The Cone Beam Computed Tomography Evaluation of Cortical Bone Plate after Piezocision-Assisted Orthodontic Upper Arch Expansion: A Case Series

Background: The purpose of the study was to evaluate cone beam computed tomography (CBCT) after piezocision-assisted orthodontic maxillary arch expansion. Methods: Forty CBCT images of 20 patients taken before and after treatment were included in the study. The following radiographic parameters were measured: buccal/palatal bone plate thickness measured in three locations, 0.5 mm, 3.5 mm, and 5 mm from the margin of alveolar process; cemento-enamel junction-crest distance (CEJ-C) measured at buccal (CEJ-B) and palatal/lingual (CEJ-P) aspects. Results: After treatment there were insignificant changes in CEJ-C and thickness of buccal/palatal plates for all the dental groups except for incisors and premolars. CEJ-B increased by 1.43 mm on premolars and CEJ-P by 1.65 mm on incisors and by 0.31 mm on premolars. On the incisors, the buccal plate width increased significantly, by 0.2 mm and 0.44 mm at 3.5-mm and 5-mm measurement points. On premolars, the buccal plate width decreased in three measuring points by 0.27 mm, 0.37 mm, and 0.25 mm. Conclusions: Piezocision-assisted orthodontic maxillary arch expansion does not cause evident negative changes of cortical plates except for the premolar region. Therefore, premolars may be at greater risk of buccal plate loss than other teeth.