Impact Of Baseline Alveolar Bone Thickness on Micro-Osteoperforation Efficacy: A CBCT Study in Thin Vs. Thick Bone Biotypes
DOI:
https://doi.org/10.53555/jaz.v42i02.5169Abstract
Background: Micro-osteoperforations (MOPs) have emerged as a minimally invasive adjunct to accelerate orthodontic tooth movement. However, the influence of alveolar bone biotype—particularly thin versus thick buccal bone—on the efficacy and safety of MOPs remains underexplored.
Objective: This study aimed to quantify and compare the outcomes of MOPs in patients with thin and thick alveolar bone phenotypes using cone-beam computed tomography (CBCT).
Methods: In this split-mouth randomized controlled trial (RCT), 38 patients undergoing maxillary canine retraction were stratified into thin (buccal bone ≤1.0 mm; n = 19) and thick (≥1.5 mm; n = 19) alveolar bone biotypes. On the experimental side, MOPs were performed adjacent to the canine prior to retraction, while the contralateral side served as control. CBCT scans were obtained at baseline and after 3 months to assess tooth movement rate, alveolar bone thickness, vertical bone loss, and bone density (measured in Hounsfield Units, HU). Statistical comparisons were performed using paired and unpaired t-tests, and Pearson correlation was used to explore associations (α = 0.05).
Results: In thin biotypes, MOPs resulted in a 58% increase in tooth movement rate compared to control (1.42 ± 0.31 mm/month vs. 0.90 ± 0.28 mm/month; p < 0.001), whereas thick biotypes showed a 22% acceleration (1.10 ± 0.25 mm/month vs. 0.90 ± 0.30 mm/month; p = 0.07). Palatal vertical bone loss was significantly higher in MOP-treated thin biotypes (0.46 ± 0.12 mm) versus control (0.28 ± 0.10 mm; p = 0.02). Additionally, bone density reduction at MOP sites was greater in thin biotypes (ΔHU: −312 ± 45) than thick ones (ΔHU: −155 ± 32; p < 0.01). An inverse correlation was observed between baseline buccal bone thickness and rate of tooth movement following MOPs (r = −0.72; p < 0.001).
Conclusion: Mops are more effective in accelerating tooth movement in patients with thin alveolar bone; however, this benefit is accompanied by greater palatal vertical bone loss and density reduction. CBCT-based bone thickness assessment should be incorporated into pretreatment protocols to individualize MOP indication and mitigate risk.
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Copyright (c) 2021 Dr. S.V. Paramesh Gowda, Dr. A. Sumathi Felicita, Dr. Shylashree. S, Dr. Anadha Gujar
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