A Novel Bi-dimensional Archwire for Miniscrew-supported En-masse Retraction
Preliminary Clinical Evaluation of a Novel Bi-dimensional Archwire During Miniscrew-Supported En-masse Retraction of the Maxillary Anterior Teeth
調査の概要
詳細な説明
This study was designed as a prospective single-arm pilot clinical trial to provide an initial clinical evaluation of a novel bi-dimensional archwire specifically developed for miniscrew-supported en-masse retraction of the maxillary anterior teeth. In adult orthodontic patients requiring extraction-based treatment, effective space closure depends not only on anchorage control, but also on the ability of the active retraction system to maintain acceptable control of the maxillary incisors during sliding mechanics. Conventional continuous rectangular stainless-steel archwires provide rigidity, but they may still be associated with frictional resistance, wire deformation, and incomplete torque control during retraction.
The archwire investigated in this study was newly developed as a single continuous stainless-steel assembly composed of a 0.019 × 0.025-inch anterior segment and 0.016 × 0.022-inch posterior segments joined by laser welding. The design was intended to combine greater anterior stiffness, to support better torque control of the maxillary incisors, with reduced posterior friction and binding during sliding mechanics. The intervention was applied under direct skeletal anchorage using self-drilling orthodontic miniscrews inserted bilaterally between the maxillary second premolars and first molars. Retraction was performed using nickel-titanium closed-coil springs delivering approximately 250 g of force per side.
Eligible participants were adult patients with skeletal Class II malocclusion and Class II Division 1 dental malocclusion who required extraction of the maxillary first premolars and en-masse retraction of the maxillary anterior teeth as part of their treatment plan. After leveling and alignment, the novel bi-dimensional archwire was inserted and the retraction phase was initiated. Participants were followed prospectively until completion of the en-masse retraction phase.
The primary outcome of the study was the monthly rate of maxillary anterior en-masse retraction assessed on three-dimensional digital dental models. The secondary outcome was the change in maxillary incisor torque measured on standardized lateral cephalometric radiographs using the bracket-archwire angle. This pilot trial was undertaken to determine whether this newly developed archwire could function as a clinically feasible biomechanical option and to generate preliminary outcome estimates for future randomized controlled trials.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Damascus、シリア、DM20AM19
- Department of Orthodontics, Faculty of Dentistry, University of Damascus
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参加基準
適格基準
就学可能な年齢
- 大人
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Adults aged 18-28 years with skeletal Class II malocclusion (ANB angle 5°-7°)
- Class II Division 1 dental malocclusion according to Angle classification
- An average or vertical facial growth pattern
- A treatment plan requiring extraction of the maxillary first premolars
- A need for maxillary anterior en-masse retraction
- The presence of all permanent maxillary teeth except the third molars
Exclusion Criteria:
- Patients with previous orthodontic treatment,
- Craniofacial anomalies, systemic diseases affecting bone metabolism
- Active periodontal disease
- Poor oral hygiene
- Missing maxillary permanent teeth, or were using
- The use of medications known to influence bone metabolism
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的:Bi-dimensional archwire
Participants will be treated using a novel bi-dimensional stainless-steel archwire during miniscrew-supported en-masse retraction of the maxillary anterior teeth
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The retraction procedure is going to be conducted using a bi-dimensional archwire which is a single continuous stainless-steel assembly composed of a 0.019 × 0.025-inch anterior segment and 0.016 × 0.022-inch posterior segments joined by laser welding.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change in the monthly rate of maxillary anterior en-masse retraction
時間枠:Time 0: completion of leveling and alignment which happens within three months); Times 1, 2, 3, 4, 5 after one, two, three, four, and five months following the end of the leveling and alignment stage; Time Final: at the end of the retraction stage.
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The amount of maxillary anterior retraction is assessed on three-dimensional digital dental models using the distance between the incisal edge of the maxillary central incisors and the medial point of the third palatal rugae as a stable intraoral reference.
The monthly retraction rate is calculated in millimeters per month by dividing the amount of anterior retraction by the corresponding duration of the retraction interval.
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Time 0: completion of leveling and alignment which happens within three months); Times 1, 2, 3, 4, 5 after one, two, three, four, and five months following the end of the leveling and alignment stage; Time Final: at the end of the retraction stage.
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change in maxillary incisor torque
時間枠:Time 0: completion of leveling and alignment stage which is expected to occur within three months, and Time Final: completion of en-masse retraction stage which occurs within 9 - 10 months following the end of the leveling and alignment stage.
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Maxillary incisor torque is assessed on standardized lateral cephalometric radiographs using the bracket-archwire angle.
A tangent is drawn along the base of the maxillary central incisor bracket, and another tangent is drawn parallel to and superimposed on the working archwire.
The obtuse angle formed between the two tangents is measured, and the actual torque value is calculated by subtracting 90° from this angle.
The change in torque is determined by comparing the measurements recorded at T0 and T1.
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Time 0: completion of leveling and alignment stage which is expected to occur within three months, and Time Final: completion of en-masse retraction stage which occurs within 9 - 10 months following the end of the leveling and alignment stage.
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協力者と研究者
スポンサー
捜査官
- 主任研究者:Abdulmalek M. H. Almasri, DDS、Damascus University
出版物と役立つリンク
一般刊行物
- Al-Sibaie S, Hajeer MY. Assessment of changes following en-masse retraction with mini-implants anchorage compared to two-step retraction with conventional anchorage in patients with class II division 1 malocclusion: a randomized controlled trial. Eur J Orthod. 2014 Jun;36(3):275-83. doi: 10.1093/ejo/cjt046. Epub 2013 Jun 20.
- Upadhyay M, Yadav S, Nagaraj K, Patil S. Treatment effects of mini-implants for en-masse retraction of anterior teeth in bialveolar dental protrusion patients: a randomized controlled trial. Am J Orthod Dentofacial Orthop. 2008 Jul;134(1):18-29.e1. doi: 10.1016/j.ajodo.2007.03.025.
- Gnaneswar SM, Sridhar P. Comparison of dual-dimensional and rectangular wires in terms of space closure and anchorage loss during retraction with miniimplants: A prospective clinical study. J Dent Res Dent Clin Dent Prospects. 2020 Winter;14(1):54-60. doi: 10.34172/joddd.2020.008.
- Hamanaka R, Cantarella D, Lombardo L, Karanxha L, Del Fabbro M, Siciliani G, Yoshida N. Dual-section versus conventional archwire for en-masse retraction of anterior teeth with direct skeletal anchorage: a finite element analysis. BMC Oral Health. 2021 Feb 25;21(1):87. doi: 10.1186/s12903-021-01443-0.
- Li Y, Tang N, Xu Z, Feng X, Yang L, Zhao Z. Bidimensional techniques for stronger anterior torque control in extraction cases: a combined clinical and typodont study. Angle Orthod. 2012 Jul;82(4):715-22. doi: 10.2319/082811-550.1. Epub 2011 Dec 8.
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研究の完了 (実際)
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本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- UDDS-2026-Ortho-4
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