Efficiency and three-dimensional effects of maxillary canine distalization using Blue Elgiloy T-loop mechanics: A prospective study

Abstract

Controlled maxillary canine distalization is biomechanically challenging due to the long root and proximity to the buccal cortical plate. Although frictionless T-loop mechanics are widely used, clinical evidence focusing on Blue Elgiloy alloys assessed with three-dimensional imaging remains limited. This prospective study included 20 patients contributing 61 maxillary canines. Canine distalization was performed using frictionless Blue Elgiloy T-loop mechanics with miniscrew anchorage. The primary outcome was assessed by measuring the R3–miniscrew distance at baseline (T0), 6 weeks (T1), 12 weeks (T2), and 18 weeks (T3). Secondary outcomes, including canine root length, alveolar bone height, root–buccal cortex distance, and buccolingual inclination, were evaluated using cone-beam computed tomography (CBCT) at T0 and T3. A significant and progressive reduction in the R3–miniscrew distance was observed over 18 weeks (all P < 0.001), with a mean cumulative distalization of 4.03 ± 0.68 mm. CBCT analysis demonstrated small but statistically significant changes in root length, alveolar bone height, root–buccal cortex distance, and buccolingual inclination, all within clinically acceptable limits. Canines on the preferred chewing side exhibited significantly greater distalization than those on the nonpreferred side ( P < 0.001). Blue Elgiloy T-loop mechanics achieved effective and progressive maxillary canine distalization with satisfactory three-dimensional control. Chewing preference was significantly associated with distalization efficiency (ΔR3), highlighting the potential influence of functional factors on orthodontic tooth movement.