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

Year 2018, Volume: 21 Issue: 3, 239 - 248, 17.10.2018
https://doi.org/10.7126/cumudj.406846

Abstract

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°<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<IMPA°<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<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<0.001). BACH was significantly higher in
Group 1 (
2.21±1.48 mm) compared to Group 2
(1.42±0.17 mm)
(p < 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.

References

  • 1. Handelman CS. The anterior alveolus: its importance in limiting orthodontic treatment and its influence on the occurrence of iatrogenic sequelae. Angle Orthod 1996;66:95-109; discussion 109-110.
  • 2. Yamada C, Kitai N, Kakimoto N, Murakami S, Furukawa S, Takada K. Spatial relationships between the mandibular central incisor and associated alveolar bone in adults with mandibular prognathism. Angle Orthod 2007;77:766-772.
  • 3. Yu Q, Pan XG, Ji GP, Shen G. The association between lower incisal inclination and morphology of the supporting alveolar bone--a cone-beam CT study. Int J Oral Sci 2009;1:217-223.
  • 4. Joss-Vassalli I, Grebenstein C, Topouzelis N, Sculean A, Katsaros C. Orthodontic therapy and gingival recession: a systematic review. Orthod Craniofac Res 2010;13:127-141.
  • 5. Djeu G, Hayes C, Zawaideh S. Correlation between mandibular central incisor proclination and gingival recession during fixed appliance therapy. Angle Orthod 2002;72:238-245.
  • 6. Yared KF, Zenobio EG, Pacheco W. Periodontal status of mandibular central incisors after orthodontic proclination in adults. Am J Orthod Dentofacial Orthop 2006;130:6 e1-8.
  • 7. Kim Y, Park JU, Kook YA. Alveolar bone loss around incisors in surgical skeletal Class III patients. Angle Orthod 2009;79:676-682.
  • 8. Melsen B, Allais D. Factors of importance for the development of dehiscences during labial movement of mandibular incisors: a retrospective study of adult orthodontic patients. Am J Orthod Dentofacial Orthop 2005;127:552-561; quiz 625.
  • 9. Wainwright WM. Faciolingual tooth movement: its influence on the root and cortical plate. Am J Orthod 1973;64:278-302.
  • 10. Sendyk M, de Paiva JB, Abrao J, Rino Neto J. Correlation between buccolingual tooth inclination and alveolar bone thickness in subjects with Class III dentofacial deformities. Am J Orthod Dentofacial Orthop 2017;152:66-79.
  • 11. Lupi JE, Handelman CS, Sadowsky C. Prevalence and severity of apical root resorption and alveolar bone loss in orthodontically treated adults. Am J Orthod Dentofacial Orthop 1996;109:28-37.
  • 12. Ten Hoeve A, Mulie RM. The effect of antero-postero incisor repositioning on the palatal cortex as studied with laminagraphy. J Clin Orthod 1976;10:804-822.
  • 13. Leuzinger M, Dudic A, Giannopoulou C, Kiliaridis S. Root-contact evaluation by panoramic radiography and cone-beam computed tomography of super-high resolution. Am J Orthod Dentofacial Orthop 2010;137:389-392.
  • 14. Zamora N, Llamas JM, Cibrian R, Gandia JL, Paredes V. Cephalometric measurements from 3D reconstructed images compared with conventional 2D images. Angle Orthod 2011;81:856-864.
  • 15. Ganguly R, Ruprecht A, Vincent S, Hellstein J, Timmons S, Qian F. Accuracy of linear measurement in the Galileos cone beam computed tomography under simulated clinical conditions. Dentomaxillofac Radiol 2011;40:299-305.
  • 16. Gahleitner A, Watzek G, Imhof H. Dental CT: imaging technique, anatomy, and pathologic conditions of the jaws. Eur Radiol 2003;13:366-376.
  • 17. Gahleitner A, Podesser B, Schick S, Watzek G, Imhof H. Dental CT and orthodontic implants: imaging technique and assessment of available bone volume in the hard palate. Eur J Radiol 2004;51:257-262.
  • 18. Kook YA, Kim G, Kim Y. Comparison of alveolar bone loss around incisors in normal occlusion samples and surgical skeletal class III patients. Angle Orthod 2012;82:645-652.
  • 19. Lee KM, Kim YI, Park SB, Son WS. Alveolar bone loss around lower incisors during surgical orthodontic treatment in mandibular prognathism. Angle Orthod 2012;82:637-644.
  • 20. Holmes PB, Wolf BJ, Zhou J. A CBCT atlas of buccal cortical bone thickness in interradicular spaces. Angle Orthod 2015;85:911-919.
  • 21. Proffit W. Limitations, controversies and special problems. St Louis Mo: Mosby; 2007.
  • 22. Hu KS, Kang MK, Kim TW, Kim KH, Kim HJ. Relationships between dental roots and surrounding tissues for orthodontic miniscrew installation. Angle Orthod 2009;79:37-45.
  • 23. Lee KJ, Joo E, Kim KD, Lee JS, Park YC, Yu HS. Computed tomographic analysis of tooth-bearing alveolar bone for orthodontic miniscrew placement. Am J Orthod Dentofacial Orthop 2009;135:486-494.
  • 24. Park J, Cho HJ. Three-dimensional evaluation of interradicular spaces and cortical bone thickness for the placement and initial stability of microimplants in adults. Am J Orthod Dentofacial Orthop 2009;136:314 e311-312; discussion 314-315.
  • 25. Timock AM, Cook V, McDonald T, Leo MC, Crowe J, Benninger BL et al. Accuracy and reliability of buccal bone height and thickness measurements from cone-beam computed tomography imaging. Am J Orthod Dentofacial Orthop 2011;140:734-744.
  • 26. Tweed C. Frankfort-mandibular incisor angle in orthodontic diagnosis, treatment planning and prognosis. Angle Orthod 1954;24:121-169.
  • 27. Tian YL, Zhao ZJ, Han K, Lv P, Cao YM, Sun HJ et al. [The relationship between labial-lingual inclination and the thickness of the alveolar bone in the mandibular central incisors assessed with cone-beam computed tomography]. Shanghai Kou Qiang Yi Xue 2015;24:210-214.
  • 28. Sarikaya S, Haydar B, Ciger S, Ariyurek M. Changes in alveolar bone thickness due to retraction of anterior teeth. Am J Orthod Dentofacial Orthop 2002;122:15-26.
  • 29. Garib DG, Yatabe, M.S., Ozawa, T.O., da Silva Filho, O.M. Alveolar bone morphology under the perspective of the computed tomography: Defining the biological limits of tooth movement. Dental Press J Orthod 2010;15:192-205.
  • 30. Newman MG, Takei, H.H., Klokkevoid, P.R., Carranza, F.A. Carranza's Clinical Periodontology. St Louis: Mo:Elseiver; 2006.
  • 31. Kallestal C, Matsson L. Criteria for assessment of interproximal bone loss on bite-wing radiographs in adolescents. J Clin Periodontol 1989;16:300-304.
  • 32. Steiner GG, Pearson JK, Ainamo J. Changes of the marginal periodontium as a result of labial tooth movement in monkeys. J Periodontol 1981;52:314-320.
  • 33. Batenhorst KF, Bowers GM, Williams JE, Jr. Tissue changes resulting from facial tipping and extrusion of incisors in monkeys. J Periodontol 1974;45:660-668.
  • 34. Gracco A, Lombardo L, Mancuso G, Gravina V, Siciliani G. Upper incisor position and bony support in untreated patients as seen on CBCT. Angle Orthod 2009;79:692-702.
  • 35. Tsunori M, Mashita M, Kasai K. Relationship between facial types and tooth and bone characteristics of the mandible obtained by CT scanning. Angle Orthod 1998;68:557-562.
  • 36. Beckmann SH, Kuitert RB, Prahl-Andersen B, Segner D, The RP, Tuinzing DB. Alveolar and skeletal dimensions associated with overbite. Am J Orthod Dentofacial Orthop 1998;113:443-452.
  • 37. Sun Z, Smith T, Kortam S, Kim DG, Tee BC, Fields H. Effect of bone thickness on alveolar bone-height measurements from cone-beam computed tomography images. Am J Orthod Dentofacial Orthop 2011;139:e117-127.
  • 38. Menezes CC, Janson G, da Silveira Massaro C, Cambiaghi L, Garib DG. Precision, reproducibility, and accuracy of bone crest level measurements of CBCT cross sections using different resolutions. Angle Orthod 2016;86:535-542.

İskeletsel Sınıf III ve Sınıf I Bireylerin Alt Santral Kesici Dişlerinin Etrafındaki Alveolar Kemiğin Karşılaştırılması ve Değerlendirilmesi

Year 2018, Volume: 21 Issue: 3, 239 - 248, 17.10.2018
https://doi.org/10.7126/cumudj.406846

Abstract

Amaç:
Bu çalışmanın amacı, konik ışınlı bilgisayarlı tomografi (KIBT) kullanılarak
iskeletsel Sınıf III ve Sınıf I malokluzyonlu bireylerde mandibuler santral
keserlerin etrafındaki alveolar kemik desteğini değerlendirmek ve
karşılaştırmaktır.

Materyal
ve Metod
: Grup 1, İskeletsel Sınıf III
malokluzyona (ortalama ANB
°=
-2,77±3,69), mezofasiyal büyüme yönüne (FMA°=27,03 ±5,11) ve linguale eğimli
mandibuler keserlere (IMPA°<85) sahip olan 20 hastadan (ortalama yaş=19,78±2,80
yıl) oluşmaktadır. Grup 2, İskeletsel Sınıf I malokluzyona (ortalama ANB
°=
2,94 ±1,46), mezofasiyal büyüme yönüne (FMA°=25,67±6,83)
ve normal eğimli mandibuler keserlere (85<IMPA°<95) sahip olan 20
hastadan
(ortalama yaş=20,85±3,97)
oluşmaktadır. Toplam 80 mandibuler santral keser dişin (her bir gruptan 40 diş)
görüntüleri kullanılarak vertikal alveolar kemik yüksekliği ve alveolar kemik
kalınlığı (AKK) ölçülmüştür. Bukkal, lingual ve total AKK; krestal, kök ortası
ve apikal seviyelerde ölçülmüştür. Bukkal (BAKY) ve lingual (LAKY) alveolar
krestal yükseklikler de değerlendirilmiştir. İstatistiksel analiz için
Mann-Whitney U, bağımsız örneklem-t-testleri ve
Pearson korelasyon
analizi uygulanmıştır.

Bulgular: Krestal ve
orta kök seviyesinde lingual AKK; apikal seviyede bukkal AKK; ve tüm
seviyelerde total AKK Grup 1’de Grup 2’ye göre anlamlı şekilde daha az
bulunmuştur (
p<0,05).  Apikal seviyede bukkal AKK (r=-0,324; p=0,042)
ve mandibuler düzlem açısı arasında negatif korelasyon bulunmuştur. Mandibuler
keser eğimindeki değişim apikal seviyedeki bukkal AKK (r=0,463; p=0,003) ve
krestal seviyedeki lingual AKK (r=0,550; p<0,001) ile pozitif korelasyon
göstermiştir. BAKY, Grup 1’de (
2,21±1,48 mm) Grup
2’ye (
1,42±0,17 mm) göre
anlamlı şekilde yüksek bulunmuştur (p<0,05)
.







Sonuçlar:
Sınıf III deformitesi olan bireylerde, mandibuler santral keser dişler
özellikle apikal seviyede alveolar kemiğin bukkal tarafında ve krestal ve kök
orta seviyelerinde ise alveolar kemiğin lingual tarafında daha az kemik
desteğine sahiptir. Mandibuler keser eğiminde ve mandibular düzlem açısındaki
değişim oranı, alveoler kemik kalınlığını etkileyebilecek önemli faktörler
olarak düşünülebilir.

References

  • 1. Handelman CS. The anterior alveolus: its importance in limiting orthodontic treatment and its influence on the occurrence of iatrogenic sequelae. Angle Orthod 1996;66:95-109; discussion 109-110.
  • 2. Yamada C, Kitai N, Kakimoto N, Murakami S, Furukawa S, Takada K. Spatial relationships between the mandibular central incisor and associated alveolar bone in adults with mandibular prognathism. Angle Orthod 2007;77:766-772.
  • 3. Yu Q, Pan XG, Ji GP, Shen G. The association between lower incisal inclination and morphology of the supporting alveolar bone--a cone-beam CT study. Int J Oral Sci 2009;1:217-223.
  • 4. Joss-Vassalli I, Grebenstein C, Topouzelis N, Sculean A, Katsaros C. Orthodontic therapy and gingival recession: a systematic review. Orthod Craniofac Res 2010;13:127-141.
  • 5. Djeu G, Hayes C, Zawaideh S. Correlation between mandibular central incisor proclination and gingival recession during fixed appliance therapy. Angle Orthod 2002;72:238-245.
  • 6. Yared KF, Zenobio EG, Pacheco W. Periodontal status of mandibular central incisors after orthodontic proclination in adults. Am J Orthod Dentofacial Orthop 2006;130:6 e1-8.
  • 7. Kim Y, Park JU, Kook YA. Alveolar bone loss around incisors in surgical skeletal Class III patients. Angle Orthod 2009;79:676-682.
  • 8. Melsen B, Allais D. Factors of importance for the development of dehiscences during labial movement of mandibular incisors: a retrospective study of adult orthodontic patients. Am J Orthod Dentofacial Orthop 2005;127:552-561; quiz 625.
  • 9. Wainwright WM. Faciolingual tooth movement: its influence on the root and cortical plate. Am J Orthod 1973;64:278-302.
  • 10. Sendyk M, de Paiva JB, Abrao J, Rino Neto J. Correlation between buccolingual tooth inclination and alveolar bone thickness in subjects with Class III dentofacial deformities. Am J Orthod Dentofacial Orthop 2017;152:66-79.
  • 11. Lupi JE, Handelman CS, Sadowsky C. Prevalence and severity of apical root resorption and alveolar bone loss in orthodontically treated adults. Am J Orthod Dentofacial Orthop 1996;109:28-37.
  • 12. Ten Hoeve A, Mulie RM. The effect of antero-postero incisor repositioning on the palatal cortex as studied with laminagraphy. J Clin Orthod 1976;10:804-822.
  • 13. Leuzinger M, Dudic A, Giannopoulou C, Kiliaridis S. Root-contact evaluation by panoramic radiography and cone-beam computed tomography of super-high resolution. Am J Orthod Dentofacial Orthop 2010;137:389-392.
  • 14. Zamora N, Llamas JM, Cibrian R, Gandia JL, Paredes V. Cephalometric measurements from 3D reconstructed images compared with conventional 2D images. Angle Orthod 2011;81:856-864.
  • 15. Ganguly R, Ruprecht A, Vincent S, Hellstein J, Timmons S, Qian F. Accuracy of linear measurement in the Galileos cone beam computed tomography under simulated clinical conditions. Dentomaxillofac Radiol 2011;40:299-305.
  • 16. Gahleitner A, Watzek G, Imhof H. Dental CT: imaging technique, anatomy, and pathologic conditions of the jaws. Eur Radiol 2003;13:366-376.
  • 17. Gahleitner A, Podesser B, Schick S, Watzek G, Imhof H. Dental CT and orthodontic implants: imaging technique and assessment of available bone volume in the hard palate. Eur J Radiol 2004;51:257-262.
  • 18. Kook YA, Kim G, Kim Y. Comparison of alveolar bone loss around incisors in normal occlusion samples and surgical skeletal class III patients. Angle Orthod 2012;82:645-652.
  • 19. Lee KM, Kim YI, Park SB, Son WS. Alveolar bone loss around lower incisors during surgical orthodontic treatment in mandibular prognathism. Angle Orthod 2012;82:637-644.
  • 20. Holmes PB, Wolf BJ, Zhou J. A CBCT atlas of buccal cortical bone thickness in interradicular spaces. Angle Orthod 2015;85:911-919.
  • 21. Proffit W. Limitations, controversies and special problems. St Louis Mo: Mosby; 2007.
  • 22. Hu KS, Kang MK, Kim TW, Kim KH, Kim HJ. Relationships between dental roots and surrounding tissues for orthodontic miniscrew installation. Angle Orthod 2009;79:37-45.
  • 23. Lee KJ, Joo E, Kim KD, Lee JS, Park YC, Yu HS. Computed tomographic analysis of tooth-bearing alveolar bone for orthodontic miniscrew placement. Am J Orthod Dentofacial Orthop 2009;135:486-494.
  • 24. Park J, Cho HJ. Three-dimensional evaluation of interradicular spaces and cortical bone thickness for the placement and initial stability of microimplants in adults. Am J Orthod Dentofacial Orthop 2009;136:314 e311-312; discussion 314-315.
  • 25. Timock AM, Cook V, McDonald T, Leo MC, Crowe J, Benninger BL et al. Accuracy and reliability of buccal bone height and thickness measurements from cone-beam computed tomography imaging. Am J Orthod Dentofacial Orthop 2011;140:734-744.
  • 26. Tweed C. Frankfort-mandibular incisor angle in orthodontic diagnosis, treatment planning and prognosis. Angle Orthod 1954;24:121-169.
  • 27. Tian YL, Zhao ZJ, Han K, Lv P, Cao YM, Sun HJ et al. [The relationship between labial-lingual inclination and the thickness of the alveolar bone in the mandibular central incisors assessed with cone-beam computed tomography]. Shanghai Kou Qiang Yi Xue 2015;24:210-214.
  • 28. Sarikaya S, Haydar B, Ciger S, Ariyurek M. Changes in alveolar bone thickness due to retraction of anterior teeth. Am J Orthod Dentofacial Orthop 2002;122:15-26.
  • 29. Garib DG, Yatabe, M.S., Ozawa, T.O., da Silva Filho, O.M. Alveolar bone morphology under the perspective of the computed tomography: Defining the biological limits of tooth movement. Dental Press J Orthod 2010;15:192-205.
  • 30. Newman MG, Takei, H.H., Klokkevoid, P.R., Carranza, F.A. Carranza's Clinical Periodontology. St Louis: Mo:Elseiver; 2006.
  • 31. Kallestal C, Matsson L. Criteria for assessment of interproximal bone loss on bite-wing radiographs in adolescents. J Clin Periodontol 1989;16:300-304.
  • 32. Steiner GG, Pearson JK, Ainamo J. Changes of the marginal periodontium as a result of labial tooth movement in monkeys. J Periodontol 1981;52:314-320.
  • 33. Batenhorst KF, Bowers GM, Williams JE, Jr. Tissue changes resulting from facial tipping and extrusion of incisors in monkeys. J Periodontol 1974;45:660-668.
  • 34. Gracco A, Lombardo L, Mancuso G, Gravina V, Siciliani G. Upper incisor position and bony support in untreated patients as seen on CBCT. Angle Orthod 2009;79:692-702.
  • 35. Tsunori M, Mashita M, Kasai K. Relationship between facial types and tooth and bone characteristics of the mandible obtained by CT scanning. Angle Orthod 1998;68:557-562.
  • 36. Beckmann SH, Kuitert RB, Prahl-Andersen B, Segner D, The RP, Tuinzing DB. Alveolar and skeletal dimensions associated with overbite. Am J Orthod Dentofacial Orthop 1998;113:443-452.
  • 37. Sun Z, Smith T, Kortam S, Kim DG, Tee BC, Fields H. Effect of bone thickness on alveolar bone-height measurements from cone-beam computed tomography images. Am J Orthod Dentofacial Orthop 2011;139:e117-127.
  • 38. Menezes CC, Janson G, da Silveira Massaro C, Cambiaghi L, Garib DG. Precision, reproducibility, and accuracy of bone crest level measurements of CBCT cross sections using different resolutions. Angle Orthod 2016;86:535-542.
There are 38 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research Articles
Authors

Ezgi Atik

Hande Gorucu-coskuner

Tülin Taner

Publication Date October 17, 2018
Submission Date March 16, 2018
Published in Issue Year 2018Volume: 21 Issue: 3

Cite

EndNote Atik E, Gorucu-coskuner H, Taner T (October 1, 2018) Comparison and Evaluation of Alveolar Bone Around Lower Central Incisors in Class III and Class I Patients. Cumhuriyet Dental Journal 21 3 239–248.

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