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Journal of Peking University(Health Sciences) ›› 2020, Vol. 52 ›› Issue (1): 77-82. doi: 10.19723/j.issn.1671-167X.2020.01.012

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Alveolar crest and relevant analysis of labial side of anterior teeth on skeletal Angle class Ⅲ patients

Ming-xin MAO1,Li XU1,△(),Wu-di JING2,Xiao XU1,Jian-xia HOU1,Xiao-tong LI3,△(),Xiao-xia WANG4   

  1. 1. Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    2. Department of Periodontology, Peking Union Medical College Hospital, Beijing 100032, China
    3. Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China
    4. Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
  • Received:2019-10-10 Online:2020-02-18 Published:2020-02-20
  • Contact: Li XU,Xiao-tong LI E-mail:xulihome@263.net;xiaotonglee@hotmail.com
  • Supported by:
    Supported by the Capital Characteristic Clinical Application Research Project(Z181100001718111)

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Abstract:

Objective: To measure the distance from cemento-enamel junction (CEJ) to alveolar crest (AC) of labial side of anterior teeth on skeletal Angle class Ⅲ patients under direct vision during periodontal bone augmentation surgery and to make relevant analysis to find the relevant factors. Methods: In the study, 46 skeletal Angle class Ⅲ patients (10 males and 36 females) received periodontal bone augmentation surgery of anterior teeth were included, with 67 jaws (27 maxillae and 40 mandibles) and 400 anterior teeth (161 maxillary anterior teeth and 239 mandibular anterior teeth). The mean age was 23.65 years. Maxillary anterior teeth consisted of 54 central incisors, 53 lateral incisors and 54 canines. Mandibular anterior teeth consisted of 79 central incisors, 80 lateral incisors and 80 canines. CEJ-AC was measured in three sites (mesial sites, central sites and distal sites) by Williams periodontal probes during periodontal bone augmentation surgery under direct vision by the same researcher. Results: The average CEJ-AC of 400 anterior teeth was (2.21±1.48) mm. The average CEJ-AC of maxillary anterior teeth was (1.72±1.13) mm, more than (2.54±1.60) mm of mandibular anterior teeth (P<0.05). The average CEJ-AC of canines was (2.42±1.78) mm, more than (2.06±1.27) mm of central incisors or (2.16±1.32) mm of lateral incisors (P<0.05). The average CEJ-AC of central sites was (3.04±2.01) mm, more than (1.79±0.86) mm of mesial sites or (1.81±0.89) mm of distal sites (P<0.05). CEJ-AC of 233 anterior teeth was more than 2 mm, accounting for 58.25%, and 117 anterior teeth with dehiscence were found, accounting for 29.25%. Multilevel and multivariate Logistic regression showed age, jaw, tooth and site were the relevant factors to the position of alveolar crest. Conclusion: The position of alveolar crest of skeletal Angle class Ⅲ patients who received periodontal bone augmentation surgery was lower than that of the general population, causing periodontal risks during decompensation orthodontics therapy before orthognathic surgery. The position of alveolar crest was lower in older patients than in younger patients, in mandibular teeth than in maxillary teeth, in canines than in central incisors or lateral incisors, and in central sites than in mesial sites or distal sites of labial side, which showed much higher risk.

Key words: Malocclusion, Angle class Ⅲ, Cemento-enamel junction, Alveolar crest

CLC Number: 

  • R781.4

Figure 1

Measuring CEJ-AC during periodontal surgery (A, mesial; B, central; C, distal)"

Table 1

Distribution of teeth of skeletal class Ⅲ patients"

Teeth Central incisors Lateral incisors Canines Total
Maxillary 54 53 54 161
Mandible 79 80 80 239
Total 133 133 134 400

Table 2

Results of CEJ-AC and comparison between maxillary and mandibular anterior teeth"

Items Maxillary/mm, x?±s Mandibular/mm, x?±s
Central incisors Lateral incisors Canines Central incisors Lateral incisors Canines
Mesial 1.33±0.64 1.51±0.59 1.60±0.72 1.94±0.91 1.95±0.91 2.08±0.96
Central 1.86±0.92 2.18±1.63 2.45±2.10 3.29±1.79 3.36±1.75 4.22±2.38
Distal 1.47±0.66 1.49±0.56 1.56±0.70 1.96±0.92 2.02±0.75 2.05±1.19
Average 1.72±1.13 2.54±1.60*

Figure 2

Comparison of CEJ-AC between different teeth CEJ-AC, the distance between cemento-enamal junction and alveolar crest. * P<0.05, vs. canines."

Figure 3

Comparison of CEJ-AC between different sites CEJ-AC, the distance between cemento-enamal junction and alveolar crest. * P<0.001, vs. central."

Table 3

Comparison of CEJ-AC of central sites between different jaws and different teeth /mm"

Items Central incisors Lateral incisors Canines Average
Maxillary 1.86±0.92 2.18±1.63 2.45±2.10 2.16±1.63
Mandibular 3.29±1.79 3.36±1.75 4.22±2.38 3.63±2.03
Average 2.71±1.66 2.89±1.79 3.51±2.42 3.04±2.01

Table 4

Distribution of teeth with CEJ-AC>2 mm and teeth with dehiscences"

Items Central incisors Lateral incisors Canines Total
CEJ-AC>2 mm Dehiscences CEJ-AC>2 mm Dehiscences CEJ-AC>2 mm Dehiscences CEJ-AC>2 mm Dehiscences
Maxillary 13 (24.07) 4 (7.41) 17 (32.08) 4 (7.55) 23 (42.59) 9 (16.67) 53 (32.92) 17 (10.56)
Mandibular 58 (73.42) 31 (39.24) 56 (70.00) 28 (35.00) 66 (82.50) 41 (51.25) 180 (75.31) 100 (41.84)
Total 71 (53.38) 35 (26.32) 73 (54.89) 32 (24.06) 89 (66.42) 50 (37.31) 233 (58.25) 117 (29.25)

Table 5

The multilevel and multivariate Logistic regression for relevant factors of position of alveolar crest"

Relevant factors Estimate OR (95%CI) P
Patient level
Gender (Female as reference) -0.143 0.867 (0.658, 1.142) 0.310
Age 0.131 1.140 (1.113, 1.168) <0.001
Body mass index(BMI) 0.030 1.030 (0.983, 1.080) 0.210
Jaw level (Mandible as reference) -1.470 0.230 (0.184, 0.287) <0.001
Tooth level (Canine as reference)
Central incisor -0.516 0.597 (0.463, 0.770) <0.001
Lateral incisor -0.282 0.754 (0.587, 0.969) 0.028
Site level (Distal site as reference)
Mesial site -0.055 0.946 (0.735, 1.219) 0.668
Central site 1.562 4.768 (0.658, 1.142) <0.001
Probing depth -0.154 0.857 (0.706, 0.961) 0.119
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