Pain and Discomfort in Two Acceleration Methods of Canine Retraction
Condition: Class II Malocclusion
MeSH terms: Malocclusion; Malocclusion, Angle Class II; Overbite
Study type: Interventional

Summary: 
      54 patients who need extraction-based treatment of the maxillary first premolars with
      subsequent retraction of the maxillary canines will be divided randomly into three groups in
      this trial. The prolonged duration of the treatment period can cause many side effects such
      as white spots, caries, periodontal diseases, and pain and discomfort. So many efforts have
      been made to reduce the treatment time. Many procedures have been introduced to accelerate
      orthodontic tooth movement, which can category as surgical or non-surgical. Piezocision is a
      minimally invasive surgical method for accelerating orthodontic tooth movement and shortening
      treatment time. Low-level laser therapy (LLLT) is one of the physical acceleration methods
      that have contributed to decreasing treatment time.

      There are three groups:

      The first group (control group): the canine retraction in this group will be performed in
      conventional method.

      The second group (Experimental group): the canine retraction in this group will be performed
      in association with piezocision.

      The third group (Experimental group): the canine retraction in this group will be performed
      in association with low-level laser therapy.
    

Detailed description: 
      Closed nickel-titanium coil springs applying 150 g of force per side will be used for
      retraction of the upper canine.

      Regarding the Piezocision, three vertical incisions will be made (3-mm depth and 8-10 mm
      length) after anesthesia. The cuts will be performed mesial and distal the upper canine as
      well as at an equal distance from the upper canine and 2nd premolar.

      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. After that, until the class I canine relationship will be achieved, the
      irradiation will be repeated every two weeks.

      The levels of pain and discomfort will be self-reported using a questionnaire with visual
      analog scales administered at five evaluation times during the first month of canine
      retraction.
    

Intervention name(s): Piezosurgery; Low-level laser therapy; Traditional treatment
Intervention type(s): Procedure; Other; Device
Intervention description(s): Three vertical incisions will be made (3-mm depth and 8-10 mm length) after anesthesia. The cuts will be performed mesial and distal the upper canine as well as at an equal distance from the upper canine and 2nd premolar.; 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 canine retraction in this group will be performed in conventional method. Closed nickel-titanium coil springs applying 150 g of force per side will be used for retraction of the upper canine.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Piezosurgery; Diode laser; low-level laser; Pain