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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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Kalina E, Grzebyta A, Zadurska M. Bone Remodeling during Orthodontic Movement of Lower Incisors-Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15002. [PMID: 36429721 PMCID: PMC9691226 DOI: 10.3390/ijerph192215002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 06/15/2023]
Abstract
The tooth movement in the alveolus is possible due to bone remodeling. This process could be the risk factor for the formation of gingival recessions-the most common side effects of orthodontic therapy. Gingival recessions are found 5.8-11.5% more frequently among the orthodontically treated patients. What is more, anterior mandibular teeth are the ones most prone to gingival recession dehiscences and fenestrations. The aim of this narrative review was to evaluate, based on CBCT (Cone beam computed tomography) scans, the changes in the alveolar bone of lower incisors in adolescent and adult patients after orthodontic tooth movements. From the pool of 108 publications, a total of 15 fulfilled the criteria of this review. Both retrospective and prospective longitudinal studies-using CBCT or CT (Computed Topography) and evaluating alveolar bone changes in mandibular incisors during orthodontic treatment performed before and after teeth movement-were included. In the group of growing patients, either proclination or retroclination of mandibular incisors led to increase of the distance from CEJ (cementoenamel junction) to marginal bone crest. The difference in bone loss was greater on the lingual side of the incisors in both types of tooth movement. The results were similar for adults patients. The thickness of the alveolar bone was reduced after proclination (total bone thickness) among growing and non-growing patients and retraction (lingual and buccal) of lower anterior teeth in the group of growing patients. The only improvement was measured for buccal thickness of mandibular incisor in bimaxillary protrusion patients treated with extraction therapy. The control of retraction movement (more root than crown movement) enhanced preservation on bone height and thickness. In order to minimize possible deterioration and place teeth in the center of alveolus, CBCT monitoring and scrupulous clinical evaluation are recommended.
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Wu YF, Guo HM. The effect of corticotomy on the compensatory remodeling of alveolar bone during orthodontic treatment. BMC Oral Health 2021; 21:134. [PMID: 33740958 PMCID: PMC7977253 DOI: 10.1186/s12903-021-01492-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/07/2021] [Indexed: 11/15/2022] Open
Abstract
Background This study aimed to explore whether compensatory remodeling of the alveolar bone surface occurred during the buccal palatal movement of orthodontic teeth. We preliminarily explored whether corticotomy could activate or accelerate osteogenesis in the alveolar bone surface by measuring the expression of TGF-β1 (transforming growth factor-β1), which can facilitate the proliferation and differentiation of osteoblasts and regulate the maturity and formation of bone. Methods Sixty 10-week-old male Wistar rats were selected. In the orthodontic group, 20 rats were implanted with a constriction device between the maxillary first molars under general anesthesia. In the corticotomy group, 20 rats were implanted with a constriction device, and a palatal incision was made to penetrate the cortical bone. In the control group, 20 rats underwent no experimental operation except general anesthesia. After 1, 3, 5 and 7 days, the maxillary first molars and the surrounding alveolar bone were harvested, and coronal sections containing the apical mesial buccal root were prepared and observed using tetracycline fluorescence, HE staining and immunohistochemical staining for TGF-β1. Image-Pro Plus software was used to assess the immunohistochemical results, and SPSS 22.0 statistical software was used to analyze variance and perform the LSD test. Results The tetracycline fluorescence results showed that in the periosteum near the apical region, an obvious fluorescence signal was observed in the orthodontic group and the corticotomy group compared with the control group. In the orthodontic group and corticotomy group, HE staining showed that the morphology was similar to cube-shaped. The immunohistochemical results showed that TGF-β1 was significantly increased in the periosteum near the apical region in the orthodontic group and corticotomy group, and there were significant differences among the three groups. In addition, the expression of TGF-β1 in the periosteum in the orthodontic group and the corticotomy group gradually increased over time, reaching a peak on day 5 and slightly decreasing on day 7. Conclusion Osteogenesis occurred on the alveolar bone surface during the buccal palatal movement of orthodontic teeth, and corticotomy had a positive effect, and TGF-β1 was involved in this process.
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Affiliation(s)
- Yi-Fei Wu
- Department of Orthodontics, Capital Medical University, School of Stomatology, Beijing, 100050, China
| | - Hong-Ming Guo
- Department of Orthodontics, Capital Medical University, School of Stomatology, Beijing, 100050, China.
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Srebrzyńska-Witek A, Koszowski R, Różyło-Kalinowska I, Piskórz M. CBCT for estimation of the cemento-enamel junction and crestal bone of anterior teeth. Open Med (Wars) 2020; 15:774-781. [PMID: 33336035 PMCID: PMC7712091 DOI: 10.1515/med-2020-0211] [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: 06/21/2019] [Revised: 02/21/2020] [Accepted: 06/10/2020] [Indexed: 11/21/2022] Open
Abstract
The aim of the study is to evaluate the usefulness of cone-beam computed tomography (CBCT) in the assessment of the relationship between the cemento-enamel junction (CEJ) and bone crest of the anterior mandibular cortex. The study population comprised 39 males and 61 females, aged 18–71. A GENDEX GXCB-500 machine, i-CAT Vision and CorelDraw 9 software were used. The distances between the CEJ and bone crest at buccal and lingual sides of six anterior mandibular teeth were measured. Descriptive statistical methods, Student’s t-test and ANOVA were used. The mean distance between the bone crest and CEJ was 2.32 mm ± 0.78 mm at the buccal and 2.52 mm ± 0.85 mm at the lingual side. It was found that in males aged over 50 years, the mean distance at the buccal side was 2.84 mm ± 0.79 mm and was significantly higher than in males aged 49 and less – 2.08 mm ± 0.41 mm. The mean distance at the lingual side was 3.28 mm ± 1.08 mm and was significantly lower in the age group of 49 years and less – 2.10 mm ± 0.41 mm. CBCT allows determining the distance between the CEJ and crestal bone margin at buccal and lingual sides. The data provide crucial information for planning orthodontic treatment, implant placement and periodontal therapy.
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Affiliation(s)
| | - Rafał Koszowski
- Academic Center of Dentistry and Specialized Medicine , Pl. Akademicki 17, 41-902 , Bytom , Poland
| | - Ingrid Różyło-Kalinowska
- Department of Dental and Maxillofacial Radiology, Medical University of Lublin, Poland , Karmelicka Street 7, 20-081 , Lublin , Poland
| | - Magdalena Piskórz
- Department of Dental and Maxillofacial Radiology, Medical University of Lublin, Poland , Karmelicka Street 7, 20-081 , Lublin , Poland
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Heryumani Sulandjari JCP, Chairunnisa AZ, Alhasyimi AA. Effect of Dentifrice Containing Crab-Shell Chitosan on the Accumulation of Dental Plaque in Fixed Orthodontic Appliances Patients: A Randomized Controlled Trial. Contemp Clin Dent 2020; 10:452-456. [PMID: 32308319 PMCID: PMC7150552 DOI: 10.4103/ccd.ccd_740_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Patients with fixed orthodontic encounter problems in cleaning their teeth and mouths. Dental plaque tends to accumulate on wires, brackets, and surfaces between bonding materials and brackets. Plaque accumulation increases the risks of decalcification, caries, and gingivitis. Chitosan extract is a potential antibacterial agent and inhibitor of dental plaque formation. This study aims to assess the effectiveness of chitosan-containing dentifrice in decreasing plaque accumulation in patients with fixed orthodontic appliances. Materials and Methods: This was a prospective, randomized, double-blind study which involved 32 samples (randomly allocated to the control and chitosan groups, after the power of the study was considered) from patients with orthodontic appliances undergoing the last stage of fixed active orthodontic treatment. Plaque accumulation before and after dentifrice use was measured using a plaque index according to O'leary, before and after using toothpaste within 5 days. The patients were instructed to brushing with chitosan-containing dentifrice and chitosan-free dentifrice as a control. Washout period that needed between brushing with chitosan-containing dentifrice and chitosan-free dentifrice as a control was 7 days. Each mouthwash used routinely for 5 days with the same duration and intensity. The data obtained was then analyzed with one-way analysis of variance followed by post hoc least significant difference. The level of significance was set as 0.05. Results: Plaque accumulation before and after dentifrice use significantly differed (P < 05) between the control and chitosan groups. The average reductions in plaque accumulation were greater in the chitosan group and control group brushing using chitosan-containing dentifrice. Conclusion: Dentifrice-containing chitosan more effectively reduces dental plaque accumulation in patients with fixed orthodontic appliances than dentifrice without chitosan.
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Affiliation(s)
| | - Afina Zahra Chairunnisa
- Department of Orthodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Java, Indonesia
| | - Ananto Ali Alhasyimi
- Department of Orthodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Java, Indonesia
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Ata-Ali F, Cobo T, De Carlos F, Cobo J, Ata-Ali J. Are there differences in treatment effects between labial and lingual fixed orthodontic appliances? A systematic review and meta-analysis. BMC Oral Health 2017; 17:133. [PMID: 29166941 PMCID: PMC5700487 DOI: 10.1186/s12903-017-0424-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 11/14/2017] [Indexed: 12/18/2022] Open
Abstract
Background An evaluation is made of possible differences in treatment effects between labial and lingual fixed appliances. Methods A comprehensive search was made of the PubMed-Medline, Cochrane Library and LILACS databases, with an additional manual search covering the period up until April 2017. There were no restrictions in terms of year of publication or language. Agreement between the authors was quantified by the Cohen kappa statistic. A random-effect model was applied to calculate weighted mean differences with 95% confidence intervals. Results A total of 249 patients corresponding to four eligible studies were included in the systematic review. Among the six angles and distances entered in the meta-analysis, a tendency was observed in lingual appliances to increase the interincisal angle (95% CI −0.80-8.99; p = 0.101) and reduce the angle between the major axis of upper central incisor and the sellar-nasion plane - though statistical significance was not reached (95% CI −5.75-0.32; p = 0.079). Conclusion The results obtained indicate that treatment with lingual appliances favors incisor tipping by exerting lingual crown torque, but there are no differences in cephalometric values between labial and lingual fixed appliances. Because of the small number of included studies, the results of this meta-analysis should be interpreted with caution. Future research should focus on the generation of a consensus document allowing selection of the type of orthodontic approach not only conditioned to the esthetic requirements of the patient but also considering the characteristics of the malocclusion. On the other hand, standardized international guidelines are lacking; the measurements of angles and distances therefore have to be unified with a view to future investigations.
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Affiliation(s)
- Fadi Ata-Ali
- Department of Surgery and Medical-Surgical Specialities, Area of Orthodontics, University Medical and Dental School, University of Oviedo, Instituto Asturiano de Odontología, Oviedo, Spain. .,Department of Dentistry, European University of Valencia, Valencia, Spain.
| | - Teresa Cobo
- Department of Surgery and Medical-Surgical Specialities, Area of Orthodontics, University Medical and Dental School, University of Oviedo, Instituto Asturiano de Odontología, Oviedo, Spain
| | - Felix De Carlos
- Department of Surgery and Medical-Surgical Specialities, Area of Orthodontics, University Medical and Dental School, University of Oviedo, Instituto Asturiano de Odontología, Oviedo, Spain
| | - Juan Cobo
- Department of Surgery and Medical-Surgical Specialities, Area of Orthodontics, University Medical and Dental School, University of Oviedo, Instituto Asturiano de Odontología, Oviedo, Spain
| | - Javier Ata-Ali
- Department of Dentistry, European University of Valencia, Valencia, Spain.,Public Dental Health Service, Arnau de Vilanova Hospital, Valencia, Spain
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