Which is Better Piezosurgery or LLLT in Accelerating Orthodontic Tooth Movement
Condition: Class II Malocclusion
MeSH terms: Malocclusion; Malocclusion, Angle Class II; Overbite
Study type: Interventional

Summary: 
      Sixty patients need extraction-based treatment of the maxillary first premolars with
      subsequent retraction of the maxillary canines will be divided randomly into three groups:
      piezocision group, low-level laser therapy group, and control group. In each group, the
      canine retraction will be started after completion of the leveling and alignment phase via
      closed nickel-titanium coil springs applying 150 g of force per side. For anchorage, a
      soldered trans-palatal arch will be used.

      Pre- and post distalization dental casts will be assessed to study the rate of canine
      retraction, as well as, canine rotation and anchorage loss over a follow-up period until a
      class I canine relationship is achieved.
    

Detailed description: 
      Before enrollment of each subject into the study, they will be examined completely to ensure
      their eligibility for this study. The operator will inform them about the aim of the study
      and ask them to provide written informed consent.

      At the end of leveling and alignment stage, the upper first premolars will be extracted. The
      rectangular stainless steel archwires (0.019" × 0.025") will be inserted, then after one
      month, the canine retraction will be started.

      Regarding the Piezocision, after anesthesia, three vertical incisions will be made (3-mm
      depth and 8-10 mm length) mesial and distal the upper canine as well as at an equal distance
      from the upper canine and 2nd premolar. The surgical procedures will be repeated after six
      weeks (only the mesial and distal canine incisions will be done) Regarding the low-level
      laser therapy (LLLT): GaALAs diode laser (wavelength: 810 nm and exposure time of 10
      seconds\point) will be applied around the upper canine in 10 sites from buccal and palatal.
      The middle of the extraction site will be also irradiated in 4 sites (2 buccally and 2
      palatally). The LLLT will be applied 5 times in the first month of canine retraction, then
      every two weeks until class I canine relationship will be achieved.

      The upper canine destalization will be done using NiTi springs. The force level will be
      controlled every 2 weeks. Retraction will be stopped when a class I canine relationship in
      both sides.

      Dental casts will be used for the quantification of the anteroposterior movement of the upper
      canine and the first molars every 30 days until the class I canine relationship will be
      achieved.
    

Intervention name(s): Piezocision; Low-level laser; Conventional treatment
Intervention type(s): Procedure; Device; Device
Intervention description(s): After anesthesia, three vertical incisions will be made (3-mm depth and 8-10 mm length) mesial and distal the upper canine as well as at an equal distance from the upper canine and 2nd premolar. The surgical procedures will be repeated after six weeks (only the mesial and distal canine incisions will be done); GaALAs diode laser (wavelength: 810 nm and exposure time of 10 seconds\point) will be applied around the upper canine in 10 sites from buccal and palatal. The middle of the extraction site will be also irradiated in 4 sites (2 buccally and 2 palatally). The LLLT will be applied 5 times in the first month of canine retraction, then every two weeks until class I canine relationship will be achieved.; The upper canine destalization will be done using NiTi springs. The force level will be controlled every 2 weeks. Retraction will be stopped when a class I canine relationship in both sides.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: LLLT; Piezocision; Canine retraction; Acceleration