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There's a scarcity in literature concerning mini-esthetics specially maxillary gingival display changes following en-masse retraction and two-step retraction. The purpose of this study is to determine, In orthodontic patients with maxillary protrusion, which technique of retraction will result in better esthetics upon smiling following en-masse retraction or two step retraction mechanics.
This study will be conducted in order to evaluate which technique of retraction will provide better outcome regarding mini and macro esthetics. In terms of mini esthetics, posed smiles will be analyzed to evaluate maxillary gingival display, as well as the analysis of smile arc, buccal corridor, inter-labial gap. In terms of macro esthetics, frontal and profile poses will be assessed to evaluate the nasolabial angle, mentolabial angle and upper and lower lip protrusion/ E- plane.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| En-Masse Retraction | Experimental | Six anterior teeth (en-Masse) retracted using a crimpable hook distal to the upper lateral incisor and a power chain |
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| two step retraction | Experimental | Six anterior teeth are retracted by two step technique by canine retraction followed by four anterior teeth retraction using a crimpable hook distal to the upper lateral incisor and a power chain |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| En-masse retraction | Procedure | Power chain and Crimpable hook for En-Masse Retraction Retraction will start on a 0.017"x0.025" Stainless steel wire using elastomeric chain (force applied will be 200 g per side) extending between the crimpable hooks and the miniscrew |
| Measure | Description | Time Frame |
|---|---|---|
| Mini-esthetics including | Evaluation of (maxillary gingival display, Smile arc, buccal corridor) from social smile photograph Evaluation of (inter-labial gap) from At Rest photograph All primary outcome characteristics will be measured before and after retraction (measured Linear/ horizontal/ vertical in millimeters) by Adobe Photoshop CC 2017 software. | From pre to post retraction (an average of 6 - 8 months)] |
| Measure | Description | Time Frame |
|---|---|---|
| Macro-esthetics evaluation of profile photograph including | 1. Nasolabial angle. 2. Mentolabial angle. 3. Incisors Inclination (Angular measurement in degrees). 4. Upper lip protrusion/ E- plane. 5. Lower lip protrusion/ E- plane. (Linear measurement in millimeters.) Cephalometric radiographs and Adobe Photoshop CC 2017 software | upto 6 months from the start of orthodontic treatment. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Yehya mostafa, Professor and chairman | Future University in Egypt | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Future University In Egypt | Cairo | Egypt |
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Only the outcome assessors will be blind. The patients name will be sealed from pre and post photographs and cephalometric radiographs. Then two assessors will carry out, blindly and independently, the measurements and analysis of the study
| Two step Retraction | Procedure | Retraction of canine started on a 0.017"x0.025" Stainless steel wire using elastomeric chain (force applied will be 150 g per side)followed by anterior teeth retraction on 0.017"x0.025" Stainless steel wire using elastomeric chain (force applied will be 160 g per side) extending between the crimpable hooks and the mini-screw. |
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