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This study investigates how the One-Step No-Prep protocol with orthodontic assistance affects dental and jaw function in adults treated for localized tooth wear. It focuses on the predictability and extent of orthodontic tooth movements, the impact on temporomandibular joint position and function, and the quality and long-term stability of the restored bite.
Participants will receive minimally invasive bonded restorations combined with simple orthodontic mechanics. The study will evaluate changes in tooth position, bite contacts, facial vertical height, and temporomandibular joint function using digital scans, low-dose 3D imaging, jaw-tracking, and clinical examinations. Patient comfort, function, and satisfaction will also be assessed through questionnaires.
The goal is to better understand how this conservative treatment performs over time.
This study evaluates the clinical, orthodontic, and functional outcomes of the One-Step No-Prep protocol with orthodontic assistance (OSNPO) in adult patients presenting with localized tooth wear. The OSNPO approach combines bonded restorations placed without tooth preparation and controlled orthodontic extrusion to re-establish posterior occlusion. Although the protocol has shown promising clinical results, several key aspects have not yet been quantified or documented systematically.
The study includes both prospective and retrospective participants treated at the University Hospital of Liège. Prospective cases undergo standardized digital assessments, including intraoral scanning, low-dose cone-beam CT, and 3D jaw-tracking, while retrospective cases contribute long-term clinical and occlusal data. Follow-up extends to 5 years, with an additional evaluation at 10 years.
The primary focus is to characterize the nature and magnitude of orthodontic tooth movements, the time required to regain full occlusion, and the short- and long-term stability of occlusal contacts after treatment. Additional analyses examine changes in vertical facial dimensions, as well as temporomandibular joint position and function before and after treatment. Secondary outcomes include the clinical performance of PICN restorations and patient-reported measures of comfort, function, esthetics, and quality of life.
By integrating digital imaging, functional analysis, and patient-centered outcomes, this study aims to clarify the biological mechanisms underlying OSNPO, identify predictors of treatment duration and stability, and support evidence-based use of this minimally invasive protocol in the management of tooth wear.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Post-Treatment CBCT, Intraoral Scan, and Modjaw Assessment | Experimental | All participants treated with the OSNPO protocol undergo additional diagnostic assessments performed specifically for research purposes after completion of their routine clinical treatment. These research-only procedures include:
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Low-dose Cone-Beam Computed Tomography | Radiation | Acquisition of a low-dose, large-field CBCT scan performed specifically for research purposes after completion of the OSNPO treatment, used to assess tooth movements, vertical facial dimensions, and temporomandibular joint position. |
| Measure | Description | Time Frame |
|---|---|---|
| Three-dimensional orthodontic tooth movements (linear) | Quantification of three-dimensional dental movements induced by the OSNPO protocol, including linear changes assessed on cone-beam computed tomography. Unit of measure : Millimeters (mm). | Baseline and end of OSNPO treatment (approximately 1 month) |
| Three-dimensional orthodontic tooth movements (angular) | Quantification of three-dimensional dental movements induced by the OSNPO protocol, including angular changes assessed on cone-beam computed tomography. Unit of measure : Degrees (°). | Baseline and end of OSNPO treatment (approximately 1 month) |
| Time required to re-establish functional occlusion | Assessment of the duration needed to re-establish a functional occlusion following OSNPO, considering the initial posterior open bite and the orthodontic mechanics applied. | Baseline and end of OSNPO treatment (approximately 1 month) |
| Occlusal contacts | Assessment of the number of occlusal contacts | Baseline; 1 month; annually up to 5 years; and at 10 years. |
| Occlusal contacts stability | Assessment of the stability of occlusal contacts over time | Baseline; 1 month; annually up to 5 years; and at 10 years. |
| Changes in vertical facial height | Assessment of the variation in vertical facial height induced by the OSNPO protocol, measured on cone-beam computed tomography. The assessment includes linear measurements between anatomical landmarks. |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical performance of PICN partial restorations | Evaluation of the clinical quality of PICN bonded restorations using standardized FDI (World Dental Federation) criteria, considering restoration thickness. Unit of measure : FDI score (1-5; higher scores indicate poorer performance). | 1 month; annually up to 5 years; 10 years. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital of Liège | Recruiting | Liège | 4000 | Belgium |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20847997 | Background | Hickel R, Peschke A, Tyas M, Mjor I, Bayne S, Peters M, Hiller KA, Randall R, Vanherle G, Heintze SD. FDI World Dental Federation - clinical criteria for the evaluation of direct and indirect restorations. Update and clinical examples. J Adhes Dent. 2010 Aug;12(4):259-72. doi: 10.3290/j.jad.a19262. |
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| ID | Term |
|---|---|
| D057085 | Tooth Wear |
| ID | Term |
|---|---|
| D014076 | Tooth Diseases |
| D009057 | Stomatognathic Diseases |
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| Baseline and end of OSNPO treatment (approximately 1 month) |
| Temporomandibular joint position | Assessment of the changes in temporomandibular joint position following the OSNPO protocol. Joint position is evaluated using cone-beam computed tomography, with measurements between anatomical landmarks. | Baseline and end of OSNPO treatment (approximately 1 month) |
| Temporomandibular joint function | Assessment of the changes in temporomandibular joint function following the OSNPO protocol assessed using the Modjaw jaw-tracking system. Functional evaluation includes three-dimensional mandibular dynamics recorded during different mandibular movements, captured in real time. Unit of measure : Movement amplitudes in millimeters (mm) | Baseline and end of OSNPO treatment (approximately 1 month) |
| Longevity of PICN partial restorations |
Evaluation of the longevity of PICN bonded restorations, considering restoration thickness, based on survival (presence vs. failure). |
| 1 month; annually up to 5 years; 10 years. |
| Oral health-related quality of life (OHIP-49) | Evaluation of the impact of the OSNPO protocol on oral health-related quality of life measured with the OHIP-49 (Oral Health Impact Profile) questionnaire. Unit of measure : Scale 1-5; higher scores indicate worse quality of life | Baseline; weekly during orthodontic treatment; 1 month; annually up to 5 years; 10 years. |
| Musculoskeletal symptoms | Evaluation of musculoskeletal discomfort related to the craniofacial, cervical and upper-body regions using the Nordic Musculoskeletal Questionnaire. Unit of measure : Nordic score (0-10 per region; higher scores indicate more severe symptoms). | Baseline; 1 month; annually up to 5 years; 10 years. |
| Patient satisfaction | Assessment of patient satisfaction regarding comfort, esthetics, function, and overall experience with the OSNPO protocol. Unit of mesure : Satisfaction score (1-10; higher scores indicate greater satisfaction). | 1 month |