A CBCT Study Comparing the Outcomes of Volumetric Bone Mass and Mini-Implant Success with Different Types of Malocclusions

Volume 11 , Issue 1 , April 2024 , Pages 39-47

Authors

Shene M. Fatah 1 ; Trefa M. Mahmood 1

1 Orthodontics Department, College of Dentistry, University of Sulaimani, Sulaimani, Iraq.

DOI logo 10.17656/sdj.10185

Keywords

Abstract

Objective: The present study aimed to determine the favorable site for orthodontic mini-implant insertion in both the maxilla and mandible in terms of cortical and trabecular bone thickness and density in different types of skeletal malocclusion using cone-beam computed tomography (CBCT).
Methods: In this study, seventy-five CBCT examinations that were requested for different purposes were used, twenty-five in each malocclusion group (class I, class II and class III), class I (ANB: 2°-4°), class II (ANB > 4°), and class III (ANB < 2°) groups. RadiAnt Dicom Viewer was utilized, measurements were done at different sites in the jaws using standardized orientations, and the three malocclusion groups were compared for cortical bone thickness and density as well as the density of trabecular bone, using the Kruskal-Wallis and Mann-Whitney test for non-parametric data and one-way ANOVA for parametric data.
Results: The highest cortical bone thickness was between 1st and 2nd molars at a 6 mm distance from the alveolar crest ranging from 1.03 mm to 1.2 mm in maxilla and 2.13 mm to 2.26 mm in the mandible. The difference between groups was only noticed between canine and 1st premolar which showed less buccal cortical bone thickness in class II cases with 1.07 mm. Cortical bone density was not significantly different between the three groups with maximum density between canine and 1st premolar with a density of 997.9 to 1078 HU in the maxilla and the mandible 1245.4 to 1329.3 HU. The trabecular bone density was also highest between canine and 1st premolar of both jaws, in maxilla 422.13 to 564.15 HU and mandible 509.81 to 799.04 HU. The difference between the groups was only in the anterior location between canine and 1st premolars which was less in class III cases with 509.81 HU
Conclusions: Skeletal relations can have an impact on the thickness of the cortical bone, although all skeletal classes have the same pattern in the maxilla, in the mandible between the canine and the 1st premolar, variations in bone thickness and trabecular density may be seen in various skeletal malocclusions. So, it is important to properly consider the placement of mini-implants with the skeletal relation to achieve the maximum primary stability. Further researches are recommended, with long term follow up, on stability of mini-implants and its correlation with bone thickness and density.

References

  1. Kanomi R. Mini-implant for orthodontic anchorage. J Clin Orthod. 1997;31 (2):763-7.
  2. Baumgaertel S, Razavi MR, Hans MG. Mini-implant anchorage for the orthodontic practitioner. Am J Orthod Dentofacial Orthop. 2008;133 (4):621-7.
  3. Papageorgiou SN, Zogakis IP, Papadopoulos MA. Failure rates and associated risk factors of orthodonitic miniscrew implants: a meta-analysis. Am J Orthod Dentofacial Orthop. 2012;142 (5):577-95.
  4. Muddugangadhar B, Amarnath G, Sonika R, Chheda PS, Garg A. Meta-analysis of failure and survival rate of implant-supported single crowns, fixed partial denture, and implant tooth-supported prostheses. J Int Oral Health. 2015;7 (9):11.
  5. Motoyoshi M, Inaba M, Ono A, Ueno S, Shimizu N. The effect of cortical bone thickness on the stability of orthodontic mini-implants and on the stress distribution in surrounding bone. Int J Oral Maxillofac Surg. 2009;38 (1):13-8.
  6. Miyawaki S, Koyama I, Inoue M, Mishima K, Sugahara T, Takano-Yamamoto T. Factors associated with the stability of titanium screws placed in the posterior region for orthodontic anchorage. Am J Orthod Dentofacial Orthop. 2003;124 (4):373-8.
  7. Deguchi T, Takano-Yamamoto T, Kanomi R, Hartsfield Jr J, Roberts W, Garetto L. The use of small titanium screws for orthodontic anchorage. J Dent Res. 2003;82 (5):377-81.
  8. Iijima M, Takano M, Yasuda Y, Muguruma T, Nakagaki S, Sakakura Y, et al. Effect of the quantity and quality of cortical bone on the failure force of a miniscrew implant. Eur J Orthod. 2013;35 (5):583-9.
  9. Chang C, Liu SS, Roberts WE. Primary failure rate for 1680 extra-alveolar mandibular buccal shelf mini-screws placed in movable mucosa or attached gingiva. Angle Orthod. 2015;85 (6):905-10.
  10. Marquezan M, Lima I, Lopes RT, Sant'Anna EF, de Souza MMG. Is trabecular bone related to primary stability of miniscrews? Angle Orthod. 2014;84 (3):500-7.
  11. Araghbidikashani M, Golshah A, Nikkerdar N, Rezaei M. In-vitro impact of insertion angle on primary stability of miniscrews. Am J Orthod Dentofacial Orthop. 2016;150 (3):436-43.
  12. Mohammed H, Wafaie K, Rizk MZ, Almuzian M, Sosly R, Bearn DR. Role of anatomical sites and correlated risk factors on the survival of orthodontic miniscrew implants: a systematic review and meta-analysis. Prog Orthod. 2018;19 (1):1-18.
  13. Machado GL. CBCT imaging - A boon to orthodontics. Saudi Dent J. 2015;27 (1):12-21.
  14. Dharmadeep G, Naik MK, Reddy YM, Cheruluri S, Raj KP, Reddy BR. Three-dimensional evaluation of interradicular areas and cortical bone thickness for orthodontic miniscrew implant placement using cone-beam computed tomography. J Pharm Bioallied Sci. 220;12 (1):S99-S104.
  15. Arisan V, Karabuda ZC, Avsever H, Özdemir T. Conventional multi-slice computed tomography (CT) and cone-beam CT (CBCT) for computer-assisted implant placement. Par I: Relationship of radiographic gray density and implant stability. Clin Implant Dent Relat Res. 2013;15 (6):893-906.
  16. Mageetla AO. Classification of skeletal and dental malocclusion: revisited. Stoma Edu J. 2016;3 (3-4):205-11.
  17. Khumsarn N, Patanaporn V, Janhom A, Jotikasthira D. Comparison of interradicular distances and cortical bone thickness in Thai patients with Class I and Class II skeletal patterns using cone-beam computed tomography. Imaging Sci Dent. 2016;46 (2):117-25.
  18. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behav Res Methods. 2009;41 (4):1149-60.
  19. Baysal A, Ucar FI, Buyuk SK, Ozer T. Uysal T. Alveolar bone thickness and lower incisor position in skeletal Class I and Class II malocclusions assessed with cone-beam computed tomography. Korean J Orthod. 2013;43 (3):134-40.
  20. Moslemzadeh SH, Sohrabi A, Rafighi A, Kananizadeh Y, Nourizadeh A. Evaluation of interdental spaces of the mandibular posterior area for orthodontic mini-implants with cone-beam computed tomography. J Clin Diagn Res. 2017;11 (4):ZC09-12.
  21. Haddad R, Saadeh M. Distance to alveolar crestal bone: a critical factor in the success of orthodontic mini-implants. Prog Orthod. 2019:20 (1):1-7.
  22. Al-Jaf NM, Wahab RMA, Hassan MIA. Buccal cortical bone thickness in different sagittal skeletal relationship. Orthod Waves. 2018;77 (4):220-5.
  23. Choi YJ, Park Y. Three-dimensional Application of Orthodontic Miniscrews and Their Long-term Stability. Tempor Anchorage Devices Clin Orthod. 2020:33:327-35.
  24. Di Stefano DA, Arosio P, Capparè P, Barbon S, Gherlone EF. Stability of dental implants and thickness of cortical bone: clinical research and future perspectives. A systematic review. Materials. 2021:14 (23):7183.
  25. Pan CY, Liu PH, Tseng YC, Chou ST, Wu CY, Chang HP. Effects of cortical bone thickness and trabecular bone density on primary stability of orthodontic mini-implants. J Dent Sci. 2019;14 (4):383-8.
  26. Nucera R, Bellocchio AM, Oteri G, Farah AJ, Rosalia L, Giancarlo C, et al. Bone and cortical bone characteristics of mandibular retromolar trigone and anterior ramus region for miniscrew insertion in adults. Am J Orthod Dentofacial Orthop. 2019;155 (3):330-8.
  27. Ozdemir F, Tozlu M, Germec-Cakan D. Cortical bone thickness of the alveolar process measured with cone-beam computed tomography in patients with different facial types. Am J Orthod Dentofacial Orthop. 2013;143 (2):190-6.
  28. Farnsworth D, Rossouw PE, Ceen RF, Buschang PH. Cortical bone thickness at common miniscrew implant placement sites. Am J Orthod Dentofacial Orthop. 2011;139 (4):495-503.
  29. Fayed MMS, Pazera P, Katsaros C. Optimal sites for orthodontic mini-implant placement assessed by cone beam computed tomography. Angle Orthod. 2010;80 (5):939-51.
  30. Usui T, Maki K, Toki Y, Shibasaki Y, Takanobu H, Takanishi A, et al. Mechanical strain on the human skull in a humanoid robotic model. Am J Orthod Dentofacial Orthop. 2004;126 (4):421-31.
  31. Watanabe H, Deguchi T, Hasegawa M, Ito M, Kim S, Takano-Yamamoto T. Orthodontic miniscrew failure rate and root proximity, insertion angle, bone contact length, and bone density. Orthod Craniofac Res. 2013;16 (1):44-55.
  32. Cha BK, Kim CH, Baek SH. Skeletal sagittal and vertical facial types and electromyographic activity of the masticatory muscle. Angle Orthod. 2007:77 (3):463-70.
  33. Cassetta M, Sofan AA, Altieri F, Barbato E. Evaluation of alveolar cortical bone thickness and density for orthodontic mini-implant placement. J Clin Exp Dent. 2013;5 (5):e245-52.
  34. Baumgaertel S, Hans MG. Buccal cortical bone thickness for mini-implant placement. Am J Orthod Dentofacial Orthop. 2009;136 (2):230-5.
  35. Germec-Cakan D, Tozlu M, Ozdemir F. Cortical bone thickness of the adult alveolar process-a retrospective CBCT study. Aust Orthod J. 2014:30 (1):54-60.
  36. Hao Y, Zhao W, Wang Y, Yu J, Zou D. Assessments of jaw bone density at implant sites using 3D cone-beam computed tomography. Group. 2014; 18 (2): 1398-1403.
  37. Wang SH, Shen YW, Fuh LJ, Peng SL, Tsai MT, Huang HL, et al. Relationship between cortical bone thickness and cancellous bone density at dental implant sites in the jawbone. Diagnostics. 2020;10 (9):710.
  38. Casarin C, Bocalini D, Leite G, Serra A, Marchetti P, Andrade E, et al. Effect of retrusive displacement of the mandible and increase of the oclusal vertical dimension on mandibular bone density and the masticatory muscles of wistar rats. Aust J Basic Appl Sci. 2015;7 (13):1-7.
  39. Koca H, Ergün S, Güneri P, Boyacıoglu H. Evaluation of trabecular bone healing by fractal analysis and digital subtraction radiography on digitized panoramic radiographs: a preliminary study. Oral Radiol. 2010;26 (1):1-8.
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