Efficacy of Minimally Invasive Surgical Technique in Accelerating Orthodontic Treatment
Condition: Malocclusion, Angle Class II
MeSH terms: Malocclusion; Malocclusion, Angle Class II; Overbite
Study type: Interventional

Summary: 
      Thirty six patients needs therapeutic extraction of the maxillary first premolars with
      subsequent retraction of the maxillary canines will be divided randomly into two groups :
      piezocision group and the ER:yttrium aluminum garnet (YAG) laser group. In each group,
      piezocision or hard laser-assisted flapless corticotomy will randomly assigned to one side of
      the maxillary arch at the first premolar region, and the other side served as the control.
      Canine retraction will be initiated after completion of the leveling and alignment phase via
      closed nickel-titanium coil springs applying 150 g of force per side, soldered trans-palatal
      arch will be used as an anchor unit.

      Pre- and post distalization dental casts will be evaluated to study rate of canine
      distalization, canine rotation and anchorage loss over a follow-up period until a Class I
      canine relationship is achieved. The levels of pain and discomfort will be self-reported
      using a questionnaire with visual analog scales administered at four assessment times during
      the first month after the minimally invasive procedure.
    

Detailed description: 
      One main issue in orthodontics is the prolonged treatment time, leading patients, especially
      adults, to avoid treatment or seek alternative options such as implants or veneers with less
      than optimal results.

      Therefore, the search for methods that decrease the treatment duration is a main challenge in
      orthodontic research. Decreased duration of therapy seems to be related not only to better
      patient compliance, but also to reduced treatment -related root resorption , better
      periodontal health and lower risk of caries and white spots. Adjunct to the proper selection
      of brackets, wires, biomechanic systems, force levels, and anchorage systems, an array of
      novel techniques has been introduced to accelerate orthodontic tooth movement. These
      techniques can be briefly categorized as surgical and non-surgical. However The surgical
      approach is the most clinically used and most tested with known predictions and stable
      results. The invasiveness of surgical procedures, requiring full mucoperiosteal flaps, might
      have been a drawback for their widespread acceptance among orthodontists and patients.
      Therefore, more conservative flapless corticotomy techniques have recently been proposed.
      Although various techniques of flapless corticotomy have been reported to be successful in
      practice, scientific evidence for their effectiveness so far has been limited to case series
      and a handful of clinical trials, generally with small groups. Therefore further controlled
      prospective studies are needed to study the effectiveness of flapless corticotomy in
      accelerating orthodontic tooth movement .
    

Intervention name(s): Piezosurgery; ER:YAG laser
Intervention type(s): Procedure; Radiation
Intervention description(s): Corticotomy cuts will be performed by this technique.; Corticotomy cuts will be performed by this technique.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment