Alveolar cortical plate changes associated with incisor retraction and its influence on the limits of orthodontic tooth movement

Elnagar, Mohammed H.; Handelman, Chester S.; Lippincott, John S; Kim, Myung-Rip; BeGole, Ellen A.

doi:10.1111/ocr.12469

Cited by 4 publications

(7 citation statements)

References 17 publications

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“…Cancellous bone was found on the labial bone at the measured levels because the pure cortical bone was found on the labial plate. When pure cortical bone is detected on all labial plates, a light force should be applied to generate the desirable bone remodeling [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

The Accuracy of Lateral Cephalogram in Representing the Anterior Maxillary Dentoalveolar Position

2022

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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.

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Section: Discussionmentioning

confidence: 99%

The Accuracy of Lateral Cephalogram in Representing the Anterior Maxillary Dentoalveolar Position

2022

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“…Thongudomporn 24 and Elnagar et al 25 The authors found a significant posterior movement of the labial cortex and non-significant change in the palatal cortex following tooth retraction. 24,25 This study found no significant changes in the extraction group and the opposite result in the non-extraction group: the labial cortex did not significantly move, while the palatal cortex resorbed anteriorly.…”

Section: Discussionmentioning

confidence: 95%

“…[15][16][17]19,20 Recent systematic reviews and meta-analysis highlighted the low quality of currently available evidence published in English in extraction cases and the lack of non-extraction data. [21][22][23] A couple of studies investigated cortical positional changes using stable external structures 24,25 and found the labial cortex resorbing with incisor retraction while the palatal cortex remained unchanged. Using an extra-alveolar stable structure as reference would circumvent the potential errors found with the tooth axis, which changes as the incisor invariably tips when retracted.…”

Section: Introductionmentioning

confidence: 99%

“…Then at T2, sagittal cross-sections were created at the same distance from the mid-palatal suture. The resulting crosssections were traced using the customized, digitally constructed lines previously devised by Elnagar et al 25 After the investigator identified the labial cemento-enamel junction (CEJ) and the root apex, the software calculated and partitioned the distance between the two landmarks, and generated guide lines parallel to the palatal | 267 plane (PP) at set levels: 0% (labial cemento-enamel junction), 25%, 50%, 75%, and 100% (root apex) (Figure 1). The landmarks to be defined were the following: sella, ANS, PNS, U1 tip, apex, labial CEJ, palatal CEJ, labial marginal bone crest, palatal marginal bone crest, labial and palatal root surfaces intersecting the 25%, 50%, 75% levels, and labial and palatal cortex intersecting the 25%, 50%, 75%, and 100% levels (Figure 1A).…”

Section: Introductionmentioning

confidence: 99%

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Cone‐beam computed tomography assessment of maxillary anterior alveolar bone remodelling in extraction and non‐extraction orthodontic cases using stable extra‐alveolar reference

Yang

Atsawasuwan

Viana

et al. 2022

Orthod Craniofacial Res

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Objective To explore alveolar cortical positional change in response to tooth movement in extraction and non‐extraction orthodontic cases, using cone‐beam computed tomography (CBCT) and stable extra‐alveolar references. Materials and Methods The pre‐treatment (T1) and post‐treatment (T2) CBCT scans of 25 extraction (EXT) and matched 25 non‐extraction (Non‐EXT) orthodontic cases were imported into Dolphin Imaging 3D, and oriented uniformly. Sagittal and axial CBCT cross‐sections were traced using customized software‐generated guides. The displacement of teeth and alveolar bone cortices were automatically measured using the palatal plane (PP) and the line perpendicular to PP and passing Sella as reference. Intra‐ and inter‐group differences between T1 and T2 were analysed. Subjects were also superimposed three‐dimensionally using Geomagic Control X for qualitative analysis of cortical remodelling. Results The EXT group showed incisor retraction, while the Non‐EXT group exhibited statistically significant incisor anterior tipping (P < .05). In EXT, both the labial and palatal cortices are resorbed. Non‐EXT showed labial cortex anterior modelling, and statistically significant palatal cortex resorption (P < .05). In both groups, statistically significant decrease in total and palatal alveolar widths, increase in labial widths, and palatal dehiscence were observed. Comparatively, EXT showed significantly more incisal total and palatal width decrease and palatal vertical bone loss. Conclusion Labial cortical remodelling was shown to follow anterior tooth movement, but the palatal cortical response to incisor retraction and labial cortical remodelling in general remained inconclusive. Narrowing of the alveolar housing and palatal dehiscence were observed regardless of extraction following orthodontic treatment.

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“…Cancellous bone was not found on the labial bone at the measured levels because pure cortical bone was found on the labial plate. When pure cortical bone is covered on all labial plates, light force should be used and always monitored [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

The Accuracy of Lateral Cephalogram for Measuring Alveolar Bone Thickness and Root Diameter on Mandibular Incisors

Limsakul,

Chanmanee,

Charoemratrote

2022

Diagnostics

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Background: The objective of the study was to ascertain whether the alveolar bone and root of the mandibular central incisor measured from cephalograms can represent the same measurements of both mandibular central and lateral incisors from CBCT. Methods: A total of 38 sets of CBCT images and cephalograms before treatment were selected for this study. Thicknesses included alveolar bone, cortical bone, and cancellous bone at the labial and lingual sides. Root diameter and total root-bone thickness were also evaluated. The measurements were performed at 3, 6, and 9 mm from the cemento-enamel junction. Heights included labial bone height and lingual bone height. All measurements were performed on cephalograms and CBCT images of the mandibular central incisor (L1CT) and mandibular lateral incisor (L2CT). The data were statistically analyzed using one-way ANOVA and Bonferroni tests (p < 0.01) to compare the cephalograms, L1CT, and L2CT. Results: The cephalograms presented thicker alveolar bone and cortical bone (labial: 0.16–0.31 mm, lingual: 0.14–0.29 mm; p < 0.001) as well as higher alveolar crest (labial: 0.46–0.48 mm, lingual: 0.38–0.39 mm; p < 0.001) than the CBCT images on both the labial and lingual sides, whereas lingual cancellous thicknesses were not significantly different (p = 0.257). The cephalograms presented greater total root-bone thicknesses than L1CT (0.19–0.30 mm; p < 0.001), whereas the cephalograms traced thinner roots than L1CT (0.18–0.23 mm; p < 0.001) and L2CT (0.39–0.59 mm; p < 0.001). Conclusion: Lateral cephalograms cannot represent both mandibular central and lateral incisor dentoalveolar thicknesses, heights, and root diameters the same as CBCT. However, the differences were less than 0.5 mm.

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Alveolar cortical plate changes associated with incisor retraction and its influence on the limits of orthodontic tooth movement

Cited by 4 publications

References 17 publications

The Accuracy of Lateral Cephalogram in Representing the Anterior Maxillary Dentoalveolar Position

The Accuracy of Lateral Cephalogram in Representing the Anterior Maxillary Dentoalveolar Position

Cone‐beam computed tomography assessment of maxillary anterior alveolar bone remodelling in extraction and non‐extraction orthodontic cases using stable extra‐alveolar reference

The Accuracy of Lateral Cephalogram for Measuring Alveolar Bone Thickness and Root Diameter on Mandibular Incisors

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