Type of tooth movement during en masse retraction of the maxillary anterior teeth using labial versus lingual biocreative therapy in adults: A randomized clinical trial

Mais M Sadek, Noha E Sabet, Islam T Hassan, Mais M Sadek, Noha E Sabet, Islam T Hassan

Abstract

Objective: The objective of this two-arm parallel trial was to compare the type of tooth movement during en masse retraction of the maxillary anterior teeth using labial versus lingual biocreative therapy.

Methods: Twenty-eight subjects were randomized in a 1 : 1 ratio to either the labial or lingual group. En masse anterior retraction was performed using labial biocreative therapy in group A and lingual biocreative therapy in group B. Cone beam computed tomography scans were taken before and after retraction and the primary outcome was the type of tooth movement during anterior retraction. Data were analyzed using paired t-tests for comparisons within each group and independent-sample t-test for comparison of the mean treatment changes between the two groups.

Results: Significant differences were found between the two groups in relation to the type of tooth movement (labiolingual inclination of the central incisor; mean difference, 5.85 ± 1.85°). The canine showed significant distal tipping in the lingual group (mean difference, 6.98 ± 1.25°). The canine was significantly more intruded in the lingual group (mean difference, 1.67 ± 0.49 mm). Good anchorage control and significant soft tissue changes occurred in both groups. No serious adverse effects were detected.

Conclusions: With a 10-mm retraction hook, the labial biocreative technique with the reverse curve overlay provided anterior retraction with good torque control, while in the lingual group, anterior retraction occurred with controlled tipping movement with significant distal tipping and intrusion of the canine (trial registration: The trial was registered at ClinicalTrials.gov [NCT03239275]).

Keywords: Biocreative therapy; En masse retraction; Skeletal anchorage; Tooth movement.

Conflict of interest statement

CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.

© 2019 The Korean Association of Orthodontists.

Figures

Figure 1. Initial photographs after final set-up,…
Figure 1. Initial photographs after final set-up, labial biocreative therapy.
Figure 2. Initial photographs after final set-up,…
Figure 2. Initial photographs after final set-up, lingual biocreative therapy.
Figure 3. Retraction finished, labial biocreative therapy.
Figure 3. Retraction finished, labial biocreative therapy.
Figure 4. Retraction finished, lingual biocreative therapy.
Figure 4. Retraction finished, lingual biocreative therapy.
Figure 5. Cone beam computed tomography measurements…
Figure 5. Cone beam computed tomography measurements for the upper right central incisor.
S ver, S-vertical plane; CR, crown retraction; RR, root retraction; V, vertical movement; inc, labio-lingual inclination.
Figure 6. CONSORT 2010 flow diagram.
Figure 6. CONSORT 2010 flow diagram.
Figure 7. Changes in the axes of…
Figure 7. Changes in the axes of the maxillary anterior teeth after retraction in the labial group. Tooth axis graph. A, Upper central incisor; B, upper lateral incisor; C, upper canine (solid line, before retraction; dotted line, after retraction). Incisor, Midpoint of incisal edge to root apex; canine, cusp tip to root apex.
Figure 8. Changes of the axes of…
Figure 8. Changes of the axes of the maxillary anterior teeth after retraction in the lingual group. Tooth axis graph. A, Upper central incisor; B, upper lateral incisor; C, upper canine (solid line, before retraction; dotted line, after retraction). Incisor, Midpoint of incisal edge to root apex; canine, cusp tip to root apex.

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