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Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 2/2022

01-03-2022 | Original Article

Color changes of maxillary and mandibular incisors following surgical orthodontic treatment

A prospective controlled clinical pilot study

Authors: Dr. Konstantinos Lazaridis, Professor Athanasios E. Athanasiou, Professor Michael Knösel, Professor Moschos A. Papadopoulos

Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie | Issue 2/2022

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Abstract

Objective

To assess possible color changes of natural teeth after surgical orthodontic treatment.

Methods

This prospective controlled clinical pilot trial included 6 consecutively treated surgical orthodontic patients with class III malocclusion and neutral vertical relation (ST: surgical treatment), 3 of which received double jaw osteotomies (SGI: surgical subgroup I) and 3 received single mandibular sagittal split ramus osteotomies (SGII: surgical subgroup II). Eleven untreated individuals (UC: untreated control) and 9 individuals who received conventional comprehensive orthodontic treatment only (OC: orthodontic control) served as controls. Tooth color measurements were performed using a reflectance spectrophotometer on the upper and lower incisors before the initiation of the surgical orthodontic treatment (T1) and after its completion (T2). Primary endpoint was ∆E* (T1–T2) of summarized CIE-L*a*b* color differences. The null hypothesis of this study was that there is no statistically significant change in total tooth color difference ∆E* CIE-(L*a*b*) in vivo at baseline and following surgical orthodontic treatment.

Results

There was a statistically significant increase in ∆E* (T1–T2) in the ST group compared to the UC and OC groups. Single mandibular surgery had a stronger effect on the lower teeth in comparison to double jaw surgery, while Le Fort I osteotomy, as part SGI, had a stronger effect on the upper teeth. Despite statistical significance, the majority of mean values of these color changes were lower than the threshold value of color alterations considered to be perceivable by the naked eye in a clinical setting (3.7 ∆E units), with the exception of the mandibular incisors in SGII, where this threshold value was slightly exceeded.

Conclusions

Orthognathic surgery showed a measurable effect on tooth color. However, esthetic disturbance or patient discomfort based on these color and lightness alterations are unlikely, due to their small impact and low perceptibility in a clinical setting.
Appendix
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Literature
1.
go back to reference Kamber R, Papageorgiou SN, Eliades T (2018) Does orthodontic treatment have a permanent effect on tooth color? J Orofac Orthop 79:73–82CrossRef Kamber R, Papageorgiou SN, Eliades T (2018) Does orthodontic treatment have a permanent effect on tooth color? J Orofac Orthop 79:73–82CrossRef
2.
go back to reference Karamouzos A, Papadopoulos MA, Kolokithas G, Athanasiou AE (2007) Precision of in vivo spectrophotometric colour evaluation of natural teeth. J Oral Rehabil 34:613–621CrossRef Karamouzos A, Papadopoulos MA, Kolokithas G, Athanasiou AE (2007) Precision of in vivo spectrophotometric colour evaluation of natural teeth. J Oral Rehabil 34:613–621CrossRef
3.
go back to reference Karamouzos A, Athanasiou AE, Papadopoulos MA, Kolokithas G (2010) Tooth-color assessment after orthodontic treatment: a prospective clinical trial. Am J Orthod Dentofacial Orthop 138:537.e1–537.e8 (discussion 537–9) Karamouzos A, Athanasiou AE, Papadopoulos MA, Kolokithas G (2010) Tooth-color assessment after orthodontic treatment: a prospective clinical trial. Am J Orthod Dentofacial Orthop 138:537.e1–537.e8 (discussion 537–9)
4.
go back to reference Athanasiou AE, Yucel-eroǧlu E (1994) Short-term consequences of orthognathic surgery on stomatognathic function. Eur J Orthod 16:491–499CrossRef Athanasiou AE, Yucel-eroǧlu E (1994) Short-term consequences of orthognathic surgery on stomatognathic function. Eur J Orthod 16:491–499CrossRef
5.
go back to reference Buckley JG, Jones ML, Hill M, Sugar AW (1999) An evaluation of the changes in maxillary pulpal blood flow associated with orthognathic surgery. Br J Orthod 26:39–45CrossRef Buckley JG, Jones ML, Hill M, Sugar AW (1999) An evaluation of the changes in maxillary pulpal blood flow associated with orthognathic surgery. Br J Orthod 26:39–45CrossRef
6.
go back to reference Eroglu SE, Sabuncuoglu FA (2014) Changes in dental pulp blood flow of different maxillary tooth types after Le Fort I osteotomy. J Craniofac Surg 25:e420–e424CrossRef Eroglu SE, Sabuncuoglu FA (2014) Changes in dental pulp blood flow of different maxillary tooth types after Le Fort I osteotomy. J Craniofac Surg 25:e420–e424CrossRef
7.
go back to reference Harada K, Sato M, Omura K (2004) Blood-flow and neurosensory changes in the maxillary dental pulp after differing Le Fort I osteotomies. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 97:12–17CrossRef Harada K, Sato M, Omura K (2004) Blood-flow and neurosensory changes in the maxillary dental pulp after differing Le Fort I osteotomies. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 97:12–17CrossRef
8.
go back to reference Lazaridis K, Lazaridou M, Athanasiou AE (2018) Pulpal and periodontal tissues changes associated with Le Fort I and sagittal split ramus osteotomies: a review. Open Dent J 12:24–31CrossRef Lazaridis K, Lazaridou M, Athanasiou AE (2018) Pulpal and periodontal tissues changes associated with Le Fort I and sagittal split ramus osteotomies: a review. Open Dent J 12:24–31CrossRef
9.
go back to reference Ramsay DS, Årtun J, Bloomquist A (1991) Orthognathic surgery and pulpal blood flow: a pilot study using laser doppler flowmetry. J Oral Maxillofac Surg 49:564–570CrossRef Ramsay DS, Årtun J, Bloomquist A (1991) Orthognathic surgery and pulpal blood flow: a pilot study using laser doppler flowmetry. J Oral Maxillofac Surg 49:564–570CrossRef
10.
go back to reference Dodson TB, Bays RA, Neuenschwander MC (1997) Maxillary perfusion during Le Fort I osteotomy after ligation of the descending palatine artery. J Oral Maxillofac Surg 52:827–831CrossRef Dodson TB, Bays RA, Neuenschwander MC (1997) Maxillary perfusion during Le Fort I osteotomy after ligation of the descending palatine artery. J Oral Maxillofac Surg 52:827–831CrossRef
11.
go back to reference Justus T, Chang BL, Bloomquist D, Ramsay DS (2001) Human gingival and pulpal blood flow during healing after Le Fort I osteotomy. J Oral Maxillofac Surg 59:2–7CrossRef Justus T, Chang BL, Bloomquist D, Ramsay DS (2001) Human gingival and pulpal blood flow during healing after Le Fort I osteotomy. J Oral Maxillofac Surg 59:2–7CrossRef
12.
go back to reference von Arx T, Chappuis V, Winzap-Kälin C, Bornstein MM (2007) Laser Doppler flowmetry for assessment of anterior mandibular teeth in conjunction with bone harvesting in the symphysis: a clinical pilot study. Int J Oral Maxillofac Implants 22:383 von Arx T, Chappuis V, Winzap-Kälin C, Bornstein MM (2007) Laser Doppler flowmetry for assessment of anterior mandibular teeth in conjunction with bone harvesting in the symphysis: a clinical pilot study. Int J Oral Maxillofac Implants 22:383
13.
go back to reference Chen E, Goonewardene M, Abbott P (2012) Monitoring dental pulp sensibility and blood flow in patients receiving mandibular orthognathic surgery. Int Endod J 45:215–223CrossRef Chen E, Goonewardene M, Abbott P (2012) Monitoring dental pulp sensibility and blood flow in patients receiving mandibular orthognathic surgery. Int Endod J 45:215–223CrossRef
14.
go back to reference Lee UL, Lee EJ, Seo HY, Han SH, Choi WC, Choi YJ (2016) Prevalence and risk factors of tooth discolouration after orthognathic surgery: a retrospective study of 1455 patients. Int J Oral Maxillofac Surg 45:1464–1470CrossRef Lee UL, Lee EJ, Seo HY, Han SH, Choi WC, Choi YJ (2016) Prevalence and risk factors of tooth discolouration after orthognathic surgery: a retrospective study of 1455 patients. Int J Oral Maxillofac Surg 45:1464–1470CrossRef
15.
go back to reference Schulz KF, Altman DG, Moher D, CONSORT Group (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. PLoS Med 24(7):e1000251CrossRef Schulz KF, Altman DG, Moher D, CONSORT Group (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. PLoS Med 24(7):e1000251CrossRef
16.
go back to reference von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, STROBE Initiative (2008) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61:344–349CrossRef von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, STROBE Initiative (2008) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61:344–349CrossRef
17.
go back to reference Johnston WM, Kao EC (1989) Assessment of appearance match by visual observation and clinical colorimetry. J Dent Res 68:119–122CrossRef Johnston WM, Kao EC (1989) Assessment of appearance match by visual observation and clinical colorimetry. J Dent Res 68:119–122CrossRef
18.
go back to reference Brown H, Prescott R (2006) Applied mixed models in medicine, 2nd edn. John Wiley & Sons, London, pp 267–268CrossRef Brown H, Prescott R (2006) Applied mixed models in medicine, 2nd edn. John Wiley & Sons, London, pp 267–268CrossRef
19.
go back to reference Mahy M, Van Eycken L, Oosterlinck A (1994) Evaluation of uniform color spaces developed after the adoption of CIELAB and CIELUV. Color Res Appl 19:105–121 Mahy M, Van Eycken L, Oosterlinck A (1994) Evaluation of uniform color spaces developed after the adoption of CIELAB and CIELUV. Color Res Appl 19:105–121
20.
go back to reference Kenward MG, Roger JH (1997) Small sample inference for fixed effects from restricted maximum likelihood. Biometrics 53:983CrossRef Kenward MG, Roger JH (1997) Small sample inference for fixed effects from restricted maximum likelihood. Biometrics 53:983CrossRef
21.
go back to reference Bland JM, Altman DG (1999) Measuring agreement in method comparison studies. Stat Methods Med Res 8:135–160CrossRef Bland JM, Altman DG (1999) Measuring agreement in method comparison studies. Stat Methods Med Res 8:135–160CrossRef
22.
go back to reference Pinheiro J, Bates D (2006) Mixed-effects models in S and S‑PLUS. Springer, New York Pinheiro J, Bates D (2006) Mixed-effects models in S and S‑PLUS. Springer, New York
23.
go back to reference Kuznetsova A, Brockhoff PB, Christensen RHB (2017) lmertest package: tests in linear mixed effects models. J Stat Softw 82:1CrossRef Kuznetsova A, Brockhoff PB, Christensen RHB (2017) lmertest package: tests in linear mixed effects models. J Stat Softw 82:1CrossRef
24.
go back to reference Zuur A, Ieno N, Walker N, Saveliev A, Smith M (2009) Mixed effects models and extensions in ecology. Springer, New YorkCrossRef Zuur A, Ieno N, Walker N, Saveliev A, Smith M (2009) Mixed effects models and extensions in ecology. Springer, New YorkCrossRef
25.
go back to reference R Core Team (2014) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna (Available via R Project For Statistical Computing: http://www.R-project.org) R Core Team (2014) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna (Available via R Project For Statistical Computing: http://​www.​R-project.​org)
26.
go back to reference Bates D, Maechler M, Bolker B, Walker S (2015) Fitting linear mixed-effects models using lme4. J Stat Softw 67:1CrossRef Bates D, Maechler M, Bolker B, Walker S (2015) Fitting linear mixed-effects models using lme4. J Stat Softw 67:1CrossRef
28.
go back to reference Yeh Y, Cummins HZ (1964) Localized fluid flow measurement with He-Ne laser spectrometer. Appl Phys Lett 4:176CrossRef Yeh Y, Cummins HZ (1964) Localized fluid flow measurement with He-Ne laser spectrometer. Appl Phys Lett 4:176CrossRef
29.
go back to reference Knösel M, Attin R, Becker K, Attin T (2007) External bleaching effect on the color and luminosity of inactive white-spot lesions after fixed orthodontic appliances. Angle Orthod 77:646–652CrossRef Knösel M, Attin R, Becker K, Attin T (2007) External bleaching effect on the color and luminosity of inactive white-spot lesions after fixed orthodontic appliances. Angle Orthod 77:646–652CrossRef
30.
go back to reference Knösel M, Attin R, Jung K, Brunner E, Kubein-Meesenburg D, Attin T (2009) Digital image color analysis compared to direct dental CIE colorimeter assessment under different ambient conditions. Am J Dent 22:67–72PubMed Knösel M, Attin R, Jung K, Brunner E, Kubein-Meesenburg D, Attin T (2009) Digital image color analysis compared to direct dental CIE colorimeter assessment under different ambient conditions. Am J Dent 22:67–72PubMed
31.
go back to reference Ranna V, Kellesarian SV, Feng C, Javed F, Ghanem A (2016) Influence of the orthognathic surgical procedure Le fort I osteotomy on the vascularity and neurosensory response of the dental pulp: a systematic review. Quintessence Int 47:677–686PubMed Ranna V, Kellesarian SV, Feng C, Javed F, Ghanem A (2016) Influence of the orthognathic surgical procedure Le fort I osteotomy on the vascularity and neurosensory response of the dental pulp: a systematic review. Quintessence Int 47:677–686PubMed
32.
go back to reference Emshoff R, Kranewitter R, Gerhard S, Norer B, Hell B (2000) Effect of segmental Le Fort I osteotomy on maxillary tooth type-related pulpal bloodflow characteristics. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89:749–752CrossRef Emshoff R, Kranewitter R, Gerhard S, Norer B, Hell B (2000) Effect of segmental Le Fort I osteotomy on maxillary tooth type-related pulpal bloodflow characteristics. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89:749–752CrossRef
Metadata
Title
Color changes of maxillary and mandibular incisors following surgical orthodontic treatment
A prospective controlled clinical pilot study
Authors
Dr. Konstantinos Lazaridis
Professor Athanasios E. Athanasiou
Professor Michael Knösel
Professor Moschos A. Papadopoulos
Publication date
01-03-2022
Publisher
Springer Medizin
Published in
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie / Issue 2/2022
Print ISSN: 1434-5293
Electronic ISSN: 1615-6714
DOI
https://doi.org/10.1007/s00056-021-00288-0

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