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Introduction: The purpose of this study was to determine how the amount of surgical insult affects the quantity
and maturity of dentoalveolar bone around teeth that have been orthodontically moved. Methods: A split-mouth
design with 8 foxhound dogs was used to evaluate bone surrounding maxillary second premolars that were
protracted for 15 days and retained for 7 weeks. The maxillary rst premolars were extracted, and the
interseptal bone was removed to within 1 mm of the second premolars; on the insult (lesser surgical insult)
side, buccal and lingual vertical grooves were made in the extraction socket to undermine the mesial root of
the second premolar; the insult1 (greater surgical insult) side was apped and had modied corticotomies
extending to, but not through, the lingual cortex 1 mm distal to the distal root, and 3 to 5 mm apical to both
roots. Microcomputed tomography analyses were used to evaluate the material density, bone volume
fraction, and trabecular characteristics of surrounding bone. Hematoxylin and eosin sections were used to
determine osteoclast numbers, bone surface areas, and bone volumes. Results: After 7 weeks of consolidation,
there was signicantly (P \0.05) less bone on the insult1 side; it was less dense and less mature than the bone
on the insult side. Relative to the control bone, bone on the insult1 side was signicantly less dense but showed
no differences in bone volume. Preliminary histologic evaluations indicated increased numbers of osteoclasts
and greater bone surface areas on the insult1 side than the insult side, but no differences in bone volume.
Conclusions: Increased surgical insults produce less dense and less mature bone but have no effect on
bone volume at 9 weeks after surgery. (Am J Orthod Dentofacial Orthop 2014;145:S92-9)
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Fig 1. Surgical procedure diagrams with corresponding photos: A, insult group diagram (buccal view);
B, sample insult group photo (occlusal view); C, insult1 group diagram (buccal view); D, sample insult1 group photo (buccal view).
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Insult
30.7
32.6
23.3
19.6
35.6
46.4
19
17
8
9
18
23
866.4
867.6
898.4
905
866.1
859
20.9
27.8
31.3
14.6
28
34.7
56.3 8
52.5 11
90.1 5
88.3 8
82.6 6
73.9 12
0.208
0.012
0.017
0.050
0.123
0.068
0.401
0.889
0.012
0.575
0.036
0.208
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Table II. Material densities, bone volume fractions, trabecular numbers, trabecular thickness, and trabecular separa-
Mean
837.5
36.1
2.1
0.2
0.5
SD
19.9
7
0.3
0
0.1
Insult
Mean
856.1
35
1.8
0.3
0.6
Control
SD
16.3
11
0.3
0.1
0.1
Mean
929.1
34.7
1.6
0.3
0.7
SD
30.8
13
0.2
0.1
0.1
Probability
Insult1 vs insult
0.036
0.779
0.093
0.111
0.123
Insult1 vs control
0.012
0.779
0.017
0.042
0.012
Insult vs control
0.012
0.779
0.263
0.203
0.176
Insult
Mean
SD
Probability
2.6
2.4
0.6
0.4
0.779
0.017
0.3
0.3
0.1
0
0.401
0.012
0.4
0.5
0.1
0.1
0.799
0.012
DISCUSSION
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Fig 3. Comparisons of the measures of bone maturity of the insult1, insult, and control groups for the
interradicular regions: A, trabecular numbers; B, trabecular thickness; C, trabecular separation.
Fig 4. Sample photomicrographs showing differences in osteoclastic activity between the insult1 (top
row) and their respective controls (bottom row): A-D, photomicrographs of the insult1 group showing
selected osteoclasts (*), osteoblasts (1), and osteocytes (o); E-H, photomicrographs of the respective
controls showing absence of osteoclasts.
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bone surface, osteoclasts per unit of volume, and osteoclasts per unit of surface area
Insult1
Control
Bone index
Mean SD Mean SD Probability
Total osteoclasts (n)
24.3 13.5
3.9 1.4
0.028
Bone volume (mm2)
7.2
1.5
7.1 1.2
0.462
Bone surface (mm)
59.9 14.2 37.1 7.4
0.046
Osteoclasts/volume (mm2)
3.4
1.6
0.6 0.2
0.028
Osteoclasts/surface (mm)
0.4
0.2
0.1 0
0.028
Based on a split-mouth design comparing bone surrounding maxillary second premolars that had and had
not been surgically insulted, the following preliminary
conclusions can be drawn.
1.
2.
3.
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