Rate Of Space Closure Research Articles

Evaluation of Rate of Space Closure Between Platelet Rich Plasma (Prp) Injection and Piezocision in Bimaxillary Protrusion Cases

Aim: Reducing orthodontic treatment duration is a significant concern for both patients and clinicians, as prolonged treatments can lead to complications like dental caries, root resorption, and decreased patient compliance. This study aims to compare the effectiveness of two minimally invasive techniques—Piezocision and platelet-rich plasma (PRP) injection—in accelerating orthodontic tooth movement during space closure in patients with bimaxillary protrusion. Methods: Sixteen patients diagnosed with Angle's Class I bimaxillary protrusion requiring extraction of first premolars were randomly assigned to two groups. Group A (n = 8) underwent Piezocision-assisted orthodontic treatment, while Group B (n = 8) received submucosal PRP injections. In both groups, one side of the maxillary arch served as the experimental side, and the contralateral side served as the control. Measurements of space closure were taken at the initiation of retraction (T₀) and after 90 days (T₁). Results: Both Piezocision and PRP significantly enhanced the rate of space closure compared to their control sides. However, Piezocision demonstrated a statistically faster rate of tooth movement than PRP injection. The mean difference in space closure between the Piezocision and PRP groups at T₁ was significant (p < 0.001). Conclusion: While both Piezocision and PRP injections effectively accelerated orthodontic tooth movement, Piezocision proved to be more efficient in reducing treatment time. Clinicians may consider Piezocision as a preferred method for patients seeking expedited orthodontic treatment.

The effect of chewing gum on the rate of en-masse space closure: A randomised controlled trial.

To evaluate the effect of chewing gum on the rate of space closure, oral hygiene, pain during space closure and appliance breakage in patients undergoing fixed appliance therapy. A prospective, single-centre, two-arm, parallel, double-blinded randomised controlled trial. Orthodontic unit of a privately funded hospital, Chennai, India. In total, 28 participants were randomly allocated into a chewing gum group (CGG) (n = 14) or a control group (CG) (n = 14). Baseline data were collected at the start of retraction (T0), at 4 weeks (T1), 8 weeks (T2) and 12 weeks (T3) after the start of retraction. Rate of space closure, pain, oral hygiene and appliance breakage were assessed at T1, T2 and T3. Data were analysed using an independent t-test with P < 0.05 considered to be statistically significant. The mean rate of space closure in the CGG was 0.9 ± 0.2 mm/month and 0.8 ± 0.2 mm/month in the CG (P = 0.07, 95% confidence intervals [CI] were 0.80-1.01 for the CGC and 0.70-0.91 for the CG). In both the groups, oral hygiene became worse between T0 and T3. At T0 and T1, participants in the CGG reported less pain at 24 h and 7 days when compared to the CG (P < 0.05). At T2 and T3, participants in the CGG reported less pain at 0 h, 24 h and 7 days when compared to the CG (P < 0.05). Appliance breakage in both groups was minimal, with an odds ratio of 0.7 (95% CI 0.1-3.8) and was similar (P = 0.66). There was minimal increase that was clinically not significant in the rate of space closure with chewing gum. Chewing gum ensured better oral hygiene, helped alleviate pain and had no effect on appliance breakage during space closure.

Comparative Study of Mini-implants versus Standard Implants in Orthodontic Anchorage for Space Closure

ABSTRACT Background: In order to obtain satisfactory treatment outcomes, orthodontic space closure frequently requires trustworthy anchoring devices. Because they are easier to install and smaller than regular implants, mini-implants have become a viable option. The purpose of this study was to evaluate the effectiveness of regular implants versus mini-implants as orthodontic anchoring devices for closing gaps in a tertiary care context. Methods: A total of 100 patients who needed space closure were split into two groups at random and given regular implants (group B, n = 50) or mini-implants (group A, n = 50). The rate of space closure, anchoring loss, and patient pain were measured using visual analog scales as the primary end measures. Resonance frequency analysis was used to assess implant stability. Based on implant survival and the lack of peri-implant problems, success rates were calculated. Findings: Mini-implants showed much lower rates of patient pain (P &lt; 0.001) and anchoring loss (P &lt; 0.05) than normal implants; however, they did show comparable rates of space closure (P = 0.42). In addition, mini-implants had comparable success rates (P = 0.78) and greater implant stability (P &lt; 0.01) when compared to normal implants. Conclusion: In conclusion, mini-implants have benefits in anchorage preservation, patient comfort, and implant stability over regular implants when used as orthodontic anchoring devices for space closure. They also offer equivalent effectiveness. These results provide credence to the use of mini-implants as practical substitutes in orthodontic practice.

Space Closure with Different Appointment Intervals: A Split-mouth Randomized Controlled Trial.

Canine retraction has been successful with various force systems and retraction techniques. The appointment interval for force reactivation in canine retraction along the archwire is 4-8 weeks. The aim was to evaluate the effect of different reactivation intervals on the rate of space closure. This split-mouth randomized clinical trial recruited 38 patients indicated for the first premolar extraction. Monthly digital models were acquired for 6 months. The first premolars were extracted, and temporary anchorage devices were placed for maximum anchorage control. The canines were retracted using elastomeric chains which were replaced every 2, 4, 6, or 8 weeks. The monthly rate of canine retraction was measured. The time to space closure was calculated. The secondary outcome was the mesial drift of the first molars. The Kaplan-Meier survival analysis and the Friedman test evaluated and compared the groups. There was no significant difference between the monthly canine retraction rate or the first molar mesial drift between the groups. The mean time to space closure was 5.74 months in the 2-week reactivation group, which was statistically less than the other groups. The 2-week reactivation interval may reduce time to space closure. Direct anchorage control with miniscrews limited anchorage loss significantly.

The effect of micro-osteoperforations on the rate of maxillary incisors' retraction in orthodontic space closure: a randomized controlled clinical trial

BackgroundThis single-centered randomized controlled clinical trial aimed to evaluate the effectiveness of micro-osteoperforations (MOPs) in accelerating the orthodontic retraction of maxillary incisors.MethodsForty-two patients aged 16–40 were recruited and randomly assigned into two groups, one which underwent MOPs (MOPG) in the buccal and palatal region of all maxillary incisors immediately before the start of retraction and one which did not (CG). Eligibility criteria included the orthodontic need for maxillary first premolars extraction and space closure in two phases. The primary outcome of the study consisted of measuring the rate of space closure and, consequently, the rate of incisors’ retraction using digital model superimposition 14 days later and monthly thereafter for the next 4 months. The secondary outcomes included measuring anchorage loss, central incisors’ inclination, and root length shortening, analyzed using cone beam computed tomography scans acquired before retraction and 4 months after retraction. Randomization was performed using QuickCalcs software. While clinical blinding was not possible, the image’s examinator was blinded.ResultsTwenty-one patients were randomly assigned to each group. However, due to various reasons, a total of 37 patients (17 male and 20 female) were analyzed (mean age: 24.3 ± 8.1 years in the MOPG; 22.2 ± 4.2 years in the CG) during the trial. No statistically significant difference was found between the MOPG and the CG regarding the incisors’ retraction measured at different time points at the incisal border (14 days, 0.4 mm vs. 0.5 mm; 1 month, 0.79 mm vs. 0.77 mm; 2 months, 1.47 mm vs. 1.41 mm; 3 months, 2.09 mm vs. 1.88 mm; 4 months, 2.62 mm vs. 2.29 mm) and at the cervical level (14 days, 0.28 mm vs. 0.30 mm; 1 month, 0.41 mm vs. 0.32 mm; 2 months, 0.89 mm vs. 0.61 mm; 3 months, 1.36 mm vs. 1.10 mm; 4 months, 1.73 mm vs. 1.39 mm). Similarly, no statistically significant differences were detected in the space closure, anchorage loss, central incisors’ inclination, and radicular length between groups. No adverse effect was observed during the trial.ConclusionsMOPs did not accelerate the retraction of the maxillary incisors, nor were they associated with greater incisor inclination or root resorption.Trial registration ClinicalTrials.gov NCT03089996. Registered 24 March 2017—https://clinicaltrials.gov/ct2/show/NCT03089996.

The Effect of Fluorosis on the Rate of Orthodontic Space Closure - A Prospective Study

Background Fluoride is known to minimize the pace of orthodontic tooth movement in animals. However the effect of fluoride on tooth movement in humans is yet to be explored.Aim To compare the rate of space closure among fluorosed FL and non-fluorosed NFL patients clinically and radiographically using study models and also to estimate the bone density using Image J Analyser among fluorosed and non-fluorosed patients.Methodology Forty subjects requiring orthodontic treatment with extraction of all the first premolars were included. The patients were divided into two groups of 20 each based on the presence of dental fluorosis - Non-fluorosed group NFL showing no signs of fluorosis and flourosed group FL consisting of patients with dental fluorosis. Rate of space closure was measured using Vernier caliper and bone density was measured using Image J analyzer software.Results Rate of tooth movement between NFL mean- 7.9 months and FL groups mean- 14.8 months showed highly significant difference between the groups P-value 0.000lt0.01. Bone density changes assessed using the radiographs showed highly significant changes in NFL and FL groups P-value 0.000lt0.01.Conclusion The average rate of tooth movement was slower among fluorosed patients when compared to non-fluorosed patients. Dental fluorosis is positively correlated with skeletal fluorosis. Bone density is high in patients with dental fluorosis which explains the decreased rate of space closure.

To Evaluate and Compare the Rate of Space Closure and Incisor Retraction between Sliding Mechanics and CNA Mushroom Loop Archwire Using Indirect Anchorage

To Evaluate and Compare the Rate of Space Closure and Incisor Retraction between Sliding Mechanics and CNA Mushroom Loop Archwire Using Indirect Anchorage

Efficacy of various Platelet concentrates on the rate of Orthodontic tooth movement – A Systematic Review and Meta-Analysis.

With increased interest in reducing the average duration of Orthodontic treatment, various techniques for accelerating tooth movement have been extensively researched. Studies have shown conflicting results with various Platelet Concentrates (PCs). Hence this review aimed to evaluate and gather evidence of the effectiveness of Platelet concentrates (PRP/PRF) during orthodontic extraction space closure about the space closure rate and the time required for and the angular measurements of the tooth movement during space closure. The electronic databases of Cochrane CENTRAL, PubMed, Scopus, Web of Science, Embase, and Google Scholar were searched up to June 2021. The criteria for selection were Randomised Controlled Trials (RCTs) comparing the use of PCs with that of no intervention/placebo during canine retraction or retraction of anterior teeth. All other studies were excluded. Two reviewers performed the entire process of study selection, extraction of data, and quality assessment independently. Cochrane's ROB2 tool was used for quality assessment in the studies selected. The quantitative analysis of the studies was performed with the use of Review Manager (RevMan5). Eight RCTs met the inclusion criteria and were included for the qualitative synthesis in this review. Of these, five RCTs were included in the quantitative analysis. The results indicated an insignificant increase in the rate of tooth movement with the administration of the PCs (0.13 mm more Tooth movement; 95% CI = -0.17 – 0.43; p = 0.40). No differences were also found in the change of canine inclination and amount of canine rotation. Quantitative synthesis of the selected five studies (3 studies had a low Risk of Bias) reveals no statistically significant difference in the rate of tooth movement with the use of PCs. The results of this analysis should be interpreted with caution owing to the existence of heterogeneity. Limited evidence suggests an actual reduction in the overall treatment duration. Future studies should be aimed at standardizing the protocol for preparing and administering the PCs. This review did not receive any funding.Trial registration number: PROSPERO CRD42021241221

Comparing patient-centered outcomes and efficiency of space closure between nickel-titanium closed-coil springs and elastomeric power chains during orthodontic treatment.

To compare patient-reported pain, discomfort, and difficulty in maintaining proper brushing between nickel-titanium closed-coil springs (CS) and elastomeric power chains (PC) when used for space closure. The secondary aims were to compare plaque control and efficiency of space closure between these two force delivery systems. A total of 48 patients who required extractions of upper first premolars and distal movement of upper canines had the CS randomly allocated to either the right or left side. Blinding was applied at data collection and analysis. Primary outcomes were pain intensity measured on visual analog scale, pain onset and duration, discomfort, and difficulty in maintaining proper brushing from the start of canine retraction at baseline and at 6 and 12 weeks thereafter. Secondary outcomes were plaque scores and the rate of space closure. No significant differences in mean pain scores, pain onset, and duration at different time intervals between CS and PC were observed. The CS side was significantly less comfortable than the PC (P < .0001) and more difficult to keep clean (P = .008). No significant differences in plaque scores were observed between CS and PC groups at any time interval. CS produced a faster rate of space closure than did PC (P = .008). CS were less tolerated than PC by patients but produced an average of 0.5 mm more movement than did the PC during the 12-week study period.

A comparative assessment of the amount and rate of orthodontic space closure toward a healed vs recent lower premolar extraction site.

To investigate and compare the amount and rate of space closure and tooth tipping during orthodontic space closure toward a recent vs healed first premolar extraction site. The mandibular arches of 23 patients were included. Treatment plans included lower first premolar extractions. After reaching 0.019 × 0.025-inch stainless-steel archwires (SSAW), patients were subdivided into two groups (Group 1: space closure was carried out toward a healed first premolar extraction space and Group 2: space closure was carried out immediately after first premolar extraction). Elastomeric power chain from second molar to second molar was used to close lower extraction spaces. The following time points were defined: T1: just before space closure; T2-T4: 1-3 months after initial space closure. Records consisted of dental study models. The amount and rate of extraction space closure were evaluated at each time point. In Group 1 (healed socket), a total amount of 1.98 mm (coronally) and 1.75 mm (gingivally) of space closure was achieved. The rate of space closure was 0.66 mm/month coronally and 0.58 mm/month gingivally. In Group 2 (recent socket), the total amount of space closure was 3.02 mm coronally and 2.68 mm gingivally. The rate of space closure was 1.01 mm/month coronally and 0.89 mm/month gingivally. Differences between the two groups were significant (P < .01). Tipping of adjacent teeth during space closure was similar in both groups (P > .05). In the lower arch, the amount and rate of space closure toward a recent extraction site were higher than that toward a healed extraction socket with similar tipping of teeth in both groups.

Effectiveness of platelet rich fibrin versus demineralized bone xenograft in periodontally accelerated osteogenic orthodontics.

To compare the rate of extraction space closure between periodontally accelerated osteogenic orthodontics (PAOO) using platelet-rich fibrin (PRF) (Group 1) and PAOO using demineralized bone xenograft (DMBM) (Group 2) and to compare the level of wound healing between the PRF group vs the DMBM group after PAOO. A two-arm prospective single blind pilot study with a split-mouth design was used in which 14 patients requiring premolar extraction were divided into two groups: PRF and DMBM. En-masse space closure was carried out with using mini implants after the PAOO procedure. The amount of space closure was measured at five time points with 2-week intervals within 2 months. The gingival healing levels were assessed using early wound healing scores on the first postoperative day. The rate of extraction space closure was faster in the experimental quadrant at all time points (T1-T4) in the PRF group and at time points (T3, T4) in the DMBM group. Comparison between experimental quadrants showed a significant increase in the rate of space closure in the PRF group T1 to T3 (P < .05). The PRF group showed higher total early healing scores than the DMBM group. PRF, when used in the PAOO procedure, produces a faster rate of space closure with better early wound healing than DMBM.

Space Closure Rate in Mandibular Canine Retraction by Elastomeric Power Chain: A Clinical Trial

Background : On a daily basis, orthodontic patients present with malocclusions and orofacial imbalance. Often times, teeth must be extracted in order to obtain proper esthetics, occlusion, and stability as well as extraction of teeth is often a need to close residual space, after the initial decrowding and aligning. Pre adjusted fixed orthodontic appliances commonly utilize sliding mechanics for space closure with different types of force delivery systems. A variety of materials have been used as force delivery systems to close spaces between teeth as in the case of canine retraction after the extraction of premolars. Elastomeric auxiliaries are relatively consistent in producing tooth movements. The purpose of the study to evaluate the rate of mandibular canine retraction by elastomeric power chain.&#x0D; Materials and methods : This obervational study was designed as split mouth study. A total number of 20 patients (40 quadrants),who required canine retraction into first premolar extraction sites as part of their orthodontic treatment in the Department of Orthodontics, BSMMU as study population. The quadrants were affixed by elastomeric power chain (Dentaurum) with 200gm force measured by Correx Tension Gauge. Space closure was measured by means of direct measurement from the mesial surface of mesial wing of the 2nd premolar bracket and the distal surface of distal wing of the canine bracket with digital Vernier Calipers.&#x0D; Results: Mean space closer rate in mandibular canine retraction was 0.99 ± 0.08 mm/month in elastomeric power chain method with p value&lt;0.001.&#x0D; Conclusion : This study revealed that space closer rate in mandibular canine retraction was 0.99 ± 0.08 mm/month by elastomeric power chain.&#x0D; Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 28-31

Space Closure Rate in Mandibular Canine Retraction by Ni-Ti Closed Coil Spring: A Clinical Trial

Introduction: In Majority of patients seeking orthodontic treatment, teeth must be extracted in order to obtain proper esthetics, occlusion, and stability as well as extraction of teeth is often a need to close residual space, after the initial decrowding and aligning. Pre adjusted fixed orthodontic appliances commonly utilize sliding mechanics for space closure with different types of force delivery systems. A variety of materials have been used as force delivery systems to close spaces between teeth as in the case of canine retraction after the extraction of premolars. Among all sliding or frictionless methods of canine retraction, super-elastic nickel titanium coil spring has a particular property in producing light continuous force at a long range of action, compared with previously available materials. Nickel-titanium closed coil spring, with a continuous action, might have some advantages in fixed appliance space closure mechanics. Materials and Methods: Over the period of one year from May 2015 to April 2016, this clinical trial was carried out and A total number of 20 patients (40 quadrants), who required canine retraction into first premolar extraction sites as part of their orthodontic treatment in the Department of Orthodontics of BSMMU selected as study population. The quadrants were affixed by nickel titanium closed coil springs (medium force, Ni-Ti extension spring, Ormco) with 200gm force measured by Correx Tension Gauge. Space closure was measured by means of direct measurement from the mesial surface of mesial wing of the 2nd premolar bracket and the distal surface of distal wing of the canine bracket with digital Vernier Calipers. Results: Mean space closer rate in mandibular canine retraction was 1.07 ± 0.12 mm/month by nickel-titanium (Ni-Ti) closed coil spring method with p value&lt;0.001. Conclusion: This study revealed that space closer rate in mandibular canine retraction by nickel-titanium (Ni-Ti) closed coil spring is 1.07 ± 0.12 mm/month. Medicine Today 2021 Vol.33(2): 90-93

Is there any difference between conventional, passive and active self-ligating brackets? A systematic review and network meta-analysis

To test the null hypothesis that there was no difference in treatment efficiency between therapies undertaken with conventional (CBs), passive self-ligating (PSLBs) or active self-ligating (ASLBs) brackets. An electronic search was performed in 3 data bases (Pubmed, Web of Science, Cochrane Library) from their origin up to January 2019. Additional references were hand searched. Search was strictly restricted to randomized controlled trials (RCTs) and split-mouth design studies (SMDs). RCTs and SMDs were initially processed separately and subsequently combined in a network meta-analysis. The following variables were evaluated: treatment duration, number of visits, occlusal outcomes, alignment rate, transverse arch dimensional changes, incisor position modification, rate of space closure, anchorage loss, bond failure, root resorption, perception of discomfort during the initial phase of alignment, time to ligate in or to untie an archwire, periodontal variables, quality of life. On 229 papers, 30 RCTs and 9 SMDs were finally included in this study. Out of 85 comparisons, 16 only revealed statistically significant differences. It was quicker to untie and ligate an 0.014 NiTi arch from/in 6 ASLBs anterior ceramic brackets compared to 6 ceramic CBs. It was also more painful to insert and remove an 0.019×0.025 SS wire in/from PSLB's brackets compared to CB's attachments. Compared to conventional brackets, there was less maxillary incisor proclination with PSLBs in non-extraction cases. Moreover, there was less bleeding on probing 4-5 weeks after bonding with PSLBs compared to CBs brackets. The only significant difference between ASLBs and PSLBs was that alignment was 10 days faster with active self-ligating braces compared with passive self-ligating braces even if treatment duration between ASLBs and PSLBs was not significantly different. The network meta-analysis revealed that IMPA was greater in extractions cases with CBs compared with both ASLBs (+2,5°) and PSLBs (+1,6°). The vast majority of the studied variables did not show any significant differences between the three types of brackets. The most significant findings were that it was quicker to insert and remove archwires from ASLBs compared to CBs, and it was more painful to insert and remove an 0.019×0.025" stainless steel wire in/from PSLBs compared to CBs. The major difference between ASLBs and PSLBs was that alignment was 10 days faster with active self-ligating braces compared with passive self-ligating braces even if treatment duration between ASLBs and PSLBs was not significantly different. Most of the claims put forward by the suppliers were not substantiated by our network meta-analysis.

Orthodontic space closure in sliding mechanics: a systematic review and meta-analysis.

The aim of this systematic review was to compare the different force delivery systems for orthodontic space closure by sliding mechanics. Multiple sources including Cochrane Central, Ovid Medline, Embase etc. were used to identify all relevant studies. Randomized controlled trials (RCT) of parallel-group and split-mouth designs were included. Orthodontic patients of any age treated with fixed orthodontic appliances and requiring space closure. Search result screening, data extraction and quality assessment were performed independently and in duplicate by 2 reviewers. The included studies were grouped into parallel-arm and split-mouth studies and subgroup analysis was then performed for the type of retraction subsets; en-masse and individual canine retraction. A traditional meta-analysis, and network meta-analysis (NMA) for direct and indirect comparisons for the rate of space closure were performed. Thirteen studies, six parallel-arm and seven split-mouth were included. The traditional meta-analysis comparing Nickel-titanium (NiTi) closed coil springs and elastomeric power chain for the rate of tooth movement showed statistically significant difference favouring NiTi springs (MD: 0.24; 95% CI, 0.03-0.45; I2 0%, P = 0.02) and the comparison between NiTi springs and active ligatures also showed statistically significant result favouring NiTi springs (MD: 0.53; 95% CI, 0.44-0.63; I2 0%, P ˂ 0.00001) for the rate of tooth movement. NMA for the rate of space closure showed fairly confident evidence for NiTi coil springs when compared with elastomeric chain and active ligatures. The NiTi coil spring ranked best between all methods of space closure. There is moderate quality evidence in favour of NiTi coil springs for the rate of space closure when compared with active ligature and low quality of evidence favouring NiTi springs when compared with elastomeric chain. The ranking from NMA showed NiTi coil springs to be the best method for space closure with 99% chance. An urgent need for standardization of study designs and the need for development of an agreed core outcome sets and core outcome instrument measurement sets is evident. PROSPERO CRD42020157811.

Comparison of Rate of Space Closure using Active Tie Back and NiTi Coil Spring in Angle's Class I Bi-Max Malocclusion Subjects following Piezocorticision

Comparison of Rate of Space Closure using Active Tie Back and NiTi Coil Spring in Angle's Class I Bi-Max Malocclusion Subjects following Piezocorticision

A Comparative Evaluation of Space Closure Rate Between Newer Generation Ceramic Brackets and Conventional Straight Wire Appliances

Background: With the emerging concept of aesthetics in orthodontics, ceramic brackets play a major role especially in the anterior region of the dental arch. However, the duration of the orthodontic treatment is one of the most important issues in treating patients with ceramic brackets. Objectives: This study is conducted to compare space closing rate between conventional MBT and Symetri ClearTM bracket systems. Methods: This study is comprised of 18 subjects who were equally separated into two groups. The first group was treated with conventional MBT pre-adjusted bracket and the second group with Symetri ClearTM brackets. Space closure was performed via 0.019 × 0.025 inch stainless steel wires using 9-mm nickel-titanium Sentalloy coil springs with a constant force of 150 g. The distance between the distal of the first molar buccal tube and the mesial of the canine bracket was measured by a digital caliper. The difference of the first and last values was determined to assess the sheer quantity of space closure. The value was then divided by the number of months during which the space closure was carried out to examine the ratio of space closure in mm per month. For the statistical analysis we used paired t test as well as independent t test and the P-value &gt; 0.05 was deemed significant. Results: The MBT group showed a 0.85 mm/appointment retraction rate while the Symetri ClearTM bracket group had a 0.83 mm/appointment retraction rate. The difference in space closing between MBT and Symetri ClearTM groups was not statistically and clinically significant (P-value &gt; 0.05). Conclusions: As the rate of space closure was almost similar in the two types of brackets, we can use Symetri ClearTM brackets instead of MBT brackets without any concern about the duration of treatment and use the esthetic benefits of these brackets simultaneously.

Effect of micro-osteoperforations on rate of space closure by mini-implant supported maxillary anterior en-masse retraction: A randomized clinical trial

BackgroundMicro-osteoperforations is one of the non-invasive surgical techniques used in attempt to accelerate OTM. Conflicting reports on its effectiveness has been reported in the literature. ObjectivesThe objectives of this trial were to investigate the effect of micro-osteoperforations on the rate of space closure and on molar anchorage loss during mini-implant supported maxillary anterior en-masse retraction. Trial designA single center, parallel arm, randomized controlled trial was conducted. MethodSixty, male and female subjects (age range 16–25 years) having Class I bimaxillary protrusion or Class II div 1 malocclusion, who required fixed mechanotherapy with either upper 1st premolar or all four 1st premolar extractions were allocated into two groups using 1:1 allocation ratio. The allocation was done by block randomization method with a block size of 6. In the experimental group, 5 MOPs per side were performed only once just before the en-masse anterior retraction. Mini-screws were placed in order to obtain maximum anchorage. Impressions were taken every month till 4 months and rate of space closure was measured on 3D study models. ResultsData of 27 subjects in control (attrition ​= ​3) and 28 subjects in experimental group (attrition ​= ​2) were analyzed at the end of this trial. There was a statistically significant increase in the rate of en-masse retraction for the 1st month(p ​= ​0.001,95%CI, 0.17, 0.37 ​mm) but there was no statistically significant difference for the subsequent 2nd (p ​= ​0.450,95%CI,0.13,0.43 ​mm), 3rd(p ​= ​0.204,95%CI,0.23,0.47 ​mm) and 4th month (p ​= ​0.680,95%CI,0.21,0.41 ​mm) between experimental and control groups. There was also no difference (p ​> ​0.05) in molar anchorage loss between both groups at all time intervals. ConclusionMicro-osteoperforations (MOPs) did not accelerate the rate of anterior en-masse retraction over a period of 4 months; however, it temporarily increases the rate of retraction only for first month and no affect on molar anchorage. Trial registrationThe trial was registered at www.ctri.nic.in with CTRI No- CTRI/2019/03/018140).

Are self-ligating brackets more efficient than conventional brackets ? A meta-analysis of randomized controlled and split-mouth trials

The aim of this systematic review and meta-analysis was to compare self-ligating brackets (SLBs) considered as a whole to conventional brackets (CBs). An electronic search was performed in three databases (PubMed, MEDLINE via Web of Science, Cochrane Library) from their origin up to June 2017. Additional articles were hand searched from January 2006 to June 2017. This meta-analysis was restricted to randomized controlled trials (RCTs) and split mouth design studies (SMDs). No distinction was made between active and passive SLBs. The following variables were investigated: treatment duration, number of visits, alignment rate, rate of space closure, perception of discomfort during the initial phase of treatment, pain experience during wire insertion or removal, bond failure rate, time to ligate in or to untie an archwire, periodontal indices, occlusal outcomes, transverse arch dimensional changes and root resorption. 25 RCTs and 9 SMDs were finally selected. It was more painful to insert or remove a 0.019× 0.025 SS archwire in/from SLBs. It was significantly quicker to insert or remove an archwire from SLBs. There was less bleeding on probing with SLBs 4 or 5 weeks after bonding. All other variables did not exhibit any significant difference between SLBs and CBs. Out of the 31 comparisons between self-ligating and conventional brackets, 9 only revealed statistically significant differences. This meta-analysis contradicts most of the promotional statements put forward by the distributors.

Evaluation of En Masse Retraction Using Microimplant versus Conventional Techniques: An in Vitro Study

Aims: The study aims to evaluate the effect of different techniques of en masse retraction on the vertical and sagittal position, axial inclination, rate of space closure, and type of movement of maxillary central incisor. Materials and methods: Three groups were used group 1(N=10, T−loop), group 2(N=10, Time−Saving loop), and group 3(N=10, Microimplant). Photographs were taken before and after retraction and measurements were made using Autodesk AutoCAD© 2010. Kruskal−Wallis one−way ANOVA and Mann−Whitney U test (p≤0.05) were used. Results: The rate of space closure showed no significant difference among the groups (p≤0.05). The type of tooth movement showed a significant difference among the groups (p≤0.05), where group 3 showed a more degree of controlled tipping than group 1 while group 2 showed an uncontrolled tipping movement. Conclusions: It is concluded that microimplant anchored sliding mechanics gives better control over the en masse retraction mechanics and greater retraction. Conventional techniques result in extrusion and move the teeth in less degree of translation.