Three-dimensional measurement of periodontal support during surgical orthodontic treatment of high-angle skeletal Class III malocclusion: A retrospective study

Abstract

This study aimed to quantify the periodontal health of incisors during surgical orthodontic treatment in patients with high-angle Class III malocclusion using a cone-beam computed tomography (CBCT) 3-dimensional (3D) reconstruction technique. The sample consisted of 30 patients with high-angle Class III malocclusion (mean age, 20.53 ± 2.86 years). CBCT images were taken before treatment (T0), after presurgical orthodontic treatment, and after treatment (T2). In addition, 3D tooth and alveolar bone models were generated. The root surface area, periodontal ligament (PDL)_Area, and vertical bone level (VBL) around the maxillary and mandibular central incisors were measured. The root surface area and PDL_Area of maxillary and mandibular central incisors decreased continuously between T0 and T2 (P<0.01). At T2, mandibular central incisors showed 38.64 ± 13.39% PDL_Area loss, and maxillary central incisors exhibited 21.13 ± 16.48% PDL_Area loss. For mandibular central incisors, the PDL_Area loss caused by VBL loss was significantly greater than that for maxillary central incisors (P<0.01) and significantly greater than the PDL_Area loss caused by root resorption (P<0.01). From T0 to T2, the lingual surface of maxillary central incisors exhibited greater VBL loss than the other 3 surfaces (P<0.01), and the labial and lingual surfaces ofmandibular central incisors demonstrated greater VBL loss than proximal surfaces (P<0.01). The 3D CBCT reconstruction method provides useful information regarding the periodontal defects of incisors in patients with high-angle skeletal Class III malocclusion. The PDL_Area of maxillary and mandibular central incisors decreased continuously during the treatment. Vertical alveolar bone levels at proximal surfaces appeared to be relatively stable.