Comparison of the Efficiency of Maxillary Canine Retraction Using Aligners Versus Conventional Brackets in Orthodontic Extraction Cases.
Comparison of the Efficiency of Maxillary Canine Retraction Using Aligners Versus Conventional Brackets in Orthodontic Extraction Cases.
The aim of this study is to compare the effectiveness of Clear aligners and Conventional
 braces for upper canine retraction (space closure) regarding canine tipping , anchorage loss
 and treatment time.
Conventional fixed orthodontic treatment with metal brackets has been rejected by some adult
 patients because of esthetic and social concerns, but the demand for orthodontic treatment is
 currently increasing. To satisfy the demands and needs of these patients, the emphasis has
 shifted toward esthetic orthodontic appliance system. Less noticeable appliances such as
 ceramic, resin, and lingual brackets, or removable clear appliances such as the Essix and
 Invisalign (Align Technology, Santa Clara, Calif) provide esthetic orthodontic appliance
 alternatives.

 Since the introduction of clear aligners to the public in 1999, it has become a popular
 treatment choice for clinicians because of the aesthetics and comfort of the removable clear
 aligners compared with traditional appliances. Several studies have shown significant
 limitations of this technique, especially in treating complex malocclusions, whereas other
 studies have reported successfully treated cases with this removable appliance. A systematic
 review conducted to determine the treatment effects of clear aligners showed that no strong
 conclusions could be made regarding the treatment effects of aligners . Therefore, clinical
 trials were still required to investigate the effectiveness of the Invisalign system.

 When using the aligners to correct severe crowding, root positions must be carefully
 controlled during extraction space closure, and clear aligners must be properly grip all
 teeth to be moved, Tipping was a common problem in premolar extraction cases during the early
 years of aligners use. Several previous reports have also discussed the limited ability of
 thermoplastic appliances to control root-tipping movements and to establish root control
 comparable to that provided by fixed appliances. The investigators describe the extraction
 treatment of a patient with moderate to severe tooth crowding using mini screws and clear
 appliances, thus eliminating the need for conventional brackets.
Inclusion Criteria:

 -  1) Moderate to severe crowding orthodontic patients.( Irregularity index of <5 mm)

 2) Good oral hygiene. (Patient with periodontally sound dentition).

 3) Patient in permanent dentition between the age range 16 - 40 years.

 4) .Patients requiring extraction of mandibular and maxillary first premolars;

 5) Patients having sound general health

 Exclusion Criteria:

 -  1) Systematic disease.

 2) Poor oral hygiene patients.

 3 ) Periodontally affected teeth.