Anatomical assessment of cortical bone in mandibular buccal shelf in adults for orthodontic bone screw in a sample of population in Erbil city (a CBCT study).
Keywords:CBCT, Orthodontic bone screw, Buccal shelf, Cortical bone
Background and objectives: The important factors for placing orthodontic bone screw include thickness of the cortical bone, width of the buccal shelf bone, insertion depth of the screw and the proximity from the inferior alveolar nerve. This study aimed to anatomically assess the mandibular buccal shelf as the insertion site for orthodontic bone screw and determine any differences according to side and gender.
Methods: The study included 20 adult patients (10 males, 10 females; average age, 20-40 years). The measurements were made on cone-beam computed tomography (CBCT) scans of these 20 untreated orthodontic patients. The measurements were taken at mesiobuccal root, distobuccal root of the first molar, mesiobuccal root and distobuccal root of the second molar. The cortical bone thickness was measured at the 4 sites. The buccal shelf bone width was measured 4, 6 and 8 mm below cemento-enamel junction at the 4 sites. The distance between the inferior alveolar nerve canal and the outer surface of the cortical bone at the same 4 sites was measured.
Results: The cortical bone thickness showed the most thickness at the mesiobuccal root area of the first molar and least thickness at the distobuccal root area of the second molar. Regarding the buccal shelf width 4, 6 and 8 mm below cemento-enamel junction the thinnest site was mesiobuccal root of first molar and the thickest site was distobuccal root of second molar. For the distance from nerve the mesiouccal root area of the first molar was
the nearest and the mesiobuccal root area of the second molar was the furthest. No significant differences were found between the right and left sides of males and females.
Conclusions: The mesiobuccal side of the mandibular second molar is considered as the most appropriate site for the bone screw placement in the buccal shelf area.
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