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Darwiche FH, Tashkandi NE, AlGhamdi M, AlMuhaish LA, Shahin SY. Effect of interproximal enamel reduction on interradicular bone volume in clear aligner therapy: a three-dimensional cone-beam computed tomography study. Clin Oral Investig 2024; 28:552. [PMID: 39320510 DOI: 10.1007/s00784-024-05938-2] [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: 06/17/2024] [Accepted: 09/14/2024] [Indexed: 09/26/2024]
Abstract
OBJECTIVES To assess the effect of inter-proximal enamel reduction (IPR) on interradicular bone volume and incisal inclination in patients undergoing clear aligner therapy (CAT). MATERIALS AND METHODS The study sample consisted of 60 cases which underwent orthodontic CAT, in a private clinic in Dammam, KSA. A total of 120 CBCT scans (60 pre-treatment and 60 post- treatment) were measured using the CS 3D Imaging software to examine bone volume (using height, width, and depth of the interproximal area) and incisal inclination. The corresponding ClinCheck models were collected to determine the amount and locations of interproximal reduction performed. Little's Irregularity Index values were measured using OrthoCAD software. Paired sample t-test was used to address the measurements of bone height, width, depth, bone volume, and inclination of upper and lower incisors before and after IPR. RESULTS IPR did not affect the upper or lower bone volume except at LR3-2 and UL 2 - 1 where a significant difference between the bone volume with and without IPR was detected (p = 0.02 and p = 0.04 respectively). Upper and lower incisor inclination showed a statistically significant decrease after IPR. There was no correlation between IPR and bone volume difference between upper and lower teeth except at LR3-2 and UL 2 - 1. CONCLUSIONS IPR had no significant effect on inter-radicular bone volume except at areas of lower right canine-lateral and at areas of upper left central-lateral. There was a positive correlation between the amount of IPR and incisal inclination. CLINICAL RELEVANCE The current study findings suggest that while IPR has a minimal and localized effect on bone volume in certain areas, it plays a role in adjusting incisal inclination, highlighting its significance in the careful planning of orthodontic treatment using clear aligners.
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Affiliation(s)
- Fadia Hussein Darwiche
- Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Nada E Tashkandi
- Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia.
| | - Maher AlGhamdi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Suliman Y Shahin
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Sadek MM, Gaber RM. Alveolar bone changes around maxillary incisors after intrusion and retraction with controlled tipping versus bodily movement : A retrospective cone-beam computed tomography study. J Orofac Orthop 2024; 85:79-93. [PMID: 37672129 DOI: 10.1007/s00056-023-00493-z] [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: 09/07/2022] [Accepted: 07/11/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVE To compare the effect of maxillary incisor intrusion and retraction with controlled tipping (CT) versus bodily movement (BM) in extraction cases on alveolar bone height and thickness, using cone-beam computed tomography (CBCT). Correlations between changes in alveolar dimensions and crown or root retraction, incisor inclination, and intrusion were also investigated. MATERIALS AND METHODS In all, 144 incisors of 36 women were retrospectively evaluated. All patients were treated with anterior intrusion and retraction with either controlled tipping (CT) (group 1) or bodily movement (BM) (group 2). CBCT scans were taken before and after retraction and intrusion and measurements of alveolar bone height and thickness at the level of mid-root and root apex were measured. The prevalence of dehiscence was also calculated. RESULTS Labial bone thickness (BT) increased at the level of the root apex with increased total BT in the CT group (p < 0.05). The BM group showed decreased palatal BT. Significant vertical bone loss with an increased incidence of dehiscences occurred on the palatal side in both groups. Changes in palatal bone area was negatively correlated with the amount of root apex retraction, while the total BT at the level of root apex was positively correlated with amount of intrusion. CONCLUSIONS Bodily retraction can result in reduced palatal bone dimensions and an increase risk of iatrogenic sequelae following anterior retraction in extraction cases. Vertical bone loss and an increased incidence of dehiscences is to be expected following anterior retraction. Careful attention must be paid to the bone boundary conditions to avoid moving the incisors out of the alveolar housing.
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Affiliation(s)
- Mais Medhat Sadek
- College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.
- Department of Orthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
| | - Ramy M Gaber
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Nicklisch N, Hinrichs C, Palaske L, Vach W, Alt KW. Variability in human tooth cementum thickness reflecting functional processes. J Periodontal Res 2024; 59:408-419. [PMID: 38126232 DOI: 10.1111/jre.13226] [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: 06/26/2023] [Revised: 11/19/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the thickness of acellular extrinsic fibre cementum (AEFC) at four root positions of anterior and posterior teeth with special focus on functional aspects. Furthermore, the correlations between cementum thickness and chronological age and sex are investigated. BACKGROUND While numerous studies confirm continuous cementum apposition with age, masticatory forces as well as physiological and orthodontically induced tooth movements also have the potential to affect tooth cementum thickness. MATERIALS AND METHODS Undecalcified teeth were embedded in resin and transverse-sectioned in the cervical third of the root. Two sections per root were selected, and digital images at four positions were obtained (mesial, distal, oral, and vestibular) using light microscopy. The AEFC thickness of 99 teeth (anterior = 66, posterior = 33, male = 54, female = 45) were measured in both sections. The differences in mean values between root positions and the association of root position variation with tooth type, age, sex, and subject as well as the overall effects of age and sex were analysed using a mixed model. RESULTS First incisors and canines showed the greatest mean AFEC thickness, in contrast to premolars which had the lowest values. Differences were found across the four root positions, with a pattern varying considerably between anterior and posterior teeth and between maxilla and mandible in the anterior teeth. An interaction between root position and subject pointed to the existence of an individual component in the variation of AEFC thickness across the four root positions. There was an age trend with an almost linear increase in cementum thickness of 1 μm per year. Overall, females tended to exhibit a significantly lesser AEFC thickness compared to males. CONCLUSIONS Distinct differences in the pattern of thickness values across the four root positions in anterior and posterior teeth support the assumption that the AEFC is strongly affected by functional processes. In addition to sex-specific differences and age-related trends, the root position variation of AEFC thickness varies from individual to individual.
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Affiliation(s)
- Nicole Nicklisch
- Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
| | | | - Lukas Palaske
- Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
| | - Werner Vach
- Institute of Prehistory and Archaeological Science, University of Basel, Basel, Switzerland
| | - Kurt W Alt
- Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
- Institute of Prehistory and Archaeological Science, University of Basel, Basel, Switzerland
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Lyu H, Ma H, Wang X, Xu L, Hou J, Zhao Y, Li W, Li X. Three-dimensional assessment of periodontal support of lower incisors for skeletal Class II malocclusion undergoing presurgical orthodontic treatment with different vertical skeletal patterns. Prog Orthod 2023; 24:45. [PMID: 38105288 PMCID: PMC10725860 DOI: 10.1186/s40510-023-00495-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/05/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND The aim of the present study was to compare periodontal support changes during retraction of mandibular anterior teeth for skeletal Class II malocclusion with different facial divergence and to analyze relevant factors influencing bone remodeling by applying three-dimensional (3D) cone-beam computed tomography (CBCT) reconstruction technology. METHODS Forty-eight patients with Class II malocclusion requiring surgical orthodontic treatment enrolled in the study were divided into the hyperdivergent group (n = 16), normodivergent group (n = 16) and hypodivergent group (n = 16) according to their vertical skeletal patterns. Cone-beam computed tomography (CBCT) scans were obtained before treatment (T1) and after presurgical orthodontic treatment (T2). The two-dimensional (2D) alveolar bone morphology, movement of mandibular central incisors and volume of the alveolar bone around incisors were measured on the labial and lingual sides by 3D CBCT reconstruction technology. Statistical analyses were performed with one-way ANOVA, paired t tests and multiple linear regression. RESULTS During presurgical orthodontic treatment, the alveolar bone height on the labial side of the hyperdivergent group decreased significantly (P ≤ 0.05), but was maintained in the normodivergent and hypodivergent groups (P > 0.05). However, the alveolar bone volume, alveolar bone thickness at each level and alveolar bone height on the lingual side decreased significantly for all the groups. Apart from the initial morphometric measurements at T1, the morphology of lingual alveolar bone at T2 was significantly influenced by the direction and amount of tooth movement. Horizontal retraction and vertical protrusion of the root apex were negatively related to the alveolar bone on the lingual side after presurgical orthodontic treatment. CONCLUSION For Class II malocclusion patients undergoing presurgical orthodontic treatment, the changes in the periodontal support of the lower central incisors varied in different vertical skeletal patterns. There exists a great periodontal risk of alveolar bone resorption on the lingual side for various vertical types. To avoid alveolar bone deterioration, it is essential to investigate the bone remodeling of patients with different alveolar bone conditions and cautiously plan tooth movement prior to orthodontic treatment. Moreover, 3D measurements based on CBCT construction can provide complementary information to traditional 2D measurements.
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Affiliation(s)
- Hangmiao Lyu
- 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, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China
| | - Huimin Ma
- 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, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China
| | - Xiaoxia Wang
- Department of Oral and Maxillofacial Surgery, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China
| | - Li Xu
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, 100081, People's Republic of China
| | - Jianxia Hou
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, 100081, People's Republic of China
| | - Yijiao Zhao
- Center of Digital Dentistry, Peking University School and Hospital of StomatologyNational Engineering Laboratory for Digital and Material Technology of StomatologyResearch Center of Engineering and Technology for Digital Dentistry of Ministry of HealthBeijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China
| | - Weiran Li
- 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, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China.
| | - Xiaotong Li
- 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, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China.
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Almagrami I, Almashraqi AA, Almaqrami BS, Mohamed AS, Wafaie K, Al-Balaa M, Qiao Y. A quantitative three-dimensional comparative study of alveolar bone changes and apical root resorption between clear aligners and fixed orthodontic appliances. Prog Orthod 2023; 24:6. [PMID: 36843193 PMCID: PMC9968667 DOI: 10.1186/s40510-023-00458-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 01/30/2023] [Indexed: 02/28/2023] Open
Abstract
BACKGROUND This study aimed to evaluate and compare the alveolar bone changes and to investigate the prevalence and severity of orthodontically induced inflammatory root resorption (OIIRR) of maxillary incisors in patients who received treatment with clear aligners (CA) versus conventional fixed appliances (FA), using cone-beam computed tomography (CBCT). METHODS One hundred sixty maxillary incisors from 40 patients with similar baseline characteristics based on the American Board of Orthodontics discrepancy index scores were divided into the CA and FA groups. The dentoalveolar quantitative changes were analyzed using pre- (T0) and post-treatment (T1) CBCT. The measured parameters included alveolar bone thickness (ABT), alveolar bone height (ABH), root length (OIIRR), and maxillary incisor inclinations. RESULTS Post-treatment, the average palatal and total ABT significantly decreased in central and lateral incisors in the FA group. In contrast, the CA group's average labial ABT of the lateral incisors decreased considerably. Regarding the ABH, both groups showed significant labial and palatal marginal bone resorption. In both groups, root lengths significantly decreased after treatment (p < 0.005). The inter-group comparison revealed that ABT and root length had significantly decreased in the FA group compared to the CA group, while the ABH showed no significant difference between the two groups. The mean absolute reductions of ABT and OIIRR in the CA group were significantly less (- 0.01 ± 0.89 and 0.31 ± 0.42) than those in the FA group (0.20 ± 0.82 and 0.68 ± 0.97), respectively. CONCLUSIONS CA and FA treatments appear to cause a significant ABT reduction and a statistically significant increased OIIRR in the maxillary incisor region, with a greater extent expected with FA treatment. However, the increased OIIRR values in the majority of both groups' cases were not clinically significant. Both treatment modalities resulted in a significant ABH reduction, with the highest found in the labial side of lateral incisors in the CA group.
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Affiliation(s)
- Ibtehal Almagrami
- grid.412633.10000 0004 1799 0733Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road Erqi District, Zhengzhou, Henan China ,grid.412413.10000 0001 2299 4112Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Sana’a University, Sanaa, Republic of Yemen
| | - Abeer A. Almashraqi
- grid.412603.20000 0004 0634 1084Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Bushra Sufyan Almaqrami
- grid.49470.3e0000 0001 2331 6153Department of Orthodontics, Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China ,Ningbo Dental Hospital, Ningbo, Zhejiang China
| | - Amin S. Mohamed
- grid.43169.390000 0001 0599 1243Department of Orthodontics, Xi’an Jiaotong Universit, Xi’an, China
| | - Khaled Wafaie
- grid.412633.10000 0004 1799 0733Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road Erqi District, Zhengzhou, Henan China
| | - Maher Al-Balaa
- grid.49470.3e0000 0001 2331 6153Department of Orthodontics, Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yiqiang Qiao
- Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road Erqi District, Zhengzhou, Henan, China.
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