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Status unknownNCT03903575Updated Apr 5, 2019

3D Comparison of Anterior Teeth Retraction and Anchorage Control Between En-masse and Two-step Mechanics

An interventional study of En masse anterior teeth retraction and Two-Step Retraction in Malocclusion, Angle Class I, Bimaxillary Protrusion and Orthodontic Space Closure, sponsored by Rio de Janeiro State University. Status unknown at 1 site in Brazil. Open to participants aged 18 Years to 40 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2019-04-05.

Sponsored by Rio de Janeiro State University · Not applicable, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Apr 2019), so the status shown — last known as Recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
32
Allocation
Randomized
Ages
18 Years to 40 Years
Sex
All
01

Study summary

The aim of this study is to compare en masse (EM) and two-step anterior teeth retraction (TSR) evaluated by means of three-dimensional images superimposition. Thirty-two adult patients with bimaxillary protrusion planed for treatment with four first premolar extractions will be enrolled. All patients will be randomly allocated in a 1:1 ratio to either EM (n=16) group or the TSR (n=16) group. Cone bean computed tomography will be taken before and after anterior retraction. A blind observer will construct separate 3D models for maxillary and mandibular surfaces using the anterior cranial fossa to register models of before and after space closing. Quantitative assessment of posterior anchorage loss and amount of anterior teeth retraction are the main outcomes. The secondary outcomes are the inclination of the molars, canines and incisors.

02

Conditions studied

  • Malocclusion, Angle Class I
  • Bimaxillary Protrusion
  • Orthodontic Space Closure
03

In context

Malocclusion, Angle Class I

35 studies on the registry are indexed under Malocclusion, Angle Class I; 10 are open to participants now.

This study's planned enrollment of 32 is close to the median of 32 across 31 interventional studies indexed under Malocclusion, Angle Class I.

Browse Malocclusion, Angle Class I studies →

Lead sponsor

Rio de Janeiro State University is the lead sponsor of 62 studies on the registry; 6 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years to 40 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Angle Class I malocclusion;
  • Bimaxillary protrusion;
  • Convex profile;
  • All natural teeth present in the mouth;
  • Absence of crowding or with negative discrepancy up to 4mm;
  • Absence of vertical and transverse occlusal problems;
  • Good oral health;
  • Good general health.

Exclusion criteria

Exclusion Criteria:

  • Lack of time to attend consultations;
  • Patients with severe systemic and psychological illness;
  • Patients with parafunction (bruxism), reflux or eating disorders;
  • Presence of periodontal disease;
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
32 participants (estimated)

Study arms

  • Experimental
    En Masse Retraction

    Group treated by retracting the six anterior teeth simultaneously.

    Procedure: En masse anterior teeth retraction

  • Active comparator
    Two-Step Retraction

    Group treated by retracting the canines incisors in two different steps.

    Procedure: Two-Step Retraction

Interventions

  • ProcedureEn masse anterior teeth retraction

    After extraction of the four premolars the posterior teeth will be tied-together and the six anterior teeth will be retracted by sliding mechanics.

  • ProcedureTwo-Step Retraction

    After extraction of the four premolars the posterior teeth will be tied-together and the canines will be retracted by sliding mechanics. After the distalization of the canines they will be tied to the posterior teeth and the incisors will be retracted by sliding mechanics.

06

What researchers measure

Primary outcomes

  1. Anchorage loss

    Quantitative assessment of posterior anchorage loss between the two groups as measured by tomographic superimposition at the end of space closure.

    Time frame: 12 months

  2. Anterior teeth retraction

    Quantitative assessment of anterior teeth retraction between the two groups as measured by tomographic superimposition at the end of space closure.

    Time frame: 12 months

Secondary outcomes

  1. Molar inclination

    Quantitative assessment of molars inclination between the two groups as measured by tomographic superimposition at the end of space closure.

    Time frame: 12 months

  2. Canine inclination

    Quantitative assessment of canines inclination between the two groups as measured by tomographic superimposition at the end of space closure.

    Time frame: 12 months

  3. Incisors inclination

    Quantitative assessment of incisors inclination between the two groups as measured by tomographic superimposition at the end of space closure.

    Time frame: 12 months

07

Study locations

1 of 1 sites recruiting
  • Faculdade de Odontologia - UERJ
    Rio de Janeiro, 20551-030, Brazil
    Recruiting
08

References and documents

Publications

  • Heo W, Nahm DS, Baek SH. En masse retraction and two-step retraction of maxillary anterior teeth in adult Class I women. A comparison of anchorage loss. Angle Orthod. 2007 Nov;77(6):973-8. doi: 10.2319/111706-464.1. PubMed 18004930 ↗
  • Xu TM, Zhang X, Oh HS, Boyd RL, Korn EL, Baumrind S. Randomized clinical trial comparing control of maxillary anchorage with 2 retraction techniques. Am J Orthod Dentofacial Orthop. 2010 Nov;138(5):544.e1-9; discussion 544-5. doi: 10.1016/j.ajodo.2009.12.027. PubMed 21055588 ↗
  • Schneider PP, Gandini Junior LG, Monini ADC, Pinto ADS, Kim KB. Comparison of anterior retraction and anchorage control between en masse retraction and two-step retraction: A randomized prospective clinical trial. Angle Orthod. 2019 Mar;89(2):190-199. doi: 10.2319/051518-363.1. Epub 2018 Nov 26. PubMed 30475647 ↗
  • Leonardi R, Annunziata A, Licciardello V, Barbato E. Soft tissue changes following the extraction of premolars in nongrowing patients with bimaxillary protrusion. A systematic review. Angle Orthod. 2010 Jan;80(1):211-6. doi: 10.2319/010709-16.1. PubMed 19852663 ↗
  • Kojima Y, Fukui H. Numerical simulation of canine retraction by sliding mechanics. Am J Orthod Dentofacial Orthop. 2005 May;127(5):542-51. doi: 10.1016/j.ajodo.2004.12.007. PubMed 15877034 ↗
  • Bennett JC, McLaughlin RP. Controlled space closure with a preadjusted appliance system. J Clin Orthod. 1990 Apr;24(4):251-60. No abstract available. PubMed 2094736 ↗
  • Ribeiro GL, Jacob HB. Understanding the basis of space closure in Orthodontics for a more efficient orthodontic treatment. Dental Press J Orthod. 2016 Mar-Apr;21(2):115-25. doi: 10.1590/2177-6709.21.2.115-125.sar. PubMed 27275623 ↗
  • Pervin S, Rolland S, Taylor G. En masse versus two-step retraction of the anterior segment. Evid Based Dent. 2018 Dec;19(4):111-112. doi: 10.1038/sj.ebd.6401343. PubMed 30573856 ↗
  • Rizk MZ, Mohammed H, Ismael O, Bearn DR. Effectiveness of en masse versus two-step retraction: a systematic review and meta-analysis. Prog Orthod. 2018 Jan 5;18(1):41. doi: 10.1186/s40510-017-0196-7. PubMed 29302879 ↗
  • Cevidanes LH, Bailey LJ, Tucker GR Jr, Styner MA, Mol A, Phillips CL, Proffit WR, Turvey T. Superimposition of 3D cone-beam CT models of orthognathic surgery patients. Dentomaxillofac Radiol. 2005 Nov;34(6):369-75. doi: 10.1259/dmfr/17102411. PubMed 16227481 ↗
  • Cevidanes LH, Styner MA, Proffit WR. Image analysis and superimposition of 3-dimensional cone-beam computed tomography models. Am J Orthod Dentofacial Orthop. 2006 May;129(5):611-8. doi: 10.1016/j.ajodo.2005.12.008. PubMed 16679201 ↗
  • Feldmann I, Bondemark L. Orthodontic anchorage: a systematic review. Angle Orthod. 2006 May;76(3):493-501. doi: 10.1043/0003-3219(2006)076[0493:OA]2.0.CO;2. PubMed 16637733 ↗
  • Geron S, Shpack N, Kandos S, Davidovitch M, Vardimon AD. Anchorage loss--a multifactorial response. Angle Orthod. 2003 Dec;73(6):730-7. doi: 10.1043/0003-3219(2003)0732.0.CO;2. PubMed 14719740 ↗
  • Domingo-Clerigues M, Montiel-Company JM, Almerich-Silla JM, Garcia-Sanz V, Paredes-Gallardo V, Bellot-Arcis C. Changes in the alveolar bone thickness of maxillary incisors after orthodontic treatment involving extractions - A systematic review and meta-analysis. J Clin Exp Dent. 2019 Jan 1;11(1):e76-e84. doi: 10.4317/jced.55434. eCollection 2019 Jan. PubMed 30697398 ↗
  • Keim RG. Space closure and anchorage control. J Clin Orthod. 2013 Mar;47(3):153-4. No abstract available. PubMed 23660788 ↗
  • Keim RG. The challenge of bimaxillary protrusion. J Clin Orthod. 2017 Jun;51(6):315-316. No abstract available. PubMed 29059058 ↗
  • Liu Y, Olszewski R, Alexandroni ES, Enciso R, Xu T, Mah JK. The validity of in vivo tooth volume determinations from cone-beam computed tomography. Angle Orthod. 2010 Jan;80(1):160-6. doi: 10.2319/121608-639.1. PubMed 19852656 ↗
  • Shearn BN, Woods MG. An occlusal and cephalometric analysis of lower first and second premolar extraction effects. Am J Orthod Dentofacial Orthop. 2000 Mar;117(3):351-61. doi: 10.1016/s0889-5406(00)70240-x. PubMed 10715095 ↗
  • Ong HB, Woods MG. An occlusal and cephalometric analysis of maxillary first and second premolar extraction effects. Angle Orthod. 2001 Apr;71(2):90-102. doi: 10.1043/0003-3219(2001)0712.0.CO;2. PubMed 11302594 ↗
  • Solem RC, Marasco R, Guiterrez-Pulido L, Nielsen I, Kim SH, Nelson G. Three-dimensional soft-tissue and hard-tissue changes in the treatment of bimaxillary protrusion. Am J Orthod Dentofacial Orthop. 2013 Aug;144(2):218-28. doi: 10.1016/j.ajodo.2013.03.018. PubMed 23910203 ↗
  • Williams R, Hosila FJ. The effect of different extraction sites upon incisor retraction. Am J Orthod. 1976 Apr;69(4):388-410. doi: 10.1016/0002-9416(76)90208-6. PubMed 1062936 ↗
  • Yoshida N, Koga Y, Mimaki N, Kobayashi K. In vivo determination of the centres of resistance of maxillary anterior teeth subjected to retraction forces. Eur J Orthod. 2001 Oct;23(5):529-34. doi: 10.1093/ejo/23.5.529. PubMed 11668872 ↗
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Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Apr 2019 (actual). Primary completion is estimated for Apr 2020, 12 months after the start.

Of 23 interventional studies with no phase under Malocclusion, Angle Class I, half reached primary completion within 21 months of starting (the median), counting those still running; a quarter within 15 and three quarters within 24. This study's planned 12 months is below that.

How these figures are worked out, and which studies are left out of them.

Registered
Apr 3, 2019
First posted
Apr 4, 2019
StartActual
Apr 3, 2019
Primary completionEst.
Apr 2020
CompletionEst.
Dec 2020
Last update
Apr 5, 2019
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Apr 5, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT03903575
Lead sponsor
Rio de Janeiro State University
Collaborators
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
Responsible party
Sergio Roberto de Oliveira Caetano (Masters in Orthodontics, PhD Student, Rio de Janeiro State University) — Principal investigator
First posted
Apr 4, 2019
Start date
Apr 3, 2019
Primary completion
Apr 2020 (estimated)
Completion
Dec 2020 (estimated)
Last update
Apr 5, 2019

Study contacts

Sergio Caetano, MSc
Contact
srocaetano@hotmail.com
+55(21)97912-5679
Flavia Artese, PhD
Contact
flaviaartese@gmail.com
+55(21)98155-4280
Sergio Caetano, MSc
principal investigator · Rio de Janeiro State University
Flavia Artese, PhD
study director · Rio de Janeiro State University
Jose Augusto M Miguel, PhD
study chair · Rio de Janeiro State University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is status unknown, as verified in Apr 2019. You cannot join it, but the record below documents what was studied.

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