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

Cinzia Maspero,Francesca Gaffuri,Iury O. Castro,Marco Farronato,Alessandro Ugolini,Valentina Lanteri

doi:10.3390/ma12244225

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.

Highlights

Orthodontic tooth movement is the result of resorption and apposition of the alveolar bone due to the application of controlled forces on teeth [1].A basic concept in orthodontics is the “Bone Traces Tooth Movement”, which refers to the strong correlation between orthodontic tooth movement and surrounding bone remodeling, together with the stretching of periodontal ligament fibers [2]
The thickness of alveolar bone may represent a limit to orthodontic movement since exceeding it can cause undesirable side effects for the periodontal tissues such as attachment loss ad gingival recession
This study focused on the remodeling pattern of the alveolar bone of maxillary and mandibular arches, considering the torque variation between the pretreatment and post-treatment

Summary

Introduction

Orthodontic tooth movement is the result of resorption and apposition of the alveolar bone due to the application of controlled forces on teeth [1].A basic concept in orthodontics is the “Bone Traces Tooth Movement”, which refers to the strong correlation between orthodontic tooth movement and surrounding bone remodeling, together with the stretching of periodontal ligament fibers [2]. Orthodontic tooth movement is the result of resorption and apposition of the alveolar bone due to the application of controlled forces on teeth [1]. Many studies have observed the mechanical adaptation of alveolar bone in response to orthodontic forces, resulting in resorption and new bone formation in the area of pressure and tension, respectively [3]. The reaction of periodontal tissue depends on the width, height, and morphology of the root, dimensions, angulation, and spatial position of Materials 2019, 12, 4225; doi:10.3390/ma12244225 www.mdpi.com/journal/materials. It has been shown that bone reaction to orthodontics forces is highly affected by the patient’s bone anatomy, physiology, and adaptability [3]. The thickness of alveolar bone may represent a limit to orthodontic movement since exceeding it can cause undesirable side effects for the periodontal tissues such as attachment loss ad gingival recession. The most critical mechanics, such as dental arch expansion and incisor buccal-lingual movements, can decentralize teeth from the alveolar bone envelope [4]

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