Alveolar bone changes around maxillary incisors after intrusion and retraction with controlled tipping versus bodily movement : A retrospective cone-beam computed tomography study.

OBJECTIVE: To compare the effect of maxillary incisor intrusion and retraction with controlled tipping (CT) versus bodily movement (BM) in extraction cases on alveolar bone height and thickness, using cone-beam computed tomography (CBCT). Correlations between changes in alveolar dimensions and crown or root retraction, incisor inclination, and intrusion were also investigated. MATERIALS AND METHODS: In all, 144 incisors of 36 women were retrospectively evaluated. All patients were treated with anterior intrusion and retraction with either controlled tipping (CT) (group 1) or bodily movement (BM) (group 2). CBCT scans were taken before and after retraction and intrusion and measurements of alveolar bone height and thickness at the level of mid-root and root apex were measured. The prevalence of dehiscence was also calculated. RESULTS: Labial bone thickness (BT) increased at the level of the root apex with increased total BT in the CT group (p < 0.05). The BM group showed decreased palatal BT. Significant vertical bone loss with an increased incidence of dehiscences occurred on the palatal side in both groups. Changes in palatal bone area was negatively correlated with the amount of root apex retraction, while the total BT at the level of root apex was positively correlated with amount of intrusion. CONCLUSIONS: Bodily retraction can result in reduced palatal bone dimensions and an increase risk of iatrogenic sequelae following anterior retraction in extraction cases. Vertical bone loss and an increased incidence of dehiscences is to be expected following anterior retraction. Careful attention must be paid to the bone boundary conditions to avoid moving the incisors out of the alveolar housing.

Root resorption of maxillary incisors after en masse intrusion and retraction with controlled tipping versus bodily movement in adults.

INTRODUCTION: The purpose of this study was to evaluate and compare the incidence of orthodontically induced inflammatory root resorption (OIIRR) after en masse maxillary incisors intrusion and retraction with controlled tipping versus bodily movement using cone beam computed tomography (CBCT). MATERIAL AND METHODS: This study is a retrospective study performed on CBCT scans of 36 adult females who had their maxillary first premolars extracted followed by en masse anterior retraction and intrusion using labial biocreative therapy type II. Subjects were divided into two groups of 18 subjects each based on the type of tooth movement required during en masse retraction: Group I; the controlled tipping group, and Group II; the bodily movement group. The amount of intrusion, crown and root retraction, change in incisor inclination, and difference in tooth length was measured from the CBCT scans. Independent t tests were used to compare the measurements between the two groups. Pearson rank correlation analysis was applied to identify the relationship between the mean dental changes and the mean changes in tooth length for all four upper incisors. RESULTS: OIIRR was found in all four maxillary incisors in both groups. No significant differences were found between the two groups. OIIRR was positively correlated to the amount of root apex retraction and negatively correlated to the change in incisor inclination. CONCLUSIONS: Anterior retraction and intrusion lead to obvious root resorption affecting all maxillary incisors. No significant differences were found between the two groups. Careful clinical monitoring is needed for patients requiring anterior retraction with intrusion with maximum anchorage.

Three-dimensional mapping of cortical bone thickness in subjects with different vertical facial dimensions.

BACKGROUND: The purpose of this study was to determine differences in cortical bone thickness among subjects with different vertical facial dimensions using cone beam computed tomography (CBCT). METHODS: From 114 pre-treatment CBCT scans, 48 scans were selected to be included in the study. CBCT-synthesized lateral cephalograms were used to categorize subjects into three groups based on their vertical skeletal pattern. Cortical bone thickness (CBT) at two vertical levels (4 and 7 mm) from the alveolar crest were measured in the entire tooth-bearing region in the maxilla and mandible. RESULTS: Significant group differences were detected with high-angle subjects having significantly narrower inter-radicular CBT at some sites as compared to average- and low-angle subjects. CONCLUSIONS: Inter-radicular cortical bone is thinner in high-angle than in average- or low-angle subjects in few selected sites at the vertical height in which mini-implants are commonly inserted for orthodontic anchorage.