External Apical Root Resorption in Maxillary Canines During Orthodontic RetractionMCA-CRNCT07458139
Comparison of Root Resorption in Modified Corticotomy-Assisted and Conventional Canine Retraction
A study testing Modified Corticotomy assisted frictionless canine retraction and Conventional Frictionless Canine retraction in people with External Apical Root Resorption in Maxillary Canines During Orthodontic Retraction, run by Islamabad Medical and Dental College at 1 site in Pakistan.
Trial summary
This randomized controlled clinical trial will compare external apical root resorption in patients undergoing maxillary canine retraction using modified corticotomy-assisted frictionless T-loop mechanics versus conventional frictionless T-loop mechanics. Read more about this study
- Who is it for?
- Ages 12 to 30 yearsHealthy volunteers can take part
- Conditions the study is for
- External Apical Root Resorption in Maxillary Canines During Orthodontic Retraction
- What is being tested?
- Modified Corticotomy assisted frictionless canine retraction and Conventional Frictionless Canine retraction
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 sitePakistan
- Study dates
- Mar 2026to Jul 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 30 years
- All sexes
- Healthy volunteers accepted
- Child, Adult
Who may be able to join
- Patients aged 12-30 years requiring canine retraction into maxillary first premolar extraction spaces
- Patients with normal vertical skeletal pattern (mandibular plane angle 32° ± 5°)
- Patients with healthy periodontium
Who cannot join
- Syndromic patients
- Patients with systemic conditions requiring long-term medication affecting orthodontic tooth movement (e.g., NSAIDs, bisphosphonates, anticonvulsants)
- Mixed dentition cases
- Patients with pre-existing root resorption
- Patients who fail to attend scheduled appointments
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site
Islamabad Dental Hospital
Islamabad, Federal, 45720
Menal Khurshid, BDS, 0333-5303397, menal.15@iideas.edu.pk
About this study
Official title: Comparison of External Apical Root Resorption in Modified Corticotomy-Assisted and Conventionally Retracted Maxillary Canines Using Frictionless T-Loop Mechanics: A Randomized Controlled Clinical Trial
This randomized controlled clinical trial will compare external apical root resorption in patients undergoing maxillary canine retraction using modified corticotomy-assisted frictionless T-loop mechanics versus conventional frictionless T-loop mechanics. Sixty orthodontic patients requiring extraction of maxillary first premolars will be randomly assigned to two groups. Changes in canine root length will be measured on panoramic radiographs taken before and after retraction to determine the extent of external apical root resorption. The study will evaluate whether modified corticotomy-assisted retraction results in different root resorption outcomes compared to conventional retraction.
Read the detailed description
External apical root resorption is a known complication of orthodontic treatment and may be influenced by the magnitude and duration of orthodontic force. Methods that accelerate tooth movement may reduce overall treatment time and potentially influence the extent of root resorption.
Corticotomy-assisted orthodontics is based on the regional acceleratory phenomenon, which enhances bone remodeling and facilitates tooth movement. Modified corticotomy techniques involve limited surgical injury to the cortical bone to stimulate accelerated movement while minimizing postoperative morbidity. Frictionless mechanics using T-loops allow controlled canine retraction with reduced frictional resistance between the bracket and archwire.
This single-center randomized controlled clinical trial will enroll 60 patients aged 12 to 30 years who require bilateral extraction of maxillary first premolars as part of orthodontic treatment. Participants will be randomly allocated in a 1:1 ratio to:
Group A: Modified corticotomy-assisted canine retraction with frictionless T-loop mechanics Group B: Conventional frictionless T-loop canine retraction
All participants will be treated using 0.022 × 0.028-inch preadjusted edgewise appliances. Standardized T-loop activation delivering controlled force will be performed at three-week intervals until canine retraction is completed.
External apical root resorption will be assessed by measuring linear changes in root length from the canine cusp tip to the root apex on calibrated pre- and post-retraction panoramic radiographs using digital measurement software. The primary outcome measure will be the mean change in root length between baseline and post-retraction assessments. Statistical analysis will compare the magnitude of root resorption between the two groups.
- Being tested
- Modified Corticotomy assisted frictionless canine retraction, Conventional Frictionless Canine retraction
- Keywords
- Maxillary Canine Retraction, External Apical Root Resorption, Frictionless Mechanics, Modified Corticotomy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Modified Corticotomy assisted frictionless canine retractionProcedure or surgery
A surgical procedure in which a buccal flap is elevated and two vertical corticotomy cuts are made in the maxillary cortical bone adjacent to the extraction site to accelerate orthodontic tooth movement.
Conventional Frictionless Canine retractionProcedure or surgery
Orthodontic space closure using 17×25 TMA T-loops activated to deliver approximately 200 g of force for frictionless canine retraction into maxillary first premolar extraction spaces.
| Study group | Role | What they receive |
|---|---|---|
| Modified Corticotomy Assisted Canine Retraction | Experimental | Description: Participants will undergo modified corticotomy procedure followed by canine retraction using frictionless T-loop mechanics after extraction of maxillary first premolars.
Intervention:
* Procedure: Modified Corticotomy
* Procedure: Frictionless T-loop canine retraction. Receives: Procedure: Modified Corticotomy assisted frictionless canine retraction |
| Conventional T-loop Canine Retraction | Active comparator | Description: Participants will undergo conventional canine retraction using frictionless T-loop mechanics without any surgical intervention after extraction of maxillary first premolars.
Intervention: Frictionless T-loop canine retraction. Receives: Procedure: Conventional Frictionless Canine retraction |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mean Loss of Canine Root Length (mm)
External apical root resorption measured as the difference in root length (in millimeters) from canine cusp tip to root apex on calibrated pre-treatment and post-retraction OPG radiographs using ViewBox software.
Measured: - Before retraction (baseline) - From baseline to completion of canine retraction (approximately 4-6 months)
Secondary outcomes (1)
Change in Root Width at Mesial and Distal Apex (mm)
Difference in mesial and distal root width measured 1 mm short of the root apex on calibrated OPG radiographs before and after canine retraction.
Measured: From baseline to completion of canine retraction (approximately 4-6 months)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Mar 2026
- Study startMar 2026 (estimated)
- Primary completionJul 2026 (estimated)
- Study completionJul 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for External Apical Root Resorption in Maxillary Canines During Orthodontic RetractionStudies of the same condition, open and under way.
- 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
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants will be randomly assigned in a 1:1 ratio to one of two parallel groups: modified corticotomy-assisted canine retraction with frictionless T-loop mechanics or conventional frictionless T-loop canine retraction.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Islamabad Medical and Dental College
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Prof. Dr. Haroon Shahid Qazi, BDS, MS, MCPS (HPE), Study chair, Islamabad Medical & Dental Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07458139
- Sponsor's protocol ID
- IDH123
- Other IDs
- IDH-ORTHO-2026
- Acronym
- MCA-CR
- Status last verified
- Mar 2026
- First submitted
- 3 Mar 2026
- Last updated
- 9 Mar 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: IPD will not be shared to maintain participant confidentiality and due to institutional data protection policies.
Publications
Sondeijker CFW, Lamberts AA, Beckmann SH, Kuitert RB, van Westing K, Persoon S, Kuijpers-Jagtman AM. Development of a clinical practice guideline for orthodontically induced external apical root resorption. Eur J Orthod. 2020 Apr 1;42(2):115-124. doi: 10.1093/ejo/cjz034.
PubMed 31087032Hatrom AA, Zawawi KH, Al-Ali RM, Sabban HM, Zahid TM, Al-Turki GA, Hassan AH. Effect of piezocision corticotomy on en-masse retraction. Angle Orthod. 2020 Sep 1;90(5):648-654. doi: 10.2319/092719-615.1.
PubMed 33378476Alikhani M, Raptis M, Zoldan B, Sangsuwon C, Lee YB, Alyami B, Corpodian C, Barrera LM, Alansari S, Khoo E, Teixeira C. Effect of micro-osteoperforations on the rate of tooth movement. Am J Orthod Dentofacial Orthop. 2013 Nov;144(5):639-48. doi: 10.1016/j.ajodo.2013.06.017.
PubMed 24182579
Study at a glance
From the registry record, last updated by the sponsor on 9 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of External Apical Root Resorption in Modified Corticotomy-Assisted and Conventionally Retracted Maxillary Canines Using Frictionless T-Loop Mechanics: A Randomized Controlled Clinical Trial
- ClinicalTrials.gov ID
- NCT07458139
- Acronym / sponsor ID
- MCA-CR / IDH123
- Keywords
- Maxillary Canine Retraction, External Apical Root Resorption, Frictionless Mechanics, Modified Corticotomy
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Islamabad Medical and Dental CollegeUniversity, hospital or other
- Study start
- Mar 2026 (estimated)
- Primary completion
- Jul 2026 (estimated)
- Study completion
- Jul 2026 (estimated)
- First posted
- 9 Mar 2026 (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.
This randomized controlled clinical trial will compare external apical root resorption in patients undergoing maxillary canine retraction using modified corticotomy-assisted frictionless T-loop mechanics versus conventional frictionless T-loop mechanics. Sixty orthodontic patients requiring extraction of maxillary first premolars will be randomly assigned to two groups. Changes in canine root length will be measured on panoramic radiographs taken before and after retraction to determine the extent of external apical root resorption. The study will evaluate whether modified corticotomy-assisted retraction results in different root resorption outcomes compared to conventional retraction.
Detailed description
External apical root resorption is a known complication of orthodontic treatment and may be influenced by the magnitude and duration of orthodontic force. Methods that accelerate tooth movement may reduce overall treatment time and potentially influence the extent of root resorption.
Corticotomy-assisted orthodontics is based on the regional acceleratory phenomenon, which enhances bone remodeling and facilitates tooth movement. Modified corticotomy techniques involve limited surgical injury to the cortical bone to stimulate accelerated movement while minimizing postoperative morbidity. Frictionless mechanics using T-loops allow controlled canine retraction with reduced frictional resistance between the bracket and archwire.
This single-center randomized controlled clinical trial will enroll 60 patients aged 12 to 30 years who require bilateral extraction of maxillary first premolars as part of orthodontic treatment. Participants will be randomly allocated in a 1:1 ratio to:
Group A: Modified corticotomy-assisted canine retraction with frictionless T-loop mechanics Group B: Conventional frictionless T-loop canine retraction
All participants will be treated using 0.022 × 0.028-inch preadjusted edgewise appliances. Standardized T-loop activation delivering controlled force will be performed at three-week intervals until canine retraction is completed.
External apical root resorption will be assessed by measuring linear changes in root length from the canine cusp tip to the root apex on calibrated pre- and post-retraction panoramic radiographs using digital measurement software. The primary outcome measure will be the mean change in root length between baseline and post-retraction assessments. Statistical analysis will compare the magnitude of root resorption between the two groups.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Participants will be randomly assigned in a 1:1 ratio to one of two parallel groups: modified corticotomy-assisted canine retraction with frictionless T-loop mechanics or conventional frictionless T-loop canine retraction.
| Arm | Type | Receives |
|---|---|---|
| Modified Corticotomy Assisted Canine Retraction | Experimental | Procedure: Modified Corticotomy assisted frictionless canine retractionDescription: Participants will undergo modified corticotomy procedure followed by canine retraction using frictionless T-loop mechanics after extraction of maxillary first premolars. Intervention: * Procedure: Modified Corticotomy * Procedure: Frictionless T-loop canine retraction. |
| Conventional T-loop Canine Retraction | Active comparator | Procedure: Conventional Frictionless Canine retractionDescription: Participants will undergo conventional canine retraction using frictionless T-loop mechanics without any surgical intervention after extraction of maxillary first premolars. Intervention: Frictionless T-loop canine retraction. |
Who may qualify
- Ages
- 12 to 30 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult
Key inclusion criteria (3 listed)
- Patients aged 12-30 years requiring canine retraction into maxillary first premolar extraction spaces
- Patients with normal vertical skeletal pattern (mandibular plane angle 32° ± 5°)
- Patients with healthy periodontium
Key exclusion criteria (5 listed)
- Syndromic patients
- Patients with systemic conditions requiring long-term medication affecting orthodontic tooth movement (e.g., NSAIDs, bisphosphonates, anticonvulsants)
- Mixed dentition cases
- Patients with pre-existing root resorption
- Patients who fail to attend scheduled appointments
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 |
|---|---|---|
| Modified Corticotomy assisted frictionless canine retractionA surgical procedure in which a buccal flap is elevated and two vertical corticotomy cuts are made in the maxillary cortical bone adjacent to the extraction site to accelerate orthodontic tooth movement. | Procedure or surgery | Modified Corticotomy Assisted Canine Retraction |
| Conventional Frictionless Canine retractionOrthodontic space closure using 17×25 TMA T-loops activated to deliver approximately 200 g of force for frictionless canine retraction into maxillary first premolar extraction spaces. | Procedure or surgery | Conventional T-loop Canine Retraction |
Primary outcome
Mean Loss of Canine Root Length (mm)
Time frame: - Before retraction (baseline) - From baseline to completion of canine retraction (approximately 4-6 months)
External apical root resorption measured as the difference in root length (in millimeters) from canine cusp tip to root apex on calibrated pre-treatment and post-retraction OPG radiographs using ViewBox software.
1 secondary outcome
Change in Root Width at Mesial and Distal Apex (mm)
Time frame: From baseline to completion of canine retraction (approximately 4-6 months)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Mar 2026.
- Background: PubMed 31087032Sondeijker CFW, Lamberts AA, Beckmann SH, Kuitert RB, van Westing K, Persoon S, Kuijpers-Jagtman AM. Development of a clinical practice guideline for orthodontically induced external apical root resorption. Eur J Orthod. 2020 Apr 1;42(2):115-124. doi: 10.1093/ejo/cjz034.
- Background: PubMed 33378476Hatrom AA, Zawawi KH, Al-Ali RM, Sabban HM, Zahid TM, Al-Turki GA, Hassan AH. Effect of piezocision corticotomy on en-masse retraction. Angle Orthod. 2020 Sep 1;90(5):648-654. doi: 10.2319/092719-615.1.
- Background: PubMed 24182579Alikhani M, Raptis M, Zoldan B, Sangsuwon C, Lee YB, Alyami B, Corpodian C, Barrera LM, Alansari S, Khoo E, Teixeira C. Effect of micro-osteoperforations on the rate of tooth movement. Am J Orthod Dentofacial Orthop. 2013 Nov;144(5):639-48. doi: 10.1016/j.ajodo.2013.06.017.
- Individual participant dataSharing planned: No. IPD will not be shared to maintain participant confidentiality and due to institutional data protection policies.
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.
Prof. Dr. Haroon Shahid Qazi, BDS, MS, MCPS (HPE) study chair
Islamabad Medical & Dental Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Modified Corticotomy assisted frictionless canine retraction and Conventional Frictionless Canine retraction in people with External Apical Root Resorption in Maxillary Canines During Orthodontic Retraction, run by Islamabad Medical and Dental College at 1 site in Pakistan.
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 5 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: opening soon, as of the sponsor's last update on 9 Mar 2026. 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 Pakistan. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Dr. Menal Khurshid, BDS (0333-5303397, menal.15@iideas.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Mean Loss of Canine Root Length (mm) (time frame: - Before retraction (baseline) - From baseline to completion of canine retraction (approximately 4-6 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 NCT07458139, which also lists 3 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 9 Mar 2026.