Evaluation of Rate of Intrusion, Retraction and Amount of Periapical Root Resorption with Jayade’s Intrusion Arch versus Modified Three-piece Intrusion Arch using CBCT: A Research Protocol

Abstract

Introduction: Deep bite, a common orthodontic malocclusion, necessitates timely intervention to prevent potential side-effects. If left untreated, a deep bite can lead to increased tooth wear, dental injuries, and Temporomandibular Joint (TMJ) disorders. Various treatment modalities, such as anterior teeth intrusion and posterior teeth extrusion, are employed to correct deep bite. However, selecting the optimal approach requires careful consideration of patient-specific factors and treatment objectives. While anterior teeth intrusion is effective for mild to moderate cases, posterior teeth extrusion may be preferred in severe deep bite scenarios. There are various treatment modalities for deep bite correction such as intrusion arches and mini screw implants. Jayade’s intrusion arch, detailed by A.V. Jayade in “Refined Begg for Modern Times” (2001), is an orthodontic appliance designed to correct vertical dental misalignments by intruding over-erupted anterior teeth. The modified three-piece intrusion arch is an advancement of the traditional intrusion arch technique. It incorporates three distinct segments: two lateral segments and a central segment. This design allows for greater precision and control over the intrusion forces applied to specific teeth or groups of teeth. Need of the Study: Simultaneous intrusion and retraction mechanics in orthodontic treatment are very challenging, and there is a paucity of data regarding the best modalities for achieving these with minimal root resorption. Aim: Comparative evaluation of the rate of intrusion, retraction and amount of periapical root resorption with Jayade’s intrusion arch and the modified three-piece intrusion arch using Cone Beam Computed Tomography (CBCT). Materials and Methods: The present prospective, two-arm parallel interventional study will be conducted in the Department of Orthodontics and Dentofacial Orthopaedics Outpatient Department, Sharad Pawar Dental College, Sawangi (Meghe), Wardha, Maharashtra, India, from September 2024 to February 2026. Study will involve the recruitment of 20 patients and all these patients will be divided into two groups for comparative analysis. The intervention will entail the use of the McLaughlin, Bennett and Trevisi (MBT) bracket system equipped with triple tubes on maxillary teeth, characterised by a slot dimension of 0.022 inches by 0.028 inches, as the standardised starting point for all cases. After initial alignment and leveling, and extractions as per the case, the intrusion arch will be applied. Jayade’s intrusion arch will be given in group A, while the modified three-piece intrusion arch will be given in group B. The assessment of intrusion rate, retraction rate and amount of root resorption will be conducted both prior to the initiation of intrusive and retractive forces, as well as, at intervals of two, four and six months following the application of the intrusion arches.

Keywords

• anchorage
• cone beam computed tomography
• deep bite
• extraction
• lateral cephalogram