Deep Bite Correction Using Auxiliary Intrusion Cantilevers With Initial Archwires in Adolescents

Study Overview
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Brief Summary
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The purpose of this study was to determine the effect of auxiliary intrusion cantilevers used with resilient archwires during the leveling and alignment phase in intruding lower incisors.

Official Title
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Deep Bite Correction Using Auxiliary Intrusion Cantilevers With Initial Archwires in Adolescents

Conditions
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Deep Overbite

Intervention / Treatment
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* Device: Auxiliary cantilever intrusion arches on initial archwires
* Device: Routine leveling and alignment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Permanent dentition present except for third molars No history of previous orthodontic treatment. Class I or II malocclusion with minimal or no lower anterior crowding (<3 mm) Excessive overbite (>3 mm). Exclusion Criteria: Syndromic patients as well as individuals with skeletal asymmetry Endodontically treated or periodontally involved loweranterior teeth. Need for tooth extraction in the lower arch. Agenesis (except for third molars) Any kind of tooth/root shape anomaly

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 17 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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Auxiliary intrusion cantilevers<br>Patients received a full set of 0.022- inch slot brackets (Mini 2000, Ormco) with Roth prescription. Lower first molars received double tubed bands while 2nd molars received single bondable tubes. Leveling and alignment phase then started with 0.014 inch NiTi wires engaging all teeth and synched behind 2nd molars. Two 0.017 x 0.025 TMA (Ormco) sectional wires were attached to auxiliary tubes on 1st molars with tip back bends mesial to the molars and attached with hooks distal to lateral incisors on top of basal leveling arch wire. Amount of intrusive force was measured to range between 20 and 40 grams per side. Basal leveling arches were upgraded whenever needed. All patients were assessed after 6 months of treatment. | Device: Auxiliary cantilever intrusion arches on initial archwires<br>* Patients received a full set of 0.022- inch slot brackets (Mini 2000, Ormco) with Roth prescription. Lower first molars received double tubed bands while 2nd molars received single bondable tubes. Leveling and alignment phase then started with 0.014 inch NiTi wires engaging all teeth and synched behind 2nd molars. Two 0.017 x 0.025 TMA (Ormco) sectional wires were attached to auxiliary tubes on 1st molars with tip back bends mesial to the molars and attached with hooks distal to lateral incisors on top of basal leveling arch wire. Amount of intrusive force was measured to range between 20 and 40 grams per side. Basal leveling arches were upgraded whenever needed. All patients were assessed after 6 months of treatment.<br>|
| Active Comparator: Routine leveling and alignment<br>Patients received a full set of 0.022- inch slot brackets (Mini 2000, Ormco) with Roth prescription, 1st and 2nd molars received tubes or bands according to each patient's further needs Lower arch was leveled and aligned with sequential wires starting with 14 NiTi and upgraded when needed. All patients were assessed after 6 months of treatment. | Device: Routine leveling and alignment<br>* Patients received a full set of 0.022- inch slot brackets (Mini 2000, Ormco) with Roth prescription, 1st and 2nd molars received tubes or bands according to each patient's further needs Lower arch was leveled and aligned with sequential wires starting with 14 NiTi and upgraded when needed. All patients were assessed after 6 months of treatment.<br>* Other names: Relative Intrusion;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overbite | Distance between incisal edges of upper and lower incisors measured on lateral cephalometric x-rays | six months | 
| True incisor intrusion | Perpendicular distance between the center of resistance of mandibular central incisor and the mandibular plane measured on lateral cephalometric x-rays | six months | 
| Proclination of lower incisors | Angle formed by the long axis of mandibular central incisor and mandibular plane measured on lateral cephalometric x-rays | six months | 
| Lower incisor intrusion and proclination | Perpendicular distance between the incisal edge of the lower central incisor and mandibular plane measured on lateral cephalometric x-rays | six months | 
| Lower incisor intrusion | Perpendicular distance between the apex of the lower central incisor and mandibular plane measured on lateral cephalometric x-rays | six months | 
| Extrusion of lower first molar | Perpendicular distance between the mesio-buccal cusp tip of the lower first molar and mandibular plane measured on lateral cephalometric x-rays | six months | 
| Distal tip of lower first molar | Angle formed between the long axis of lower 1st molar and mandibular plane measured on lateral cephalometric x-rays | six months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Depth of curve of Spee | Measured on dental casts by summing the right and left side maximum depths from a flat plane formed by the tips of the mandibular incisors anteriorly and the distal cusp tips of the second molars posteriorly | six months | 
| Depth of gingival sulcus | The sulcus depth was measured using Michigan O periodontal probe. | six months | 
| Width of keratinized gingiva | Measured with the aid of periodontal probe from the free gingival margin to the mucogingival junction. | six months | 
| Root resorption of lower incisors | Length of lower incisor roots was compared in before- and after-periapical radiographs taken with a paralleling technique. | six months |