Background: This study aims to explore the detailed correlation between the movement of maxillary and mandibular central incisors and alveolar bone resorption in adults who had orthodontic premolar extraction treatment. Methods: A total of 63 adult patients (mean age, 24.41 years) who received orthodontic treatment with the extraction of four first premolars were included in this study. CBCT images were obtained before and after treatment. Three-dimensional evaluations of the movement of 252 central incisors (126 maxillary and 126 mandibular incisors) and alveolar bone changes were conducted. Four points were used to describe the incisor movement: C (cusp point), R (root apex point), M (mid-point of root neck), and L (labial cementoenamel junction point). The thickness of labial and palatal alveolar bone was assessed at the crestal, mid-root, and apical levels of incisors. The results were analyzed with Spearman’s correlation and multilinear regression. Results: Matching the measurements of central incisor movement and alveolar bone resorption, significant correlations could be observed. For maxillary central incisors, the labial alveolar bone resorption at the crestal level was correlated with the movement of Point L (r = 0.290, p < 0.05), and the labial alveolar bone resorption at the apical level was correlated with Point M (r = 0.387, p < 0.05). For mandibular central incisors, the labial alveolar bone resorption at the apical level was correlated with the movement of Point M (r = 0.493, p < 0.05) and R (r = 0.498, p < 0.01); the palatal alveolar bone resorption at the mid-root level with Point M (r = -0.170, p < 0.01); and the palatal alveolar bone resorption at the apical level with Point R (r = 0.177, p < 0.01). Conclusions: This study investigated the concrete correlations between central incisor movement and alveolar bone resorption in adults after orthodontic treatment with premolar extraction. It is potentially helpful for orthodontists to have a relatively accurate prediction of alveolar bone resorption based on the specific movements of central incisors and to reduce the risk of alveolar bone resorption by better adjusting the three-dimensional movement types of incisors.
Background: This article studies the association between psychological status and condylar bony changes in adults and assesses psychological questionnaires as an indicator of potential condylar bony changes. It is meaningful because condylar bony changes, a severe subtype of TMD and big concern in orthodontic treatment, would likely be ignored in patients with few TMD symptoms, in which case, even with potential psychological problems (depression, somatization and anxiety) being noticed, orthodontists may underestimate the possibility or severity of condylar bony changes and thus may not perform relevant examinations. Methods: A total of 195 adults (145 female and 50 male) who consulted orthodontists and had clinical records were included in this study. Initial CBCT images taken before orthodontic treatment were used for observing their condylar bony changes, and a comprehensive questionnaire conducted by each adult to evaluate psychological status was collected. Age, sex, TMD symptom history, scores on Patient Health Questionnaire-9 (PHQ-9), PHQ-15 and Generalized Anxiety Disorder-7 (GAD-7), and condylar bony changes of these adults were recorded. Odds ratios (OR) and 95% confidence intervals (CIs) for identifying the independent risk factors associated with condylar bony changes were calculated with univariate and multivariate logistic regression analysis. The kappa statistic was used to assess intraobserver reliability of CBCT analysis. Results: The scores of PHQ-15 (OR: 2.088, 95% CI: 1.061–4.108, p < 0.05) and GAD-7 (OR: 2.133, 95% CI: 1.082–4.204, p < 0.05) were correlated with the condylar bony changes on CBCT. Besides, the probability of having condylar bony changes was positively correlated with the number of psychological problems concomitantly present in an adult (OR: 1.440, 95% CI: 1.10–1.867, p < 0.01). The intraobserver agreement value for CBCT analysis was substantial (κ = 0.732). Conclusions: This study found that positive PHQ-15 (somatization) and GAD-7 (anxiety) scores were associated with condylar bony changes in adults. Moreover, the number of psychological problems concomitantly present in an adult was positively associated with the probability of having condylar bony changes.
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