Evaluation of periodontal changes in the anterior dentoalveolar region following orthodontic treatment using cone-beam computed tomography

The aim of this retrospective study is to examine the dentoalveoler changes caused by fixed orthodontic treatment mechanics in the anterior region during the correction of Class II malocclusion. The study included a total of 96 maxillary and mandibular incisors (central and lateral) from 6 female and 6 male patients with an average age of 14.91 years (range: 13–17 years). Among these individuals, 3 females and 3 males underwent extraction of the maxillary first premolars on both sides, while the remaining 3 females and 3 males were treated with distalization using a miniscrew-supported Palatal-Distalizer appliance. All patients subsequently underwent fixed orthodontic treatment with brackets for an average duration of 29.91 months (range: 24–37 months). Cone-beam computed tomography (CBCT) images taken before (T0) and after treatment (T1) were analyzed to assess the dentoalveolar changes. Orthodontic treatment of Class II malocclusion resulted in increased inclination of maxillary and mandibular incisors, decreased root lengths, and resorption in mesiodistal and buccolingual directions at all levels. An increase in the distance between cementoenamel junction and the marginal bone (CEJ-MB) was observed on the palatal side of maxillary incisors and on both the buccal and lingual sides of mandibular incisors, accompanied by marginal bone loss. Proclination of upper and lower incisors led to remodeling of the alveolar bone, with changes in bone thickness in the apical and cervical regions. Root resorption increased with age and was more pronounced in pubertal females compared to males. Mesiodistal root resorption in the cervical region was more extensive in extraction cases, while distalization cases exhibited greater reductions in buccal bone thickness at 3 mm and 6 mm levels relative to the MSS.