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. 2014 Aug 19;2014(8):CD005098. doi: 10.1002/14651858.CD005098.pub3

Maddalone 2010.

Methods
  • Trial design: single‐centre RCT (parallel group)

  • Location: Italy, exact setting not specified

  • Recruitment period: not stated

  • Funding source: institutional funding

  • Source of participants: patients attending clinic

  • Study duration: 4 months

  • Time points at which follow‐up are reported: from start of canine retraction for 4 months

Participants
  • 38: age range between 12 and 54 years, gender distribution not mentioned

  • 19 in the mini‐screw implant group

  • 19 in the conventional anchorage group

  • Inclusion criteria:

  1. the need to distalize upper and/or lower canines into an extraction space, for a distance between 2 and 6 mm, in order to complete the correction of the overjet or the resolution of incisal crowding

Interventions
  • Comparison 1: Mini‐screw implants (Imtec Ortho Implant, 3M Unitek)

  1. Placed between second premolar and molar, at an angle of 45º to 90º

  2. Chlorhexidine mouthwash 2% was prescribed 2 times/day 1 day before insertion and 15 days after insertion

  • Comparison 2: Conventional anchorage

  1. This consisted of elastomeric chains or NiTi springs

  2. Attached to second premolar and first molars which were tied together by steel ligatures

  3. The force applied ranged from 75 to 150 g

  4. Replaced every 15 days to maintain force level

  5. Force was measured by using a 'dynamometer' 5‐mini‐implants were placed between molars

  6. Mini‐implants were placed between molars to act as markers for measurement of molar movement

Outcomes
  • Mesial movement (mm) of maxillary first molar measured clinically using the head of the implant as a reference, measure 4 months after commencement of space closure

  • Success/failure of mini‐implant (loosening of mini‐implant)

  • Duration of space closure phase

Notes Information for this study was obtained from a Google translation of the manuscript reporting the study
The method of measurement of molar movement used the head of the mini‐screw implants and the canines as a reference, it is unknown if the implant is a stable reference point
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Translated quote: "The items were assigned randomly to two groups of study: 19 were treated with distalisation…"
Comment: insufficient information about the sequence generation process to permit judgement
Allocation concealment (selection bias) Unclear risk The method of allocation concealment was not mentioned
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk Not addressed
Incomplete outcome data (attrition bias) 
 mesial movement of upper first maxillary molar Low risk All randomised patients were analysed
Selective reporting (reporting bias) High risk
  • Selective reporting of outcomes: insufficient information to permit judgement

  • Selective reporting of data: mesial movement of molars was incompletely reported as the means were reported without standard deviations

Other bias Low risk Study appears to be free of other sources of bias