Evaluation of the Effect of Electrical Stimulation on the Rate of Orthodontic Tooth Movement and the Dental Arches
Condition: Class II Malocclusion
MeSH terms: Malocclusion; Malocclusion, Angle Class II; Overbite
Study type: Interventional

Summary: 
      Thirty-eight patients requiring extraction of maxillary first premolars and maximum anchorage
      to retract the upper anterior teeth will participate in the study. They will be divided
      randomly into two groups: electrical group and control group. In each group, en-masse
      retraction will be initiated after completion of the leveling and alignment phase via closed
      nickel-titanium coil springs applying 250 g of force per side, Mini-implants will be used as
      an anchor unit.

      The dental changes will be detected using dental casts and to evaluate the rate of teeth
      retraction.
    

Detailed description: 
      Prior to enrollment of each subject into the study, they will be examined completely to
      determine the orthodontic treatment plan. The operator will inform them about the aim of the
      study and ask them to provide a written informed consent.

      Self-drilling titanium mini-implants (1.6mm diameter and 8mm length) will be used. They will
      be inserted between the maxillary second premolar and first molar at approximately 8-10mm
      above the archwires at the mucogingival junction and will be checked for primary stability
      (mechanical retention). Then the maxillary first premolar will be extracted. The maxillary
      arch will be levelled and aligned. The rectangular stainless steel archwires (0.019" ×
      0.025") with anterior 8mm height soldered hooks distal to the canines will be inserted.

      A removable device containing a small electrical circuit will be applied to each patient to
      supply the required electric current.

      Each patient in the electrical group will be asked to wear the device for five hours a day
      until the completion of the retraction of the upper anterior.

      (250-300) g force will be applied on each side using two NiTi springs attached between the
      mini-implants and the soldered hooks in a direction approximately parallel to the occlusal
      plane for conducting an en-masse retraction. The force level will be measured every 2 weeks.
      Retraction will be stopped when a class I canine relationship will be achieved and a good
      incisor relationship will be obtained.

      Dental casts will be used for the quantification of the anteroposterior movement of the
      anterior teeth and the first molars every 30 days until class I canine relationship will be
      achieved and a good incisor relationship will be obtained. Photographs of the upper casts
      will be taken with a central vertical projection on the occlusal plane and with a millimeter
      scale at the same level used to standardize and calibrate the conditions to match the casts
      when photographing them. Reference points will be used for upper casts study and the
      measurements will be calculated using the Image J computer program. To evaluate the movement
      of the anterior teeth: we will project the incisive edge on the median line and measure the
      distance from this point to the projected position of the medial end of the third palatine
      wrinkle on the median line.

      To evaluate the movement of the first molars: we will project the mesial contact point of the
      first molar on the median line and measure the distance from this point to the to the
      projected position of the medial end of the third palatine wrinkle on the median line.
    

Intervention name(s): electric current; Traditional treatment
Intervention type(s): Device; Device
Intervention description(s): Electric current will be applied in this group of patients using removable device.; No acceleration method will be performed in this group.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Electrical stimulation; Low-intensity electrical current (LIEC); En-masse retraction; Pain; Discomfort