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Class II Division 1 MalocclusionNCT05040945

Evaluation of the Levels of Pain and Discomfort Associated With Two Techniques of Corticotomy

A study testing Traditional corticotomy and Flapless corticotomy in people with Class II Division 1 Malocclusion, run by Damascus University at 1 site in Syria.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study aims to estimate the levels of pain and discomfort associated with the en-masse retraction of the six upper anterior teeth and assisted by either conventional or flapless corticotomy. Read more about this study

Who is it for?
Ages 18 to 30 years
Conditions the study is for
Class II Division 1 Malocclusion
What is being tested?
Traditional corticotomy and Flapless corticotomy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
34 participants
Where
1 siteSyria
Study dates
15 Feb 2018to 15 May 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 30 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Age range between 18 and 30 years.
  • Class II division 1 malocclusion requiring extraction of upper first premolars.
  • Mild to moderate skeletal class II malocclusion.
  • Normal or excessive anterior facial height.
  • No or mild crowding (tooth-size arch-length discrepancy ≤3 mm).
  • Overjet >5 mm and <10 mm.
Show all 10Show fewer
  • Completion permanent dentition (regardless of third molars).
  • No previous orthodontic treatment.
  • No drug use or systematic disease that would affect the bone and tooth movement rate.
  • Healthy periodontium and good oral hygiene.

Who cannot join

  • Patients with previous orthodontic treatment.
  • Patients with severe skeletal dysplasia in all three dimensions.
  • Patients suffer from systemic diseases or syndromes
  • Patients on medication for systemic disorders, pregnancy or steroid therapy.
  • Patients showing any signs of active periodontal disease
  • Patients with severe crowding (≥ 3.5 mm) in maxillary arch
  • Patients with missing or extracted teeth in maxillary arch except third molar.

Trial locations and contacts

1 site in 1 country.

Syria1 site
  • Department of Orthodontics, University of Damascus Dental School

    Damascus

Other trials in Syria

About this study

Official title: Evaluation of the Levels of Pain and Discomfort Associated With Traditional or Flapless Corticotomy-assisted Maxillary En-masse Retraction: a Single- Center, Randomized Controlled Clinical Trial

This study aims to estimate the levels of pain and discomfort associated with the en-masse retraction of the six upper anterior teeth and assisted by either conventional or flapless corticotomy.

Thirty-four adult patients exhibiting class П division 1 malocclusion will be randomly allocated to either the conventional corticotomy group or the flapless corticotomy group, and they will be treated by extraction of maxillary first premolars with applying mini-screws between maxillary second premolar and first molar as temporary skeletal anchorage devices (TSADs). The levels of pain and discomfort will be rated after 24 hours of corticotomy (T1), four days (T2), seven days (T3), 14 days (T4) and after 28 days of corticotomy, by asking the patients to fill in a questionnaire for assessing levels of pain and discomfort.

Read the detailed description

Increasing the treatment duration is one of the most important difficulties facing the orthodontist. Several therapeutic procedures accompanying orthodontic treatment have been introduced in order to reduce the treatment duration and the most important one is the corticotomy. Although traditional corticotomy proved to be effective in accelerating different types of tooth movement, it is considered aggressive in nature. Hence, there is an interest to develop minimally invasive surgical techniques. These techniques include the flapless corticotomy using the piezosurgery device.

In flapless corticotomy group, vertical soft-tissue incisions will be made on the buccal and palatal gingiva. One incision will be made between the roots of the six upper anterior teeth, and two incisions will be made between the upper canines and second premolars. The incisions will be 5 mm long and started 4 mm apical to the interdental papilla. Then a piezosurgery knife will be inserted to perform the cortical alveolar incisions with 3-mm in-depth and 8-mm in length. No suturing will be needed.

In traditional corticotomy group, a full-thickness mucoperiosteal flap will be elevated, extended from the distal side of the second premolar on the right side to the same position on the left side without performing any vertical releasing incisions. The full-thickness flap will be extended 3 mm above the root apices, from the buccal and palatal sides. Then, one vertical incision between the roots of upper anterior teeth and two vertical incisions in the site of first premolar extraction will be made by the piezosurgery knife. The vertical incisions will be connected by a horizontal incision using the piezosurgery knives. The vertical incisions will be 3 mm in depth, starting 2-3 mm apical to the alveolar crest, and extending 3 mm beyond the root apices. The interrupted technique of suturing will be done using a non-absorbent 3-0 black silk.

The levels of pain and discomfort will be rated after 24 hours of corticotomy (T1), four days (T2), seven days (T3), 14 days (T4) and after 28 days of corticotomy, by asking the patients to fill in a questionnaire based on the Visual Analogue Scale (VAS), and patient's responses will be obtained regarding their feelings of pain, discomfort, swelling, mastication and swallowing difficulties, jaw movement restriction, satisfaction and recommend the procedure to a friend.

Being tested
Traditional corticotomy, Flapless corticotomy
Keywords
Pain and discomfort, En-masse, Class II division 1, Extraction, Tooth movement acceleration, Traditional corticotomy, Fapless corticotomy, Mini-screws
Medical subject headings
Malocclusion, Angle Class II, Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Traditional corticotomyProcedure or surgery

    Adult patients will be treated by extraction of maxillary first premolars with applying mini-screws between maxillary second premolar and first molar as temporary skeletal anchorage devices (TSADs). Then en-masse retraction associated with traditional corticotomy will be applied.

  • Flapless corticotomyProcedure or surgery

    Adult patients will be treated by extraction of maxillary first premolars with applying mini-screws between maxillary second premolar and first molar as temporary skeletal anchorage devices (TSADs). Then en-masse retraction associated with flapless corticotomy will be applied.

Study groups in NCT05040945
Study groupRoleWhat they receive
Traditional corticotomyActive comparatorAdult patients will be treated by en-masse retraction associated with traditional corticotomy
Receives: Procedure: Traditional corticotomy
Flapless corticotomyExperimentalAdult patients will be treated by en-masse retraction associated with flapless corticotomy
Receives: Procedure: Flapless corticotomy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in the levels of pain perception

    Assessment will be performed using questionnaires via Visual Analog Scale (VAS) for each question.The scale has a minimum scale of 0 (no pain) and a maximum scale of 100 (maximum pain).

    Measured: Levels of pain perception will be assessed at: 24 hours following the surgical intervention (T1), 4 days (T2), one week (T3), two weeks (T4), and four weeks (T5) following the surgical intervention

  2. Change in the levels of discomfort perception

    Assessment will be performed using questionnaires via Visual Analog Scale (VAS) for each question.The scale has a minimum scale of 0 (no discomfort) and a maximum scale of 100 (maximum discomfort)

    Measured: Levels of discomfort perception will be assessed at: 24 hours following the surgical intervention (T1), 4 days (T2), one week (T3), two weeks (T4), and four weeks (T5) following the surgical intervention

Secondary outcomes (7)
  1. Change in the levels of swelling perception

    Assessment will be performed using questionnaires via Visual Analog Scale (VAS) for each question

    Measured: This outcome will be assessed at: 24 hours following the surgical intervention (T1), 4 days (T2), one week (T3), two weeks (T4), and four weeks (T5) following the surgical intervention

  2. Change in the levels of mastication difficulty perception

    Assessment will be performed using questionnaires via Visual Analog Scale (VAS) for each question

    Measured: This outcome will be assessed at: 24 hours following the surgical intervention (T1), 4 days (T2), one week (T3), two weeks (T4), and four weeks (T5) following the surgical intervention

  3. Change in the levels of swallowing difficulty perception

    Assessment will be performed using questionnaires via Visual Analog Scale (VAS) for each question

    Measured: This outcome will be assessed at: 24 hours following the surgical intervention (T1), 4 days (T2), one week (T3), two weeks (T4), and four weeks (T5) following the surgical intervention

  4. Change in the levels of Jaw movement restriction perception

    Assessment will be performed using questionnaires via Visual Analog Scale (VAS) for each question

    Measured: This outcome will be assessed at: 24 hours following the surgical intervention (T1), 4 days (T2), one week (T3), two weeks (T4), and four weeks (T5) following the surgical intervention

  5. The levels of satisfaction

    Assessment will be performed using questionnaires via Visual Analog Scale (VAS) for each question

    Measured: This outcome will be assessed after four weeks following the surgical intervention

  6. Which surgical intervention is more troublesome

    Assessment will be performed using a three-point scale:

    1. premolar extraction.
    2. Corticotomy procedure.
    3. Both of them are similar.

    Measured: This outcome will be assessed after four weeks following the surgical intervention

  7. Recommendation of the procedure to a friend

    Assessment will be performed using a two-point scale to answer yes or no

    Measured: This outcome will be assessed after four weeks following the surgical intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Sep 2021
  2. Study start15 Feb 2018
  3. Primary completion31 Jul 2018
  4. Study completion15 May 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
34 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05040945
Sponsor's protocol ID
UDDS-Ortho-08-2021
Status last verified
Sep 2021
First submitted
2 Sep 2021
Last updated
10 Sep 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Al-Sibaie S, Hajeer MY. Assessment of changes following en-masse retraction with mini-implants anchorage compared to two-step retraction with conventional anchorage in patients with class II division 1 malocclusion: a randomized controlled trial. Eur J Orthod. 2014 Jun;36(3):275-83. doi: 10.1093/ejo/cjt046. Epub 2013 Jun 20.

    PubMed 23787192
  • Khlef HN, Hajeer MY, Ajaj MA, Heshmeh O. En-masse Retraction of Upper Anterior Teeth in Adult Patients with Maxillary or Bimaxillary Dentoalveolar Protrusion: A Systematic Review and Meta-analysis. J Contemp Dent Pract. 2019 Jan 1;20(1):113-127.

    PubMed 31058623
  • Alfawal AMH, Hajeer MY, Ajaj MA, Hamadah O, Brad B, Latifeh Y. Evaluation of patient-centered outcomes associated with the acceleration of canine retraction by using minimally invasive surgical procedures: A randomized clinical controlled trial. Dent Med Probl. 2020 Jul-Sep;57(3):285-293. doi: 10.17219/dmp/120181.

    PubMed 32909702
  • Gibreal O, Hajeer MY, Brad B. Evaluation of the levels of pain and discomfort of piezocision-assisted flapless corticotomy when treating severely crowded lower anterior teeth: a single-center, randomized controlled clinical trial. BMC Oral Health. 2019 Apr 16;19(1):57. doi: 10.1186/s12903-019-0758-9.

    PubMed 30991984
  • Khlef HN, Hajeer MY, Ajaj MA, Heshmeh O, Youssef N, Mahaini L. The effectiveness of traditional corticotomy vs flapless corticotomy in miniscrew-supported en-masse retraction of maxillary anterior teeth in patients with Class II Division 1 malocclusion: A single-centered, randomized controlled clinical trial. Am J Orthod Dentofacial Orthop. 2020 Dec;158(6):e111-e120. doi: 10.1016/j.ajodo.2020.08.008. Epub 2020 Nov 4.

    PubMed 33158633

Questions about this trial

What is this clinical trial studying?

A study testing Traditional corticotomy and Flapless corticotomy in people with Class II Division 1 Malocclusion, run by Damascus University at 1 site in Syria.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 Sep 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Syria. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in the levels of pain perception (time frame: Levels of pain perception will be assessed at: 24 hours following the surgical intervention (T1), 4 days (T2), one week (T3), two weeks (T4), and four weeks (T5) following the surgical intervention). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05040945, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Sep 2021.

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