Changes in alveolar bone thickness due to retraction of anterior teeth during orthodontic treatment: A cephalometric and computed tomography comparative study

Krishna, U S Nayak; Shetty, Ashutosh; Girija, M P; Nayak, Reshma

doi:10.4103/0970-9290.127623

Cited by 21 publications

(28 citation statements)

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“…All five articles were retrospective, and of moderate quality according to the criteria proposed by Mattos et al (9). Four concerned Angle class I patients with double protrusion who underwent extraction of the four first premolars (6,13,14,15), while the remaining work studied class II division 1 patients who underwent extraction of the maxillary first premolars (3) ( Table 1).…”

Section: Resultsmentioning

confidence: 99%

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Changes in the alveolar bone thickness of maxillary incisors after orthodontic treatment involving extractions — A systematic review and meta-analysis

et al. 2019

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BackgroundOrthodontic treatment involving en-masse retraction of incisors following premolar extractions, may induce morphological alterations of the alveolar bone surrounding the anterior teeth.ObjectiveTo assess changes in alveolar bone thickness around the incisors of extraction patients measured with CBCT.Material and MethodsAn electronic search was conducted in PubMed, Scopus, Embase and Cochrane Library, using search terms, with no limitation on publication date, up to April 2018. The articles selected for analysis included randomized controlled trials, case-control studies and cohort studies of patients treated with fixed appliances and premolar extractions, which had measured alveolar bone thickness with CBCT before and after treatment. Changes in bone thickness were calculated and the heterogeneity of the studies was assessed using the I2 and Cochran’s Q tests.ResultsOf the 136 articles identified in the initial search, 19 were related to the review subject. After removing a further 14 that did not meet the inclusion criteria, 5 articles were selected for analysis. All five were retrospective studies of medium quality. The main changes in alveolar bone thickness were found in the labial cervical third of the central incisor, presenting increases of 0.4-0.64 mm. On the palatal side the results varied considerably.ConclusionsA significant increase in alveolar bone thickness occurs in the labial cervical third of the central incisor. These changes may be influenced by incisor position and inclination, the orthodontic technique and mechanics employed, the timing of the final CBCT scan and the bone remodeling capacity during en-masse retraction. Key words:Cone-beam computed tomography, alveolar bone, orthodontics.

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Section: Resultsmentioning

confidence: 99%

“…Three of the studies had been approved by an ethics committee (13-15). The other two articles did not mention approval (3,6).…”

Section: Resultsmentioning

confidence: 99%

Changes in the alveolar bone thickness of maxillary incisors after orthodontic treatment involving extractions — A systematic review and meta-analysis

et al. 2019

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“…As our objective was to assess changes in alveolar bone thickness from buccal to palatal cortical bone, this distance was measured in a standardized and reproducible manner. We did not measure the distances from the tooth root to the buccal cortical bone and from the tooth root to the palatal cortical bone as other authors did, 2 , 24 since this measure reflects mainly the displacement of the tooth root through the alveolar bone and not specifically changes in bone thickness of the region of interest. Our study presented small non-significant differences in alveolar bone thickness, which either decreased or increased.…”

Section: Discussionmentioning

confidence: 99%

Maxillary dentoalveolar assessment following retraction of maxillary incisors: a preliminary study

Oliveira

Claudino

Mattos

et al. 2016

Dental Press J. Orthod.

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Objective: The aim of this preliminary study was to assess changes in tooth length and alveolar thickness following retraction of maxillary incisors. Methods: A total of 11 patients presenting severe maxillary dentoalveolar protrusion revealed by initial (T1) cone-beam computed tomography (CBCT), and whose treatment plan included extraction of maxillary first premolars and retraction of maxillary incisors, were selected and submitted to CBCT examination one month after the end of incisors retraction (T2). The premaxilla was assessed through seven axial slices by means of Dolphin ImagingTM software. In each of these slices, five measurements of the distance from the buccal cortical bone to the palatal cortical bone were performed. Tooth length of maxillary incisors (n = 44) was also measured in sagittal slices. Measurements were repeated after a two-week interval, and intraclass correlation coefficient (ICC) was used to test examiner calibration. Wilcoxon test was used to detect differences in measurements performed at the two time intervals. Results: The ICC was satisfactory for tooth length (0.890) and for premaxilla alveolar thickness measurements (0.980). Analysis of data showed no statistically significant differences (p > 0.05) in tooth length or alveolar thickness between the two-time intervals assessed. Conclusion: The force used in retraction of maxillary incisors in this research did not promote significant changes in tooth length of maxillary incisors or in premaxilla alveolar thickness.

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“…The authors also suggested that there were limitations in the amount of incisor retraction in patients with a very thin anterior cortical plate in the maxilla, thus in patients with severe skeletal discrepancies, orthognathic surgery should be considered 13 . Also, the studies on the labial and palatal alveolar bone thickness of incisors after incisor retraction showed more significant changes in palatal bone compared to the labial side 4,5,10 .…”

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confidence: 94%

“…However, if there is excessive lingual inclination of anterior teeth as a result of putting too much emphasis on the esthetic aspect without considering the alveolar bone remodeling response following orthodontic tooth movement, unwanted iatrogenic sequelae such as root resorption, alveolar bone loss and fenestration, dehiscence and gingival recession would likely occur 4 – 10 .…”

Section: Introductionmentioning

confidence: 99%

A study on the morphologic change of palatal alveolar bone shape after intrusion and retraction of maxillary incisors

Son

Kim

Hong

et al. 2020

Sci Rep

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The purpose of this study is to evaluate the changes in the palatal alveolar bone thickness and find the factors related to the resorption of the palatal alveolar bone caused by tooth movement after the maxillary incisors were retracted and intruded during orthodontic treatment. The study group comprised of 33 skeletal Class II malocclusion patients who underwent extraction for orthodontic treatment. Palatal alveolar bone thickness changes and resorption factors were identified and analyzed. The changes of maxillary central incisors and palatal alveolar bone thickness were measured, and the corresponding sample t test was performed using SPSS (IBM SPSS version 22). The amount of palatal alveolar bone resorption was measured and various parameters were analyzed to determine which factors affected it. Correlation analysis adopting the amount of palatal alveolar bone resorption as a dependent variable demonstrated that the SNB, mandibular plane angle, and the inclination of the maxillary central incisor were significantly correlated with before treatment. On the other hand, mandibular plane angle, angle of convexity, the inclination of the upper incisor, and the occlusal plane (UOP, POP) were significantly correlated with post-treatment. In addition, the variables related to palatal contour (PP to PAS, SN to PAS, palatal surface angle) and occlusal planes (UOP/POP) were significantly correlated with the difference in palatal bone resorption. During initial diagnosis, high angle class II with normal upper incisor inclination can be signs of high-risk factors. In addition, maintaining the occlusal plane during treatment helps to prevent palatal bone loss. Patients seeking orthodontic treatment to resolve bimaxillary protrusion usually desire to change facial features which is important in establishing confidence and improving quality of life. To resolve these chief complaints, extraction of 4 premolars is usually required and surgery may also be utilized in cases when orthodontics only treatment is inadequate. Recent universalization of the temporary anchorage devices (TADs) and mini-plates has led to more stable and esthetic facial improvements through skeletal anchorage in orthodontic treatment 1-3. However, if there is excessive lingual inclination of anterior teeth as a result of putting too much emphasis on the esthetic aspect without considering the alveolar bone remodeling response following orthodontic tooth movement, unwanted iatrogenic sequelae such as root resorption, alveolar bone loss and fenestration, dehiscence and gingival recession would likely occur 4-10. Orthodontic tooth movement is a process where application of a force induces bone resorption on the pressure side and bone apposition on the tension side. Alexder et al. mentioned that a basic axiom in orthodontics is "Bone traces tooth movement, " suggesting that whenever orthodontic movement occurs, the bone around the alveolar socket will remodel to the same extent 11. However, there is evidence that this premise does not hold true in the anterio...

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Changes in alveolar bone thickness due to retraction of anterior teeth during orthodontic treatment: A cephalometric and computed tomography comparative study

Abstract: When incisors are retracted, the risk of adverse effect is present. This must be carefully monitored to avoid negative iatrogenic effects. This study needs follow up after 6 months or 1 year after completion of the orthodontic treatment to assess the long-term consequences.

Cited by 21 publications

References 0 publications

Changes in the alveolar bone thickness of maxillary incisors after orthodontic treatment involving extractions — A systematic review and meta-analysis

Changes in the alveolar bone thickness of maxillary incisors after orthodontic treatment involving extractions — A systematic review and meta-analysis

Maxillary dentoalveolar assessment following retraction of maxillary incisors: a preliminary study

A study on the morphologic change of palatal alveolar bone shape after intrusion and retraction of maxillary incisors

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