Efficiency of Canine Retraction Using Different Reactivation Intervals

Comparing Canine Retraction Using Two-week, Four-week, Six-week and Eight-week Reactivation Intervals

Canine retraction after 1st premolar extracion into the extraction space is a routine treatment in orthodontics. Orthodontic patients requiring first premolar extraction, canine retraction and maximum anchorage were recruited for this randomized controlled trial. A search of the literature did not indicate the ideal frequency of elastomeric chain reactivation for optimum canine retraction. The study was approved by the ethical committee. The first premolars were extracted. Elastomeric chains were used to retract the canine distally into the 1st premolar space. The optimum reactivation interval was evaluated regarding the efficiency of treatment in terms of rate of canine retraction, canine tipping and rotation, root resorption and pain at the intervals of 2, 4, 6 and 8 weeks. Three dimensional imaging, as well as digital scanning were the methods for data collection.

Study Overview

• Status: Recruiting
• Conditions: Bimaxillary Protrusion; Class III Malocclusion; Class II Division 1 Malocclusion; Crowding, Tooth
• Intervention / Treatment: Procedure: Canine retraction

Detailed Description

The canines, 2nd premolars, 1st molars and 2nd molars were bonded and banded. Leveling and alignment was achieved. After the first premolar extraction, temporary anchorage devices were inserted interradicular between 2nd premolar and 1st molar. Canine retraction was performed on a 0.016" X 0.022" stainless steel arch wire. A power arm was extended to apply the force closer to the center of resistance and achieve bodily movement. Elastomeric chains were calibrated to deliver a force of 150g and extended from the power arm to the mini screws directly. Recruited patients were randomly allocated to four groups according to the duration between the elastomeric chain reactivation. Canine reactivation intervals were 2, 4, 6, or 8 weeks. Cone beam computed tomography was performed before canine retraction and after 6 months of retraction. Digital dental casts were taken before canine retraction and monthly for 6 months.

• Study Type: Interventional
• Enrollment (Anticipated): 56
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Reem ElShazly, MSc; Phone Number: +201114666516; Email: reemhazem24@gmail.com
• Study Contact Backup: Name: Rudayna El-Badawy, MSc; Phone Number: +201159218899; Email: rudaynaelbadawy@gmail.com

Study Locations

• Egypt
  • Cairo, Egypt, 11865
    • Recruiting
    • Future University in Egypt
    • Contact: Yehya Mostafa, PhD; Email: yehya3d@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 13 years to 30 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Patients requiring 1st premolar extraction (e.g bimaxillary dentoalveolar protrusion)
• Erupted full set of permanent teeth (excluding 3rd molars)

Exclusion Criteria:

• Systemic diseases that would interfere with bone metabolism
• Craniofacial syndromes
• congenitally missing or extracted permanent teeth.
• periodontally compromised patients
• smokers
• pregnant women
• previous orthodontic treatment

Study Plan

How is the study designed?

Design Details

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

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 2-week reactivation interval; Replacement of elastomeric chain every 2 weeks and reestablishing a 150 g force	Procedure: Canine retraction; Canines will be retracted using short elastomeric chains. Force applied to canines will be 150g.
Active Comparator: 4-week reactivation interval; Replacement of elastomeric chain every 4 weeks and reestablishing a 150 g force	Procedure: Canine retraction; Canines will be retracted using short elastomeric chains. Force applied to canines will be 150g.
Experimental: 6-week reactivation interval; Replacement of elastomeric chain every 6 weeks and reestablishing a 150 g force	Procedure: Canine retraction; Canines will be retracted using short elastomeric chains. Force applied to canines will be 150g.
Experimental: 8-week reactivation interval; Replacement of elastomeric chain every 8 weeks and reestablishing a 150 g force	Procedure: Canine retraction; Canines will be retracted using short elastomeric chains. Force applied to canines will be 150g.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rate of canine retraction	The distance measured between the canine cusp tips for each two consecutive digital models superimposed on the right and left medial palatal rugae.	Baseline to 1 month
Rate of canine retraction	The distance measured between the canine cusp tips for each two consecutive digital models superimposed on the right and left medial palatal rugae.	1month to 2 months
Rate of canine retraction	The distance measured between the canine cusp tips for each two consecutive digital models superimposed on the right and left medial palatal rugae.	2 months to 3 months
Rate of canine retraction	The distance measured between the canine cusp tips for each two consecutive digital models superimposed on the right and left medial palatal rugae.	3 months to 4 months
Rate of canine retraction	The distance measured between the canine cusp tips for each two consecutive digital models superimposed on the right and left medial palatal rugae.	4 months to 5 months
Rate of canine retraction	The distance measured between the canine cusp tips for each two consecutive digital models superimposed on the right and left medial palatal rugae.	5 months to 6 months.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Amount of canine retraction	The change in distance measured from the canine cusp tip to the frontal plane, in millimeters; measured on CBCT	Baseline to 6 months
Canine tipping	CBCT images at T0 and T1 were analyzed using Invivo 5 software. linear measurements were made from the long axis of the canines (cusp tip to root apex) to FP1 and FP2 for the upper and lower canines, respectively.	Baseline to 6 months
Canine rotation	The change in the angle between a line connecting the maximum mesial and distal crown convexities and FP1 and FP2, for the upper and lower canines, respectively; measured on CBCT	Baseline to 6 months
Canine root resorption	The change in the canine length, in millimeters, measured from cusp tip to root apex; measured on CBCT	Baseline to 6 months
First molar anchorage loss	The change in distance measured from the mesio-buccal cusp tip of the first molar to the frontal plane, in millimeters; measured on CBCT	Baseline to 6 months
Pain score	The patient makes a mark along the Visual Analogue Scale (VAS) scale denoting the severity of pain: 0-100 0= no pain and 100= worst pain imaginable	baseline to day 1
Pain score	The patient makes a mark along the Visual Analogue Scale (VAS) scale denoting the severity of pain: 0-100 0= no pain and 100= worst pain imaginable	Baseline to day 2
Pain score	The patient makes a mark along the Visual Analogue Scale (VAS) scale denoting the severity of pain: 0-100 0= no pain and 100= worst pain imaginable	Baseline to day 3
Pain score	The patient makes a mark along the Visual Analogue Scale (VAS) scale denoting the severity of pain: 0-100 0= no pain and 100= worst pain imaginable	Baseline to day 4
Pain score	The patient makes a mark along the Visual Analogue Scale (VAS) scale denoting the severity of pain: 0-100 0= no pain and 100= worst pain imaginable	Baseline to day 5
Pain score	The patient makes a mark along the Visual Analogue Scale (VAS) scale denoting the severity of pain: 0-100 0= no pain and 100= worst pain imaginable	Baseline to day 6
Pain score	The patient makes a mark along the Visual Analogue Scale (VAS) scale denoting the severity of pain: 0-100 0= no pain and 100= worst pain imaginable	Baseline to day 7
Pain score	The patient makes a mark along the Visual Analogue Scale (VAS) scale denoting the severity of pain: 0-100 0= no pain and 100= worst pain imaginable	Baseline to day 8
Pain score	The patient makes a mark along the Visual Analogue Scale (VAS) scale denoting the severity of pain: 0-100 0= no pain and 100= worst pain imaginable	Baseline to day 9
Pain score	The patient makes a mark along the Visual Analogue Scale (VAS) scale denoting the severity of pain: 0-100 0= no pain and 100= worst pain imaginable	Baseline to day 10.

Collaborators and Investigators

• Sponsor: Future University in Egypt
• Investigators: Study Director: Yehya Mostafa, PhD, Future University in Egypt

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2017
• Primary Completion (Anticipated): June 1, 2022
• Study Completion (Anticipated): June 1, 2022

Study Registration Dates

• First Submitted: May 23, 2021
• First Submitted That Met QC Criteria: May 23, 2021
• First Posted (Actual): May 27, 2021

Study Record Updates

• Last Update Posted (Actual): May 27, 2021
• Last Update Submitted That Met QC Criteria: May 23, 2021
• Last Verified: May 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Congenital Abnormalities; Musculoskeletal Diseases; Stomatognathic Diseases; Tooth Diseases; Stomatognathic System Abnormalities; Jaw Abnormalities; Jaw Diseases; Maxillofacial Abnormalities; Craniofacial Abnormalities; Musculoskeletal Abnormalities; Mandibular Diseases; Malocclusion; Prognathism; Malocclusion, Angle Class III
• Other Study ID Numbers: 20153110-8-14-2017

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