Three-dimensional evaluation of root position at the reset appointment without radiographs: a proof-of-concept study

BackgroundAccurate root position is integral for successful orthodontic treatment. Current methods of monitoring root position are either inaccurate, exhibit poor resolution, or use relatively large amount of radiation relative to the benefits for the patient. The purpose of this study was to present an approach that can monitor root position during orthodontic treatment with minimal radiation.MethodsCone-beam computed tomography (CBCT) scans were taken for a patient at pre-treatment and at a dedicated reset appointment. An extra-oral laser scan of a poured up cast was taken at the reset appointment. An expected root position (ERP) setup, an approximation of the root position at the reset appointment, was generated using the pre-treatment CBCT scan and reset appointment cast. The ERP setup was compared to the CBCT scan taken at the reset appointment which served as the control. Color displacement maps were generated to measure any differences between the expected and true root positions.ResultsColor map displacement analysis after indirect superimposition found displacement differences of 0.021 mm ± 0.396 mm for the maxillary roots and 0.079 mm ± 0.499 mm for the mandibular roots.ConclusionsThis approach was demonstrated in a patient at the reset appointment to have the potential to accurately monitor root positions during treatment in three dimensions without the need for additional radiographs.

[1]  J. Waerhaug Eruption of teeth into crowded position, loss of attachment, and downgrowth of subgingival plaque. , 1980, American journal of orthodontics.

[2]  A. Johal,et al.  Near-end of treatment panoramic radiograph in the assessment of mesiodistal root angulation. , 2008, The Angle orthodontist.

[3]  L. Andrews The six keys to normal occlusion. , 1972, American journal of orthodontics.

[4]  E L Gottlieb,et al.  1996 JCO Study of Orthodontic Diagnosis and Treatment Procedures. Part 1. Results and trends. , 1996, Journal of clinical orthodontics : JCO.

[5]  David C Hatcher,et al.  Operational principles for cone-beam computed tomography. , 2010, Journal of the American Dental Association.

[6]  S. E. Owens,et al.  Objective grading system for dental casts and panoramic radiographs. American Board of Orthodontics. , 1998, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[7]  Sharon L. Brooks,et al.  CBCT Dosimetry: Orthodontic Considerations , 2009 .

[8]  Sunny Young Hutchinson Cone beam computed tomography panoramic images vs. traditional panoramic radiographs , 2005 .

[9]  D Bowman,et al.  Variations in bracket placement in the preadjusted orthodontic appliance. , 1992, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[10]  C. Lascala,et al.  Analysis of the accuracy of linear measurements obtained by cone beam computed tomography (CBCT-NewTom). , 2004, Dento maxillo facial radiology.

[11]  G. van Belle,et al.  A longitudinal study comparing apically repositioned flaps, with and without osseous surgery. , 1985, The International journal of periodontics & restorative dentistry.

[12]  Paul Seelbach,et al.  Accuracy of digital and conventional impression techniques and workflow , 2012, Clinical Oral Investigations.

[13]  P L Sadowsky,et al.  Variability in three morphologic features of the permanent maxillary central incisor. , 1984, American journal of orthodontics.

[14]  E Johnson,et al.  Bracket positioning and resets: five steps to align crowns and roots consistently. , 2001, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[15]  M. A. van 't Hof,et al.  Classification, reproducibility and prevalence of root proximity in periodontal patients. , 2005, Journal of clinical periodontology.

[16]  Paul W Major,et al.  Accuracy of mesiodistal root angulation projected by cone-beam computed tomographic panoramic-like images. , 2010, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[17]  A. Rönnerman,et al.  Crown-root angles of upper central incisors. , 1973, American journal of orthodontics.

[18]  S. Brooks,et al.  Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT. , 2006, Dento maxillo facial radiology.

[19]  Anoop Sondhi,et al.  The implications of bracket selection and bracket placement on finishing details , 2003 .

[20]  HyeRan Choo,et al.  Practical applications of cone-beam computed tomography in orthodontics. , 2010, Journal of the American Dental Association.

[21]  D. Naidu,et al.  Validity, reliability, and reproducibility of the iOC intraoral scanner: a comparison of tooth widths and Bolton ratios. , 2013, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[22]  A. Weissheimer,et al.  Monitoring of typodont root movement via crown superimposition of single cone-beam computed tomography and consecutive intraoral scans. , 2014, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[23]  A. Mehl,et al.  Full arch scans: conventional versus digital impressions--an in-vitro study. , 2011, International journal of computerized dentistry.

[24]  B. F. Dewel Clinical observations on the axial inclination of teeth. , 1949, American journal of orthodontics.

[25]  A. Militi,et al.  Low-dose protocol of the spiral CT in orthodontics: comparative evaluation of entrance skin dose with traditional X-ray techniques , 2013, Progress in orthodontics.

[26]  M. Nevins Interproximal periodontal disease - the embrasure as an etiologic factor. , 1982, The International journal of periodontics & restorative dentistry.

[27]  B. Klassman,et al.  Treatment of a periodontal defect resulting from improper tooth alignment and local factors. , 1969, The Journal of Periodontology.

[28]  Manuel O Lagravère,et al.  Three-dimensional accuracy of measurements made with software on cone-beam computed tomography images. , 2008, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[29]  Ulrich Wolf,et al.  Cone-beam computed tomography for routine orthodontic treatment planning: a radiation dose evaluation. , 2008, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[30]  B Melsen,et al.  Effect of variation in tooth morphology and bracket position on first and third order correction with preadjusted appliances. , 1999, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[31]  Robert J. Lee,et al.  Three-dimensional monitoring of root movement during orthodontic treatment. , 2015, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[32]  M. Akiyoshi,et al.  Marginal periodontitis: a histological study of the incipient stage. , 1967, Journal of periodontology.

[33]  P. Major,et al.  Effect of buccolingual root angulation on the mesiodistal angulation shown on panoramic radiographs. , 2008, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[34]  M. A. van 't Hof,et al.  Root proximity as a risk marker for periodontal disease: a case-control study. , 2005, Journal of clinical periodontology.

[35]  R J Isaacson,et al.  Three biologic variables modifying faciolingual tooth angulation by straight-wire appliances. , 1989, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[36]  Robert G Keim,et al.  2008 JCO study of orthodontic diagnosis and treatment procedures, part 1: results and trends. , 2008, Journal of clinical orthodontics : JCO.

[37]  B. Orban,et al.  The Crests of the Interdental Alveolar Septa , 1953 .

[38]  P. Major,et al.  The effect of vertical and horizontal head positioning in panoramic radiography on mesiodistal tooth angulations. , 2009, The Angle orthodontist.

[39]  A Ender,et al.  Influence of scanning strategies on the accuracy of digital intraoral scanning systems. , 2013, International journal of computerized dentistry.

[40]  R R Miethke,et al.  Zahnbewegungen dritter ordnung bei straight-wire-apparaturen , 1997, Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie.

[41]  Tabea V Flügge,et al.  Precision of intraoral digital dental impressions with iTero and extraoral digitization with the iTero and a model scanner. , 2013, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.