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A Weekly Assessment of Canine Retraction with Elastomeric Chains and Nickel-Titanium Coil Springs Using Dental Monitoring Technology: A Split-Mouth Randomized Clinical Trial
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26-046-2
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A Weekly Assessment of Canine Retraction with Elastomeric Chains and Nickel-Titanium Coil Springs Using Dental Monitoring Technology: A Split-Mouth Randomized Clinical Trial
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Dr. Flavio Uribe
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Rationale for this study: The proposed study aims to fill a gap in the current literature by providing a high-resolution analysis of weekly canine retraction using dental monitoring technology. Conducting a study that directly measures tooth movement on a weekly basis would fill this critical gap by providing high-frequency data on the progression of space closure. Previous studies have evaluated the effectiveness of elastomeric chains and NiTi coil springs in space closure, but they have primarily relied on periodic in-office measurements, which may not capture the dynamic nature of tooth movement. By incorporating remote monitoring, this study will enable a more precise assessment in 3D of tooth displacement over time, offering insights into the behavior of tooth movement with different systems. Such an approach would allow for a more precise understanding of the short-term effects of different force delivery systems, force decay patterns, and biological variability, ultimately improving the evidence base for clinical decision-making in orthodontics. Canine retraction is a fundamental phase of orthodontic treatment, especially after premolar extraction. Two primary methods used are nickel-titanium (NiTi) coil springs and elastomeric chains, which differ in biomechanical efficiency and force degradation. Despite their widespread use, there is a lack of high-frequency clinical data describing the weekly pattern of tooth movement and molar anchorage loss using these systems. Study Design: This is a split-mouth randomized clinical trial. Each patient receives NiTi coil spring retraction on one side and elastomeric chain retraction on the other. Tooth movement is measured both in-clinic (iTero® Lumina™ scanner) and remotely (DM app) over 12-13 weeks. Study Population and Sample Size: A total of 20 orthodontic patients, aged 18-45 years, requiring bilateral maxillary first premolar extractions will be recruited from the UConn Health orthodontic clinic. Power analysis based on prior data supports this sample size. Major Study Interventions: All participants receive standard orthodontic treatment. At the start of the study (T0), retraction force of 150g is applied to the maxillary canines using NiTi coil springs on one side and elastomeric chains on the other (randomized). Intraoral digital scans are captured at T0, T1 (4-5 weeks), T2 (8-9 weeks), and T3 (12-13 weeks). Weekly at-home DM scans are also submitted by patients using the ScanBox and app. Hypotheses, Aims, and Objectives: Hypothesis: Null Hypothesis Primary Outcome: Weekly rate of canine retraction evaluated in 3D with 6 degrees of freedom. There is no significant difference in the weekly rate of canine retraction and in all 3 dimensions between nickel-titanium (NiTi) coil springs and elastomeric chains as measured using DM technology. Secondary Outcome: Weekly movement rate of maxillary molar displacement in 3D evaluated with 6 degrees of freedom, plaque accumulation and oral hygiene status. There is no significant difference in the magnitude of molar displacement in 3D evaluated with 6 degrees of freedom. There is no difference in plaque accumulation and oral hygiene status between NiTi coil springs and elastomeric chains. Alternative Hypothesis There is a significant difference in the weekly rate of canine retraction evaluated in 3D with 6 degrees of freedom between nickel-titanium (NiTi) coil springs and elastomeric chains as measured using Dental Monitoring technology. Aims/objectives: To compare the weekly rate of canine retraction evaluated in 3D with 6 degrees of freedom between NiTi coil springs and elastomeric chains using Dental Monitoring technology. To compare the weekly rate of molar displacement evaluated in 3D with 6 degrees of freedom between NiTi coil springs and elastomeric chains using Dental Monitoring technology. To compare plaque accumulation and oral hygiene status with NiTi coil springs versus elastomeric chains.
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Dental, Including Mouth
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Check with study contact
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Behnoosh Hormozi. Telephone: 860-679-2550. Email: hormozi@uchc.edu
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Enrolling/recruiting. For current recruitment status, please check with study contact.
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