Evaluation of Treatment Duration of En-masse Versus Two Steps Retraction in Patients Having Maxillary Protrusion

Study Overview
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Brief Summary
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Brief summary: there's a scarcity in literature concerning time needed to retract anterior segment following premolars extraction. the purpose of this study is to determine, in orthodontic patients with maxillary protrusion, which form of technique of retraction offers a faster treatment duration of retraction : en-masse or two step techniques

Detailed Description
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Anterior segment retraction can be done in one of two ways: through En masse or two step techniques. Both are viable options, but, ideally, the investigator wanted to retract and complete the orthodontic treatment as quickly as possible, in order to decrease the negative effects that may occur during treatment. Which of these techniques results in a decreased treatment time is still up for debate.

Official Title
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Evaluation of Treatment Duration of En-masse Versus Two Steps Retraction in Patients Having Maxillary Protrusion: A Randomized Clinical Trial

Conditions
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Bimaxillary Protrusion

Intervention / Treatment
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* Procedure: En masse retraction
* Procedure: Two-Step retraction


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults and adolescent patients ( both gender) Age range (14- 24) patient with maxillary protrusion requiring first premolars extraction ( bimaxillary protrusion or class II division 1 cases) patients with fully erupted permanent teeth ( not necessarily including the third molar). cases required maximum anchorage during retraction. good general and oral health Exclusion Criteria: patients suffering from any systemic diseases interfering with tooth movement. patients with extracted or missing permanent teeth (except for third molars). patients with badly decayed teeth. patients with any parafunctional habits ( i.e. Bruxism, tongue thrusting, mouth breathing, etc.,.....) patients with previous orthodontic treatment

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 24 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: En masse retraction<br>six anterior teeth are retracted by en masse technique using a crimpable hook distal to upper lateral incisor and a power chain. | Procedure: En masse retraction<br>* Retraction stated on a 0.017''x 0.025'' Stainless steel wire using elastomeric chain ( force applied 200 g per side) extending between the crimpable hooks and the mini-screw.<br>|
| Experimental: two step retraction<br>six anterior teeth are retracted by two step technique by canine retraction followed by four anterior teeth retraction using a crimpable hook distal to upper lateral incisor and a power chain. | Procedure: Two-Step retraction<br>* Retraction of canine started on a 0.017''x0.025'' Stainless steel wire using elastomeric chain ( force applied 150 g per side) followed by anterior teeth retraction on 0.017''x0.025'' Stainless steel wire using elastomeric chain ( force applied 160 g per side) extending between crimpable hooks and the mini-screw.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to close extraction space | the antero-posterior movement of anterior teeth are assessed by monthly taken models and patient record sheets | from pre to post retraction ( an average of 10 - 12 months) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Anchorage loss | Digitalized dental models taken before and after completion of retraction will be measured by identifying landmarks and reference lines and planes ( measured in mm) | From pre to post retraction ( an average of 10- 12 months) | 
| pain of intervention | Each patient was informed to fill a questionnaire regarding treatment experience in Visual analogue scale scoring from (0 -10) 0 means no pain and 10 means severe pain | From pre to post retraction ( an average of 10 - 12 months) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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En-masse retraction, two step retraction, friction, retraction time, Dental models