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A randomized clinical trial to compare the effectiveness of canine lacebacks with reference to canine tip

¹ University Dental Hospital of Manchester, UK
² St Anne’s Dental Clinic, Lytham St. Anne’s, UK
³ Union St. Orthodontic Practice, Oldham, UK
⁴ Chesterfield Royal Hospital, UK
⁵ University Dental Hospital of Manchester, UK

Dr N. A. Mandall, Orthodontic Unit, Department of Dental Medicine and Surgery, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester M15 6FH, UK. Email: Nicky{at}fs1.den.man.ac.uk.

Abstract

Aim: To assess the effectiveness of canine lacebacks on the proclination of the upper incisors with reference to pre-treatment canine tip.

Study design: Randomized clinical trial.

Sample: Patients receiving upper and lower fixed appliances attending the orthodontic departments of five orthodontic treatment providers. Sixteen patients received canine lacebacks as part of their treatment and 19 patients did not have canine lacebacks.

Method: Patients were randomly allocated to receive canine lacebacks or not receive canine lacebacks. Upper study models were collected at the initial archwire placement and then when the working 0.019 x 0.025-inch stainless steel archwire was placed. The start canine angulation, change in upper incisor proclination/overjet, and any mesial movement of the upper first permanent molars during levelling and aligning was measured with a reflex metrograph.

Statistics: The effect of the use of canine lacebacks on upper incisor proclination and mesial molar movement was assessed using Student t-tests. Regression analysis was used to evaluate any effect of the initial angulation of the canine.

Results: A mean incisor retroclination of 0.5 mm was observed in the canine lacebacks compared with a mean proclination of 0.36 mm when canine lacebacks were not used (P = 0.025). There was no statistically significant difference between groups for mesial movement of upper first molars (P = 0.99). If the canine was more distally inclined at the start of treatment, the incisors was more likely to procline, regardless of whether or not canine lacebacks were used (P = 0.027).

Conclusions: The effect of canine lacebacks on preventing upper incisor proclination at the start of treatment is in the order of 1 mm and their effect on mesial molar movement is insignificant. Canines lacebacks have similar effects that are independent of pre-treatment canine angulation.

Key words: Canine lacebacks, upper incisor proclination, overjet, canine tip, randomized clinical trial

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