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Evaluation of apical root resorption following extraction therapy in subjects with Class I and Class II malocclusions.

The purpose of this study was to determine the amount of root resorption during orthodontic treatment, and to examine the relationship between tooth movement and apical root resorption. Twenty-seven Class I and 27 Class II patients treated with edgewise mechanics following first premolar extractions were selected. The following measurements were made on the pre- and post-treatment cephalograms: upper central incisor to palatal plane distance, the inclination of upper central incisor to the FH and AP planes, the perpendicular distances from the incisor tip to the AP and PTV planes, and incisor apex to PTV. The amount of apical root resorption of the maxillary central incisors was determined for each patient by subtracting the post-treatment tooth length from the pre-treatment tooth length measured directly on cephalograms. Intra-group differences were evaluated by the Student's t-test and inter-group differences by the Mann-Whitney U-test. For correlations the Pearson correlation coefficient was used. The results show that there was a mean of approximately 1 mm (P < 0.01) of apical root shortening in Class I patients, but in Class II division I subjects the mean root resorption was more than 2 mm (P < 0.001). The inter-group differences were statistically significant. No significant correlations were found between the amount of apical root resorption and tooth inclination, or the duration of active treatment.

Adolescent↗

The effect of tooth position on the image of unerupted canines on panoramic radiographs.

The purpose of this study was to evaluate whether panoramic tomograms, which are routinely used in orthodontic practice, can provide adequate information to localize an impacted canine. The effect of changes in position and inclination of an impacted canine on orthopantomograms was investigated in an experimental set-up. An upper canine was removed from a human skull and replaced in a positioning system, enabling simulated positional variations in impactions. In comparison with the image of a contralateral well-aligned canine, the length of the impacted tooth always decreased or remained unchanged, whereas the tooth width increased or remained unchanged. The angulation of the image was unaffected by varying the position of the impacted canine, but altered when the inclination of the tooth in a sagittal or frontal direction was changed. If there was any transversal shift of the impacted canine on the orthopantomogram, it was always towards the mid-sagittal plane. The curvature of the tooth increased after dorsal inclination and decreased after ventral inclination (in comparison with the contralateral well-aligned canine).

Cephalometry↗

Long-term follow-up of maxillary incisors with severe apical root resorption.

The purpose of the study was to analyse the mobility of teeth with severe orthodontically induced root resorption, at follow-up several years after active treatment, and to evaluate mobility in relation to root length and alveolar bone support. Seventy-three maxillary incisors were examined in 20 patients, 10-15 years after active treatment in 13 patients (age 24-32 years) and 5-10 years after active treatment in seven patients (age 20-25 years). All had worn fixed or removable retainers; seven still had bonded twistflex retainers. Total root length and intra-alveolar root length were measured on intra-oral radiographs. Tooth mobility was assessed clinically according to Miller's Index (0-4) and the Periotest method. Crestal alveolar bone level, periodontal pocket depth, gingival, and plaque indices, occlusal contacts during occlusion and function, and dental wear were recorded. There was a significant correlation (P < 0.05) between tooth mobility, and total root length and intra-alveolar root length. No correlation was found between tooth mobility and retention with twistflex retainers. None of the variables for assessment of periodontal status, occlusion and function were related to total root length or tooth mobility. It is concluded that there is a risk of tooth mobility in a maxillary incisor that undergoes severe root resorption during orthodontic treatment, if the remaining total root length is < or = 9 mm. The risk is less if the remaining root length is > 9 mm. Follow-up of teeth with severe orthodontically induced root resorption is indicated.

Adult↗

Mixed dentition space analysis in a Thai population.

This study produced simple linear regression equations to be used for mixed dentition space analysis for males and females, and sexes pooled in a population living in northeastern Thailand. Measurements of teeth were made to within 0.01 mm on the dental casts of 215 boys and 215 girls (mean age 15.7 years). All dentitions were required to be free of any signs of dental pathology or anomalies. It was found that males had significantly larger teeth than females as represented by summations of mandibular incisor, canine, and premolar widths. ANOVA of regression indicated a close relationship between mandibular incisor summation and corresponding summations of canine and premolars. The low coefficients of determination (r2) of the regressions ranged between 0.29 and 0.42, and were higher for females than males, which might be attributable to the ethnic diversity of the sampled population. The regression equations produced predictions of mesio-distal width summations for maxillary and mandibular canine, and premolar arch segments that were slightly different from other reported Asian studies. Moyers' prediction tables at the 50th percentile were found to under-estimate tooth size summation compared with the present investigation. The predictions from simplified regression equations matched well with those of this study for sexes pooled, and for males and females separately.

Adolescent↗

Effect of rapid maxillary expansion on skeletal, dental, and nasal structures: a postero-anterior cephalometric study.

The purpose of this study was to compare the transverse dimensions of skeletal, dental, and nasal structures of a group of patients with maxillary narrowness before and after rapid maxillary expansion (RME) with an untreated control group using postero-anterior (PA) cephalometric radiographs. The material consisted of PA cephalograms of 25 children with a posterior crossbite (mean age 13 years 4 months), and 25 age- and sex-matched controls (mean age 13 years 11 months). Both groups consisted of 20 females and five males. Thirty-four reference points were digitized using the Dentofacial Planner software program. The 17 variables studied consisted of six skeletal, four dental, and seven intra-nasal linear measurements. Student's t-tests were used to compare the differences between the groups, and the effect of RME on skeletal, dental, and nasal structures. RME produced small, but statistically significant changes in maxillary width, upper and lower molar widths, the width between upper central incisor apices, and intra-nasal width. When compared with previous studies, the changes observed were similar for patients of a similar age group, but less than reported for a younger population. There is some evidence that the pattern of expansion produced by RME will vary depending on the age and maturity of the subject.

Adolescent↗

Relationships among facial type, buccolingual molar inclination, and cortical bone thickness of the mandible.

The purpose of this study was to evaluate the relationships between different facial types, and both the buccolingual molar inclination and cortical bone thickness of the mandible. The material consisted of 31 dry skulls of modern Japanese males from the Museum of the University of Tokyo. They all demonstrated normal occlusion with minimal dental discrepancy, and without crossbite or facial asymmetry. The buccolingual inclination of the second molar (M2) in the long-faced subjects was significantly smaller than the same dimension in the average- and short-faced subjects. It was found that the teeth of long-faced subjects were more lingually inclined than those of the short-faced subjects. The cortical bone thickness of the first molar (M1) and M2 sections was thicker in short-faced subjects than in average- and long-faced subjects. The results of this study provide evidence that a significant, but complex relationship exists between structures of the mandibular body and facial types. The morphological features that relate to masticatory function and facial types are associated with the cortical bone thickness of the mandibular body, and the buccolingual inclination of the first and second molars.

Adolescent↗

Tightness of dental contact points in spaced and non-spaced permanent dentitions.

One of the characteristics of normal occlusion is tight dental contact points (CPs). However, the magnitude and distribution of the tightness of a dental contact point (TDCP) in non-spaced versus spaced dentitions are unknown, as well as the mechanism controlling this arrangement. Two hypotheses were examined: the compression theory, i.e. the teeth touch each other in a compressive state; and the resistance theory, i.e. size and number of roots determine TDCP values. For the study, 60 subjects (27 men, 33 women), mean age 25 +/- 4.3 years, with a complete permanent dentition and no missing teeth were divided into spaced (n = 22) and non-spaced dentitions (n = 38). For each CP, four repeated measurements of peak strain were performed with a one-month interval. No significant differences were found between repeated measurements. All CPs demonstrated a continuous decreased TDCP in the postero-anterior direction. Consequently, in non-spaced dentitions TDCPs between molars were 100 per cent higher than incisors. The five anterior CPs of each jaw demonstrated similar TDCP values. Maxillary TDCPs versus mandibular antagonists were not significant. Mandibular TDCPs were significantly higher in men than in women (14 per cent). Anterior TDCPs were less in spaced than in non-spaced dentitions (55 per cent). Posterior TDCPs were also lower in spaced dentitions, however, to a lesser extent (25 per cent). With the exception of TDCPnon-spaced > TDCPspaced, which is partially explained by the compression theory, most of the findings support the resistance theory regulating TDCP characteristics of the permanent dentition.

Adult↗

Tooth dimensions in hypodontia patients, their unaffected relatives and a control group measured by a new image analysis system.

Tooth dimensions were compared between index patients with severe hypodontia (six or more congenitally missing teeth), their relatives with a full complement of teeth, and a control group. The groups consisted of 12 index cases (seven females and five males), 21 relatives without hypodontia (13 females and eight males), and a control group of 10 males and 10 females with complete dentitions, and no family history of hypodontia. All formed teeth were imaged buccally and occlusally from study models, with a digital camera linked to a computer. The images were acquired and measured using Adobe Photoshop and Image Pro Plus, respectively. Mesiodistal, buccolingual, or occlusogingival area and perimeter measurements were determined from each image. In the index hypodontia group tooth dimensions were significantly smaller (P < 0.001, Bonferroni corrected level) for maxillary and mandibular canines, and first premolars for all dimensions from the buccal view, and for maxillary and mandibular canines and first premolars, maxillary central incisors, maxillary first molars, mandibular lateral incisors, and mandibular second premolars for all dimensions from the occlusal view. In the relatives without hypodontia compared with the control group, mesiodistal dimensions from the buccal view were significantly smaller (P < 0.001) for the central incisors and maxillary first and second premolars, and for the maxillary and mandibular first premolars for all dimensions from the occlusal view. There was a trend for the tooth dimensions of all teeth in the index group to be smaller compared with the control group. The tooth dimensions of the relatives without hypodontia also tended to be smaller than the control group, but were larger than those of the index cases.

Analysis of Variance↗

Maxillary tooth size variation in dentitions with palatal canine displacement.

The association between the presence of palatally displaced maxillary canines (PDC) and other anomalies is well known, particularly with regard to the size and form of the lateral incisor. The present study investigated the connection between the maxillary canine anomaly and the existence of a reduction in the size of the other teeth in the maxilla in 58 consecutively treated patients (37 females, 21 males) aged 11-15 years, and compared these with a control group of 40 consecutively treated subjects (20 males, 20 females) with normally erupted maxillary canines. The findings indicate that the teeth of PDC males are reduced in size and similar to those of PDC females, in sharp contrast to the general population, where males have larger teeth. This is the result of a dimensional reduction in the teeth of PDC males, which was statistically significant for all teeth (P < 0.01) in the bucco-lingual (B-L) dimension, and for the first premolars and first molars in the mesio-distal (M-D) dimension. The sole teeth affected for both sexes were the lateral incisors in their B-L dimension. Bilaterally and unilaterally affected subjects presented differing M-D and B-L tooth dimensions.

Adolescent↗

The effect of changes in tooth position of unerupted canines on cephalograms.

Although many radiographic procedures have been described to localize an impacted canine, they all submit the patient to extra radiation. The purpose of the entire study was to evaluate if the combined interpretation of cephalograms and dental panoramic tomograms (DPTs), which are used in orthodontic practice, can provide adequate information as to the position of impacted canines. In a previous study the radiographic image of impacted canines on DPTs was evaluated. In this investigation, the effect of changes in position and inclination of an impacted canine on cephalograms was studied in an experimental set-up. An upper canine was removed from a human skull and placed in a positioning device to imitate various positions of impaction. Starting from a buccally impacted position, three different displacements were simulated: 10 mm frontally, 10 mm sagittally, and 5 mm vertically. In each of these positions nine different changes in inclination (in the sagittal and the frontal plane) were registered, resulting in 36 different cephalographic exposures. Analysis revealed the following: the degree of vertical and sagittal displacement of the incisal point of the impacted canine, the angulation of the tooth as well as the tooth length, measured on a cephalogram, appeared to give an accurate representation of the experimental set-up. Combining these findings and those from the previous study, it became possible to define a series of points to enable an adequate three-dimensional (3D) estimation of the canine's position. A clinical case of an impacted canine is used as an illustration of this experimental set-up.

Cephalometry↗

Tooth size in dentitions with buccal canine ectopia.

Much interest has been expressed in recent years regarding various features common to dentitions with palatally displaced canines (PDC), particularly in relation to delayed dental development and reduced tooth size. The aims of the present study were to determine whether dentitions with buccally displaced canines (BDC) have features in common, which may be specific for the condition, when compared with PDC dentitions and those with normally erupting canines. Mesiodistal and buccolingual tooth dimensions were determined for 41 subjects with BDC (21 females and 20 males) aged between 11 and 15 years, who formed the experimental sample. The PDC sample was made up of 58 individuals (37 females and 21 males) and the control group comprised 40 age-matched and consecutively treated subjects (20 males and 20 females), exhibiting normally erupted and undisplaced maxillary canines. The results revealed marked sexual dimorphism. Larger-than-average teeth were present in BDC females, whereas the teeth in BDC males were normally sized. Unilaterally affected females had smaller teeth than bilaterally affected females. Tooth size in BDC was consistently larger than in PDC subjects, although the reason was different between the sexes. In females the PDC teeth were normally sized versus large BDC teeth, whereas in the males, the PDC teeth were small and the BDC teeth normal. It is concluded that combining male and female subjects into an overall BDC group obscures important differences that exist between the two sexes.

Adolescent↗

A comparison of mesio-distal crown dimensions of the permanent teeth in subjects with and without fluorosis.

This investigation was undertaken to compare the mesio-distal crown dimensions of the permanent teeth in subjects with and without fluorosis. For this study, 25 pairs of study models cast immediately from alginate impressions of children from each of the two groups were evaluated. Their mean ages were 13.9 +/- 1.6 and 13.9 +/- 1.4 years, respectively. A dental vernier calliper was used to record the maximum mesio-distal dimensions. Analysis of the study models showed that there were no statistically significant differences between the left and right sides (P > 0.05). The results indicated that the mesio-distal crown diameters were consistently larger in the subjects with non-fluorotic permanent teeth. With the exception of the mandibular first premolars, there were no statistically significant differences in the mesio-distal crown diameters of the two groups.

Adolescent↗