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Volumetric pulpal changes in permanent first molars following AdvanSyncTM and Twin Block functional appliance: A CBCT
Raj K Verma1, Sanjeev Verma1, Satinder P Singh1
1Unit of Orthodontics and Dentofacial Deformities, Oral Health and Sciences Centre (OHSC), Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Introduction:
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.
Objective:
To evaluate the 3D volumetric changes of the dental coronal pulp of maxillary and mandibular permanent first molars 6 months after AdvanSyncTM fixed functional and Twin Block removable functional appliance therapy and followed at 18 months of treatment (T2).
Materials And Methods:
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 AdvanSyncTM (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.
Results:
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.
Conclusion:
Functional appliance therapy with both Twin Block and AdvanSyncTM functional appliance tends to decrease the first molar pulpal volume.
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