Root resorption and marginal alveolar bone level change during orthodontic treatment in periodontally compromised patients. A cone beam computed tomographic study
| Author | Affiliation |
|---|---|
Lund, Henrik | Department of Oral and Maxillofacial Radiology, Sahlgrenska Academy, Institute of Odontology, University of Gothenburg, Sweden |
Lindsten, Rune | Departments of Orthodontics, Institute for Postgraduate Dental Education, Jonkoping, Sweden |
Jansson, Henrik | Departments of Periodontology, Institute for Postgraduate Dental Education, Jonkoping, Sweden |
| Date |
|---|
2019-06-17 |
AIMS: To examine external apical root resorption (EARR) and marginal alveolar bone level (ABL) change after orthodontic treatment (OT) in patients with periodontal disease. SUBJECTS AND METHOD: Fifty patients with periodontal disease, who had received periodontal-orthodontic treatment. OT was performed with a straightwire appliance. Micro-implants or implants were used for anchorage. Personal and professional oral hygiene was ensured before and throughout treatment. Cone beam computed tomographic examinations were performed before and after OT. RESULTS: EARR after OT was observed at a median of 80.7 per cent [interquartile range (IQR) 22.02, range 40-100%] of teeth with a mean value of 1.2 mm (standard deviation 0.44). In 82.3 per cent of teeth EARR was ≤ 2 mm. Severe EARR was found in 8 per cent of patients and five maxillary incisors (< 1% of all teeth). A significantly higher extent of mean EARR was observed, if OT lasted >18 months. No significant mean ABL change (0.06 mm, 95% confidence interval: –0.07, 0.19) could be found after OT (P = 0.35). Small significant ABL gain was observed on the mesial and distal surfaces (P < 0.01). A small significant difference was found between mean ABL before and after OT in maxillary posterior teeth (–0.2 mm, IQR 0.69; P = 0.03). CONCLUSION: ABL changes after periodontal and OT in patients with periodontal disease are small and not deleterious. A small ABL gain was observed mesially and distally. However EARR was found in about 81 per cent of teeth. Longer OT influenced the extent of EARR. Meticulous personal oral hygiene and optimal sub-gingival control of inflammation should be ensured before the start and throughout the combined treatment.