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Analysis of midpalatal miniscrew-assisted maxillary molar distalization patterns with simultaneous use of fixed appliances: A preliminary study.

Su Jung MAH ; Ji Eun KIM ; Eun Jin AHN ; Jong Hyun NAM ; Ji Young KIM ; Yoon Goo KANG

The Korean Journal of Orthodontics.2016;46(1):55-61. doi:10.4041/kjod.2016.46.1.55

Skeletal anchorage-assisted upper molar distalization has become one of the standard treatment modalities for the correction of Class II malocclusion. The purpose of this study was to analyze maxillary molar movement patterns according to appliance design, with the simultaneous use of buccal fixed orthodontic appliances. The authors devised two distinct types of midpalatal miniscrew-assisted maxillary molar distalizers, a lingual arch type and a pendulum type. Fourteen patients treated with one of the two types of distalizers were enrolled in the study, and the patterns of tooth movement associated with each type were compared. Pre- and post-treatment lateral cephalograms were analyzed. The lingual arch type was associated with relatively bodily upper molar distalization, while the pendulum type was associated with distal tipping with intrusion of the upper molar. Clinicians should be aware of the expected tooth movement associated with each appliance design. Further well designed studies with larger sample sizes are required.
Humans ; Malocclusion ; Molar* ; Orthodontic Appliances ; Sample Size ; Tooth Movement

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Facial and occlusal esthetic improvements of an adult skeletal Class III malocclusion using surgical, orthodontic, and implant treatment.

Mauricio DE ALMEIDA CARDOSO ; Rafael Scaf DE MOLON ; Erica Dorigatti DE AVILA ; Fabio Pinto GUEDES ; Valter Antonio Ban BATTILANI FILHO ; Leopoldino CAPELOZZA FILHO ; Marcio Aurelio CORREA ; Hugo NARY FILHO

The Korean Journal of Orthodontics.2016;46(1):42-54. doi:10.4041/kjod.2016.46.1.42

The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects.
Adult* ; Crowns ; Dental Implants ; Esthetics ; Follow-Up Studies ; Gingival Recession ; Humans ; Incisor ; Malocclusion* ; Molar ; Orthodontics ; Orthognathic Surgery ; Overbite ; Rehabilitation ; Tooth

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A survey on retention practice among orthodontists in Malaysia.

Norma AB RAHMAN ; Tze Fui LOW ; Nur Shaheera IDRIS

The Korean Journal of Orthodontics.2016;46(1):36-41. doi:10.4041/kjod.2016.46.1.36

OBJECTIVE: The aim of this study was to evaluate retention practices commonly employed by orthodontists. The objectives were to identify the types of retainer frequently used and to investigate the variations in retention practice. METHODS: A total of 97 orthodontists were randomly selected, and a questionnaire consisting of 25 multiple-choice questions sent to them by mail. Upon receiving of the completed questionnaires, the data were statistically analyzed. RESULTS: A total of 32 responses were received; among these, 59.4% of orthodontists' practiced is in a government setting and 40.6% were in private practice. A vacuum-formed retainer was the most commonly used removable retainer for both maxillary (46.9%) and mandibular (46.9%) arches, followed by a Hawley retainer (maxilla, 43.8%; mandible, 37.5%), and a fixed retainer (maxilla, 3.1%; mandible, 9.4%). Of the responding orthodontists, 78.1% prescribed full-time wear (more than 20 h per day) for a duration of 3-9 months for a maxillary arch, compared to 71.9% for the mandibular arch. Only 18.8% of the orthodontists prescribed part-time wear of the retainer for the maxillary arch, compared to 21.9% for the mandibular arch. The majority of orthodontists did not instruct their patients to stop wearing removable retainers (71.9%) or fixed retainers (66.8%) at any specific time and they preferred their patients to continue wearing retainers. CONCLUSIONS: Vacuum-formed retainers are the most commonly used retainers among orthodontists. The majority of orthodontists prescribed full-time wear for more than 20 h per day with a duration of 3-9 months and preferred indefinite use of the retainer.
Humans ; Malaysia* ; Mandible ; Postal Service ; Private Practice

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Computerized occlusal analysis: correlation with occlusal indexes to assess the outcome of orthodontic treatment or the severity of malocculusion.

Sang Min LEE ; Jin Woo LEE

The Korean Journal of Orthodontics.2016;46(1):27-35. doi:10.4041/kjod.2016.46.1.27

OBJECTIVE: The aims of our study were to verify the validity of the T-Scan III system (Tekscan) as an objective occlusal evaluation tool, and to assess the differences between two occlusal indexes-the peer assessment rating (PAR) index and the American Board of Orthodontics objective grading system (OGS)-by comparing the scores derived from the T-Scan III system with the two occlusal indexes and analyzing the correlations between them. METHODS: The final study sample included 48 adult volunteers (39 men and 9 women, mean age 24.14 +/- 3.16 years), after excluding 29 volunteers whose occlusion could not be evaluated by the T-Scan III system due to severe skeletal or occlusal problems. PAR index and OGS scores were assessed using dental study models, and measurements of centric occlusion, protrusive movement, and lateral excursion movement were obtained via the T-Scan III system. The results were analyzed to determine correlations. RESULTS: Occlusal analysis by the T-Scan III system was clinically reliable (p < 0.05), and the PAR index and OGS scores were significantly correlated with several measurements obtained with the T-Scan III system (p < 0.05). CONCLUSIONS: The T-Scan III system is a quantitative and reliable method for occlusal evaluation, and represents a potential substitute for occlusal indexes. Compared to the PAR index, the OGS scores of more variables were significantly correlated with the T-Scan measurements.
Adult ; Female ; Humans ; Male ; Orthodontics ; Volunteers

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Patients' and parents' concerns and decisions about orthodontic treatment.

Fatih KAZANCI ; Cihan AYDOGAN ; Ozer ALKAN

The Korean Journal of Orthodontics.2016;46(1):20-26. doi:10.4041/kjod.2016.46.1.20

OBJECTIVE: Patients' and parents' expectations are important in orthodontic treatment decision making. The literature generally demonstrates the perceived benefits of orthodontic treatment, but patients' and their parents' concerns about orthodontic treatment have not been investigated comprehensively. The aim of this study was to identify patients' and parents' concerns about orthodontic treatment and compare them according to sex, age, and treatment demand level. METHODS: One hundred and eighty-nine children and their parents were interviewed about concerns related to orthodontic treatment. Patients and parents were asked about orthodontic treatment decisions. Answers were recorded as "yes," "no," or "don't know." Chi-squared and Fisher's exact tests were used to compare concerns between age groups, sexes, and treatment demand levels. Kappa statistics were used to assess agreement between patients and their parents. RESULTS: Concerns about orthodontic treatment were gathered under 10 items as follows: "feeling pain," "the appearance of braces," "being teased," "avoiding smiling," "speech problems," "dietary changes," "problems with transportation," "economic problems," "long treatment duration," and "missing school." There was no statistically significant difference in concerns between the sexes or age groups. Some concern items and treatment demand were inversely related in patients. CONCLUSIONS: The results of this study demonstrate patients' and parents' concerns about orthodontic treatment. Differences between the concerns of patients with different treatment demands imply that children might reject orthodontic treatment because of their concerns. Appropriate consultation of patients addressing their concerns may help reduce anxiety and improve the acceptance of treatment.
Anxiety ; Child ; Decision Making ; Humans ; Parents ; Psychology ; Socioeconomic Factors

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Accuracy of Bolton analysis measured in laser scanned digital models compared with plaster models (gold standard) and cone-beam computer tomography images.

Jooseong KIM ; Manuel O LAGRAVERE

The Korean Journal of Orthodontics.2016;46(1):13-19. doi:10.4041/kjod.2016.46.1.13

OBJECTIVE: The aim of this study was to compare the accuracy of Bolton analysis obtained from digital models scanned with the Ortho Insight three-dimensional (3D) laser scanner system to those obtained from cone-beam computed tomography (CBCT) images and traditional plaster models. METHODS: CBCT scans and plaster models were obtained from 50 patients. Plaster models were scanned using the Ortho Insight 3D laser scanner; Bolton ratios were calculated with its software. CBCT scans were imported and analyzed using AVIZO software. Plaster models were measured with a digital caliper. Data were analyzed with descriptive statistics and the intraclass correlation coefficient (ICC). RESULTS: Anterior and overall Bolton ratios obtained by the three different modalities exhibited excellent agreement (> 0.970). The mean differences between the scanned digital models and physical models and between the CBCT images and scanned digital models for overall Bolton ratios were 0.41 +/- 0.305% and 0.45 +/- 0.456%, respectively; for anterior Bolton ratios, 0.59 +/- 0.520% and 1.01 +/- 0.780%, respectively. ICC results showed that intraexaminer error reliability was generally excellent (> 0.858 for all three diagnostic modalities), with < 1.45% discrepancy in the Bolton analysis. CONCLUSIONS: Laser scanned digital models are highly accurate compared to physical models and CBCT scans for assessing the spatial relationships of dental arches for orthodontic diagnosis.
Cone-Beam Computed Tomography ; Dental Arch ; Diagnosis ; Humans

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A comparison of the precision of three-dimensional images acquired by 2 digital intraoral scanners: effects of tooth irregularity and scanning direction.

Ji Won ANH ; Ji Man PARK ; Youn Sic CHUN ; Miae KIM ; Minji KIM

The Korean Journal of Orthodontics.2016;46(1):3-12. doi:10.4041/kjod.2016.46.1.3

OBJECTIVE: The purpose of this study was to compare the precision of three-dimensional (3D) images acquired using iTero(R) (Align Technology Inc., San Jose, CA, USA) and Trios(R) (3Shape Dental Systems, Copenhagen, Denmark) digital intraoral scanners, and to evaluate the effects of the severity of tooth irregularities and scanning sequence on precision. METHODS: Dental arch models were fabricated with differing degrees of tooth irregularity and divided into 2 groups based on scanning sequence. To assess their precision, images were superimposed and an optimized superimposition algorithm was employed to measure any 3D deviation. The t-test, paired t-test, and one-way ANOVA were performed (p < 0.05) for statistical analysis. RESULTS: The iTero(R) and Trios(R) systems showed no statistically significant difference in precision among models with differing degrees of tooth irregularity. However, there were statistically significant differences in the precision of the 2 scanners when the starting points of scanning were different. The iTero(R) scanner (mean deviation, 29.84 +/- 12.08 microm) proved to be less precise than the Trios(R) scanner (22.17 +/- 4.47 microm). CONCLUSIONS: The precision of 3D images differed according to the degree of tooth irregularity, scanning sequence, and scanner type. However, from a clinical standpoint, both scanners were highly accurate regardless of the degree of tooth irregularity.
Dental Arch ; Imaging, Three-Dimensional* ; Tooth*

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Reader's Forum.

Joohyung KIM

The Korean Journal of Orthodontics.2016;46(1):1-2. doi:10.4041/kjod.2016.46.1.1

No abstract available.

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Evaluation of alveolar bone loss following rapid maxillary expansion using cone-beam computed tomography.

Asli BAYSAL ; Tancan UYSAL ; Ilknur VELI ; Torun OZER ; Irfan KARADEDE ; Seyit HEKIMOGLU

The Korean Journal of Orthodontics.2013;43(2):83-95. doi:10.4041/kjod.2013.43.2.83

OBJECTIVE: To evaluate the changes in cortical bone thickness, alveolar bone height, and the incidence of dehiscence and fenestration in the surrounding alveolar bone of posterior teeth after rapid maxillary expansion (RME) treatment using cone-beam computed tomography (CBCT). METHODS: The CBCT records of 20 subjects (9 boys, mean age: 13.97 +/- 1.17 years; 11 girls, mean age: 13.53 +/- 2.12 year) that underwent RME were selected from the archives. CBCT scans had been taken before (T1) and after (T2) the RME. Moreover, 10 of the subjects had 6-month retention (T3) records. We used the CBCT data to evaluate the buccal and palatal aspects of the canines, first and second premolars, and the first molars at 3 vertical levels. The cortical bone thickness and alveolar bone height at T1 and T2 were evaluated with the paired-samples t-test or the Wilcoxon signed-rank test. Repeated measure ANOVA or the Friedman test was used to evaluate the statistical significance at T1, T2, and T3. Statistical significance was set at p < 0.05. RESULTS: The buccal cortical bone thickness decreased gradually from baseline to the end of the retention period. After expansion, the buccal alveolar bone height was reduced significantly; however, this change was not statistically significant after the 6-month retention period. During the course of the treatment, the incidence of dehiscence and fenestration increased and decreased, respectively. CONCLUSIONS: RME may have detrimental effects on the supporting alveolar bone, since the thickness and height of the buccal alveolar bone decreased during the retention period.
Alveolar Bone Loss ; Bicuspid ; Cone-Beam Computed Tomography ; Incidence ; Molar ; Palatal Expansion Technique ; Periodontium ; Retention (Psychology) ; Tooth

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Condylar repositioning using centric relation bite in bimaxillary surgery.

Chang Youn LEE ; Chang Su JANG ; Ju Won KIM ; Jwa Young KIM ; Byoung Eun YANG

The Korean Journal of Orthodontics.2013;43(2):74-82. doi:10.4041/kjod.2013.43.2.74

OBJECTIVE: The purpose of this study was to evaluate displacement of the mandibular condyle after orthognathic surgery using a condylar-repositioning device. METHODS: The patient group comprised 20 adults who underwent bimaxillary surgery between August 2008 and July 2011. The degree of condylar displacement was measured by pre- and postoperative tomographic analysis using centric relation bite and a wire during surgery. A survey assessing temporomandibular joint (TMJ) sound, pain, and locking was performed. The 20 tomographs and surveys were analyzed using the Wilcoxon signed-rank test and McNemar's test, respectively. RESULTS: No significant changes were observed in the anterior, superior, or posterior joint space of the TMJ (p > 0.05). In addition, no significant change was observed in TMJ sound (p > 0.05). However, TMJ pain and locking both decreased significantly after surgery (p < 0.05). CONCLUSIONS: Due to its simplicity, this method may be feasible and useful for repositioning condyles.
Adult ; Bites and Stings ; Centric Relation ; Displacement (Psychology) ; Humans ; Joints ; Mandibular Condyle ; Orthognathic Surgery ; Temporomandibular Joint

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