Measuring Rate of Anteriors Retraction With Two Different Techniques
Condition: Class II Division 1 Malocclusion
MeSH terms: Malocclusion
Study type: Interventional

Summary: 
      Few studies had investigated the effectiveness of segmental retraction. As a result of that,
      this study was concerned about comparing retraction rate of maxillary incisors between buccal
      and palatal mini-implant supported retraction groups in Class II division 1 non growing
      patients for 3 months interval.
    

Detailed description: 
      Almost all patients their primary concern is the total duration of orthodontic treatment. So,
      the need to choose the best mean to fasten the tooth movement rate with least drawbacks
      increased . Many new bracket techniques and prescriptions have been evolved since straight
      wire technique of Andrew's was advanced. All of these progressions are to make a system of
      force which can decrease the overall management time.

      Commonly, extractions and maximum anchorage are planned to manage different malocclusions in
      orthodontic treatment especially in protrusion cases. Space closure is an important step
      following extraction. So, space closure strategy must be individually adjusted depending on
      diagnosis and plan of treatment. Nowadays several options are used to fasten movement of
      tooth. New techniques like implants assisted retraction, lessen the time of retraction and
      accordingly the total time of treatment.

      Control of anchorage is an important factor in orthodontic therapy success. Mini-implants are
      method of absolute anchorage control .These systems improves the anchorage, but still have
      some drawbacks like surgical intervention and patient compliance. However, their usage
      becomes a necessity and unavoidable in many cases. Buccal TADs could provide superior results
      when retracting anterior teeth in patients with moderate to severe protrusion.

      Lingual orthodontics introduction created novel horizons in orthodontic therapy. Labial
      orthodontics varied differentially in biomechanics from the lingual one. Because of its
      positional biomechanical advantage, lingual orthodontics offers higher anchorage and higher
      rate of retraction; as the lingual appliance force applied near to the tooth center of
      resistance than in the labial ones.

      Control of torque is not simple in traditional lingual orthodontics. The C-lingual retractor
      is great for lip protrusion cases that need maximum anchorage.Bonding the C-retractor to the
      palatal aspect of the upper anteriors, adding maximum esthetics. Mini-implants are inserted
      palataly and decrease the need of posterior anchorage for retraction of upper anterior teeth.
      This is named lingual biocreative therapy. Palatal TSADs can provide wide range of force
      application level, due to the depth of palatal vault. By the adjustment of the lever arm
      length and position of miniscrews, the desired line of action of the retraction force with
      respect to the center of resistance of the anterior segment can be achieved.Segmental
      retraction is an approach using palatal TSADs as direct anchorage. The anterior teeth were
      splinted on the lingual side, and they are retracted to the palatal TSADs using elastomers or
      NiTi coil springs through a lever connected to the anterior segment.

      It is critical to locate and manage the center of resistance relative to the force vector of
      retraction. By using this, the orthodontist can estimate the power arm length which would
      provide controlled tipping, or bodily movement of the anterior area.

      There is a lack of studies evaluating the rate of movement of incisors in cases treated with
      palatal retraction so new investigations are needed in this area. Because of the
      biomechanical differences between buccal and palatal retraction, this study targeted the
      comparison of the rate of retraction in upper anteriors following leveling and alignment in
      class II division 1 patients managed by either method.
    

Intervention name(s): palatal and buccal retraction
Intervention type(s): Device
Intervention description(s): comparison
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Orthodontics, incisors retraction, mini-implants, direct- anchorage.