Reducing the burden of orthodontic care for children with clefts: evaluating the effectiveness of pre-alveolar bone graft orthodontics in unilateral non-syndromic cleft patients (PABO study)— A study protocol for a multicentric randomised controlled trial

From Springer Nature via Jisc Publications RouterHistory: received 2021-05-12, registration 2021-08-02, accepted 2021-08-02, pub-electronic 2021-08-28, online 2021-08-28, collection 2021-12Publication status: PublishedFunder: Science and Engineering Board, Department of Science and Technology, Govt. of India; Grant(s): CRG/2019/005689Abstract: Background: An alveolar cleft commonly affects 75% of cleft lip and palate patients. While it is common practice to provide a course of orthodontic treatment before alveolar bone grafting, there are no previous high-quality studies reporting on the benefits of this type of treatment. Aim: The aim of the study is to evaluate the effectiveness of pre-alveolar bone graft orthodontics for unilateral non-syndromic cleft palate patients. Method: The PABO trial is a multicentric, parallel, two-arm, single-blinded randomised controlled trial. The inclusion criteria include unilateral cleft alveolus patients requiring bone graft and between the age group of 8 and 13 years with erupted upper central incisors. Participants will be recruited at three centres across India. Participants will be randomised to orthodontic treatment or no orthodontic treatment group. Both groups of participants will have alveolar bone graft surgery and will be followed up for 6 months after surgery. The primary outcome will be the success of the alveolar bone graft measured by anterior oblique radiograph and secondary outcomes include quality of life, cost analysis and quality of the dento-occlusal outcome. Data analysis will be carried out by an independent statistician at the end of the study. Discussion: This study is the first to evaluate the effect of orthodontics on alveolar bone graft success. The increased burden of care for these patients with multiple treatments required from multiple specialists from birth to adult life highlights the need for reducing unnecessary treatment provision. Trial Registration: Clinical Trials Registry – India, CTRI/2020/10/028756. Trial prospectively registered on 29 October 2020.

Palatal implants are a good alternative to headgear: A randomized trial

Introduction: The objective of this study was to compare the effectiveness of midpalatal implants with that of headgear as methods of supplementing anchorage during orthodontic treatment. This was a randomized, clinical trial at the Chesterfield and North Derbyshire Royal Hospital NHS Trust and the Charles Clifford Dental Hospital, Sheffield, United Kingdom. Methods: Fifty-one orthodontic patients between the ages of 12 and 39 with absolute anchorage requirements were randomly allocated to receive either a midpalatal implant or headgear to reinforce orthodontic anchorage. The outcome measures of the trial were the surgical and orthodontic success rates of the implants, the number of visits, and the length of treatment time, and the success of treatment as judged by the peer assessment rating (PAR) score reductions and the patients’ attitudes to implant placement. Results: The surgical success rate of the implants was 75%, and the orthodontic success rate was more than 90%. Both implants and headgear proved to be effective methods of reinforcing anchorage. The total number of visits was greater in the implant group, but the overall treatment times were almost identical. There were no statistically significant differences between the 2 groups in PAR scores either at the start or the end of treatment, and the percentages of PAR score reductions were almost identical. The patients had no problems accepting midpalatal implants as a method of reinforcing anchorage. Conclusions: Midpalatal implants are an acceptable technique for reinforcing anchorage in orthodontic patients and a good alternative for patients who do not wish to wear headgear

A comparision of the effectiveness of the twin bloack and the dynamax appliances for the treatment of class 2 division 1 malocclusion patients : A randomised controlled trial

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