Multivariate analysis of alveolar bone dehiscence and fenestration in anterior teeth after orthodontic treatment: A retrospective study.

OBJECTIVE: To compare the prevalence of fenestration and dehiscence between pre- and post-orthodontic treatment and to explore the factors related to fenestration and dehiscence in the anterior teeth after treatment. METHODS: This study included 1000 cone-beam computed tomography (CBCT) scans of 500 patients before (T1) and after (T2) orthodontic treatment. These images were imported into Dolphin 11.9 software to detect alveolar fenestration and dehiscence in the anterior teeth area. The chi-square test and Fisher's exact test were performed to compare the prevalence of alveolar bone defects between time points T1 and T2. A total of 499 patients were selected for logistic regression analysis to examine the correlation among age, sex, crowding, sagittal facial type, extraction, miniscrew use and fenestration or dehiscence post-treatment. RESULTS: Except for the maxillary lingual fenestration and labial fenestration of mandibular canines, a significant change in the prevalence of fenestration and dehiscence was noted between time points T1 and T2 (P < .025). Multinomial logistic regression showed that age, miniscrew use and extraction highly influenced the prevalence of anterior lingual dehiscence (P < .05). Dehiscence of the mandibular labial side (skeletal Class III vs. I, OR = 2.368, P = .000) and fenestration of the mandibular lingual side (skeletal Class II vs. I, OR = 2.344, P = .044) were strongly correlated with the sagittal facial type. Dehiscence of the maxillary labial side (moderate vs. mild, OR = 1.468, P = .017) was significantly associated with crowding. CONCLUSIONS: Older age, maxillary moderate crowding, skeletal Class III, extraction and miniscrew potentially significantly affect the prevalence of anterior teeth dehiscence. Adult females, skeletal Class III patients on the mandibular labial side and skeletal Class II patients on the mandibular lingual side should be monitored for anterior teeth fenestration.

Positive relationship between the dimensions of clinical gingival recessions and associated alveolar bone dehiscences: a biometric study.

OBJECTIVES: To analyze the relationships between the dimension of clinical gingival recession and of the actual bone dehiscence. METHOD AND MATERIALS: Data included measurements taken before and during root coverage surgical procedures. General health, smoking status, previous orthodontic treatment, probing depth, clinical measurements taken on gingival recessions, and the exposed alveolar bone dehiscences were recorded. Data were analyzed using descriptive statistics and linear regression model. RESULTS: Twenty-three patient files were available. The mean age was 31.3 ± 12.1 years (range 13 to 51 years). Eight patients had previous orthodontic treatment. Incisor, canine, and premolar recessions amounted to 9, 8, and 6 teeth, respectively. The deepest recession per patient was recorded. The mean alveolar bone dehiscence depth was 6.78 ± 1.2 mm (range 5 to 9 mm). Patient-related or systemic findings, preceding orthodontic treatment, and tooth type were not correlated with alveolar bone dehiscence dimensions. A significant association was found between clinical recession and the alveolar bone dehiscence depths (P < .001, Fisher exact test). On average, each 1 mm increase in clinical recession depth involved an increase of 1.45 mm in alveolar bone dehiscence depth (P < .001, linear regression). The ratio between the clinical recession depth and width was significantly associated with the depth of the bone dehiscence (P = .007, Fisher exact test). CONCLUSION: Within the limitations of the size of this study, clinical recession depth and width dimensions may help to predict the underling bone dehiscence magnitude. Gingival recession is associated with deformities of the underlying alveolar bone; this may be revealed during mucogingival procedures associated with full-thickness flaps. The association between the two may be of particular value to the operator as it may significantly affect the outcome of treatment. Furthermore, this relationship is of utmost importance in minimally invasive procedures that avoid flap elevation. A significant association was found between the depth of the clinical gingival recession and that of alveolar bone dehiscence. In addition, the ratio between the clinical recession depth and width was significantly associated with the depth of the bone dehiscence. Clinical recession depth and width dimensions may serve as an assessment predictor for the underling bone dehiscence magnitude.