Evaluation of Maxillary Molar Distalization With Two Bone Supported Protocols Using Cone Beam Computed Tomography

May 15, 2026 updated by: Nouran Mohamed Abdelwahab Eissa, Tanta University

The goal of this clinical trial is to to evaluate and compare the skeletal and dental changes of bone supported Fast Back and bone supported modified Leaf Spring Self-Activated Expander in bilateral distalization of maxillary molars using CBCT in Egyptian people. The main question it aims to answer are: • If bone supported Fast Back and bone supported modified Leaf Spring Self-Activated Expander will be effective in bilateral distalization of maxillary molars

The patients will be selected according to the following criteria:

  1. Patient with full permanent dentition.
  2. Good oral hygiene.
  3. None of the patients had received any orthodontic treatment.
  4. Class II molar relationship.
  5. Minimal or no crowding in the mandibular arch.
  6. Non-extraction treatment plan with molar distalization.
  7. Low angle cases.
  8. No medical problems or active periodontal disease.

Researchers will compare between bone supported Fast Back appliance and bone supported modified Leaf Spring Self-Activated and see if they will be effective in maxillary molars distalization.

Study Overview

Detailed Description

The patients will be divided into two groups:

Group 1: Consisted of 10 patients, their upper molar will be distalized with bone suppored Fast Back (Fast Back Rapid Distalizer, leone, s.p.a, Italy).

Group 2: Consisted of 10 patients, their upper molar will be distalized with bone supported modified Leaf Spring Self-Activated Expander. (Leaf Self Expander, leone, s.p.a, Italy).

  • Assessment of the 3D dentoskeletal treatment effects of the palatally bone supported Fast Back and palatally bone supported modified Leaf Spring Self-Activated Expander will be performed by using the CBCT scans.
  • Pretreatment CBCT (T1) and post-distalization until study completion with an average of 1 year (T2) for each subject

All data will be collected, tabulated and statistically analyzed using the SPSS.

Study Type

Interventional

Enrollment (Actual)

20

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Gharbia Governorate
      • Tanta, Gharbia Governorate, Egypt, 6620010
        • Faculty of Dentistry

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

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Patient with full permanent dentition.
  • Good oral hygiene.
  • Class II molar relationship.
  • Non-extraction treatment plan with molar distalization.
  • Low angle cases.
  • medical problems or active periodontal disease.

Exclusion Criteria:

  • The patients had received any orthodontic treatment.
  • Crowding in the mandibular arch.
  • Medical problems or active periodontal disease.

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: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Palatally bone supported Fast Back
Group I : Consisted of 10 patients, their upper molar will be distalized with bone supported Fast Back (Fast Back Rapid Distalizer, leone, s.p.a, Italy).
The Fast Back Rapid Distalizer (Leone S.p.A., Italy) was inserted intraorally following molar band cementation. Two palatal miniscrews (2.0 × 13 mm) were placed under local anesthesia and engaged into the eyelets of the anterior arms of the appliance to provide skeletal anchorage. The appliance was reactivated monthly (one turn per side) until bilateral Class I or cusp-to-cusp molar relationship was achieved.
Experimental: Palatally bone supported modified Leaf Spring Self-Activated Expander
Group II : Consisted of 10 patients, their upper molar will be distalized with bone supported Modified Leaf Spring Self-Activated Expander (Leaf Self Expander, Leone S.p.A., Italy)
The Modified Leaf Spring Self-Activated Expander (Leaf Self Expander, Leone S.p.A., Italy) was inserted intraorally following molar band cementation. Two palatal miniscrews (2.0 × 13 mm) were placed under local anesthesia and engaged into the eyelets of the anterior arms of the appliance. Upon insertion, the two retaining staples were removed to activate the superelastic NiTi leaf springs. No further reactivation was required throughout treatment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Linear distalization of maxillary teeth relative to pterygoid vertical (PTV) plane
Time Frame: Through study completion, maximum 18 months

Distance of maxillary teeth (UR/UL 6, 5, 4, 3, 1) crown tips from PTV plane measured by CBCT.

Unit of Measure: Millimeters (mm)

Through study completion, maximum 18 months
Angular inclination of maxillary teeth relative to Frankfort horizontal (FH) plane
Time Frame: Through study completion, maximum 18 months
Inclination of long axis of maxillary teeth (UR/UL 6, 5, 4, 3, 1) relative to FH plane measured by CBCT Unit of Measure: Degrees
Through study completion, maximum 18 months
Molar relationship at end of distalization phase
Time Frame: Through study completion, maximum 18 months
Clinical assessment of bilateral molar relationship categorized as Class I or cusp-to-cusp upon completion of the distalization phase
Through study completion, maximum 18 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Sagittal skeletal parameters
Time Frame: Through study completion, maximum 18 months.

Angular measurements including SNA, SNB, ANB, and SN-Pog assessed on CBCT-derived lateral cephalometric views.

Unit of Measure: Degrees

Through study completion, maximum 18 months.
Vertical skeletal parameters
Time Frame: Through study completion, maximum 18 months
Angular and linear measurements including SN-MP, FH-MP, LAFH, TAFH, PFH, LAFH/TAFH ratio, and PFH/TAFH ratio assessed on CBCT-derived lateral cephalometric views Unit of Measure: Degrees and millimeters
Through study completion, maximum 18 months
Overjet and overbite
Time Frame: Through study completion, maximum 18 months
Horizontal and vertical overlap of maxillary and mandibular incisors measured clinically at baseline (T1) and end of distalization phase (T2) Unit of Measure: Millimeters (mm)
Through study completion, maximum 18 months
Vertical position of mesiobuccal and distobuccal cusps of maxillary first molars
Time Frame: Through study completion, maximum 18 months
Heights of mesiobuccal (MBU R6, MBU L6) and distobuccal (DBU R6, DBU L6) cusps of maxillary first molars relative to Frankfort horizontal plane measured by CBCT Unit of Measure: Millimeters (mm)
Through study completion, maximum 18 months
Arch depth and arch perimeter
Time Frame: Through study completion, maximum 18 months
Linear measurements of maxillary arch depth and arch perimeter assessed on CBCT-derived arch models Unit of Measure: Millimeters (mm)
Through study completion, maximum 18 months
Axial inclinations of maxillary first molars and first premolars
Time Frame: Through study completion, maximum 18 months
Axial angular measurements of maxillary right and left first molars (UR6, UL6) and first premolars (UR4, UL4) in the axial plane measured by CBCT Unit of Measure: Degrees
Through study completion, maximum 18 months
Treatment duration
Time Frame: Through study completion, maximum 18 months

Total active distalization period from appliance insertion to achievement of bilateral Class I or cusp-to-cusp molar relationship.

Unit of Measure: Months

Through study completion, maximum 18 months

Collaborators and Investigators

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

Investigators

  • Principal Investigator: Safaa M Gaballah, Professor, Tanta University
  • Study Director: Shaimaa M Elmarhoumy, professor, Tanta University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 10, 2024

Primary Completion (Actual)

February 10, 2026

Study Completion (Estimated)

July 10, 2026

Study Registration Dates

First Submitted

February 29, 2024

First Submitted That Met QC Criteria

March 6, 2024

First Posted (Actual)

March 13, 2024

Study Record Updates

Last Update Posted (Actual)

May 20, 2026

Last Update Submitted That Met QC Criteria

May 15, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

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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