The Impact of Orthodontic Bands on the Marginal Periodontium of Maxillary First Molars: A Retrospective Cross-Sectional Radiographic Analysis.

Sabine Teubner,Giorgio Menghini,Patrick R Schmidlin,Thomas Attin,Stefan Baumgartner

doi:10.2174/1874210601812010312

Sabine Teubner, Giorgio Menghini + Show 3 more

Open Access

https://doi.org/10.2174/1874210601812010312

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Abstract

Aim:Available information on the effect of orthodontic treatment on crestal alveolar bone levels measured in radiographs is contradictory. The aim of this study was to compare the alveolar bone level and periodontal ligament space of banded upper first molars to untreated controls.Materials and Methods:This retrospective cross-sectional radiographic study investigated alveolar bone levels of upper first molars of an orthodontic test group and an untreated control group of comparable age (15-16.25 years), using existing bitewing radiographs.Eighty-six individuals were included in each group. Three parameters were measured mesially and distally on both sides of the patient as follows: I) Alveolar Bone Level (ABL): measured as the distance between the cemento-enamel junction and the alveolar crest, II) the Periodontal Ligament Space (PLS): measured as the most coronal distance between the alveolar crest and the tooth surface, and III) angle between the lines (alveolar crests mesial and distal) and (cemento-enamel junction mesial and distal).Results:The mean duration of the orthodontic treatment in the test group was 2.5 years. The periodontal ligament space was statistically significantly wider on mesial areas of right molars (mean 0.2 mm, p<0.01), but there was no statistically significant difference found in the three other areas (distal part of the right molar, mesial and distal parts of the left molar). There was a statistically significant mean alveolar bone loss in the right and left mesial areas, respectively accounting for 0.3 mm (p<0.001) and 0.2 mm (p<0.01). No statistically significant alveolar bone loss was measured on the distal surfaces of the upper molars. The angle was wider on both sides for the test group (right p<0.001 and left p<0.05).Conclusions:A significant alveolar bone loss on the mesial tooth surface of upper first molars after orthodontic treatment was found with concurrent different levelling angles in the test group. On all other sites, no statistically significant changes were found. There was some minimal statistical significant alveolar bone loss after finishing treatment in patients who had orthodontic bands placed on their maxillary 1st molars, but no clinical significance was found.

Highlights

The terminal attachments of fixed orthodontic appliances are placed on molar teeth, usually on first permanent molars
The periodontal ligament space was statistically significantly wider on mesial areas of right molars, but there was no statistically significant difference found in the three other areas
No statistically significant alveolar bone loss was measured on the distal surfaces of the upper molars

Summary

Introduction

The terminal attachments of fixed orthodontic appliances are placed on molar teeth, usually on first permanent molars. These attachments can be a cemented band or a bonded molar tube. The latter have, higher failure rates than molar bands [1 - 3], causing emergency visits, lengthening of the treatment or patient dissatisfaction. Because of lower failure rates and higher reliability, many orthodontists tend to favor molar bands. It has been hypothesized that permanent loss of crestal alveolar bone may be the consequence of both increased retention of microbial plaque around fixed appliances and higher osteoclastic activity during tooth movement [5]

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