Laser-assisted Flapless Corticotomy in Accelerating Canine Retraction

Study Overview
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Brief Summary
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Erbium lasers have been suggested to accomplish corticotomy without flap reflection due to their attractive advantages. The current trial aimed to evaluate the efficacy of laser-assisted flapless corticotomy in accelerating orthodontic tooth movement. The secondary aim was to evaluate the patients' responses to laser application. It was postulated that canine retraction after laser-assisted flapless corticotomy would be accomplished within a shorter period compared with the conventional canine retraction method, with no significant degree of pain and discomfort.

Detailed Description
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Comprehensive orthodontic treatment with fixed appliances usually takes more than 18 months in mild and severe cases. Prolonged treatment time can cause many adverse effects such as pain, discomfort, external root resorption, white spots and dental caries. Decreasing the treatment time for tooth movement has been the focus of both the clinicians and the patients. For the last few decades, investigators have recommended many treatment approaches intending to reduce overall treatment time such as low friction and self-ligating bracket systems, low-level laser irradiation, electrical currents, pharmacological approaches, local platelet-rich plasma (PRP) injection and surgical approaches like dentoalveolar distraction and selective alveolar decortication or corticotomy

Official Title
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Evaluation of the Efficacy of Laser-assisted Flapless Corticotomy in Accelerating Canine Retraction: A Split-mouth Randomized Controlled Clinical Trial

Conditions
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Class II Division 1 Malocclusion, Maxillary Prognathism, Protrusion, Incisor

Intervention / Treatment
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* Procedure: Er:YAG laser


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Class II division 1 patients requiring orthodontic treatment with fixed appliances and a need for upper first-premolar extraction using a two-step retraction technique. Permanent dentition with an age range from 16 to 24 years. Healthy with no systemic conditions. Adequate oral hygiene and healthy periodontal tissues no previous orthodontic treatment Absence of canine endodontic treatment. Exclusion Criteria: Bimaxillary dentoalveolar severe protrusion. Previous orthodontic treatment. Subject with psychological abnormalities. Subject with systemic diseases.

Ages Eligible for Study
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Minimum Age: 16 Years
Maximum Age: 26 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: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Laser-assisted corticotomy<br>Er:YAG laser beam was used to perform several perforations to the alveolar bone around the canine in one side of the mouth hoping that would accelerate canine retraction | Procedure: Er:YAG laser<br>* This application was made before the onset of canine retraction in one side of the mouth<br>|
| No Intervention: Traditional treatment<br>Canines in this group were retracted by the conventional manner. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in the canine retraction rate | The distance between the first molar labial hook and the canine bracket hook was recorded using Digital Boely gauge and then this distance was divided by the time that passed between two assessment points. | 10 minutes after laser application, one, two, four, 8 and 12 weeks after laser application | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in the levels of pain and discomfort | A questionnaire was administered at the 1st, 3rd, 5th and 7th day after laser application. The questionnaire contained 5 questions (using 4-point Likert ordinal scales) to collect patients' responses on the following questions: Question 1: Do you feel pain during eating? Question 2: Do you feel pain during the day? Question 3: Do you feel pain that can awaken you during the night? Question 4: Do you feel swollen on the surgical side? The possible answers were: 1. No 2.Mild 3.Moderate 4. Severe For the first four questions, the higher the score, the worse the feeling was. Question 5: Which one of the following has caused more discomfort to you? 1. Extraction of premolars 2. Laser application 3.Both | at the 1st day following laser application (10 minutes) and at the 3rd, 5th and 7th days following laser application | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Tooth movement, Acceleration of tooth movement, Er:YAG laser-assisted corticotomy