Overall Orthodontic Treatment Changes in Bone Mineral Density Distribution of Maxilla and Mandibular Alveolar Bone Assessed Using Dual-energy X-ray Absorptiometry: A Prospective Study.

Abstract

Aim: To investigate alterations in alveolar bone mineral density (BMD) following comprehensive orthodontic treatment in both arches using dual-energy X-ray absorptiometry (DEXA).

Materials and methods: Thirty subjects receiving fixed orthodontic therapy and aged between 18 and 35 years were included in the study. Bone mineral density measurements were obtained in both the arches before treatment and immediately after the active treatment completion in the maxillary anterior region, the maxillary posterior region, the mandibular anterior region, and the mandibular posterior region of interest (ROI). Statistical analyses included paired t-tests and one-way analysis of variance (ANOVA).

Results: The study demonstrated a significant reduction in alveolar BMD from pretreatment (T0) to posttreatment (T1) across all regions, with mean values decreasing from 0.92 to 0.78 gm/cm² in the maxillary anterior, 0.98 to 0.86 gm/cm² in the maxillary posterior, 1.05 to 0.96 gm/cm² in the mandibular anterior, and 1.12 to 1.04 gm/cm² in the mandibular posterior region. The greatest reduction was observed in the maxillary anterior region (0.14 gm/cm²; 15.2%), followed by the maxillary posterior region (0.12 gm/cm²; 12.2%), while smaller decreases were seen in the mandibular anterior (0.09 gm/cm²; 8.6%) and mandibular posterior (0.08 gm/cm²; 7.1%) regions.

Conclusion: In conclusion, comprehensive orthodontic treatment resulted in significant, region-specific reductions in alveolar BMD, with greater changes in the maxillary arch and anterior regions. These findings reflect physiological bone remodeling associated with orthodontic tooth movement. Dual-energy X-ray absorptiometry is a reliable, non-invasive method for assessing these changes.

Clinical significance: Orthodontic treatment induces measurable changes in alveolar BMD. Bone remodeling appears to be more pronounced in the maxillary and anterior regions. A temporary reduction in bone density should be considered when designing retention protocols. Dual-energy X-ray absorptiometry provides a reliable and minimally invasive method for monitoring skeletal changes.