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Bone density changes around the 3 levels of each patient's teeth during orthodontic treatment (UL1 ¼ upper left central incisor, UL2 ¼ upper left lateral incisor, UL3 ¼ upper left canine, UR1 ¼ upper right central incisor, UR2 ¼ upper right lateral incisor, UR3 ¼ upper right canine). Left column: changes between T1 and T0, right column: changes between T2 and T0. (A) Patient 1; (B) Patient 2; (C) Patient 3; (D) Patient 4; (E) Patient 5; (F) Patient 6; (G) Patient 7; (H) Patient 8.
Source publication
Few studies involving human participants have been conducted to investigate the effect of orthodontic treatment on alveolar bone density around the teeth. Our previous study revealed that patients who received 6 months of active orthodontic treatment exhibited an ∼24% decrease in alveolar bone density around the teeth. However, after an extensive r...
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Introduction:
The literature reports the association of external root resorption (ERR) with orthodontic movement. In cases of premolars extractions, orthodontic movement of anterior teeth is usually quite expressive, which are precisely the most susceptible teeth to suffer from ERR.
Objective:
The aim of this study was to assess the root morphol...
Citations
... [1] e effects of OTM on bone density are not well understood. Decrease, [2] increase, [3] and no change in bone density around orthodontically treated teeth have all been reported. [4] is may be attributed to the different types and magnitudes of orthodontic forces, leading to different remodeling responses. ...
... Digital image analysis of microradiographs, [20] for example, cannot accurately reproduce the three-dimensional (3D) bone tissue structure. [2] Another example is, computed tomography scans; [21] their excessive radiation dose makes them unsuitable for repeated scanning over a short period of time. [2] CBCTs, on the other hand, can yield sufficient image quality with a relatively low radiation exposure, together with providing superior diagnostic value in comparison to the two-dimensional imaging techniques. ...
... [2] Another example is, computed tomography scans; [21] their excessive radiation dose makes them unsuitable for repeated scanning over a short period of time. [2] CBCTs, on the other hand, can yield sufficient image quality with a relatively low radiation exposure, together with providing superior diagnostic value in comparison to the two-dimensional imaging techniques. erefore, CBCTs have become the tools of choice for the assessment of different changes in the alveolar bone. ...
Objectives
Low-level laser therapy (LLLT) has been widely implemented in the acceleration of orthodontic tooth movement (OTM). However, the impact of LLLT on the alveolar bone changes accompanying OTM has not been comprehensively addressed in a clinical trial. Hence, the objective of this investigation was to perform a three-dimensional (3D) assessment of the impact of LLLT on the changes in bone quality (bone density), and quantity (bone thickness and volume) during the canine retraction stage of orthodontic treatment.
Material and Methods
Twenty patients requiring maxillary first premolars’ extraction followed by canine retraction were recruited for this split-mouth study. Before the commencement of canine retraction, the maxillary arch in each of the enrolled subjects was randomly split into an “experimental” side, and a “control” side. In the experimental group, LLLT was performed on days 0, 3, 7, 14, and then every two weeks until the completion of the research duration (12 weeks). The employed diode laser was of 980 nanometers (nm) wavelength and a dosage of 8 joules per square centimeter (J/cm ² ), in a continuous mode. Canine distalization was accomplished using nickel-titanium closed-coil springs, with a force of 150 grams (g). Pre-retraction and post-retraction cone-beam computed tomography was performed to assess bone quality and quantity, in terms of alveolar bone density, thickness, and volume.
Results
A statistically significant reduction in bone density and volume was found following canine retraction ( P < 0.05) with and without LLLT application. For the total bone thickness, a statistically significant decrease was observed at both the coronal and mid-root levels of the maxillary canine ( P < 0.05), whereas an insignificant change was reported at the apical level ( P > 0.05) in both the studied groups. Furthermore, insignificant differences were documented in all the measured outcomes between the experimental and the control groups ( P > 0.05).
Conclusion
With the employed parameters in the present study, LLLT does not positively influence the changes in neither bone quality (bone density) , nor bone quantity (bone thickness and volume) accompanying OTM. Moreover, a significant reduction in bone density, in bone thickness (coronal and mid-root levels), as well as in bone volume accompanies canine distalization in both groups.
... Therefore, although doctors' experience was not considered a factor affecting the success rate in the present study, it should be considered in the future. Moreover, there are reports that alveolar bone density decreases during orthodontic treatment [37,38]. Hence, future studies should evaluate the effect of orthodontic treatment duration on these findings. ...
This study aimed to analyze the relationship between bone density, habitual chewing side (HCS), and mini-screw stability to investigate the intra-individual factors contributing to mini-screw failure. This retrospective study included 86 sides in 43 adults, who underwent bilateral maxillary mini-screw placement with subsequent unilateral failure of the mini-screw. Pre-treatment cone-beam computed tomography was used to measure the buccal cortical bone thickness and bone density on the failed and successful sides. Pre-treatment mandibular kinesiographic records were used to determine the HCS. Paired t-tests, one-proportion z-tests, and multivariable multilevel Poisson regression were used to examine the statistical significance. The buccal cortical bone thicknesses were 0.93 ± 0.27 mm (unsuccessful side) and 1.01 ± 0.27 mm (successful side), with no significant difference. The bone density on the unsuccessful side (1059.64 ± 202.64 mg/cm3) was significantly lower than the success side (1317.89 ± 332.23 mg/cm3). Regarding HCS, 27.9% of failures occurred on the preferred side, and 62.8% occurred on the non-preferred side. After adjusting for all factors, the non-preferred side showed a 2.22 times higher prevalence ratio for mini-screw failure than the preferred side. HCS is significantly related to mini-screw stability, while the cortical bone thickness, bone density, and site of mini-screw implantation were not correlated.
... Therefore, in recent years, CBCT has been used in human dentistry as a diagnostic imaging modality to assess bone quality before implant surgery [13][14][15]. CBCT imaging modality, even though not high-resolution, delivers Hounsfield units (HU) reflecting bone quality [14][15][16][17]. ...
Background
Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) syndrome is a dental disease where the radiographic signs may be quantified using radiographic texture features. This study aimed to implement the scaled–pixel–counting protocol to quantify and compare the image structure of teeth and the density standard in order to improve the identification of the radiographic signs of tooth resorption and hypercementosis using the EOTRH syndrome model.
Methods and results
A detailed examination of the oral cavity was performed in 80 horses and maxillary incisor teeth were evaluated radiographically, including an assessment of the density standard. On each of the radiographs, pixel brightness (PB) was extracted for each of the ten steps of the density standard (S1–S10). Then, each evaluated incisor tooth was assigned to one of 0–3 EOTRH grade–related groups and annotated using region of interest (ROI). For each ROI, the number of pixels (NP) from each range was calculated. The linear relation between an original X–ray beam attenuation and PB was confirmed for the density standard. The NP values increased with the number of steps of the density standard as well as with EOTRH degrees. Similar accuracy of the EOTRH grade differentiation was noted for data pairs EOTRH 0–3 and EOTRH 0–1, allowing for the differentiation of both late and early radiographic signs of EOTRH.
Conclusion
The scaled–pixel–counting protocol based on the use of density standard has been successfully implemented for the differentiation of radiographic signs of EOTRH degrees.
... Hsu and colleagues found a decrease in bone density around the teeth, with the greatest reduction seen in the upper-right and upper-left central incisors after seven months of treatment, as measured by CBCT scans [42]. Another study also reported similar findings, showing that orthodontic-induced reduction in the alveolar bone density around the teeth can recover into its original state after two years of retention [43]. ...
This research aims to investigate the relationship between orthodontic treatment (OT) and altered passive eruption (APE). Materials and Methods: A case–control study was carried out among the dentistry students at Jazan University. A total of 21 students were recruited for the case group and 20 others for the control group. Variables were measured on the maxillary incisor teeth. They included an image analysis of the teeth width-to-height (W/H) ratio, a cone beam computed tomography (CBCT) analysis of buccal bone thickness (BCT), and the distance from the cementoenamel junction (CEJ) to the bone crest (BC) (CEJ–BC). In addition, a systematic review was performed following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Prominent literature databases, including Medline/PubMed, the Cochrane Library, Embase, Scopus, Saudi Digital Library, and Google Scholar, were searched for articles published before November 2022 on two main concepts (APE and orthodontics). Quality of evidence was assessed using the Newcastle–Ottawa scale (NOS), and the certainty of evidence was assessed using the grading of recommendations assessment development and evaluation (GRADE) approach. Results: A total of 164 teeth were evaluated. No statistical differences were observed in the W/H ratio and BCT between the two groups. A significant increase in the CEJ–BC distance in the right and left maxillary lateral incisors was observed for people who had undergone OT (p ≤ 0.002 and 0.001, respectively). In the systematic review, two articles were included for qualitative synthesis. One of the included studies showed an increase in the post-orthodontics clinical crown length of the maxillary anterior teeth. Another study reported no difference in the prevalence of APE between orthodontically treated and untreated people. Conclusion: This research concludes that OT might not be an etiological factor for APE. However, more clinical and radiological studies must be conducted to arrive at decisive conclusions.
... According to our results, we can speculate that upregulation of OPG limits unnecessary bone loss during OTM. 21 In the present study, only healthy young female patients who had their first menstrual period 2 y ago were included, to exclude confounding factors such as gender and hormonal differences in oestrogen levels. ...
Objectives:
The aim of this study was to monitor changes in Osteoprotegerin (OPG) and receptor activator of nuclear factor-kappa ligand (RANKL) levels in the saliva during orthodontic tooth movement (OTM).
Materials and methods:
Nine healthy females (15-20 y of age) with four pre-molar extractions and fixed appliance were included. In total, 134 stimulated and 134 unstimulated saliva samples were collected: at baseline and then every 6-8 weeks at follow-up appointments during the whole orthodontic treatment. Twelve age-matched females with no active orthodontic treatment served as a control group. Saliva samples were analysed by enzyme-linked immunosorbent assay (Elisa). The mean levels of OPG and RANKL were calculated according to the different orthodontic treatment stages: alignment, space closure and finishing. A mixed model analysis was used to compare the means of treatment stages. Baseline OPG levels were compared with the control group using an independent t-test. OPG levels were measured in stimulated saliva due to low levels in unstimulated saliva.
Results:
No significant difference was observed between baseline OPG values and the control group. OPG increased significantly at all treatment stages: alignment, space closure and finishing compared with baseline (P = 0.002, P = 0.039, P ≤ 0.001, respectively). The salivary levels of OPG increased gradually, except during space closure, reaching peak levels at finishing. RANKL was undetectable in stimulated and unstimulated saliva by sandwich Elisa during OTM.
Conclusions:
This novel approach shows the changes in the levels of OPG in OTM and indicates how and when to sample saliva during orthodontic treatment to analyse bone remodelling.
... However, the results of the present study show that the variation trends of cortical bone thickness and cancellous bone density are not consistent. In comparing previous literature on cortical bone thickness in the four jawbone regions [25][26][27] and on cancellous bone density [10,14,15,28,29], it can be seen that these two parameters exhibit different patterns. In addition, our team's previous research further demonstrated that there is only a low correlation between the two [16] which indicates that in jawbones, "the thickest cortical bone may be paired with the most porous cancellous bone, and the thinnest cortical bone may also be paired with the densest cancellous bone. ...
Objective
This study proposed a new classification method of bone quantity and quality at the dental implant site using cone-beam computed tomography (CBCT) image analysis, classifying cortical and cancellous bones separately and using CBCT for quantitative analysis.
Methods
Preoperative CBCT images were obtained from 128 implant patients (315 sites). First, measure the crestal cortical bone thickness (in mm) and the cancellous bone density [in grayscale values (GV) and bone mineral density (g/cm³)] at the implant sites. The new classification for bone quality at the implant site proposed in this study is a “nine-square division” bone classification system, where the cortical bone thickness is classified into A: > 1.1 mm, B:0.7–1.1 mm, and C: < 0.7 mm, and the cancellous bone density is classified into 1: > 600 GV (= 420 g/cm³), 2:300–600 GV (= 160 g/cm³–420 g/cm³), and 3: < 300 GV (= 160 g/cm³).
Results
The results of the nine bone type proportions based on the new jawbone classification were as follows: A1 (8.57%,27/315), A2 (13.02%), A3 (4.13%), B1 (17.78%), B2 (20.63%), B3 (8.57%) C1 (4.44%), C2 (14.29%), and C3 (8.57%).
Conclusions
The proposed classification can complement the parts overlooked in previous bone classification methods (bone types A3 and C1).
Trial registration
The retrospective registration of this study was approved by the Institutional Review Board of China Medical University Hospital, No. CMUH 108-REC2-181.
... Дані про вплив ортодонтичного переміщення зуба на щільність кісткової тканини є суперечливими і описують як зменшення щільності кісткової тканини навколо ортодонтично оброблених зубів, так і її збільшення. Такі різниці ймовірно пояснюються дією різних ортодонтичних апаратів з різними типами та величинами руху зубів, а також вихідним станом кісткової тканини до початку ортодонтичного лікування [37,38,39]. ...
Today, the frequency of dental and jaw anomalies and the need for their correction is extremely high. Orthodontic treatment has a direct impact on the state of the apparatus that supports and retains the teeth; this requires timely detection of periodontal diseases and their therapy in order to save the teeth and successfully correct the bite. The purpose of this work is to review and analyze modern professional literature on the impact of orthodontic treatment of maxillofacial anomalies on the periodontal status of patients, in particular pathogenetic mechanisms of the development of periodontal diseases and features of their clinical course in this category of patients. The study has demonstrated the use of various types of orthodontic appliances for the treatment of maxillofacial anomalies is accompanied by the deterioration of hygienic status, a decrease in the local immune response, dysbiotic changes in periodontal tissues, hemodynamic and microcirculatory disorders and loss of bone tissue. This causes the rapid development and progression of inflammatory diseases of periodontal tissues such as catarrhal and hypertrophic gingivitis, as well as generalized periodontitis in young and working-age individuals. Therefore, the analysis of this problem is relevant and necessary for deeper understanding of the pathogenesis of the development of this pathology in persons having orthodontic treatment, for its timely diagnosis and prevention. The in-depth analysis of scientific literature on the issue enables to systematize and understand the main pathogenetic mechanisms of the development of periodontal diseases in patients during orthodontic treatment. Both the negative multi-vector effect of orthodontic appliances on the periodontal status of patients due to the deterioration of hygienic indicators and the increase of microbial contamination in the early stages of treatment, as well as the positive role in stabilizing the state of supporting tissues in the long term, were noted.
... Studies on bone-density changes after orthodontic treatment have reported varying conclusions with certain studies reporting a decrease in bone density 28,29 and some studies an increase in bone density. 30 Verification of bone density surrounding impacted canines pre-and postdisimpaction can be used to establish specific associations between bone density and orthodontic tooth movement. ...
Aim:
The aim of this study was to assess alveolar bone microstructure around impacted maxillary canines derived from fractal analysis.
Materials and methods:
The present study was a retrospective cone-beam computed tomography (CBCT) study. In total, 61 scans (25 males, 36 females; age range - 12-28 years) were analyzed. About 64 × 64-pixel regions of interest (ROI) in the maxillary alveolar process containing trabecular bone between the premolars were selected. ImageJ software was utilized to process images and bone density was assessed by determining bone surface area (BSA) and bone marrow surface area (BMSA) for the impacted and nonimpacted sides separately. Selected fractals were plotted in a histogram using box-counting method and the results were tabulated. Paired t-tests were used to determine significant differences between the groups and gender differences.
Results:
For both buccally and palatally impacted maxillary canines, BSA was increased, BMSA decreased in the region of the impacted canine and the difference was statistically significant (p <0.05) in both genders. Bone fractal dimension (FD) values were greater in the region of the impacted canine for both buccally (1.47 > 1.21) and palatally (1.53 > 1.43) displaced canines, while bone marrow FD values were greater in the region of the nonimpacted canine for both buccally (1.37 > 1.28) and palatally displaced canines (1.41 > 1.33). Females had significantly higher BMSA than males around impacted canines (p <0.05).
Conclusion:
Denser bone microstructure was noted around impacted canines when compared with fully erupted canines. No gender-related differences were noted for BSA, whereas BMSA was higher in females implying lower bone density when compared with males.
Clinical significance:
Retrospective evaluation of bone microstructure surrounding unerupted/impacted canines can provide analytical information about treatment prognosis and anchorage considerations. With FD analysis of CBCT images, BSA and BMSA can be measured and bone density estimated in a reliable manner.
... Bone turnover is increased during OTM [14], which correlates with our study showing increased OPG levels. According to our results, we can speculate that upregulation of OPG limits unnecessary bone loss during OTM [19]. In the present study, only healthy young female patients who had their rst menstrual period two years ago were included, to exclude confounding factors such as gender and hormonal differences in oestrogen levels. ...
Background and objective: Receptor activator of nuclear factor-kappa ligand (RANKL) and Osteoprotegerin (OPG) perform functions in orthodontic tooth movement (OTM) by regulation of osteoblast and osteoclast activation. This novel approach aims to monitor continuous changes in OPG and RANKL levels in the saliva during two years of OTM.
Material and methods: Nine healthy females (15-20 years of age) were included in this prospective longitudinal pilot study. All patients had crowding requiring four premolar extractions and fixed appliances in both jaws. In total, 134 stimulated and 134 unstimulated saliva samples were collected: before tooth extractions (baseline), and then every 6-8 weeks at follow-up appointments during the whole treatment period of two years. All saliva samples were analysed by enzyme-linked immunosorbent assay. The mean levels of OPG and RANKL were calculated according to the different orthodontic treatment stages: alignment, space closure and finishing. A mixed model analysis was used to compare the means of treatment stages.
Results: RANKL was not detectable either in stimulated or unstimulated saliva. OPG levels were measured in stimulated saliva due to low levels in unstimulated saliva. A significant increase in OPG was observed at all treatment stages: alignment, space closure and finishing compared with baseline (p = 0.002, p = 0.039, p = < 0.001, respectively). A small non-significant decrease was seen in space closure compared with alignment. OPG reached peak levels during the finishing stage.
Conclusions: The salivary levels of OPG increased gradually, except during space closure, reaching peak levels at the finishing stage. This novel approach shows the changes in the levels of OPG in OTM and indicates how and when to sample saliva during orthodontic treatment to analyse bone remodelling.
... [36][37][38] In addition, ABDs/ABFs were measured immediately posttreatment in this study. It has been reported that alveolar bone remodeling and an increase in bone density may occur immediately after the completion of OT and up to 24 months of retention 39,40 ; so it is unclear whether the increased counts of ABDs/ABFs will persist long-term. In this regard, it cannot be overlooked that an overestimation of ABDs/ABFs might have occurred in areas of thin cortical bone because of a lack of remineralization immediately posttreatment. ...
Introduction: This study aimed to assess the association between nonextraction clear aligner therapy (CAT)
and the presence of alveolar bone dehiscences (ABDs) and fenestrations (ABFs) in adults with mild-tomoderate
crowding. Methods: Cone-beam computed tomography images from 29 adults were obtained before
and immediately after nonextraction CAT. Total root lengths were evaluated in axial and cross-sectional slices.
Linear measurement for dehiscence (LM-D) was defined as the distance between the alveolar crest to the
cementoenamel junction of each root (critical point set at 2 mm). Linear measurement for fenestration (LM-F)
was recorded when the defect involved only the apical one-third of a root (critical point set at 2.2 mm).
Counts of ABDs/ABFs and magnitudes of LM-Ds/LM-Fs were recorded before and immediately after
nonextraction CAT at buccal and lingual root surfaces. Binary logistic regression analyses and repeated
measures analyses of variance were performed. Results: Counts of ABDs/ABFs and magnitudes of LM-Ds/
LM-Fs increased at most jaw locations and root surfaces. Nonextraction CAT was associated with an
increased presence of ABDs and ABFs. Nonextraction CAT was associated with a higher magnitude of LMDs
but not LM-Fs. Conclusions: Immediate posttreatment cone-beam computed tomography scans showed
that nonextraction CAT is associated with increased ABDs and ABFs in adults with mild-to-moderate
crowding.
