Clinical Research Directory

Maxillary Canine Retraction Using Stainless Steel and Titanium-molybdenum Alloy Wires in TAD-supported Segmental Mechanics

The goal of this randomized clinical study is to compare the effectiveness of stainless steel (SS) and titanium-molybdenum alloy (TMA) wires for maxillary canine retraction using TAD-supported segmental mechanics. The main question it aims to answer is: Which wire material, stainless steel or titanium-molybdenum alloy, provides better outcomes in maxillary canine retraction when used with TAD-supported segmental mechanics? Researchers will compare SS reverse-closing loops with TMA reverse-closing loops to evaluate differences in the rate of canine retraction and canine angulation changes during orthodontic space closure. Participants will: * Receive mini-implants/TADs on both sides of the maxillary arch. * Receive a stainless steel reverse-closing loop on one side and a TMA reverse-closing loop on the contralateral side. * Receive the same standardized force of 150 g on both sides. * Visit the clinic every 4 weeks for a total duration of 4 months. * Undergo OPG radiographs before retraction and after the 4-month study period to assess canine angulation.

Comparative Assessment of Maxillary Canine Retraction With and Without Piezocision

Intraoral impressions with alginate will be taken at the start of treatment and plaster casts will be obtained by using ortho plaster. Separators will be passed mesial and distal to first molars to create space for band placement. After 7-10 days bands will be cemented on first molars. Pre- adjusted edgewise brackets with 0.022 in-slot Roth appliance will be bonded on teeth according to the treatment plan. Extractions will be done according to the treatment plan and piezocision will be carried out after levelling and alignment. This will be a split mouth study with one side receiving piezocision (experimental) and the other side acting as control, after random allocation. Randomization will be done by simple randomization method in which experimental side will be randomly allocated to the patient and opposite side of the same patient will act as control. First patient will have piezocision on right side and 2nd patient will have piezocision on left side, 3rd patient will have piezocision on right side and 4th patient will have piezocision on left side and so on. After extraction of maxillary first premolars, piezocision will be performed on experimental side whereas the opposite side will be taken as control. Piezocision will be performed under local anesthesia by giving two vertical interproximal incisions on mesiobuccal \& distobuccal line angles of canine on experimental side 2mm below the interdental papilla with piezo electrical knife without flap reflection. Piezoelectric incisions of the cortical alveolar bone will then be made with piezotome. The incisions will be sutured with non resorbable 4-0 black silk with the interrupted suture technique. After piezocision canine retraction will be carried out by either continuous mechanics, sectional mechanics or sliding mechanics depending on the treatment plan. Mechanics will be same on left and right side of the patient and mean retraction will be measured at four time intervals. T0 at the start of canine retraction, T1 at 4 weeks, T2 at 8 weeks and T3 at 12 weeks after piezocision

Comparison of Rate of Tooth Movement Between MOPs vs MOPs & LLLT Combined

Orthodontic treatment is often prolonged, requiring years to achieve desirable outcomes. The prolonged duration of treatment increases the risk of complications such as root resorption, periodontal damage, and patient non-compliance. To address these concerns, various methods have been explored to accelerate orthodontic tooth movement, including pharmacological agents, mechanical vibration, corticotomies, and minimally invasive techniques like Micro-Osteoperforations (MOPs) and Low-Level Laser Therapy (LLLT). Micro-Osteoperforations (MOPs) have gained popularity as a minimally invasive technique that enhances bone remodeling by inducing a localized inflammatory response, thereby accelerating tooth movement. Studies have shown that MOPs can effectively stimulate the expression of cytokines, increasing osteoclastic activity and facilitating rapid orthodontic tooth movement. However, the extent of its effectiveness varies among individuals, necessitating additional interventions to maximize efficiency. Low-Level Laser Therapy (LLLT), also known as photobiomodulation, is another promising adjunct in orthodontics. LLLT has been reported to enhance cellular activity, promote osteoblastic and osteoclastic function, and improve tissue healing, leading to accelerated tooth movement. Several studies suggest that LLLT alone can expedite orthodontic treatment, but its combination with MOPs has not been extensively explored. This study aims to compare the rate of orthodontic tooth movement between MOPs alone and MOPs combined with LLLT. By evaluating these two techniques, this research seeks to determine whether LLLT enhances the effectiveness of MOPs in accelerating tooth movement. The findings of this study could provide valuable insights into optimizing orthodontic treatment duration while minimizing potential risks and discomfort for patients.

Assessment of the Locally Administrated Vitamin D3 and Corticision Efficacy on Orthodontic Canine Retraction

To study the effect vitamin D effect on orthodontic tooth movement when used in combination with coticision technique, independent t test or an equivalent non-parametric test will be used for comparison. According to a previous study by (S. T. Varughese, et al. (2019) , "Effect of vitamin D on canine distalization and alveolar bone density using multi-slice spiral CT: a randomized controlled trial

Comparing Ligation Methods During Canine Retraction Stage Using Conventional Brackets

The goal of this Randomized Controlled Trial (RCT) is to determine the most effective way to tie the main wire to the regular orthodontic brackets during the stage of orthodontic treatment where the canines are retracted. This study is for orthodontic patients aged 16 years and older who need to have their canines retracted into spaces where other teeth have been removed. The main questions it aims to answer are: 1. What is the effect of different ways of tying the wire to the braces on how much the maxillary canine moves back using conventional brackets? 2. How do various ways of tying the wire influence unwanted movements of the maxillary canines-specifically rotation, tipping, and extrusion? 3. What is the effect of these different tying methods on how much the back molar teeth shift forward (this is called "anchorage loss") while the maxillary canine is being pulled back? Researchers will compare three different ways of tying the wire to the braces to see if they differ in the amount of maxillary canine retraction, three-dimensional positional changes (rotation, tipping, and extrusion), and anchorage loss of maxillary first molars: * Group A: Uses an elastic power chain that wraps around all four parts (wings) of the brace. * Group B: Uses thin stainless-steel wires (ligatures) to tie the brace first, then an elastic power chain is placed over these wires, also wrapping around all four parts of the brace. * Group C: Uses small elastic rings on the two front parts (mesial wings) of the brace, and an elastic power chain on the two back parts (distal wings) of the brace. Participants will consist of orthodontic patients aged 16 years and above from the Postgraduate Orthodontic Clinic, Kulliyyah of Dentistry, IIUM, Kuantan, who require extraction of one or both maxillary first premolars, are planned for maximum anchorage using a Nance appliance, need at least 4mm of maxillary canine retraction, and have good oral hygiene. Participants will: * Undergo screening and provide written informed consent for participation. * Receive a comprehensive orthodontic examination, including photographic records, impressions, and radiographs. * Have molar bands fitted and a Nance button fabricated and cemented, followed by dental extractions of maxillary first premolars. * Undergo bond-up with conventional stainless-steel brackets and initial archwire placement. * Progress through an alignment and levelling phase using progressively larger archwires, culminating in a 0.019 x 0.025-inch stainless steel archwire. * At baseline (T0) and subsequent 4-week follow-up intervals (T1, T2, T3), have intraoral three-dimensional scans taken after archwire removal. * Receive canine retraction using elastomeric power chains delivering a standardized 150g force. This is done as a two-step retraction, where the canine is retracted in isolation. * Continue to receive full orthodontic treatment to completion even after the data collection period ends at T3.