Leveling and alignment time and the periodontal status in patients with severe upper crowding treated by corticotomy-assisted self-ligating brackets in comparison with conventional or self-ligating brackets only: a 3-arm randomized controlled clinical trial

Background No previous trial (randomized and controlled) studied the levels of pain, discomfort, and acceptability associated with acceleration of dental movement during orthodontic treatment using corticision. The purpose of this study is to compare the pain, discomfort, ease of procedure, patient satisfaction, and analgesic use during corticision-assisted (without extraction) decrowding of the lower anterior teeth with the traditional orthodontic method. Materials and Methods Fifty-two patients (38 females, 14 males; mean age: 21.38 ± 1.05) were randomly distributed into two groups: the corticision group (CORT, n=26) and the control group (CONT, n=26). Corticision was applied by a surgical blade and a hammer at three anterior regions on the lower jaw using three radiological guides. The levels of pain, discomfort, swelling and chewing difficulties were registered on a visual analog scale (VAS) at one, seven, and 14 days after applying the first wire (0.14-inch NiTi archwire). Questionnaires were administered to assess the level of satisfaction, ease of the procedure, and the number of analgesics patients took. Mann-Whitney U tests were used to detect significant differences between the two groups. The Chi-Square test was used to study the significance of differences in taking analgesics during the first week of treatment. Results One day following the intervention, there were no statistically significant differences between the two groups concerning pain levels, discomfort, and difficulties of mastication (P=0.293, P=0.166, P=0.538; respectively), but there was a statistically significant difference in the perceived swelling (P=0.012). On the seventh and 14th days of assessment, there were no statistically significant differences between the two groups regarding the previous variables. In the CORT group, the proportion of patients who were satisfied with treatment was approximately 94%, the proportion of those who found the treatment easy was 96%, 84% of patients wanted to repeat the procedure, and 92% of them would recommend this procedure to a friend. Conclusions There were no statistically significant differences in pain perception, discomfort, difficulties with mastication, and analgesic consumption between the interventional group and the control group. The perception of swelling was greater in the experiment group (the corticision group) at 24 hours following the first archwire engagement, and then it gradually decreased. Patients in both groups showed high levels of satisfaction following leveling and alignment. Those in the experimental groups showed a high level of willingness to undergo the same procedure again and a high level to recommend this procedure to a friend.

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Evaluation of Perceived Pain, Discomfort, Functional Impairments, and Satisfaction When Relieving Crowded Lower Anterior Teeth in Young Adult Patients Using Corticision-Assisted Fixed Orthodontic Treatment: A Randomized Controlled Trial

Sirri¹,

Burhan²,

Hajeer³

et al. 2022

“…The characteristics of the eight included studies are mentioned in Table 3 . The studies included in this systematic review consist of seven RCTs [ 25 , 33 - 39 ] and one controlled clinical trial (CCT) [ 40 ]. The total number of patients included in all studies was 339, aged between 12.9 and 34 years.…”

Section: Reviewmentioning

confidence: 99%

“…[ 13 - 20 ]. In addition, numerous studies have investigated the effect of self-ligating brackets in accelerating teeth movements [ 21 - 25 ]. Many have shown that using self-ligating brackets shortens the treatment duration [ 23 - 25 ].…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Accelerating Orthodontic Tooth Movement by Combining Self-Ligating Brackets With One or More Acceleration Methods: A Systematic Review

Al-Ibrahim¹,

Hajeer²,

Burhan³

et al. 2022

This review aimed to evaluate the effectiveness of using one or more acceleration methods with self-ligating brackets to accelerate orthodontic tooth movement in adults and the associated effects of these interventions. An electronic search of the following databases (PubMed, Scopus, Google Scholar, EMBASE) was performed (From January 1990 to November 2021). ClinicalTrials.gov and the International Clinical Trials Registry Platform were also electronically searched to find any unpublished studies and ongoing trials. The selected randomized controlled trials (RCTs) involved adult patients treated using self-ligating brackets combined with one or more acceleration methods compared with self-ligating brackets or conditional brackets alone. The risk of bias was assessed using Cochrane’s risk of bias tool. A total of seven RCTs and one controlled clinical trial (CCT) were included in this review. Combining self-ligating brackets with flapless corticotomy, low-level laser therapy (LLLT), and infrared light accelerated orthodontic movement by 43% and 50% for surgical methods, 20-50% for LLLT, and 22% for infrared light. Regarding side effects on periodontal tissues, neither flapless corticotomy nor low-frequency vibrational forces caused any damage. Combining self-ligating brackets and flapless corticotomy, low-level laser, or infrared light effectively accelerated orthodontic movement by 20% to 50 %. In contrast, the combination of self-ligating brackets with vibrational forces did not affect speeding tooth movement. The acceleration methods did not have any side effects on the periodontal tissues, but the available evidence was insufficient. There is a need for further primary research regarding the effectiveness of combining self-ligating brackets with acceleration methods and the possible untoward side effects.

“…The complete correction of Class III deformities is time-consuming. In general, many interventions have been proposed to accelerate the orthodontic movement, including surgical methods [ 16 ], physical methods [ 17 ], mechanical methods [ 18 , 19 ], or injection of some biological factors [ 20 ]. Traditionally, sagittal skeletal discrepancies used to be treated by functional appliances without applying any acceleration methods.…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Assessment of the Temporomandibular Joint Changes Following Reversed Twin Block Therapy of Patients With Skeletal Class III Malocclusion in Conjunction With the Photobiomodulation Therapy: A Randomized Controlled Clinical Trial

Khwanda¹,

Burhan²,

Hajeer³

et al. 2022

Background: Despite the positive effect of the photobiomodulation therapy (PBMT) application on animals, the primary role of this technique on the human condyle is still unclear. Several experimental reports have shown the efficacy of PBMT in inducing cellular changes in the temporomandibular joint (TMJ) region during functional treatment of patients with skeletal deformities. Still, the lack of information about its effects on human condyles requires further studies. Objectives: This study aimed to evaluate the effect of PBMT on the TMJ components following Class III treatment with the reversed twin block (RTB) appliance in growing patients. Materials and Method: Forty children (12 females, 28 males) between the age of nine and eleven years with skeletal Class III were assigned randomly to the RTB group with photobiomodulation (RTB+PBMT) or the control group (RTB). The PBMT was applied to the TMJ region using an 808-nm wavelength Ga-Al-As semiconductor laser device with 5 Joules/cm 2 energydensity on days 1, 3, 7, and 14 of the first month. Afterwards, the irradiation was conducted every 15 days until the end of the treatment. Cone-beam computerized tomography (CBCT) images were taken before (T1) treatment and following the end of treatment (T2) to assess TMJ and skeletal changes. Results: Condylar volume was significantly increased in the RTB group only by a mean of 287.97 mm 3 (p<0.001). The significantly backward and upward condylar movement was observed in the RTB and RTB+PBMT groups (superior joint space (SJS): 0.26 mm, 0.15 mm; posterior joint space (PJS): 0.42mm, 0.11mm, respectively). The RTB group showed the most remarkable changes. Significant improvement of the sagittal maxilla-mandibular relationship was greater in the RTB+PBMT group compared to the RTB group (p=0.02). Conclusion: There were no considerable differences in the condylar position after Class III treatment between the RTB and the RTB+PBMT groups. But a difference in the condylar volume was noticed between the two group.