Background: To evaluate the dentoalveolar position and root diameters of the maxillary incisors from cone beam computed tomograms (CBCT) compared with cephalometric tracings. Methods: A total of 64 sets of initial lateral cephalograms and CBCT images were enrolled. Measurements of dentoalveolar position included bone thicknesses and heights of alveolar, cortical, and cancellous bone. Root diameter and total root-bone thickness were also evaluated. All measurements were performed on cephalograms and CBCT images of the maxillary central incisor (U1CT) and maxillary lateral incisor (U2CT). The data were statistically analyzed using one-way ANOVA and Bonferroni tests (p < 0.01) to compare the cephalograms, U1CT, and U2CT. Results: The cephalograms presented thicker alveolar bone (labial: 0.20–0.67 mm, palatal: 0.41–0.60 mm; p < 0.001) and cortical bone (labial: 0.20–0.67 mm, palatal: 0.41–0.52 mm; p < 0.001) as well as higher alveolar crest (labial: 0.23–0.27 mm, palatal: 0.15–0.17 mm; p < 0.001) and cortical height (labial: 0.35–0.47 mm; p = 0.051, palatal: 0.14–0.18 mm; p < 0.001) than the CBCT images on both the labial and palatal sides, whereas palatal cancellous thickness was not significantly greater (p > 0.01). The cephalograms presented a greater total root-bone thicknesses (0.80–1.08 mm; p < 0.001), whereas the cephalograms traced thinner roots than the CBCT images (0.36–0.52 mm; p < 0.01). Conclusion: Routine lateral cephalograms are not suitable for alveolar bone evaluation in orthodontic treatment due to errors in representing dentoalveolar thicknesses and heights.
Corticotomy is a surgical procedure that induces injury to the cortical bone to accelerate tooth movement. This study aimed to increase the depth of corticotomy to the trabecular bone and to evaluate the amount and rate of tooth movement and alveolar bone changes in response to various degrees of cortical and trabecular bone injury. Seventy-eight male Wistar rats were randomly divided into four groups based on procedure used: (1) baseline control group of orthodontic tooth movement (OTM) only; (2) OTM + 4 corticotomies (CO); (3) OTM + 4 osteotomies (OS); and (4) OTM + 16 CO. A closed-coil nickel–titanium spring was placed to move the maxillary first molar mesially with a 10 g force. On days 0, 7, 14, and 21, alveolar bone alteration and tooth movement were measured using microcomputed tomography. Significant tooth movement was related to the number and the depth of the perforations. The OTM + 16 CO group showed a greater amount and rate of tooth movement than the OTM + 4 CO group. When osteotomy and corticotomy were compared with the same volume of bone removed, the OTM + 4 OS group had a faster rate of tooth movement than the OTM + 16 CO group during the first week, with significantly reduced bone volume. However, no significant difference was observed in the amount of tooth movement between the OTM + 4 OS and OTM + 16 CO groups at the end of the study. Extending the depth of corticotomy to trabecular bone increased the amount of tooth movement by accelerating the induction and completion of bone remodeling, which accelerated the rate of tooth movement during the initial stage.
Following corticotomy surgery, patients experience moderate to severe post-operative pain that necessitates prescriptions of analgesics. The prostaglandin inhibitory effect of ibuprofen influences the mobility of teeth during orthodontic treatment. This study aimed to determine how ibuprofen affects histological reactions and dental root resorption during orthodontic tooth movement aided by corticotomy. Forty-two male Wistar rats were divided into three groups by random selection: (1) control group, (2) corticotomy group (CO), and (3) corticotomy with 0.6 mL of 15 mg/kg ibuprofen group (CI). On each buccal and palatal alveolar bone, two decortication points were made. Orthodontic tooth movement was induced on the maxillary first molar for 21 days utilizing a NiTi-closed coil spring with 10 g of force. Hematoxylin and eosin were used to prepare and stain the histological sections. The numbers of osteoclasts on days 0, 7, 14, and 21 were determined, and the root resorption area on days 0 and 21 was measured. Compared to the control group, the osteoclast counts in the CO and CI groups were considerably greater (p < 0.002). No significant differences were observed between the CO and CI groups in the numbers of osteoclasts or the percentages of root resorption (p > 0.05). The amounts of osteoclast activity and root resorption were unaffected by the administration of ibuprofen in corticotomy-facilitated tooth movement.
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