,正畸正颌治疗,锥形束CT,牙根吸收," /> ,正畸正颌治疗,锥形束CT,牙根吸收,"/> Evaluation of root resorption after surgical orthodontic treatment of skeletal Class Ⅲ malocclusion by three-dimensional volumetric measurement with cone-beam CT
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Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (4): 719-726. doi: 10.19723/j.issn.1671-167X.2022.04.022

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Evaluation of root resorption after surgical orthodontic treatment of skeletal Class Ⅲ malocclusion by three-dimensional volumetric measurement with cone-beam CT

Juan GAO1,2,Hang-miao LV1,Hui-min MA1,Yi-jiao ZHAO3,Xiao-tong LI1,*()   

  1. 1. Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
    2. Department of Orthodontics, Guiyang Stomatological Hospital, Guiyang 550002, China
    3. Digital Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing 100081, China
  • Received:2021-05-12 Online:2022-08-18 Published:2022-08-11
  • Contact: Xiao-tong LI E-mail:xiaotonglee@hotmail.com
  • Supported by:
    the New Technology and New Therapy Fund of Peking University Stomatology Hospital(PKUSSNCT-19B04);the National Multi-disciplinary Collaborative Diagnosis and Treatment Capacity Building Project for Major Diseases(PKUSSNMP-201902);the Guiyang Science and Technology Project([2019]9-7-9)

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Abstract:

Objective: To explore the method of measuring root volume with cone-beam computed tomography (CBCT) three-dimensional reconstruction technology, and to study root length and root volume of upper and lower central incisors in patients with skeletal Class Ⅲ malocclusion treated by surgical orthodontic treatment. Methods: Twenty patients with skeletal Class Ⅲ malocclusion undergoing surgical orthodontic treatment were selected. CBCT data at three time points, before decompensation treatment (T0), after decompensation treatment (before orthognathic surgery, T1), and the end of post-operative orthodontic treatment (T2) were collected. Three-dimensional reconstruction technology was used to measure the root length and root volume of the upper and lower central incisors (including total root volume, cervical root and apical root), calculate the percentage of reduction volume, and measure the distance of tooth movement after orthodontic treatment. Data were statistically analyzed by SPSS 20.0 software. Least significant difference (LSD) method was used for pair comparison between the groups subject to normal distribution, and non-parametric test was used for comparison between the groups not subject to normal distribution. The differences of root length and root volume of upper and lower incisors were compared, and the characteristics of root absorption were analyzed. Results: Root length and root volume of the upper and lower central incisors were reduced during the surgical orthodontic treatment (P < 0.05) in cases. Both the root volume of cervical root and apical root were significantly reduced (P < 0.05), the reduction of apical root was more significant. The percentage of root volume reduction of the upper central incisor was (30.51±23.23)%, and lower central incisor (23.24±11.96)%. Compared with the upper central incisor, the root volume reduction amount and percentage of the lower central incisor were smaller, and apical root volume reduction of the upper central incisor was greater than that of the lower central incisor, which was statistically significant (P < 0.05). During pre-surgical orthodontic treatment, maxillary central incisor palatal moving was in a controlled tipping manner, and the mandibular central incisor tipped labially. Conclusion: In patients with skeletal Class Ⅲ malocclusion, root length and total root volume of upper and lower central incisors decreased during surgical orthodontic treatment. Root volume measurement indicated that the cervical root also had root resorption. The difference in root resorption of the upper and lower central incisors might be related to the distance and direction of teeth movement. CBCT three-dimensional reconstruction will compensate for the limitation of root length measurement in evaluating root resorption.

Key words: Skeletal Class Ⅲ malocclusion, Surgical orthodontic treatment, Cone-beam computed tomography, Tooth root resorption

CLC Number: 

  • R783.5

Figure 1

Schematic diagram of 3D reconstruction of upper and under anterior teeth"

Figure 2

Mimics software modeling, virtual segmentation and measurement A, modeling of upper and lower anterior teeth; B, volume measurement; C, schematic diagram of virtual root segmentation."

Figure 3

Measurement of root length in two dimensions A, the lowest point of labial enamel cementum boundary; B, the lowest point of lingual enamel cementum boundary; C, the midpoint of A and B lines; D, the apical point. C and D lines are the root length."

Table 1

Changes of root volume and length of upper and under central incisors in patients with skeletal Class Ⅲ malocclusion during orthodontic combined orthodontic treatment"

Change parts T0, $\bar x \pm s$ T1, $\bar x \pm s$ T2, $\bar x \pm s$ P Comparison among groups
Upper central incisor
    Root length/mm 10.47±2.13 9.41±2.36 8.95±2.37 < 0.001 T0>T1>T2
    Total root volume/mm3 156.90±31.77 145.29±31.49 135.16±31.46 < 0.001 T0>T1>T2
    Root apical volume/mm3 62.55±21.74 53.13±22.47 46.88±21.96 < 0.001 T0>T1>T2
    Root cervical volume/mm3 94.34±15.16 92.15±15.83 88.27±15.41 0.001 (T0, T1)>T2
Under central incisor
    Root length/mm 10.97±0.91 10.16±0.93 9.72±0.86 < 0.001 T0>T1>T2
    Total root volume/mm3 98.07±15.18 89.04±17.10 82.69±16.37 < 0.001 T0>T1>T2
    Root apical volume/mm3 43.71±8.95 37.72±9.28 33.72±9.25 < 0.001 T0>T1>T2
    Root cervical volume/mm3 54.35±8.28 51.32±10.27 48.96±9.05 < 0.001 (T0, T1)>(T1, T2)

Table 2

Difference of root volume and root length reduction and percentage of upper and under central incisors after orthodontic combined orthodontic treatment (T2-T0) in patients with skeletal Class Ⅲ malocclusion"

Items Upper central incisor, $\bar x \pm s$ Under central incisor, $\bar x \pm s$ P
Root length/mm 1.51±1.34 1.24±0.70 0.41
Total root volume/mm3 21.73±13.81 15.38±7.78 0.08
Root apical volume/mm3 15.66±9.63 9.99±5.54 0.04
Root cervical volume/mm3 6.07±7.06 5.39±4.54 0.69
Percentage of root length/% 14.86±12.39 11.21±5.94 0.24
Volume percentage of total root/% 13.96±8.44 15.93±8.15 0.39
Volume percentage of root apical/% 30.51±23.23 23.24±11.96 0.15
Volume percentage of root neck/% 6.37±7.55 10.03±8.52 0.11

Table 3

Comparison of volume reduction and percentage of root neck and root body of upper and under central incisors after combined orthodontic treatment (T2-T0) in patients with skeletal Class Ⅲ malocclusion"

Items Root neck, $\bar x \pm s$ Root body, $\bar x \pm s$ P
Upper central incisor
    Volume change/mm3 6.07±7.06 15.66±9.63 < 0.001
    Volume reduction percentage/% 6.37±7.54 30.51±23.23 < 0.001
Under central incisor
    Volume change/mm3 5.39±4.53 9.99±5.54 0.005
    Volume reduction percentage/% 10.02±8.51 23.23±11.96 < 0.001

Table 4

Comparison of tooth movement of upper and under central incisors before and after orthodontic combined orthodontic treatment in patients with skeletal Class Ⅲ malocclusion"

Items T0, $\bar x \pm s$ T1, $\bar x \pm s$ T1′, $\bar x \pm s$ T2, $\bar x \pm s$ ΔT1-T0, $\bar x \pm s$ ΔT2-T1′, $\bar x \pm s$ P1 (T1-T0) P2 (T2-T1)
Upper central incisor
    S-edge/mm 70.43±5.72 66.51±5.63 64.24±6.09 65.66±5.58 -3.92±1.78 1.42±2.73 < 0.001 0.048
    V-edge/mm 76.14±3.72 77.26±3.54 75.24±3.67 74.11±3.21 1.12±1.63 -1.13±2.25 0.012 0.055
    S-root/mm 57.75±5.54 56.31±6.00 57.55±4.79 56.82±4.77 -1.44±1.63 -0.73±1.42 0.002 0.050
    V-root/mm 57.17±4.04 57.84±3.79 56.12±4.13 56.36±3.78 0.67±1.14 0.24±1.57 0.027 0.537
Under central incisor
    S-edge/mm 71.44±7.72 74.61±8.45 61.81±6.17 62.49±5.67 3.16±1.97 1.06±2.79 < 0.001 0.151
    V-edge/mm 77.16±5.07 78.06±4.49 74.36±3.84 72.25±3.54 0.89±1.82 -2.30±2.63 0.070 0.003
    S-root/mm 64.79±8.09 64.42±9.03 53.18±6.33 54.57±5.81 -0.37±2.05 1.91±3.68 0.485 0.056
    V-root/mm 96.76±4.02 95.55±3.95 91.32±3.70 89.55±3.82 -1.22±1.60 -1.84±2.31 0.011 0.006
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