Andrea Bresin

Masticatory Demands Induce Region-Specific Changes in Mandibular Bone Density in Growing Rats

This study investigates the structural adaptation of the mandibular bone when subjected to different masticatory functional and mechanical demands during growth. The effect of two experimental factors, the insertion of a bite block and the alteration of food consistency, on the bone mineral density (BMD) of the mandible was investigated in growing rats. Fifty-two male albino rats were divided into two equal groups, fed with either the standard hard diet or soft diet, at the age of four weeks. After two weeks, half the animals in both groups had their upper molars fitted with an upper posterior bite block. The remaining animals served as a control. Region-specific BMD of the mandible was subsequently measured using dual-energy X-ray absorptiometry (DXA). Soft diet and the consequent reduction of the forces applied to the mandible during mastication resulted in the reduction of BMD in all regions under study. The insertion of the bite-opening appliance (bite block) and the resulting stretching of the soft tissues led to the application of a continuous light force on the lower molars, which was associated with a significant increase of the BMD in the part of the alveolar process just below the root apices. These results raise the question of whether orthodontic treatment with similar appliances may have some, previously unsuspected, short- or long-term effects on the mandibular bone during growth and whether their effects depend on the individual soft-tissue characteristics.

Influence of masticatory hypofunction on the alveolar bone and the molar periodontal ligament space in the rat maxilla

Previous studies have established that complete absence of masticatory function results in a narrower alveolar process and periodontal ligament (PDL). The aim of our study was to investigate, for the first time, both the alveolar process and the PDL in masticatory hypofunction. Twenty-six rats, 3 wk of age, were randomly assigned to either a hard- or a soft-diet group (n = 13 each group). The rats were killed after 6 wk and their skulls were scanned using micro-computed tomography (micro-CT). We measured the cross-sectional width of the space occupied by the PDL, as well as the cross-sectional alveolar socket surface (AS) and the cross-sectional root surface (RS). We also measured the width of the alveolar process. The alveolar process was narrower, the PDL width was thinner, and the AS was smaller in rats fed a soft diet compared with rats fed a hard diet. The PDL width was correlated to the alveolar process width and the AS. The narrower alveolar process found in rats fed a soft diet is the result of alterations to both the alveolar bone and the PDL. The correlation between them provides evidence that a reduction of occlusal loading induces a simultaneous response in both tissues.

Diagnosing the severity of buccal caries lesions in orthodontic patients at de-bonding using digital photographs

Abstract Objective. The aims of this study were (1) to evaluate the severity of buccal caries lesions according to the International Caries Detection and Assessment System (ICDAS) criteria via scoring buccal caries lesions on digital photographs at the time of de-bonding and (2) to compare this method with clinical examination. Materials and methods. In total, 89 patients treated with upper and lower fixed appliances were clinically examined immediately after de-bonding by the first author and buccal caries were scored according to the ICDAS-II. Close-up digital photographs were taken of 245 teeth with different buccal caries lesion scores according to the ICDAS-II. Thirteen postgraduate orthodontics students independently scored the buccal caries lesions in the digital photographs using the modified clinical criteria (ICDAS-II). Intra- and inter-examiner reliabilities were evaluated by calculating the weighted kappa. To evaluate the validity of diagnosing the severity of buccal caries lesions using digital photographs compared to clinical examination, Spearmans correlation coefficient was calculated. Results. Intra-examiner reliability and the reliability between each examiner and the clinical examination showed moderate-to-excellent agreement, with kappa values of 0.52–0.83. Scoring buccal caries lesions via clinical examinations and scoring via photographs were well correlated according to the modified ICDAS-II criteria (Spearmans correlation coefficient, 0.76). Conclusions. Thus, scoring buccal caries lesions on digital photographs according to ICDAS-II criteria is a reliable and valid method for assessing the severity of buccal caries lesions.

Cone-beam computed tomographic evaluation of the long-term effects of orthodontic retainers on marginal bone levels

Introduction Fixed retainers are widely used after orthodontic treatment, sometimes for extended periods, despite insufficient knowledge of their possible long‐term adverse effects on the periodontium. The aim of this study was to evaluate whether bonded orthodontic retainers have an adverse long‐term effect on the marginal bone levels of the mandibular front teeth. Methods The study included 62 consecutive patients in 3 groups: (1) patients who underwent orthodontic treatment and wore a fixed retainer for 10 years, (2) patients who underwent orthodontic treatment but did not have a fixed retainer, and (3) untreated controls. The marginal bone levels were measured by cone‐beam computed tomography 10 years after treatment. Additionally, multivariate data analysis was used to analyze possible correlations between the marginal bone levels at 10 years and the variables obtained from the study casts and profile radiographs. Results The results demonstrated a significantly lower marginal bone level on the buccal side of the mandibular front teeth in the orthodontically treated patients compared with the orthodontically untreated group. There was no difference in the marginal bone levels between the retainer group and the no‐retainer group. Multivariate analysis indicated that a low marginal bone level was correlated with a basal open vertical relationship, posterior rotation of the mandible, pretreatment of the incisor protrusion, and extraction therapy. Conclusions Within the limits of this research design, the long‐term retention phase in general does not seem to cause any adverse effects on the marginal bone levels after 10 years. HighlightsLong‐term bonded lingual retention does not adversely affect marginal bone level.Orthodontic patients had lower marginal bone levels buccally on the mandibular front teeth.Low marginal bone level was correlated with a basal open vertical relationship.It was also correlated with mandibular posterior rotation in orthodontic patients.

Effect of different masticatory functional demands on the 3D mandibular condyle morphology of growing rats using posterior bite-blocks

Background and objectives Apart from the primary effect of bite-blocks on tooth position, they may also influence the mandibular condylar growth. Our aim was to investigate their influence on the condylar morphology, with variable masticatory forces. Material and methods Fifty-two 4-week old male rats were divided into hard and soft diet groups in order to create individuals with different masticatory muscle capacity. Two weeks later, they were equally divided into bite-block and control groups. After a total of 6 weeks experimental time, the animals were sacrificed. The mandibles were scanned with high-resolution micro-CT and 3D analysis was performed on the condylar neck and head of the condyle. The volume and the length of the condylar process were measured. Statistical analysis was done with a one-way analysis of variance. Results The use of bite-blocks decreased the length of the condylar process (P = 0.001) as well as the volume of the condylar neck (P = 0.001) and head (P = 0.006). The soft diet decreased the volume of the condylar neck (P < 0.001) and head (P < 0.001) two to three times more than the bite-blocks but did not affect the condylar process length. The interaction between the two variables was not statistically significant. Conclusions Both the bite-block appliance and weak masticatory muscle function reduced the volume at all regions of the condylar process, although the functional factor had a substantially greater effect. However, only the bite-block appliance affected the condylar process length. In the presence of both factors, an additive effect was found but no interaction detected.

The influence of altered functional loading and posterior bite-blocks on the periodontal ligament space and alveolar bone thickness in rats

Abstract Objectives: Posterior bite-blocks are resin-based structures elevating the occlusion and creating intrusive force on the posterior teeth. Bite-blocks were applied to the molars of growing rats and a hard and soft diet was used to create altered functional masticatory forces. The aim of the present investigation was to study the effect of this appliance on the periodontal ligament space and alveolar bone thickness when combined with altered masticatory forces. Material and methods: Fifty-two four-week-old rats were divided into two groups, hard and soft diet. Two weeks later, half of them received a bite-block appliance, creating four groups: control hard (CH), control soft (CS), bite-block hard (BH) and bite-block soft (BS). All were sacrificed at age of 10 weeks. Their heads were scanned by micro-CT and periodontal ligament space (PDL) width, cross-sectional alveolar socket surface and alveolar bone thickness were measured. Analysis of variance (ANOVA) was used to compare the groups. Results: The PDL was 9.2% thinner in the CS group (p < 0.001) and 20.7% in the bite-block groups (p  < 0.001) compared to the CH group. Within each of the four groups, the mesiodistal PDL space was larger than the palatobuccal. The alveolar bone was thinner by 5.8% (p = 0.018) in the CS group, 10.7% in the BH group (p < 0.001) and 16.7% in the BS group (p < 0.001) compared to the CH group. Conclusions: Young rats wearing posterior bite-blocks have narrower PDL space and thinner alveolar bone compared to controls. When fed a soft diet, the alveolar bone is even thinner but the PDL showed no difference.