Evaluation of the Periodontal Status After the Treatment of Palatally Impacted Canines Using Acceleration Procedures

Study Overview
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Brief Summary
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Impacted canine causes many problems for patients, such as damage to the adjacent teeth roots, effects on gingival tissues, aesthetic problems, difficulty, and prolonged orthodontic treatment duration. Therefore, solutions to accelerate the movement of impacted canines with the help of surgical procedures to reduce treatment time will be investigated, such as intra-operative alveolar perforations and piezocision. We also aimed to evaluate periodontal changes associated with such accelerating procedures compared with the conventional traction method.

Detailed Description
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Patients with palatally impacted maxillary canines will be treated using fixed appliances assisted by some surgical procedures. The effects of this treatment approach on the periodontal status will be assessed using periodontal measurements. There are two groups : conventional treatment group minimally-invasive corticotomy-assisted treatment group Patients will be allocated to the two groups randomly. Data will be collected using periodontal variables.

Official Title
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Comparison of Posttreatment Periodontal Status of Palatally Impacted Canines Aligned by Conventional Versus Accelerated Minimally-invasive Corticotomy-assisted Orthodontic Traction Treatment: A Randomized Controlled Trial

Conditions
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Impacted Canine

Intervention / Treatment
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* Device: Fixed appliances
* Procedure: Corticotomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age of patients: 18-28 years. Palatal or Mid-alveolar impacted canine. There is no previous orthodontic treatment. Healthy periodontal tissues and good oral health (i.e., the Plaque Index is less or equal to 1 according to Loe and Silness(1963). The patient does not take any drug that may interfere with the tooth movement (Cortisone, NSAIDs …). Mild or no crowding on the upper jaw. No history of previous trauma to the maxillofacial region or surgical interventions. Exclusion Criteria: Any systemic diseases that would affect tooth movement Antidepressant prevents oral surgery Any congenital syndromes or cleft lip and palate cases Bad oral health Previous orthodontic treatment

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 28 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Conventional treatment<br>Patients will be treated using the fixed appliances to track the impacted canines after opening the appropriate distance | Device: Fixed appliances<br>* Metal brackets with a straight-wire prescription will be used. Patients will be treated conventionally.<br>|
| Experimental: Surgically-assisted treatment<br>Patients will be treated using fixed appliances assisted by minimally-invasive corticotomy (alveolar perforations and piezocision) to accelerate impacted canines' traction after opening the appropriate distance. | Procedure: Corticotomy<br>* Patients will be treated in conjunction with a surgical intervention using metal brackets with a straight-wire prescription. Corticotomy (alveolar perforation and piezocision) will induce acceleration in canine traction movement during the orthodontic treatment in only one group.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in the periodontal pocket depth (PPD) | The distance from the gingival margin to the base of the pocket of the first premolar, canine, and lateral incisor. | Time 1: immediately before the surgical exposure; Time 2: immediately at the end of the active treatment | 
| Changes in the gingival margin (GM) | The distance from the cementoenamel junction (CEJ) to the gingival margin of the first premolar, canine, and lateral incisor. | Time 1: immediately before the surgical exposure; Time 2: immediately at the end of the active treatment | 
| Changes in the width of the keratinized tissue (KT) | The distance from the gingival margin to the mucogingival junction of the first premolar, canine, and lateral incisor | Time 1: immediately before the surgical exposure; Time 2: immediately at the end of the active treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in the Gingival Index (GI) | The gingival status will be assessed using the following classification 0= Normal gingiva. Mild inflammation: slight color change, slight edema, No bleeding on probing. Moderate inflammation: redness, edema and glazing. Bleeding on probing. Severe inflammation: marked redness and edema. Tendency to spontaneous bleeding. Ulceration. | Time 1: immediately before the surgical exposure; Time 2: immediately at the end of the active treatment | 
| Changes in the Bleeding Index (BI) | The healthiness of the gingival margin and the attached gingivae will be assessed depending on the status of gingival inflammation. 0= No bleeding. Bleeding some seconds after probing. Bleeding immediately after probing. Bleeding on probing spreading towards the marginal gingiva. | Time 1: immediately before the surgical exposure; Time 2: immediately at the end of the active treatment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Impacted canine, accelerate canine traction, periodontal index, periodontal status