Assessment of the relationship between tooth inclination and gingival and alveolar bone dimensions using computed tomography of the maxillary anterior teeth: a cross-sectional study

MONTANHA-ANDRADE, Katia; CRUSOÉ-REBELLO, Ieda Margarida; BARRETO, Mauricio; NEVES, Frederico Sampaio; SANTOS, Jean Nunes dos; CURY, Patricia Ramos

doi:10.1590/2177-6709.27.4.e222136.oar

Brasil

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ORIGINAL ARTICLE • Dental Press J. Orthod. 27 (04) • 2022 • https://doi.org/10.1590/2177-6709.27.4.e222136.oar linkcopy

Assessment of the relationship between tooth inclination and gingival and alveolar bone dimensions using computed tomography of the maxillary anterior teeth: a cross-sectional study

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ABSTRACT

Objective: The present study aimed to investigate the relationship between tooth inclination and gingival and bone dimensions in maxillary anterior teeth.

Methods: This cross-sectional study included cone-beam computed tomography (CBCT) images of 160 maxillary anterior teeth (30 individuals). Tooth inclination, gingival and bone thickness, and distances from cementoenamel junction to alveolar bone crest and gingival margin were measured in the labial surface. The correlations were analyzed using Pearson and partial correlation tests (p≤0.05).

Results: In the central incisors, tooth inclination was positively and significantly related to apical bone thickness (R = 0.34, p= 0.001). In the canines, tooth inclination was negatively and significantly related to cervical bone thickness (R = - 0.34, p= 0.01) and positively associated to apical bone thickness (R = 0.36, p= 0.01) and to gingival margin-cementoenamel junction distance (R = 0.31, p= 0.03). In the lateral incisors, tooth inclination was not associated with gingival or bone dimensions.

Conclusions: In the central incisors, the greater the labial tooth inclination, the greater is the apical bone thickness. In the canines, the greater the labial tooth inclination, the smallest is the cervical bone thickness, the greater is the apical bone thickness, and the greater is the gingival margin. Gingival and bone dimensions should be assessed when planning orthodontic treatment involving buccal movement of central incisors and canines.

Keywords: Alveolar process; Gingiva; Periodontics; Orthodontics; Tomography

	Central incisors / Tooth third			Lateral incisors / Tooth third			Canines / Tooth third
	Cervical	Middle	Apical	Cervical	Middle	Apical	Cervical	Middle	Apical
Inclination	112.10±6.90*			114.52±6.32*			106.57±6.10
BT	0.48±0.20*	0.53±0.34	0.31±0.31	0.46±0.26*	0.56±0.43	0.32±0.56	0.35±0.20	0.44±0.36	0.26 ± 0.28
GT	0.62±0.22*	0.61±0.20		0.51±0.27*	0.61±0.27		0.39±0.19	0.39±0.25
CEJ-BC	1.93±0.68			2.10±1.40			2.33±1.06
GM-CEJ	1.05±0.82			1.34±1.24*			0.74±1.11
GM-BC	2.99±0.88			3.44±1.26			3.07±0.78

Dimensions	Central incisor		Lateral incisor		Canine
Dimensions	Female	Male	Female	Male	Female	Male
GM-BC	3.1 ± 0.75	2.8 ± 1.06*	3.41 ± 1.06	3.47 ± 1.51	2.30 ± 0.79	3.20 ± 0.76
CEJ-BC	1.84 ± 0.68	2.10 ± 0.67	1.90 ± 0.99	2.42 ± 1.87	2.22 ± 1.21	2.56 ± 0.78
GM-CEJ	1.24 ± 0.85	0.74 ± 0.68*	1.51 ± 1.32	1.05 ± 1.07	0.81 ± 1.05	0.64 ± 1.20
BT
Cervical	0.54 ± 0.19	0.39 ± 0.17*	0.44 ± 0.24	0.48 ± 0.28	0.31 ± 0.22	0.40 ± 0.16
Middle	0.47 ± 0.28	0.63 ± 0.41	0.46 ± 0.31	0.70 ± 0.57	0.34 ± 0.36	0.63 ± 0.25*
Apical	0.28 ± 0.33	0.36 ± 0.28	0.26 ± 0.55	0.40 ± 0.58	0.18 ± 0.20	0.39 ± 0.33*
GT
Cervical	0.64 ± 0.20	0.57 ± 0.26	0.53 ± 0.29	0.48 ± 0.25	0.40 ± 0.17	0.39 ± 0.21
Middle	0.60 ± 0.20	0.61 ± 0.20	0.61 ± 0.23	0.61 ± 0.32	0.36 ± 0.23	0.42 ± 0.27

Dimensions	Central incisor		Lateral incisor		Canine
Dimensions	< 50 years	≥ 50 years	< 50 years	≥ 50 years	< 50 years	≥ 50 years
GM-BC	3.10 ± 0.92	2.59 ± 0.50	3.54 ±1.29	2.81 ± 0.73	3.15 ± 0.77	2.58 ± 0.68
CEJ-BC	1.89 ± 0.71	2.20 ± 0.50	2.05 ±1.49	2.20 ± 0.86	2.24 ± 1.08	2.96 ± 0.78
GM-CEJ	1.17 ± 0.80	0.33 ± 0.52*	1.49 ± 1.23	0.45 ± 0.76*	0.91 ± 0.99	-0.46 ± 1.06*
BT
Cervical	0.50 ± 0.22	0.45 ± 0.10	0.47 ± 0.25	0.33 ± 0.26	0.34 ± 0.21	0.38 ± 0.12
Middle	0.56 ± 0.35	0.43 ± 0.28	0.55 ± 0.42	0.53 ± 0.55	0.43 ± 0.36	0.49 ± 0.33
Apical	0.33 ± 0.32	0.23 ± 0.28	0.26 ± 0.51	0.58 ± 0.72	0.24 ± 0.24	0.38 ± 0.44
GT
Cervical	0.65 ± 0.22	0.47 ± 0.16*	0.53 ± 0.27	0.39 ± 0.23	0.39 ± 0.19	0.38 ± 0.16
Middle	0.63 ± 0.18	0.50 ± 0.23	0.63 ± 0.27	0.46 ± 0.17	0.38 ± 0.26	0.40 ± 0.19

Dimensions	Correlation coefficient (R)
Dimensions	Central incisors n = 52	Lateral incisors n = 55	Canines n = 53
GM-BC	0.13	-0.24	-0.11
CEJ-BC	0.25	-0.05	0.27
GM-CEJ	0.12	-0.19	-0.31**
Cervical GT	-0.04	0.05	0.20
Cervical BT	0.13	0.04	-0.34*
Middle GT	0.29	0.17	0.17
Middle BT	0.12	0.09	0.14
Apical BT	0.34*	0.12	0.36**

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[TFN1] * p ≤ 0.05 (compared to canines; Tukey test). BT = bone thickness, GT = gingival thickness, CEJ-BC = distance from cementoenamel junction to bone crest; GM-CEJ = distance from gingival margin to cementoenamel junction; GM-BC = distance from gingival margin to bone crest.