Comparing Labial and Lingual Orthodontic Appliances on Root Resorption and Bone Height

Damascus University

Status: Completed

Conditions: Crowding of Anterior Maxillary Teeth; Crowding of Anterior Mandibular Teeth

Treatments: Procedure: Lingual brackets; Procedure: Buccal brackets

Study type: Interventional

Funder types: Other

Identifiers

NCT06401369

UDDS-Ortho-1-2024

Details and patient eligibility

About

Patients who have moderate crowding that could be treated on a non-extraction will be treated in this study. The apical root resorption and alveolar bone height of the lingual and labial fixed appliances will be assessed. All patients will receive a cone-beam computed tomography (CBCT) scan at two different times (T0: Before treatment, T1: After treatment).

There are two groups: The first group (Experimental): The patients in this group will be treated using Lingual Fixed Orthodontic Appliances. The second group (Control): The patients in this group will be treated using Labial Fixed Orthodontic Appliances.

Full description

Recently, the therapeutic results of lingual orthodontics have become similar to those produced by labial orthodontics. However, lingual appliances act differently. The application of force near the center of resistance and the distance between the lingual brackets leads to an increase in friction and, thus, an increase in the force applied during treatment. In addition, the contact of the lower incisors with the brackets of the upper incisors in the lingual technique can lead to the intrusion of these incisors. Therefore, these factors can be potential risks for apical root resorption and alveolar bone height in lingual orthodontics.

2D radiographs may not accurately depict the true amount of root resorption due to magnification errors and difficulties in obtaining repeatable images. Besides, conventional two-dimensional radiographs cannot accurately assess alveolar bone height in the anterior region. CBCT has proven to be valuable in diagnosing root resorption due to its capability to produce distortion-free images, as well as its ability to maintain a high level of reproducibility despite changes in tooth positions after treatment, with high sensitivity and specificity. On the other hand, the use of CBCT allows for an evaluation of alveolar bone height in the anterior region with high accuracy and precision.

Enrollment: 40 patients

Sex: All

Ages: 18 to 25 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Class I molar and canine relationships on both sides.
2. Moderate crowding of both arches of about 4 to 6 mm treated on a non-extraction basis.
3. Age from 18 to 25 years.
4. The presence of permanent dentition (except third molars).

Exclusion criteria

1. The existence of craniofacial syndromes, cleft lip and/or palate (soft and/or hard).
2. Skeletal or dental crossbite.
3. Patients with missing teeth or periodontal diseases.
4. Previous orthodontic treatment.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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40 participants in 2 patient groups

The lingual fixed orthodontic group (LA)

Experimental group

Description:

This group received treatment with lingual brackets with 0.018-inch slots (DTC Orthodontics, Hangzhou, China) applied with the aid of a special, indirect bonding technique, the "Modified HIRO® Technique." Individual lingual archwires (Forestadent®, Germany) were also used.

Treatment:

Procedure: Lingual brackets

The labial fixed orthodontic group (BA)

Active Comparator group

Description:

Patients in this group received treatment with labial appliances with 0.018-inch slots (American Orthodontics brackets, Mini Master series, MBT prescription) directly bonded on both arches. Prefabricated archwires (American Orthodontics, Sheboygan, WI, USA) were also used.

Treatment:

Procedure: Buccal brackets