{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:32:59Z","timestamp":1789605179372,"version":"build-2803163510"},"reference-count":68,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n To evaluate anchorage loss after en masse retraction in bimaxillary dentoalveolar protrusion patients using friction vs frictionless mechanics.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n Thirty patients with bimaxillary dentoalveolar protrusion needing extraction of upper first premolars and en masse retraction with maximum anchorage were included in this two-arm, parallel, single-center, single-blinded randomized clinical trial with a 1:1 allocation ratio using fully sealed opaque envelopes. Friction group retraction utilized elastomeric power chain between miniscrews and hooks crimped mesial to upper canines on 17 \u00d7 25 stainless steel archwire. Frictionless group used customized T-loop springs loading upper first molars indirectly anchored to miniscrews. Activation was every 4 weeks until full retraction. The primary outcome assessed was anchorage loss evaluated at cusp tip and root apex of the first molar. First molar rotation, incisor tip and torque, and root resorption of anterior teeth were evaluated on digital models and cone beam computed tomography taken before and after space closure.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Anchorage loss at crown of first molar was significantly more in frictionless group by 2.1 mm (95% CI = \u22120.4 to 3.5), (\n P<\/jats:italic>\n = .014), while there was no significant difference in anchorage loss at root apex between groups. Significant mesial in molar rotation of 6.672\u00b0 (95% CI = 12.2\u201321.2), (\n P<\/jats:italic>\n = 0.02) was greater in the frictionless group. Both groups showed comparable tip, torque, and root resorption values. No severe harms were reported. There was mild gingival overgrowth and inflammation in the frictionless group due to T-loop irritation.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Extra anchorage considerations are needed during en masse retraction when frictionless mechanics is implemented as higher anchorage loss and molar rotation were detected. No difference in tip, torque, and root resorption was observed.<\/jats:p>\n <\/jats:sec>","DOI":"10.2319\/113023-791.1","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T20:00:35Z","timestamp":1716494435000},"page":"532-540","source":"Crossref","is-referenced-by-count":11,"title":["Evaluation of anchorage loss after en masse retraction in orthodontic patients with maxillary protrusion using friction vs frictionless mechanics: randomized clinical trial"],"prefix":"10.2319","volume":"94","author":[{"given":"Amr Mahmoud","family":"Attia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leena A.","family":"Shibl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heba M.","family":"Dehis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yehya A.","family":"Mostafa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr R.","family":"El-beialy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i1945-7103-94-5-532-b01","series-title":"Angle Orthod","first-page":"333","article-title":"Bimaxillary dentoalveolar protrusion: traits and orthodontic correction","volume":"75","author":"Bills","year":"2005","unstructured":"Bills\n DA,\n \n \n Handelman\n CS,\n \n \n Begole\n EA.\n \n \n Bimaxillary dentoalveolar protrusion: traits and orthodontic correction. Angle Orthod. 2005;75:333\u2013339."},{"issue":"5","key":"i1945-7103-94-5-532-b02","series-title":"Am J Orthod Dentofacial Orthop","first-page":"544.e1\u20139","article-title":"Randomized clinical trial comparing control of maxillary anchorage with 2 retraction techniques","volume":"138","author":"Xu","year":"2010","unstructured":"Xu\n TM,\n \n \n Zhang\n X,\n \n \n Oh\n HS,\n \n \n Boyd\n RL,\n \n \n Korn\n EL,\n \n \n Baumrind\n S.\n \n \n Randomized clinical trial comparing control of maxillary anchorage with 2 retraction techniques. Am J Orthod Dentofacial Orthop. 2010;138(5):544.e1\u20139."},{"issue":"5","key":"i1945-7103-94-5-532-b03","series-title":"J Dent Res","first-page":"377","article-title":"The use of small titanium screws for orthodontic anchorage","volume":"82","author":"Deguchi","year":"2003","unstructured":"Deguchi\n T,\n \n \n Takano-Yamamoto\n T,\n \n \n Kanomi\n R,\n \n \n Hartsfield\n JK,\n \n \n Roberts\n WE,\n \n \n Garetto\n LP.\n \n \n The use of small titanium screws for orthodontic anchorage. J Dent Res. 2003;82(5):377\u2013381."},{"issue":"2","key":"i1945-7103-94-5-532-b04","series-title":"Dental Press J Orthod","first-page":"115","article-title":"Understanding the basis of space closure in orthodontics for a more efficient orthodontic treatment","volume":"21","author":"Ribeiro","year":"2016","unstructured":"Ribeiro\n GLU,\n \n \n Jacob\n HB.\n \n \n Understanding the basis of space closure in orthodontics for a more efficient orthodontic treatment. 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Am J Orthod Dentofacial Orthop. 1996;109(4):393\u2013402."},{"issue":"5","key":"i1945-7103-94-5-532-b17","series-title":"Dental Press J Orthod","first-page":"47","article-title":"Quantification of intrusive\/retraction force and moment generated during en-masse retraction of maxillary anterior teeth using mini-implants: a conceptual approach","volume":"22","author":"Sumathi","year":"2017","unstructured":"Sumathi\n FA.\n \n \n Quantification of intrusive\/retraction force and moment generated during en-masse retraction of maxillary anterior teeth using mini-implants: a conceptual approach. 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Angle Orthod. 2005;75:333\u2013339."},{"issue":"5","key":"i1945-7103-94-5-532-b02","series-title":"Am J Orthod Dentofacial Orthop","first-page":"544.e1\u20139","article-title":"Randomized clinical trial comparing control of maxillary anchorage with 2 retraction techniques","volume":"138","author":"Xu","year":"2010","unstructured":"Xu\n TM,\n \n \n Zhang\n X,\n \n \n Oh\n HS,\n \n \n Boyd\n RL,\n \n \n Korn\n EL,\n \n \n Baumrind\n S.\n \n \n Randomized clinical trial comparing control of maxillary anchorage with 2 retraction techniques. Am J Orthod Dentofacial Orthop. 2010;138(5):544.e1\u20139."},{"issue":"5","key":"i1945-7103-94-5-532-b03","series-title":"J Dent Res","first-page":"377","article-title":"The use of small titanium screws for orthodontic anchorage","volume":"82","author":"Deguchi","year":"2003","unstructured":"Deguchi\n T,\n \n \n Takano-Yamamoto\n T,\n \n \n Kanomi\n R,\n \n \n Hartsfield\n JK,\n \n \n Roberts\n WE,\n \n \n Garetto\n LP.\n \n \n The use of small titanium screws for orthodontic anchorage. J Dent Res. 2003;82(5):377\u2013381."},{"issue":"2","key":"i1945-7103-94-5-532-b04","series-title":"Dental Press J Orthod","first-page":"115","article-title":"Understanding the basis of space closure in orthodontics for a more efficient orthodontic treatment","volume":"21","author":"Ribeiro","year":"2016","unstructured":"Ribeiro\n GLU,\n \n \n Jacob\n HB.\n \n \n Understanding the basis of space closure in orthodontics for a more efficient orthodontic treatment. Dental Press J Orthod. 2016;21(2):115\u2013125."},{"issue":"3","key":"i1945-7103-94-5-532-b05","series-title":"Evid Based Dent","first-page":"82","article-title":"Mini-implants for orthodontic anchorage","volume":"18","author":"Reynders","year":"2017","unstructured":"Reynders\n RM,\n \n \n Ladu\n L.\n \n \n Mini-implants for orthodontic anchorage. Evid Based Dent. 2017;18(3):82\u201385."},{"key":"i1945-7103-94-5-532-b06","series-title":"Am J Orthod Dentofacial Orthop","first-page":"442","article-title":"Friction and resistance to sliding in orthodontics: a critical review","volume":"135","author":"Burrow","year":"2009","unstructured":"Burrow\n SJ.\n \n \n Friction and resistance to sliding in orthodontics: a critical review. Am J Orthod Dentofacial Orthop. 2009;135:442\u2013447."},{"issue":"1","key":"i1945-7103-94-5-532-b07","series-title":"Am J Orthod","first-page":"1","article-title":"Optimizing anterior and canine retraction","volume":"70","author":"Burstone","year":"1976","unstructured":"Burstone\n CJ,\n \n \n Koenig\n HA.\n \n \n Optimizing anterior and canine retraction. Am J Orthod. 1976;70(1):1\u201319."},{"key":"i1945-7103-94-5-532-b08","series-title":"Angle Orthod","first-page":"493","article-title":"Orthodontic anchorage: a systematic review","volume":"76","author":"Feldmann","year":"2006","unstructured":"Feldmann\n I,\n \n \n Bondemark\n L.\n \n \n Orthodontic anchorage: a systematic review. Angle Orthod. 2006;76:493\u2013501. 16637733"},{"key":"i1945-7103-94-5-532-b09","series-title":"Modern Edgewise Mechanics and the Segmented Arch Technique","author":"Burstone","year":"1995","unstructured":"Burstone\n CJ,\n \n \n van Steenbergen\n EP,\n \n \n Hanley\n KJ.\n \n \n \n Modern Edgewise Mechanics and the Segmented Arch Technique\n . Ormco; 1995."},{"key":"i1945-7103-94-5-532-b10","series-title":"Prog Orthod","article-title":"An assessment of the magnitude, parallelism, and asymmetry of micro-implant-assisted rapid maxillary expansion in non-growing patients","volume":"21","author":"Elkenawy","year":"2020","unstructured":"Elkenawy\n I,\n \n \n Cantarella\n D,\n \n \n Moon\n W,\n \n \n Sfogliano\n L,\n \n \n Paredes\n A.\n \n \n An assessment of the magnitude, parallelism, and asymmetry of micro-implant-assisted rapid maxillary expansion in non-growing patients. 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