Effects of posttreatment skeletal maturity measured with the cervical vertebral maturation method on incisor alignment relapse.

INTRODUCTION: Our aim was to test the hypothesis that relapse of incisor alignment is associated with skeletal maturity at the end of treatment, as assessed with the cervical vertebral maturation (CVM) method. METHODS: This was a case-control study with information from the postretention database at the University of Washington. Mandibular incisor irregularity (II) at least 10 years out of retention (T3) was used to define the subjects (II >6 mm, relapse group) and the controls (II <3.5 mm, stable group). The following model measurements were made: II at pretreatment (T1), II at posttreatment (T2), and intercanine width at T1 and T2. On cephalograms taken T2, the CVM status was determined. Logistic regression analyses were used to determine the association between relapse and CVM status after treatment. The models were adjusted for potentially confounding variables (II at pretreatment and posttreatment, intercanine width change during treatment, sex, age at T2, and treatment alternatives). RESULTS: No association between CVM stage at T2 and relapse was found (P = 0.89). Both groups had similar distributions of the CVM stages (P >0.05). Pretreatment II and postretention time were found to be correlated with long-term incisor stability (P = 0.007 and 0.034, respectively). Sex was not related to relapse (P = 0.33). CONCLUSIONS: Maturity of craniofacial structures at the end of treatment evaluated with the CVM method is not associated with long-term stability of incisor alignment.

Trabecular and cortical bone as risk factors for orthodontic relapse.

INTRODUCTION: Dental relapse of the mandibular incisors after orthodontic treatment is a common problem, and few risk factors have been identified. The purpose of this case-control study was to evaluate whether the amount or the structure of mandibular bone affects the potential for postorthodontic mandibular incisor relapse. METHODS: The subject sample was selected from the postretention database at the University of Washington. Subjects were chosen based on the availability of lateral cephalograms and mandibular periapical radiographs taken approximately 10 years postretention (T3). The mandibular incisor irregularity index (II) was measured on the T3 casts. Two groups were identified: subjects with the II greater than 6 mm (relapse or case) and those with the II less than 3.5 mm (stable or control). Once the case/control status was determined, the II was measured on models taken at the initial orthodontic examination (T1) and at the end of treatment (T2). Sixty relapse and 263 stable subjects were identified. Mandibular cortical thickness measured on both panoramic and lateral cephalometric radiographs was used to assess the amount of mandibular bone, and fractal analysis was used to analyze the trabecular bone structure around the mandibular incisors on the periapical radiographs. Logistic regression analyses were used to determine the association between dental relapse and significant bone parameters. The models were adjusted for potentially confounding variables (initial II, sex, age, and postretention time). RESULTS: The relapse subjects had a larger mean II at T1 and a longer postretention time than the stable subjects. The mean cephalometric mandibular cortical thickness was significantly smaller in the relapse group than in the stable group at T1, T2, and T3. There were no statistically significant differences in the trabecular structure of bone, as measured with fractal analyses, between the relapse and stable groups. CONCLUSIONS: These results indicate that patients with thinner mandibular cortices are at increased risk for dental relapse.