Comparison Between Prebent & Miniplates in Fixation of Lefort I Osteotomty in Maxillary Advancement.

November 23, 2018 updated by: Hagar Mahmoud Ahmed Mohamed, Cairo University

Stability of Maxillary Advancement by Lefort I Osteotomy in Patients With Retruded Maxilla Fixed With Two Prebent Plates Versus Four Miniplates. (Randomised Clinical Trial.)

In patients with retruded maxilla ,Will the use of two prebent plates produce more stable results postoperatively in fixation of Le Fort I osteotomy in maxillary advancement than conventional four minplates ? Many studies have been conducted to compare between the two plates and these studies showed that the prebent plate, the plate is not excessively twisted so that it can be adapted passively leading to less changes in the property of the material ,increased titanium contact surface to the bone leading to better force distribution resulting in better rigid fixation as no stresses will be transmitted from the plate to the bone leading to faster bone healing and consequently better long term postoperative stability.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Unknown

Conditions

Conditions

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Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

The stability of maxillary advancement after Le Fort I osteotomy in retruded maxilla patients has been an issue that has attracted the attention of numerous researchers. That's why different fixation methods have been compared in vitro and in vivo.

Prebent plates is one of the recent modifications of the plate systems used in maxillofacial surgery , they were created to reduce the need for bending and contouring of the titanium miniplates.

Lye et al.,(the only in vivo study in English), aimed to evaluate the predictability of advancement surgery with the use of prebent plates in 36 patients & he proved the prebent plates have been proven to significantly affect the advancement & reliable.

In a biomechanical study, prebent plates provided better results than the standard two plate scenario in terms of resistance to displacement, permanent deformation and load for breaking.

Fatih Mehmet Coskunses et al., in 2015 has done in vitro study to evaluate the segmental displacement, and von mises stress on the titanium miniplates & the maximum principal stress on the bone, with the use of prebent plates and two standard L plates adapted to either the zygomaticomaxillary buttress or the nasal piriform following anterior advancement of 5 mm or 10 mm by Le Fort I osteotomy.

The results of the study were, In 5 mm maxillary advancement using prebent plates for the fixation of bone segments resulted in less segmental displacement than the standard two plate.

Even when adapted posteriorly or anteriorly, the prebent plates were able to be more stable than two plates technique. Moreover, Not only the one prebent scenario had the lowest segmental displacements, but also the lowest maximum principal stresses on bone in the anteriorly adapted group.

These results are due to the structure of the prebent plates that have two arms extending in opposite directions (anteriorly and posteriorly) and it is suggested that the prebent plates are preferable alternatives to the traditional two plate configurations in osteotomies with up to 5 mm advancement. The prebent plates showed similar satisfactory results with 10 mm advancement only when adapted anteriorly. In contrast, when adapted posteriorly, the prebent plates resulted in obvious failure in the 10 mm advancement model.

Based on these data , My research will compare the postoperative stability between 2 groups of retruded maxilla patients having maxillary advancement up to 5 mm

  1. the 1st group will be fixed using 2 prebent plates placed at nasal piriform
  2. the 2nd group will be fixed using 4 miniplates placed at nasal piriform & zygmoaticomaxillay buttress.

The aim of this study:

To find out if the two prebent plates provides a stable postoperative maxillary advancement movement than the traditional four miniplates.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Anticipated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
12

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

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Study Contact

Study Contact

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Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

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Ages Eligible for Study

18 years to 45 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients with retruded maxilla & need advancement by le fort I osteotomy.
  • Patients free from any systemic disease & bone metabolism diseases.
  • Patients with no signs or symptoms of temporomandibular joint disorders.
  • No sex predilection
  • Age range ( 18-45)

Exclusion Criteria:

  • Patients with systemic disease & bone metabolism diseases.
  • Patients with cleft lip & palate.
  • Patients with temporomandibular joint disorders
  • Patients receiving chemotherapy or radiotherapy "due to the risk of low bone quality and healing
  • Age less than 18

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: prebent plate
fixation of le fort I osteotomy using prebent plate
Procedure: lefort I osteotomy for maxillary advancement
fixation of lefort I osteotomy in patients with retruded maxilla with two prebent plates versus four miniplates.
Other Names:
  • four miniplates
Active Comparator: Conventional four miniplates
fixation of le fort I osteotomy using conventional four miniplates
Procedure: lefort I osteotomy for maxillary advancement
fixation of lefort I osteotomy in patients with retruded maxilla with two prebent plates versus four miniplates.
Other Names:
  • four miniplates

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Maxillary stability
Time Frame: 12 months
Linear measurements (from A point to the nasion perpendicular, A point perpendicular to Frankfort plane) & Angular measurements (SNA , Maxillary depth angle ) will be obtained from the immediate postoperative lateral cephalometry and after 12 months.
12 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Cairo University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Hagar A Mohamed, BDS, Cairo University

Publications and helpful links

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General Publications

Study record dates

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Study Major Dates

Study Start (Anticipated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
December 1, 2018

Primary Completion (Anticipated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 1, 2019

Study Completion (Anticipated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2019

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 16, 2018

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 23, 2018

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 26, 2018

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 26, 2018

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 23, 2018

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2018

More Information

Terms related to this study

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • CEBD-CU-2018-11-19

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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