1
|
Liu K, Chu G, Zhang C, Yang Y. Boundary of mandibular molar distalization in orthodontic treatment: A systematic review and meta-analysis. Orthod Craniofac Res 2024; 27:515-526. [PMID: 38462853 DOI: 10.1111/ocr.12778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/08/2024] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Abstract
To explore the mandibular retromolar space length (MRSL), initial root-inner cortex contact percentage (IRCCP), and the various factors that influence mandibular molar distalization. Searches were undertaken in PubMed, EMBASE, Web of Science, Cochrane Library, Scopus, and grey literature (Google Scholar and OpenGrey) for eligible cross-sectional observational studies measuring the MRSL and IRCCP in healthy adult patients. The risk of bias and evidence quality were evaluated using the Joanna Briggs Institute's checklist and GRADE framework. Thirteen studies involving 1169 patients were included for qualitative synthesis. Seven of these studies were eligible for quantitative analysis. Meta-analysis showed that the mean MRSL at the subfurcation-6 mm plane in Asian normodivergent cases was 3.78 mm (95% confidence interval [CI]: 2.81-4.35; I2 = 79.7%) for skeletal Class-I malocclusions, 3.02 mm (95% CI: 2.10-3.94; I2 = 62.5%) for Class-II, and 4.43 mm (95% CI: 3.14-5.73; I2 = 75.1%) for Class-III. The mean MRSL at the sub-cementoenamel junction (CEJ)-10 mm plane for Asian, Class-I, normodivergent cases was 3.28 mm (95% CI: 2.44-4.12; I2 = 68.9%). The mean IRCCP for Asian, Class-I, normodivergent cases was 27.2% (95% CI: 0.22-0.32; I2 = 0%). In Asian normodivergent cases, MRSL ranges from 3.28 to 4.43 mm with a 27.2% IRCCP for Class-I. Cone-beam computed tomography imaging is recommended for measuring the MRSL in the apex region particularly before molar distalization. Factors influencing MRSL and IRCCP include different races, skeletal patterns, facial types, and third-molar status.
Collapse
Affiliation(s)
- Keyuan Liu
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Guang Chu
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Chengfei Zhang
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Yanqi Yang
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| |
Collapse
|
2
|
Han S, Fan X, Xiao D. Evaluation of the anterior dentoalveolar relationship in skeletal Class III malocclusion patients with different vertical facial patterns using cone-beam computed tomography. Angle Orthod 2024; 94:187-193. [PMID: 38381801 PMCID: PMC10893926 DOI: 10.2319/081723-563.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/01/2023] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVES To measure and compare labiolingual inclinations of the teeth and alveolar bone and the anterior dentoalveolar inclination in patients with skeletal Class III malocclusions with different vertical facial patterns using cone-beam computed tomography (CBCT). MATERIALS AND METHODS Based on the inclusion and exclusion criteria, 84 CBCT images of patients with untreated skeletal Class III malocclusion were selected. There were 28 patients each in the hypo-, normo-, and hyperdivergent groups. The labiolingual inclinations of the teeth, the corresponding alveolar bone, and the anterior dentoalveolar inclinations were measured and analyzed statistically. RESULTS The inclinations of the mandibular canine and corresponding alveolar bone were smaller in the hypodivergent group than in the hyperdivergent group. The inclination of the alveolar bone and the maxillary dentoalveolar inclination were smaller in the hyperdivergent group than in the hypodivergent group. CONCLUSIONS There were differences in the inclination of the teeth, corresponding alveolar bone, and dentoalveolar inclinations at different positions among skeletal Class III patients with different vertical facial patterns. The roots were generally located on the labial side of the alveolar bone.
Collapse
|
3
|
Dalaie K, Hajimiresmail YS, Safi Y, Baghban AA, Behnaz M, Rafsanjan KT. Correlation of alveolar bone thickness and central incisor inclination in skeletal Class I and II malocclusions with different vertical skeletal patterns: A CBCT study. Am J Orthod Dentofacial Orthop 2023; 164:537-544. [PMID: 37140495 DOI: 10.1016/j.ajodo.2023.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 05/05/2023]
Abstract
INTRODUCTION This study aimed to assess the alveolar bone thickness (ABT) and labiolingual inclination of maxillary and mandibular central incisors in patients with Class I and II skeletal patterns with normal-angle, high-angle, and low-angle vertical patterns. METHODS The study sample consisted of 200 cone-beam computed tomography scans of patients with skeletal Class I and II malocclusions. Each group was further divided into low-angle, normal-angle, and high-angle subgroups. Labiolingual inclinations of maxillary and mandibular central incisors and ABT were measured at 4 levels from the cementoenamel junction in the labial and lingual surfaces. The Kolmogorov-Smirnov test, independent t test, 2-way analysis of variance, and Spearman's correlation test were applied for statistical analyses. RESULTS The only significant difference between Class I and II groups regarding the ABT was found at the labial side of the maxillary central incisor, 9 mm apical to the crest. At this level, the mean ABT was 0.87 mm in patients with a skeletal Class I malocclusion, which was significantly greater than that in patients with a skeletal Class II malocclusion with a mean ABT of 0.66 mm (P = 0.02). Comparisons among the vertical subgroups revealed that on the labial and lingual sides of the mandible, as well as the palatal side of the maxilla, significantly thinner alveolar bone was found in patients with high-angle growth patterns than those with normal-angle and low-angle patterns in both sagittal groups (P <0.05). Significant weak to moderate correlations were found between ABT and tooth inclination (P <0.05). CONCLUSIONS Significant differences in ABT covering central incisors between patients with skeletal Class I and II malocclusion are merely observed at the labial surface of the maxilla, 9 mm apical to the cementoenamel junction. Compared with patients with normal-angle and low-angle, those with a high-angle growth pattern and Class I and II sagittal relationships have thinner alveolar bone support around maxillary and mandibular incisors.
Collapse
Affiliation(s)
- Kazem Dalaie
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Behnaz
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Katayoun Talebi Rafsanjan
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
4
|
Haider O, Sharaf MA, Abdulqader AA, Alhashimi N, Sharhan HM, Chen C, Alsoufi W, Ting ZY, Wei XL, Alhammadi MS. Three-dimensional relationship between the degree of bilateral impacted mandibular third molars angulation and the mandibular dental arch parameters: a cross-sectional comparative study. Clin Oral Investig 2023; 27:4301-4311. [PMID: 37184614 DOI: 10.1007/s00784-023-05047-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 04/26/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVE The purpose of this study was to three-dimensionally evaluate the relationship between the degree of bilateral impacted mandibular third molar (IM3M) angulation and the mandibular dental arch parameters in normal skeletal and dental malocclusion patients. MATERIALS AND METHODS In this retrospective cross-sectional comparative study, 120 adult subjects' cone-beam computed tomography (CBCT) images were three-dimensionally analyzed. The sample included 120 adults aged 20-30 years, with a gender distribution of 51 male and 69 female participants. The sample was divided into 100 adults with bilateral IM3M (study group) and 20 adults with normal bilateral erupted M3M (control group). The study group was sub-divided into three groups according to the degree of IM3M buccolingual angulation (BL°): group A, < 12° on the center of the ridge (N = 30), group B, 12-24° off-center of the ridge (N = 40), group C, > 24° off-center of the ridge (N = 30). The study group was also sub-divided into two groups according to IM3M mesiodistal angulation (MD°): group 1 from 10 to 45° (N = 36), group 2 > 45° (N = 64). Comparison within and between groups was performed using one-way ANOVA followed by Tukey's post hoc test. The correlation between IM3M, BL, and MD angulation and the mandibular arch parameter was calculated using Pearson's correlation coefficient. RESULTS Statistically significant differences (P < 0.001) were found between the IM3M BL° and anterior teeth inclination, arch length (AL), and inter-second molar width (inter 2nd MW) as well as between the IM3M MD° with anterior crowding and the arch length (P < 0.001). A significant positive correlation was found between IM3M BL° and anterior teeth inclination and between IM3M MD° and anterior teeth crowding and inter 2nd MW. A significant negative correlation was observed between IM3M BL° and inter 1st MW and 2nd MW. CONCLUSION The degree of buccolingual and mesiodistal angulation of the impacted mandibular third molars was related with mandibular dentoalveolar changes. Increased buccolingual angulation is generally associated with increased anterior teeth inclination and decreased 1st and 2nd inter-molar width. The increase in mesiodistal angulations was generally related with increased anterior teeth crowding and 2nd inter-molar width. CLINICAL RELEVANCE Assessment of the relationship between the impacted mandibular third molars and the degree of arch discrepancy, and the position of mandibular incisors in the three planes of space might help in the decision-making process for the extraction of the impacted third molars in adult patients.
Collapse
Affiliation(s)
- Ohood Haider
- Department of Orthodontics, Medical Center of Stomatology, Second Xiangya Hospital, Central South University, Changsha, China
- Department of Orthodontics, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Mufeed Ahmed Sharaf
- Department of Orthodontics, Faculty of Dentistry, Ibb University, Ibb, Yemen
- Department of Oral Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, China
| | - Abbas Ahmed Abdulqader
- Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Najah Alhashimi
- Unit and Divisional Chief Orthodontics at Hamad Medical Corporation; Associate professor, College of Dental Medicine, Qatar University, Doha, Qatar
| | - Hasan M Sharhan
- Department of Orthodontics and Dentofacial Orthopedics, College of Dentistry, Lanzhou University, Lanzhou, China
- Department of Orthodontics, Faculty of Dentistry, Thamar University, Dhamar, Yemen
| | - Chen Chen
- Department of Orthodontics, Medical Center of Stomatology, Second Xiangya Hospital, Central South University, Changsha, China
| | - Waleed Alsoufi
- Department of Orthodontics, Medical Center of Stomatology, Second Xiangya Hospital, Central South University, Changsha, China
| | - Zeng Yun Ting
- Department of Orthodontics, Medical Center of Stomatology, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiao Li Wei
- Department of Orthodontics, Medical Center of Stomatology, Second Xiangya Hospital, Central South University, Changsha, China.
| | - Maged S Alhammadi
- Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| |
Collapse
|
5
|
Nookala H, Sreenivasagan S, Sivakumar A, S AK. Computed Tomographic Evaluation of Buccal Shelf Dimensions in South Indian Patients With Sagittal Skeletal Class III Malocclusion: A Retrospective Study. Cureus 2023; 15:e43883. [PMID: 37746425 PMCID: PMC10511672 DOI: 10.7759/cureus.43883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 08/20/2023] [Indexed: 09/26/2023] Open
Abstract
Background Computed tomographic evaluation of mandibular buccal shelf region in skeletal class III malocclusion cone beam computed tomography (CBCT) studies have been reported to have great alteration in the thickness of mandibular buccal shelf region owing to the different growth patterns and ethnic variations. The aim of this study was to determine the total and cortical bone thickness in the mandibular buccal shelf (MBS) region for extra-alveolar mini-screw placement in South Indian patients with sagittal skeletal class III malocclusion. Material and methods This retrospective computed tomographic study consisted of archived files of the Dravidian population with class III skeletal base that met the eligibility criteria. The total bone and cortical bone thickness of the buccal shelf regions were evaluated in relation to three anatomical sites at various depths and angulations. One-way ANOVA and Tukey honestly significant difference (HSD) post hoc tests were used for statistical analysis. Pearson correlation coefficient was performed to compare if any relation existed between bone thickness and the growth pattern. Results The maximum bone thickness in the buccal shelf region in our study was found at the distal portion of the second molar root, 8-12 mm from its cementoenamel junction (CEJ) and at 30-45 ° angulation (p-value<0.005). There was a positive correlation between the hypo-divergent growth pattern and the thickness of the bone. Conclusion Based on the sites recorded, the preferred site for mini screw placement in Class III patients is the distobuccal cusp region with respect to the second molar at a depth of 8-12 mm and at angulation of 30-45 °. There was a moderate correlation with hypo-divergent growth patterns, suggestive of a wider and thicker mandibular buccal shelf region in these subjects.
Collapse
Affiliation(s)
- Havisha Nookala
- Orthodontics and Dentofacial Orthopedics, Saveetha Dental College and Hospital, Saveetha University, Chennai, IND
| | - Swapna Sreenivasagan
- Orthodontics and Dentofacial Orthopedics, Saveetha Dental College and Hospital, Saveetha University, Chennai, IND
| | - Arvind Sivakumar
- Orthodontics and Dentofacial Orthopedics, Reface Dental Hospital, Chennai, IND
| | - Aravind Kumar S
- Orthodontics and Dentofacial Orthopedics, Saveetha Dental College and Hospital, Saveetha University, Chennai, IND
| |
Collapse
|
6
|
Jafary Pour SM, Gooran M, Dabbaghi A, Parsi F, Rohani A, Moradinejad M, Mohagheghi SA, Rakhshan V. Factors affecting the maxillary and mandibular incisors' buccolingual inclinations and buccal and lingual cortical plate heights. BMC Oral Health 2023; 23:511. [PMID: 37481542 PMCID: PMC10362708 DOI: 10.1186/s12903-023-03225-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 07/13/2023] [Indexed: 07/24/2023] Open
Abstract
INTRODUCTION Orthodontics is closely related to periodontics. The buccolingual inclination (BLI) of the incisors and deficiencies in their buccal (BHd) and lingual (LHd) cortical plate heights may affect orthodontic outcomes. Identifying risk factors that can compromise buccal or lingual bone heights may have clinical value. The literature on BLI/BHd/LHd is not only scarce but also limited to one jaw. We aimed to examine, for the first time, factors affecting BLI/BHd/LHd not evaluated before as well as other factors with scarce literature about them. METHODS In this two-phase epidemiological and analytical study, inclinations and cortical heights of 248 incisors (bilateral centrals and laterals) were evaluated blindly on 62 randomly selected high-resolution pretreatment cone-beam computed tomography volumes (30 maxillae [13 men, 17 women], 32 mandibles [13 men, 19 women]). The sample was balanced in terms of sexes, jaws, and ages. The BLI/BHd/LHd of bilateral incisors were measured (intraobserver agreement > 95%). The effects of jaws, sexes, age, sides, and incisor types on each of the anatomical variables (BLI/BHd/LHd) were analyzed using a Mixed-Model Multiple Linear Regression analysis. Correlations among continuous variables were assessed using a Pearson coefficient (α = 0.05). RESULTS For the maxillary centrals, BLI, BHd, and LHd were 106.79 ± 5.06, 1.94 ± 0.95, and 1.50 ± 0.76, respectively. These parameters were '110.56 ± 5.97, 1.81 ± 0.83, 1.23 ± 0.69' for the maxillary laterals; '97.64 ± 8.26, 2.98 ± 1.48, 3.46 ± 1.45' for the mandibular centrals; and '95.98 ± 6.80, 3.29 ± 1.72, and 2.73 ± 1.15' for the mandibular laterals. BLI was greater in the maxilla compared to the mandible and in the lateral incisors compared to centrals (P < 0.05). BHd was greater (more deficient) in the mandible (P = 0.000). Age, sex, or side were not associated with BLI (P > 0.05). Age, sex, side, or incisor types were not associated with BHd (P > 0.05). LHd was greater in the mandible, older individuals, and centrals (P < 0.05). There were some significant but weak correlations between BLI with BHd and especially LHd (P < 0.05). CONCLUSION In the maxilla, but not in the mandible, incisors' BLI may determine LHd. Maxillary incisors may have greater BLIs as well as greater buccal and lingual alveolar bone heights compared to mandibular incisors. BLI might be greater in the laterals compared to the centrals in both jaws combined.
Collapse
Affiliation(s)
- Seyed Mohammad Jafary Pour
- Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Morteza Gooran
- Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Arash Dabbaghi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Farnoush Parsi
- Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Rohani
- Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehrnaz Moradinejad
- Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Arman Mohagheghi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Vahid Rakhshan
- Department of Dental Anatomy, Dental Faculty, Azad University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
7
|
He J, Jiang L, Song S, Mo S. Transverse differences between cleft lip and palate and non-cleft palate with skeletal Class III malocclusion using buccolingual inclination: a cone-beam computed tomography retrospective study. BMC Oral Health 2022; 22:631. [PMID: 36550501 PMCID: PMC9783461 DOI: 10.1186/s12903-022-02675-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the differences between buccolingual inclination (BI) of maxillary posterior teeth in patients with cleft lip and palate (CLP) and non-cleft palate with skeletal Class III malocclusion. We propose a method of maxillary expansion which is more suitable for patients with CLP. METHODS For this retrospective study, 40 patients with CLP and 21 patients with skeletal Class III malocclusion were selected. The CLP group was divided into the unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) groups. The BI of the maxillary first premolar (BI4), maxillary second premolar (BI5) and first molar (BI6) were measured using cone-beam computed tomography, and the differences between them were compared and analyzed by Student's t-test. RESULTS There were significant differences between cleft side BI4 and non-cleft side BI4 in the UCLP group, BI5 in the BCLP group, BI4 and BI5 in all CLP groups and the skeletal Class III malocclusion group. BI6 was similar across all three groups. CONCLUSIONS The premolars of patients with CLP do not exhibit the same regularity as those with Class III malocclusion; this may be related to surgical scarring of the cleft palate. Greater attention should be paid to the correction of BI in the maxillary expansion of patients with CLP.
Collapse
Affiliation(s)
- Jiabei He
- grid.256607.00000 0004 1798 2653Department of Orthodontics, College & Stomatology Hospital, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China ,grid.256607.00000 0004 1798 2653Guangxi Key laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Lihua Jiang
- grid.256607.00000 0004 1798 2653Guangxi Key laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Shaohua Song
- grid.256607.00000 0004 1798 2653Department of Orthodontics, College & Stomatology Hospital, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China ,grid.256607.00000 0004 1798 2653Guangxi Key laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Shuixue Mo
- grid.256607.00000 0004 1798 2653Department of Orthodontics, College & Stomatology Hospital, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| |
Collapse
|
8
|
Lei C, Yu Q, Wu D, Cai K, Weigl P, Tang C. Comparison of alveolar bone width and sagittal tooth angulation of maxillary central incisors in Class I and Class III canine relationships: a retrospective study using CBCT. BMC Oral Health 2022; 22:303. [PMID: 35869442 PMCID: PMC9308311 DOI: 10.1186/s12903-022-02331-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Canine relationship is a key reference identifying anterior malocclusion and an important implication for evaluating preimplantation bone morphology at maxillary esthetic zone. This study aimed to compare the differences of maxillary central incisor-related measurements (alveolar bone thickness and tooth sagittal angulation) between Class I and Class III canine relationship and further explore the risk factors for immediate implant placement in the anterior maxilla based on cone beam computed tomography (CBCT) data. Methods CBCT digital imaging and communications in medicine (DICOM) files of 107 patients (54 with Class I canine relationship and 53 with Class III canine relationship) were collected and the alveolar bone thickness at mid-root (mid-root buccal thickness/MBT; palatal/MPT), apical regions (apical buccal thickness/ABT; palatal/APT) and sagittal angulation (SA) of the maxillary central incisor at the examined side were measured on the mid-sagittal observation plane. Descriptive statistical analysis and frequency distributions of the measurements based on Class I or Class III canine relationship were established. Statistical analyses were performed using Fisher’s exact test, independent samples t test and Pearson correlation test with the significance level set at p < 0.05. Results The frequency distributions of maxillary central incisors’ MPT, ABT, APT and SA showed significant differences between Class I and Class III canine relationships (p = 0.030, 0.024, 0.000 and 0.000, respectively). MPT (2.48 ± 0.88 mm vs. 3.01 ± 1.04 mm, p = 0.005), APT (6.79 ± 1.65 mm vs. 8.47 ± 1.93 mm, p = 0.000) and SA (12.23 ± 5.62° vs. 16.42 ± 4.49°, p = 0.000) were significantly smaller in patients with Class III canine relationship. Moreover, SA showed a strong positive correlation with APT (R = 0.723, p = 0.000) and a moderate negative correlation with ABT (R = − 0.554, p = 0.000). Conclusions In populations with Class III canine relationship, maxillary central incisors were significantly more labially inclined and have a thinner palatal bone plate at the apex compared with Class I relationship. Clinicians should avoid palatal perforation during immediate implantation at sites of originally protrusive maxillary incisors.
Collapse
|
9
|
Li C, Dimitrova B, Boucher NS, Chung CH. Buccolingual Inclination of Second Molars in Untreated Adolescents and Adults with Near Normal Occlusion: A CBCT Study. J Clin Med 2022; 11:jcm11226629. [PMID: 36431105 PMCID: PMC9698869 DOI: 10.3390/jcm11226629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/04/2022] [Accepted: 11/05/2022] [Indexed: 11/11/2022] Open
Abstract
The mandibular second molars are lingually positioned relative to the alveolar ridge and have a limited amount of lingual alveolar bony support. As the maxillary second molars are articulated with the mandibular second molars, maintaining the normal buccolingual inclination of both maxillary and mandibular second molars would potentially help to not only optimize the masticatory function, but also avoid dehiscence and fenestration. The current study evaluated the buccolingual inclination of second molars in untreated adolescents and adults. One hundred and two Caucasian subjects with skeletal class I and minimum dental arch crowding/spacing were selected and divided into two groups: (1) adolescent group: age 12-18 years, N = 51 (21 females, 30 males); (2) adult group: age 19-65 years, N = 51 (40 females, 11 males). For each subject, the inclination for each second molar was measured as the angle between the long axis of each tooth and a vertical line on cone beam computed tomography images. The Mann-Whitney U test was used for intergroup comparisons. Maxillary second molars exhibited a buccal inclination of 15.30° in the adolescent group and 15.70° in the adult group. Mandibular second molars exhibited a lingual inclination of 17.05° in the adolescent group and 15.20° in the adult group. No statistically significant differences were detected between the age groups. In addition, a statistically significant difference was only found between genders in the adolescent group for the maxillary second molar inclination. In summary, maxillary second molars exhibited buccal inclination and mandibular second molars exhibited lingual inclination. The amount of buccolingual inclination of the second molars was similar in the adolescent and adult groups.
Collapse
|
10
|
Montanha-Andrade K, Crusoé-Rebello IM, Barreto M, Neves FS, Santos JND, Cury PR. Assessment of the relationship between tooth inclination and gingival and alveolar bone dimensions using computed tomography of the maxillary anterior teeth: a cross-sectional study. Dental Press J Orthod 2022; 27:e222136. [PMID: 36169497 PMCID: PMC9507018 DOI: 10.1590/2177-6709.27.4.e222136.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 07/14/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The present study aimed to investigate the relationship between tooth inclination and gingival and bone dimensions in maxillary anterior teeth. METHODS This cross-sectional study included cone-beam computed tomography (CBCT) images of 160 maxillary anterior teeth (30 individuals). Tooth inclination, gingival and bone thickness, and distances from cementoenamel junction to alveolar bone crest and gingival margin were measured in the labial surface. The correlations were analyzed using Pearson and partial correlation tests (p≤0.05). RESULTS In the central incisors, tooth inclination was positively and significantly related to apical bone thickness (R = 0.34, p= 0.001). In the canines, tooth inclination was negatively and significantly related to cervical bone thickness (R = - 0.34, p= 0.01) and positively associated to apical bone thickness (R = 0.36, p= 0.01) and to gingival margin-cementoenamel junction distance (R = 0.31, p= 0.03). In the lateral incisors, tooth inclination was not associated with gingival or bone dimensions. CONCLUSIONS In the central incisors, the greater the labial tooth inclination, the greater is the apical bone thickness. In the canines, the greater the labial tooth inclination, the smallest is the cervical bone thickness, the greater is the apical bone thickness, and the greater is the gingival margin. Gingival and bone dimensions should be assessed when planning orthodontic treatment involving buccal movement of central incisors and canines.
Collapse
Affiliation(s)
| | - Ieda Margarida Crusoé-Rebello
- Universidade Federal da Bahia, Faculdade de Odontologia, Departamento de Radiologia Dentomaxilofacial (Salvador/BA, Brazil)
| | - Mauricio Barreto
- Escola Bahiana de Medicina e Saúde Pública, Departamento de Implantologia (Salvador/BA, Brazil)
| | - Frederico Sampaio Neves
- Universidade Federal da Bahia, Faculdade de Odontologia, Departamento de Radiologia Dentomaxilofacial (Salvador/BA, Brazil)
| | - Jean Nunes Dos Santos
- Universidade Federal da Bahia, Faculdade de Odontologia, Departamento de Patologia Oral (Salvador/BA, Brazil)
| | - Patricia Ramos Cury
- Universidade Federal da Bahia, Faculdade de Odontologia, Departamento de Periodontia (Salvador/BA, Brazil)
| |
Collapse
|
11
|
Kurt Demirsoy K, Türker G, Amuk M, Kurt G. How much should incisors be decompensated? periodontal bone defects during presurgical orthodontic treatment in class III double-jaw orthognathic surgery patients. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e133-e139. [PMID: 35263684 DOI: 10.1016/j.jormas.2022.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 05/16/2023]
Abstract
INTRODUCTION The aims of this study were to evaluate periodontal bone defects around the lower and upper incisors and to identify changes in the buccolingual inclination of the incisors during orthodontic decompensation in skeletal Class III orthognathic surgery patients. MATERIALS AND METHODS The sample consisted of 26 adults with skeletal Class III deformity who had undergone presurgical orthodontic treatment and orthognathic surgery. Lateral cephalograms obtained before orthodontic treatment and before surgery were used to determine the inclination and position changes of the incisors. Cephalometric measurements were taken using Dolphin Imaging 11.95. Three-dimensional images were generated from cone-beam computed tomography (CBCT) scans prior to surgery and used to detect periodontal bone defects, including fenestration (F) and dehiscence (D). RESULTS Intraclass correlation coefficients (ICC) were determined and the measurements showed high reproducibility. The cephalometric data showed normal distribution and there were no differences between genders in terms of cephalometric changes, dehiscence, fenestration, or coexistent (D-F/DF) formation. The patients presented maxillary incisor retroclination and mandibular incisor proclination, which was consistent with the tooth decompensation. CBCT assessment was performed for a total of 208 teeth; while 81 upper and 94 lower incisors had D-F/DF formation, 23 upper and 10 lower incisors were healthy. Statistically significant correlations were not found between the inclination degree of the incisors and D-F/DF formation. CONCLUSIONS Decompensation of incisors during presurgical orthodontic treatment increases the risk of periodontal defects. There is no linear relationship between the increase in the inclination degrees of incisors and D-F/DF formation.
Collapse
Affiliation(s)
- Kevser Kurt Demirsoy
- Department of Orthodontics, Faculty of Dentistry Nevşehir Hacı Bektaş Veli University, Nevşehir, Türkiye.
| | - Gökhan Türker
- Department of Orthodontics, Faculty of Dentistry, Mersin University, Mersin, Türkiye
| | - Mehmet Amuk
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye
| | - Gökmen Kurt
- Department of Orthodontics, Faculty of Dentistry, Bezmialem Foundation University, İstanbul, Türkiye
| |
Collapse
|
12
|
Fan Z, Zhang Q, Jiang Y, Qin Q, Huang S, Guo J. Mandibular retromolar space in adults with different sagittal skeletal patterns. Angle Orthod 2022; 92:483764. [PMID: 35849081 PMCID: PMC9374353 DOI: 10.2319/112021-854.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 04/01/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To analyze the mandibular retromolar space among normal-divergent adult patients with different sagittal skeletal patterns by cone-beam computed tomography (CBCT). MATERIALS AND METHODS CBCTs of a total of 120 normal-divergent adult patients were investigated. Patients were categorized into the following three groups according to their ANB angle: skeletal Class I (48 patients), skeletal Class II (36 patients), and skeletal Class III (36 patients). Four different planes parallel to the mandibular occlusal plane were used to measure the retromolar space. The retromolar space was measured by two reference lines and then compared between different sagittal skeletal patterns groups. The incidence of root contact with the inner lingual cortex was compared among the three groups. RESULTS The retromolar space of the Class III patients was significantly larger than that of Class I patients and Class II patients. Compared with Class I and Class III patients, Class II patients had a smaller retromolar space and higher incidence of contact with the inner cortex of the mandible. CONCLUSIONS Class III patients had a larger retromolar space than Class I patients and Class II patients in four different planes. The mandibular retromolar space should be evaluated by CBCT in patients who need mandibular molar distalization.
Collapse
|
13
|
A preliminary study of buccal and lingual alveolar bone thickness of posterior teeth in patients with skeletal Class III malocclusion and mandibular asymmetry. Am J Orthod Dentofacial Orthop 2022; 162:66-79.e6. [DOI: 10.1016/j.ajodo.2021.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 11/23/2022]
|
14
|
Jekl V, Brinek A, Zikmund T, Jeklova E, Kaiser J. Use of Micro-CT Imaging to Assess Ventral Mandibular Cortical Thickness and Volume in an Experimental Rodent Model With Chronic High-Phosphorus Intake. Front Vet Sci 2021; 8:759093. [PMID: 34957278 PMCID: PMC8695870 DOI: 10.3389/fvets.2021.759093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
Adverse effects of high dietary phosphorus on bone health have been observed in both animal and human studies. The aim of the investigation was to examine chronic effects of high phosphorus diet on the apical mandibular cortical thickness and volume in a hystricomorph rodent (Octodon degus) using microcomputed tomography. Male degus were randomly divided into two groups fed by different mineral contents from the age of 12 weeks till the age of 17 months. The micro-CT scanning and wall thickness analysis were applied on the region of the mandible exactly under the apices of the 4th premolar tooth, first molar tooth, and second molar tooth in two animals from each group. General overview and mapping of the ventral mandibular bone thickness revealed pronounced bony mandibular protrusions in all the animals fed a high-phosphorus diet with obvious bone thinning apically to the 4th premolar and first and second molar tooth apices. Mandibular bone volume and thickness located apically to the premolar and molars were statistically significantly smaller/thinner in the group fed by a high phosphorus diet. The thinnest bone measured 0.004 mm, where the mandibular 4th premolar tooth almost perforated the mandibular cortex. Similar studies of metabolic bone disease and its influence on alveolar bone were also published in rats and mice. The influence of different environmental, infectious, or metabolic factors on the growing tooth, alveolar bone formation, and bone pathologies must be done experimentally on growing animals. In contrast, degus have continuously growing dentition, and the effect of any of the above listed factors can be studied in this animal model at any age and for longer time periods.
Collapse
Affiliation(s)
- Vladimir Jekl
- Department of Pharmacology and Pharmacy, Faculty of Veterinary Medicine, Veterinary University Brno, Brno, Czechia.,Jekl & Hauptman Veterinary Clinic, Brno, Czechia
| | - Adam Brinek
- CEITEC - Central European Institute of Technology, Brno University of Technology, Brno, Czechia
| | - Tomas Zikmund
- CEITEC - Central European Institute of Technology, Brno University of Technology, Brno, Czechia
| | - Edita Jeklova
- Department of Infectious Diseases and Preventive Medicine, Veterinary Research Institute, v.v.i., Brno, Czechia
| | - Josef Kaiser
- CEITEC - Central European Institute of Technology, Brno University of Technology, Brno, Czechia
| |
Collapse
|
15
|
Heimes D, Schiegnitz E, Kuchen R, Kämmerer PW, Al-Nawas B. Buccal Bone Thickness in Anterior and Posterior Teeth-A Systematic Review. Healthcare (Basel) 2021; 9:1663. [PMID: 34946389 PMCID: PMC8700878 DOI: 10.3390/healthcare9121663] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Immediate dental implant placement has been a subject of great interest over the last decade. Here, information regarding the anatomy and bone thickness of the jaw prior to dental implant placement is crucial to increase the surgery's success and the patient's safety. The clinical premises for this approach have been controversially discussed. One of those heavily discussed premises is a buccal bone thickness of at least 1 mm thickness. This meta-analysis aims to systematically review buccal bone thickness (BBT) in healthy patients. Thus, the feasibility of immediate dental implant placement in daily practice can be assessed. (2) Methods: A search in the electronic databases was performed to identify articles reporting on BBT that was measured by computed tomography in adults. (3) Results: We were able to find 45 studies, including 4324 patients with 25,452 analyzed teeth. The analysis showed a BBT at the alveolar crest of 0.76 ± 0.49 mm in the maxillary frontal and of 1.42 ± 0.74 mm in the maxillary posterior region. In the mandible, the average measured values were similar to those in the maxilla (front: 0.95 ± 0.58 mm; posterior: 1.20 ± 0.96 mm). In the maxillary frontal region 74.4% and in the mandibular frontal region 61.2% of the crestal buccal bones showed widths <1 mm. (4) Conclusions: In more than 60% of the cases, the BBT at the alveolar crest is <1 mm in maxillary and mandibular frontal regions. This anatomic data supports careful pre-surgical assessment, planning of a buccal graft, and critical selection of indication for immediate implant placement, especially in the maxillary and mandibular frontal and premolar region.
Collapse
Affiliation(s)
- Diana Heimes
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Robert Kuchen
- Institute for Medical Statistics, Epidemiology and Informatics, University Medical Center of the Johannes-Gutenberg-University Mainz, 55131 Mainz, Germany;
| | - Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| |
Collapse
|
16
|
Ravikumar PAT, Dinesh SPS. Identifying cortical plate inclination as a parameter to re-assess transverse discrepancies in untreated adults with different vertical facial heights-A retrospective CBCT study. Orthod Craniofac Res 2021; 25:219-225. [PMID: 34398503 DOI: 10.1111/ocr.12529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/11/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the inclination angles of buccal, palatal cortical plates and assess its harmony with existing molar buccolingual inclination in adults with different vertical facial heights. The aim of this study was to identify the role of cortical plate inclination as a diagnostic tool for determining alveolar support in adults with transverse discrepancies. MATERIALS AND METHODS One-hundred and fifty seven CBCTs (50-Hypo-divergent, 51-Normo-divergent and 56-Hyper-divergent growth patterns) of untreated adults were utilized. Cross-sectional slices with respect to the maxillary first molar were taken as orientation landmarks in defined reference planes. Inclination angles for the first molar, buccal and palatal cortical plate were determined with respect to the palatal plane. ANOVA and Post Hoc Tukey's HSD test were carried out to determine significant differences between groups. RESULTS Molar inclination was significantly greater in hyper-divergent groups compared to normo-divergent and hypo-divergent groups (P < .05). Greater variation between molar inclination and cortical plate inclination (buccal and palatal) was seen in hyper-divergent groups (P < .05). Hypo-divergent and normo-divergent groups showed almost similar molar and cortical plate inclinations; however, there was a significant difference between the buccal and palatal cortical plates (P < .05). CONCLUSIONS Cortical plate inclination is in agreement with molar inclination in hypo- and normo-divergent groups when compared to hyper-divergent groups. In adults with decreased/normal facial heights, greater balance and harmony is observed between the dental and alveolar substructures in the posterior region. In adults with increased facial heights, a greater amount of dentoalveolar compensation is seen with respect to the molar and its surrounding bone support.
Collapse
Affiliation(s)
- Prasanna Arvind T Ravikumar
- Department of Orthodontics, Saveetha Dental College, Saveetha Institute Of Medical And Technical Sciences, Chennai, India
| | - S P Saravana Dinesh
- Department of Orthodontics, Saveetha Dental College, Saveetha Institute Of Medical And Technical Sciences, Chennai, India
| |
Collapse
|
17
|
Shafizadeh M, Tehranchi A, Shirvani A, Motamedian SR. Alveolar bone thickness overlying healthy maxillary and mandibular teeth: A systematic review and meta-analysis. Int Orthod 2021; 19:389-405. [PMID: 34366263 DOI: 10.1016/j.ortho.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/02/2021] [Accepted: 07/03/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To systematically review and meta-analyse the Alveolar Bone Thickness (ABT) overlying healthy teeth. The secondary objective was to review the association of ABT with gender, age, and smoking. MATERIALS AND METHODS The PubMed, Embase, Scopus, ProQuest, Web of Science, and Cochrane Library databases were searched up to July 2020. English articles (sample size≥10) which had used CT or CBCT to measure the ABT at clearly defined reference points were included. The maximum likelihood approach meta-analysis was used to estimate the means (95% CIs). RESULTS A total of 68 articles were included. The meta-analysis results were as follows: In the anterior maxilla, the mean labial plate thickness ranged from 0.42-1.75mm, while it was thicker for the posterior teeth (0.78-4.31mm). The palatal plate thickness ranged from 0.97-8.13mm. In the anterior mandible, the thickness of labial and lingual plates ranged from 0.4-3.71mm and 0.38-5.44mm, respectively. The alveolar bone was thicker for the posterior teeth both at the labial (0.66-6.31mm) and lingual (2.31-7.77mm) sides. Meta-regression revealed a significant relationship between gender and ABT at several points. There was a controversy regarding the association of ABT with age. No significant difference was evidenced between smokers and non-smokers. CONCLUSIONS This study presents a clear image of the alveolar bone structure. Since it has pooled ABT values from various populations, outcomes could be acknowledged as global averages. Therefore, it could provide perspective for several dental procedures, including orthodontic treatments and immediate implant placement.
Collapse
Affiliation(s)
- Marziyeh Shafizadeh
- Dentofacial Deformities Research Centre, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran
| | - Azita Tehranchi
- Dentofacial Deformities Research Centre, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran
| | - Armin Shirvani
- Department of Orthodontics, School of Dentistry, Dental Research Centre, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran
| | - Saeed Reza Motamedian
- Dentofacial Deformities Research Centre, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran; Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran.
| |
Collapse
|
18
|
Al-Balaa M, Li H, Ma Mohamed A, Xia L, Liu W, Chen Y, Omran T, Li S, Hua X. Predicted and actual outcome of anterior intrusion with Invisalign assessed with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2021; 159:e275-e280. [PMID: 33518439 DOI: 10.1016/j.ajodo.2020.10.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 09/01/2020] [Accepted: 10/01/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The purpose of this study was to compare predicted anterior teeth intrusion measurements with the actual clinical intrusion measurements using cone-beam computed tomography. Understanding the precision of the software in anticipating changes may help practitioners predict the need for overcorrection. METHODS Twenty-two patients, with a mean age of 23.74 years, who underwent Invisalign (Align Technology, Santa Clara, Calif) clear aligners treatment for both arches only after having completed treatment with an initial series of aligners were included in this study. The pretreatment and posttreatment cone-beam computed tomography scans after the initial series were acquired by a single orthodontist practitioner. ClinCheck measurements were recorded with Align Technology. The long axis of the anterior tooth intrusion movement was measured in 142 teeth. A comparison between the predicted and actual measurements of anterior intrusion of the teeth was performed, and the intraclass correlation coefficients showed an almost perfect agreement in the linear measurements. RESULTS A statistically notable difference between the predicted and actual measurements of anterior intrusion. The predicted intrusion movement of the maxillary canines (P = 0.001), maxillary lateral incisors (P <0.0001), and maxillary central incisors (P <0.0001) significantly differed from the actual values. Similarly, the intrusion movement in the mandibular teeth seemed to be inaccurate, with significant differences in the mandibular canines (P <0.0001) and mandibular lateral and central incisors (P <0.0001). CONCLUSIONS The mean precision of true anterior intrusion with Invisalign clear aligners was 51.19%, and the mean amount of correction was 48.81%. The use of other supplementary methods of anterior teeth intrusion may be helpful to reduce the rate of midcourse corrections and refinements.
Collapse
Affiliation(s)
- Maher Al-Balaa
- Department of Orthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hanyue Li
- Department of Orthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | | | - Lulu Xia
- Department of Orthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Liu
- Department of Orthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yaosen Chen
- Department of Stomatology, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Tamer Omran
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shufang Li
- Department of Orthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xianming Hua
- Department of Orthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| |
Collapse
|
19
|
Sendyk M, Cevidanes LHS, Ruellas ACDO, Fattori L, Mendes FM, Paiva JBD, Rino Neto J. Three-dimensional evaluation of dental decompensation and mandibular symphysis remodeling on orthodontic-surgical treatment of Class III malocclusion. Am J Orthod Dentofacial Orthop 2020; 159:175-183.e3. [PMID: 33390311 DOI: 10.1016/j.ajodo.2019.12.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 11/01/2019] [Accepted: 12/01/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The purposes of this research were to identify the buccolingual inclinations of the mandibular teeth and the mandibular symphysis remodeling that result from the orthodontic decompensation movement. METHODS The sample consisted of 30 adults with Class III dentofacial deformity, who had presurgical orthodontic treatment. Three-dimensional images were generated by cone-beam computed tomography scans at 2 different times (initial and before orthognathic surgery). Three-dimensional virtual models were obtained and superimposed using automated voxel-based registration at the mandible to evaluate B-point displacement, mandibular molar and incisor decompensation movement, and symphysis inclination and thickness. The 3-dimensional displacements of landmarks at the symphysis were quantified and visualized with color-coded maps using 3D Slicer (version 4.0; www.slicer.org) software. RESULTS The measurements showed high reproducibility. The patients presented mandibular incisor proclination, which was consistent with the movement of tooth decompensation caused by the presurgical orthodontic treatment. Statistically significant correlations were found between the inclination of the mandibular incisors, symphysis inclination, and B-point displacement. Regarding the thickness of the symphysis and the inclination of the incisors, no statistically significant correlation was found. CONCLUSIONS The buccolingual orthodontic movement of the mandibular incisors with presurgical leveling is correlated with the inclination of the mandibular symphysis and repositioning of the B-point but not correlated to the thickness of the symphysis.
Collapse
Affiliation(s)
- Michelle Sendyk
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil.
| | | | | | - Liana Fattori
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fausto Medeiros Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - João Batista de Paiva
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - José Rino Neto
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
20
|
Yao CCJ, Chang ZC, Lai HH, Hsu LF, Hwang HM, Chen YJ. Architectural changes in alveolar bone for dental decompensation before surgery in Class III patients with differing facial divergence: a CBCT study. Sci Rep 2020; 10:14379. [PMID: 32873841 PMCID: PMC7463229 DOI: 10.1038/s41598-020-71126-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/10/2020] [Indexed: 11/09/2022] Open
Abstract
This study aimed to investigate alveolar bone change around mandibular anterior teeth during orthodontic decompensation in patients with skeletal Class III malocclusion and different vertical facial patterns. The records of 29 consecutive Class III patients selected from those pending two-jaw orthognathic surgery were divided into low (≤ 28°), average (30°-37°), and high (≥ 39°) mandibular plane angle (MPA) groups. The DICOM files of CBCT scans and STL files of digital dental models, taken before (T1) and after (T2) presurgical orthodontic treatment, were imported into Dolphin imaging software to reconstruct dentoskeletal images. T1 and T2 images were superimposed and analyzed for bone thickness and height at the level of root apex on each mid-sagittal slice of six mandibular anterior teeth. Differences between T1 and T2 were analyzed by non-parametric tests and mixed-effect model analysis. The results showed that the measurements of alveolar bone height generally decreased after treatment, regardless of MPA. The facial divergence, incisor irregularity, tooth site, treatment time, and change in proclination were identified as the significant factors affecting alveolar bone thickness and height during treatment. The presurgical orthodontic treatment to decompensate mandibular anterior teeth should be very careful in all MPA groups.
Collapse
Affiliation(s)
- Chung-Chen Jane Yao
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan.,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Zwei-Chieng Chang
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan.,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Hsiang-Hua Lai
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan.,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Li-Fang Hsu
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan.,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Hann-Min Hwang
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan.,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Yi-Jane Chen
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan. .,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan.
| |
Collapse
|
21
|
Hu X, Huang X, Gu Y. Assessment of buccal and lingual alveolar bone thickness and buccolingual inclination of maxillary posterior teeth in patients with severe skeletal Class III malocclusion with mandibular asymmetry. Am J Orthod Dentofacial Orthop 2020; 157:503-515. [PMID: 32241357 DOI: 10.1016/j.ajodo.2019.04.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the buccal and lingual alveolar bone thickness and buccolingual inclination of maxillary posterior teeth in patients with severe skeletal Class III malocclusion with and without mandibular asymmetry and compare with those in patients with skeletal Class I malocclusion. METHODS Cone-beam computed tomography images of 69 patients with severe skeletal Class III malocclusion and 30 patients with skeletal Class I malocclusion were collected and reconstructed with Dolphin 3D software. Based on the distance from menton to the sagittal plane (d), the patients with skeletal Class III malocclusion were divided into a symmetry group (d ≤ 2 mm) and an asymmetry group (d ≥ 4 mm). Buccal and lingual alveolar bone thickness and buccolingual inclination of maxillary posterior teeth were measured and compared. Correlations among dental measurements, severity of sagittal discrepancy, and mandibular deviation were analyzed. RESULTS Maxillary posterior teeth on the deviated side in Class III asymmetry group and symmetry group were buccally inclined compared with the Class I group (P < 0.001). A significant negative correlation was noted between buccolingual inclination of maxillary posterior teeth and ANB value with Spearman correlation coefficient of maxillary first molar, second premolar, and first premolar of -0.687, -0.485 and -0.506, respectively (P < 0.001). Maxillary first molar showed thinner buccal alveolar bone on deviated side in asymmetry group and symmetry group of Class III, compared with the Class I group, with average values of 1.21 mm, 1.19 mm, and 1.83 mm, respectively (P < 0.05). The maxillary first premolar also showed thinner buccal alveolar bone on deviated side in Class III asymmetry group compared with the Class I group, with average values of 0.87 mm and 1.28 mm, respectively (P < 0.05). CONCLUSIONS Decompensation of buccally inclined posterior teeth in patients with skeletal Class III malocclusion should be more cautious owing to thinner buccal alveolar bone to avoid a high risk of fenestration and dehiscence.
Collapse
Affiliation(s)
- Xinnong Hu
- Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiaoyi Huang
- Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yan Gu
- Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.
| |
Collapse
|
22
|
Do TA, Shen YW, Fuh LJ, Huang HL. Clinical assessment of the palatal alveolar bone thickness and its correlation with the buccolingual angulation of maxillary incisors for immediate implant placement. Clin Implant Dent Relat Res 2019; 21:1080-1086. [PMID: 31424162 DOI: 10.1111/cid.12835] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/14/2019] [Accepted: 07/28/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Clinicians needed to be aware of the thinness of the palatal bone plate when identifying severe protrusion of maxillary incisors, as this could result in perforation of the palatal bone plate during surgical procedures associated with immediate maxillary implant placement. PURPOSE This study evaluated the thickness of the palatal bone plate, the buccolingual angulation of maxillary incisors, and the correlation between these two parameters in relation to immediate implant placement. MATERIALS AND METHODS Cone-beam computed tomography images of 37 Asian patients (20-60 years old) with no evidence of dental treatment in the maxillary incisor area were collected and classified into groups based on sex and incisor locations. Sagittal slices were used to measure the palatal bone plate thickness at the cervical, middle, and apical levels, and the buccolingual angulation of each tooth was also measured. The intraclass correlation, Shapiro-Wilk test, descriptive analysis, Student's t-test, and Pearson correlation were used for statistical and correlation analyses, with P < .05 applied as the criterion for statistical significance. RESULTS At the apical level of all inspected teeth and the middle level of lateral incisors, the palatal bone was significantly thicker in males than in females. The inclination of the maxillary lateral incisor showed a moderate negative linear correlation with the palatal bone thickness at the apical level (R = -0.517 and R = -0.579 for males and females, respectively). CONCLUSIONS In an Asian population, an increased buccolingual angulation of the maxillary lateral incisors was correlated with a thinner palatal bone plate at the apical level.
Collapse
Affiliation(s)
- Thanh A Do
- School of Dentistry, China Medical University, Taichung, Taiwan
| | - Yen-Wen Shen
- School of Dentistry, China Medical University, Taichung, Taiwan
| | - Lih-Jyh Fuh
- School of Dentistry, China Medical University, Taichung, Taiwan
| | - Heng-Li Huang
- School of Dentistry, China Medical University, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| |
Collapse
|
23
|
Raber A, Kula K, Ghoneima A. Three-dimensional evaluation of labial alveolar bone overlying the maxillary and mandibular incisors in different skeletal classifications of malocclusion. Int Orthod 2019; 17:287-295. [PMID: 31015017 DOI: 10.1016/j.ortho.2019.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate differences in the thickness of the labial bone overlying the maxillary and mandibular incisors in class I, II, and III skeletal classifications using three-dimensional cone-beam computed tomographs (CBCT) technology. METHODS Pretreatment CBCTs of 54 Caucasian subjects (44 males, 10 females) were collected from the archives of a graduate orthodontic clinic. The subjects were divided into three groups based on their skeletal classification. CBCT scans were oriented to the long axis of each maxillary and mandibular incisor from the root apex to incisal tip and the axial inclination of each incisor was measured and recorded. Labial bone thickness was measured at the apex (A) and at the midpoint (MP) on each maxillary and mandibular incisor. A linear measurement, perpendicular to the long axis, was recorded from the labial bone surface to the most anterior root surface at two points. The effects of skeletal classification, jaw, incisor position, and side on A, MP, and Inclination were evaluated using mixed-model ANOVA. A 5% significance level was used for all tests. RESULTS Significantly greater bone thickness at the apex and midpoint was reported in class III individuals than class I or II. Central incisors had significantly greater bone thickness at both the root apex and midpoint. Significantly greater bone thickness was noted in the mandible at the level of the apex. At the level of the midpoint, significantly greater thickness was reported in the maxilla. There was a positive correlation between thickness and angle within each jaw-incisor combination for class I patients and for central incisors in class III patients. CONCLUSION The thickness of labial alveolar bone over the incisors varies based on the underlying skeletal discrepancy in each patient. Skeletal discrepancy influences the inclination of the maxillary and mandibular incisors.
Collapse
Affiliation(s)
- Andrew Raber
- Indiana University School Dentistry, Department of Orthodontics and Oral Facial Genetics, Indianapolis, IN, USA
| | - Katherine Kula
- Indiana University School Dentistry, Department of Orthodontics and Oral Facial Genetics, Indianapolis, IN, USA
| | - Ahmed Ghoneima
- Indiana University School Dentistry, Department of Orthodontics and Oral Facial Genetics, Indianapolis, IN, USA; Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Hamdan Bin Mohammed College of Dental Medicine, Department of Orthodontic, Dubai, United Arab Emirates; Al-Azhar University, Faculty of Dental Medicine, Department of Orthodontics, Cairo, Egypt.
| |
Collapse
|
24
|
Coşkun İ, Kaya B. Appraisal of the relationship between tooth inclination, dehiscence, fenestration, and sagittal skeletal pattern with cone beam computed tomography. Angle Orthod 2019; 89:544-551. [PMID: 30741575 DOI: 10.2319/050818-344.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To examine the relationship between sagittal facial pattern and dehiscence/fenestration presence in conjunction with buccolingual tooth inclination by using cone beam computed tomography. MATERIALS AND METHODS The study was carried out on the cone beam computed tomography scans of the following three groups of patients (n = 20 in each group): Class I, Class II, Class III. Buccolingual tooth inclination, buccal dehiscence/fenestration presence, and lingual dehiscence/fenestration presence were evaluated on each tooth. Analysis of variance, Kruskall-Wallis H, Scheffe, and chi-square tests were used for statistical comparisons. RESULTS Differences (P < .05) were observed between the groups for inclination of upper incisors and all lower teeth except for second molars. Dehiscence prevalence in the upper buccal and posterior buccal regions was higher (P < .05) in the Class I group when compared with the other groups. Lower buccal and anterior buccal regions showed higher (P = .0001) dehiscence prevalence in all groups. No difference was observed in fenestration prevalence between the groups. The upper buccal and anterior buccal regions showed higher (P = .0001) fenestration prevalence in all groups. CONCLUSIONS Orthodontists must consider concealed alveolar defects in treatment planning to avoid gingival recession or tooth mobility.
Collapse
|
25
|
Atik E, Gorucu-Coskuner H, Taner T. COMPARISION AND EVALUATION OF ALVEOLAR BONE AROUND LOWER CENTRAL INCISORS IN CLASS III AND CLAS I PATIENTS. CUMHURIYET DENTAL JOURNAL 2018. [DOI: 10.7126/cumudj.406846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
26
|
Silva Zatarain AN, Gutiérrez Rojo JF, Castrejón S. Comparación de distancias interradiculares y grosor del hueso cortical en dos sectores del maxilar inferior para colocación de mini implantes. ACTA ODONTOLÓGICA COLOMBIANA 2018. [DOI: 10.15446/aoc.v8n2.73876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción: la colocación de mini implantes interradiculares, como alternativa para el anclaje de aparatología ortodóntica, varía acorde a la clasificación esquelética del paciente Clase I o II. Es necesario realizar la correcta identificación de la ubicación radicular y grosor cortical como parte del análisis estratégico del área a intervenir. Objetivo: comparar tomográficamente las distancias interradiculares y grosor del hueso cortical en dos sectores del maxilar inferior para colocación de mini implantes. Materiales y métodos: estudio transversal que incluyó 120 tomografías computarizadas de haz cónico, pertenecientes a pacientes Clase I (60) y Clase II (60) esquelética. Se identificó tomográficamente la distancia interradicular, el ancho bucolingual y el grosor del hueso cortical bucal, a partir de la cresta alveolar entre el segundo premolar y primer molar inferior derecho y entre el canino y lateral del mismo lado. Un análisis estadístico con prueba t Student al 95% de confianza comparó la ubicación de las estructuras anatómicas para clase I y II esquelética. Resultados: en la distancia interradicular, comparativamente entre clase I y II, se encontró significancia entre canino y lateral derecho (p=< 0.054) a los 8 mm. En este mismo sector, en el ancho bucolingual, se encontró diferencia significativa a 6mm de altura (p=<.04). En el grosor del hueso cortical no se encontraron diferencias estadísticas al comparar los valores para la Clase I y II. Conclusiones: en Clase I y II, el mayor espesor para la colocación de mini implantes se registró en el espacio interradicular a 8 mm de altura y en el ancho bucolingual a 6 mm.
Collapse
|