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Multidimensional tooth movement boundaries in the extended aesthetic zone: a cone-beam computed tomography study

Ruoyan Zhang
Ruoyan Zhang
, 
Linyi Li
Linyi Li
, 
Zhiyao Lu
Zhiyao Lu
, 
Zhixin Song
Zhixin Song
, 
Xinyue Fan
Xinyue Fan
, 
Jianing Xu
Jianing Xu
, 
Xu Zhang
Xu Zhang
, 
Zuolin Jin
Zuolin Jin
 e 
Yanning Ma
Yanning Ma
   | 13 mar 2024
Australasian Orthodontic Journal's Cover Image
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Pubblicato online: 13 mar 2024
Pagine: 25 - 36
Ricevuto: 01 nov 2023
Accettato: 01 gen 2024
DOI: https://doi.org/10.2478/aoj-2024-0004
© 2024 Ruoyan Zhang et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1.

The cephalometric measurements used in this study. (1) SNMP; (2) S-Go/N-Me (a/b).
The cephalometric measurements used in this study. (1) SNMP; (2) S-Go/N-Me (a/b).

Figure 2.

(A) Axial plane; (B) Sagittal plane; (C) Coronal plane.
(A) Axial plane; (B) Sagittal plane; (C) Coronal plane.

Figure 3.

(A) Measurements at the apex section of the anterior teeth; (B) A schematic diagram showing measurements in the sagittal plane: (a, b) labial CBT at the 1/3 root section (close to the CEJ); (c, d) lingual CBT at the 1/3 root section (close to the CEJ); (e, f) labial CBT at the 2/3 root section; (g, h) lingual CBT at the 2/3 root section; arc L1: labial CBT at apex section; arc L2: lingual CBT at apex section; h1: lingual ABH; h2: labial ABH. (C) Measurements in the coronal plane. h3: distal ABH; h4: mesial ABH. CBT, cancellous bone thickness; ABH, alveolar bone height.
(A) Measurements at the apex section of the anterior teeth; (B) A schematic diagram showing measurements in the sagittal plane: (a, b) labial CBT at the 1/3 root section (close to the CEJ); (c, d) lingual CBT at the 1/3 root section (close to the CEJ); (e, f) labial CBT at the 2/3 root section; (g, h) lingual CBT at the 2/3 root section; arc L1: labial CBT at apex section; arc L2: lingual CBT at apex section; h1: lingual ABH; h2: labial ABH. (C) Measurements in the coronal plane. h3: distal ABH; h4: mesial ABH. CBT, cancellous bone thickness; ABH, alveolar bone height.

Figure 4.

Distribution of cancellous bone thickness in the maxillary/mandibular alveolar bone. U: upper jaws; L: lower jaws; 1: central incisors; 2: lateral incisors; 3: canine teeth; 4: first premolar teeth; 5: second premolar teeth; LA_1: labial cancellous bone thickness at the 1/3 root section (close to the CEJ) of central incisors; LA_2: labial cancellous bone thickness at the 2/3 root section; LA_3: labial cancellous bone thickness at root apex; LL_1: lingual cancellous bone thickness at the 1/3 root section (close to the CEJ); LL_2: lingual cancellous bone thickness at the 2/3 root section; LL_3: lingual cancellous bone thickness at root apex.
Distribution of cancellous bone thickness in the maxillary/mandibular alveolar bone. U: upper jaws; L: lower jaws; 1: central incisors; 2: lateral incisors; 3: canine teeth; 4: first premolar teeth; 5: second premolar teeth; LA_1: labial cancellous bone thickness at the 1/3 root section (close to the CEJ) of central incisors; LA_2: labial cancellous bone thickness at the 2/3 root section; LA_3: labial cancellous bone thickness at root apex; LL_1: lingual cancellous bone thickness at the 1/3 root section (close to the CEJ); LL_2: lingual cancellous bone thickness at the 2/3 root section; LL_3: lingual cancellous bone thickness at root apex.

Mandibular cancellous alveolar bone thickness after merging the left and right teeth

Labial Lingual
LA_1 LA_2 LA_3 LL_1 LL_2 LL_3
Central incisor 0 (0)* 0 (0.64)* 2.19 (1.1) 0 (0) 0.68 (1.01) 2.22 (1.17)
Lateral incisor 0 (0)* 0 (0)* 2.18 ± 1.84* 0 (0.53) 0.82 (1.16) 2.53 (1.16)
Canine 0 (0)* 0 (0.73)* 2.78 ± 2.20* 0.65 (0.96) 1.4 (1.1) 4.02 ± 2.80
First premolar 0 (0)* 0.38 (0.8)* 2.38 ± 1.97* 0.59 (0.95) 2.18 ± 1.98 4.53 ± 2.77
Second premolar 0 (0.62)* 0.86 (0.53)* 2.71 ± 2.04* 0.93 (0.97) 2.67 ± 2.27 4.79 ± 2.92

Maxillary alveolar bone height after merging the left and right teeth

LA_h LL_h M_h D_h
Central incisor 10.22 ± 3.48* 10.51 ± 3.34 12.59 ± 3.76 12.29 ± 3.57
Lateral incisor 11.04 ± 2.86 10.90 ± 2.98 12.82 ± 3.04 12.15 ± 2.97
Canine 13.78 ± 4.19* 14.48 ± 4.32 16.41 ± 4.16 14.73 ± 3.67
First premolar 10.03 ± 3.59* 10.53 ± 3.52 11.75 ± 3.77 11.51 ± 3.36
Second premolar 10.36 ± 4.01 10.33 ± 4.22 11.68 ± 4.13 10.48 ± 4.39

Mandibular alveolar bone height after merging the left and right teeth

LA_h LL_h M_h D_h
Central incisor 9.72 ± 2.95* 9.34 ± 2.60 10.84 ± 2.44 10.83 ± 2.44
Lateral incisor 10.88 ± 3.42* 10.37 ± 3.41 11.98 ± 2.73 11.65 ± 2.65
Canine 13.18 ± 4.76* 13.68 ± 4.27 15.45 ± 4.25 14.31 ± 4.19
First premolar 12.26 ± 3.87 12.37 ± 3.63 12.88 ± 3.29 12.55 ± 3.30
Second premolar 12.10 ± 4.03 12.11 ± 3.89 12.78 ± 3.93 12.33 ± 3.77

Cancellous bone thickness of the maxilla and mandible of individuals with different vertical skeletal patterns

Alveolar bone thickness
Measurement Hypodivergent Normodivergent P-value
U1LA_3 1.10 (1.61) 0.51 (1.45) 0.031*
U2LA_3 0.93 (1.66) 0.00 (0.89) 0.001*
U3LA_3 1.03 (1.58) 0.00 (0.99) 0.001*
U4LA_3 1.33 (1.22) 0.00 (1.31) 0.000*
U5LA_3 2.73 (1.55) 2.1 (1.49) 0.000*
U1LL_3 6.60±1.91 5.97±1.49 0.047*
U2LL_3 5.66±1.52 5.57±1.50 0.734
U3LL_3 8.62±1.85 7.70±1.76 0.006*
U4LL_3 6.67±2.54 5.57±2.40 0.015*
U5LL_3 7.35±3.15 6.16±2.43 0.021*
L1LA_3 2.32 (1.35) 1.99 (0.91) 0.015*
L2LA_3 2.48±0.98 1.87±0.80 0.000*
L3LA_3 3.17±1.11 2.44±0.97 0.000*
L4LA_3 2.69±1.01 2.10±0.92 0.001*
L5LA_3 2.92±1.23 2.50±0.93 0.028*
L1LL_3 2.48 (1.27) 2.04 (0.98) 0.011*
L2LL_3 2.69 (1.33) 2.44 (1.23) 0.168
L3LL_3 4.07±1.32 4.00±1.56 0.154
L4LL_3 4.53±1.31 4.57±1.41 0.872
L5LL_3 4.67±1.46 4.90±1.50 0.392

Alveolar bone height of the maxilla and mandible of individuals with different vertical skeletal patterns

Alveolar bone height Alveolar bone height
Measurement Hypodivergent Normodivergent P-value Measurement Hypodivergent Normodivergent P-value
U1LA_h 10.49 ± 1.73 9.95 ± 1.84 0.099 L1LA_h 9.88 ± 1.55 9.49 ± 1.41 0.148
U1LL_h 10.64 ± 1.65 10.36 ± 1.76 0.373 L1LL_h 9.41 ± 1.38 9.18 ± 1.21 0.315
U1M_h 12.64 ± 2.11 12.53 ± 1.76 0.741 L1M_h 10.83 ± 1.35 10.80 ± 1.13 0.914
U1D_h 12.43 ± 1.89 12.13 ± 1.78 0.363 L1D_h 10.83 ± 1.30 10.77 ± 1.17 0.772
U2LA_h 11.33 ± 1.41 10.78 ± 1.43 0.035* L2LA_h 11.04 ± 1.53 10.67 ± 1.89 0.228
U2LL_h 11.19 ± 1.56 10.67 ± 1.41 0.059 L2LL_h 10.51 ± 1.70 10.18 ± 1.69 0.297
U2M_h 13.07 ± 1.58 12.65 ± 1.49 0.132 L2M_h 12.03 ± 1.59 11.89 ± 1.11 0.581
U2D_h 12.47 ± 1.57 11.87 ± 1.40 0.028* L2D_h 11.75 ± 1.55 11.52 ± 1.03 0.338
U3LA_h 14.19 ± 2.13 13.35 ± 2.12 0.031* L3LA_h 13.39 ± 2.29 12.97 ± 2.52 0.337
U3LL_h 14.87 ± 2.15 14.05 ± 2.25 0.042* L3LL_h 13.70 ± 2.28 13.65 ± 2.09 0.900
U3M_h 16.70 ± 2.09 16.05 ± 2.15 0.095 L3M_h 15.43 ± 2.13 15.49 ± 2.20 0.891
U3D_h 14.85 ± 1.78 14.53 ± 1.94 0.350 L3D_h 14.26 ± 2.04 14.39 ± 2.17 0.746
U4LA_h 10.23 ± 1.91 9.72 ± 1.71 0.121 L4LA_h 12.31 ± 2.11 12.16 ± 1.79 0.676
U4LL_h 10.47 ± 1.86 10.53 ± 1.75 0.850 L4LL_h 12.60 ± 2.01 12.06 ± 1.63 0.107
U4M_h 11.89 ± 1.81 11.51 ± 2.06 0.279 L4M_h 13.02 ± 1.79 12.63 ± 1.52 0.207
U4D_h 11.69 ± 1.82 11.24 ± 1.61 0.154 L4D_h 12.77 ± 1.74 12.22 ± 1.57 0.067
U5LA_h 10.71 ± 2.02 9.82 ± 1.94 0.015* L5LA_h 12.19 ± 2.29 11.88 ± 1.72 0.404
U5LL_h 10.68 ± 2.12 9.85 ± 2.14 0.034* L5LL_h 12.18 ± 2.10 11.97 ± 1.85 0.564
U5M_h 11.93 ± 2.28 11.29 ± 1.89 0.092 L5M_h 12.77 ± 1.94 12.64 ± 2.05 0.716
U5D_h 10.68 ± 2.53 10.13 ± 1.88 0.176 L5D_h 12.35 ± 1.85 12.22 ± 2.00 0.717

Maxillary cancellous alveolar bone thickness after merging the left and right teeth

Labial Lingual
LA_1 LA_2 LA_3 LL_1 LL_2 LL_3
Central incisor 0 (0)* 0 (0)* 0.93 (1.55)* 1.16 (0.91) 2.99 (1 .43) 6.29 ± 3.36
Lateral incisor 0 (0)* 0 (0)* 0 (1.29)* 0.87 (0.79) 2.53 (1.63) 5.60 ± 2.93
Canine 0 (0)* 0 (0)* 0 (1.38)* 1.4 (1.59) 4.28 ± 3.40 8.15 ± 3.59
First premolar 0 (0.76)* 0 (0.74)* 1.11 (1.55)* 0.70 (1.06) 1.8 (1.46) 6.16 ± 4.90
Second premolar 1.28 (1.08)* 1.38 (0.99)* 2.5 (1.73)* 1.04 (1.26) 2.38 (1.82) 6.85 ± 5.64

Comparison of alveolar bone thickness between two prevalent vertical skeletal patterns in individuals with normal occlusion with existing literature

Region Section Classification n P-value (Labial/Lingual)
Gaffuri[29] Incisors & Canines Apex Normodivergent 10 NS
Hypodivergent 10
Dalaie[17] Central incisors 9mm# Normodivergent \ U: NS / NS
Hypodivergent \ L: Hpo>N* / Hpo<N*
Casanova-Sarmiento[19] Mandibular central incisors Apex Normodivergent 44 Hpo>N***
Hypodivergent 48
Sadek[18] All teeth Apex Normodivergent 17 U2: NS / Hpo>N*
U3: NS / Hpo>N**
Hypodivergent 15 L4: Hpo>N** / NS
else: NS
Li[33] Incisors & canines 5mm# Normodivergent 46 U1: NS / NS
U2: NS / Hpo>N*
U3: NS / Hpo>N*
Hypodivergent 45 L1: Hpo>N* / Hpo>N***
L2: NS / Hpo>N***
L3: NS / Hpo>N**
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