Correlation between Dental Vestibular–Palatal Inclination and Alveolar Bone Remodeling after Orthodontic Treatment: A CBCT Analysis

Abstract

The aim of this study was to evaluate the correlation between dental vestibular–palatal inclination changes and the cortical bone remodeling after fixed orthodontic treatment using cone beam computed tomography (CBCT). Twenty-two patients with Angle Class I malocclusion, permanent dentition, and mild to moderate dental crowding were included in the present three-dimensional (3D) analysis. Bone dimensions were evaluated by CBCT scans obtained before and after orthodontic treatment, whereas the torque values were calculated by means of digital models using the 3D VistaDent software. A paired t-test was used to compare the changes between the pretreatment and post-treatment measurements. The correlations between variables were analyzed with linear regression analysis. A significant correlation between torque variations and bone thickness changes was observed for the apical buccal level of the anterior side (P < 0.05). Limited and not significant alveolar bone resorption for the apical thickness of anterior teeth occurred at ± 5 degrees of torque variation, while for tooth inclination exceeding +5 or −5 degrees, the bone remodeling was more evident. The present study demonstrated that anterior region was the most affected area by bone remodeling and that torque variation was highly related to apical bone thickness adaptation for maxillary and mandibular incisors and maxillary canines.

Alveolar bone changes in maxillary and mandibular anterior teeth during orthodontic treatment: A systematic review and meta‐analysis

“…Measurements of bone height and bone thickness at the cervical (S1), middle (S2) and apical (S3) levels on the labial and lingual sides of anterior teeth were synthesized and are illustrated in Figure 2. Based on the tooth movement direction and periodontal status, the included studies were divided into four subgroups for assessment: 14 studies 6,7,14,15,17‐25 with extraction (lingual movement of anterior teeth), 7 studies 25‐31 without extraction (labial movement of anterior teeth), 3 studies 10,11,32 including skeletal class III patients (labial movement of mandibular anterior teeth with thin alveolar bone) and 3 studies 33‐35 including well‐controlled periodontitis patients (with periodontally compromised anterior teeth). Study characteristics are summarized in Table 2, and the outcomes of the included studies are listed in Table .…”

“…Four studies evaluated alveolar bone changes in maxillary anterior teeth 25,26,28,31 . A reduction of labial alveolar bone during labial movement of maxillary anterior teeth is commonly reported.…”

“…Our meta‐analysis revealed vertical alveolar bone loss on both the labial (0.97 mm) and lingual sides (0.86 mm) of mandibular incisors. Regarding maxillary incisors, Maspero et al observed significant labial vertical bone loss in maxillary central incisors (0.5 mm), whereas lingual vertical bone changes were not significant 28 . Castro et al reported no significant changes in labial or lingual vertical bone levels in maxillary incisors, but there was significant labial vertical bone loss in maxillary canines 31 .…”

“…Methodological heterogeneity was also noted in the present study. Most of the included studies measured bone thickness at three levels (cervical, middle and apical levels), while one study measured it at five levels from the cementoenamel junction to the apical apex, 23 and three studies measured it at two levels (mid‐root and apex levels) 10,28,29 . The inconsistent studies were excluded from the quantitative analysis and were only included in the qualitative analysis.…”

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

“…Maspero 19 suggested that CBCT is essential to investigate palatal bone change after orthodontic treatment. Vasconcelos 20 indicated that CBCT is the only way to detect the buccal and palatal surface of alveolar bone.…”