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Impacted canine causes many problems for patients, such as damage to the adjacent teeth roots, effects on gingival tissues, aesthetic problems, difficulty, and prolonged orthodontic treatment duration. Therefore, solutions to accelerate the movement of impacted canines with the help of surgical procedures to reduce treatment time will be investigated, such as intra-operative alveolar perforations and piezocision. We also aimed to evaluate periodontal changes associated with such accelerating procedures compared with the conventional traction method.
Patients with palatally impacted maxillary canines will be treated using fixed appliances assisted by some surgical procedures. The effects of this treatment approach on the periodontal status will be assessed using periodontal measurements.
There are two groups :
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Conventional treatment | Active Comparator | Patients will be treated using the fixed appliances to track the impacted canines after opening the appropriate distance |
|
| Surgically-assisted treatment | Experimental | Patients will be treated using fixed appliances assisted by minimally-invasive corticotomy (alveolar perforations and piezocision) to accelerate impacted canines' traction after opening the appropriate distance. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fixed appliances | Device | Metal brackets with a straight-wire prescription will be used. Patients will be treated conventionally. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Changes in the periodontal pocket depth (PPD) | The distance from the gingival margin to the base of the pocket of the first premolar, canine, and lateral incisor. | Time 1: immediately before the surgical exposure; Time 2: immediately at the end of the active treatment |
| Changes in the gingival margin (GM) | The distance from the cementoenamel junction (CEJ) to the gingival margin of the first premolar, canine, and lateral incisor. | Time 1: immediately before the surgical exposure; Time 2: immediately at the end of the active treatment |
| Changes in the width of the keratinized tissue (KT) | The distance from the gingival margin to the mucogingival junction of the first premolar, canine, and lateral incisor | Time 1: immediately before the surgical exposure; Time 2: immediately at the end of the active treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in the Gingival Index (GI) | The gingival status will be assessed using the following classification 0= Normal gingiva.
| Time 1: immediately before the surgical exposure; Time 2: immediately at the end of the active treatment |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mahran R Mousa, DDS,MSc | Department of orthodontics, Damascus University, Syria | Study Chair |
| Mohammad Y. Hajeer, DDS,MSc,PhD | Department of orthodontics, Damascus University, Syria | Study Director |
| Omar Heshmeh, DDS,MSc,PhD | Department of oral and maxillofacial surgery, Damascus University, Syriam | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Damascus | Damascus | Syria |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23349422 | Background | Smailiene D, Kavaliauskiene A, Pacauskiene I, Zasciurinskiene E, Bjerklin K. Palatally impacted maxillary canines: choice of surgical-orthodontic treatment method does not influence post-treatment periodontal status. A controlled prospective study. Eur J Orthod. 2013 Dec;35(6):803-10. doi: 10.1093/ejo/cjs102. Epub 2013 Jan 24. | |
| 23910198 |
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| ID | Term |
|---|---|
| D000077744 | Orthodontic Appliances, Fixed |
| ID | Term |
|---|---|
| D009967 | Orthodontic Appliances |
| D009970 | Orthodontics |
| D003813 | Dentistry |
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| Corticotomy | Procedure | Patients will be treated in conjunction with a surgical intervention using metal brackets with a straight-wire prescription. Corticotomy (alveolar perforation and piezocision) will induce acceleration in canine traction movement during the orthodontic treatment in only one group. |
|
| Changes in the Bleeding Index (BI) | The healthiness of the gingival margin and the attached gingivae will be assessed depending on the status of gingival inflammation. 0= No bleeding.
| Time 1: immediately before the surgical exposure; Time 2: immediately at the end of the active treatment |
| Parkin NA, Milner RS, Deery C, Tinsley D, Smith AM, Germain P, Freeman JV, Bell SJ, Benson PE. Periodontal health of palatally displaced canines treated with open or closed surgical technique: a multicenter, randomized controlled trial. Am J Orthod Dentofacial Orthop. 2013 Aug;144(2):176-84. doi: 10.1016/j.ajodo.2013.03.016. |
| 17257160 | Background | Crescini A, Nieri M, Buti J, Baccetti T, Mauro S, Prato GP. Short- and long-term periodontal evaluation of impacted canines treated with a closed surgical-orthodontic approach. J Clin Periodontol. 2007 Mar;34(3):232-42. doi: 10.1111/j.1600-051X.2006.01042.x. Epub 2007 Jan 25. |
| 10711607 | Background | Pini Prato G, Baccetti T, Magnani C, Agudio G, Cortellini P. Mucogingival interceptive surgery of buccally-erupted premolars in patients scheduled for orthodontic treatment. I. A 7-year longitudinal study. J Periodontol. 2000 Feb;71(2):172-81. doi: 10.1902/jop.2000.71.2.172. |
| 8291494 | Background | Crescini A, Clauser C, Giorgetti R, Cortellini P, Pini Prato GP. Tunnel traction of infraosseous impacted maxillary canines. A three-year periodontal follow-up. Am J Orthod Dentofacial Orthop. 1994 Jan;105(1):61-72. doi: 10.1016/S0889-5406(94)70100-8. |
| 18251594 | Background | Zasciurinskiene E, Bjerklin K, Smailiene D, Sidlauskas A, Puisys A. Initial vertical and horizontal position of palatally impacted maxillary canine and effect on periodontal status following surgical-orthodontic treatment. Angle Orthod. 2008 Mar;78(2):275-80. doi: 10.2319/010907-8.1. |