Clinical Trial: Orthodontic Reduction of an Increased Overbite in Adolescents - the Mechanism and Rate of Occlusal Adaptation

Study Status: Not yet recruiting
Recruit Status: Not yet recruiting
Study Type: Interventional

Official Title: Orthodontic Reduction of an Increased Overbite in Adolescents - the Mechanism and Rate of Occlusal Adaptation

Brief Summary:

The correction of a deep overbite is assumed to involve incisor intrusion and the extrusion or eruption of premolars and molars. The latter is also assumed to be the major contributor for growing patients where the vertical facial growth increase accommodates for the additional eruption of posterior teeth with anterior bite plane appliances.

In this study the nature and rate of adaptation of the occlusal changes following insertion of a fixed anterior bite plane for the reduction of a deep overbite in growing patients will be investigated.


Detailed Summary:

All subjects who meet the inclusion criteria will be informed of the study and written consent sought for their participation. Subjects will be recruited from the new patient clinics and routine treatment waiting list. A standard initial lateral cephalogram will be taken of all subjects, unless this is already available within the specified age range. Active growth will be determined using the Bacetti CVM method. For the Intervention group - an intra-oral scanner will be used to accurately record the occlusal relationships prior to insertion of the fixed anterior bite plane (T0) and repeated immediately after placement (T1). Each subject will then be re-scanned on a six weekly basis for a period of six months (T2-T5). Conventional clinical photographs and three-dimensional stereophotogrammetry will be used to assess the vertical facial relationships at T0-T5. A further lateral cephalogram will be taken at T5 to assess for skeletal change and assess for evidence of intrusion and eruption as well as determine if there has been an alteration in incisor inclination.

A control group of subjects from the treatment waiting list who meet the inclusion criteria will be used. An intra-oral scanner will record the baseline occlusal relationship (T0) and will be repeated after six months (T5). The control group will also have a standard pre-treatment lateral cephalogram taken, as well as conventional and three-dimensional stereophotogrammetry at baseline (T0) and after six months (T5). This will allow changes resulting from growth to be assessed whilst no active orthodontic treatment has taken place.

The primary outcomes to be assessed will be the nature of the change in occlusal-vertical dimension and the rate of occlusal adaptation in relation to facial growth changes. The intra-oral scans and photographs will be analysed using thre
Sponsor: NHS Tayside

Current Primary Outcome:

  • The rate of occlusal reestablishment (measured as first molar contact) following insertion of fixed anterior bite planes (measured in weeks) [ Time Frame: Measured 6-weekly for a period of 6 months (T0-T5) ]
    An intra-oral scanner will allow detailed analysis of the occlusal changes following insertion of fixed anterior bite planes. Participants will be re-scanned every 6 weeks for a period of 6 months to determine if and when first molar contact is re-established.
  • The nature of occlusal changes following insertion of fixed anterior bite planes (measured in millimetres) [ Time Frame: Measured 6-weekly for a period of 6 months (T0-T5) ]
    An intra-oral scanner will allow detailed analysis of what occlusal changes occur (eruption/intrusion) following insertion of fixed anterior bite planes


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • The acceptability of fixed anterior bite planes and intra-oral scanning in adolescents (questionnaire) [ Time Frame: 6 months ]
    A questionnaire will be used in the intervention group after 6 months to determine the acceptability of the fixed bite planes
  • If treatment with bite planes increases participants knowledge of overbite reduction and relation to oral health/ orthodontic treatment (questionnaire) [ Time Frame: 6 months ]
    Questionnaires will be used at T0 and T5 (in the intervention group) to assess participants knowledge of overbite reduction and its impact on dental health.
  • Economic impact of using fixed bite planes as an alternative to a removable appliance (measured in pounds sterling) [ Time Frame: 6 months ]
    An estimate will be made of the cost of providing the fixed bite planes compared to the standard method of overbite reduction using a removable appliance


Original Secondary Outcome: Same as current

Information By: NHS Tayside

Dates:
Date Received: September 22, 2016
Date Started: October 2016
Date Completion: August 2018
Last Updated: October 4, 2016
Last Verified: October 2016