Abstract
Background: The purpose of the study was to evaluate cone beam computed tomography (CBCT) after piezocision-assisted orthodontic maxillary arch expansion. Methods: Forty CBCT images of 20 patients taken before and after treatment were included in the study. The following radiographic parameters were measured: buccal/palatal bone plate thickness measured in three locations, 0.5 mm, 3.5 mm, and 5 mm from the margin of alveolar process; cemento-enamel junction-crest distance (CEJ-C) measured at buccal (CEJ-B) and palatal/lingual (CEJ-P) aspects. Results: After treatment there were insignificant changes in CEJ-C and thickness of buccal/palatal plates for all the dental groups except for incisors and premolars. CEJ-B increased by 1.43 mm on premolars and CEJ-P by 1.65 mm on incisors and by 0.31 mm on premolars. On the incisors, the buccal plate width increased significantly, by 0.2 mm and 0.44 mm at 3.5-mm and 5-mm measurement points. On premolars, the buccal plate width decreased in three measuring points by 0.27 mm, 0.37 mm, and 0.25 mm. Conclusions: Piezocision-assisted orthodontic maxillary arch expansion does not cause evident negative changes of cortical plates except for the premolar region. Therefore, premolars may be at greater risk of buccal plate loss than other teeth.
Highlights
Evaluation of the soft and hard periodontal tissues’ status is crucial while adequately diagnosing and making a corresponding orthodontic treatment plan
Gingival recession is a consequence of a decrease in cortical bone thickness and the formation of bone dehiscence/fenestration after orthodontic tooth shifting/tipping [1,3,4,5,6]
To minimalize the probability of complications in the course of orthodontic treatment or in the retention phase, additional surgical procedures are proposed such as minimally invasive corticotomy-piezocision
Summary
Evaluation of the soft and hard periodontal tissues’ status is crucial while adequately diagnosing and making a corresponding orthodontic treatment plan. It seems that the thin periodontal phenotype is a meaningful risk factor for gingival recessions’ appearance after dental arch expansion [1,2]. It has been shown that bone injury leads to significant acceleration of bone turnover by increasing the number of osteoclasts, causing transient osteopenia and, allowing tooth movement with an adjacent demineralized bone matrix.
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