Evaluation of maxillary buccal alveolar bone before and after orthodontic alignment without extractions: A cone beam computed tomographic study

Abstract

Objectives: To assess the changes in the maxillary buccal alveolar bone during alignment without extractions. Secondarily, to evaluate the changes in arch dimensions and buccolingual inclinations of teeth and to identify risk factors for bone loss. Materials and Methods: Twenty-two adolescents with crowded permanent dentitions were treated without extractions with Damon 3MX brackets. Cone beam computed tomographic scans were taken before treatment (T0) and after alignment (T1). Bone thickness (BT) and height from the cementoenamel junction to the alveolar crest (BH) were evaluated at the maxillary central incisors, second premolars, and buccal roots of first molars. Changes in all variables from T0 to T1 were assessed. Correlations between bone changes and initial bone thickness, initial arch widths, initial crowding, amount of expansion, amount of tipping, and amount of molar rotation were calculated. Results: BT decreased and BH increased significantly for the incisors and mesiobuccal root of the first molars. Arch dimensions generally increased together with tipping. Bone loss was correlated with crowding and amount of expansion in the premolar region. Initially thinner BT was correlated with greater apical migration of bone for the incisors. Conclusions: Nonextraction alignment with self-ligating brackets led to arch expansion associated with tipping of teeth. Expansion related to alignment resulted in horizontal and vertical bone loss at the incisors and mesiobuccal root of the first molars. Thinner BTs and more severe crowding before treatment increased the risk for buccal bone loss. (Angle Orthod. 2018;88:748-756.)

Assessment of Buccal Bone Thickness in the Anterior Maxilla: A Cone Beam Computed Tomography Study

“…Morais et al 18 measured the bone thickness and bone height of the maxillary central incisors in 22 patients before and after orthodontic therapy. The thickness of the bone layers was measured at 3 mm and 6 mm apical from the crest level.…”

Displacement in root apex and changes in incisor inclination affect alveolar bone remodeling in adult bimaxillary protrusion patients: a retrospective study

“…However, without taking the alveolar anatomy and its remodeling capacity into consideration, digital setup-aided orthodontics as well as traditional orthodontics may possibly place the dentition out of the boundary, leading to instability, root resorption and alveolar bone loss [7] . Although alveolar bone remodeling during alignment has been reported in the CBCT study [13,14] , present data regarding the correlation between incisor retraction and alveolar bone remodeling is rather limited. To facilitate predicating the final position of root in the dentoalveolar bone in the treatment of bimaxillary protrusion, we aimed to investigate dynamic changes in the alveolar bone in the incisor region and to explore its relationship with displacement of root apex as well as changes in the inclination of maxillary incisors.…”

Dentoskeletal and facial features comparison between individuals treated with four first premolar extraction in the 1970s and in the new millennium

“…Depending on the amount of crowding and the age of the patient, crowding can be treated by rapid palatal expansion, dentoalveolar compensation, interproximal reduction or with tooth extraction (HAAS, 1970; KONSTANTONIS; ANTHOPOULOU; MAKOU, 2013). Moderate-to-severe crowding treated without extractions increase teeth labial tipping and soft tissue procumbency (MORAIS et al, 2018), so other factors, such as profile characteristics must be considered (KONSTANTONIS et al, 2018). Malocclusion severity can also determine the necessity of teeth extraction.…”

“…Currently there are different nonextraction treatments for solving dental crowding, such as rapid palatal expansion, dentoalveolar compensation and interproximal reduction (HAAS, 1970;MORAIS et al, 2018). However, nonextraction treatment can increase facial procumbency (MORAIS et al, 2018), principally in the presence of moderate-to-sever crowding. So, four first premolar extraction must be considerate in the presence of crowding associated with biprotrusion.…”

“…Due to the aforementioned factors, extraction frequency has shown a constant decrease since the 1970s decade. In the end of the XX century and the beginning of the XXI century four first premolar extraction treatment showed a prevalence of approximately 10% (JANSON; MARIA;.Great differences are observed between extraction and nonextration treatments, from the initial features to the expected results (KONSTANTONIS; ANTHOPOULOU;KONSTANTONIS et al, 2018;MORAIS et al, 2018). Minor skeletal discrepancies and mild-to-moderate dental discrepancies are usually treated with a non-extraction approach (KONSTANTONIS; ANTHOPOULOU;KONSTANTONIS et al, 2018).…”