Comparison Between Lingual and Labial Fixed Orthodontic Appliances in the Treatment of Crowding Cases

Study Overview
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Brief Summary
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Patients who have moderate crowding that could be treated without extraction will be treated in this study using either lingual or labial fixed orthodontic appliances. All patients will receive a cone-beam computed tomography (CBCT) scan in two different times (T0: before treatment, T1: after treatment). The dentoalveolar changes will be assessed.

Detailed Description
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Lingual orthodontic appliances provide an ultimate esthetic solution for patients who do not want visible orthodontic appliances. Recently, lingual orthodontic treatment outcomes have become similar and comparable to those produced with labial orthodontic treatment. However, placement of orthodontic brackets on the lingual surfaces of teeth causes changes in their morphology, which results in articulation problems, chewing difficulties, tongue irritation and other impairments. In this respect, the main difference between the labial and lingual techniques is the distance between the point of application of the force that is transmitted through the bracket and the centre of resistance of the tooth. Consequently, the displacement and stress induced in bone by these two techniques will also differ, and these need to be evaluated so that useful comparisons can be made between these two techniques. Patients who have moderate crowding that could be treated without extraction will be treated in this study using either lingual or labial fixed orthodontic appliances. All patients will receive a cone-beam computed tomography (CBCT) scan in two different times (T0: before treatment, T1: after treatment). The dentoalveolar changes will be assessed.

Official Title
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Assessment of Dentoalveolar Changes Resulting From Orthodontic Treatment of Crowding With Fixed Lingual Orthodontic Appliances Versus Fixed Labial Orthodontic Appliances. 'A Clinical Randomized Controlled Trial

Conditions
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Crowding

Intervention / Treatment
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* Device: Lingual appliances
* Device: Labial appliances


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Class I malocclusion. Moderate crowding in the dental arch (3 to 5-mm tooth-size arch-length discrepancy). Exclusion Criteria: Inappropriate oral hygiene and periodontal diseases. Previous orthodontic treatment. Craniofacial syndromes, cleft lip and/or palate (soft and/or hard). Subject with systemic diseases.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 25 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 |
| --- | --- |
| Experimental: Lingual appliances AO®<br>Patients with moderate crowding will be treated without extraction using lingual fixed appliances from American Orthodontics company. | Device: Lingual appliances<br>* Patients with moderate crowding will be treated without extraction using lingual appliances.<br>|
| Experimental: Labial appliances AO®<br>Patients with moderate crowding will be treated without extraction using labial fixed appliances from American Orthodontics company. | Device: Labial appliances<br>* Patients with moderate crowding will be treated without extraction using labial appliances.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dentoalveolar changes after crowding treatment | Dentoalveolar changes before and after crowding treatment will be evaluated using CBCT. | Changes will be evaluated before and after crowding treatment which will take approximately 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ABO- Objective Grading System | Objective grading system phase III examination will be done to systematically grade post treatment records. The ABO-OGS contains eight criteria: alignment, marginal ridges, buccolingual inclination, occlusal relationships, occlusal contacts, overjet, interproximal contacts and root angulation. Patients will be deducted for any discrepancy from ideal as described by the ABO. Every case that loses 30 or fewer points generally receives a passing grade for the ABO phase III examination. | After treatment completion, an average of 1 year | 
| Change in oral health related quality of life | Patients in both groups will be given a questionnaire to be filled. The questionnaire to be used is called Oral-Health-Impact-Profile with 14 items (OHIP-14) which can be filled in 3 minutes. OHIP-14 includes a subjective evaluation of the individual's oral health, functional well being, emotional well being, expectations and satisfaction with care and sense of self. | (1) at the beginning of the treatment, (2) after week, (3) after 2 weeks, (4) after 4 weeks, (5) after 6 months, (6) after treatment completion, an average of 1 year. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Fixed appliances, labial appliances, lingual appliances