Treatment of Skeletal Class III Malocclusion Using Orthodontic Removable Traction Appliance

NCT ID: NCT03172442

Last Updated: 2019-07-18

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

22 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-05-01

Study Completion Date

2019-02-15

Brief Summary

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This experimental study aims to evaluate the efficiency of the orthodontic removable traction appliance in the treatment of skeletal class III malocclusion. The study sample will consist of 44 patients with skeletal class III malocclusion. The sample will be allocated randomly into two groups: experimental group and control group. The dentoskeletal changes will be assessed by using lateral cephalometric radiographs before treatment and after obtaining 3mm positive overjet.

Detailed Description

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Treatment of class III malocclusion is a major challenge in orthodontic contemporary practice, Several appliance have suggested for the treatment of class III malocclusion, such as the facial mask and chin cup.

Despite of the efficiency of this extraoral appliance, its external appearance and its big size reduce patients' cooperation which decrease its clinical effects.

Another Class III treatment modality is the Orthodontic Removable Traction Appliance (ORTA). It is a removable appliance that can be used in conjunction with rapid palatal expansion or fixed appliances, It was developed in the 1980's by Dr. David Musich who developed this appliance in order to overcome issues of compliance that Dr. Musich experienced with use of the protraction facemask.

There is only one study that evaluated this appliance which is a retrospective study compared the treatment effects of the ORTA and protraction facemask in treatment of Class III malocclusions. However, this study has a lot of limitations which made it difficult to accurately evaluate the efficiency of this device.

The aim of this study is studying the dentoskeletal changes that result from treatment by this device, by comparing them to the changes in matched untreated group,by studying the cephalometric x-rays.

Conditions

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Class III Malocclusion

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The patients will be randomly assigned to one of the two groups, case or control.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

No masking could be applied

Study Groups

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orthodontic removable traction appliance

Patients in this group will be treated using the orthodontic removable traction appliance (vacuum plate with two hooks between lateral incisor and canine in each side). An rapid maxillary expander will be applied to disarticulate maxillary sutures to allow more efficient forward protraction of the maxilla.

Class III elastic traction from upper first molar to the hook in both side. This appliance will be used full-time with Class III elastics (6- to 8-ounce) traction.

Group Type EXPERIMENTAL

Vacuum plate

Intervention Type DEVICE

Vacuum plate with two hooks between lateral incisor and canine in each side will be applied on the lower arch.

Rapid maxillary expander

Intervention Type DEVICE

Rapid maxillary expander will be applied in the maxilla to disarticulate maxillary sutures to allow more efficient forward protraction of the maxilla.

Class III elastics

Intervention Type DEVICE

Class III elastic traction from upper first molar to the hook in both side will be applied.

Control group

without intervention

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Vacuum plate

Vacuum plate with two hooks between lateral incisor and canine in each side will be applied on the lower arch.

Intervention Type DEVICE

Rapid maxillary expander

Rapid maxillary expander will be applied in the maxilla to disarticulate maxillary sutures to allow more efficient forward protraction of the maxilla.

Intervention Type DEVICE

Class III elastics

Class III elastic traction from upper first molar to the hook in both side will be applied.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients in early mixed dentation (8-10 years old).
* Skeletal class III caused by maxillary deficiency with or without mandibular prognathism judged clinically and confirmed radiographically(ANB≤1).
* Anterior crossbite on two teeth or more or an edge-to-edge bite.
* Normal inclination of the lower incisors with the mandibular plane.

Exclusion Criteria

* Poor oral hygiene.
* Previous orthodontic treatment.
* Patients with syndromes, clefts, or craniofacial abnormalities.
* Severe skeletal class III primarily resulting from mandibular prognathism (ANB less than - 4)
* Patients with facial asymmetry.
* Patients with vertical growth pattern.
Minimum Eligible Age

8 Years

Maximum Eligible Age

10 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Damascus University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ahmad S Burhan, PhD.

Role: STUDY_CHAIR

Department of Orthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria

Locations

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Damascus University

Damascus, , Syria

Site Status

Countries

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Syria

References

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Suda N, Ishii-Suzuki M, Hirose K, Hiyama S, Suzuki S, Kuroda T. Effective treatment plan for maxillary protraction: is the bone age useful to determine the treatment plan? Am J Orthod Dentofacial Orthop. 2000 Jul;118(1):55-62. doi: 10.1067/mod.2000.104491.

Reference Type RESULT
PMID: 10893473 (View on PubMed)

Cha KS. Skeletal changes of maxillary protraction in patients exhibiting skeletal class III malocclusion: a comparison of three skeletal maturation groups. Angle Orthod. 2003 Feb;73(1):26-35. doi: 10.1043/0003-3219(2003)0732.0.CO;2.

Reference Type RESULT
PMID: 12607852 (View on PubMed)

Mandall N, DiBiase A, Littlewood S, Nute S, Stivaros N, McDowall R, Shargill I, Worthington H, Cousley R, Dyer F, Mattick R, Doherty B. Is early Class III protraction facemask treatment effective? A multicentre, randomized, controlled trial: 15-month follow-up. J Orthod. 2010 Sep;37(3):149-61. doi: 10.1179/14653121043056.

Reference Type RESULT
PMID: 20805344 (View on PubMed)

Gautam P, Valiathan A, Adhikari R. Skeletal response to maxillary protraction with and without maxillary expansion: a finite element study. Am J Orthod Dentofacial Orthop. 2009 Jun;135(6):723-8. doi: 10.1016/j.ajodo.2007.06.016.

Reference Type RESULT
PMID: 19524831 (View on PubMed)

Turley PK. Orthopedic correction of Class III malocclusion with palatal expansion and custom protraction headgear. J Clin Orthod. 1988 May;22(5):314-25. No abstract available.

Reference Type RESULT
PMID: 3075214 (View on PubMed)

Other Identifiers

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UDDS-Ortho-03-2017

Identifier Type: -

Identifier Source: org_study_id

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