Efficacy and Periodontal Parameters in Self-ligating Brackets Alone or With Corticotomy vs Conventional Brackets
Condition: Crowding of Anterior Maxillary Teeth
Study type: Interventional

Summary: 
      Patients who have severe crowding on the upper jaw that requires two first premolars
      extraction will be enrolled in this trial. The different types of brackets, such as
      self-ligating brackets and conventional brackets, and the various acceleration methods, such
      as corticotomy, have different effects on the orthodontic treatment time and the periodontal
      tissues. So, this study will assess and compare the overall leveling and aligning time and
      the changes in periodontal indices between patients with severe crowding, treating with
      self-ligating brackets associated with flapless corticotomy versus conventional brackets
      alone versus self-ligating brackets alone.

      There are three groups:

      The first group (control group): the patients in this group will be treated using
      conventional brackets alone.

      The second group (Experimental group): the patients in this group will be treated using
      self-ligating brackets alone.

      The third group (Experimental group): the patients in this group will be treated using
      self-ligating brackets associated with flapless corticotomy.
    

Detailed description: 
      The prolonged duration of the treatment period can cause many problems such as caries and
      periodontal diseases. The oral environment is considered a suitable environment for many
      germs and microorganisms to grow. Any increase in the percentage of these germs predisposes
      to the occurrence of dental and periodontal problems.

      Several studies have used various procedures and many types of brackets to accelerate dental
      movement in order to reduce treatment time.

      Orthodontic treatment using different devices usually contributes to change the nature of the
      oral environment and its contents of microorganisms Many bracket systems have been used, such
      as the conventional brackets and self-ligating brackets. The use of self-ligating brackets
      has increased significantly in recent years. The absence of wired or elastic elements may
      cause less accumulation of plaque.
    

Intervention name(s): Conventional brackets; Self-ligating brackets; Self-Ligating Brackets with flapless corticotomy
Intervention type(s): Device; Device; Procedure
Intervention description(s): These brackets are used in a conventional way, where the orthodontist used to apply elastic parts to engage the arch to the slot of the brackets.; These brackets do not need to use elastic parts to engage the arch to the brackets. The orthodontist can use sliding caps to open and close the slots of these brackets.; These brackets do not need to use elastic parts to engage the arch to the brackets. The orthodontist can use sliding caps to open and close the slots of these brackets.
Flapless corticotomy will be performed in order to stimulate acceleration in tooth movement during the orthodontic treatment in this group only.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment