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CTRI Number  CTRI/2025/07/091614 [Registered on: 24/07/2025] Trial Registered Prospectively
Last Modified On: 24/07/2025
Post Graduate Thesis  Yes 
Type of Trial  Interventional 
Type of Study   Dentistry 
Study Design  Randomized, Parallel Group, Active Controlled Trial 
Public Title of Study   comparison of canine retraction using in-house direct-printed aligners with versus without attachment 
Scientific Title of Study   Comparison of tooth movement, root resorption and predictability of canine retraction using direct printed clear aligners with versus without attachment: A Cone-beam computed tomography-based study 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr.Keerthi Raja S 
Designation  Post graduate 
Affiliation  Tagore dental college and Hospital 
Address  Department of orthodontics, Tagore dental college and hospital, Rathinamangalam, Melakkottaiyur Post, Near Vandalur Chennai,Tamil Nadu,India pincode- 600127

Chennai
TAMIL NADU
600127
India 
Phone  8056127584  
Fax    
Email  keerthiraja017@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr.Mahalakshmi.K 
Designation  Reader 
Affiliation  Tagore dental college and Hospital 
Address  Department of orthodontics, Tagore dental college and hospital, Rathinamangalam, Melakkottaiyur Post, Near Vandalur Chennai, Tamil Nadu, India pincode- 600127

Chennai
TAMIL NADU
600127
India 
Phone  9840504523  
Fax    
Email  mahakrishnasai@gmail.com  
 
Details of Contact Person
Public Query
 
Name  Dr.Keerthi Raja S 
Designation  Post graduate 
Affiliation  Tagore dental college and Hospital 
Address  Department of orthodontics, Tagore dental college and hospital, Rathinamangalam, Melakkottaiyur Post, Near Vandalur Chennai, Tamil Nadu, India pincode- 600127

Chennai
TAMIL NADU
600127
India 
Phone  8056127584  
Fax    
Email  keerthiraja017@gmail.com  
 
Source of Monetary or Material Support  
Tagore Dental College and Hospital,Rathinamangalam, Melakkottaiyur Post, Near Vandalur,Chennai,Tamil Nadu, India pincode-600127 
 
Primary Sponsor  
Name  Dr Keerthi Raja S 
Address  Department of orthodontics, Tagore dental college and hospital, Rathinamangalam, Melakkottaiyur Post, Near Vandalur Chennai,Tamil Nadu,India pincode- 600127  
Type of Sponsor  Other [Self] 
 
Details of Secondary Sponsor  
Name  Address 
Dr Mahalakshmi K  Melakkottaiyur Post, Near Vandalur Chennai 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Keerthi Raja S  Tagore dental college and hospital  Department of orthodontics, Tagore dental college and hospital, Rathinamangalam, Melakkottaiyur Post, Near Vandalur Chennai,Tamil Nadu,India pincode- 600127
Kancheepuram
TAMIL NADU 
08056127584

keerthiraja017@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
INSTITUTE ETHICS COMMITTIEE TAGORE DENTAL COLLEGE AND HOSPITAL  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: M264||Malocclusion, unspecified,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  canine retraction using in-house direct-printed aligners with attachment  • On the contralateral side, canine retraction will use aligners with attachments FOR A TOTAL DURATION OF 3 MONTHS, including vertical rectangular attachments on canines for retraction and horizontal rectangular attachments on first molars and second premolars for anchorage 
Intervention  canine retraction using in-house direct-printed aligners without attachment  • On one randomly assigned side, the canine will be retracted using direct-printed clear aligners without attachments, employing varied aligner thicknesses FOR A TOTAL DURATION OF 3 MONTHS 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  50.00 Year(s)
Gender  Both 
Details  Age greater than 18 years
Class I or II malocclusion
Good general and oral health
No dental caries
Good oral hygiene
Indication for clear aligner therapy
 
 
ExclusionCriteria 
Details  Crowding less than 4mm (Little’s Irregularity Index)
Systemic diseases affecting bone metabolism
Craniofacial anomalies or syndromes
Missing or previously extracted permanent molars
Periodontal disease, pregnancy, history of orthodontic treatment
Smokers and non-compliant patients
 
 
Method of Generating Random Sequence   Coin toss, Lottery, toss of dice, shuffling cards etc 
Method of Concealment   Sequentially numbered, sealed, opaque envelopes 
Blinding/Masking   Outcome Assessor Blinded 
Primary Outcome  
Outcome  TimePoints 
translation of canine and predictability  3months 
 
Secondary Outcome  
Outcome  TimePoints 
root resorption  3 months 
anchorage loss  3 months 
periodontal status  monthly 
 
Target Sample Size   Total Sample Size="14"
Sample Size from India="14" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 2/ Phase 3 
Date of First Enrollment (India)   04/08/2025 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="1"
Months="6"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Open to Recruitment 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - YES
  1. What data in particular will be shared?
    Response - Individual participant data that underlie the results reported in this article, after de-identification (text, tables, figures, and appendices).

  2. What additional supporting information will be shared?
    Response -  Study Protocol
    Response -  Statistical Analysis Plan
    Response - Informed Consent Form
    Response - Clinical Study Report

  3. Who will be able to view these files?
    Response - Researchers whose proposed use of the data has been approved by an independent review committee identified for this purpose.

  4. For what types of analyses will this data be available?
    Response - To achieve aims in the approved proposal.

  5. By what mechanism will data be made available?
    Response - Proposals should be directed to [keerthiraja017@gmail.com].

  6. For how long will this data be available start date provided 30-09-2027 and end date provided 29-09-2030?
    Response - Beginning 9 months and ending 36 months following article publication.

  7. Any URL or additional information regarding plan/policy for sharing IPD? 
    Additional Information - nil
Brief Summary  

Title

Comparison of Tooth Movement, Root Resorption, and Predictability of Canine Retraction Using Direct Printed Clear Aligners with Versus Without Attachment: A Cone-Beam Computed Tomography-Based Study

This split-mouth, in-vivo clinical study aims to compare the efficiency, predictability, and biological effects of canine retraction using in-house direct-printed clear aligners with and without attachments. The study will be conducted among orthodontic patients indicated for bilateral maxillary first premolar extractions and aligner therapy.

A total of 7 patients (14 samples) will be recruited following specific inclusion criteria such as age above 18, Class I or II malocclusion, good oral hygiene, and absence of systemic or periodontal disease. Each patient will undergo a split-mouth intervention, where one side of the arch will be randomly assigned to receive aligners with attachments, while the opposite side will receive aligners without attachments. Attachments include vertical rectangular shapes on canines to facilitate retraction and horizontal attachments on premolars and molars for anchorage. All aligners will be fabricated using a 3D printer and biocompatible resin and will be worn for 22 hours/day, with tray changes every 10 days over a 3-month period.

Cone-Beam Computed Tomography (CBCT) will be used at baseline (T0) and after retraction (T2) to obtain 3D models and assess treatment changes. Tooth movement will be measured in sagittal, transverse, and vertical planes, using defined anatomical reference planes and points. Parameters evaluated will include distalisation, tipping, rotation, extrusion, and bodily movement. In addition, root resorption will be measured by comparing root lengths between pre- and post-treatment CBCT scans.

Predictability will be assessed by comparing predicted movement (T1) with actual outcomes (T2) using Geomagic software for 3D superimposition, referencing the palatal vault and rugae. The main outcomes include differences in tooth movement, the extent of root resorption, and overall treatment predictability between the two groups.

This study addresses a critical gap in evidence regarding the role of attachments in improving the biomechanical performance of aligners during canine retraction. Findings from this research may influence clinical decision-making, aligner design, and enhance patient outcomes by supporting safer and more efficient orthodontic treatment protocols.


 
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