Associations of pretreatment parameters with changes during orthodontic treatment.

OBJECTIVES: To examine whether pretreatment conditions of a patient can determine alveolar bone changes after orthodontic treatment. SETTING AND SAMPLE POPULATION: Cone beam computed tomography (CBCT) images were obtained from 44 patients (17 male and 27 female, 14.02 ± 1.29 years). MATERIAL AND METHODS: Buccal bone height (BBH), buccal bone thickness (BBT), and molar angulation (MA) of right and left maxillary molars and intermolar distance (ID) were measured using the CBCT images obtained before and after orthodontic treatment using conventional brackets and self-ligating conventional brackets. RESULTS: There was a significant change only in BBH after treatment. All posttreatment parameters had significant positive correlations with the corresponding pretreatment parameters (r2  = 0.376-0.719, P < 0.001). Most of the changes had significant negative correlations with the corresponding pretreatment parameter (r2  = 0.054-0.249, P < 0.03). The results were not significantly influenced by the different bracket types. CONCLUSION: The current findings suggest that the CBCT-based morphological information about dentition and oral bone conditions of patients can provide a better pretreatment plan to estimate the results of orthodontic treatment.

Effect of bone thickness on alveolar bone-height measurements from cone-beam computed tomography images.

INTRODUCTION: Cone-beam computed tomography (CBCT) has been used to assess alveolar bone changes after rapid palatal expansion. The purpose of this study was to investigate the accuracy of alveolar bone-height measurements from CBCT images with varied bone thicknesses and imaging resolutions. METHODS: Eleven maxillary specimens from 6-month-old pigs were measured for alveolar bone height (distance between drilled reference holes and alveolar crests) at 6 locations with a digital caliper, followed by CBCT scanning at 0.4-mm and 0.25-mm voxel sizes. Buccal alveolar bone of these locations was then reduced approximately by 0.5 to 1.5 mm, followed by CBCT rescanning with the same voxel sizes. The CBCT images were measured by using 3-dimensional software to determine alveolar bone height and thickness in buccolingual slices by independent, blinded raters. The specimens were subsequently cut into buccolingual sections at reference-hole levels, and direct bone height and thickness were measured from these sections. Intrarater and interrater repeatability and the differences between CBCT and direct measurements were assessed. RESULTS: Excellent intrarater (intraclass correlations, r = 0.89-0.98) and good interrater (r = 0.64-0.90) repeatability values were found for alveolar bone-height measurements from the CBCT images. Before alveolar bone reduction, the thickness was much greater than the CBCT voxel size (0.4 mm), and bone-height measurements from the CBCT images were 0.5 to 1 mm more than the direct measurements (paired t tests, P <0.017 at most locations). After bone reduction, the thickness at the subcrest 1-mm level was near or below the CBCT voxel size (0.4 mm), and bone-height measurements from the CBCT images were 0.9 to 1.2 mm less than the direct measurements (paired t tests, P <0.017 at most locations). These measurement inaccuracies were substantially improved by decreasing the CBCT voxel size to 0.25 mm. CONCLUSIONS: Alveolar bone-height measurements from conventional clinical 0.4-mm voxel size CBCT images might overestimate alveolar bone-height loss associated with rapid palatal expansion.