Changes in Mandibular Alveolar Bone Thickness Following All 4s and All 5s Premolar Extraction In Bimaxillary Protrusion Cases: A CBCT Study

Background: Bimaxillary protrusion is a common orthodontic condition characterized by excessive forward positioning of both the maxilla and mandible. The treatment often involves premolar and molar extractions to achieve optimal alignment and retraction. Cone-beam computed tomography (CBCT) offers a...

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Main Authors: Neha Rathore, Rashme Rashme, P. M. Roveena, N. Lingeshkumar, Mariea Francis, S. Vikram
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-06-01
Series:Journal of Pharmacy and Bioallied Sciences
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Online Access:https://journals.lww.com/10.4103/jpbs.jpbs_143_25
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author Neha Rathore
Rashme Rashme
P. M. Roveena
N. Lingeshkumar
Mariea Francis
S. Vikram
author_facet Neha Rathore
Rashme Rashme
P. M. Roveena
N. Lingeshkumar
Mariea Francis
S. Vikram
author_sort Neha Rathore
collection DOAJ
description Background: Bimaxillary protrusion is a common orthodontic condition characterized by excessive forward positioning of both the maxilla and mandible. The treatment often involves premolar and molar extractions to achieve optimal alignment and retraction. Cone-beam computed tomography (CBCT) offers a precise method to evaluate changes in mandibular alveolar bone morphology following such extractions. This study aims to compare the morphological changes in the mandibular alveolar bone following 4-premolar and 5-premolar/molar extractions in patients with bimaxillary protrusion. Materials and Methods: A total of 40 patients with bimaxillary protrusion were selected for this study and divided into two groups: Group A (n = 20) underwent 4-premolar extractions, while Group B (n = 20) underwent 5th premolar/molar extractions. CBCT scans were taken pre-treatment and 12 months post-treatment. Key parameters assessed included alveolar bone height, thickness at different root levels (3 mm, 6 mm, and 9 mm from the cementoenamel junction), and cortical bone thickness. Statistical analysis was performed using paired t-tests and independent t-tests, with a significance level set at P < 0.05. Results: Group A showed a significant reduction in alveolar bone thickness at all root levels, with mean reductions of 1.2 mm (±0.3), 1.5 mm (±0.4), and 1.8 mm (±0.5) at 3 mm, 6 mm, and 9 mm, respectively. Group B demonstrated similar reductions but with slightly higher values: 1.4 mm (±0.4), 1.7 mm (±0.5), and 2.0 mm (±0.6). Alveolar bone height decreased significantly in both groups, with a greater reduction observed in Group B (mean decrease of 2.5 mm versus 1.9 mm in Group A). Cortical bone thickness changes were minimal and statistically insignificant in both groups. Conclusion: Both 4-premolar and 5-premolar/molar extractions lead to significant changes in mandibular alveolar bone morphology. However, 5th premolar/molar extractions result in slightly greater reductions in alveolar bone height and thickness. CBCT provides a reliable method for monitoring these changes, emphasizing the need for careful planning in extraction-based orthodontic treatment.
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publisher Wolters Kluwer Medknow Publications
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spelling doaj-art-7e2c8dedb01b48f3adf10f4f29c561852025-08-20T03:31:38ZengWolters Kluwer Medknow PublicationsJournal of Pharmacy and Bioallied Sciences0976-48790975-74062025-06-0117Suppl 2S1586S158810.4103/jpbs.jpbs_143_25Changes in Mandibular Alveolar Bone Thickness Following All 4s and All 5s Premolar Extraction In Bimaxillary Protrusion Cases: A CBCT StudyNeha RathoreRashme RashmeP. M. RoveenaN. LingeshkumarMariea FrancisS. VikramBackground: Bimaxillary protrusion is a common orthodontic condition characterized by excessive forward positioning of both the maxilla and mandible. The treatment often involves premolar and molar extractions to achieve optimal alignment and retraction. Cone-beam computed tomography (CBCT) offers a precise method to evaluate changes in mandibular alveolar bone morphology following such extractions. This study aims to compare the morphological changes in the mandibular alveolar bone following 4-premolar and 5-premolar/molar extractions in patients with bimaxillary protrusion. Materials and Methods: A total of 40 patients with bimaxillary protrusion were selected for this study and divided into two groups: Group A (n = 20) underwent 4-premolar extractions, while Group B (n = 20) underwent 5th premolar/molar extractions. CBCT scans were taken pre-treatment and 12 months post-treatment. Key parameters assessed included alveolar bone height, thickness at different root levels (3 mm, 6 mm, and 9 mm from the cementoenamel junction), and cortical bone thickness. Statistical analysis was performed using paired t-tests and independent t-tests, with a significance level set at P < 0.05. Results: Group A showed a significant reduction in alveolar bone thickness at all root levels, with mean reductions of 1.2 mm (±0.3), 1.5 mm (±0.4), and 1.8 mm (±0.5) at 3 mm, 6 mm, and 9 mm, respectively. Group B demonstrated similar reductions but with slightly higher values: 1.4 mm (±0.4), 1.7 mm (±0.5), and 2.0 mm (±0.6). Alveolar bone height decreased significantly in both groups, with a greater reduction observed in Group B (mean decrease of 2.5 mm versus 1.9 mm in Group A). Cortical bone thickness changes were minimal and statistically insignificant in both groups. Conclusion: Both 4-premolar and 5-premolar/molar extractions lead to significant changes in mandibular alveolar bone morphology. However, 5th premolar/molar extractions result in slightly greater reductions in alveolar bone height and thickness. CBCT provides a reliable method for monitoring these changes, emphasizing the need for careful planning in extraction-based orthodontic treatment.https://journals.lww.com/10.4103/jpbs.jpbs_143_25alveolar morphologybimaxillary protrusioncbctmandibular alveolar bonemolar extractionsorthodontic treatmentpremolar extractions
spellingShingle Neha Rathore
Rashme Rashme
P. M. Roveena
N. Lingeshkumar
Mariea Francis
S. Vikram
Changes in Mandibular Alveolar Bone Thickness Following All 4s and All 5s Premolar Extraction In Bimaxillary Protrusion Cases: A CBCT Study
Journal of Pharmacy and Bioallied Sciences
alveolar morphology
bimaxillary protrusion
cbct
mandibular alveolar bone
molar extractions
orthodontic treatment
premolar extractions
title Changes in Mandibular Alveolar Bone Thickness Following All 4s and All 5s Premolar Extraction In Bimaxillary Protrusion Cases: A CBCT Study
title_full Changes in Mandibular Alveolar Bone Thickness Following All 4s and All 5s Premolar Extraction In Bimaxillary Protrusion Cases: A CBCT Study
title_fullStr Changes in Mandibular Alveolar Bone Thickness Following All 4s and All 5s Premolar Extraction In Bimaxillary Protrusion Cases: A CBCT Study
title_full_unstemmed Changes in Mandibular Alveolar Bone Thickness Following All 4s and All 5s Premolar Extraction In Bimaxillary Protrusion Cases: A CBCT Study
title_short Changes in Mandibular Alveolar Bone Thickness Following All 4s and All 5s Premolar Extraction In Bimaxillary Protrusion Cases: A CBCT Study
title_sort changes in mandibular alveolar bone thickness following all 4s and all 5s premolar extraction in bimaxillary protrusion cases a cbct study
topic alveolar morphology
bimaxillary protrusion
cbct
mandibular alveolar bone
molar extractions
orthodontic treatment
premolar extractions
url https://journals.lww.com/10.4103/jpbs.jpbs_143_25
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