Comparative Evaluation of 3 Dimensional Changes of Dentition in Post Orthodontic Patients With Immediate vs Delayed (Post 24 Hours) Retainer Delivery

Study Overview
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Brief Summary
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Orthodontic treatment goals can be expressed as achieving ideal tooth alignment, esthetic, functional occlusion and stability. Various occlusal changes occur after active phase of orthodontic treatment, these unwanted changes are called relapse. Reitan pointed out that major percentage of changes following active phase of treatment is seen within 24 hours. To alleviate the effect of relapse, retention is needed. There is little agreement among clinicians about orthodontic retention protocol due to insufficient evidence in the literature on 1. time of retainer delivery 2. unexpected post- treatment changes. 3.quantification of relapse tendency. The present study will be undertaken to assess the changes and compare if there is any difference in the movement of teeth in post orthodontic treatment cases with immediate and delayed (post 24 hours) retainer delivery. Thus help in deciding when should the retainer delivery is preffered.

Detailed Description
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The proposed study will be a prospective, non-pharmacological, single blind, randomized clinical trial to evaluate if there is a difference in transverse (Xaxis), A-P(Y-axis) and Vertical plane(Z-axis) of dentition in two group of post orthodontic treatment patients with immediate retainer delivery in one group and post 24 hours retainer delivery in other group of patients. The present study will be conducted in the Department of Orthodontic and Dentofacial Orthopedics, P.G.I.D.S, Pt. B.D Sharma University of health sciences, Rohtak. The study will be carried out after the institutional approval obtained from ethical committee. A sample size of 18 patients was calculated keeping confidence interval 95% with power 80%. Accounting for a 10% drop out rate, 20 patients will be enrolled in each group. Patient will be randomly allocated to the study group by a person not involved in the trial using computer generated randomization list. Changes in the tooth movement in transverse(X-axis), A-P(Y-axis), Vertical plane(Zaxis) will be compared in terms of intercanine width, intermolar width, overjet, overbite and contact point displacement between the two groups at following time intervals. These parameters will be charted at T0, T1, T2,T3 and T4 for each patient.Changes in the tooth movement in transverse(X-axis), A-P(Y-axis), Vertical plane(Z-axis) will be compared in terms of intercanine width, intermolar width, overjet, overbite and contact point displacement between the two groups at following time intervals. These parameters will be charted at T0, T1, T2,T3 and T4 for each patient. T0 - Baseline records, at the time of debonding. T1 - Records obtained at the time of retainer delivery. T2 - Records obtained after 1 month of retainer delivery. T3 - Records obtained after 3 months of retainer delivery. T4 - Records obtained after 6 months of retainer delivery

Official Title
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Comparative Evaluation of 3 Dimensional Changes of Dentition in Post Orthodontic Patients With Immediate vs Delayed (Post 24 Hours) Retainer Delivery-A Randomized Control Trial

Conditions
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Relapse

Intervention / Treatment
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* Other: immediate orthodontic retainer delivery
* Other: delayed orthodontic retainer delivery.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult orthodontic patients treated with 022*028 MBT appliance with following sequence of wires- 014, 016, 16*22, 17*25, 19*25 NiTi followed by 19*25 SS. Treatment duration of 24-36 months with Optimal functional occlusion at end of treatment (PAR score >70%). Class I bimax and Class II div I with pre-treatment Little's irregularity index <6mm in both upper and lower arch. Nonsurgical and non-orthopedic patients. Non syndromic patients and no impaction of teeth except third molars. No previous orthodontic treatment. Optimal periodontal condition and Good oral hygiene. Good compliance regarding retainer wear (Cases who never missed more than 2 consecutive appointment and who reported with less no of breakages) Exclusion Criteria: Subjects with incomplete orthodontic treatment. TMJ disorder patients. Any systemic disease affecting bone and general growth. Patients with incomplete records. Patient who fail to follow up or undergo complete treatment. Patient with learning difficulties

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: control group- immediate retainer delivery<br>Retainer will be given to the patients immediately [ Just after debonding] | Other: immediate orthodontic retainer delivery<br>* post orthodontic treatment patients will be given orthodontic retainer immediately after debonding.<br>|
| Active Comparator: experimental group- delayed retainer delivery<br>Retainer will be given to the patient 24 hours post debonding. | Other: delayed orthodontic retainer delivery.<br>* post orthodontic treatment patients will be given orthodontic retainer after 24 hours of debonding.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overjet | sagittal distance between upper and lower incisors | T0 - baseline on the day of debonding | 
| Overjet | sagittal distance between upper and lower incisors | T1 - 24 hours after debonding | 
| Overjet | sagittal distance between upper and lower incisors | T2 - 1 month after debonding | 
| Overjet | sagittal distance between upper and lower incisors | T3 - 3 month after debonding | 
| Overjet | sagittal distance between upper and lower incisors | T4 - 6 month after debonding | 
| contact point displacement | displacement of contact points in anterior teeth | T0 - baseline on the day of debonding | 
| contact point displacement | displacement of contact points in anterior teeth | T1 - 24 hours after debonding | 
| contact point displacement | displacement of contact points in anterior teeth | T2 - 1 month after debonding | 
| contact point displacement | displacement of contact points in anterior teeth | T3 - 3 month after debonding | 
| contact point displacement | displacement of contact points in anterior teeth | T4 - 6 month after debonding | 
| overbite | vertical overlap of upper and lower incisors | T0 - baseline on the day of debonding | 
| overbite | vertical overlap of upper and lower incisors | T1 - 24 hours after debonding | 
| overbite | vertical overlap of upper and lower incisors | T2 - 1 month after debonding | 
| overbite | vertical overlap of upper and lower incisors | T3 - 3 month after debonding | 
| overbite | vertical overlap of upper and lower incisors | T4 - 6 month after debonding | 
| intermolar width | transverse distance between the first molars | T0 - baseline on the day of debonding | 
| intermolar width | transverse distance between the first molars | T1 - 24 hours after debonding | 
| intermolar width | transverse distance between the first molars | T2 - 1 month after debonding | 
| intermolar width | transverse distance between the first molars | T3 - 3 month after debonding | 
| intermolar width | transverse distance between the first molars | T4 - 6 month after debonding | 
| intercanine width | transverse distance between the canine | T0 - baseline on the day of debonding | 
| intercanine width | transverse distance between the canine | T1 - 24 hours after debonding | 
| intercanine width | transverse distance between the canine | T2 - 1 month after debonding | 
| intercanine width | transverse distance between the canine | T3 - 3 month after debonding | 
| intercanine width | transverse distance between the canine | T4 - 6 month after debonding | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Orthodontic Retention