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Orthodontic Anchorage ProceduresNCT02644811

Miniscrews as Anchorage Device for Orthodontic Treatment

A study testing Topical anesthesia (buccal and palatal), Local anesthesia (buccal and palatal) and Extraction of the maxillary first premolars in people with Orthodontic Anchorage Procedures and Orthodontic Space Closure, run by Region Gävleborg at 1 site in Sweden.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

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. Read more about this study

Who is it for?
Ages 11 to 20 yearsHealthy volunteers can take part
What is being tested?
Topical anesthesia (buccal and palatal), Local anesthesia (buccal and palatal) and Extraction of the maxillary first premolars
Could I receive a placebo?
No, everyone receives an active treatment
How many people
80 participants
Where
1 siteSweden
Study dates
Nov 2009to 21 Sep 2018
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 11 to 20 years
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult

Who may be able to join

  • 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.

Who cannot join

  • Experience of previous orthodontic treatment
  • Need for orthognathic surgery
  • Need for maximum anchorage.

Trial locations and contacts

1 site in 1 country.

Sweden1 site
  • Specialisttandvården Ortodonti

    Gävle, Gävleborg County, 80102

Other trials in Sweden

About this study

Official title: Miniscrews as Anchorage Device for Orthodontic Treatment - Randomized Controlled Trials on Anchorage Capacity, Cost Efficiency and Patient Acceptance

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
Read the detailed description

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

Being tested
Topical anesthesia (buccal and palatal), Local anesthesia (buccal and palatal), Extraction of the maxillary first premolars, Topical anesthesia (buccal), Local anesthesia (buccal)
Keywords
Miniscrew, Temporary anchorage device (TAD), mini-implants, Miniscrew implant (MSI)

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Topical anesthesia (buccal and palatal)Drug

    Also called Anesthesic Jelly (buccal and palatal)

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

  • Local anesthesia (buccal and palatal)Drug

    Also called Injection (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).

  • Extraction of the maxillary first premolarsProcedure or surgery

    Careful extraction of the maxillary first premolars after mobilization.

  • Topical anesthesia (buccal)Drug

    Also called Anesthesic Jelly (buccal)

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

  • Local anesthesia (buccal)Drug

    Also called Injection (buccal)

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

  • MolarblockDevice

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

  • Spider Screw K1 short neckDevice

    Also called Temporary anchorage device, TAD, Orthodontic mini-implant

    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.

Study groups in NCT02644811
Study groupRoleWhat they receive
Group A - MiniscrewsExperimentalTopical 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.
Receives: Drug: Topical anesthesia (buccal and palatal); Drug: Local anesthesia (buccal and palatal); Procedure: Extraction of the maxillary first premolars; Drug: Topical anesthesia (buccal); Drug: Local anesthesia (buccal); Device: Spider Screw K1 short neck
Group B - MolarblockActive comparatorTopical 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.
Receives: Drug: Topical anesthesia (buccal and palatal); Drug: Local anesthesia (buccal and palatal); Procedure: Extraction of the maxillary first premolars; Device: Molarblock

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Tooth Position of the Maxillary Molars During Space Closure

    Tooth movement is assessed in millimeters using superimposition of study models and lateral cephalograms.

    Measured: Through Space Closure (T2-T3), an average of 9 months

Secondary outcomes (3)
  1. Experience of Pain and Discomfort

    Experiences of pain and discomfort are examined with validated self-report questionnaires.

    Measured: Baseline, the evening after tooth extractions, one week after tooth extractions, the evening after miniscrew placement, one week after miniscrew placement

  2. Change in Tooth Position of the Maxillary Molars During Levelling and Alignment

    Tooth movement is assessed in millimeters using superimposition of study models and lateral cephalograms.

    Measured: Through Levelling and Alignment (T1-T2), an average of 9 months

  3. Societal Costs

    Societal costs are the sum of direct and indirect treatment costs. Direct costs are treatment time in the clinic and used material. Indirect costs are travel costs and costs for parents following the participant to the clinic.

    Measured: Through Study Completion, an average of 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Jan 2016 (estimated)
  2. Study startNov 2009
  3. Primary completionJul 2018
  4. Study completion21 Sep 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
80 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02644811
Sponsor's protocol ID
CFUG-479851
Status last verified
Feb 2019
First submitted
18 Dec 2015
Last updated
27 Feb 2019
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • 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.

    PubMed 17319767
  • 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.

    PubMed 25138361
  • 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.

    PubMed 19061808
  • 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.

    PubMed 21503849
  • 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.

    PubMed 17605489
  • 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.

    PubMed 21300723
  • 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.

    PubMed 11168281
  • 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.

    PubMed 18984395
  • 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.

    PubMed 17317235
  • 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.

    PubMed 30668660
  • 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.

    PubMed 30477773

Questions about this trial

What is this clinical trial studying?

A study testing Topical anesthesia (buccal and palatal), Local anesthesia (buccal and palatal) and Extraction of the maxillary first premolars in people with Orthodontic Anchorage Procedures and Orthodontic Space Closure, run by Region Gävleborg at 1 site in Sweden.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Feb 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Tooth Position of the Maxillary Molars During Space Closure (time frame: Through Space Closure (T2-T3), an average of 9 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02644811, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Feb 2019.

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