Korean J Orthod.  2013 Apr;43(2):83-95. 10.4041/kjod.2013.43.2.83.

Evaluation of alveolar bone loss following rapid maxillary expansion using cone-beam computed tomography

• Baysal A
• Uysal T
• Veli I
• Ozer T
• Karadede I
• Hekimoglu

• KMID: 1975147
• DOI: http://doi.org/10.4041/kjod.2013.43.2.83

Abstract

OBJECTIVE
To evaluate the changes in cortical bone thickness, alveolar bone height, and the incidence of dehiscence and fenestration in the surrounding alveolar bone of posterior teeth after rapid maxillary expansion (RME) treatment using cone-beam computed tomography (CBCT).
METHODS
The CBCT records of 20 subjects (9 boys, mean age: 13.97 +/- 1.17 years; 11 girls, mean age: 13.53 +/- 2.12 year) that underwent RME were selected from the archives. CBCT scans had been taken before (T1) and after (T2) the RME. Moreover, 10 of the subjects had 6-month retention (T3) records. We used the CBCT data to evaluate the buccal and palatal aspects of the canines, first and second premolars, and the first molars at 3 vertical levels. The cortical bone thickness and alveolar bone height at T1 and T2 were evaluated with the paired-samples t-test or the Wilcoxon signed-rank test. Repeated measure ANOVA or the Friedman test was used to evaluate the statistical significance at T1, T2, and T3. Statistical significance was set at p < 0.05.
RESULTS
The buccal cortical bone thickness decreased gradually from baseline to the end of the retention period. After expansion, the buccal alveolar bone height was reduced significantly; however, this change was not statistically significant after the 6-month retention period. During the course of the treatment, the incidence of dehiscence and fenestration increased and decreased, respectively.
CONCLUSIONS
RME may have detrimental effects on the supporting alveolar bone, since the thickness and height of the buccal alveolar bone decreased during the retention period.

Keyword

Rapid maxillary expansion; Cone-beam computed tomography; Periodontium

MeSH Terms

Alveolar Bone Loss
Bicuspid
Cone-Beam Computed Tomography
Incidence
Molar
Palatal Expansion Technique
Periodontium
Retention (Psychology)
Tooth

Figure

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  Figure 1 Buccal cortical bone thickness (BCBT) and palatal cortical bone thickness (PCBT) at the level of the trifurcation of the first molar.

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  Figure 2 Buccal alveolar height (BAH: distance between the cusp tip and the buccal alveolar crest) of the maxillary first molar.

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  Figure 3 The presence of dehiscence at 3 consecutive views. Arrow shows the localization of dehisence.

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  Figure 4 The presence of fenestration at 3 consecutive views. Arrow shows the localization of dehisence.

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  Figure 5 An example of a decrease in the buccal cortical bone thickness of the maxillary right molar.

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  Figure 6 An example of an increase in the buccal alveolar height of the maxillary left molar.

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  Figure 7 An example of treatment changes: the palatal cortical bone thickness increased after active expansion and decreased at the end of retention.

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