Assessment of the relationship between tooth inclination and gingival and alveolar bone dimensions using computed tomography of the maxillary anterior teeth: a cross-sectional study.

OBJECTIVE: The present study aimed to investigate the relationship between tooth inclination and gingival and bone dimensions in maxillary anterior teeth. METHODS: This cross-sectional study included cone-beam computed tomography (CBCT) images of 160 maxillary anterior teeth (30 individuals). Tooth inclination, gingival and bone thickness, and distances from cementoenamel junction to alveolar bone crest and gingival margin were measured in the labial surface. The correlations were analyzed using Pearson and partial correlation tests (p≤0.05). RESULTS: In the central incisors, tooth inclination was positively and significantly related to apical bone thickness (R = 0.34, p= 0.001). In the canines, tooth inclination was negatively and significantly related to cervical bone thickness (R = - 0.34, p= 0.01) and positively associated to apical bone thickness (R = 0.36, p= 0.01) and to gingival margin-cementoenamel junction distance (R = 0.31, p= 0.03). In the lateral incisors, tooth inclination was not associated with gingival or bone dimensions. CONCLUSIONS: In the central incisors, the greater the labial tooth inclination, the greater is the apical bone thickness. In the canines, the greater the labial tooth inclination, the smallest is the cervical bone thickness, the greater is the apical bone thickness, and the greater is the gingival margin. Gingival and bone dimensions should be assessed when planning orthodontic treatment involving buccal movement of central incisors and canines.

Tomographic assessment of infrazygomatic crest bone depth for extra-alveolar miniscrew insertion in subjects with different vertical and sagittal skeletal patterns.

OBJECTIVE: To evaluate bone availability at the infrazygomatic crest for extra-alveolar bone miniscrew insertion in subjects with different vertical and sagittal skeletal patterns. SETTING AND SAMPLE POPULATION: Measurements of the infrazygomatic crest were performed on multislice computed tomography scans from 58 adults with different skeletal patterns. MATERIALS AND METHODS: Infrazygomatic crest bone depth was measured at 4, 5 and 6 mm from the cementoenamel junction (CEJ) of the maxillary first molar at three different angles (60°, 70° and 80°) in the first molar occlusal plane. The sagittal and vertical skeletal patterns were determined. Analysis of variance followed by Tukey's post hoc test was used (P ≤ .05). RESULTS: Bone depth was greater near the CEJ (8.7 ± 3.1 mm) and lower in the apical area (5.8 ± 2.7 mm). In Class II subjects, considering 6 mm from the CEJ, there was a significantly lower depth at the 80° angle (5.4 ± 2.5 mm) than at 60° (8.6 ± 3.5 mm; P = .007). In mesofacial subjects, considering 5 and 6 mm from the CEJ, bone depth was lower at 80° (5.7 ± 3.2 mm and 5.3 ± 2.5 mm) than at 60° considering 4 mm from the CEJ (P ≤ .019). CONCLUSION: Bone availability was lower at the apical level, especially in Class II and mesofacial subjects. Therefore, when the planned insertion site is located in the apical direction, it is recommended to choose shorter miniscrews (2.0 x 12mm) and a smaller insertion angle (60°) and/or to plan a miniscrew bone insertion deep enough to allow bicortical fixation.

Assessment of the relationship between tooth inclination and gingival and alveolar bone dimensions using computed tomography of the maxillary anterior teeth: a cross-sectional study

ABSTRACT Objective: The present study aimed to investigate the relationship between tooth inclination and gingival and bone dimensions in maxillary anterior teeth. Methods: This cross-sectional study included cone-beam computed tomography (CBCT) images of 160 maxillary anterior teeth (30 individuals). Tooth inclination, gingival and bone thickness, and distances from cementoenamel junction to alveolar bone crest and gingival margin were measured in the labial surface. The correlations were analyzed using Pearson and partial correlation tests (p≤0.05). Results: In the central incisors, tooth inclination was positively and significantly related to apical bone thickness (R = 0.34, p= 0.001). In the canines, tooth inclination was negatively and significantly related to cervical bone thickness (R = - 0.34, p= 0.01) and positively associated to apical bone thickness (R = 0.36, p= 0.01) and to gingival margin-cementoenamel junction distance (R = 0.31, p= 0.03). In the lateral incisors, tooth inclination was not associated with gingival or bone dimensions. Conclusions: In the central incisors, the greater the labial tooth inclination, the greater is the apical bone thickness. In the canines, the greater the labial tooth inclination, the smallest is the cervical bone thickness, the greater is the apical bone thickness, and the greater is the gingival margin. Gingival and bone dimensions should be assessed when planning orthodontic treatment involving buccal movement of central incisors and canines.

RESUMO Objetivo: O presente estudo teve como objetivo investigar a relação entre a inclinação dentária e as dimensões ósseas e gengivais em dentes anteriores superiores. Métodos: Esse estudo transversal incluiu imagens de tomografia computadorizada de feixe cônico (TCFC) de 160 dentes anteriores superiores divididos em três grupos (incisivo central, incisivo lateral e canino). Todos os pacientes tinham 18 anos ou mais, não tinham tratamento ortodôntico prévio nem história clínica que pudesse afetar as dimensões ósseas ou gengivais. A inclinação dentária, a espessura do osso e da gengiva e as distâncias da junção cemento-esmalte à crista óssea alveolar e à margem gengival foram medidas na face vestibular. As correlações foram analisadas por meio dos testes de Pearson e de correlação parcial (p≤0,05). Resultados: Nos incisivos centrais, a inclinação dentária foi positiva e significativamente relacionada à espessura do osso apical (R = 0,34, p= 0,001). Nos caninos, a inclinação dentária foi negativa e significativamente relacionada à espessura do osso cervical (R = - 0,34, p= 0,01) e positivamente associada à espessura do osso apical (R = 0,36, p= 0,01) e à distância entre a margem gengival e a junção cemento-esmalte (R = 0,31, p= 0,03). Nos incisivos laterais, a inclinação do dente não foi associada às dimensões do osso ou da gengiva. Conclusões: Nos incisivos centrais, quanto maior a inclinação vestibular do dente, maior a espessura do osso apical. Nos caninos, quanto maior a inclinação vestibular do dente, menor a espessura do osso cervical, maior a espessura do osso apical e maior a margem gengival. As dimensões ósseas e gengivais devem ser avaliadas ao se planejar o tratamento ortodôntico envolvendo a movimentação vestibular dos incisivos centrais e caninos.

Evaluation of alveolar process resorption after tooth extraction using the socket shield technique without immediate installation of implants: a randomised controlled clinical trial.

Our aim was to evaluate resorption of the alveolar ridge using the socket shield technique (SST) without immediate placement of dental implants. This randomised controlled clinical trial included 27 patients: 14 maxillary non-molar teeth were partially extracted using the SST (test group) and 13 were extracted using a minimally traumatic extraction approach (control group). Alterations in height and thickness of the alveolar ridge were evaluated by cone beam computed tomograms taken immediately after, and 100 days after, surgery. Minor resorption was observed in the height of the buccal and palatal plates, without intergroup difference (p ≥ 0.10). The test group showed significantly better preservation of the buccal-to-palatal crest dimension (p ≤ 0.05). In the control group, preservation of buccal plate thickness was significantly greater (p ≤ 0.05), but intragroup vertical resorption of the buccal plate and reduction in the buccal-to-palatal crest distance were greater (p ≤ 0.05). The SST without the immediate placement of implants showed greater preservation of the buccal-to-palatal crest dimension and lower preservation of buccal wall thickness compared with minimally traumatic extraction. In addition, it provided superior maintenance of the baseline buccal wall height. The modified SST is a promising approach, but factors that interfere with the results should be investigated.

Dental health status and its indicators in adult Brazilian Indians without exposition to drinking water fluoridation: a cross-sectional study.

Water fluoridation is considered a cost-effective and practical method for controlling and preventing dental caries in the general population. The objective of this study was to evaluate the dental health status and risk indicators for dental caries in adult Brazilian Indians without exposition to dental caries-preventive effects of water fluoridation. Decayed (DT), missing (MT), and filled (FT) permanent teeth (DMFT), as well as plaque index, unstimulated salivary flow rate, salivary buffering capacity, and fasting blood glucose were examined in 225 adult Indians. Smoking habits and sociodemographic data were evaluated using a structured questionnaire. Drinking water samples from 10 Indian villages were analyzed for the natural fluoride concentration. The mean DMFT was 10.33 ± 6.91 (DT, 4.19 ± 3.99; MT, 4.99 ± 5.64; FT, 1.14 ± 1.75). DMFT index ≥ 9 was associated with age ≥ 35 years (p = 0.000), lower education (p = 0.03), and plaque index > 40% (p = 0.003). DT was associated only with plaque index (p = 0.03). MT was associated with age (p < 0.001) and plaque index (p = 0.01). FT was negatively associated with age (p = 0.02) and income (p = 0.02). Fluoride concentration varied from 0.01 to 0.07 mg/L and was not associated with dental health status (p ≥ 0.29). In conclusion, poorer dental health status was associated with older age, higher plaque index, and lower education and income levels. The fluoride level in the drinking water of Kiriri villages was lower than the level recommended for preventing dental caries. Water fluoridation may be recommended for this population.