Clinical Effects of Electrical Stimulation on Speeding up Orthodontic Tooth Movement
Condition: Class II Malocclusion
MeSH terms: Malocclusion; Malocclusion, Angle Class II; Overbite
Study type: Interventional

Summary: 
      Thirty two patients requiring extraction of maxillary first premolars and en-masse retraction
      of 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 overall retraction duration will be calculated. The skeletal, dental and soft tissue
      changes will be detected using panoramic and lateral cephalometric radiographs which will be
      obtained pretreatment, pre and post en-masse retraction of the anterior teeth.
    

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 8-10 mm
      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 a removable device containing a
      small electrical circuit that will supply the required electric current for five hours a day
      until the completion the retraction of the upper anterior teeth.

      (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.

      The duration of retraction will be calculated by calculating the time required to achieve
      complete retraction of the upper anterior teeth through clinical examination.

      Panoramic and lateral cephalometric radiographs will be obtained pretreatment, pre and post
      en-masse retraction of the anterior teeth, to assess the skeletal, dental and soft tissue
      changes.

      Periodontal health will be assessed at the beginning of orthodontic treatment, before and
      after en-masse retraction by evaluating the following parameters: plaque index, gingival
      index, bleeding index, probing depth and gingival recession.
    

Intervention name(s): Low-intensity electrical current (LIEC); Traditional fixed orthodontic appliance
Intervention type(s): Device; Device
Intervention description(s): Each patient in the electrical group will be asked to wear a removable device containing a small electrical circuit that will supply the required electric current for five hours a day until the completion the retraction of the upper anterior teeth.; 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. (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.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: En-masse retraction; Acceleration; Low-intensity electric current