Miniscrews as Anchorage Device for Orthodontic Treatment

NCT ID: NCT02644811

Last Updated: 2019-02-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-11-30

Study Completion Date

2018-09-21

Brief Summary

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The purpose of this trial is to study and compare two different anchorage techniques. Adolescent patients in need for orthodontic treatment are randomized into Group A and B. Both groups are treated with extractions of the maxillary first premolars and fixed appliance. Anchorage is reinforced by miniscrews in Group A and by molarblock in Group B.

The hypotheses are:

* that placement of miniscrews does not cause more pain or discomfort than premolar extractions
* that molarblock provides increase of anchorage
* that miniscrews have a better anchorage capacity than molarblock
* that miniscrews are more cost-efficient than conventional anchorage techniques

Detailed Description

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Participants are recruited from the orthodontic specialist clinic in Gävle, Sweden. After informed consent participants are randomized into Group A and B. The treatment starts with extractions of the maxillary first premolars. Extractions are performed by the participants´ general practitioner. Orthodontic treatment starts after the tooth extractions.

All participants get treatment with fixed appliance according to the straight wire concept (3M Victory brackets, .022 slot size, McLaughlin-Bennet-Trevesi prescription). The recommended wire sequence is: .016 Heat Activated Nickel Titanium, .019x.025 Heat Activated Nickel Titanium, .019x.025 Stainless Steel. Treatment time is about two years.

The following measurements are taken at:

T0 (Before treatment start): Study models, baseline questionnaire,

T1 (after tooth extractions, before the orthodontic treatment): Study models, cephalographic x-ray, questionnaire at the evening after tooth extractions, questionnaire one week after tooth extractions.

T2 (After miniscrew placement (Group A), Before space closure): Study models, cephalographic x-ray, questionnaire at the evening after miniscrew placement, questionnaire one week after miniscrew placement.

T3 (After space closure and miniscrew removal): Study models, cephalographic x-ray, questionnaire after screw removal

Conditions

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Orthodontic Anchorage Procedures Orthodontic Space Closure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Group A - Miniscrews

Topical anesthesia (buccal and palatal) followed by local anesthesia (buccal and palatal). Extraction of the maxillary first premolars.

Fixed appliance in the maxilla or maxilla and mandible.

Anchorage reinforcement with miniscrews (Spider Screw K1 short neck). Miniscrews are placed buccally between the maxillary second premolar and the first molar after topical anesthesia (buccal) and injection (buccal). Miniscrews are placed when space closure starts. Space closure is performed as en masse retraction. Miniscrew are immediately loaded with 150g Nickel Titanium coil springs.

Group Type EXPERIMENTAL

Topical anesthesia (buccal and palatal)

Intervention Type DRUG

Saliva is removed with a sterile swab followed by application of 5% Lidocaine gel (APL, Sweden) on the gingiva.

Local anesthesia (buccal and palatal)

Intervention Type DRUG

Injection of 1,5 ml Xylocaine Dental Adrenaline (Lidocaine hydrochloride 20 mg/ml, adrenaline 12.5 µg/ml, Dentsply Pharmaceutical, Weybridge, Surrey, UK).

Extraction of the maxillary first premolars

Intervention Type PROCEDURE

Careful extraction of the maxillary first premolars after mobilization.

Topical anesthesia (buccal)

Intervention Type DRUG

Saliva is removed with a sterile swab followed by application of 5% Lidocaine gel (APL, Sweden) on the gingiva.

Local anesthesia (buccal)

Intervention Type DRUG

Injection of 0.3 ml Xylocaine Dental Adrenaline (Lidocaine hydrochloride 20 mg/ml, adrenaline 12.5 µg/ml, Dentsply Pharmaceutical, Weybridge, Surrey, UK).

Spider Screw K1 short neck

Intervention Type DEVICE

The Spider Screw K1 (Health Development Company, Sarcedo, Italy) is a self-drilling and self-tapping screw. Short neck screws (SCR-1508 and SCR-1510) with a diameter of 1.5 mm and length 8 or 10 mm are used.

Group B - Molarblock

Topical anesthesia (buccal and palatal) followed by local anesthesia (buccal and palatal. Extraction of the maxillary first premolars.

Fixed appliance in the maxilla or maxilla and mandible.

Anchorage reinforcement with molarblocks - a Stainless steel ligature connecting the maxillary second premolar with the maxillary first and second molar. Molarblocks are installed from the beginning of leveling and alignment. Space closure is performed as en masse retraction with type one active tie-backs.

Group Type ACTIVE_COMPARATOR

Topical anesthesia (buccal and palatal)

Intervention Type DRUG

Saliva is removed with a sterile swab followed by application of 5% Lidocaine gel (APL, Sweden) on the gingiva.

Local anesthesia (buccal and palatal)

Intervention Type DRUG

Injection of 1,5 ml Xylocaine Dental Adrenaline (Lidocaine hydrochloride 20 mg/ml, adrenaline 12.5 µg/ml, Dentsply Pharmaceutical, Weybridge, Surrey, UK).

Extraction of the maxillary first premolars

Intervention Type PROCEDURE

Careful extraction of the maxillary first premolars after mobilization.

Molarblock

Intervention Type DEVICE

Molarblock is a Stainless steel ligature connecting the maxillary second premolar with the maxillary first and second molar.

Interventions

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Topical anesthesia (buccal and palatal)

Saliva is removed with a sterile swab followed by application of 5% Lidocaine gel (APL, Sweden) on the gingiva.

Intervention Type DRUG

Local anesthesia (buccal and palatal)

Injection of 1,5 ml Xylocaine Dental Adrenaline (Lidocaine hydrochloride 20 mg/ml, adrenaline 12.5 µg/ml, Dentsply Pharmaceutical, Weybridge, Surrey, UK).

Intervention Type DRUG

Extraction of the maxillary first premolars

Careful extraction of the maxillary first premolars after mobilization.

Intervention Type PROCEDURE

Topical anesthesia (buccal)

Saliva is removed with a sterile swab followed by application of 5% Lidocaine gel (APL, Sweden) on the gingiva.

Intervention Type DRUG

Local anesthesia (buccal)

Injection of 0.3 ml Xylocaine Dental Adrenaline (Lidocaine hydrochloride 20 mg/ml, adrenaline 12.5 µg/ml, Dentsply Pharmaceutical, Weybridge, Surrey, UK).

Intervention Type DRUG

Molarblock

Molarblock is a Stainless steel ligature connecting the maxillary second premolar with the maxillary first and second molar.

Intervention Type DEVICE

Spider Screw K1 short neck

The Spider Screw K1 (Health Development Company, Sarcedo, Italy) is a self-drilling and self-tapping screw. Short neck screws (SCR-1508 and SCR-1510) with a diameter of 1.5 mm and length 8 or 10 mm are used.

Intervention Type DEVICE

Other Intervention Names

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Anesthesic Jelly (buccal and palatal) Injection (buccal and palatal) Anesthesic Jelly (buccal) Injection (buccal) Temporary anchorage device TAD Orthodontic mini-implant

Eligibility Criteria

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Inclusion Criteria

* Adolescents in need of orthodontic treatment with fixed appliance including extractions of the maxillary first premolars
* Need for Anchorage reinforcement
* Permanent dentition including the maxillary second molars in occlusion (DS4M2 according to Björk)
* Regular dental care in Sweden since the age of three.

Exclusion Criteria

* Experience of previous orthodontic treatment
* Need for orthognathic surgery
* Need for maximum anchorage.
Minimum Eligible Age

11 Years

Maximum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Malmö University

OTHER

Sponsor Role collaborator

Department of Research and Development, County Council of Gavleborg and Uppsala University

UNKNOWN

Sponsor Role collaborator

Swedish Dental Associations Scientific Funds

UNKNOWN

Sponsor Role collaborator

Thuréus Foundation for the Promotion of Dental Science, Uppsala University, Sweden

UNKNOWN

Sponsor Role collaborator

Region Gävleborg

OTHER

Sponsor Role lead

Responsible Party

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Niels Ganzer

DDS, Senior Consultant Orthodontist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Lars Bondemark, Professor

Role: STUDY_CHAIR

Malmö University

Locations

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Specialisttandvården Ortodonti

Gävle, Gävleborg County, Sweden

Site Status

Countries

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Sweden

References

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Feldmann I, List T, John MT, Bondemark L. Reliability of a questionnaire assessing experiences of adolescents in orthodontic treatment. Angle Orthod. 2007 Mar;77(2):311-7. doi: 10.2319/0003-3219(2007)077[0311:ROAQAE]2.0.CO;2.

Reference Type BACKGROUND
PMID: 17319767 (View on PubMed)

Upadhyay M, Yadav S, Nanda R. Biomechanics of incisor retraction with mini-implant anchorage. J Orthod. 2014 Sep;41 Suppl 1:S15-23. doi: 10.1179/1465313314Y.0000000114.

Reference Type BACKGROUND
PMID: 25138361 (View on PubMed)

Upadhyay M, Yadav S, Patil S. Mini-implant anchorage for en-masse retraction of maxillary anterior teeth: a clinical cephalometric study. Am J Orthod Dentofacial Orthop. 2008 Dec;134(6):803-10. doi: 10.1016/j.ajodo.2006.10.025.

Reference Type BACKGROUND
PMID: 19061808 (View on PubMed)

Lehnen S, McDonald F, Bourauel C, Baxmann M. Patient expectations, acceptance and preferences in treatment with orthodontic mini-implants. A randomly controlled study. Part I: insertion techniques. J Orofac Orthop. 2011 Mar;72(2):93-102. doi: 10.1007/s00056-011-0013-8. English, German.

Reference Type BACKGROUND
PMID: 21503849 (View on PubMed)

Feldmann I, List T, Feldmann H, Bondemark L. Pain intensity and discomfort following surgical placement of orthodontic anchoring units and premolar extraction: a randomized controlled trial. Angle Orthod. 2007 Jul;77(4):578-85. doi: 10.2319/062506-257.1.

Reference Type BACKGROUND
PMID: 17605489 (View on PubMed)

Feldmann I, List T, Bondemark L. Orthodontic anchoring techniques and its influence on pain, discomfort, and jaw function--a randomized controlled trial. Eur J Orthod. 2012 Feb;34(1):102-8. doi: 10.1093/ejo/cjq171. Epub 2011 Feb 7.

Reference Type BACKGROUND
PMID: 21300723 (View on PubMed)

Melsen B, Costa A. Immediate loading of implants used for orthodontic anchorage. Clin Orthod Res. 2000 Feb;3(1):23-8. doi: 10.1034/j.1600-0544.2000.030105.x.

Reference Type BACKGROUND
PMID: 11168281 (View on PubMed)

Lai EH, Yao CC, Chang JZ, Chen I, Chen YJ. Three-dimensional dental model analysis of treatment outcomes for protrusive maxillary dentition: comparison of headgear, miniscrew, and miniplate skeletal anchorage. Am J Orthod Dentofacial Orthop. 2008 Nov;134(5):636-45. doi: 10.1016/j.ajodo.2007.05.017.

Reference Type BACKGROUND
PMID: 18984395 (View on PubMed)

Papadopoulos MA, Tarawneh F. The use of miniscrew implants for temporary skeletal anchorage in orthodontics: a comprehensive review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 May;103(5):e6-15. doi: 10.1016/j.tripleo.2006.11.022. Epub 2007 Feb 21.

Reference Type BACKGROUND
PMID: 17317235 (View on PubMed)

Ganzer N, Feldmann I, Petren S, Bondemark L. A cost-effectiveness analysis of anchorage reinforcement with miniscrews and molar blocks in adolescents: a randomized controlled trial. Eur J Orthod. 2019 Mar 29;41(2):180-187. doi: 10.1093/ejo/cjy041.

Reference Type DERIVED
PMID: 30668660 (View on PubMed)

Ganzer N, Feldmann I, Bondemark L. Anchorage reinforcement with miniscrews and molar blocks in adolescents: A randomized controlled trial. Am J Orthod Dentofacial Orthop. 2018 Dec;154(6):758-767. doi: 10.1016/j.ajodo.2018.07.011.

Reference Type DERIVED
PMID: 30477773 (View on PubMed)

Other Identifiers

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CFUG-479851

Identifier Type: -

Identifier Source: org_study_id

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