Three-dimensional evaluation of labial alveolar bone overlying the maxillary and mandibular incisors in different skeletal classifications of malocclusion

Int Orthod. 2019 Jun;17(2):287-295. doi: 10.1016/j.ortho.2019.03.011. Epub 2019 Apr 20.

Abstract

Objectives: The purpose of this study was to investigate differences in the thickness of the labial bone overlying the maxillary and mandibular incisors in class I, II, and III skeletal classifications using three-dimensional cone-beam computed tomographs (CBCT) technology.

Methods: Pretreatment CBCTs of 54 Caucasian subjects (44 males, 10 females) were collected from the archives of a graduate orthodontic clinic. The subjects were divided into three groups based on their skeletal classification. CBCT scans were oriented to the long axis of each maxillary and mandibular incisor from the root apex to incisal tip and the axial inclination of each incisor was measured and recorded. Labial bone thickness was measured at the apex (A) and at the midpoint (MP) on each maxillary and mandibular incisor. A linear measurement, perpendicular to the long axis, was recorded from the labial bone surface to the most anterior root surface at two points. The effects of skeletal classification, jaw, incisor position, and side on A, MP, and Inclination were evaluated using mixed-model ANOVA. A 5% significance level was used for all tests.

Results: Significantly greater bone thickness at the apex and midpoint was reported in class III individuals than class I or II. Central incisors had significantly greater bone thickness at both the root apex and midpoint. Significantly greater bone thickness was noted in the mandible at the level of the apex. At the level of the midpoint, significantly greater thickness was reported in the maxilla. There was a positive correlation between thickness and angle within each jaw-incisor combination for class I patients and for central incisors in class III patients.

Conclusion: The thickness of labial alveolar bone over the incisors varies based on the underlying skeletal discrepancy in each patient. Skeletal discrepancy influences the inclination of the maxillary and mandibular incisors.

Keywords: Alveolar bone thickness; Cone-beam computed tomography; Décalage squelettique; Skeletal discrepancy; Tomographie à faisceaux coniques assistée par ordinateur; Épaisseur de l’os alvéolaire.

MeSH terms

  • Adult
  • Alveolar Process / diagnostic imaging*
  • Alveolar Process / pathology*
  • Cephalometry
  • Cone-Beam Computed Tomography / methods
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods*
  • Incisor / anatomy & histology*
  • Incisor / diagnostic imaging*
  • Male
  • Malocclusion / diagnostic imaging*
  • Malocclusion / pathology*
  • Malocclusion / therapy
  • Mandible / anatomy & histology
  • Mandible / diagnostic imaging
  • Maxilla / anatomy & histology
  • Maxilla / diagnostic imaging
  • Tooth Apex / anatomy & histology
  • Tooth Apex / diagnostic imaging
  • Young Adult