Buccolingual alveolar bone condition of mandibular molar distalization in skeletal class III patients

Buccolingual alveolar bone condition of mandibular molar distalization in skeletal class III patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Buccolingual alveolar bone condition of mandibular molar distalization in skeletal class III patients Liya Jiang, Luxi Weng, Liqi Xu, Jun Lin This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2900976/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective: To investigate the alveolar bone condition of mandibular molar distalization in skeletal Class III patients from buccolingual direction. Methods: 45 skeletal class III patients were recruited. The alveolar bone volume, buccal cortical bone thickness and lingual cortical bone thickness were measured in five planes from mesial to distal and at five depths from gingival to root. The effects of the gender of the patients, the second molar lingual inclination, and wisdom tooth on alveolar bone volume and cortical bone thickness were evaluated. To explore the effect of wisdom tooth extraction on alveolar bone condition, the measurements before and after wisdom tooth extraction were compared. Results: The impacted wisdom tooth had significantly greater alveolar bone volume and thicker buccal cortical bone at cervical third of molar, while the erupted wisdom tooth had greater alveolar bone volume at apical third. After wisdom tooth extraction, these advantages would weaken owing to the reconstruction of alveolar bone. Patients with lingual inclined molar were observed to own thicker lingual cortical bone. Male tended to have greater alveolar bone volume, but no significant differences were shown in this study. Conclusions: The growth of wisdom tooth and the second molar lingual inclination can effectively make the alveolar bone condition more favorable for mandibular molar distalization, but gender has trivial effects on alveolar bone condition. Shortly after the wisdom tooth extraction surgery, the better bone condition can be maintained. mandibular molar distalization alveolar bone condition alveolar bone volume cortical bone thickness wisdom tooth Figures Figure 1 Figure 2 Figure 3 Figure 4 INTRODUCTION Recently, the prevalence of skeletal class III malocclusion has increased from 9.02 to 19% in Asians [ 1 , 2 ], which is significantly higher than 2.8–4.2% in Africans or Caucasians [ 3 – 5 ]. Regardless of ethnicity, skeletal class III malocclusion is likely affected by muscular forces, nutrition, or basal metabolism [ 6 ]. In non-growing patients, orthognathic surgery is considered as an effective treatment option [ 7 , 8 ]. However, due to the high risks and costs, more patients tend to opt for camouflage treatment, displacing teeth to compensate for a jaw discrepancy, in order to achieve normal occlusion and esthetics, especially for patients with mild or moderate discrepancy [ 9 , 10 ]. Mandibular molar distalization is one of the camouflage treatments. Several studies have reported the effectiveness of molar distalization, and the distance of molar moving is 1.85 to 4.00 millimeters [ 11 – 16 ]. The development of mini-screws effectively decreased the tipping movement of molars, and the stability has been preliminary proved [ 12 – 13 , 16 – 17 ]. Thanks to the universal use of cone beam computed tomography (CBCT) in recent years, the lingual cortical bone of posterior mandibular body was found to be the distal limitation of molar distalization instead of the anterior border of the mandibular ramus [ 18 – 20 ]. However, few studies have focused on the buccolingual alveolar bone condition, which is another anatomic limitation. If the alveolar bone volume is insufficient and the root contacts cortical bone during the moving procedure, there is a potential risk of root resorption or the occurrence of dehiscence and fenestration [ 21 – 24 ]. Therefore, cortical bone thickness is also worth studying. It has been reported that alveolar bone thickness is closely related to periodontal condition, which may lead to different orthodontic results [ 25 ]. A thinner cortical bone at the cervical third of tooth increases the risk of periodontal damage such as gingival recession or alveolar bone loss [ 3 , 24 , 26 ]. On the other hand, strong buccal cortical bone is also a basis for anchorage devices such as mini-screws or miniplates, which helps to achieve a greater distance and prevent anchorage loss [ 27 , 28 ]. According to the finite element method, the maximum stress occurred in the alveolar cortical bone near the cervical areas of mini-screws [ 29 ]. It has been reported that mini-screws can maintain the orthodontic strength if the cortical bone thickness is more than 1 mm [ 27 , 30 ]. In this paper, we investigated the buccolingual alveolar bone condition of mandibular molar distalization by studying the alveolar bone volume and cortical bone thickness. The cortical bone thickness was discussed separately at cervical third and apical third of the tooth because of their different roles. Tooth cervical third cortex is a guarantee for molar moving, while the apical one is more concerned as a spot for mini-screws, which is commonly used in cases where molar distalization is needed. Three factors including gender, second molar lingual inclination and wisdom tooth were included in the experiment to explore the effects of these factors on the alveolar bone condition. To skeletal class III patients, compensated lingual inclination usually occurs in the mandibular posterior dentition [ 31 – 33 ], which probably has an effect on cortex thickness. Few attempts have been made to discuss the association between the alveolar bone condition and second molar lingual inclination. In addition, although scientists have reported that the growth condition of wisdom tooth has no relationship with the contact of the second molar and cortical bone [ 23 ], they did not differentiate between the impacted wisdom tooth and erupted ones, and quantitative studies are also lacking. The effect of wisdom tooth on the anatomical structure of mandible remains obscure, thus the third molar is another factor to be considered. The aim of the study was to investigate the alveolar bone condition of mandibular molar distalization in skeletal Class III patients from buccolingual direction. The null hypothesis (H0) were (1) there would be no significant differences in alveolar bone volume between male and female, between upright and inclined second molar, and among erupted, impacted and absent wisdom tooth; (2) there would be no significant differences in cortical bone thickness between male and female, between upright and inclined second molar, and among erupted, impacted and absent wisdom tooth. MATERIALS AND METHODS The study protocol was reviewed and approved by the Clinical Research Ethics Committee XXXXX (No.XXX) (anonymous). This retrospective study collected samples from Chinese patients who had undergone CBCT and lateral cephalogram at the department of orthodontics from April 2019 to March 2021. The inclusion criteria were the following: (1) patients older than 16 years of age; (2) mild or moderate skeletal class III patients, with the range of ANB angle (got from the lateral cephalograms) from − 10 ~ 0 degrees; (3) no other severe malocclusion. The exclusion criteria were the following: (1) a history of orthodontic treatment, orthognathic surgery or implant treatment at the retromolar area; (2) severe periodontal diseases; (3) a history of radiotherapy or trauma. According to the sample size calculation formula (prevalence rate of 9.02%, attendance rate of 25%, µ = 1.96, δ = 0.01), at least 37 patients were needed, whereas 45 patients (19 women and 26 men) were eventually selected. The average age of the patients at the beginning of treatment was 23.24 years and ranged from 16 to 30 years. The average ANB angle was − 2.73 degrees, ranging from − 8.2 to -0.2 degrees. The Peer Assessment Rating (PAR) index of the patients was all less than 30. All the 45 patients accepted orthodontic treatment with braces. Mini-screws were implanted and implant-supported s-springs were chose to complete the molar distaliazation. The measurements were performed on both sides of each patient and an average was given. The assessments focused on the mandibular second molar and retromolar space. The CBCT scans of the patients were obtained using a scanner (NewTom VGI, NewTom, Italy) with the following operation settings: tube voltage, 110 kV; tube current, 0–20 mA; scan time, 10 seconds; voxel size, 0.3 mm; field of view: full, 15*15 cm. The scan plane was parallel to the Frankfort plane, and the range was from the middle part of skull to the lower margin of mandible. Each CBCT contained 502 images. The images were saved in Digital Imaging and Communications in Medicine (DICOM) format. Lateral cephalograms were performed by Planmeca Promax (Planmeca Oy, Helsinki, FInland) with the settings: voltage, 64 kV; image size: 300*270 mm. Data were measured using Dolphin (Dolphin Imaging & Mangement Solutions, Chatsworth California, USA). During the CBCT examinations, the participants maintained their head in a natural position, and the position was fixed by the scanning instrument. After CBCT was imported into Dolphin, the orbital floor connecting line was adjusted to the horizontal in the coronal plane, as shown in Fig. 1 (a). The condyle connecting line was adjusted to the horizontal in the frontal plane, as shown in Fig. 1 (b). The skull was repositioned so that the molar alveolar crest line was adjusted to the horizontal in the sagittal plane, as shown in Fig. 1 (c). The reference plane equivalent to the height of the meso-distal alveolar crest of the lower second molar was called “0-plane”, as shown in Fig. 2. The B-plane was tangential to the most distal point of the lower second molar (the red point) and perpendicular to the 0-plane. The other four planes, which were mesially 1 mm and distally 1, 2, 3 mm away from the B-plane, were called “A-plane,” “C-plane,” “D-plane”, and “E-plane”, respectively. In each plane, a buccolingual line connecting the alveolar crest of the lower second molar was called “0-line”, as shown in Fig. 3. The other four lines that were parallel to the 0-line and apically 3, 6, 9, 12 mm away from the 0-line were called “3-line”, “6-line”, “9-line”, and “12-line”, respectively. All these lines were used for measuring the alveolar bone volume, buccal cortical bone thickness and lingual cortical bone thickness. Statistical analysis was performed using SPSS for Mac (version 26; IBM, Armonk, NY, USA). The participants were classified by gender (male vs female), second molar inclination (lingual vs upright) and wisdom tooth (erupted vs impacted vs absent). We used two-tailed independent t test and one-way ANOVA to compare the alveolar bone volume and buccal or lingual cortical bone thickness. Homogeneity of variance and normal distribution were also tested, and the data all conformed to the normal distribution. The mesial inclined angle of wisdom tooth (the angle between the tooth axis and the normal) and the lingual inclined angle of the second molar (the angle between the tangency of the most convex point on the buccal crown and the normal) were measured, and we performed multiple linear regression analysis at the 0-line of A and E planes and 12-line of A and E planes. Besides, 18 patients accepted the wisdom tooth extraction at the beginning of molar diatalization, therefore, 36 wisdom teeth were extracted. They were screened to investigate whether the measurements had a significant difference before and after the surgery by a two-tailed paired t test. Statistical significance was set at P < 0.05. The Benjamini-Hochberg style was used to correct P , as we conducted multiple significance tests. Before the experiment, the age or ANB angle of the participants were collected and tested by two-tailed independent t test to ensure that the intergroup differences would not interfere with the results ( P > 0.05). The same examiner performed the measurements again after 2 weeks, and Dahlberg's formula ( \(D=\sqrt {\sum\limits_{{i=1}}^{n} {\frac{{d_{i}^{2}}}{{2n}}} }\) ) was used for reporting the error between measured and re-measured data. d i is the difference between the first and the second measure, and n is the sample size which was re-measured. In this study, D ranged from 0.06 to 0.32mm. RESULTS The patient characteristics were shown in Table I. The study population included 26 males and 19 females. In 21 of the 45 samples, the lower second molars were regarded as lingual inclination (the lingual inclined angle is greater than 35 degree). Erupted wisdom tooth, impacted wisdom tooth and absent wisdom tooth were assessed for 16, 17 and 12 samples, respectively. The independent t test and one-way ANOVA were used to test age and ANB angle between different groups according to gender, second molar inclination and wisdom tooth, and no significant differences were found, indicating that the age and ANB angle (severity of malocclusion) were average among different groups and would not affect the experimental results ( P > 0.05). Table 1 Patient Characteristics Variables Patients ( n ) Age, y (mean ± SD ) ANB Angle, ° (mean ± SD ) Gender Male 26 22.54 ± 3.61 -3.04 ± 2.36 Female 19 24.21 ± 3.66 -2.31 ± 2.15 P value 1 0.13 0.29 The second molar Lingual 21 22.57 ± 3.99 -2.72 ± 2.36 Upright 24 23.83 ± 3.37 -2.50 ± 2.23 P value 1 0.26 0.48 Wisdom tooth Erupted 16 22.63 ± 3.38 -2.53 ± 1.93 Impacted 17 23.06 ± 3.25 -3.14 ± 2.16 Absent 12 24.33 ± 4.64 -2.41 ± 2.91 P value 2 0.47 0.64 SD , standard deviation; P value 1 , independent-samples t-test; P value 2 , one-way ANOVA test. 1. Alveolar bone volume The effects of gender, the second molar lingual inclination and wisdom tooth on the alveolar bone volume are shown in Fig. 4 . According to an independent t test, males tended to have a greater alveolar bone volume than females, but the difference was less than 1 mm (Fig. 4 , a). As shown in Fig. 4 (b), the effect of second molar lingual inclination on alveolar bone volume decreased gradually from crown to root. At the cervical third, the alveolar bone volume of lingual inclined molar was 0.68–1.16 mm larger than that of upright molars, but the increased volume decreased to 0.11–0.65 mm when it came to the apical third. As shown in Fig. 4 (c), at the cervical third (0-line and 3-line), the alveolar bone volume of the impacted wisdom tooth was 3–5 mm larger than that of absent wisdom tooth, and it was 2–3 mm larger than that of erupted wisdom tooth. These differences were significant. At the apical third (9-line and 12-line), the alveolar bone volume of erupted wisdom tooth was 2 mm larger than that of the absent wisdom tooth, and 0.5-1 mm larger than that of the impacted wisdom tooth. That is, the wisdom tooth had the greatest effect on alveolar bone volume compared with gender and molar lingual inclination. Furthermore, the correlation coefficient B and P value were obtained by multiple linear regression (Table 2 ). As shown in Table 2 , the positive correlated factors of alveolar bone volume at the tooth cervical third were mesial inclined angle of wisdom tooth, and the negative correlated factors of alveolar bone volume at the tooth apical third were gender. Table 2 The correlation coefficient with regard to the variables affecting the alveolar bone volume B P value B P value Gender 0-A 0.38 0.48 0-E 0.19 0.85 Angle 1 -0.08 0.10 0.09 0.13 Angle 2 0.05 0.00** 0.07 0.00** Gender 12-A -1.75 0.02* 12-E -1.35 0.03* Angle 1 0.05 0.20 0.01 0.76 Angle 2 -0.01 0.31 -0.02 0.07 Statistical significance is tested by multiple linear regression. Angle 1, Lingual inclined angle of the second molar; Angle 2, Mesial inclined angle of wisdom tooth; B , correlation coefficient; * P value < 0.05; ** P value < 0.01; 0-A, 0-line of A plane; 0-E, 0-line of E plane; 12-A, 12-line of A plane; 12-E, 12-line of E plane. 2. Cortical bone thickness The measurements of buccal and lingual cortical bone thickness at the cervical third (0-line and 3-line) were presented in Table 3 . The statistics of gender were not listed because it did not show a significant effect on the cortical bone thickness. In patients with lingually inclined second molars, the buccal cortical bone was slightly thicker (about 0.1–0.2 mm) and the lingual cortical bone was significantly thicker (about 0.3–0.4 mm) than those in patients with an upright molar. The differences were significant in the A-plane. The buccal cortical bone of the impacted wisdom tooth group was about 1.5 mm thicker than that of the absent group; the erupted group was in-between. Significant differences were found at the 0-line and 3-line of A-plane. However, when it comes to lingual cortical bone, the three groups were very similar. That in the absent group seemed a little thicker than in the other two groups. ​ Table 3 The effects of the second molar lingual inclination and wisdom tooth on the cortical bone thickness at the cervical third (0-line and 3-line) Variables Buccal cortical bone Lingual cortical bone Mean 95% CI Mean 95% CI 0-A The second molar Lingual 2.53 (2.11, 2.90) 1.66 (1.48, 1.83) Upright 2.36 (1.87, 2.90) 1.40 (1.29, 1.51) P value 1 0.62 0.01** Wisdom tooth Erupted 2.24 b (1.71, 2.78) 1.51 (1.28, 1.75) Impacted 3.15 a (2.56, 3.74) 1.51 (1.34, 1.68) Absent 1.69 b (1.30, 2.08) 1.54 (1.37, 1.71) P value 2 0.00** 0.98 3-A The second molar Lingual 3.31 (2.93, 3.70) 2.10 (1.88, 2.32) Upright 3.20 (2.72, 3.67) 1.79 (1.62, 1.97) P value 1 0.73 0.01** Wisdom tooth Erupted 3.14 (2.46, 3.82) 1.86 (1.53, 2.19) Impacted 3.45 (2.97, 3.92) 1.98 (1.74, 2.21) Absent 3.12 (2.47, 3,76) 1.98 (1.75, 2.20) P value 2 0.64 0.77 0-B The second molar Lingual 2.82 (2.37, 3.31) 2.04 (1.90, 2.20) Upright 2.63 (2.10, 3.10) 2.00 (1.79, 2.24) P value 1 0.59 0.78 Wisdom tooth Erupted 2.56 ab (1.91, 3.20) 1.82 (1.56, 2.08) Impacted 3.41 a (2.81, 4.00) 2.10 (1.84, 2.36) Absent 1.95 b (1.70, 2.20) 2.18 (1.93, 2.42) P value 2 0.00** 0.11 3-B The second molar Lingual 3.60 (3.23, 3.92) 2.69 (2.41, 2.94) Upright 3.20 (2.86, 3.52) 2.48 (2.14, 2.81) P value 1 0.12 0.35 Wisdom tooth Erupted 3.39 (2.74, 4.05) 2.34 (1.92, 2.76) Impacted 3.39 (3.12, 3.67) 2.64 (2.28, 2.99) Absent 3.35 (2.91, 3.79) 2.82 (2.35, 3.28) P value 2 0.99 0.23 0-C The second molar Lingual 2.95 (2.42, 3.44) 2.37 (2.16, 2.60) Upright 2.82 (2.29, 3.31) 2.09 (1.87, 2.31) P value 1 0.73 0.10 Wisdom tooth Erupted 2.61 (1.78, 3.44) 1.90 (1.64, 2.16) Impacted 3.34 (2.77,3.90) 2.40 (2.11, 2.69) Absent 2.61 (2.12,3.10) 2.40 (2.09, 2.71) P value 2 0.16 0.01** 3-C The second molar Lingual 3.59 (3.23, 3.91) 2.74 (2.49, 3.00) Upright 3.35 (3.08, 3.62) 2.36 (2.12, 2.61) P value 1 0.31 0.04* Wisdom tooth Erupted 3.36 (2.83, 3.89) 2.43 (2.05, 2.81) Impacted 3.49 (3.17, 3.82) 2.53 (2.29, 2.76) Absent 3.56 (3.18, 3.94) 2.69 (2.23, 3.15) P value 2 0.79 0.56 0-D The second molar Lingual 2.93 (2.46, 3.38) 2.19 (2.00, 2.35) Upright 2.60 (2.07, 3.08) 2.10 (1.83, 2.37) P value 1 0.36 0.62 Wisdom tooth Erupted 2.46 (1.63, 3.28) 1.92 (1.61, 2.22) Impacted 3.26 (2.74, 3.79) 2.16 (1.90, 2.43) Absent 2.43 (1.99, 2.86) 2.40 (2.06, 2.74) P value 2 0.09 0.08 3-D The second molar Lingual 3.67 (3.26, 4.09) 2.67 (2.40, 2.93) Upright 3.40 (3.17, 3.63) 2.38 (2.15, 2.60) P value 1 0.26 0.11 Wisdom tooth Erupted 3.38 (2.96, 3.79) 2.44 (2.08, 2.80) Impacted 3.61 (3.20, 4.02) 2.40 (2.17, 2.63) Absent 3.60 (3.07, 4.13) 2.78 (2.37, 3.19) P value 2 0.66 0.19 0-E The second molar Lingual 3.13 (2.63, 3.58) 2.25 (2.05, 2.43) Upright 2.69 (2.18, 3.15) 2.06 (1.82, 2.29) P value 1 0.22 0.23 Wisdom tooth Erupted 2.73 (1.87, 3.60) 1.96 (1.63, 2.29) Impacted 3.17 (2.66, 3.68) 2.12 (1.85, 2.39) Absent 2.73 (2.19, 3.26) 2.44 (2.27, 2.61) P value 2 0.51 0.06 3-E The second molar Lingual 3.53 (3.11, 3.95) 2.44 (2.19, 2.67) Upright 3.48 (3.22, 3.71) 2.36 (2.12, 2.57) P value 1 0.81 0.64 Wisdom tooth Erupted 3.35 (2.86, 3.84) 2.23 (1.89, 2.56) Impacted 3.52 (3.23, 3.81) 2.34 (2.10, 2.58) Absent 3.71 (3.08, 4.27) 2.70 (2.38, 3.02) P value 2 0.58 0.07 All data are presented in millimeters. CI , Confidence level; P value 1 , independent-samples t-test; P value 2 , one-way ANOVA test; * P value < 0.05; ** P value < 0.01; ab , differences tested by one-way ANOVA test. 3. Alveolar remodeling after wisdom tooth extraction As mentioned above, the impacted wisdom tooth was proved to have a significant effect on the alveolar bone volume at the cervical third of tooth, therefore, the 0-line was used to investigate whether the measurements would change after an extraction operation. As shown in Table 4 , according to 18 patients who accepted wisdom tooth extraction, a significantly smaller alveolar bone volume and thinner cortical bone thickness were witnessed at the original wisdom tooth area. Table 4 Comparison of the alveolar bone condition before and after the extraction 0-A 0-B 0-C 0-D 0-E Alveolar bone volumn before-after 1.22 2.43 3.59 3.82 4.43 95% CI (0.06, 2.38) (0.83, 4.03) (1.93, 5.26) (2.29, 5.35) (2.58, 6.29) P value 1 0.04* 0.01** 0.00** 0.00** 0.00** Buccal cortical bone before-after 0.95 1.25 0.86 0.62 0.59 95% CI (0.44, 1.46) (0.73, 1.77) (0.22, 1.50) (0.03, 1.22) (-0.09, 1.28) P value 1 0.00** 0.00** 0.01** 0.04* 0.09 Lingual cortical bone before-after 0.12 0.30 0.44 0.27 0.24 95% CI (-0.06, 0.31) (0.04, 0.56) (0.20, 0.69) (0.02, 0.51) (0.05, 0.43) P value 1 0.19 0.03* 0.00** 0.03* 0.02* All data are presented in millimeters. Before-after, difference between before and after wisdom tooth extraction; CI , Confidence level; P value 1 , independent-samples t-test; * P value < 0.05; ** P value < 0.01. DISCUSSION Mandibular dentition distalization is a common treatment option for class III malocclusion patients; however, few investigations have addressed the buccolingual alveolar bone condition. Ignoring the thin cortex at the cervical third is likely to result in periodontal diseases, such as the recession of gingival and alveolar bone crest during treatment [ 3 , 26 ]. Buccal cortical bone thickness at the apical third was especially focused on in this study to discuss the condition for planting mini-screws. Furthermore, if the alveolar bone volume is insufficient, alveolar bone damage or root resorption may occur, causing an irreparable loss to patient [ 21 – 24 ]. CBCT is regarded as the best imaging tool for investigating maxillofacial anatomy, as it can clearly show the structure from the three-dimensional direction. In this experiment, CBCT was used to investigate the alveolar bone condition of mandibular molar distalization by measuring the alveolar bone volume and cortical bone thickness, and to explore whether gender, second molar lingual inclination and wisdom tooth would influence the condition. We found that the development of wisdom tooth is closely linked to the buccolingual alveolar bone condition. By one-way ANOVA, significant differences were observed at the cervical third (0-line and 3-line) and apical third (9-line and 12-line). Greater alveolar bone volume at the tooth apical third was observed in the erupted group vs. the absent group, while the alveolar bone volume at the tooth cervical third was larger in the impacted group. This could be ascribed to the location of the tooth. The impacted wisdom tooth is usually located at the cervical third of the second molar root, and it seldom has an effect on the alveolar bone at the apical third. This location assumption may also explain the significantly increased thickness of buccal cortical bone at the cervical third of the impacted group and the apical third of the erupted group. In addition, according to the statistics in our experiment, the greater volume and cortical bone thickness would decrease after tooth extraction. Since thicker cortex and greater alveolar bone volume are considered as advantages for molar distalization, it is suggested that the better condition should be utilized as soon as possible after the wisdom tooth extraction surgery. Previous study reported males tended to have greater alveolar bone volume than females [ 34 ]. In this study, although the difference was not significant, the alveolar bone volume of male was about 10% larger than that of female. Second molar lingual inclination molar brought thicker lingual cortex at the cervical third of the second molar. The explanation for this may be the dumping pressure of the molar, which activates osteogenic activity at the cervical third. It has been reported that a thinner cortical bone was correlated with an increase in vertical bone loss [ 3 ], therefore, when moving molars, class III patients with compensatory inclined second molars may probably have advantages to some extent. According to the multiple linear regression, the correlation between the mesial inclined angle of wisdom tooth and alveolar bone volume was complex—positive at the tooth cervical third and negative at the apical third. In other words, the more mesial inclination of the wisdom tooth, the greater the alveolar bone volume at the cervical third, and the smaller the alveolar bone volume at the apical third. The lingual inclined angle of the second molar was positively correlated with alveolar bone volume at the apical third. That is, the larger the angle, the greater the alveolar bone volume. This study still has some limitations. We did not consider soft tissue like the attached gingival in this study, which is also important for periodontal health and the anchoring of mini-screws [ 2 ]. What is more, the cortical bone boundary was judged by the experience of the researcher. More accurate methods can be explored, such as evaluation by software that can measure the bone mineral density. CONCLUSIONS The growth of third molars yields greater alveolar volume and thicker cortical bone, making the alveolar bone condition more favorable for molar distalization, and the favorable bone condition would be maintained by full utilization shortly after the wisdom tooth extraction surgery. The second molar lingual inclination makes the cortical bone thicker and helps to reducing the loss of alveolar crest during the distalization. Gender has trivial effects on alveolar bone condition. Declarations Ethics approval and consent to participate All experiments were performed in accordance with relevant guidelines and regulations. The study protocol was reviewed and approved by the Clinical Research Ethics Committee of the First Affiliated Hospital, College of Medicine, Zhejiang University (IIT20210035A). Since this study was a retrospective study, the informed consent was waived off by the Clinical Research Ethics Committee of the First Affiliated Hospital, College of Medicine, Zhejiang University. Consent for publication Not applicable Availability of data and materials The datasets used and analyzed during the current study are available from the corresponding author on reasonable request. Competing interests No competing interests. Funding This work was supported by the National Natural Science Foundation of China [grant no. 81970978]. Authors' contribution LJ conceived and designed the study, searched the literature, performed data acquisition and statistical analysis, and drafted the manuscript. LW offered the resources and helped with a major revision. LX performed data curation and helped with the revision. JL critically revised the manuscript for important intellectual content, performed supervision and administrated the project. All authors read and approved the final manuscript. Acknowledgements None. References Doraczynska-Kowalik A, Nelke KH, Pawlak W, Sasiadek MM, Gerber H. Genetic Factors Involved in Mandibular Prognathism. J Craniofac Surg. 2017; 28(5): e422–e431. Kajii TS, Oka A, Saito F, Mitsui J, Iida J. Whole-exome sequencing in a Japanese pedigree implicates a rare non-synonymous single-nucleotide variant in BEST3 as a candidate for mandibular prognathism. Bone. 2019; 122:193–198. Garlock DT, Buschang PH, Araujo EA, Behrents RG, Kim KB. 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Nonsurgical correction of a Class III malocclusion in an adult by miniscrew-assisted mandibular dentition distalization. Am J Orthod Dentofacial Orthop. 2013;143(6):877–887. Wu D, Zhao Y, Ma M, Zhang Q, Lei H, Wang Y, et al. Efficacy of mandibular molar distalization by clear aligner treatment. J Cent South Univ. 2021;46(10):1114–1121. Chen G, Teng F, Xu TM. Distalization of the maxillary and mandibular dentitions with miniscrew anchorage in a patient with moderate Class I bimaxillary dentoalveolar protrusion. Am J Orthod Dentofacial Orthop. 2016;149(3):401–410. Chen K, Cao Y. Class III malocclusion treated with distalization of the mandibular dentition with miniscrew anchorage: A 2-year follow-up. Am J Orthod Dentofacial Orthop. 2015; 148(6):1043–1053. Anders B, á GH, Jarle CI, Inger K. Predicting lower third molar eruption on panoramic radiographs after cephalometric comparison of profile and panoramic radiographs. Eur J Orthod. 2013;35(4):460-6. Kim SJ, Choi TH, Baik HS, Park YC, Lee KJ. Mandibular posterior anatomic limit for molar distalization. Am J Orthod Dentofacial Orthop. 2014;146(2):190-7. Choi YT, Kim YJ, Yang KS, Lee DY. Bone availability for mandibular molar distalization in adults with mandibular prognathism. Angle Orthod. 2017;88(1):52-7. Wainwright WM. Faciolingual tooth movement: its influence on the root and cortical plate. Am J Orthod Dentofacial Orthop. 1973;64(3):278-302. Kaley JP, Phillips C. Factors related to root resorption in edgewise practice. Angle Orthod. 1991;61(2):125-32. Chen CL, Chen CH, Pan CY, Chang HP, Tseng YC. Cone beam computed tomographic analysis of the spatial limitation during mandibular arch distalization. BMC Med Imaging. 2020;20(1):39. He H. Periodontal limits of orthodontic tooth movement. Zhonghua Kou Qiang Yi Xue Za Zhi. 2021; 56(10):966–970. Barreda GJ, Dzierewianko EA, Mazza V, Muñoz KA, Piccoli GI, Romanelli HJ. Expansion treatment using Invisalign®: Periodontal health status and maxillary buccal bone changes. A clinical and tomographic evaluation. Acta Odontol Latinoam. 2021; 33(2):69–81. Garib DG, Henriques J, Janson G, Freitas MD, Fernandes AY. Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: A computed tomography evaluation. Am J Orthod Dentofacial Orthop. 2006;129(6):749-58. Popa A, Dehelean C, Calniceanu H, et al. A Custom-Made Orthodontic Mini-Implant-Effect of Insertion Angle and Cortical Bone Thickness on Stress Distribution with a Complex In Vitro and In Vivo Biosafety Profile. Materials (Basel, Switzerland). 2020; 13(21):4789 Sugawara Y, Kuroda S, Tamamura N, Takano-Yamamoto T. Adult patient with mandibular protrusion and unstable occlusion treated with titanium screw anchorage. Am J Orthod Dentofacial Orthop. 2008;133(1):102-11. Benaissa A, Merdji A, Bendjaballah MZ, Ngan P, Mukdadi OM. Stress influence on orthodontic system components under simulated treatment loadings. Comput Methods Programs Biomed. 2020; 195:105569. Erbay Elibol FK, Oflaz E, Buğra E, Orhan M, Demir T. Effect of cortical bone thickness and density on pullout strength of mini-implants: An experimental study. Am J Orthod Dentofacial Orthop. 2020; 157(2), 178–85. Sha HN, Lim SY, Kwon SM, Cha JY. Camouflage treatment for skeletal Class III patient with facial asymmetry using customized bracket based on CAD/CAM virtual orthodontic system. Angle Orthod. 2020; 90(4):607–618. Ahn J, Kim SJ, Lee JY, Chung CJ, Kim KH. Transverse dental compensation in relation to sagittal and transverse skeletal discrepancies in skeletal Class III patients. Am J Orthod Dentofacial Orthop. 2017; 151(1):148–156. Kau CH, Bakos K, Lamani E. Quantifying changes in incisor inclination before and after orthodontic treatment in class I, II, and III malocclusions. J World Fed Orthod. 2020; 9(4):170–174. Zhang W, Tullis J, Weltman R. Cone beam computerized tomography (CBCT) measurement of alveolar ridge at posterior mandible for implant graft estimation. J Oral Implantol. 2015;41(6): e231-7. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2900976","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":198770257,"identity":"718c7048-bd8d-4717-903d-9438cfa57889","order_by":0,"name":"Liya Jiang","email":"","orcid":"","institution":"ShangHai Stomatological Hospital, Fudan University.","correspondingAuthor":false,"prefix":"","firstName":"Liya","middleName":"","lastName":"Jiang","suffix":""},{"id":198770259,"identity":"a119eafa-0627-44d0-a78e-e90e5f2efaf3","order_by":1,"name":"Luxi Weng","email":"","orcid":"","institution":"The First Affiliated Hospital, College of Medicine, Zhejiang University.","correspondingAuthor":false,"prefix":"","firstName":"Luxi","middleName":"","lastName":"Weng","suffix":""},{"id":198770261,"identity":"acd31516-932f-413a-a282-7a99114bbca6","order_by":2,"name":"Liqi Xu","email":"","orcid":"","institution":"The First Affiliated Hospital, College of Medicine, Zhejiang University.","correspondingAuthor":false,"prefix":"","firstName":"Liqi","middleName":"","lastName":"Xu","suffix":""},{"id":198770262,"identity":"3fc3e42e-e6f0-449c-a523-33b994d95572","order_by":3,"name":"Jun Lin","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA90lEQVRIie3RsWrDMBCA4RMH6uLKq0wgfgUZQ0qg9FnOBDJl6FSy1WBwp+7pW+gRFALu4rarR5W+QMBLt1ZOlk6yx0D1j+I+dEgAodAFlmJsDSl+F8eVATkcmRGSPUXM2q1YJbuGphH4iDCz7ZzpcqPOJ2OEVdeNLOoFKmj747KGueiI9fcecoVi7cha3OCzVkkNedIRznbeW2DhSIPL8k2TI4XuiGPk2+xwIj9Mm401jjxOIFGuqOUDYaUjpMZIVvHC0pYPj5yDfJfZS/tZzXwkjQ9m/33+yq9ePtym4nW1772L/Q3l6TNZORW42eP02VAoFPpH/QIbM02Kphvm/AAAAABJRU5ErkJggg==","orcid":"","institution":"The First Affiliated Hospital, College of Medicine, Zhejiang University.","correspondingAuthor":true,"prefix":"","firstName":"Jun","middleName":"","lastName":"Lin","suffix":""}],"badges":[],"createdAt":"2023-05-06 08:29:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2900976/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2900976/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":36958743,"identity":"ea219ec3-32fe-4502-8c7c-39fbe9410717","added_by":"auto","created_at":"2023-05-12 14:53:36","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":867692,"visible":true,"origin":"","legend":"\u003cp\u003e(a) The orbital floor connecting line (white horizontal line) was adjusted to the horizontal in the coronal plane. (b) The condyle connecting line (white horizontal line) was adjusted to the horizontal in the frontal plane. (c) The molar alveolar crest line (white horizontal line) was adjusted to the horizontal in the sagittal plane.\u003c/p\u003e","description":"","filename":"figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-2900976/v1/7062c6bfe6175728ac94b1f7.png"},{"id":36957491,"identity":"0a1bfbff-8a65-4314-9c8f-4dbc6d1526cd","added_by":"auto","created_at":"2023-05-12 14:45:35","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1577170,"visible":true,"origin":"","legend":"\u003cp\u003eThe 0-plane (orange horizontal line) was equivalent to the height of the meso-distal alveolar crest of the lower second molar. The B-plane (orange vertical line) was perpendicular to the 0-plane and tangential to the most distal point of the lower second molar. The A, C, D, E-planes (white lines) were mesially 1 mm and distally 1, 2, 3 mm away from the B-plane.\u003c/p\u003e","description":"","filename":"figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-2900976/v1/c0eeef05fdf632c74c5160fc.png"},{"id":36957492,"identity":"36a5e9a5-f171-4b86-9872-50cf0518fea6","added_by":"auto","created_at":"2023-05-12 14:45:36","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":908973,"visible":true,"origin":"","legend":"\u003cp\u003eThe 0-line (orange line) was a buccolingual line connecting the alveolar crest of the lower second molar. The 3-, 6-, 9-, and 12-lines (white lines) were parallel to the 0-line and apically 3, 6, 9, 12 mm away from it.\u003c/p\u003e","description":"","filename":"figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-2900976/v1/5ab0f1283eadad87a98cc527.png"},{"id":36957494,"identity":"18c4d33d-bae4-4448-82d5-2a3ebf2ff429","added_by":"auto","created_at":"2023-05-12 14:45:36","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":1669780,"visible":true,"origin":"","legend":"\u003cp\u003ea) The effects of gender on the alveolar bone volume. (b) The effects of the second molar lingual inclination on the alveolar bone volume. (c) The effects of wisdom tooth on the alveolar bone volume. *\u003cem\u003eP\u003c/em\u003e value\u0026lt;0.05; **\u003cem\u003eP\u003c/em\u003e value\u0026lt;0.01. The error line shows 95% confidence interval.\u003c/p\u003e","description":"","filename":"figure4.png","url":"https://assets-eu.researchsquare.com/files/rs-2900976/v1/da8d0f6970e4d5a652b5099e.png"},{"id":43824684,"identity":"0b479c6e-67c9-4129-a384-2bbefee12fff","added_by":"auto","created_at":"2023-09-28 12:37:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":4676898,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2900976/v1/e084aa1e-39dd-4365-a6fd-3ebedec8ce07.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Buccolingual alveolar bone condition of mandibular molar distalization in skeletal class III patients","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eRecently, the prevalence of skeletal class III malocclusion has increased from 9.02 to 19% in Asians [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], which is significantly higher than 2.8\u0026ndash;4.2% in Africans or Caucasians [\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Regardless of ethnicity, skeletal class III malocclusion is likely affected by muscular forces, nutrition, or basal metabolism [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn non-growing patients, orthognathic surgery is considered as an effective treatment option [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. However, due to the high risks and costs, more patients tend to opt for camouflage treatment, displacing teeth to compensate for a jaw discrepancy, in order to achieve normal occlusion and esthetics, especially for patients with mild or moderate discrepancy [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Mandibular molar distalization is one of the camouflage treatments. Several studies have reported the effectiveness of molar distalization, and the distance of molar moving is 1.85 to 4.00 millimeters [\u003cspan additionalcitationids=\"CR12 CR13 CR14 CR15\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The development of mini-screws effectively decreased the tipping movement of molars, and the stability has been preliminary proved [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThanks to the universal use of cone beam computed tomography (CBCT) in recent years, the lingual cortical bone of posterior mandibular body was found to be the distal limitation of molar distalization instead of the anterior border of the mandibular ramus [\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. However, few studies have focused on the buccolingual alveolar bone condition, which is another anatomic limitation. If the alveolar bone volume is insufficient and the root contacts cortical bone during the moving procedure, there is a potential risk of root resorption or the occurrence of dehiscence and fenestration [\u003cspan additionalcitationids=\"CR22 CR23\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Therefore, cortical bone thickness is also worth studying. It has been reported that alveolar bone thickness is closely related to periodontal condition, which may lead to different orthodontic results [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. A thinner cortical bone at the cervical third of tooth increases the risk of periodontal damage such as gingival recession or alveolar bone loss [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. On the other hand, strong buccal cortical bone is also a basis for anchorage devices such as mini-screws or miniplates, which helps to achieve a greater distance and prevent anchorage loss [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. According to the finite element method, the maximum stress occurred in the alveolar cortical bone near the cervical areas of mini-screws [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. It has been reported that mini-screws can maintain the orthodontic strength if the cortical bone thickness is more than 1 mm [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn this paper, we investigated the buccolingual alveolar bone condition of mandibular molar distalization by studying the alveolar bone volume and cortical bone thickness. The cortical bone thickness was discussed separately at cervical third and apical third of the tooth because of their different roles. Tooth cervical third cortex is a guarantee for molar moving, while the apical one is more concerned as a spot for mini-screws, which is commonly used in cases where molar distalization is needed.\u003c/p\u003e \u003cp\u003eThree factors including gender, second molar lingual inclination and wisdom tooth were included in the experiment to explore the effects of these factors on the alveolar bone condition. To skeletal class III patients, compensated lingual inclination usually occurs in the mandibular posterior dentition [\u003cspan additionalcitationids=\"CR32\" citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], which probably has an effect on cortex thickness. Few attempts have been made to discuss the association between the alveolar bone condition and second molar lingual inclination. In addition, although scientists have reported that the growth condition of wisdom tooth has no relationship with the contact of the second molar and cortical bone [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], they did not differentiate between the impacted wisdom tooth and erupted ones, and quantitative studies are also lacking. The effect of wisdom tooth on the anatomical structure of mandible remains obscure, thus the third molar is another factor to be considered.\u003c/p\u003e \u003cp\u003eThe aim of the study was to investigate the alveolar bone condition of mandibular molar distalization in skeletal Class III patients from buccolingual direction. The null hypothesis (H0) were (1) there would be no significant differences in alveolar bone volume between male and female, between upright and inclined second molar, and among erupted, impacted and absent wisdom tooth; (2) there would be no significant differences in cortical bone thickness between male and female, between upright and inclined second molar, and among erupted, impacted and absent wisdom tooth.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cp\u003eThe study protocol was reviewed and approved by the Clinical Research Ethics Committee XXXXX (No.XXX) (anonymous). This retrospective study collected samples from Chinese patients who had undergone CBCT and lateral cephalogram at the department of orthodontics from April 2019 to March 2021. The inclusion criteria were the following: (1) patients older than 16 years of age; (2) mild or moderate skeletal class III patients, with the range of ANB angle (got from the lateral cephalograms) from \u0026minus;\u0026thinsp;10\u0026thinsp;~\u0026thinsp;0 degrees; (3) no other severe malocclusion. The exclusion criteria were the following: (1) a history of orthodontic treatment, orthognathic surgery or implant treatment at the retromolar area; (2) severe periodontal diseases; (3) a history of radiotherapy or trauma. According to the sample size calculation formula (prevalence rate of 9.02%, attendance rate of 25%, \u003cem\u003e\u0026micro;\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.96, \u003cem\u003e\u0026delta;\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.01), at least 37 patients were needed, whereas 45 patients (19 women and 26 men) were eventually selected. The average age of the patients at the beginning of treatment was 23.24 years and ranged from 16 to 30 years. The average ANB angle was \u0026minus;\u0026thinsp;2.73 degrees, ranging from \u0026minus;\u0026thinsp;8.2 to -0.2 degrees. The Peer Assessment Rating (PAR) index of the patients was all less than 30. All the 45 patients accepted orthodontic treatment with braces. Mini-screws were implanted and implant-supported s-springs were chose to complete the molar distaliazation. The measurements were performed on both sides of each patient and an average was given. The assessments focused on the mandibular second molar and retromolar space.\u003c/p\u003e\n\u003cp\u003eThe CBCT scans of the patients were obtained using a scanner (NewTom VGI, NewTom, Italy) with the following operation settings: tube voltage, 110 kV; tube current, 0\u0026ndash;20 mA; scan time, 10 seconds; voxel size, 0.3 mm; field of view: full, 15*15 cm. The scan plane was parallel to the Frankfort plane, and the range was from the middle part of skull to the lower margin of mandible. Each CBCT contained 502 images. The images were saved in Digital Imaging and Communications in Medicine (DICOM) format. Lateral cephalograms were performed by Planmeca Promax (Planmeca Oy, Helsinki, FInland) with the settings: voltage, 64 kV; image size: 300*270 mm. Data were measured using Dolphin (Dolphin Imaging \u0026amp; Mangement Solutions, Chatsworth California, USA).\u003c/p\u003e\n\u003cp\u003eDuring the CBCT examinations, the participants maintained their head in a natural position, and the position was fixed by the scanning instrument. After CBCT was imported into Dolphin, the orbital floor connecting line was adjusted to the horizontal in the coronal plane, as shown in Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e(a). The condyle connecting line was adjusted to the horizontal in the frontal plane, as shown in Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e(b). The skull was repositioned so that the molar alveolar crest line was adjusted to the horizontal in the sagittal plane, as shown in Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e(c).\u003c/p\u003e\n\u003cp\u003eThe reference plane equivalent to the height of the meso-distal alveolar crest of the lower second molar was called \u0026ldquo;0-plane\u0026rdquo;, as shown in Fig. 2. The B-plane was tangential to the most distal point of the lower second molar (the red point) and perpendicular to the 0-plane. The other four planes, which were mesially 1 mm and distally 1, 2, 3 mm away from the B-plane, were called \u0026ldquo;A-plane,\u0026rdquo; \u0026ldquo;C-plane,\u0026rdquo; \u0026ldquo;D-plane\u0026rdquo;, and \u0026ldquo;E-plane\u0026rdquo;, respectively. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn each plane, a buccolingual line connecting the alveolar crest of the lower second molar was called \u0026ldquo;0-line\u0026rdquo;, as shown in Fig. 3. The other four lines that were parallel to the 0-line and apically 3, 6, 9, 12 mm away from the 0-line were called \u0026ldquo;3-line\u0026rdquo;, \u0026ldquo;6-line\u0026rdquo;, \u0026ldquo;9-line\u0026rdquo;, and \u0026ldquo;12-line\u0026rdquo;, respectively. All these lines were used for measuring the alveolar bone volume, buccal cortical bone thickness and lingual cortical bone thickness.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eStatistical analysis was performed using SPSS for Mac (version 26; IBM, Armonk, NY, USA). The participants were classified by gender (male vs female), second molar inclination (lingual vs upright) and wisdom tooth (erupted vs impacted vs absent). We used two-tailed independent \u003cem\u003et\u003c/em\u003e test and one-way ANOVA to compare the alveolar bone volume and buccal or lingual cortical bone thickness. Homogeneity of variance and normal distribution were also tested, and the data all conformed to the normal distribution. The mesial inclined angle of wisdom tooth (the angle between the tooth axis and the normal) and the lingual inclined angle of the second molar (the angle between the tangency of the most convex point on the buccal crown and the normal) were measured, and we performed multiple linear regression analysis at the 0-line of A and E planes and 12-line of A and E planes. Besides, 18 patients accepted the wisdom tooth extraction at the beginning of molar diatalization, therefore, 36 wisdom teeth were extracted. They were screened to investigate whether the measurements had a significant difference before and after the surgery by a two-tailed paired \u003cem\u003et\u003c/em\u003e test. Statistical significance was set at \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05. The Benjamini-Hochberg style was used to correct \u003cem\u003eP\u003c/em\u003e, as we conducted multiple significance tests. Before the experiment, the age or ANB angle of the participants were collected and tested by two-tailed independent \u003cem\u003et\u003c/em\u003e test to ensure that the intergroup differences would not interfere with the results (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The same examiner performed the measurements again after 2 weeks, and Dahlberg\u0026apos;s formula (\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(D=\\sqrt {\\sum\\limits_{{i=1}}^{n} {\\frac{{d_{i}^{2}}}{{2n}}} }\\)\u003c/span\u003e\u003c/span\u003e) was used for reporting the error between measured and re-measured data. \u003cem\u003ed\u003c/em\u003e\u003csub\u003e\u003cem\u003ei\u003c/em\u003e\u003c/sub\u003e is the difference between the first and the second measure, and \u003cem\u003en\u003c/em\u003e is the sample size which was re-measured. In this study, \u003cem\u003eD\u003c/em\u003e ranged from 0.06 to 0.32mm.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eThe patient characteristics were shown in Table I. The study population included 26 males and 19 females. In 21 of the 45 samples, the lower second molars were regarded as lingual inclination (the lingual inclined angle is greater than 35 degree). Erupted wisdom tooth, impacted wisdom tooth and absent wisdom tooth were assessed for 16, 17 and 12 samples, respectively. The independent \u003cem\u003et\u003c/em\u003e test and one-way ANOVA were used to test age and ANB angle between different groups according to gender, second molar inclination and wisdom tooth, and no significant differences were found, indicating that the age and ANB angle (severity of malocclusion) were average among different groups and would not affect the experimental results (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u0026nbsp;\u003c/p\u003e\u0026nbsp;\u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003ePatient Characteristics\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePatients\u003c/p\u003e\n \u003cp\u003e(\u003cem\u003en\u003c/em\u003e)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAge, y\u003c/p\u003e\n \u003cp\u003e(mean\u0026thinsp;\u0026plusmn;\u0026thinsp;\u003cem\u003eSD\u003c/em\u003e)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eANB Angle, \u0026deg;\u003c/p\u003e\n \u003cp\u003e(mean\u0026thinsp;\u0026plusmn;\u0026thinsp;\u003cem\u003eSD\u003c/em\u003e)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22.54\u0026thinsp;\u0026plusmn;\u0026thinsp;3.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.04\u0026thinsp;\u0026plusmn;\u0026thinsp;2.36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24.21\u0026thinsp;\u0026plusmn;\u0026thinsp;3.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.31\u0026thinsp;\u0026plusmn;\u0026thinsp;2.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eThe second molar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLingual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22.57\u0026thinsp;\u0026plusmn;\u0026thinsp;3.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.72\u0026thinsp;\u0026plusmn;\u0026thinsp;2.36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUpright\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23.83\u0026thinsp;\u0026plusmn;\u0026thinsp;3.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.50\u0026thinsp;\u0026plusmn;\u0026thinsp;2.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eWisdom tooth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eErupted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22.63\u0026thinsp;\u0026plusmn;\u0026thinsp;3.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.53\u0026thinsp;\u0026plusmn;\u0026thinsp;1.93\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImpacted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23.06\u0026thinsp;\u0026plusmn;\u0026thinsp;3.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.14\u0026thinsp;\u0026plusmn;\u0026thinsp;2.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24.33\u0026thinsp;\u0026plusmn;\u0026thinsp;4.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.41\u0026thinsp;\u0026plusmn;\u0026thinsp;2.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eSD\u003c/em\u003e, standard deviation; \u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e, independent-samples t-test; \u003cem\u003eP\u003c/em\u003e value \u003csup\u003e2\u003c/sup\u003e, one-way ANOVA test.\u003c/p\u003e\n\u003cp\u003e\u003cspan\u003e\u003cstrong\u003e1. Alveolar bone volume\u003c/strong\u003e\u003cbr\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eThe effects of gender, the second molar lingual inclination and wisdom tooth on the alveolar bone volume are shown in Fig. \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e. According to an independent \u003cem\u003et\u003c/em\u003e test, males tended to have a greater alveolar bone volume than females, but the difference was less than 1 mm (Fig. \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e, a). As shown in Fig. \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e(b), the effect of second molar lingual inclination on alveolar bone volume decreased gradually from crown to root. At the cervical third, the alveolar bone volume of lingual inclined molar was 0.68\u0026ndash;1.16 mm larger than that of upright molars, but the increased volume decreased to 0.11\u0026ndash;0.65 mm when it came to the apical third. As shown in Fig. \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e(c), at the cervical third (0-line and 3-line), the alveolar bone volume of the impacted wisdom tooth was 3\u0026ndash;5 mm larger than that of absent wisdom tooth, and it was 2\u0026ndash;3 mm larger than that of erupted wisdom tooth. These differences were significant. At the apical third (9-line and 12-line), the alveolar bone volume of erupted wisdom tooth was 2 mm larger than that of the absent wisdom tooth, and 0.5-1 mm larger than that of the impacted wisdom tooth. That is, the wisdom tooth had the greatest effect on alveolar bone volume compared with gender and molar lingual inclination.\u003c/p\u003e\n\u003cp\u003eFurthermore, the correlation coefficient \u003cem\u003eB\u003c/em\u003e and \u003cem\u003eP\u003c/em\u003e value were obtained by multiple linear regression (Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). As shown in Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e, the positive correlated factors of alveolar bone volume at the tooth cervical third were mesial inclined angle of wisdom tooth, and the negative correlated factors of alveolar bone volume at the tooth apical third were gender.\u0026nbsp;\u003c/p\u003e\u0026nbsp;\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eThe correlation coefficient with regard to the variables affecting the alveolar bone volume\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e0-A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e0-E\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAngle 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAngle 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.00**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.00**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e12-A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-1.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.02*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e12-E\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-1.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.03*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAngle 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAngle 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eStatistical significance is tested by multiple linear regression. Angle 1, Lingual inclined angle of the second molar; Angle 2, Mesial inclined angle of wisdom tooth; \u003cem\u003eB\u003c/em\u003e, correlation coefficient; *\u003cem\u003eP\u003c/em\u003e value\u0026thinsp;\u0026lt;\u0026thinsp;0.05; **\u003cem\u003eP\u003c/em\u003e value\u0026thinsp;\u0026lt;\u0026thinsp;0.01; 0-A, 0-line of A plane; 0-E, 0-line of E plane; 12-A, 12-line of A plane; 12-E, 12-line of E plane.\u003c/p\u003e\n\u003cp\u003e\u003cspan\u003e\u003cstrong\u003e2. Cortical bone thickness\u003c/strong\u003e\u003cbr\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eThe measurements of buccal and lingual cortical bone thickness at the cervical third (0-line and 3-line) were presented in Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e. The statistics of gender were not listed because it did not show a significant effect on the cortical bone thickness.\u003c/p\u003e\n\u003cp\u003eIn patients with lingually inclined second molars, the buccal cortical bone was slightly thicker (about 0.1\u0026ndash;0.2 mm) and the lingual cortical bone was significantly thicker (about 0.3\u0026ndash;0.4 mm) than those in patients with an upright molar. The differences were significant in the A-plane. The buccal cortical bone of the impacted wisdom tooth group was about 1.5 mm thicker than that of the absent group; the erupted group was in-between. Significant differences were found at the 0-line and 3-line of A-plane. However, when it comes to lingual cortical bone, the three groups were very similar. That in the absent group seemed a little thicker than in the other two groups.\u003c/p\u003e\n\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cbr\u003e\u003c/div\u003e​\u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eThe effects of the second molar lingual inclination and wisdom tooth on the cortical bone thickness at the cervical third (0-line and 3-line)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" rowspan=\"2\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eBuccal cortical bone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eLingual cortical bone\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95% \u003cem\u003eCI\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95% \u003cem\u003eCI\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"7\"\u003e\n \u003cp\u003e0-A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eThe second molar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLingual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.11, 2.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.48, 1.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUpright\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.87, 2.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.29, 1.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.01**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eWisdom tooth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eErupted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.24 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.71, 2.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.28, 1.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImpacted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.15 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.56, 3.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.34, 1.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.69 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.30, 2.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.37, 1.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.00**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"7\"\u003e\n \u003cp\u003e3-A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eThe second molar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLingual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.93, 3.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.88, 2.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUpright\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.72, 3.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.62, 1.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.01**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eWisdom tooth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eErupted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.46, 3.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.53, 2.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImpacted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.97, 3.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.74, 2.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.47, 3,76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.75, 2.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"7\"\u003e\n \u003cp\u003e0-B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eThe second molar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLingual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.37, 3.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.90, 2.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUpright\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.10, 3.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.79, 2.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eWisdom tooth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eErupted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.56 \u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.91, 3.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.56, 2.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImpacted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.41 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.81, 4.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.84, 2.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.95 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.70, 2.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.93, 2.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.00**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"7\"\u003e\n \u003cp\u003e3-B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eThe second molar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLingual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(3.23, 3.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.41, 2.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUpright\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.86, 3.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.14, 2.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eWisdom tooth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eErupted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.74, 4.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.92, 2.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImpacted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(3.12, 3.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.28, 2.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.91, 3.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.35, 3.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"7\"\u003e\n \u003cp\u003e0-C\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eThe second molar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLingual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.42, 3.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.16, 2.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUpright\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.29, 3.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.87, 2.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eWisdom tooth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eErupted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.78, 3.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.64, 2.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImpacted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.77,3.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.11, 2.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.12,3.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.09, 2.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.01**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"7\"\u003e\n \u003cp\u003e3-C\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eThe second molar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLingual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(3.23, 3.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.49, 3.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUpright\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(3.08, 3.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.12, 2.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.04*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eWisdom tooth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eErupted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.83, 3.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.05, 2.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImpacted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(3.17, 3.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.29, 2.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(3.18, 3.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.23, 3.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"7\"\u003e\n \u003cp\u003e0-D\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eThe second molar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLingual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.46, 3.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.00, 2.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUpright\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.07, 3.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.83, 2.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eWisdom tooth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eErupted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.63, 3.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.61, 2.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImpacted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.74, 3.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.90, 2.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.99, 2.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.06, 2.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"7\"\u003e\n \u003cp\u003e3-D\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eThe second molar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLingual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(3.26, 4.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.40, 2.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUpright\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(3.17, 3.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.15, 2.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eWisdom tooth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eErupted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.96, 3.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.08, 2.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImpacted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(3.20, 4.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.17, 2.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(3.07, 4.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.37, 3.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"7\"\u003e\n \u003cp\u003e0-E\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eThe second molar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLingual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.63, 3.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.05, 2.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUpright\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.18, 3.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.82, 2.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eWisdom tooth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eErupted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.87, 3.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.63, 2.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImpacted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.66, 3.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.85, 2.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.19, 3.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.27, 2.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"7\"\u003e\n \u003cp\u003e3-E\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eThe second molar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLingual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(3.11, 3.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.19, 2.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUpright\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(3.22, 3.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.12, 2.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003eWisdom tooth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eErupted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.86, 3.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.89, 2.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImpacted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(3.23, 3.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.10, 2.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(3.08, 4.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.38, 3.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAll data are presented in millimeters. \u003cem\u003eCI\u003c/em\u003e, Confidence level; \u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e, independent-samples t-test; \u003cem\u003eP\u003c/em\u003e value \u003csup\u003e2\u003c/sup\u003e, one-way ANOVA test; *\u003cem\u003eP\u003c/em\u003e value\u0026thinsp;\u0026lt;\u0026thinsp;0.05; **\u003cem\u003eP\u003c/em\u003e value\u0026thinsp;\u0026lt;\u0026thinsp;0.01; \u003csup\u003eab\u003c/sup\u003e, differences tested by one-way ANOVA test.\u003c/p\u003e\n\u003cp\u003e\u003cspan\u003e\u003cstrong\u003e3. Alveolar remodeling after wisdom tooth extraction\u003c/strong\u003e\u003cbr\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eAs mentioned above, the impacted wisdom tooth was proved to have a significant effect on the alveolar bone volume at the cervical third of tooth, therefore, the 0-line was used to investigate whether the measurements would change after an extraction operation. As shown in Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e, according to 18 patients who accepted wisdom tooth extraction, a significantly smaller alveolar bone volume and thinner cortical bone thickness were witnessed at the original wisdom tooth area. \u0026nbsp;\u003c/p\u003e\n\u003ctable id=\"Tab4\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eComparison of the alveolar bone condition before and after the extraction\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e0-A\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e0-B\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e0-C\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e0-D\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e0-E\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eAlveolar bone volumn\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebefore-after\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95% \u003cem\u003eCI\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(0.06, 2.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(0.83, 4.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(1.93, 5.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.29, 5.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(2.58, 6.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.04*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.00**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.00**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.00**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eBuccal cortical bone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebefore-after\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95% \u003cem\u003eCI\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(0.44, 1.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(0.73, 1.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(0.22, 1.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(0.03, 1.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(-0.09, 1.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.00**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.00**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.04*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eLingual cortical bone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ebefore-after\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95% \u003cem\u003eCI\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(-0.06, 0.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(0.04, 0.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(0.20, 0.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(0.02, 0.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(0.05, 0.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.03*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.00**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.03*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.02*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAll data are presented in millimeters. Before-after, difference between before and after wisdom tooth extraction; \u003cem\u003eCI\u003c/em\u003e, Confidence level; \u003cem\u003eP\u003c/em\u003e value \u003csup\u003e1\u003c/sup\u003e, independent-samples t-test; *\u003cem\u003eP\u003c/em\u003e value\u0026thinsp;\u0026lt;\u0026thinsp;0.05; **\u003cem\u003eP\u003c/em\u003e value\u0026thinsp;\u0026lt;\u0026thinsp;0.01.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eMandibular dentition distalization is a common treatment option for class III malocclusion patients; however, few investigations have addressed the buccolingual alveolar bone condition. Ignoring the thin cortex at the cervical third is likely to result in periodontal diseases, such as the recession of gingival and alveolar bone crest during treatment [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Buccal cortical bone thickness at the apical third was especially focused on in this study to discuss the condition for planting mini-screws. Furthermore, if the alveolar bone volume is insufficient, alveolar bone damage or root resorption may occur, causing an irreparable loss to patient [\u003cspan additionalcitationids=\"CR22 CR23\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCBCT is regarded as the best imaging tool for investigating maxillofacial anatomy, as it can clearly show the structure from the three-dimensional direction. In this experiment, CBCT was used to investigate the alveolar bone condition of mandibular molar distalization by measuring the alveolar bone volume and cortical bone thickness, and to explore whether gender, second molar lingual inclination and wisdom tooth would influence the condition.\u003c/p\u003e \u003cp\u003eWe found that the development of wisdom tooth is closely linked to the buccolingual alveolar bone condition. By one-way ANOVA, significant differences were observed at the cervical third (0-line and 3-line) and apical third (9-line and 12-line). Greater alveolar bone volume at the tooth apical third was observed in the erupted group vs. the absent group, while the alveolar bone volume at the tooth cervical third was larger in the impacted group. This could be ascribed to the location of the tooth. The impacted wisdom tooth is usually located at the cervical third of the second molar root, and it seldom has an effect on the alveolar bone at the apical third. This location assumption may also explain the significantly increased thickness of buccal cortical bone at the cervical third of the impacted group and the apical third of the erupted group. In addition, according to the statistics in our experiment, the greater volume and cortical bone thickness would decrease after tooth extraction. Since thicker cortex and greater alveolar bone volume are considered as advantages for molar distalization, it is suggested that the better condition should be utilized as soon as possible after the wisdom tooth extraction surgery.\u003c/p\u003e \u003cp\u003ePrevious study reported males tended to have greater alveolar bone volume than females [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. In this study, although the difference was not significant, the alveolar bone volume of male was about 10% larger than that of female. Second molar lingual inclination molar brought thicker lingual cortex at the cervical third of the second molar. The explanation for this may be the dumping pressure of the molar, which activates osteogenic activity at the cervical third. It has been reported that a thinner cortical bone was correlated with an increase in vertical bone loss [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], therefore, when moving molars, class III patients with compensatory inclined second molars may probably have advantages to some extent.\u003c/p\u003e \u003cp\u003eAccording to the multiple linear regression, the correlation between the mesial inclined angle of wisdom tooth and alveolar bone volume was complex\u0026mdash;positive at the tooth cervical third and negative at the apical third. In other words, the more mesial inclination of the wisdom tooth, the greater the alveolar bone volume at the cervical third, and the smaller the alveolar bone volume at the apical third. The lingual inclined angle of the second molar was positively correlated with alveolar bone volume at the apical third. That is, the larger the angle, the greater the alveolar bone volume.\u003c/p\u003e \u003cp\u003eThis study still has some limitations. We did not consider soft tissue like the attached gingival in this study, which is also important for periodontal health and the anchoring of mini-screws [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. What is more, the cortical bone boundary was judged by the experience of the researcher. More accurate methods can be explored, such as evaluation by software that can measure the bone mineral density.\u003c/p\u003e"},{"header":"CONCLUSIONS","content":"\u003cp\u003eThe growth of third molars yields greater alveolar volume and thicker cortical bone, making the alveolar bone condition more favorable for molar distalization, and the favorable bone condition would be maintained by full utilization shortly after the wisdom tooth extraction surgery. The second molar lingual inclination makes the cortical bone thicker and helps to reducing the loss of alveolar crest during the distalization. Gender has trivial effects on alveolar bone condition.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll experiments were performed in accordance with relevant guidelines and regulations. The study protocol was reviewed and approved by the\u0026nbsp;Clinical Research Ethics Committee of the\u0026nbsp;First Affiliated Hospital, College of Medicine, Zhejiang University\u0026nbsp;(IIT20210035A).\u0026nbsp;Since this study was a retrospective study, the informed consent was waived off by the\u0026nbsp;Clinical Research Ethics Committee of the\u0026nbsp;First Affiliated Hospital, College of Medicine, Zhejiang University.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and analyzed during the current study are available from the corresponding author on reasonable request.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo competing interests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the National Natural Science Foundation of China [grant no. 81970978].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contribution\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLJ conceived and designed the study, searched the literature, performed data acquisition and statistical analysis, and drafted the manuscript. LW offered the resources and helped with a major revision. LX performed data curation and helped with the revision. JL critically revised the manuscript for important intellectual content, performed supervision and administrated the project. All authors read and approved the final manuscript. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eDoraczynska-Kowalik A, Nelke KH, Pawlak W, Sasiadek MM, Gerber H. Genetic Factors Involved in Mandibular Prognathism. J Craniofac Surg. 2017; 28(5): e422\u0026ndash;e431.\u003c/li\u003e\n \u003cli\u003eKajii TS, Oka A, Saito F, Mitsui J, Iida J. Whole-exome sequencing in a Japanese pedigree implicates a rare non-synonymous single-nucleotide variant in BEST3 as a candidate for mandibular prognathism. 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Angle\u0026nbsp;Orthod. 2020; 90(4):607\u0026ndash;618.\u003c/li\u003e\n \u003cli\u003eAhn J, Kim SJ, Lee JY, Chung CJ, Kim KH. Transverse dental compensation in relation to sagittal and transverse skeletal discrepancies in skeletal Class III patients. Am J Orthod Dentofacial Orthop. 2017; 151(1):148\u0026ndash;156.\u003c/li\u003e\n \u003cli\u003eKau CH, Bakos K, Lamani E. Quantifying changes in incisor inclination before and after orthodontic treatment in class I, II, and III malocclusions. J World Fed Orthod. 2020; 9(4):170\u0026ndash;174.\u003c/li\u003e\n \u003cli\u003eZhang W, Tullis J, Weltman R. Cone beam computerized tomography (CBCT) measurement of alveolar ridge at posterior mandible for implant graft estimation. J Oral Implantol. 2015;41(6): e231-7.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"mandibular molar distalization, alveolar bone condition, alveolar bone volume, cortical bone thickness, wisdom tooth","lastPublishedDoi":"10.21203/rs.3.rs-2900976/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2900976/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo investigate the alveolar bone condition of mandibular molar distalization in skeletal Class III patients from buccolingual direction.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e45 skeletal class III patients were recruited. The alveolar bone volume, buccal cortical bone thickness and lingual cortical bone thickness were measured in five planes from mesial to distal and at five depths from gingival to root. The effects of the gender of the patients, the second molar lingual inclination, and wisdom tooth on alveolar bone volume and cortical bone thickness were evaluated. To explore the effect of wisdom tooth extraction on alveolar bone condition, the measurements before and after wisdom tooth extraction were compared.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe impacted wisdom tooth had significantly greater alveolar bone volume and thicker buccal cortical bone at cervical third of molar, while the erupted wisdom tooth had greater alveolar bone volume at apical third. After wisdom tooth extraction, these advantages would weaken owing to the reconstruction of alveolar bone. Patients with lingual inclined molar were observed to own thicker lingual cortical bone. Male tended to have greater alveolar bone volume, but no significant differences were shown in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe growth of wisdom tooth and the second molar lingual inclination can effectively make the alveolar bone condition more favorable for mandibular molar distalization, but gender has trivial effects on alveolar bone condition. Shortly after the wisdom tooth extraction surgery, the better bone condition can be maintained.\u003c/p\u003e","manuscriptTitle":"Buccolingual alveolar bone condition of mandibular molar distalization in skeletal class III patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-05-12 14:45:31","doi":"10.21203/rs.3.rs-2900976/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5cb676d3-16f4-4a3a-8ff1-9f005addeeb4","owner":[],"postedDate":"May 12th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-09-28T12:29:25+00:00","versionOfRecord":[],"versionCreatedAt":"2023-05-12 14:45:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2900976","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2900976","identity":"rs-2900976","version":["v1"]},"buildId":"J0_U0BvcaRcwD8yVFaRlm","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}