria |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27021451 | Background | Abbas NH, Sabet NE, Hassan IT. Evaluation of corticotomy-facilitated orthodontics and piezocision in rapid canine retraction. Am J Orthod Dentofacial Orthop. 2016 Apr;149(4):473-80. doi: 10.1016/j.ajodo.2015.09.029. | |
| 27696311 | Background | Alfawal AM, Hajeer MY, Ajaj MA, Hamadah O, Brad B. Effectiveness of minimally invasive surgical procedures in the acceleration of tooth movement: a systematic review and meta-analysis. Prog Orthod. 2016 Dec;17(1):33. doi: 10.1186/s40510-016-0146-9. Epub 2016 Oct 24. |
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| ID | Term |
|---|---|
| D008312 | Malocclusion, Angle Class II |
| ID | Term |
|---|---|
| D008310 | Malocclusion |
| D014076 | Tooth Diseases |
| D009057 | Stomatognathic Diseases |
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| Traditional Corticotomy | Procedure | Piezo-surgery will be employed following flaps' elevation. |
|
The changes in the canine axis during retraction will be studied by calculating canine angulation (arithmetic mean of the angulation of the right and left upper canine axis with the anterior cranial base plane) on lateral cephalometric radiographs. The difference between the canine angulation on T1 and T2 will be calculated after comparing the two cephalometric using Viewbox version 4.0.0.98. |
| T1: at the end of the alignment stage (which is expected within 3 to 4 months); T2: at the end of the canine retraction stage (which is expected to occur with 4 to five months following the onset of this stage). |
| 24182579 | Background | Alikhani M, Raptis M, Zoldan B, Sangsuwon C, Lee YB, Alyami B, Corpodian C, Barrera LM, Alansari S, Khoo E, Teixeira C. Effect of micro-osteoperforations on the rate of tooth movement. Am J Orthod Dentofacial Orthop. 2013 Nov;144(5):639-48. doi: 10.1016/j.ajodo.2013.06.017. |
| 25989211 | Background | Aksakalli S, Calik B, Kara B, Ezirganli S. Accelerated tooth movement with piezocision and its periodontal-transversal effects in patients with Class II malocclusion. Angle Orthod. 2016 Jan;86(1):59-65. doi: 10.2319/012215-49.1. Epub 2015 May 19. |
| 29436571 | Background | Buyuk SK, Yavuz MC, Genc E, Sunar O. A novel method to accelerate orthodontic tooth movement. Saudi Med J. 2018 Feb;39(2):203-208. doi: 10.15537/smj.2018.2.21235. |