Condição periodontal em longo prazo de incisivos centrais superiores após o tracionamento ortodôntico: TCFC e achados clínicos

Purpose: The aim of this study was to evaluate the buccal and lingual alveolar bone morphology and the periodontal clinical condition of impacted permanent maxillary central incisors at least 6 months after the orthodontic traction. Methods: This split mouth transversal study evaluated a sample of 11 patients a mean of 15.41 years after the orthodontic traction of unilateral impacted maxillary central incisor. The experimental group (TR) consisted of 11 impacted central incisors. The comparison group (NTR) consisted of 11 non-impacted contralateral teeth. High-resolution CBCT exams of central incisors were performed using Accuitomo (J. Morita, Kyoto, Japan). Cross section imagens passing through the center of maxillary central incisors were used to measure buccal and lingual alveolar bone level. Presence of fenestration, root dilacerations, root coverage, and position of the root apex were also assessed in the same images. Clinical parameters included the periodontal probing depth, attachment level, gingival bleeding index, plaque index, degree of gingival recession, amount of gingival mucosa and evaluation of interproximal papilla and black triangle. Digital model analysis included an assessment of clinical crown height and width. Intergroup comparisons were performed using paired t tests, McNemar and Wilcoxon tests (p<0.05). Pearson correlation coefficient was calculated to determine the relationship between the clinical and CBCT findings. Results: TR group showed a significantly thinner buccal bone plate thickness at the middle and apical root level compared to NTR group. A decreased buccal alveolar crest level was observed in TR group in comparison to NTR group. The TR group showed a greater frequency of buccal bone dehicences and root dilacerations than antimeres. Experimental group showed more gingival recession, a decreased amount of gingival mucosa and an increased clinical attachment level at the buccal aspect than the NTR group. Moderate inverse correlation was found between buccal bone plate thickness of central incisors and attachment level and moderate positive correlation was found between buccal alveolar crest height and attachment level Conclusions: The periodontal conditions of maxillary central incisors long-term after orthodontic traction are different compared to its antimere. A decreased thickness and height of buccal alveolar bone and gingival recessions were observed in central incisors 15 years after orthodontic traction.Introdução: o objetivo deste estudo foi avaliar a morfologia óssea alveolar vestibular e lingual e a condição clínica periodontal de incisivos centrais superiores impactados há, pelo menos, 6 meses após o tracionamento ortodôntico. Material e Métodos: Este estudo transversal de boca dividida avaliou uma amostra de 11 pacientes com média de 15,41 anos após a mecânica de tração ortodôntica de incisivo central superior retido unilateral. O grupo experimental (TR) foi composto por 11 incisivos centrais retidos. O grupo controle (NTR) foi composto por 11 incisivos contralaterais irrompidos naturalmente. Exames de TCFC de alta resolução dos incisivos centrais foram realizados utilizando o Accuitomo (J. Morita, Kyoto, Japão). As imagens transversais que passaram pelo centro dos incisivos centrais superiores foram utilizadas para medir o nível ósseo alveolar vestibular e lingual. A presença de fenestração, dilaceração, recobrimento radicular e posição do ápice radicular também foram avaliados nas mesmas imagens. Os parâmetros clínicos incluíram profundidade de sondagem periodontal, nível de inserção clínico, índice de sangramento gengival, índice de placa, grau de recessão gengival, quantidade de mucosa queratinizada e avaliação da presença de triângulo negro na papila interproximal. A análise de modelo digital consistiu da avaliação da altura e largura da coroa clínica. As comparações intergrupos foram realizadas utilizando os testes de t pareado, McNemar e Wilcoxon (p