The purpose of this study was to investigate immediate changes in the mandibular dentition after maxillary molar distalization using headgear in non-growing patients. Sixteen patients (mean age, 18.9 ± 2.0 years) with Class II molar relationship and crowding were included in the present study. To correct the molar relationship, headgear was used for maxillary molar distalization. Cone-beam computed tomography-generated half-cephalograms (CG Cephs) and dental casts were used to evaluate dental changes for each subject before and immediately after molar distalization using headgear. The mean duration that subjects wore the headgear was 6.3 months. CG Cephs showed that the first maxillary molars were distalized 4.2 ± 1.6 mm with 9.7°± 6.1° of distal angulation. The intercanine, interpremolar, and intermolar widths of the mandible increased after maxillary molar distalization. The present study's results suggest that maxillary molar distalization using headgear induces a spontaneous response in the untreated mandibular dentition of non-growing patients.
Dentition* ; Humans ; Malocclusion ; Mandible ; Molar*

The aim of this case report was to describe an innovative orthodontic treatment method that combined surgical and orthodontic techniques. The novel method was used to achieve a positive result in a case of moderate crowding by employing a computer-guided piezocision procedure followed by the use of clear aligners. A 23-year-old woman had a malocclusion with moderate crowding. Her periodontal indices, oral health-related quality of life (OHRQoL), and treatment time were evaluated. The treatment included interproximal corticotomy cuts extending through the entire thickness of the cortical layer, without a full-thickness flap reflection. This was achieved with a three-dimensionally printed surgical guide using computer-aided design and computer-aided manufacturing. Orthodontic force was applied to the teeth immediately after surgery by using clear appliances for better control of tooth movement. The total treatment time was 8 months. The periodontal indices improved after crowding correction, but the oral health impact profile showed a slight deterioration of OHRQoL during the 3 days following surgery. At the 2-year retention follow-up, the stability of treatment was excellent. The reduction in surgical time and patient discomfort, increased periodontal safety and patient acceptability, and accurate control of orthodontic movement without the risk of losing anchorage may encourage the use of this combined technique in appropriate cases.
Computer-Aided Design ; Crowding* ; Female ; Follow-Up Studies ; Humans ; Malocclusion ; Methods ; Operative Time ; Oral Health ; Periodontal Index ; Quality of Life ; Tooth ; Tooth Movement ; Young Adult

OBJECTIVE: To evaluate the effects of facemask therapy, which was anchored from the zygomatic buttresses of the maxilla by using two miniplates, in skeletal Class III patients with maxillary deficiency. METHODS: Eighteen skeletal Class III patients (10 girls and 8 boys; mean age, 11.4 ± 1.28 years) with maxillary deficiency were treated using miniplate-anchored facemasks, and their outcomes were compared with those of a Class III control group (9 girls and 9 boys; mean age, 10.6 ± 1.12 years). Two I-shaped miniplates were placed on the right and left zygomatic buttresses of the maxilla, and a facemask was applied with a 400 g force per side. Intragroup comparisons were made using the Wilcoxon test, and intergroup comparisons were made using the Mann-Whitney U-test (p < 0.05). RESULTS: In the treatment group, the maxilla moved 3.3 mm forward, the mandible showed posterior rotation by 1.5°, and the lower incisors were retroclined after treatment. These results were significantly different from those in the control group (p < 0.05). No significant anterior rotation of the palatal plane was observed after treatment. Moreover, changes in the sagittal positions of the maxillary incisors and molars were similar between the treatment and control groups. CONCLUSIONS: Skeletally anchored facemask therapy is an effective method for correcting Class III malocclusions, which also minimizes the undesired dental side effects of conventional methods in the maxilla.
Female ; Gravitation ; Humans ; Incisor ; Malocclusion* ; Mandible ; Maxilla ; Methods ; Molar ; Orthopedics*

OBJECTIVE: To investigate the effects of frontal facial type (FFT) and sex on preferred chin projection (CP) in three-dimensional (3D) facial images. METHODS: Six 3D facial images were acquired using a 3D facial scanner (euryprosopic [Eury-FFT], mesoprosopic [Meso-FFT], and leptoprosopic [Lepto-FFT] for each sex). After normal CP in each 3D facial image was set to 10° of the facial profile angle (glabella–subnasale-pogonion), CPs were morphed by gradations of 2° from normal (moderately protrusive [6°], slightly protrusive [8°], slightly retrusive [12°], and moderately retrusive [14°]). Seventy-five dental students (48 men and 27 women) were asked to rate the CPs (6°, 8°, 10°, 12°, and 14°) from the most to least preferred in each 3D image. Statistical analyses included the Kolmogorov-Smirnov test, Kruskal-Wallis test, and Bonferroni correction. RESULTS: No significant difference was observed in the distribution of preferred CP in the same FFT between male and female evaluators. In Meso-FFT, the normal CP was the most preferred without any sex difference. However, in Eury-FFT, the slightly protrusive CP was favored in male 3D images, but the normal CP was preferred in female 3D images. In Lepto-FFT, the normal CP was favored in male 3D images, whereas the slightly retrusive CP was favored in female 3D images. The mean preferred CP angle differed significantly according to FFT (Eury-FFT: male, 8.7°, female, 9.9°; Meso-FFT: male, 9.8°, female, 10.7°; Lepto-FFT: male, 10.8°, female, 11.4°; p < 0.001). CONCLUSIONS: Our findings might serve as guidelines for setting the preferred CP according to FFT and sex.
Chin* ; Female ; Humans ; Male ; Sex Characteristics ; Students, Dental

OBJECTIVE: To analyze the long-term changes in maxillary arch widths and buccal corridor ratios in orthodontic patients treated with and without premolar extractions. METHODS: The study included 53 patients who were divided into the extraction (n = 28) and nonextraction (n = 25) groups. These patients had complete orthodontic records from the pretreatment (T1), posttreatment (T2), and postretention (T3) periods. Their mean retention and postretention times were 4 years 2 months and 17 years 8 months, respectively. Dental models and smiling photographs from all three periods were digitized to compare the changes in three dental arch width measurements and three buccal corridor ratios over time between the extraction and nonextraction groups. Data were analyzed using analysis of variance tests. Post-hoc multiple comparisons were made using Bonferroni correction. RESULTS: Soft-tissue extension during smiling increased with age in both groups. The maximum dental width to smile width ratio (MDW/SW) also showed a favorable increase with treatment in both groups (p < 0.05), and remained virtually stable at T3 (p > 0.05). According to the MDW/SW ratio, the mean difference in the buccal corridor space of the two groups was 2.4 ± 0.2% at T3. Additionally, no significant group × time interaction was found for any of the buccal corridor ratios studied. CONCLUSIONS: Premolar extractions did not negatively affect transverse maxillary arch widths and buccal corridor ratios. The long-term outcome of orthodontic treatment was comparable between the study groups.
Bicuspid ; Dental Arch ; Dental Models ; Esthetics* ; Humans ; Smiling

OBJECTIVE: The aims of this study were to measure and compare the facial dimensions of the Miss Korea pageant contestants and a selected group of women from the general population by using three-dimensional (3D) image analysis, as well as to compare various facial ratios to the golden ratio within each group. METHODS: Three-dimensional images of 52 Miss Korea pageant contestants (MK group) and 41 young female adults selected from the general population (GP group) were acquired. Fifty-four variables and ratios were measured and calculated. Intergroup comparisons were performed using multivariate analysis of variance. RESULTS: Compared to the GP group, the MK group showed greater total facial height and eye width, lesser lower-facial height, and lesser facial, lower-facial, and nasal widths. Moreover, compared to the GP group, the MK group had more protruded noses with greater nasolabial angle, greater vertical curvature of the foreheads, lesser horizontal curvature of the cheek, and lesser lower-lip-and-chin volume. CONCLUSIONS: The MK group had longer faces but smaller lower lips and chins than did the GP group. The golden ratio was not matching the current facial esthetic standards. These data might be beneficial for treatment planning of patients undergoing orthognathic and plastic surgeries.
Adult ; Cheek ; Chin ; Esthetics* ; Female ; Forehead ; Humans ; Imaging, Three-Dimensional ; Korea* ; Lip ; Multivariate Analysis ; Nose ; Plastics

OBJECTIVE: The aim of this study was to evaluate the skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion (MARPE) in young adults by cone-beam computed tomography (CBCT). METHODS: This retrospective study included 14 patients (mean age, 20.1 years; range, 16–26 years) with maxillary transverse deficiency treated with MARPE. Skeletal and dentoalveolar changes were evaluated using CBCT images acquired before and after expansion. Statistical analyses were performed using paired t-test or Wilcoxon signed-rank test according to normality of the data. RESULTS: The midpalatal suture was separated, and the maxilla exhibited statistically significant lateral movement (p < 0.05) after MARPE. Some of the landmarks had shifted forwards or upwards by a clinically irrelevant distance of less than 1 mm. The amount of expansion decreased in the superior direction, with values of 5.5, 3.2, 2.0, and 0.8 mm at the crown, cementoenamel junction, maxillary basal bone, and zygomatic arch levels, respectively (p < 0.05). The buccal bone thickness and height of the alveolar crest had decreased by 0.6–1.1 mm and 1.7–2.2 mm, respectively, with the premolars and molars exhibiting buccal tipping of 1.1°–2.9°. CONCLUSIONS: Our results indicate that MARPE is an effective method for the correction of maxillary transverse deficiency without surgery in young adults.
Adult ; Bicuspid ; Cone-Beam Computed Tomography* ; Crowns ; Humans ; Maxilla ; Methods ; Molar ; Retrospective Studies ; Sutures ; Tooth Cervix ; Young Adult* ; Zygoma

No abstract available.
Analysis of Variance ; Esthetics ; Facial Expression ; Malocclusion ; Overbite ; Smiling

OBJECTIVE: To evaluate the effects of ultrasonic instrumentation with different scaler-tip angulations on the shear bond strength (SBS) and bond failure mode of metallic orthodontic brackets. METHODS: Adhesive pre-coated metallic brackets were bonded to 72 extracted human premolars embedded in autopolymerizing acrylic resin. The teeth were randomly divided into 3 groups (n = 24 each) to undergo no treatment (control group) or ultrasonic instrumentation with a scaler-tip angulation of 45degrees (45degrees-angulation group) or 0degrees (0degrees-angulation group). SBS was tested in a universal testing machine, and adhesive remnant index (ARI) scores were recorded. The Kruskal-Wallis test and Mann-Whitney U-test were used for statistical analysis. RESULTS: The control group had a significantly higher mean SBS value than the treated groups, which showed no significant differences in their mean SBS values. The ARI scores were not significantly different among the groups. CONCLUSIONS: Ultrasonic instrumentation around the bracket base reduces the SBS of metallic orthodontic brackets, emphasizing the need for caution during professional oral hygiene procedures in orthodontic patients. The scaler-tip angulation does not influence the SBS reduction and bond failure mode of such brackets.
Adhesives ; Bicuspid ; Humans ; Oral Hygiene ; Orthodontic Brackets* ; Tooth ; Ultrasonics*

OBJECTIVE: The purpose of this study was to quantitatively evaluate the cortical bone densities of the maxillary and mandibular alveolar processes in adults with different vertical facial types using cone-beam computed tomography (CBCT) images. METHODS: CBCT images (n = 142) of adult patients (20-45 years) were classified into hypodivergent, normodivergent, and hyperdivergent groups on the basis of linear and angular S-N/Go-Me measurements. The cortical bone densities (in Hounsfield units) at maxillary and mandibular interdental sites from the distal aspect of the canine to the mesial aspect of the second molar were measured on the images. RESULTS: On the maxillary buccal side, female subjects in the hyperdivergent group showed significantly decreased bone density, while in the posterior region, male subjects in the hyperdivergent group displayed significantly decreased bone density when compared with corresponding subjects in the other groups (p<0.001). Furthermore, the subjects in the hyperdivergent group had significantly lower bone densities on the mandibular buccal side than hypodivergent subjects. The maxillary palatal bone density did not differ significantly among groups, but female subjects showed significantly denser palatal cortical bone. No significant difference in bone density was found between the palatal and buccal sides in the maxillary premolar region. Overall, the palatal cortical bone was denser anteriorly and buccal cortical bone was denser posteriorly. CONCLUSION: Adults with the hyperdivergent facial type tend to have less-dense buccal cortical bone in the maxillary and mandibular alveolar processes. Clinicians should be aware of the variability of cortical bone densities at mini-implant placement sites.
Adult* ; Alveolar Process ; Bicuspid ; Bone Density* ; Cone-Beam Computed Tomography* ; Evaluation Studies as Topic* ; Female ; Humans ; Male ; Molar