Avaliação da espessura de esmalte de dentes anteriores em tomografia computadorizada cone-beam

Abstract

Introduction: Interproximal reduction (IPR) is a common procedure in Orthodontics practice. When stripping is recommended, it is important to assess the amount of enamel that can be removed. Individual differences related to enamel thickness cannot be underestimated, since many factors such as group of teeth, proximal surface, gender and ethnic are related to different enamel thickness. Purpose: The aims of this study were to evaluate the enamel thickness of human teeth (upper and lower central incisors, lateral incisors and canines) in cone-beam computed tomography (CBCT) and to review interproximal reduction techniques. Material and methods: 191 teeth were evaluated in high quality CBCT obtained by the PreXion 3D with 50x50mm FOV and 0,10mm Voxel. The scans were requested for different types of dentistry treatments and for dental evaluation. Healthy teeth, without signs of incisal wear and the absence of orthodontic retainers were selected. Teeth with fillings and with anomalous form and size were excluded of the sample. Results: A statistically significant difference was found between mesial and distal enamel thickness. The distal surface presented a greater amount of enamel (p=0,012). No significant difference was found between the teeth of the right and left sides neither between gender. Besides, no correlation was found between the enamel thickness and the age of the patients. However, it was found a correlation between the mesiodistal width and the shape of the teeth, and between the mesiodistal width and the distal and mesial enamel thickness. Conclusions: The individual differences related to enamel thickness should be considered, since several factors are associated with different enamel thickness. Cone-beam computed tomography, periapical and interproximal radiographs are tools that should be used to measure dental crown dimensions and interproximal enamel thickness. With this quantification and measurements, orthodontists and clinicians are able to plan the appropriate sites and the amount of enamel wear to perform safely and obtain effective results.