Cone beam computed tomography evaluations of marginal alveolar bone before and after orthodontic treatment combined with premolar extractions

Using cone beam computed tomography (CBCT) we investigated the distance between the cementoenamel junction (CEJ) and the marginal bone crest (MBC) at buccal, lingual, mesial, and distal surfaces of incisors to first molars in adolescents before (baseline) and after extractive orthodontic treatment (study end point). Patients with Class I malocclusion, crowding and an overjet of =5mm were examined with a CBCT unit using a 60x60-mm field of view and a 0.125-mm voxel size. Large differences in marginal bone height were found at baseline, particularly between tooth surfaces. There was a slight correlation between age and CEJMBC distance. From baseline to the study end point, large bone-height changes among teeth and tooth surfaces could be seen. Lingual surfaces, followed by buccal surfaces, showed the largest changes. Eighty-four per cent of lingual surfaces of mandibular central incisors exhibited a bone-height decrease of >2 similar to mm. The bone-height decrease was larger at lingual surfaces in the mandible than in the maxilla, and larger in girls (mean=1.8mm) than in boys (mean=1.5mm). Fewer than 1% of proximal surfaces exhibited changes of >2mm. It is unknown whether the changes in marginal bone height are transitory. A high-quality CBCT technique may help to determine this by providing a deeper insight into the long-term side effects of orthodontic treatment.