An interventional study of Corticotomy and Conventional traction in Impaction of Tooth, sponsored by Damascus University. Completed at 1 site in Syria. Open to participants aged 18 Years to 28 Years. Per ClinicalTrials.gov, last updated 2025-12-29.
Sponsored by Damascus University · Not applicable, Interventional, and Treatment
The impaction of maxillary canines is a challenge for orthodontists. Recently, new methods have been proposed to accelerate canine withdrawal. The associated dental changes between the conventional and accelerated methods of canine traction have not yet been assessed.
Impacted canines are defined as those that have not erupted within 6 six months after completing the formation of their roots or that were not present within the dental arch during their eruption phase. Upper Impacted canines are present in 2% of the general population and occur in females at a rate of 1.17%, which is almost twice the incidence in males. The incidence of palatal impaction ranges from 60% to 80% and is present bilaterally with a rate of 75-95%. The upper canines usually erupt at an average age of 10.5 years in females and 11.5 years in males, with an individual difference of 3-4 years. Eruption failure of the upper canines occurs because of hard or soft tissue obstructions or an abnormal eruption pathway.
The most important causes of palatally impaction of upper canines are dental arch length deficiency, over-retained primary teeth, and trauma during the canine formation stage. One local mechanical cause is a decrease in the width of the upper dental arch. McConnell et al. reported that patients with upper impacted canines had a reduction in dental arch width, especially in the anterior region. On the other hand, unilateral or bilateral upper canine impaction can affect upper dental arch width and alter smile symmetry.
The impaction of the upper canine is also considered as one of the causes that lead to a lack of transverse development of the maxillary dental arch, especially the inter-premolar width. This is supported by the functional matrix theory, which considers that the presence of the organ stimulates bone growth. Thus, the natural eruption of the canine stimulates the normal transverse growth of the dental arch.
Many treatment strategies were used to treat impacted canine cases, but orthodontic traction after surgical exposure was the most commonly recommended method in the literature, given the great aesthetic and functional value of the upper canines. Two main surgical methods are used for this purpose: the open and closed surgical approaches.
Several mechanical means have been used to obtain the traction force. However, choosing the appropriate mechanical method that produces the least undesirable effects on adjacent teeth was a challenge for the clinical practitioner.
Many factors could result in unwanted changes in the spatial position of the adjacent teeth, such as the use of an open coil spring, direct reliance on these teeth to tract the impacted canine, the type of baseline orthodontic archwire used, and the type of orthodontic anchorage means. These side effects on adjacent teeth can be minimized by using techniques such as the segmented archwire technique and temporary anchorage devices (TADs).
122 studies on the registry are indexed under Tooth, Impacted; 15 are open to participants now.
This study's enrollment of 44 is below the median of 70 across 88 interventional studies indexed under Tooth, Impacted.
Browse Tooth, Impacted studies →Damascus University is the lead sponsor of 212 studies on the registry; 11 are open to participants now.
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Exclusion Criteria:
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Perforations of the bone surrounding the impacted canine will be conducted at the time of canine exposure. Two months later, another flapless corticotomy procedure will be performed during the withdrawal of the impacted canine.
Procedure: Corticotomy
The canines will be withdrawn to the dental arch using the conventionnal method without subjecitng the patient to any additional surgical intervention.
Procedure: Conventional traction
During the surgical exposure phase in the acceleration group, the cortical bone will be perforated around the exposed canine crown (6-8 holes) wherever possible-this procedure aims to accelerate the withdrawal movement of the impacted canine. A 1 mm round bur will be used to create circular holes (1 mm in diameter, 1-2 mm in depth, and spaced about 1.5 mm apart). After two months of the surgical exposure, the second acceleration procedure will be performed. Two or three vertical incisions (8 mm height) will be made using a surgical scalpel at the buccal side of the impaction area. The cortical cuts (2-3 mm in depth, 1 mm in width, and spaced about 2 mm apart) will be performed using a flapless piezosurgery technique along the vertical lines.
Also known as: flapless corticotomy, piezocision, piezosurgery
The canines will be withdrawn using conventional methods without any surgical acceleration.
Change in the upper dental midline deviation
The deviation of the upper dental midline will be measured in millimeters as the distance from the maxillary central incisors contact point to the maxillary model midline. This will be performed on the plaster models.
Time frame: T1: before the commencement of canine traction (expected to occur within 3-5 months following the beginning of fixed orthodontic treatment). T2: at the end of the canine traction stage (expected to occur with 5-8 months after T1)
Change in the rotation of the lateral incisor.
The rotation will be measured in degrees as the angle between the maxillary model midline and the line connecting the mesial-distal marginal points of the adjacent lateral incisor.
Time frame: T1: before the commencement of canine traction (expected to occur within 3-5 months following the beginning of fixed orthodontic treatment). T2: at the end of the canine traction stage (expected to occur with 5-8 months after T1)
Change in the rotation of the first premolar
The rotation will be measured in degrees as the angle between the maxillary model midline and the line connecting the mesial-distal marginal points of the adjacent first premolar.
Time frame: T1: before the commencement of canine traction (expected to occur within 3-5 months following the beginning of fixed orthodontic treatment). T2: at the end of the canine traction stage (expected to occur with 5-8 months after T1)
Change in the inter-premolar width
Inter-premolar width will be measured in millimeters as the distance from the deepest point in the central groove of the adjacent first premolar and its counterpart on the contralateral side
Time frame: T1: before the commencement of canine traction (expected to occur within 3-5 months following the beginning of fixed orthodontic treatment). T2: at the end of the canine traction stage (expected to occur with 5-8 months after T1)
Plan to share: No
Ran from Mar 2023 to primary completion in Oct 2024, 19 months.
Of 55 non-industry interventional studies with no phase under Tooth, Impacted, half reached primary completion within 20 months of starting (the median), counting those still running; a quarter within 8 and three quarters within 35. This study's 19 months is close to that.
Counting every sponsor, half of 56 studies reached it within 20 months; a quarter within 8 and three quarters within 34.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in Dec 2025. You cannot join it, but the record below documents what was studied.
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