Clinical Research Directory

Inclusion Criteria: * Participants who need both maxillary first molar extractions for orthodontic treatment. * Class Ⅰ (Bimaxillary proclination), Class Ⅱ division 1 malocclusion. * Participants with full permanent dentition present (excluding 3rd molar). * Participants with good general health conditions and oral hygiene status. * The age range of the patients will be 16 years to 25 years. * Sex of the participants will be male, female, or third gender. * The treatment plan of maximum anchorage value preservation used mini-implant anchorage during retraction of teeth to obtain good esthetics and correct the molar relationship. * No previous orthodontic treatment. Exclusion Criteria: * Medically compromised patients with uncontrolled diabetes mellitus and compromised immune systems. * Participants taking medications that alter bone metabolism like bisphosphonates, nonsteroidal anti-inflammatory drugs (NSAIDs), and on long-term corticosteroids. * Vitamin D deficiency. * Cleft lip /palate, craniofacial syndrome or facial asymmetry. * Severe class Ⅲ malocclusion. * Pregnant women. * Smoker. * Non-compliant patient.