Jeremy Haines


Introduction: Sagittal root position (SRP) of maxillary incisors is an important factor in implant treatment planning. Kan et al defined four classes of SRP in an effort to aid implant placement treatment planning and these SRP classifications represent a novel approach to describing bone changes around the maxillary incisors. The effect of orthodontic tooth movement, specifically changes in inclination, on SRP is of interest in potentially facilitating immediate implant placement. Purpose: The purpose of this study was to use Cone Beam Computed Tomography (CBCT) to evaluate the adaptation of alveolar bone around the maxillary incisors as a result of orthodontic tooth movement and describe the effect of said changes on SRP classification. Methods: This study compared changes in dimension (mm) of labial/palatal bone of the anterior maxilla surrounding the central incisors on CBCT images acquired before (T1) and after (T2) orthodontic treatment. Initial (T1) and final (T2) digital imaging and communications in medicine (DICOM) CBCT images of 77 patients were imported into Osirix MD software for analysis. Mid-sagittal images of 127 central incisors that met inclusion criteria were obtained. SRP was recorded for each incisor at T1 and T2. Labial,

palatal, and total alveolar width changes (mm) were analyzed using Wilcoxon Signed Rank Test, Mann-Whitney U Test, and Independent Samples Kruskal-Wallis Test (α = 0.05). Results: Statistically significant differences in dimension changes between T1 and T2 were found for teeth that experienced positive inclination change (PIC). Labial bone dimensions increased and palatal dimensions decreased, differing in magnitude (p < 0.05), resulting in a decrease in total alveolar width dimension. Most changes in the negative inclination change (NIC) group were not statistically significant. 82% of teeth were class I SRP and 18% were class II SRP at T1. SRP classification changed in 54% of teeth between T1 and T2 (67% and 19% of PIC and NIC groups, respectively). Conclusion: Statistically significant adaptation of the alveolar process around maxillary central incisors occurs in teeth that experience PIC and follows a predictable pattern. Orthodontic movement that causes changes in inclination also results in changes in SRP classification.

LLU Discipline

Orthodontics and Dentofacial Orthopedics


Orthodontics and Dentofacial Orthopedics


School of Dentistry

First Advisor

Rungcharassaeng, Kitichai

Second Advisor

Caruso, Joseph M.

Third Advisor

Kan, Joseph

Degree Name

Master of Science (MS)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Orthodontics; Corrective -- therapy; Dental Implants; Cone-Beam Computed Tomography;

Subject - Local

Sagittal Root Position; Maxillary Incisors; Alveolar bone adaptation;



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website


Loma Linda University. Del E. Webb Memorial Library. University Archives