orthodontics In summary by Farooq Ahmed

August 21, 2024 What Happens To Adults When We Expand With Aligners? 6 MINUTE SUMMARY

Join me for a podcast summary looking at the effects of

aligners when expansion occurs. In this podcast we will explore if bone loss

occurs with expansion and why bone loss doesn’t necessarily cause recession. The

podcast is based on the lecture and research by Greg Huang presented at this year’s

AAO, and includes some more recent research on the topic

PICO

Population adults, 22 maxillary arches, 20 mandibular arches

Intervention – expansion with aligners, average 3.7mm

Control – minimal expansion, average 0.6mm

Outcome – bone height and width from CBCT

What was the bone loss?

Maxilla

Minimal bone loss

Minimal bone height and width change

Mandibular

Significant bone loss

1.5mm height mandibular centrals

1.4mm height premolars

What movement took place of the incisors?

Maxilla

Little change in bucco-lingual inclination

Mandibular

Labial and buccal tipping increased

What were the overall changes?

Dental changes

3-4mm of expansion

Mainly at

premolars

Mainly buccal tipping, not bodily movement

Lower incisors procline

Similar bone loss with aligners expansion from other studies,

Zhang 2023 , Allahham 2023

Should CBCT’s debate within the literature regarding voxel

size of a CBCT and false negatives. Accuracy of alveolar height CBCT 2019 Yuan Li BA

systematic review showed

CBCT Vs skulls/patients

Bone height 0.03mm

Bone width 0.11mm

My thoughts: no difference in cbct and gold standard,

however the measurements were all of large structures, not bone height or

thickness of less than the voxel size

Predict bone loss

Upper arch no predictors as limited changes

Lower arch, same as for fixed appliances, but

the quantity was missing

Proclination

Expansion

Buccal expansion and tipping

Systematic review of orthodontics 48 articles de

Llano-Pérula 2023

Proclination

Less keratinised tissue

Does bone loss = gingival recession?

Not generally found from Greg’s study

When significant bone loss of 3mm, far less than

3mm gingival recession

Significant retraction of upper incisors and intrusion Kim

2024. Loss of Palatal bone however in retention palatal bone recovered

Hypothesis

If PDL and periosteum are maintained epithelium is maintained

If the root moves back into the bone, the bone

recovers – as PDL and periosteum osteogenic, and tension generated between PDL

and periosteum

PDL-periosteum hypothesis – proposed by Greg

Huang

What I liked about Greg’s lecture was that he started with

declaring his conflict of interest as an academic, both the royalties he

receives for his books as well as research funding, which was great to hear and

a trend I hope continues. Acknowledged the hard work of the research lead, his trainee

and the time-consuming process of orientating

CBCT slices of 1000s of images

...more

Share orthodontics In summary

Sign up to save your podcasts

orthodontics In summary

FAQs about orthodontics In summary:

How many episodes does orthodontics In summary have?

orthodontics In summary episodes:

FAQs about orthodontics In summary:

How many episodes does orthodontics In summary have?