Outcome of periodontal-orthodontic treatment in subjects with periodontal disease. Part II: a CBCT study of alveolar bone level changes.

Abstract

To examine alveolar bone level (ABL) changes before (T1) and after (T2) orthodontic treatment (OT) in subjects with periodontal disease. The study included 50 subjects with periodontal disease. All patients received subgingival debridement following baseline examination. Control group patients received final periodontal treatment before the start of OT. For the test group patients final periodontal treatment was performed simultaneous to OT. OT was performed with a straight-wire appliance. Micro-implants or temporary crowns on implants were used for posterior anchorage when needed. ABL measurements of 3821 tooth surfaces were performed on cone beam computed tomography images. No difference was observed between mean ABL at T1 and T2. ABL remained unchanged on 69 per cent of surfaces. A mean of 15.6 (SD 7.4) per cent of surfaces experienced ABL gain, and a mean of 15.1 (SD 7.5) per cent was found with ABL loss. Small significant median ABL difference was observed on mesial and distal surfaces (P < 0.001). A significant difference was found between median ABL changes on mesial/distal in comparison to buccal/lingual surfaces (P < 0.01). Significantly more buccal (17.9 %) and lingual (18.5 %) surfaces experienced ABL loss when compared with mesial (11.3 %) and distal (12.0 %) surfaces (P < 0.001). Significant difference was found in the median ABL change of intruded (0.5 (IQR 0.94) mm) and non-intruded (-0.4 (IQR 1.07) mm) maxillary incisors (P = 0.04). Significant median ABL gain was found on the lingual surface of maxillary incisors, which were retroclined more than 8.6 degree and intruded more than 1.6 mm. ABL changes after periodontal-orthodontic treatment in patients with periodontal disease were small. ABL gain was more observed on mesial and distal surfaces and ABL loss on buccal and lingual surfaces. Larger orthodontic movements of maxillary incisors influenced ABL gain.