Dentoalveolar process remodelling in the anterior mandible after Class III camouflage treatment with lower premolar extractions.

Abstract

Background: The aim of this investigation was to evaluate if the hard and soft tissue dentoalveolar process of the mandible follows the tooth movements after lower premolar extractions and anterior retraction in Class III camouflage treatment.

Methods: This retrospective study included 25 patients in retention (f/m 12,13) who had previously been treated with lower premolar extractions for Class III camouflage with a completely customized lingual appliance (Wits at T0 -6.7, ± 2.5 mm). The periodontal and dental health of the lower 6 anterior teeth was evaluated (T1) by a thermal sensitivity test, probing and visual inspection after a mean retention period of 3.1 years (± 2.5, min/max 1.0/9.6 years). A novel non-invasive method was used to measure the thickness of the hard and soft tissue dentoalveolar process on the labial and lingual side of the teeth before treatment (T0) and in retention (T1) at 3 different levels using superimposed intraoral scans. A paired t-test with α = 5% was used to evaluate differences between the endpoints.

Results: At T1, all 25 patients (mean age 26.8 ± 9.7 years, min/max 16.3/49.5 years) presented uncompromised periodontal and dental situations in the lower anterior segment. The presented digital method for evaluating dimensional changes of the dentoalveolar process had excellent reliability (ICC) with a method error of 0.01 mm. The mean total labio-lingual dimension of the hard and soft tissue dentoalveolar process (min/max 7.89/10.02 mm at T0) was identical at T0 and T1 (mean change of 0.00 ± 0.33 mm, min/max -0.98/0.8 mm). At all levels, the teeth moved only 0.12 mm to the lingual side within the dentoalveolar process and therefore, they moved with the dentoalveolar process and not through it.

Conclusion: In non-surgical camouflage treatment with lower premolar extractions in moderate to severe Class III malocclusions, the dentoalveolar process can follow the movement of the mandibular incisors and canines during controlled retraction without any adverse effects.