Verma Raj K, Verma Sanjeev, Singh Satinder P, Kumar Vinay, Rajagopalan Anjana, Subbaiah Naveen K, Lal Chaman
Unit of Orthodontics and Dentofacial Deformities, Oral Health and Sciences Centre (OHSC), Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
J Orthod Sci. 2025 Mar 25;14:1. doi: 10.4103/jos.jos_68_24. eCollection 2025.
Dental pulp may respond differently to adverse orthodontic forces. Major physiological effects of optimum orthodontic force application on dental pulp are vascular pulpal changes, pulpal calcification, and fibrosis. Functional appliances taking anchorage from the dentition tend to exert reciprocal higher orthodontic forces.
To evaluate the 3D volumetric changes of the dental coronal pulp of maxillary and mandibular permanent first molars 6 months after AdvanSync fixed functional and Twin Block removable functional appliance therapy and followed at 18 months of treatment (T2).
This retrospective study was performed on CBCT records obtained from a previous prospective study (Randomized Clinical Trial) comprising 32 patients [females: 17 (9.0-14.5 years), males: 15 (10.5-15.0 years)] who underwent functional mandibular advancement with Twin Block (group 1) and AdvanSync (group 2). Pretreatment (T0), 6 months (T1), and 18 months (T2) follow-up CBCT were assessed for dental pulp volume by using ITK-SNAP software version 3.2.
Intragroup volumetric pulpal changes showed a significant decrease in #16, #26, and #36 at time intervals T0-T1, T0-T2, and T1-T2 in groups 1 and 2. Intergroup comparison of pulpal volume for #16 and #26 was statistically significant at T1. A statistically significant decrease in pulpal volume for #46 was observed at time intervals T0-T1, T0-T2, and T1-T2 in both groups.
Functional appliance therapy with both Twin Block and AdvanSync functional appliance tends to decrease the first molar pulpal volume.
牙髓对正畸矫治力的反应可能有所不同。施加最佳正畸力对牙髓的主要生理影响包括牙髓血管变化、牙髓钙化和纤维化。依赖牙列作为支抗的功能性矫治器往往会施加相对较大的正畸力。
评估AdvanSync固定功能性矫治器和Twin Block可摘功能性矫治器治疗6个月后以及治疗18个月（T2）时，上下颌第一恒磨牙牙冠部牙髓的三维体积变化。
本回顾性研究基于先前一项前瞻性研究（随机临床试验）的CBCT记录进行，该研究纳入了32例患者[女性：17例（9.0 - 14.5岁），男性：15例（10.5 - 15.0岁）]，他们分别接受了Twin Block（第1组）和AdvanSync（第2组）功能性下颌前伸治疗。使用ITK-SNAP软件版本3.2对治疗前（T0）、6个月（T1）和18个月（T2）随访时的CBCT进行牙髓体积评估。
第1组和第2组在T0 - T1、T0 - T2和T1 - T2时间间隔内，组内牙髓体积变化显示16、26和36号牙有显著减小。16和26号牙在T1时组间牙髓体积比较有统计学意义。两组在T0 - T1、T0 - T2和T1 - T2时间间隔内，46号牙的牙髓体积均有统计学意义的减小。
Twin Block和AdvanSync功能性矫治器进行功能性矫治均倾向于减小第一恒磨牙的牙髓体积。
