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21 March 2013 
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An investigation of two methods of orthodontic space closure: Nickel Titanium versus Stainless Steel Springs
ISRCTN ISRCTN05771195
DOI 10.1186/ISRCTN05771195
ClinicalTrials.gov identifier
EudraCT number
Public title An investigation of two methods of orthodontic space closure: Nickel Titanium versus Stainless Steel Springs
Scientific title Nickel Titanium versus Stainless Steel Springs: A randomized clinical trial of two methods of orthodontic space closure
Acronym N/A
Serial number at source N/A
Study hypothesis Nickel titanium (NiTi) coil spring and stainless steel springs are commonly used to close space in between teeth in brace treatment. However, we do not know which of these two springs is faster at closing gaps. The purpose of this study is to find out which orthodontic spring closes gaps the fastest, therefore shortening treatment time.

The null hypothesis is that there is no difference in the rate of orthodontic space closure between patients treated with NiTi coil springs or stainless steel springs.
Lay summary Background and study aims
In this study, we intend to determine whether stainless steel springs are as effective as Nickel Titanium (NiTi) coil springs in orthodontic space closure during orthodontic treatment. If we can show that stainless steel springs work as effectively in terms of the rate of space closure, this will be an important finding with respect to orthodontic care and health care expenditure.
The aims of this study were to:
• Compare the rate of orthodontic space closure between NiTi coil springs and stainless steel springs during fixed appliance treatment.
• Compare the cost effectiveness of NiTi coil springs and stainless steel springs in orthodontic space closure.

Who can participate?
Patients currently receiving orthodontic treatment in Countess of Chester Hospital and University of Manchester Dental Hospital.

What does the study involve?
In general, patients currently receiving orthodontic treatment who require orthodontic space closure between the first permanent molar and canine are suitable for this trial. All subjects who are eligible for inclusion will be interviewed and the purpose of trial will be outlined in written information sheets. Once consent is obtained, the patient will be randomly allocated to receive the stainless steel or nickel titanium spring as part of our routine space closing treatment. An impression of their teeth will be taken for study records at the start and completion of this trial. Apart from these, all participants will undertake the same routine treatment, as other non-trial patient would have. At the end of the trial, an examiner will take measurements of initial distance of space to be closed and after completion of space closure to determine the rate of space closure for each type of spring.

What are the possible benefits and risks of participating?
The possible benefits are rapid orthodontic space closure and shorter treatment time.
There are no significant risks or burdens for participants apart from the additional 5-10minutes during treatment time to undertake 2 sets of teeth impressions (study moulds) before and after the study trial commence

Where is the study run from?
This trial has been set up in Orthodontic Department, Countess of Chester Hospital and University of Manchester Dental Hospital.

When is the study starting and how long is it expected to run for?
This trial started in April 2011 and ran for one year until April 2012. However this trial may extend beyond this to collect, analyze and publish the data.

Who is funding the study?
There was no cost involved in purchasing these springs, as they were already available in the clinic. However, indemnity for this trial as has been provided by The University of Manchester.

Who is the main contact?
Dr Noraina Norman, norainanorman@gmail.com
Dr Stephen Chadwick, steve.chadwick@coch.nhs.uk
Ethics approval NHS/HSC Research and Development North West 3 (Liverpool East) Research Ethics Committee 10 February 2011, (Reference: 10/H1002/71) for both sites of this study.
Study design Prospective two-centred randomized clinical trial
Countries of recruitment United Kingdom
Disease/condition/study domain Rapid orthodontic space closure
Participants - inclusion criteria 1. Patients currently undergoing orthodontic brace treatment. We intend to include patients who are currently undergoing fixed appliance (brace) therapy regardless of age or sex. Although that, most orthodontic patients are adolescents between 12-17 year old.
2. Patients who require space closure between the canine and the first permanent molar
3. Informed written consent was obtained from the patient or the guardian/parent
Participants - exclusion criteria 1. Patients who decline to take part in the study
2. Patients who cannot be given brace treatment due to poor oral hygiene
Anticipated start date 01/04/2011
Anticipated end date 01/04/2012
Status of trial Completed
Patient information material Not available in web format, please use the contact details below to request a patient information sheet
Target number of participants 50
Interventions The intervention group will be allocated the stainless steel springs to close the space, whereas the control group will be allocated the nickel titanium coil springs.
Primary outcome measure(s) The rate of space closure in millimetres per month (4 weeks) in any quadrant requiring orthodontic space closure. Study record was taken at the start and conclusion of space closure period.
Secondary outcome measure(s) 1. Treatment time that is required to close the space
2. To compare the cost effectiveness between the two groups of springs
Sources of funding University of Manchester (UK)
Trial website
Publications
Contact name Dr  Stephen  Chadwick
  Address Countess of Chester Hospital NHS Foundation Trust
Oral Surgery and Orthodontic Department
Liverpool Road
  City/town Chester
  Zip/Postcode CH2 1UL
  Country United Kingdom
  Email steve.chadwick@coch.nhs.uk
Sponsor University of Manchester (UK)
  Address c/o Dr Karen Shaw
Head of Research Office
Christie Building
Oxford Road
  City/town Manchester
  Zip/Postcode M13 9PL
  Country United Kingdom
  Sponsor website: http://www.manchester.ac.uk/
Date applied 21/01/2013
Last edited 29/01/2013
Date ISRCTN assigned 29/01/2013
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