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Differential alveolar bone modeling after orthodontic retraction.

Chooryung J Chung, Woowon Jang, Christian Piers

    Journal of the American Dental Association (1939)
    |March 30, 2019
    PubMed
    Summary

    Irregular bony protuberances after orthodontic anterior teeth retraction are not exostoses but result from differential alveolar bone modeling. This finding is crucial for orthodontists managing patient expectations and esthetic concerns.

    Keywords:
    3-dimensional imagingBone remodelingcone-beam computed tomographyexostosesorthodontic space closureperiodontal ligamenttooth movement

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    Area of Science:

    • Dentistry
    • Orthodontics
    • Oral Surgery

    Background:

    • Irregular, hard nodular protuberances on the labial alveolar bone after anterior teeth retraction in adults resemble exostoses.
    • These bony protuberances have been attributed to loading but lack specific characterization.

    Purpose of the Study:

    • To investigate the nature of labial bony protuberances observed after orthodontic retraction of anterior teeth.
    • To differentiate these protuberances from true exostoses.

    Main Methods:

    • Case reports of three patients with multiple labial bony protuberances after anterior teeth retraction.
    • Evaluation using serial clinical photographs, lateral cephalograms, digital models, and cone-beam computed tomography (CBCT) scans.
    • 3-dimensional superimpositions of digital models and CBCT scans for detailed analysis.

    Main Results:

    • The irregular protuberances developed and became more prominent during orthodontic retraction.
    • Analysis revealed the protuberances are due to differential alveolar bone modeling, not bone overgrowth.
    • Bone resorption over the tooth root was greater than interdental bone resorption.

    Conclusions:

    • The observed labial bony protuberances are a result of differential bone modeling, not true exostoses.
    • These may cause esthetic or comfort concerns for patients, perceived as 'outgrowths'.
    • Clinicians should be aware of this phenomenon in cases involving significant anterior teeth retraction and root movement; alveoloplasty may be considered for psychosocial issues.