Abstract
Identifying buccal and oral bone as an important supporting periodontal structure for teeth provides important information for treatment planning in periodontics and orthodontics. This study aims to add evidence to the knowledge of preciseness of cone beam computed tomography (CBCT) measurements of the vertical dimension of buccal and oral bone. The hypothesis is that CBCT is an accurate and reliable method to measure vertical vestibular and oral bone loss. The amount of vertical buccal and oral bone loss (bl) of 260 sites of 10human cadavers was investigated clinically and radiographically by CBCT. Radiographic measurements were rated by two blinded raters. Measurements and the corresponding differences between clinical and radiological findings are described by medians and quartiles (Q1-Q3). For statistical analysis, Lin's concordance correlation coefficient (CCC) and Bland-Altman plots were calculated. The CCC between the raters was 0.994 (95% confidence interval 0.992-0.995). The median bone loss (bl) distance from the cementoenamel junction (CEJ) to the bony defect (BD) was 3.5 mm (range 3-5 mm). The median bl measured in the CBCT was 3.8 mm (range 3.1-4.8 mm). The median difference of the 2measurements for all sites included in the study (N = 260) was -0.2 mm (-0.7 to 0.3 mm). CBCT seems to be an accurate and highly reliable method to detect and describe vertical buccal and oral bone loss. It could improve planning and prediction for successful combined periodontal and orthodontic therapies.
Highlights
Identifying the amount of buccal and lingual bone as a periodontal structure supporting teeth provides important information for treatment planning in several fields of dentistry such as periodontics and orthodontics
The lateral cephalometric radiograph only shows a superposition of the front teeth and their oral and buccal bone [2]
Casanova-Sarmiento et al analyzed mandibular anterior alveolar thickness and height in individuals with different sagittal and vertical skeletal relationships [7]. They concluded that there is no influence on the alveolar thickness or height, even if dental compensation was present, due to sagittal skeletal relationship
Summary
Identifying the amount of buccal and lingual bone as a periodontal structure supporting teeth provides important information for treatment planning in several fields of dentistry such as periodontics and orthodontics. Diagnostic radiographic techniques, frequently used in daily orthodontic practice, are lateral cephalometric radiographs and the panoramic view [1, 2] Both methods are helpful diagnostic tools that provide a two-dimensional image of the bone anatomy [2, 3]. The role of bone covering the lower incisors is an issue often discussed among orthodontists [4] These teeth experience gingival recessions, maybe caused by excessive movement—naturally or iatrogenic—out of the bone [5]. Several studies investigating the correlation of orthodontic health conditions and the amount of buccal bone present around teeth have been published. According to this study skeletal discrepancy influenced the inclination of the maxillary and mandibular incisors [8]
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