Comparison of Maxillary Canine Retraction Rate Among Conventional (Labial) vs. Dual (Simultaneous Labial and Palatal) Mechanics During Fixed Orthodontic Treatment—A Randomised Controlled Trial

OBJECTIVE: The aim of this split-mouth randomised controlled trial was to compare the rate of maxillary canine retraction, degree of canine rotation and pain perception between conventional labial force application and dual force application (simultaneous labial and palatal force). MATERIALS AND METHODS: Forty-five orthodontic patients requiring extraction of maxillary first premolars were recruited between June 2023 and June 2024. Following levelling and alignment, each maxillary arch was randomly allocated into two study groups using a split-mouth design with allocation concealment through sealed opaque envelopes. Group 1 (control) received conventional labial force application, whereas Group 2 (experimental) received dual force application. Canine retraction was evaluated at six time points. The primary outcome was the rate of canine retraction, while canine rotation and pain perception were secondary outcomes. Statistical significance was set at p ≤ 0.05. RESULTS: The dual force application group demonstrated a significantly greater rate of canine retraction at T1, T2, T3 and T4 (p = < 0.01) after that retraction was completed. Canine rotation was lower in the dual force group (p = < 0.01). Pain scores were slightly higher during the first month of retraction in the dual force group, but no significant differences were observed at subsequent time points. CONCLUSION: Dual force application achieved faster canine retraction with improved rotational control compared with conventional labial force applications. Although pain levels were initially higher, they decreased over time and were clinically acceptable. TRIAL REGISTRATION: ClinicalTrials.gov: NCT07508384.