Single Versus Repeated Piezocision-assisted Orthodontic Tooth Movement

Study Overview
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Brief Summary
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The primary aim of the study is to evaluate the effect of single and repeated piezocisions on the rate of orthodontic tooth movement. Secondary aims are to evaluate the effect of both protocols on molar anchorage loss, as well as on canine root resorption.

Official Title
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Single Versus Repeated Piezocision-assisted Orthodontic Tooth Movement: a Randomized Controlled Clinical Trial

Conditions
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Orthodontic Tooth Movement, Canine Retraction

Intervention / Treatment
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* Procedure: Single Piezocision
* Procedure: Repeated Piezocision


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Malocclusion that requires at least the extraction of maxillary first premolars, such as Class I bimaxillary protrusion, and Class II division 1 cases. Normal shape and structure of the maxillary canines, with no history of root canal treatment Exclusion Criteria: Patients who underwent previous orthodontic treatment. Patients currently receiving drug therapy that may affect orthodontic tooth movement, e.g. hormonal therapy and corticosteroids.

Ages Eligible for Study
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Minimum Age: 15 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: Single Piezocision<br> | Procedure: Single Piezocision<br>* Piezocision will be performed only once before the onset of canine retraction (T0) on one side of the maxillary arch that will be randomly chosen.<br>|
| Experimental: Repeated Piezocision<br> | Procedure: Repeated Piezocision<br>* Piezocision will be repeated three times, on a monthly basis (T0, T1, and T2), over the 12-week study period.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measurement of canine retraction | Several landmarks will be identified on the dental arch, including the mid-palatal raphe, the most medial points on the third right and left rugae, and the cusp tips of the right and left maxillary canines. Perpendicular lines will be drawn from the medial points of the right and left third rugae, and the cusp tips of the right and left maxillary canines to the mid-palatal raphe. The antero-posterior measurements will be carried out between the canine lines and the third rugae lines bilaterally, to assess the rate of canine retraction. | 12 weeks | 
| Measurement of molar anchorage loss | Perpendicular lines will be drawn from the central fossae of both maxillary right and left first molars to the mid-palatal raphe. Consequently, molar anchorage loss will be calculated by measuring the distance between those lines, and the lines representing the third rugae as previously mentioned. | 12 weeks | 
| Measurement of canine root resorption | Root resorption of the maxillary canines will be evaluated and measured by comparing pre-retraction and post-retraction CBCT scans. | 12 weeks |