Askari et al., Dentistry 2015, 5:10
DOI: 10.4172/2161-1122.1000336
Open Access Research Articles
Voume 5 • Issue 10 • 1000336
Dentistry
ISSN: 2161-1122 Dentistry, an open access journal
*Corresponding author: Stanley A Alexander, DMD, Chief Dental Offcer, Holyoke
Health Center, 230 Maple Street, Holyoke, MA 01041, United States, Tel: 413-420-
6257; E-mail: stanalexander427@gmail.com
Received July 22, 2015; Accepted September 03, 2015; Published September
13, 2015
Citation: Askari M, Williams R, Romberg E, Stone M, Alexander SA (2015)
CBCT Assessment of Dental and Skeletal Changes Using the Damon versus
Conventional (MBT) System. Dentistry 5: 336. doi:10.4172/2161-1122.1000336
Copyright: © 2015 Askari M, et al. This is an open-access article distributed under
the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and
source are credited.
CBCT Assessment of Dental and Skeletal Changes Using the Damon
versus Conventional (MBT) System
Marjan Askari
1,2
, Robert Williams
3
, Elaine Romberg
4
, Maureen Stone
5
and Stanley A Alexander
6,7
*
1
Assistant Clinical Professor, Department of Pediatric Dentistry, School of Dental Medicine, Tufts University, Massachusetts, United States
2
Director of Orthodontics, Holyoke Health Center, Holyoke, Massachusetts, United States
3
Clinical Assistant Professor of Orthodontics, School of Dentistry, University of Maryland, Maryland, United States
4
Professor of Endodontics, School of Dentistry, University of Maryland, Maryland, United States
5
Professor of Neural and Pain Sciences, School of Dentistry, University of Maryland, Maryland, United States
6
Chief Dental Offcer, Holyoke Health Center, Holyoke, Massachusetts, United States
7
Distinguished Teaching Professor Emeritus, Stony Brook University, Stony Brook, New York, United States
modality resulted in a generalized expansion of the buccal segments
along with the advancement of the lower incisors, and found that
expansion was greatest at the second premolars and least at the canines
[8]. Other studies using a single type of expansion appliance (rapid
palatal expansion, quad-helix, lip bumper, or tandem mechanics) all
resulted in a greater mean change in mandibular arch width [9-12].
Te Damon system was frst introduced in the 1990s and
incorporates low friction and low force wire technology with the use
of passive self-ligating brackets. Te general philosophy underlying
this system is to approximate biologically induced tooth moving forces
that results in the alteration of the arch form. Te new arch form is
adapted from the basic arch form and is “physiologically determined”,
while creating a new equilibrium that allows the arch to reshape itself
Keywords: CBCT; Class I malocclusions; Damon system
Introduction
Te evolution of the shape of the human dental arch is distinct
when compared to other primates, while hominid evolution has
demonstrated that the arch form in man is parabolic [1]. For over
100 years the size and shape of the ideal dental arch has been used
for diagnosis and treatment of malocclusions and two diverging
methods of therapy: extraction versus non-extraction. Proponents of
non-extraction treatment have indicated that extractions result in a
detrimental result in profle and smile esthetics, large buccal corridors
and faulty fnal occlusions. Recent reports indicate that extraction
therapy does not negatively impact on sof tissue [2,3], nor does it
negatively afect smile esthetics [4-6]. If the current state of evidence
points in the direction that extraction therapy has no detrimental efect
in facial esthetics and provides a superior occlusion to non-extraction
treatment, one would expect a greater predominance of patients treated
with the extraction of teeth to successfully resolve their malocclusions.
However, with the advent of the Damon philosophy and through the
use of self-ligation with low force, low friction arch wires, the pathway
to non-extraction treatment has been resurrected and gaining favor in
orthodontic therapy.
Opposition to non-extraction therapy was largely based on the
retention period where relapse of crowding was due to lateral expansion
of the arches and proclination of the incisors [7]. Te treatment of
Class I malocclusions without extraction irrespective of the treatment
Abstract
Introduction: The primary aim of this pilot study was to compare cases treated with the Damon System and a
Conventional Mechanics system utilizing Cone Beam Computed Tomography (CBCT) in the evaluation of changes in
dental and skeletal arch width and length. The secondary purpose was to evaluate differences between the three CBCT
views (3-D coordinate, sectional, and volume views).
Methods: Eleven patients (≥ 18 years of age; measured total of 40 maxillary antimeres and 44 mandibular
antimeres) with moderate to severe crowding who had both pre and post-treatment CBCTs and were treated non-
extraction, either with conventional edgewise or self-ligating Damon appliances were retrospectively selected from
two orthodontic practices. The arch length, inter-occlusal, inter-apical, inter-buccal and inter-lingual alveolar crest arch
widths and the bucco-lingual angulation for canine, premolars and frst molars were measured. Different CBCT views
were evaluated by frst measuring the inter-occlusal distances of the respective teeth in the coronal section and the
volume views. These measurements were compared with those gathered previously using the 3-D coordinate system.
A paired t-test, an independent t-test, and an ANOVA were used for statistical analysis.
Results: Both non-extraction treatment modalities resulted in inter-occlusal arch width expansion in both the
maxilla and mandible. The overall expansion of arches in the Damon treated cases was statistically greater than in the
Conventional cases. Maxillary and mandibular arch lengths were increased, but not signifcantly in both groups. There
were no statistically signifcant differences between the three CBCT views.
Conclusions: Both the Damon and the Conventional systems resulted in increased arch width and length, but
the Damon system caused signifcantly more overall arch expansion. There was less tipping of the teeth during arch
expansion in the Conventional system. The ratio of crown to root movement in the Conventional system versus the
Damon system in the maxilla was approximately 1:1 versus 3:1, and in the mandible 3.6:1 versus 6:1, respectively.
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ISSN: 2161-1122
Dentistry