Alveolar bone changes around upper incisors in Class I non extraction patient after orthodontic treatment using cone beam computed tomography

Introduction: The position and movement of incisors play important role in orthodontics. Efficient tooth movement and stable position cannot be ensured without adequate alveolar bone support. The bone loss estimated by traditional radiograph is always less than real bone loss so CBCT is currently best to evaluate bone changes. The purpose of this study was to use CBCT to evaluate and compare changes in alveolar bone thickness and Vertical alveolar bone height around maxillary anterior teeth of Class I malocclusion patient after orthodontic treatment. Materials and Method: Forty patients with Class I occlusion between ages of 12 to 18 years were selected. The cone beam computed tomography (CBCT) and lateral cephalograms were taken before treatment (T0) and after treatment (T1). The lateral cephalograms were used to assess the change in tooth inclination whereas CBCT was used to assess the alveolar bone change. All the data were statistically analyzed using paired sample t-test and independent sample test. Result: Significant changes in alveolar bone thickness and vertical bone height were found on the palatal surface of the anterior teeth compared to that of labial surface with significant change in tooth inclination. Conclusion: Based on the results, we can conclude that the palatal alveolar bone loss and vertical bone loss was greater than that of the labial alveolar bone.

Planning orthodontic frontal teeth inclination and estimating bone thickness from cone-beam computed tomography images

Changing the vestibulo-oral inclination (torque) of the frontal teeth is an important component of orthodontic treatment. Cone-beam computed tomography is recommended as an accurate diagnostic tool allowing the orthodontist to estimate the safety of frontal tooth movement and inclination. This tool is helpful in measuring bone thickness at different levels of the tooth root and estimating incisal inclination and position. The aim of our study was to analyze bone thickness in patients with pathologically and normally inclined teeth using CT images and to create a universal table that will provide useful information about the thickness of the bone around different segment of the root required for a safe change in tooth inclination. Using the proposed table, the orthodontist can assess the feasibility of the planned tooth movement in the setting of changed tooth inclination, with due account of critical bone deficit regions. This will ensure the safety of tooth movement, stable retention and a positive treatment outcome.

Comparative analysis of bone volume in the anterior region in patients with protrusion and normal tooth inclination based on CBCT

The introduction of cone beam computed tomography (CBCT) methods allow to most accurately visualize the bone structures of the maxillofacial region, which enables the specialist to obtain a detailed 3D model of the jaws and teeth with a fairly high resolution. This article provides the use of computed beam tomography method in orthodontic practice to analyze the initial thickness of bone tissue at various levels of the root length of the frontal group of teeth during their retrusion and protrusion. The calculation results allow us to draw conclusions about the volume of bone tissue and the possibility of orthodontic manipulations. The results of the study significantly improve the diagnosis and planning of orthodontic treatment for pathology in the frontal jaw.

Multidisciplinary approach for anatomical correction and diastema closure with laminates veneers – a clinical report

Objective: multidisciplinary treatment has become increasingly common in dental offices and this treatment strategy is based on the achievement of a healthy, harmonious, and pleasant smile. In addition, the development of new ceramic systems and the possibility of making indirect restorations with a low thickness, such as laminates veneers, allowed combining highly satisfactory aesthetic properties, preserving the dental structure through minimal wear. Case report: this paper describes a multidisciplinary approach involving periodontics and restorative dentistry for the successful, functional, and aesthetic treatment in an adult patient. The digital smile design was performed as a guide to plan the clinical case considering factors such as tooth inclination and position, golden proportion, tooth size and shape. Discussion: based on these concepts, the present work reports, through a clinical case, the restoration of aesthetics and function with ceramic laminates veneers in lithium disilicate, in the case of anatomical correction and diastema closure. Conclusion: overall, the multidisciplinary treatment plan demonstrated to have greater advantages both for the aesthetics and function of the patient, as well as for the work team. During the 24-month follow-up, this case presented great functional and aesthetics results.KEYWORDSCeramic veneers; Aesthetic dentistry; Multidisciplinary treatment.

Appraisal of the relationship between tooth inclination, dehiscence, fenestration, and sagittal skeletal pattern with cone beam computed tomography

ABSTRACT Objectives: To examine the relationship between sagittal facial pattern and dehiscence/fenestration presence in conjunction with buccolingual tooth inclination by using cone beam computed tomography. Materials and Methods: The study was carried out on the cone beam computed tomography scans of the following three groups of patients (n = 20 in each group): Class I, Class II, Class III. Buccolingual tooth inclination, buccal dehiscence/fenestration presence, and lingual dehiscence/fenestration presence were evaluated on each tooth. Analysis of variance, Kruskall-Wallis H, Scheffe, and chi-square tests were used for statistical comparisons. Results: Differences (P < .05) were observed between the groups for inclination of upper incisors and all lower teeth except for second molars. Dehiscence prevalence in the upper buccal and posterior buccal regions was higher (P < .05) in the Class I group when compared with the other groups. Lower buccal and anterior buccal regions showed higher (P = .0001) dehiscence prevalence in all groups. No difference was observed in fenestration prevalence between the groups. The upper buccal and anterior buccal regions showed higher (P = .0001) fenestration prevalence in all groups. Conclusions: Orthodontists must consider concealed alveolar defects in treatment planning to avoid gingival recession or tooth mobility.

Evaluation of miniscrew-supported rapid maxillary expansion in adolescents: A prospective randomized clinical trial

ABSTRACT Objectives: To evaluate and compare the dental and skeletal changes with conventional and miniscrew-supported maxillary expansion appliances in adolescents. Materials and Methods: Forty patients were divided into two groups, with one group receiving a tooth-borne expander and the other group receiving an expander supported by four miniscrews (bone-borne). Multiplanar coronal and axial slices obtained from cone-beam computed tomography images were used to measure the changes in transverse skeletal widths, buccal bone thickness, tooth inclination, and root length. Paired t-tests and independent-sample t-tests were used to compare the two expansion methods. Results: Bone-borne expansion increased the maxillary suture opening more than 2.5 times than tooth-borne expansion both anteriorly and posteriorly. Between the maxillary first premolars, sutural expansion accounted for 28% and 70% of the total transverse width increase in the tooth-borne and bone-borne expander groups, respectively. Similarly, 26% and 68% of the total expansion was of skeletal nature in the tooth-borne and bone-borne expander groups between the maxillary first molars. The pattern of expansion was variable, with most of the patients in both groups demonstrating a triangular-shaped sutural opening that was wider anteriorly. Subjects in the conventional group experienced significantly more buccal bone reduction and greater buccal inclination of the teeth. No significant differences were observed for root length measurements between the two groups. Conclusion: Use of bone-borne expansion in the adolescent population increased the extent of skeletal changes in the range of 1.5 to 2.8 times that of tooth-borne expansion and did not result in any dental side effects.

Evaluation of alveolar bone support around incisors in patients with unilateral cleft lip, alveolus, and palate in late mixed dentition using cone beam computed tomography

ABSTRACT Objectives: To evaluate alveolar bone support around cleft-adjacent maxillary central incisors (U1) in patients with unilateral cleft lip, alveolus and palate (UCLAP) in the late mixed dentition and to investigate the correlation between the alveolar bone thickness (ABT) and tooth inclination. Materials and Methods: Cone beam computed tomography scans of 45 subjects with UCLAP (29 boys, 16 girls; mean age = 10.74 ± 1.08 years) were assessed. The distance between the cementoenamel junction (CEJ) and alveolar bone crest (AC), and the ABTs at 3 mm, 6 mm, and the apex were measured on the labial, lingual and distal surfaces of U1. The cleft and normal sides were compared using a paired t-test and Pearson's χ2 test. Pearson's correlation was used to explore the association between the ABT and tooth inclination of cleft-adjacent U1 in the labiolingual and mesiodistal dimensions. Results: The CEJ-AC distances were significantly greater in cleft-adjacent U1 (P < .01), with more bone height reduction observed labially and distally (P < .001). The labial, lingual, and apico-distal ABTs were decreased on the cleft side (P < .01). A positive correlation was found between the apico-labial ABT and the labiolingual inclination (r = 0.568, P < .01). Conclusions: Patients with UCLAP have reduced alveolar bone support around the cleft-adjacent U1, and the apico-labial ABT tends to decrease with increasing lingual tooth inclination; however, the correlation was weak.