Effects of relapse forces on periodontal status of mandibular incisors following orthognathic surgery.
ABSTRACT In this case-control study, the relationship between the relapse forces and periodontal changes in the mandibular incisor region were investigated following orthognathic surgery.
Mucogingival and alveolar changes in 36 subjects with mandibular prognathism were analyzed by clinical and roentgenographic methods just before mandibular setback surgery and 7.4 months postoperatively. The results were compared to two control groups: 36 subjects with no orthodontic history and 33 orthodontic patients. The mean age of the 105 subjects was 20.21 years.
The intergroup comparisons showed significant differences in all parameters, except for the plaque index and alveolar height measurements. By an incisor proclination of 3.3 mm and a tipping of +8.5 degrees (postoperative relapse: 0.8 mm and 0.14 degrees ), the surgery group revealed significant changes in single parameters of both alveolar height and sulcus depth measurements.
Compared to both control groups, the preoperative periodontal condition of the surgery patients was less acceptable than in the orthodontically treated patients, whereas subjects without braces presented the most ideal hygienic conditions. In the short term, the decompensation process prior to mandibular setback surgery did not affect periodontal structures significantly, and the current study did not find any negative effects of early postoperative relapse forces on the mandibular incisor area.
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ABSTRACT: The mandible of a deceased 19-year-old young woman who had been treated with an edgewise appliance was removed during autopsy. The overall tooth movements during the 19 months of treatment were reconstructed (treatment documents) and compared with the macroscopic, radiologic, and micromorphologic findings of the incisor/alveolar bone/symphysis complex of the dry mandible. The initial lateral cephalogram revealed an extremely narrow and high symphysis, with an incisor position straight above the thin bone. During treatment, the incisors had been moved to lingual (lingual root torque) and derotated. Morphologic evaluation of the dry mandible revealed lingual (oral) aspects of the roots reaching some millimeters out of the lingual alveolar bone and largely without cortical plate covering. Lateral dental contact radiographs of any bone/incisor segment showed the sagittal alveolar bone width to be smaller than the labiolingual (orobuccal) diameter of the incisor roots. A comparison of the approximate pretherapeutic alveolar bone height, which was assessed by measuring the distance from the cementoenamel junction to the most coronal margin of any root resorption in scanning electron microscopy, with that of the specimen showed a calculated bone loss on the lingual aspect extending from 2.3 to 6.9 mm. On the labial (buccal) aspect, bone loss was far less pronounced. These results suggest that in the case of a narrow and high symphysis, pronounced sagittal incisor movements and derotation during routine orthodontic treatment with a fixed appliance may be critical and lead to progressive bone loss of lingual and labial cortical plates.American Journal of Orthodontics and Dentofacial Orthopedics 10/1996; 110(3):239-46. · 1.46 Impact Factor
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ABSTRACT: In this study population the following observations have been made: Periodontal destruction, gingival inflammation and mobility were not significantly related to axial inclination of the incisor teeth. Labial gingival recession of the mandibular incisor was related to linguoversion (less than 85 degrees to GoGn). No other associations between incisor inclination and labial or lingual recession were found. Age was not related to either maxillary or mandibular incisor inclination. The periodontal-incisor inclination relationships reported above for periodontal destruction and gingival inflammation were not altered by the factor of age. Study of the secondary influence of incisor inclination on the relationships of selected occlusal factors and periodontal pathosis showed: A. Severe overjet (more than 6mm) had been found to be associated with more periodontal destruction. With severe overjet maxillary incisors in linguoversion (less than 100 degrees to SN) were somewhat healthier than all others. Among the same cases of severe overjet mandibular incisors in labioversion had slightly more disease than all others. B. The absence of a significant correlation between anterior overbite or crowding reported previously was not influenced by incisor inclination. C. Facial alveolar bone thickness, observed clinically, was studied for its relation to periodontal destruction and gingival inflammation. Thick facial alveolar bone was found to be associated with increased pathosis. This finding was not consistent for the maxillary and mandibular incisor and the influence of other factors might be suspected: Incisor inclination had no effect on the bone thickness-periodontal disease findings.The Angle Orthodontist 05/1976; 46(2):99-110. · 1.18 Impact Factor
- The European Journal of Orthodontics 06/1982; 4(2):77-86. · 1.08 Impact Factor