Abstract
Objective
The objective of this study was to determine whether there are differences among the arch forms created from assessments of tooth surfaces, alveolar bone, and overlying soft tissue.
Materials and methods
This study included 18 individuals who presented with a class I malocclusion, mild crowding, and a cone beam computed tomography (CBCT) image of good diagnostic quality. The facial axis point was chosen to create the arch form from teeth, the Bowman–Kau (BK) point was used to establish the arch form from alveolar bone, and the WALA ridge was used to calculate the soft tissue arch form. A predetermined algorithm was then used to create five separate arch forms per patient. These arch forms were categorized according to shape and were superimposed. The distances between the tooth-, bone-, and soft tissue-derived arch forms were calculated.
Results
The calculated distances between all arch forms were significantly different. The distances between the tooth- and bone-derived arch forms were larger for the mandible compared to the maxilla (mean 3.30 vs. 2.48 mm, respectively). The larger distances seemed to be located more posteriorly in the arch than anteriorly. The distance between tooth- and soft tissue-derived arch forms was largest for the second premolar (2.35 ± 1.59 mm), first molar (2.86 ± 0.63 mm), and second molar (3.25 ± 0.87 mm). There were no significant differences in the distance between the tooth- and either bone- or soft tissue-derived arch forms with regard to sex.
Conclusions
The arch form shapes obtained from the teeth, alveolar bone, and soft tissue are correlated and show the same general shape. Although future large-scale studies are needed for confirmation, our results suggest that evaluating the easily visualized external features, including the WALA ridge, can adequately predict the underlying bone shape, and thus the desired arch form. Nevertheless, the shapes vary significantly between patients, so the final treatment plan should be individualized rather than relying on over-simplified general wire shapes.
Zusammenfassung
Zielsetzung
Ziel dieser Studie war es, festzustellen, ob es Unterschiede zwischen den Zahnbogenformen gibt, die sich aus der Beurteilung der Zahnoberflächen, des Alveolarknochens und des darüber liegenden Weichgewebes ergeben.
Materialien und Methoden
An der Studie nahmen 18 Patienten teil, die sich mit einer Klasse-I-Malokklusion, leichtem Engstand und einer CBCT(digitale Volumentomographie)-Aufnahme von guter diagnostischer Qualität vorstellten. Der faziale Achsenpunkt wurde gewählt, um die Bogenform aus den Zähnen zu erstellen, der BK(Bowman-Kau)-Punkt wurde verwendet, um die Bogenform aus dem Alveolarknochen zu bestimmen, und der WALA-Kamm, um die Bogenform aus dem Weichgewebe zu berechnen. Anhand eines vorgegebenen Algorithmus wurden dann fünf separate Bogenformen pro Patient erstellt, nach ihrer Form kategorisiert und überlagert. Die Abstände zwischen den aus den Zähnen, dem Knochen und dem Weichgewebe abgeleiteten Bogenformen wurden berechnet.
Ergebnisse
Die berechneten Abstände zwischen allen Bogenformen waren signifikant unterschiedlich. Die Abstände zwischen den zahn- und knochenabgeleiteten Bogenformen waren für den Unterkiefer größer als für den Oberkiefer (Mittelwert 3,30 vs. 2,48 mm). Die größeren Abstände schienen sich eher posterior im Bogen zu befinden als anterior. Der Abstand zwischen zahn- und weichgewebeabgeleiteten Bogenformen war am größten für den zweiten Prämolaren (2,35 ± 1,59 mm), den ersten Molaren (2,86 ± 0,63 mm) und den zweiten Molaren (3,25 ± 0,87 mm). Es gab keine signifikanten Unterschiede im Abstand zwischen den zahn- und knochen- bzw. weichgewebebasierten Bogenformen in Bezug auf das Geschlecht.
Schlussfolgerungen
Die aus den Zähnen, dem Alveolarknochen und dem Weichgewebe gewonnenen Bogenformen sind korreliert und zeigen insgesamt grundsätzlich die gleiche Form. Obwohl zukünftige groß angelegte Studien zur Bestätigung erforderlich sind, deuten unsere Ergebnisse darauf hin, dass die Auswertung der leicht zu visualisierenden äußeren Merkmale, einschließlich des WALA-Kamms, die zugrunde liegende Knochenform und damit die gewünschte Bogenform adäquat vorhersagen kann. Da die Formen jedoch zwischen den Patienten erheblich variieren, sollte der endgültige Behandlungsplan individualisiert werden, statt sich auf vereinfachte generelle Drahtformen zu verlassen.
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Acknowledgements
We thank Dr. Kathlyn Bowman and Dr. Philip Pan for their work on the KB point.
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R. O’Neil and C.H. Kau declare that they have no competing interests.
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Ethics approval was granted by the Institution Review Board (IRB) of the University of Alabama at Birmingham. All patient provided consent for the imaging and treatment, and for the publication of their data. Consent for publication has been obtained by the authors as outlined by the IRB. Consent for 3D CBCT were obtained from each patient.
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This paper was part of the Masters of Science Thesis for Dr. Rick O’Neil for the completion of the Orthodontic Residency Program.
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O’Neil, R., Kau, C.H. Comparison of dental arch forms created from assessment of teeth, alveolar bone, and the overlying soft tissue. J Orofac Orthop 82, 413–421 (2021). https://doi.org/10.1007/s00056-021-00282-6
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DOI: https://doi.org/10.1007/s00056-021-00282-6