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There is scarcity in literature regarding the effectiveness of friction and frictionless mechanics during ''En-masse retraction''technique on anchorage loss of posterior segment in orthodontic patients with maxillary protrusion. Moreover there is deficiency in studies measuring the patient pain and satisfaction regarding the different techniques of retraction.
The aim of the current study is to evaluate the effects of friction versus frictionless mechanics, implemented during "En-masse retraction", on anchorage loss. Additionally, assessment of both techniques regarding their rates, effects on root resorption as well as patient satisfaction.
One of the most common complaints of orthodontic patients is proclination of anterior teeth where there is an increase in facial convexity and as well as incompetent lips. Bimaxillary dentoalveolar protrusion and class II division I cases always have this appearance. Frequently this situation requires extraction of the first premolars followed by fixed orthodontic appliance for space closure and retraction of anterior teeth. Different techniques are used including "Two-step retraction" where canines are retracted as a first step followed by anterior four incisors as a second step and "En-masse retraction" where anterior teeth are retracted as one unit. However, the method of "En-masse retraction" is controversial - whether to use frictionless or friction mechanics.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Power Chain and Crimpable hook for En-masse retraction | Experimental | Retraction will start on a 0.017x0.025" Stainless Steel wire using elastomeric chain ( force applied will be 212 g per side ) extending between the crimpable hooks and the miniscrew |
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| T-loop | Experimental | Closing retraction T-loops will be fabricated using 0.017x0.025" TMA wire. The loop will be positioned halfway the extraction space and the canine. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Power chain and Crimpable hook fro En-masse Retraction | Procedure | Retraction will start on a 0.017x0.025" stainless steel wire using elastomeric chain ( for applied will be 212 g per side ) extending between the cripmable hooks and the miniscrew |
| Measure | Description | Time Frame |
|---|---|---|
| Anchorage loss | Digitally scanned dental models taken pre and post completion of retraction will be measured by identifying landmarks and reference lines and planes ( measured in mm ) | from pre to post retraction/intervention ( an average of 6-8 months ) |
| Measure | Description | Time Frame |
|---|---|---|
| Retraction Rate | The antero-posterior movement of anterior teeth and first molars will be assessed by measuring the digitally scanned dental models taken of the patients monthly ( measured in mm ) | from pre to post retraction/intervention ( an average of 6-8 months ) |
| Molar Rotation |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Yehia Mostafa, Professor and Chairman | Future University in Egypt | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Amr Attia | Cairo | Future University in Egypt | Egypt |
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Data will be available after Publication
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Dec 31, 2019 | May 23, 2021 | Prot_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Dec 31, 2019 | May 23, 2021 | ICF_001.pdf |
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Only the outcome assessors will be blind. The patients name will be sealed from pre and post radiographs and study models. Then two assessors will carry out, blindly and independently, the measurements and analysis of the study
| T-loop | Procedure | closing retraction T-loops will be fabricated using 0.017x0.025 TMA wire. The loop will be positioned halfway the extraction space and the canine. |
|
Digitally scanned dental models that are taken before and after retraction will be assess the rotation of the maxillary first permanent molar in relation to a reference line ( measurement of the angles in degrees ) |
| from pre to post retraction/intervention ( an average of 6-8 months ) |
| Pain of Intervention | each patient will fill a questionnaire regarding his treatment experience in a Visual Analog Scale (VAS) scoring from 1-10 by making a handwritten mark on a 10-cm line that represents a continuum between "no pain" on the left end (0 cm) of the scale and the "worst pain" on the right end of the scale (10 cm). The question-naire will include several questions related to oral hygiene, pain and discomfort experienced throughout the trial. | from pre to post retraction/intervention ( an average of 6-8 months ) |
| Anterior teeth extrusion/intrusion | The principle investigator will examine pre and post Cone Beam CT ( CBCT ) in Relation to lines and reference planes ( measured in mm ) | from pre to post retraction/intervention ( an average of 6-8 months ) |
| Anterior teeth torque | The principle investigator will examine pre and post Cone Beam CT ( CBCT ) in Relation to lines and reference planes ( measured in degrees ) | from pre to post retraction/intervention ( an average of 6-8 months ) |
| Anterior teeth tip | The principle investigator will examine pre and post Cone Beam CT ( CBCT ) in Relation to lines and reference planes ( measured in degrees ) | from pre to post retraction/intervention ( an average of 6-8 months ) |