Maxillary cortical bone remodeling characteristics in extraction patients: A cone-beam computed tomography study

This study aimed to evaluate labial and palatal cortical bone remodeling (BR) characteristics and related aspects of maxillary incisors after retraction, as these aspects are still controversial among orthodontists.Cortical BR and incisor movement of 44 patients (aged 26.18 ± 4.71 years) who underwent maxillary first premolar extraction and incisor retraction were analyzed using superimposed cone-beam computed tomography images. Labial BR/tooth movement (BT) ratios at the crestal, midroot (S2), and apical (S3) levels were compared using the Friedman test and pairwise comparisons. Multivariate linear regressions were used to explore the relationships between the labial BT ratio and several factors, including age, ANB angle, mandibular plane angle, and incisor movement patterns. According to the type of palatal cortical BR observed, the patients were divided into 3 groups: type I (no BR without root penetration of the original palatal border [RPB]), type II (BR with RPB), and type III (no BR with RPB). Student's t test was used to compare the type II and III groups.The mean labial BT ratios at all levels were <1.00 (0.68-0.89). This value at the S3 level was significantly smaller than that at the crestal and S2 levels (P <0.01). Multivariate linear regression indicated that the tooth movement pattern negatively correlates with the BT ratio at S2 and S3 levels (P <0.01). Type I was noted in 40.9% of the patients, and similar proportions exhibited type II (29.5%, 25.0%) or type III remodeling (29.5%, 34.1%). The retraction distance of the incisors in type III patients was significantly larger than in type II patients (P <0.05).The amount of cortical BR secondary to maxillary incisor retraction is less than the tooth movement. Bodily retraction may lead to lower labial BT ratios at the S3 and S2 levels. Roots penetrating the original border of the cortical plate are necessary for palatal cortical BR initiation.