title: A randomized clinical trial to compare the effectiveness of canine lacebacks with reference to canine tip.
abstract: OBJECTIVE
  To assess the effectiveness of canine lacebacks on the proclination of the upper incisors with reference to pre-treatment canine tip.
  
  
  METHODS
  Randomized clinical trial.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: University Dental Hospital of Manchester, UK.
authors.forename: T
authors.initials: T
authors.lastname: Usmani
authors.forename: K D
authors.initials: KD
authors.lastname: O'Brien
authors.forename: H V
authors.initials: HV
authors.lastname: Worthington
authors.forename: S
authors.initials: S
authors.lastname: Derwent
authors.forename: D
authors.initials: D
authors.lastname: Fox
authors.forename: S
authors.initials: S
authors.lastname: Harrison
authors.forename: P J
authors.initials: PJ
authors.lastname: Sandler
authors.forename: N A
authors.initials: NA
authors.lastname: Mandall
mesh_terms: D000293:Adolescent; D002648:Child; D003481:Cuspid / Q000503:physiopathology; D005260:Female; D006801:Humans; D007180:Incisor / Q000503:physiopathology*; D016014:Linear Models; D008297:Male; D008310:Malocclusion / Q000628:therapy*; D008437:Maxilla; D008963:Molar / Q000503:physiopathology; D009969:Orthodontic Wires; D011446:Prospective Studies; D014085:Tooth Migration / Q000517:prevention & control; D014087:Tooth Movement Techniques / Q000295:instrumentation*