Palatal Expansion TechniqueNCT04225637
Comparison Between Two Rates of Activation of Miniscrew-Supported Upper Jaw Expander in Adolescents
A study testing Miniscrew-Supported Maxillary Expander- Slow activation and Miniscrew-Supported Maxillary Expander- Rapid activation in people with Palatal Expansion Technique and Malocclusion, run by Alexandria University at 1 site in Egypt.
Trial summary
Miniscrew-supported maxillary expanders provide advantages over conventional tooth-supported expanders. However, there is no consensus in the literature regarding their activation protocol. Read more about this study
- Who is it for?
- Ages 12 to 16 years
- Conditions the study is for
- Palatal Expansion Technique, Malocclusion, Posterior Crossbite
- What is being tested?
- Miniscrew-Supported Maxillary Expander- Slow activation and Miniscrew-Supported Maxillary Expander- Rapid activation
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 30 participants
- Where
- 1 siteEgypt
- Study dates
- 1 Mar 2019to 1 Jun 2021
- 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 12 to 16 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Permanent dentition.
- Participants indicated for skeletal maxillary expansion due to unilateral or bilateral posterior cross bite or maxillary transverse deficiency
- Good oral hygiene
Who cannot join
- History of previous orthodontic or orthopedic treatment
- History of maxillary trauma
- Patients with congenital craniofacial malformations
- Patients receiving pharmacological agents or having systemic diseases that might affect the bone metabolism or the pain response
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Comparison Between Two Activation Protocols of Miniscrew-Supported Maxillary Expander in Adolescents: A Randomized Controlled Clinical Trial
Miniscrew-supported maxillary expanders provide advantages over conventional tooth-supported expanders. However, there is no consensus in the literature regarding their activation protocol. The purpose of the clinical trial is to evaluate and compare the effects of slow and rapid activation rates of miniscrew-supported expanders on the skeletal changes, dento-alveolar changes and the pain experience.
Read the detailed description
Transverse maxillary deficiency is one of the problems that are commonly encountered in the orthodontic practice. Miniscrew-supported maxillary expansion represents a promising modality for the treatment of transverse maxillary deficiency. However, controversies still exist regarding the activation protocol. One of these controversies is whether using a slow activation protocol would be more beneficial to the patients compared to a rapid activation protocol. Another question that consequently ensues is whether such activation protocol would result in less pain compared to the rapid activation protocol.
The null hypothesis of the current study is that there is no difference between slow and rapid activation protocols of miniscrew-supported expander.
- Being tested
- Miniscrew-Supported Maxillary Expander- Slow activation, Miniscrew-Supported Maxillary Expander- Rapid activation
- Keywords
- Rapid Palatal Expansion, Slow Palatal Expansion, Miniscrew, Bone-borne Expander
- Medical subject headings
- Malocclusion, Retrognathia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Miniscrew-Supported Maxillary Expander- Slow activationDevice
A maxillary expander is supported on 4 palatal miniscrews. The appliance is activated slowly by turning the expansion screw once every other day to correct the transverse maxillary deficiency.
Miniscrew-Supported Maxillary Expander- Rapid activationDevice
A maxillary expander is supported on 4 palatal miniscrews. The appliance is activated rapidly by turning the expansion screw twice per day to correct the transverse maxillary deficiency.
| Study group | Role | What they receive |
|---|---|---|
| Slow maxillary expansion | Experimental | The miniscrew-supported maxillary expander is activated by turning the expansion screw once every other day. Receives: Device: Miniscrew-Supported Maxillary Expander- Slow activation |
| Rapid maxillary expansion | Experimental | The miniscrew-supported maxillary expander is activated by turning the expansion screw twice daily. Receives: Device: Miniscrew-Supported Maxillary Expander- Rapid activation |
What is being measured
The primary outcome is the main question the study is designed to answer.
Transverse skeletal changes from baseline to an average of 5 months after the initial activation, measured using cone beam computed tomography (CBCT)
The data from CBCT scans at the different time points will be exported in Digital Imaging and Communications in Medicine (DICOM) format and processed using suitable software. The relevant landmarks will be defined and located by the investigator to measure the transverse skeletal changes in mm from baseline to the end of passive retention of the expansion.
Measured: At baseline and an average of 5 months after the initial activation
Dento-alveolar inclination changes from baseline to an average of 5 months after the initial activation, measured using CBCT
The data from CBCT scans at the different time points will be exported in DICOM format and processed using suitable software. The relevant landmarks will be defined and located by the investigator to measure the changes in dento-alveolar inclination from baseline to the end of passive retention of the expansion.
Measured: At baseline and an average of 5 months after the initial activation
Secondary outcomes (4)
Pain score on Numeric Rating Scale (NRS) at baseline
Measures pain and how it affects the daily activities on a NRS where each respondent selects a whole number, between 0 and 10, with 0 being the lowest extreme and 10 being the highest extreme.
Measured: Baseline
Pain score on NRS after the first activation of the maxillary expander
Measures pain and how it affects the daily activities on a NRS where each respondent selects a whole number, between 0 and 10, with 0 being the lowest extreme and 10 being the highest extreme.
Measured: On day 1 after the first activation of the maxillary expander
Pain score on NRS after 1 week of activation of the maxillary expander
Measures pain and how it affects the daily activities on a NRS where each respondent selects a whole number, between 0 and 10, with 0 being the lowest extreme and 10 being the highest extreme.
Measured: After 1 week of activation of the maxillary expander
Pain score on NRS after the last activation of the maxillary expander
Measures pain and how it affects the daily activities on a NRS where each respondent selects a whole number, between 0 and 10, with 0 being the lowest extreme and 10 being the highest extreme.
Measured: At the end of active expansion (an estimated average of 2 to 3 weeks in the rapid expansion group, and 7 to 12 weeks in the slow expansion group)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Jan 2020
- Study start1 Mar 2019
- Primary completion28 Apr 2021
- Study completion1 Jun 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (6)Papers the sponsor has linked to this study.
- Other trials for Palatal Expansion TechniqueStudies of the same condition, open and under way.
- More trials run by Alexandria UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- 30 participants (actual)
Sponsor and investigators
- Lead sponsor
- Alexandria University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Yomna Mohamed Mohamed Yacout, Alexandria University
- Investigators
- Yomna M Yacout, BDS, MSc, Principal investigator, Alexandria UniversityNadia M El Harouni, BDS,MSc,PhD, Study chair, Alexandria UniversityEssam M Abdallah, BDS,MSc,PhD, Study chair, Alexandria University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04225637
- Sponsor's protocol ID
- 01012019
- Status last verified
- Jun 2021
- First submitted
- 5 Jan 2020
- Last updated
- 21 Jun 2021
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Lin L, Ahn HW, Kim SJ, Moon SC, Kim SH, Nelson G. Tooth-borne vs bone-borne rapid maxillary expanders in late adolescence. Angle Orthod. 2015 Mar;85(2):253-62. doi: 10.2319/030514-156.1. Epub 2014 Dec 9.
PubMed 25490552Yilmaz A, Arman-Ozcirpici A, Erken S, Polat-Ozsoy O. Comparison of short-term effects of mini-implant-supported maxillary expansion appliance with two conventional expansion protocols. Eur J Orthod. 2015 Oct;37(5):556-64. doi: 10.1093/ejo/cju094. Epub 2015 Jan 6.
PubMed 25564504Lagravere MO, Carey J, Heo G, Toogood RW, Major PW. Transverse, vertical, and anteroposterior changes from bone-anchored maxillary expansion vs traditional rapid maxillary expansion: a randomized clinical trial. Am J Orthod Dentofacial Orthop. 2010 Mar;137(3):304.e1-12; discussion 304-5. doi: 10.1016/j.ajodo.2009.09.016.
PubMed 20197161Algharbi M, Bazargani F, Dimberg L. Do different maxillary expansion appliances influence the outcomes of the treatment? Eur J Orthod. 2018 Jan 23;40(1):97-106. doi: 10.1093/ejo/cjx035.
PubMed 28486682Carvalho Trojan L, Andres Gonzalez-Torres L, Claudia Moreira Melo A, Barbosa de Las Casas E. Stresses and Strains Analysis Using Different Palatal Expander Appliances in Upper Jaw and Midpalatal Suture. Artif Organs. 2017 Jun;41(6):E41-E51. doi: 10.1111/aor.12817. Epub 2016 Dec 7.
PubMed 27925236ElNaghy R, Al-Qawasmi R, Hasanin M. Do patient-reported outcomes of miniscrew-supported maxillary expansion in adolescent patients differ between slow and rapid activation protocol? Evid Based Dent. 2023 Mar;24(1):28-29. doi: 10.1038/s41432-023-00858-8. Epub 2023 Mar 8.
PubMed 36890253
Study at a glance
From the registry record, last updated by the sponsor on 21 Jun 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison Between Two Activation Protocols of Miniscrew-Supported Maxillary Expander in Adolescents: A Randomized Controlled Clinical Trial
- ClinicalTrials.gov ID
- NCT04225637
- Acronym / sponsor ID
- 01012019
- Keywords
- Rapid Palatal Expansion, Slow Palatal Expansion, Miniscrew, Bone-borne Expander
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 30 participants (actual)
- Lead sponsor
- Alexandria UniversityUniversity, hospital or other
- Study start
- 1 Mar 2019 (actual)
- Primary completion
- 28 Apr 2021 (actual)
- Study completion
- 1 Jun 2021 (actual)
- First posted
- 13 Jan 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Miniscrew-supported maxillary expanders provide advantages over conventional tooth-supported expanders. However, there is no consensus in the literature regarding their activation protocol. The purpose of the clinical trial is to evaluate and compare the effects of slow and rapid activation rates of miniscrew-supported expanders on the skeletal changes, dento-alveolar changes and the pain experience.
Detailed description
Transverse maxillary deficiency is one of the problems that are commonly encountered in the orthodontic practice. Miniscrew-supported maxillary expansion represents a promising modality for the treatment of transverse maxillary deficiency. However, controversies still exist regarding the activation protocol. One of these controversies is whether using a slow activation protocol would be more beneficial to the patients compared to a rapid activation protocol. Another question that consequently ensues is whether such activation protocol would result in less pain compared to the rapid activation protocol.
The null hypothesis of the current study is that there is no difference between slow and rapid activation protocols of miniscrew-supported expander.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Slow maxillary expansion | Experimental | Device: Miniscrew-Supported Maxillary Expander- Slow activationThe miniscrew-supported maxillary expander is activated by turning the expansion screw once every other day. |
| Rapid maxillary expansion | Experimental | Device: Miniscrew-Supported Maxillary Expander- Rapid activationThe miniscrew-supported maxillary expander is activated by turning the expansion screw twice daily. |
Who may qualify
- Ages
- 12 to 16 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (3 listed)
- Permanent dentition.
- Participants indicated for skeletal maxillary expansion due to unilateral or bilateral posterior cross bite or maxillary transverse deficiency
- Good oral hygiene
Key exclusion criteria (4 listed)
- History of previous orthodontic or orthopedic treatment
- History of maxillary trauma
- Patients with congenital craniofacial malformations
- Patients receiving pharmacological agents or having systemic diseases that might affect the bone metabolism or the pain response
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Miniscrew-Supported Maxillary Expander- Slow activationA maxillary expander is supported on 4 palatal miniscrews. The appliance is activated slowly by turning the expansion screw once every other day to correct the transverse maxillary deficiency. | Device | Slow maxillary expansion |
| Miniscrew-Supported Maxillary Expander- Rapid activationA maxillary expander is supported on 4 palatal miniscrews. The appliance is activated rapidly by turning the expansion screw twice per day to correct the transverse maxillary deficiency. | Device | Rapid maxillary expansion |
Primary outcome
Transverse skeletal changes from baseline to an average of 5 months after the initial activation, measured using cone beam computed tomography (CBCT)
Time frame: At baseline and an average of 5 months after the initial activation
The data from CBCT scans at the different time points will be exported in Digital Imaging and Communications in Medicine (DICOM) format and processed using suitable software. The relevant landmarks will be defined and located by the investigator to measure the transverse skeletal changes in mm from baseline to the end of passive retention of the expansion.
Dento-alveolar inclination changes from baseline to an average of 5 months after the initial activation, measured using CBCT
Time frame: At baseline and an average of 5 months after the initial activation
The data from CBCT scans at the different time points will be exported in DICOM format and processed using suitable software. The relevant landmarks will be defined and located by the investigator to measure the changes in dento-alveolar inclination from baseline to the end of passive retention of the expansion.
4 secondary outcomes
Pain score on Numeric Rating Scale (NRS) at baseline
Time frame: Baseline
Pain score on NRS after the first activation of the maxillary expander
Time frame: On day 1 after the first activation of the maxillary expander
Pain score on NRS after 1 week of activation of the maxillary expander
Time frame: After 1 week of activation of the maxillary expander
Pain score on NRS after the last activation of the maxillary expander
Time frame: At the end of active expansion (an estimated average of 2 to 3 weeks in the rapid expansion group, and 7 to 12 weeks in the slow expansion group)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Jun 2021.
- Background: PubMed 25490552Lin L, Ahn HW, Kim SJ, Moon SC, Kim SH, Nelson G. Tooth-borne vs bone-borne rapid maxillary expanders in late adolescence. Angle Orthod. 2015 Mar;85(2):253-62. doi: 10.2319/030514-156.1. Epub 2014 Dec 9.
- Background: PubMed 25564504Yilmaz A, Arman-Ozcirpici A, Erken S, Polat-Ozsoy O. Comparison of short-term effects of mini-implant-supported maxillary expansion appliance with two conventional expansion protocols. Eur J Orthod. 2015 Oct;37(5):556-64. doi: 10.1093/ejo/cju094. Epub 2015 Jan 6.
- Background: PubMed 20197161Lagravere MO, Carey J, Heo G, Toogood RW, Major PW. Transverse, vertical, and anteroposterior changes from bone-anchored maxillary expansion vs traditional rapid maxillary expansion: a randomized clinical trial. Am J Orthod Dentofacial Orthop. 2010 Mar;137(3):304.e1-12; discussion 304-5. doi: 10.1016/j.ajodo.2009.09.016.
- Background: PubMed 28486682Algharbi M, Bazargani F, Dimberg L. Do different maxillary expansion appliances influence the outcomes of the treatment? Eur J Orthod. 2018 Jan 23;40(1):97-106. doi: 10.1093/ejo/cjx035.
- Background: PubMed 27925236Carvalho Trojan L, Andres Gonzalez-Torres L, Claudia Moreira Melo A, Barbosa de Las Casas E. Stresses and Strains Analysis Using Different Palatal Expander Appliances in Upper Jaw and Midpalatal Suture. Artif Organs. 2017 Jun;41(6):E41-E51. doi: 10.1111/aor.12817. Epub 2016 Dec 7.
- Derived from this study: PubMed 36890253ElNaghy R, Al-Qawasmi R, Hasanin M. Do patient-reported outcomes of miniscrew-supported maxillary expansion in adolescent patients differ between slow and rapid activation protocol? Evid Based Dent. 2023 Mar;24(1):28-29. doi: 10.1038/s41432-023-00858-8. Epub 2023 Mar 8.
- Institutional Review Board (IORG0008839/IRB00010556- Faculty of Dentistry - Alexandria University )Link provided by the sponsor.
- Individual participant dataSharing planned: No
Related trials for Palatal Expansion Technique
Active, not recruiting
Teleorthodontics Versus Conventional Follow-up During Early Interceptive Orthodontic Treatment in Children
Teledentistry, Orthodontics, Interceptive
Recruiting
The Effectiveness of Early Intervention to Correct the Position of PDC:s
Ectopic Tooth Eruption, Palatal Expansion Technique
Not yet recruiting
Miniscrew-Assisted Rapid Palatal Expansion for Obstructive Sleep Apnea
OSA - Obstructive Sleep Apnea, Palatal Expansion Technique
Recruiting
3D Evaluation of Maxillary Expansion Methods
Maxillary Transverse Deficiency
Recruiting
Evaluation of Hard and Soft Tissue Change During Maxillary Expansion Using a Computer-aided Design / Computer-aided Manufacturing Appliance.
Palatal Expansion Technique
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Yomna M Yacout, BDS, MSc principal investigator
Alexandria University
Nadia M El Harouni, BDS,MSc,PhD study chair
Alexandria University
Essam M Abdallah, BDS,MSc,PhD study chair
Alexandria University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Miniscrew-Supported Maxillary Expander- Slow activation and Miniscrew-Supported Maxillary Expander- Rapid activation in people with Palatal Expansion Technique and Malocclusion, run by Alexandria University at 1 site in Egypt.
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 3 inclusion and 4 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 21 Jun 2021. 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 Egypt. 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?
Transverse skeletal changes from baseline to an average of 5 months after the initial activation, measured using cone beam computed tomography (CBCT) (time frame: At baseline and an average of 5 months after the initial activation). The study lists 2 primary outcomes in all. 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 NCT04225637, which also lists 6 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 21 Jun 2021.