Lingual Alveolar Bone Thickness Research Articles

Correlation of Tongue Dimensions and Posture with Lower Central Incisor Inclination and Alveolar Bone Thickness in Skeletal Class I and II Malocclusion: A CBCT Study

Background: In this study, Cone-Beam Computed Tomography (CBCT) was used to assess the dimension and posture of the tongue, as well as Alveolar Bone Thickness (ABT) and labiolingual inclination of mandibular central incisors in order to look for any correlations. Methods: A total of 200 CBCT images of skeletal Class I and II individuals were studied. Each group of malocclusion was divided into three subgroups: low-angle, normal-angle, and high-angle. Buccal and lingual alveolar bone thickness (BT & LT), and the Inclination of Mandibular Plane Angle (IMPA) were measured and compared by using T-test. The spearman rank correlations test analyzed the correlations between dental variables and tongue measurements (p<0.05). Results: Significant weak correlations were identified between dental variables and tongue measurements. In Cl I malocclusion, IMPA and Tongue Length (TGL) were found to be significantly correlated with a correlation value of 0.324 (p=0.001). In Cl II malocclusion, there was a significant correlation between BT3 and TGH. About BT3, there was a significant correlation with D4’ and a negative correlation with D5’. Further comparison among vertical subgroups revealed the same results. Conclusion: Class I patients with superior tongue posture may have thicker lingual alveolar bone around mandibular incisors and Class II patients showed that thicker labial alveolar bone of lower incisor and thinner alveolar bone at the lingual side may be associated with a superior position of the posterior portion of the tongue.

Three-dimensional assessment of alveolar bone changes and root resorption in extraction patients after fixed orthodontic treatment: A prospective study

The aim of this study was to evaluate the alveolar crestal bone height, alveolar bone thickness, and root resorption in mandibular incisors after fixed orthodontic treatment. A total of 35 patients (mean age 17.02 ± 3.24 years) with moderate to severe mandibular anterior crowding requiring first premolar extraction were included. Cone beam computed tomography scans of the mandibular anterior region were obtained from the patients before and after orthodontic treatment. The alveolar crestal bone height, cortical bone thickness (CBT) (at apex and midroot level), labial and lingual alveolar bone thickness, and root resorption were assessed for all mandibular incisors. Paired Student's t test was used to compare pretreatment and post-treatment alveolar bone changes and root resorption. A significant decrease in lingual crestal bone height was observed in all mandibular incisors after orthodontic treatment (P < 0.001). Lingual CBT decreased at the midroot level significantly for all mandibular incisors after completion of orthodontic treatment (P < 0.001). A significant decrease in total lingual bone thickness was observed in all mandibular incisors (P < 0.001). Root lengths of mandibular incisors decreased significantly in the sagittal and coronal sections after orthodontic treatment (P < 0.001). Fixed orthodontic treatment with premolar extraction results in a significant reduction of alveolar crestal bone height, CBT (at midroot level), and alveolar bone thickness on the lingual aspect of mandibular incisors. Significant orthodontically induced inflammatory root resorption was observed in all mandibular incisors after orthodontic treatment.

Impact of vertical facial type on alveolar bone thickness and tooth morphology: A retrospective CBCT-based clinical study

IntroductionThe relationship between vertical facial patterns and the morphology of the alveolar bone and teeth is crucial for successful orthodontic treatment planning. This study aimed to evaluate the relationship between vertical facial patterns, bone thickness, and root-crown dimensions in the maxillary anterior teeth. MethodsThis retrospective study screened 300 cone-beam computed tomography (CBCT) scans of orthodontic patients between December 2022 and November 2023, with 115 meeting the inclusion criteria. Buccal and lingual alveolar bone thickness, along with crown and root lengths of maxillary anterior teeth, were measured and compared across short, normal, and long facial types, classified according to the Frankfort-Mandibular Plane Angle. One-way ANOVA, independent-samples Kruskal-Wallis, and post-hoc tests were used for statistical analysis. ResultsSignificant differences in alveolar bone thickness were observed across facial types, with short facial types showing consistently greater thickness in the apical and mid-palatal regions compared to normal and long facial types (p < 0.05). No significant differences in crown or root lengths were found among the facial types. ConclusionFacial type significantly influences alveolar bone thickness, particularly in short facial types, which demonstrate greater bone support. These findings underscore the importance of considering facial type in orthodontic treatment planning to minimize complications.

Clinical and radiographic effect of simultaneously labial and lingual augmented corticotomy: a prospective case series study

Objective: To investigate soft-and hard-tissue changes after simultaneously labial and lingual augmented corticotomy in patients with insufficient alveolar bone thickness of lower anterior teeth both in labial and lingual side during orthodontic treatment. Methods: From January 2021 to June 2022, 10 patients [2 males and 8 females, (26.2±3.1) years old] who received orthodontic and orthognathic combined treatment from the Fourth Clinical Division, Peking University School and Hospital of Stomatology were selected. The alveolar bone thickness of lower anterior teeth both in labial and lingual side in these patients was less than 0.5 mm according to cone-beam CT examination before or during treatment, and 60 lower anterior teeth were included. The 10 patients were treated with simultaneously labial and lingual augmented corticotomy. The differences in gingival recession, papilla index and the differences in labial and lingual alveolar bone thickness of lower anterior teeth were compared. Results: Six months after surgery, the alveolar bone thicknesses at the 4 mm under cemento-enamel junction (CEJ), 8 mm under CEJ and at the apical level [labial side: (1.02±0.39), (2.22±0.89) and (4.87±1.35) mm; lingual side: (1.07±0.46), (2.31±1.04) and (3.91±1.29) mm] were significantly higher than that before surgery [labial side: (0.02±0.09), (0.06±0.21) and (2.71±1.33) mm]; lingual side: (0.14±0.29), (0.40±0.52) and (2.13±1.02) mm] (P<0.001), respectively. The increases in alveolar bone thickness of central incisors [apical level on labial side: (2.53±1.20) mm, 8 mm under CEJ on lingual side: (2.27±1.24) mm, apical level on lingual side: (2.66±1.49) mm] and lateral incisors [apical level on labial side: (2.42±1.30) mm, 8 mm under CEJ on lingual side: (2.28±0.92) mm, apical level on lingual side: (1.94±1.15) mm] were significantly higher than that of canines [apical level on labial side: (1.52±1.47) mm, 8 mm under CEJ on lingual side: (1.17±1.09) mm,apical level on lingual side: (0.74±1.37) mm] (P<0.01). There were no significant differences in the degree of gingival recession [labial side before surgery: (0.72±0.88) mm, lingual side before surgery: (0.80±1.09) mm; labial side 6 months after surgery: (0.72±0.81) mm,lingual side 6 months after surgery: (0.89±0.21) mm] and gingival papilla index [before surgery: 1.00(0.75, 2.00); 6 months after surgery: 1.00(1.00, 2.00) ] between pre-operation and 6 months after surgery (P>0.05). No serious complications occurred. Conclusions: The method used in this article for simultaneously labial and lingual augmented corticotomy was safe and feasible. This surgery has positive clinical significance for the stability of the periodontal tissue in orthodontic treatment for patients with alveolar bone thickness less than 0.5 mm of lower anterior teeth both in labial and lingual side.

Relationship between different skeletal facial types and anterior alveolar bone thickness with cone-beam computed tomography in an Asian population.

BackgroundTo investigate the relationship between different skeletal facial types and anterior alveolar bone thickness with cone-beam computed tomography (CBCT) in an Asian population.MethodsA total of 130 patients with 1,560 healthy anterior teeth were enrolled. On three-dimensional reconstructed images, Frankfurt-mandibular plane angle (FMA) value and angle formed by subspinale, nasion, and supramental (ANB) value were measured, and subjects were categorized into different groups based on their vertical skeletal patterns as well as sagittal jaw relationships. For each tooth, the thickness of alveolar bone was measured at three locations: 1, 3, and 5 mm apical to alveolar bone crest. Descriptive statistics were used. Kruskal-Wallis test, one-way ANOVA, and independent-samples t-test were used for further analysis.ResultsMen’s maxillary anterior teeth’s lingual alveolar bone thickness was significantly greater than women’s (P<0.05). Strong correlations were found between vertical skeletal patterns and lingual alveolar bone thickness of maxillary/mandibular anterior teeth (R2=0.302, P<0.01 in the maxilla; R2=0.311, P<0.01 in the mandible). However, no significant difference was shown in the alveolar bone thickness among people with different sagittal bone profiles.ConclusionsThe lingual alveolar bone of the maxillary anterior teeth is thicker in males than in females. With the increase of FMA, the anterior alveolar bone gradually became thinner.

A preliminary study of buccal and lingual alveolar bone thickness of posterior teeth in patients with skeletal Class III malocclusion and mandibular asymmetry

The purposes of this retrospective study were to investigate the buccal and lingual alveolar bone thickness values of the posterior teeth in patients with asymmetrical skeletal Class III malocclusion and compare them with patients with symmetrical skeletal Class III and Class I malocclusion. Seventy-eight cone-beam computed tomography scans were classified into 3 groups according to the sagittal pattern and menton deviation: asymmetrical Class III (n= 26), symmetrical Class III (n= 26), and symmetrical Class I (n= 26). The buccal and lingual alveolar bone thickness of the first molar and premolars in the maxilla and mandible were measured at 3, 6, and 8 mm apical to the cementoenamel junction and the apical and middle levels of the root. Measurements were compared among the 3 groups. In the asymmetrical Class III group, the buccal alveolar bone along the distobuccal root of the maxillary first molar on the deviated side was thinner by 1.07 to 1.10 mm than that in the symmetrical Class I group at 6-mm, 8-mm, and middle-level planes (P<0.001, P<0.01, and P<0.001). The buccal alveolar bone thickness along the distal and mesial roots of the mandibular first molar on the deviated side was thinner by 1.28 to 1.85 mm, and by 0.72 to 1.21 mm, respectively (P <0.001 and P <0.01), than that in the symmetrical Class I group at 6-mm, 8-mm, apical and middle-level planes. In this preliminary study, patients with skeletal Class III malocclusion showed thinner buccal and lingual alveolar bone in the posterior teeth than subjects with Class I malocclusion. Particular attention should be paid to buccal alveolar bone thickness along the distobuccal root of the maxillary and distal root of the mandibular first molar to prevent periodontal complications in decompensation. Future studies should involve larger sample sizes, more repeatable and comprehensive measuring and statistical methods.

Symphysis morphology and mandibular alveolar bone thickness in patients with β-thalassemia major and different growth patterns

ABSTRACTObjective: The present study aimed to assess the morphology of symphysis and alveolar bone thickness (ABT) surrounding mandibular incisors in thalassemic patients, as compared to unaffected individuals. Methods: This case-control study was conducted on lateral cephalograms of 60 thalassemic and 60 unaffected patients with Class II malocclusion seeking orthodontic treatment at Dental School, Shiraz University of Medical Sciences. The sample was divided into three subgroups including hyperdivergent, normodivergent, and hypodivergent, according to the Jarabak index. Symphysis dimensions and alveolar bone thickness surrounding mandibular incisors were measured using AutoCad software. Finally, the correlation between alveolar bone thickness and symphysis morphology was assessed. Results: In general, chin dimensions and bone thickness at different levels of mandibular incisor roots (cervical, middle, apical) were smaller in thalassemic adolescents than controls. Concerning the total sample as well as the normodivergent subgroup, significantly lower values were observed in thalassemic patients for symphysis width, total ABT at the cervical, and lingual ABT at the apical root area compared to controls (p < 0.05). The hypodivergent growth pattern was not associated with any statistical differences between the groups (p> 0.05). In both thalassemic and control subjects, symphysis width showed a weak to moderate positive correlation with ABT of lower incisors (p< 0.05), whereas symphysis height showed a moderate positive correlation with cervical ABT in only ß‐thalassemia patients (p< 0.05). Conclusions: Compared to controls, ß-thalassemia patients showed thinner alveolar bone at different levels of lower incisor roots and smaller symphysis dimensions. There were significant correlations between symphysis dimensions and alveolar bone thickness of mandibular incisors in the sample.

Assessment of buccal and lingual alveolar bone thickness and buccolingual inclination of maxillary posterior teeth in patients with severe skeletal Class III malocclusion with mandibular asymmetry

The purpose of this study was to evaluate the buccal and lingual alveolar bone thickness and buccolingual inclination of maxillary posterior teeth in patients with severe skeletal Class III malocclusion with and without mandibular asymmetry and compare with those in patients with skeletal Class I malocclusion. Cone-beam computed tomography images of 69 patients with severe skeletal Class III malocclusion and 30 patients with skeletal Class I malocclusion were collected and reconstructed with Dolphin 3D software. Based on the distance from menton to the sagittal plane (d), the patients with skeletal Class III malocclusion were divided into a symmetry group (d≤2mm) and an asymmetry group (d≥4mm). Buccal and lingual alveolar bone thickness and buccolingual inclination of maxillary posterior teeth were measured and compared. Correlations among dental measurements, severity of sagittal discrepancy, and mandibular deviation were analyzed. Maxillary posterior teeth on the deviated side in Class III asymmetry group and symmetry group were buccally inclined compared with the Class I group (P<0.001). A significant negative correlation was noted between buccolingual inclination of maxillary posterior teeth and ANB value with Spearman correlation coefficient of maxillary first molar, second premolar, and first premolar of -0.687, -0.485 and -0.506, respectively (P<0.001). Maxillary first molar showed thinner buccal alveolar bone on deviated side in asymmetry group and symmetry group of Class III, compared with the Class I group, with average values of 1.21mm, 1.19mm, and 1.83mm, respectively (P<0.05). The maxillary first premolar also showed thinner buccal alveolar bone on deviated side in Class III asymmetry group compared with the Class I group, with average values of 0.87mm and 1.28mm, respectively (P<0.05). Decompensation of buccally inclined posterior teeth in patients with skeletal Class III malocclusion should be more cautious owing to thinner buccal alveolar bone to avoid a high risk of fenestration and dehiscence.

Comparison and Evaluation of Alveolar Bone Around Lower Central Incisors in Class III and Class I Patients

Objectives: The aim was to compare the alveolar bone support of mandibular central incisors in subjects with Class III and Class I skeletal patterns using cone-beam computed tomography (CBCT). Materials and Methods: Group 1 included 20 patients (mean age=19.78±2.80) with Class III malocclusion (mean ANB°=-2.77±3.69), mesofacial growth pattern (FMA°=27.03 ±5.11) and lingual-inclined mandibular incisors (IMPA°&amp;lt;85). Group 2 included 20 patients (mean age=20.85±3.97) with Class I malocclusion (mean ANB°=2.94 ±1.46), mesofacial growth pattern (FMA°=25.67±6.83) and normal inclined mandibular incisors (85&amp;lt;IMPA°&amp;lt;95). Vertical alveolar bone level and alveolar bone thickness (ABT) of total 80 mandibular central incisors (40 from each group) were evaluated. Buccal, lingual and total ABT were measured at the crestal, midroot, and apical levels. Buccal (BACH) and lingual (LACH) alveolar crestal heights were also evaluated. Mann-Whitney U, independent samples-t-tests, and Spearman’s rank correlation analysis were applied for statistical analysis. Results: The lingual ABT at the crestal and midroot level, buccal ABT at the apical level, and total ABT at all levels were significantly lower in Group 1 than Group 2 (p&amp;lt;0.05). There was a negative correlation between the buccal (r=-0.324; p=0.042) ABT at the apical level and mandibular plane angle. The change in mandibular incisor inclination was positively correlated with buccal ABT at the apical level (r=0.463; p=0.003) and lingual ABT at the crestal level (r=0.550;p&amp;lt;0.001). BACH was significantly higher in Group 1 (2.21±1.48 mm) compared to Group 2 (1.42±0.17 mm) (p &amp;lt; 0.05). Conclusions: In subjects with Class III deformities, mandibular central incisors have less bone support especially at the buccal side of the alveolar bone at the apical level and lingual side of the alveolar bone at the crestal and midroot levels. Rate of change in mandibular incisor inclination and mandibular plane angle can be thought as significant factors that may influence alveolar bone thickness.

Alveolar bone thickness around maxillary central incisors of different inclination assessed with cone-beam computed tomography.

ObjectiveTo assess the labial and lingual alveolar bone thickness in adults with maxillary central incisors of different inclination by cone-beam computed tomography (CBCT).MethodsNinety maxillary central incisors from 45 patients were divided into three groups based on the maxillary central incisors to palatal plane angle; lingual-inclined, normal, and labial-inclined. Reformatted CBCT images were used to measure the labial and lingual alveolar bone thickness (ABT) at intervals corresponding to every 1/10 of the root length. The sum of labial ABT and lingual ABT at the level of the root apex was used to calculate the total ABT (TABT). The number of teeth exhibiting alveolar fenestration and dehiscence in each group was also tallied. One-way analysis of variance and Tukey's honestly significant difference test were applied for statistical analysis.ResultsThe labial ABT and TABT values at the root apex in the lingual-inclined group were significantly lower than in the other groups (p < 0.05). Lingual and labial ABT values were very low at the cervical level in the lingual-inclined and normal groups. There was a higher prevalence of alveolar fenestration in the lingual-inclined group.ConclusionsLingual-inclined maxillary central incisors have less bone support at the level of the root apex and a greater frequency of alveolar bone defects than normal maxillary central incisors. The bone plate at the marginal level is also very thin.

Residents' journal review

Residents' journal review

Augmented Corticotomy-Assisted Surgical Orthodontics Decompensates Lower Incisors in Class III Malocclusion Patients

To quantitatively evaluate lower incisor decompensation and the surrounding periodontal region after augmented corticotomy-assisted surgical orthodontics in patients with Class III malocclusion. This prospective study enrolled patients with severe Class III malocclusion who underwent augmented corticotomy in the lower anterior region before orthodontic surgery. Cone-beam computed tomograms and lateral cephalograms were obtained before treatment (T0), after presurgical orthodontic treatment (T1), and at removal of the orthodontic surgical appliances (T2). Repeated measures analysis of variance was used to compare variables at each time point: root length (RL), anterior vertical alveolar bone level at the labial side (AVBL), posterior vertical alveolar bone level at the lingual side (PVBL), labial alveolar bone thickness at the apex (LA), lingual alveolar bone thickness at the apex (LP), and angle of the incisor to the mandibular plane (L1-MP). In the 8 subjects studied, RL was maintained from T0 to T2 (P > .05), whereas AVBL and PVBL increased from T0 to T1 (P < .05) and then decreased from T1 to T2 (P < .05). LA and L1-MP increased from T0 to T1 (P < .001) but remained steady from T1 to T2 (P > .05). LP decreased from T0 to T1 (P < .05) but increased from T1 to T2 (P < .05) with no further change. Augmented corticotomy-assisted surgical orthodontics can achieve adequate tooth decompensation with minimal periodontal side-effects in the lower anterior region in patients with Class III malocclusion.

Augmented Corticotomy-Assisted Presurgical Orthodontics of Class III Malocclusions

The purpose of this study was to evaluate mandibular incisor decompensation and the surrounding periodontal status with augmented corticotomy-assisted presurgical orthodontics of class III patients. Fifty-six surgical class III patients were enrolled in this study, 26 of whom chose augmented corticotomy-assisted presurgical orthodontics (G1), and 30 chose conventional procedures (G2). Cone-beam computed tomography images and lateral cephalograms were obtained from each patient before and after presurgical orthodontics. Measurements of variables were compared using Student t tests and separate variance estimation t tests. The amount of mandibular incisor decompensation and the increase in labial alveolar bone thickness in G1 were greater than those in G2 during presurgical orthodontics (P < 0.001), however, root resorption (P < 0.001), the decrease in lingual alveolar bone thickness (P < 0.001), and vertical alveolar bone loss on both labial (P < 0.05) and lingual sides (P < 0.001) were less in G1 than in G2. Sufficient mandibular incisor decompensation and better periodontal preservation were achieved with augmented corticotomy-assisted presurgical orthodontics for class III patients compared with traditional procedures.

Alveolar bone loss around incisors in Class I bidentoalveolar protrusion patients: a retrospective three-dimensional cone beam CT study

The aim of this study was to test the null hypothesis that there is no difference in the alveolar bone thickness, bone loss or incidence of fenestrations between upper and lower incisors in skeletal Class I bidentoalveolar protrusive patients before orthodontic treatment. Three-dimensional (3D) cone beam CT (CBCT) images were taken of 24 patients from the Republic of Korea (17 females and 7 males). Reformatted CBCT images were used to measure labial and lingual alveolar bone thickness (ABT) of the 4 upper incisors and 4 lower incisors of the 24 patients (total n = 192 incisors) at every 1/10 of root length (Level 0, cementoenamel junction (CEJ) area; Level 10, root apex area) as well as alveolar bone area (ABA) and alveolar bone loss (%BL) rate to dental root length. The numbers of fenestration teeth were also tallied. All anterior teeth were supported by <1 mm of ABT on the labial surfaces up to root length Level 8. ABA was statistically greater on the lingual aspect than the labial aspect in lower incisors. The %BL was 26.98% in the lower labial region, 19.27% in upper labial aspect and most severe on the lower lingual plate 31.25% compared with the labial plate. There were no significant differences in %BL between subgroups when categorized by sex or age. Fenestrations were 1.37 times more frequent on lower incisors (37) than upper incisors (27). The null hypothesis was rejected, confirming that incisor periodontal support is poor and alveolar bone loss is severe even prior to the start of orthodontic treatment. Careful diagnosis using 3D CBCT images is needed to avoid iatrogenic degeneration of periodontal support around anterior teeth, particularly in the lower lingual bone plate region.