Changes in the alveolar bone thickness of maxillary incisors after orthodontic treatment involving extractions - A systematic review and meta-analysis

María Domingo-Clérigues, José-María Montiel-Company, José-Manuel Almerich-Silla, Verónica García-Sanz, Vanessa Paredes-Gallardo, Carlos Bellot-Arcís, María Domingo-Clérigues, José-María Montiel-Company, José-Manuel Almerich-Silla, Verónica García-Sanz, Vanessa Paredes-Gallardo, Carlos Bellot-Arcís

Abstract

Background: Orthodontic treatment involving en-masse retraction of incisors following premolar extractions, may induce morphological alterations of the alveolar bone surrounding the anterior teeth.

Objective: To assess changes in alveolar bone thickness around the incisors of extraction patients measured with CBCT.

Material and methods: An electronic search was conducted in PubMed, Scopus, Embase and Cochrane Library, using search terms, with no limitation on publication date, up to April 2018. The articles selected for analysis included randomized controlled trials, case-control studies and cohort studies of patients treated with fixed appliances and premolar extractions, which had measured alveolar bone thickness with CBCT before and after treatment. Changes in bone thickness were calculated and the heterogeneity of the studies was assessed using the I2 and Cochran's Q tests.

Results: Of the 136 articles identified in the initial search, 19 were related to the review subject. After removing a further 14 that did not meet the inclusion criteria, 5 articles were selected for analysis. All five were retrospective studies of medium quality. The main changes in alveolar bone thickness were found in the labial cervical third of the central incisor, presenting increases of 0.4-0.64 mm. On the palatal side the results varied considerably.

Conclusions: A significant increase in alveolar bone thickness occurs in the labial cervical third of the central incisor. These changes may be influenced by incisor position and inclination, the orthodontic technique and mechanics employed, the timing of the final CBCT scan and the bone remodeling capacity during en-masse retraction. Key words:Cone-beam computed tomography, alveolar bone, orthodontics.

Conflict of interest statement

Conflict of interest statement: The authors have declared that no conflict of interest exist.

Figures

Figure 1
Figure 1
PRISMA flow diagram. From: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement.
Figure 2
Figure 2
a. Forest plot summarizing the changes in bone thickness of labial segment S1. b. Forest plot summarizing the changes in bone thickness of labial segment S2. c. Forest plot summarizing the changes in bone thickness of labial segment S3.
Figure 3
Figure 3
a. Forest plot summarizing the changes in bone thickness of palatal segment S1. b. Forest plot summarizing the changes in bone thickness of palatal segment S2. c. Forest plot summarizing the changes in bone thickness of palatal segment S3.

References

    1. Isaacson KG, Thom AR, Atack NE, Horner K, Whaites E. Orthodontic radiographs—guidelines for the use of radiographs in clinical orthodontics. 3rd ed. London, United Kingdom: British Orthodontic Society; 2008.
    1. Mah JK, Huang JC, Choo H. Practical Applications of Cone-Beam Computed Tomography in Orthodontics. J Am Dent Assoc. 2009;141:7S–13S.
    1. Picanço PRB, Valarelli FP, Cançado RH, de Freitas KM, Picanço GV. Comparison of the changes of alveolar bone thickness in maxillary incisor area in extraction and non-extraction cases: computerized tomography evaluation. Dental Press J Orthod. 2013;18:91–8.
    1. Yared KFG, Zenobio EG, Pacheco W. Periodontal status of mandibular central incisors after orthodontic proclination in adults. Am J Orthod Dentofacial Orthop. 2006;130:1–8.
    1. 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;127:552–61.
    1. 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.
    1. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.
    1. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;3:159–74.
    1. Mattos CT, Vilani GNL, Sant'Anna EF, Ruellas AC, Maia LC. Effects of orthognathic surgery on oropharyngeal airway: a meta-analysis. Int J Oral Maxillofac Surg. 2011;40:1347–56.
    1. Fernández-Ferrer L, Montiel-Company JM, Pinho T, Almerich-Silla JM, Bellot-Arcís C. Effects of mandibular setback surgery on upper airway dimensions and their influence on obstructive sleep apnoea - a systematic review. J Craniomaxillofac Surg. 2015;43:248–53.
    1. Serra-Torres S, Bellot-Arcís C, Montiel-Company JM, Marco-Algarra J, Almerich-Silla JM. Effectiveness of mandibular advancement appliances in treating obstructive sleep apnea syndrome: A systematic review. Laryngoscope. 2016;126:507–14.
    1. Bermell-Baviera A, Bellot-Arcís C, Montiel-Company JM, Almerich-Silla JM. Effects of mandibular advancement surgery on the temporomandibular joint and muscular and articular adaptive changes—a systematic review. Int J Oral Maxillofac Surg. 2016;45:545–52.
    1. Ahn HW, Moon SC, Baek SH. Morphometric evaluation of changes in the alveolar bone and roots of the maxillary anterior teeth before and after en masse retraction using cone-beam computed tomography. Angle Orthod. 2013;83:212–21.
    1. Yodthong N, Charoemratrote C, Leethanakul C. Factors related to alveolar bone thickness during upper incisor retraction. Angle Orthod. 2013;83:394–401.
    1. Nayak Krishna US, Shetty A, Girija MP, Nayak R. Changes in alveolar bone thickness due to retraction of anterior teeth during orthodontic treatment: A cephalometric and computed tomography comparative study. Indian J Dent Res. 2013;24:736–41.
    1. Kapila S, Conley RS, Harrell WE. The current status of cone beam computed tomography imaging in orthodontics. Dentomaxillofac Radiol. 2011;40:24–34.
    1. Fuhrmann RA, Wehrbein H, Langen HJ, Diedrich PR. Assessment of the dentate alveolar process with high resolution computed tomography. Dentomaxillofac Radiol. 1995;24:50–4.
    1. Vardimon AD, Oren E, Ben-Bassat Y. Cortical bone remodeling/tooth movement ratio during maxillary incisor retraction with tip versus torque movements. Am J Orthod Dentofacial Orthop. 1998;114:520–29.
    1. Handelman CS. The anterior alveolus: Its importance in limiting orthodontic treatment and its influence on the occurrence of iatrogenic sequelae. Angle Orthod. 1996;66:95–110.
    1. De Angelis V. Observationson the response of alveolar bone to orthodontic force. Am J Orthod. 1970;58:2884–94.
    1. Wainwright WM. Faciolingualtooth movement: its influence on the root and cortical plate. Am J Orthod. 1973;64:278–302.
    1. Wehrbein H, Bauer W, Diedrich PR. Mandibular incisor, alveolar bone, and symphysis after orthodontic tooth movement. Am J Orthod Dentofacial Orthop. 1996;110:239–46.

Source: PubMed

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