Evaluation of bone density changes around maxillary anterior teeth during orthodontic treatment: A prospective longitudinal study

Objectives: This prospective longitudinal study evaluated bone density changes around maxillary anterior teeth during fixed orthodontic treatment following first premolar extractions using cone-beam computed tomography (CBCT). Material and Methods: Twelve patients aged 15–30 years undergoing fixed orthodontic treatment with bilateral first premolar extractions were enrolled. CBCT scans were acquired at 2 time points: Post-extraction and appliance placement (T1) and after 7 months of treatment (T2). Bone density, measured in Hounsfield units (HU), was assessed at cervical, intermediate, and apical levels around 6 maxillary anterior teeth (11, 12, 13, 21, 22, and 23) using CS 3D Imaging Software. Results: Significant bone density reductions were observed, particularly in canines, with tooth 23 showing the greatest decrease (mean difference = 170.74 HU; P = 0.025) at the apical level. Central incisors exhibited minimal changes, while lateral incisors showed significant reductions primarily at the apical level. Conclusion: CBCT effectively detected site-specific bone density reductions, emphasizing the need for tailored force application and retention strategies to ensure periodontal health and post-treatment stability.