Does Orthodontic Treatment Affect the Alveolar Bone Density?

Yu, Jian; Huang, Hsuan‐Jung; Liu, Chien Feng; Wu, Jang Yen; Li, Yu Fen; Tsai, Ming Tzu

doi:10.1097/md.0000000000003080

Cited by 35 publications

(29 citation statements)

References 40 publications

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“…It is often thought that alveolar bone remodeling follows orthodontic tooth movement. Retracted teeth move through the alveolar bone, causing bone remodeling to occur with potential change in bone density and thickness to adapt to its new position [1][2][3]. Premolar extraction and orthodontic correction have been shown to be very effective in reducing dental protrusion in many studies [4].…”

Section: Introductionmentioning

confidence: 99%

Alveolar bone remodeling during maxillary incisor intrusion and retraction

et al. 2019

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Background: Maxillary incisor protrusion is a prevalent dental deformity and is often treated by upper incisor intrusion and retraction. The mechanical loading triggers the resorption and apposition of the bone. Alveolar bone remodeling is expected to follow orthodontic tooth movement in a one-to-one relationship. However, in many cases, the outcomes are different. Alveolar bone might still remain thick causing lip protrusion and other aesthetic problems after treatment. Additional corrective procedures such as alveoloplasty. On the other hand, if the labial bone becomes too thin, periodontal problems like gingival recession might occur. The unpredictability of the treatment result and the risk of requiring corrective procedures pose significant challenges to both the providers and patients. The aim of this study is to determine factors that can help to predict the alveolar bone reaction before maxillary incisor intrusion and retraction. Methods: The cohort included 34 female patients (mean age 25.8 years) who were diagnosed with skeletal class II malocclusion with upper incisor protrusion. These patients underwent extraction and orthodontic treatment with upper incisor intrusion and retraction. Lateral cephalograms at pre-treatment and post-treatment were taken. Linear and angular measurements were analyzed to evaluate the alveolar bone changes based on initial conditions. Results: The study found that the relative change, calculated as change in alveolar bone thickness after treatment divided by the initial alveolar thickness, was inversely correlated with the initial thickness. There was a significant increase of labial alveolar bone thickness at 9-mm apical from cementoenamel junction (B3) (P < 0.05) but no statistically significant change in the thickness at other levels. In addition, the change in angulation between the incisor and alveolar bone was inversely correlated with several initial angulations: between the initial palatal plane and upper incisor angle, between the initial palatal plane and upper incisor labial surface angle, and between the initial palatal plane and bone labial surface angle. On the other hand, the change in labial bone thickness was neither significantly correlated with the initial thickness nor significantly correlated to the amount of retraction. Conclusion: The unpredictability of alveolar bone remodeling after upper incisor intrusion and retraction poses significant challenges to treatment planning and patient experience. The study showed that the initial angulation between the incisor and alveolar bone is correlated with the change in angulation after treatment, the initial thickness of the alveolar bone was correlated with the relative change of the alveolar bone thickness (defined as change in thickness after treatment divided by its initial thickness), and the amount of intrusion was correlated with the alveolar bone thickness change at 9-mm apical from the cementoenamel junction after treatment. The results of the present study also revealed that the change in labial alve...

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Section: Introductionmentioning

confidence: 99%

Alveolar bone remodeling during maxillary incisor intrusion and retraction

et al. 2019

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“…Furthermore, three adjacent slices were used, obtained at the cervical and intermediate level and two adjacent slices obtained at the apical level to acquire secure more complete information. At each level the measurements were carried out in four regions: at the palatal (P), vestibular (V), mesial (M) and distal (D) levels to measure the alveolar bone density on the four sides of the tooth (Figure 2) 11,12 .…”

Section: Resultsmentioning

confidence: 99%

“…HUs are defined as linear transformations of X-ray attenuation coefficients measured in a material with reference to water (HU= 0). Nevertheless studies have been conducted to investigate the micro-structure of the bone through the analysis of fractals obtained from bone trabeculae 10 , the analysis of HU remains the traditional method for assessing the quality of the supporting bone of the tooth included 11 .…”

Section: Introductionmentioning

confidence: 99%

Analysis of bone density in a group of patients with dental inclusion

Abazi¹,

Guglielmo²,

Cenko³

et al. 2019

Balkan J Dent Med

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Summary Background/Aim: Genetic and environmental etiologic factors have been described for maxillary canine impaction, except for the trabecular bone characteristics in the impacted area. The aim of this study was to evaluate the surface area and bone density using cone-beam computed tomography (CBCT) images of patients with maxillary impacted canines. Material and Methods: The sample comprised preorthodontic treatment, CBCT images of 24 participants with unilateral maxillary impacted canines, using the impacted side as study group and the non-impacted side as control group. CBCT images were acquired in portrait mode (17 × 23 cm high field of view) at 120 kV, 5 mA, 8.9 seconds exposure time, and 0.3 mm voxel size. Each root was divided into three levels (cervical, intermediate, and apical) to determine whether the bone density change varied with the tooth level. Moreover, each level was divided into four regions (palatal, distal, mesial, and buccal sides). Bone density was measured using Hounsfield Units. Comparisons were made using paired t tests and linear regression. Repeated measurements were obtained randomly from about 20% of the sample. Results: In subjects with unilateral impactions, the maxillary bone density was higher in the impacted side, with a mean difference of 350 HU. Bone density increases in the corono-apical direction of about 100 HU in the impaction site and about 50 HU in the site of the erupted canine. The repeated measurements showed similar results. Conclusions: The maxillary alveolar bone area and bone density are increased in the impacted side compared with the nonimpacted side.

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“…Accountable for bone resorption and bone formation, osteoclasts and osteoblasts are crucial points in this process. 45,46 Some studies 47 have verified the effect of the LLLT on stimulating this process of bone remodeling. Speed growth of orthodontic movement following the use of laser irradiation could be observed because of an increased number of osteoclasts and/or activities in the laser-treated area of the animal models.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Low-Level Laser Therapy on the Acceleration of Orthodontic Tooth Movement

2020

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In clinical practice, low-level laser therapy (LLLT) is widely used. The main aim of this review is to assess the effectiveness of LLLT in accelerating tooth movement in human subjects. The PRISMA checklist was utilized as a guideline to carry out this systematic review. The electronic databases were searched from Google Scholar (2014-2018) and PubMed, and comprehensive research on this topic was also manually conducted. Therefore, 77 articles randomized clinical trials (RCTs) or controlled clinical trials (CCTs) were selected. After screening studies, consequently, eleven trials met the inclusion criteria. Eight out of 11 studies showed LLLT has a significant impact on the acceleration of orthodontic tooth movement, and there was no statistically significant difference in the rate of tooth movement between the laser group and the control group in the two remaining studies. Furthermore, five out of 11 articles showed that LLLT has no adverse effects. Although we have some degree of understanding from a cellular point of view to LLLT effects, we still do not know whether these cellular level changes have any effect on the clinical acceleration of orthodontic tooth movement. The results are inconclusive and cannot be generalized to the public community; therefore, well-structured studies are required.

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Does Orthodontic Treatment Affect the Alveolar Bone Density?

Cited by 35 publications

References 40 publications

Alveolar bone remodeling during maxillary incisor intrusion and retraction

Alveolar bone remodeling during maxillary incisor intrusion and retraction

Analysis of bone density in a group of patients with dental inclusion

The Effect of Low-Level Laser Therapy on the Acceleration of Orthodontic Tooth Movement

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