• Title/Summary/Keyword: Intrusion of alveolar bone

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Evaluation of changes in the maxillary alveolar bone after incisor intrusion

  • Atik, Ezgi;Gorucu-Coskuner, Hande;Akarsu-Guven, Bengisu;Taner, Tulin
    • The korean journal of orthodontics
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    • v.48 no.6
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    • pp.367-376
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    • 2018
  • Objective: This study was performed to investigate the changes in alveolar bone after maxillary incisor intrusion and to determine the related factors in deep-bite patients. Methods: Fifty maxillary central incisors of 25 patients were evaluated retrospectively. The maxillary incisors in Group I (12 patients; mean age, $16.51{\pm}1.32years$) were intruded with a base-arch, while those in Group II (13 patients; mean age, $17.47{\pm}2.71years$) were intruded with miniscrews. Changes in the alveolar envelope were assessed using pre-intrusion and post-intrusion cone-beam computed tomography images. Labial, palatal, and total bone thicknesses were evaluated at the crestal (3 mm), midroot (6 mm), and apical (9 mm) levels. Buccal and palatal alveolar crestal height, buccal bone height, and the prevalence of dehiscence were evaluated. Two-way repeated measure ANOVA was used to determine the significance of the changes. Pearson's correlation coefficient analysis was performed to assess the relationship between dental and alveolar bone measurement changes. Results: Upper incisor inclination and intrusion changes were significantly greater in Group II than in Group I. With treatment, the alveolar bone thickness at the labial bone thickness (LBT, 3 and 6 mm) decreased significantly in Group II (p < 0.001) as compared to Group I. The LBT change at 3 mm was strongly and positively correlated with the amount of upper incisor intrusion (r = 0.539; p = 0.005). Conclusions: Change in the labial inclination and the amount of intrusion should be considered during upper incisor intrusion, as these factors increase the risk of alveolar bone loss.

Cone-beam computed tomographic evaluation of mandibular incisor alveolar bone changes for the intrusion arch technique: A retrospective cohort research

  • Lin Lu;Jiaping Si;Zhikang Wang;Xiaoyan Chen
    • The korean journal of orthodontics
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    • v.54 no.2
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    • pp.79-88
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    • 2024
  • Objective: Alveolar bone loss is a common adverse effect of intrusion treatment. Mandibular incisors are prone to dehiscence and fenestrations as they suffer from thinner alveolar bone thickness. Methods: Thirty skeletal class II patients treated with mandibular intrusion arch therapy were included in this study. Lateral cephalograms and cone-beam computed tomography images were taken before treatment (T1) and immediately after intrusion arch removal (T2) to evaluate the tooth displacement and the alveolar bone changes. Pearson's and Spearman's correlation was used to identify risk factors of alveolar bone loss during the intrusion treatment. Results: Deep overbite was successfully corrected (P < 0.05), accompanied by mandibular incisor proclination (P < 0.05). There were no statistically significant change in the true incisor intrusion (P > 0.05). The labial and lingual vertical alveolar bone levels showed a significant decrease (P < 0.05). The alveolar bone is thinning in the labial crestal area and lingual apical area (P < 0.05); accompanied by thickening in the labial apical area (P < 0.05). Proclined incisors, non-extraction treatment, and increased A point-nasion-B point (ANB) degree were positively correlated with alveolar bone loss. Conclusions: While the mandibular intrusion arch effectively corrected the deep overbite, it did cause some unwanted incisor labial tipping/flaring. During the intrusion treatment, the alveolar bone underwent corresponding changes, which was thinning in the labial crestal area and thickening in the labial apical area vice versa. And increased axis change of incisors, non-extraction treatment, and increased ANB were identified as risk factors for alveolar bone loss in patients with mandibular intrusion therapy.

Three-dimensional finite element analysis on intrusion of upper anterior teeth by three-piece base arch appliance according to alveolar bone loss (치조골 상실에 따른 three-piece base arch appliance를 이용한 상악전치부 intrusion에 대한 3차원 유한요소법적 연구)

  • Ha, Man-Hee;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.31 no.2 s.85
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    • pp.209-223
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    • 2001
  • At intrusion of upper anterior teeth in patient with periodontal defect, the use of three-piece base arch appliance for pure intrusion is required. To investigate the change of the center of resistance and of the distal traction force according to alveolar bone height at intrusion of upper anterior teeth using this appliance, three-dimensional finite element models of upper six anterior teeth, periodontal ligament and alveolar bone were constructed. At intrusion of upper anterior teeth by three-piece base arch appliance, the following conclusions were drawn to the locations of the center of resistance according to the number of teeth, the change of distal traction force for pure intrusion and the correlation to the change of vertical, horizontal location of the center of resistance according to alveolar bone loss. 1. When the axial inclination and alveolar bone height were normal, the anteroposterior locations of center of resistance of upper anterior teeth according to the number of teeth contained were as follows : 1) In 2 anterior teeth group, the center of located in the mesial 1/3 area of lateral incisor bracket. 2) In 4 anterior teeth group. the center of resistance was located in the distal 2/3 of the distance between the bracket of lateral incisor and canine. 3) In 6 anterior teeth group, the center of resistance was located in the central area of first premolar bracket .4) As the number of teeth contained in anterior teeth group increased, the center of resistance shifted to the distal side. 2. When the alveolar bone height was normal, the anteroposterior position of the point of application of the intrusive force was the same position or a bit forward position of the center of resistance at application of distal traction force for pure intrusion. 3. When intrusion force and the point of application of the intrusive force were fixed, the changes of distal traction force for pure intrusion according to alveolar bon loss were as follows :1) Regardless of the alveolar bone loss, the distal traction force of 2, 4 anterior teeth groups were lower than that of 6 anterior teeth group. 2) As the alveolar bone loss increased, the distal traction forces of each teeth group were increased. 4. The correlations of the vertical, horizontal locations of the center of resistance according to maxillary anterior teeth groups and the alveolar bone height were as follows : 1) In 2 anterior teeth group, the horizontal position displacement to the vortical position displacement of the center of resistance according to the alveolar bone loss was the largest. As the number of teeth increased, the horizontal position displacement to the vertical position displacement of the center of resistance according to the alveolar bone loss showed a tendency to decrease. 2) As the alveolar bone loss increased, the horizontal position displacement to the vertical position displacement of the center of resistance regardless of the number of teeth was increased.

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The effects of alveolar bone loss and miniscrew position on initial tooth displacement during intrusion of the maxillary anterior teeth: Finite element analysis

  • Cho, Sun-Mi;Choi, Sung-Hwan;Sung, Sang-Jin;Yu, Hyung-Seog;Hwang, Chung-Ju
    • The korean journal of orthodontics
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    • v.46 no.5
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    • pp.310-322
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    • 2016
  • Objective: The aim of this study was to determine the optimal loading conditions for pure intrusion of the six maxillary anterior teeth with miniscrews according to alveolar bone loss. Methods: A three-dimensional finite element model was created for a segment of the six anterior teeth, and the positions of the miniscrews and hooks were varied after setting the alveolar bone loss to 0, 2, or 4 mm. Under 100 g of intrusive force, initial displacement of the individual teeth in three directions and the degree of labial tilting were measured. Results: The degree of labial tilting increased with reduced alveolar bone height under the same load. When a miniscrew was inserted between the two central incisors, the amounts of medial-lateral and anterior-posterior displacement of the central incisor were significantly greater than in the other conditions. When the miniscrews were inserted distally to the canines and an intrusion force was applied distal to the lateral incisors, the degree of labial tilting and the amounts of displacement of the six anterior teeth were the lowest, and the maximum von Mises stress was distributed evenly across all the teeth, regardless of the bone loss. Conclusions: Initial tooth displacement similar to pure intrusion of the six maxillary anterior teeth was induced when miniscrews were inserted distal to the maxillary canines and an intrusion force was applied distal to the lateral incisors. In this condition, the maximum von Mises stresses were relatively evenly distributed across all the teeth, regardless of the bone loss.

Histological analysis on tissues around orthodontically intruded maxillary molars using temporary anchorage devices: A case report

  • Hui-Chen Tsai;Julia Yu-Fong Chang;Chia-Chun Tu;Chung-Chen Jane Yao
    • The korean journal of orthodontics
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    • v.53 no.2
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    • pp.125-136
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    • 2023
  • Before progress was recently made in the application of temporary anchorage devices (TADs) in bio-mechanical design, orthodontists were rarely able to intrude molars to reduce upper posterior dental height (UPDH). However, TADs are now widely used to intrude molars to flatten the occlusal plane or induce counterclockwise rotation of the mandible. Previous studies involving clinical or animal histological evaluation on changes in periodontal conditions after molar intrusion have been reported, however, studies involving human histology are scarce. This case was a Class I malocclusion with a high mandibular plane angle. Upper molar intrusion with TADs was performed to reduce UPDH, which led to counterclockwise rotation of the mandible. After 5 months of upper molar intrusion, shortened clinical crowns were noticed, which caused difficulties in oral hygiene and hindered orthodontic tooth movement. The mid-treatment cone-beam computed tomography revealed redundant bone physically interfering with buccal attachment and osseous resective surgeries were followed. During the surgeries, bilateral mini screws were removed and bulging alveolar bone and gingiva were harvested for biopsy. Histological examination revealed bacterial colonies at the bottom of the sulcus. Infiltration of chronic inflammatory cells underneath the non-keratinized sulcular epithelium was noted, with abundant capillaries being filled with red blood cells. Proximal alveolar bone facing the bottom of the gingival sulcus exhibited active bone remodeling and woven bone formation with plump osteocytes in the lacunae. On the other hand, buccal alveolar bone exhibited lamination, indicating slow bone turnover in the lateral region.

Three-dimensional evaluation of maxillary anterior alveolar bone for optimal placement of miniscrew implants

  • Choi, Jin Hwan;Yu, Hyung Seog;Lee, Kee Joon;Park, Young Chel
    • The korean journal of orthodontics
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    • v.44 no.2
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    • pp.54-61
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    • 2014
  • Objective: This study aimed to propose clinical guidelines for placing miniscrew implants using the results obtained from 3-dimensional analysis of maxillary anterior interdental alveolar bone by cone-beam computed tomography (CBCT). Methods: By using CBCT data from 52 adult patients (17 men and 35 women; mean age, 27.9 years), alveolar bone were measured in 3 regions: between the maxillary central incisors (U1-U1), between the maxillary central incisor and maxillary lateral incisor (U1-U2), and between the maxillary lateral incisor and the canine (U2-U3). Cortical bone thickness, labio-palatal thickness, and interdental root distance were measured at 4 mm, 6 mm, and 8 mm apical to the interdental cementoenamel junction (ICEJ). Results: The cortical bone thickness significantly increased from the U1-U1 region to the U2-U3 region (p < 0.05). The labio-palatal thickness was significantly less in the U1-U1 region (p < 0.05), and the interdental root distance was significantly less in the U1-U2 region (p < 0.05). Conclusions: The results of this study suggest that the interdental root regions U2-U3 and U1-U1 are the best sites for placing miniscrew implants into maxillary anterior alveolar bone.

INVASION OF ALVEOLAR BONE INTO ROOT CANAL AFTER TRAUMATIC INJURY (외상 후 근관내로의 치조골 함입)

  • Im, Ye-Jin;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.4
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    • pp.399-406
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    • 2011
  • Traumatic injury on tooth occurs frequently among trauma patients, and mainly occurs on tooth with premature roots which influences pulp tissue, periodontal ligament, alveolar bone, and Hertwig's epithelial root sheath. According to the degree of trauma, a number of kinds of healing process can be observed, such as complete re-vascularization of pulp, root canal obliteration, growth suspension of root apex, and invasion of alveolar bone into root canal, and there can be some complications such as necrotic change of inflammatory root resorption and partial pulp necrosis due to pulp necrosis toward complete necrosis. In this clinical case, 3 patients who had traumatic injury showed root growth suspension and alveolar bone invasion into root canal due to proliferation of periodontal ligament cell and osteocyte at the base of extraction socket into pulp chamber because of the injury on Hertwig's epithelial root sheath. If intrusion of alveolar bone into root canal due to injury on Hertwig's epithelial root sheath after having traumatic injury doesn't show any complication, the pulp may be considered to have normal vitality and doesn't need any further treatment, therefore differential diagnosis is very necessary. However, it may be accompanied with suspension of root growth, therefore, additional trauma during the treatment of injured tooth should not be applied.

Effectiveness of Invisalign® aligners in the treatment of severe gingival recession: A case report

  • de Figueiredo, Marcio Antonio;Romano, Fabio Lourenco;Feres, Murilo Fernando Neuppmann;Stuani, Maria Bernadete Sasso;Nahas-Scocate, Ana Carla Raphaelli;Matsumoto, Mirian Aiko Nakane
    • The korean journal of orthodontics
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    • v.51 no.4
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    • pp.293-300
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    • 2021
  • In this report, we demonstrate the effectiveness of the Invisalign® system in the treatment of severe gingival recession and bone dehiscence through torque, translation, and intrusion movements in a young woman. Cone-beam computed tomography was used to assess bone parameters and check the teeth during treatment. The root of the mandibular right central incisor, which was buccally positioned and exhibited bone dehiscence of 9.4 mm, was moved toward the center of the alveolar process by using the Invisalign® system and SmartForce® features. The patient was monitored by a periodontist throughout the orthodontic treatment period. Her gingival recession reduced, while the bone dehiscence reduced from 9.40 mm to 3.14 mm. Thus, movement of the root into the alveolus promoted bone neoformation and treated the gingival recession. The findings from this case suggest that orthodontic treatment using the Invisalign® system, along with periodontal monitoring, can aid in the treatment of gingival recession and alveolar defects.

CONSIDERATION OF THE ANTERIOR OPENBITE AND DEEP BITE IN CLASS III AND THEIR TREATMENT WITH MULTILOOP EDGEWISE ARCHWIRE (MEAW) (골격형 III급 전치개교와 과개교합에 대한 비교고찰 및 MEAW에 의한 치험예)

  • Baek, Seung-Hak;Yang, Won-Sik
    • The korean journal of orthodontics
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    • v.21 no.3
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    • pp.685-699
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    • 1991
  • The purpose of this report is to review vertical dysplasia such as openbite or deep bite in skeletal Class III malocclusion and their treatment modality and to present two cases treated with MEAW. The results obtained were as follows A. Open bite case 1. The treatment time was 3 year 8 months. 2. Upper and lower incisors showed extrusion and especially lower anterior alveolar process showed remodelling. 3. The mesially inclined upper and lower molars were uprighted and especially lower first molars showed extrusion that means remodelling of alveolar bone. 4. Normal overbite and overjet were established. 5. Mandible showed slight clockwise rotation. 6. Maxilla showed slight downward bending of ANS part. 7. Upper lip showed downward drop and lower lip showed retraction and touch between upper and lower lip was established. 8. Tongue posture of post-treatment was more raised than pretreatment. B. Deep bite case 1. The treatment time was 1 year 8 months. 2. Upper incisors showed intrusion and labioversion and lower incisors showed slight intrusion and linguoversion. 3. The lower molars showed distal uprighting and intrusion and upper molars showed mesial movement and extrusion. 4. Normal overbite and overjet were established. 5. Maxilla did not show downward movement. 6. Mandible showed slight clockwise rotation. 7. Lower lip showed retraction and downward drop and upper lip showed downward drop.

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