Three-dimensional interpretation of periodontal lesions and remodeling during orthodontic treatment. Part III.

In a clinical study of 11 adult patients, HR-CT-examinations were performed before or during and after orthodontic treatment with fixed appliances. The treatment period between the first and second CT-scanning varied from 12 to 24 months. Comparison of the first and second CT-examination permits three-dimensional evaluation of osteoclastic and osteoblastic alveolar remodeling. The incidence of periodontal lesions such as bone dehiscences, fenestrations and root resorptions was assessed in relation to the initial periodontal situation and the orthodontic treatment concept. Anatomical risks were a small alveolar process, thin buccal or lingual bone plates, eccentric position of teeth, basally extended maxillary sinus and progressive alveolar bone loss. Therapeutic risks were uncontrolled sagittal or vertical movements of incisors and cortical or intermaxillary anchorage preparation. CT-scanning of the alveolar process during orthodontic treatment with HR-CT allows three-dimensional interpretation of the alveolar osteodynamics, especially the development and repair of orthodontically induced bone dehiscences in relation to tooth movement.