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The Improvement and Completion of Outcome index: A new assessment system for quality of orthodontic treatment.

Mihee HONG ; Yoon Ah KOOK ; Myeng Ki KIM ; Jae Il LEE ; Hong Gee KIM ; Seung Hak BAEK

The Korean Journal of Orthodontics.2016;46(4):199-211. doi:10.4041/kjod.2016.46.4.199

OBJECTIVE: Given the considerable disagreement between the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation, we aimed to develop a novel assessment system-the Improvement and Completion of Outcome (ICO) index-to evaluate the outcome of orthodontic treatment. METHODS: Sixteen criteria from 4 major categories were established to represent the pretreatment malocclusion status, as well as the degree of improvement and level of completion of outcome during/after treatment: dental relationship (arch length discrepancy, irregularity, U1-SN, and IMPA); anteroposterior relationship (overjet, right and left molar position, ANB); vertical relationship (anterior overbite, anterior open-bite, lateral open-bite, SN-MP); and transverse relationship (dental midline discrepancy, chin point deviation, posterior cross-bite, occlusal plane cant). The score for each criterion was defined from 0 or −1 (worst) to 5 (ideal value or normal occlusion) in gradations of 1. The sum of the scores in each category indicates the area and extent of the problems. Improvement and completion percentages were estimated based on the pre- and post-treatment total scores and the maximum total score. If the completion percentage exceeded 80%, treatment outcome was considered successful. RESULTS: Two cases, Class I malocclusion and skeletal Class III malocclusion, are presented to represent the assessment procedure using the ICO index. The difference in the level of improvement and completion of treatment outcome can be clearly explained by using 2 percentage values. CONCLUSIONS: Thus, the ICO index enables the evaluation of the quality of orthodontic treatment objectively and consecutively throughout the entire treatment process.
Chin ; Dental Occlusion ; Malocclusion ; Molar ; Orthodontics ; Overbite ; Treatment Outcome

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Stress distributions in peri-miniscrew areas from cylindrical and tapered miniscrews inserted at different angles.

Sung Hwan CHOI ; Seong Jin KIM ; Kee Joon LEE ; Sang Jin SUNG ; Youn Sic CHUN ; Chung Ju HWANG

The Korean Journal of Orthodontics.2016;46(4):189-198. doi:10.4041/kjod.2016.46.4.189

OBJECTIVE: The purpose of this study was to analyze stress distributions in the roots, periodontal ligaments (PDLs), and bones around cylindrical and tapered miniscrews inserted at different angles using a finite element analysis. METHODS: We created a three-dimensional (3D) maxilla model of a dentition with extracted first premolars and used 2 types of miniscrews (tapered and cylindrical) with 1.45-mm diameters and 8-mm lengths. The miniscrews were inserted at 30°, 60°, and 90° angles with respect to the bone surface. A simulated horizontal orthodontic force of 2 N was applied to the miniscrew heads. Then, the stress distributions, magnitudes during miniscrew placement, and force applications were analyzed with a 3D finite element analysis. RESULTS: Stresses were primarily absorbed by cortical bone. Moreover, very little stress was transmitted to the roots, PDLs, and cancellous bone. During cylindrical miniscrew insertion, the maximum von Mises stress increased as insertion angle decreased. Tapered miniscrews exhibited greater maximum von Mises stress than cylindrical miniscrews. During force application, maximum von Mises stresses increased in both groups as insertion angles decreased. CONCLUSIONS: For both cylindrical and tapered miniscrew designs, placement as perpendicular to the bone surface as possible is recommended to reduce stress in the surrounding bone.
Bicuspid ; Dentition ; Finite Element Analysis ; Head ; Maxilla ; Periodontal Ligament

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Hyo Won AHN

The Korean Journal of Orthodontics.2016;46(4):187-188. doi:10.4041/kjod.2016.46.4.187

No abstract available.

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Effect of labiolingual inclination of a maxillary central incisor and surrounding alveolar bone loss on periodontal stress: A finite element analysis.

Sung Hwan CHOI ; Young Hoon KIM ; Kee Joon LEE ; Chung Ju HWANG

The Korean Journal of Orthodontics.2016;46(3):155-162. doi:10.4041/kjod.2016.46.3.155

OBJECTIVE: The aim of this study was to investigate whether labial tooth inclination and alveolar bone loss affect the moment per unit of force (M(t)/F) in controlled tipping and consequent stresses on the periodontal ligament (PDL). METHODS: Three-dimensional models (n = 20) of maxillary central incisors were created with different labial inclinations (5°, 10°, 15°, and 20°) and different amounts of alveolar bone loss (0, 2, 4, and 6 mm). The M(t)/F necessary for controlled tipping (M(t)/F(cont)) and the principal stresses on the PDL were calculated for each model separately in a finite element analysis. RESULTS: As labial inclination increased, M(t)/F(cont) and the length of the moment arm decreased. In contrast, increased alveolar bone loss caused increases in M(t)/F(cont) and the length of the moment arm. When M(t)/F was near M(t)/F(cont), increases in M(t)/F caused compressive stresses to move from a predominantly labial apical region to a palatal apical position, and tensile stresses in the labial area moved from a cervical position to a mid-root position. Although controlled tipping was applied to the incisors, increases in alveolar bone loss and labial tooth inclination caused increases in maximum compressive and tensile stresses at the root apices. CONCLUSIONS: Increases in alveolar bone loss and labial tooth inclination caused increases in stresses that might cause root resorption at the root apex, despite the application of controlled tipping to the incisors.
Alveolar Bone Loss* ; Arm ; Finite Element Analysis* ; Incisor* ; Periodontal Ligament ; Root Resorption ; Tooth

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Preparation and antimicrobial assay of ceramic brackets coated with TiO2 thin films.

Shuai CAO ; Ye WANG ; Lin CAO ; Yu WANG ; Bingpeng LIN ; Wei LAN ; Baocheng CAO

The Korean Journal of Orthodontics.2016;46(3):146-154. doi:10.4041/kjod.2016.46.3.146

OBJECTIVE: Different methods have been utilized to prevent enamel demineralization and other complications during orthodontic treatment. However, none of these methods can offer long-lasting and effective prevention of orthodontic complications or interventions after complications occur. Considering the photocatalytic effect of TiO2 on organic compounds, we hoped to synthesize a novel bracket with a TiO2 thin film to develop a photocatalytic antimicrobial effect. METHODS: The sol-gel dip coating method was used to prepare TiO2 thin films on ceramic bracket surfaces. Twenty groups of samples were composed according to the experimental parameters. Crystalline structure and surface morphology were characterized by X-ray diffraction and scanning electron microscopy, respectively; film thickness was examined with a surface ellipsometer. The photocatalytic properties under ultraviolet (UV) light irradiation were analyzed by evaluating the degradation ratio of methylene blue (MB) at a certain time. Antibacterial activities of selected thin films were also tested against Lactobacillus acidophilus and Candida albicans. RESULTS: Films with 5 coating layers annealed at 700℃ showed the greatest photocatalytic activity in terms of MB decomposition under UV light irradiation. TiO2 thin films with 5 coating layers annealed at 700℃ exhibited the greatest antimicrobial activity under UV-A light irradiation. CONCLUSIONS: These results provide promising guidance in prevention of demineralization by increasing antimicrobial activities of film coated brackets.
Candida albicans ; Ceramics* ; Crystallins ; Dental Enamel ; Esthetics ; Hope ; Lactobacillus acidophilus ; Methods ; Methylene Blue ; Microscopy, Electron, Scanning ; Ultraviolet Rays ; X-Ray Diffraction

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Five-year investigation of a large orthodontic patient population at a dental hospital in South Korea.

Yongxu PIAO ; Sung Jin KIM ; Hyung Seog YU ; Jung Yul CHA ; Hyoung Seon BAIK

The Korean Journal of Orthodontics.2016;46(3):137-145. doi:10.4041/kjod.2016.46.3.137

OBJECTIVE: The purpose of this study was to investigate the characteristics of orthodontic patients at Yonsei Dental Hospital from 2008 to 2012. METHODS: We evaluated Angle's classification from molar relationships, classification of skeletal malocclusion from the A point-nasion-B point angle, facial asymmetry, and temporomandibular joint disorders (TMDs) from the records of 7,476 patients who received an orthodontic diagnosis. The orthognathic surgery rate, extraction rate, and extraction sites were determined from the records of 4,861 treated patients. RESULTS: The patient number increased until 2010 and gradually decreased thereafter. Most patients were aged 19-39 years, with a gradual increase in patients aged ≥ 40 years. Angle's Class I, Class II divisions 1 and 2, and Class III malocclusions were observed in 27.7%, 25.6%, 10.6%, and 36.1% patients, respectively, with a gradual decrease in the frequency of Class I malocclusion. The proportion of patients with skeletal Class I, Class II, and Class III malocclusions was 34.3%, 34.3%, and 31.4%, respectively, while the prevalence of facial asymmetry and TMDs was 11.0% and 24.9%, respectively. The orthognathic surgery rate was 18.5%, with 70% surgical patients exhibiting skeletal Class III malocclusion. The overall extraction rate among nonsurgical patients was 35.4%, and the maxillary and mandibular first premolars were the most commonly extracted teeth. CONCLUSIONS: The most noticeable changes over time included a decrease in the patient number after 2010, an increase in the average patient age, and a decrease in the frequency of Angle's Class I malocclusion. Our results suggest that periodic characterization is necessary to meet the changing demands of orthodontic patients.
Bicuspid ; Classification ; Diagnosis ; Epidemiology ; Facial Asymmetry ; Humans ; Korea* ; Malocclusion ; Molar ; Orthognathic Surgery ; Prevalence ; Temporomandibular Joint Disorders ; Tooth

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Evaluation of digital dental models obtained from dental cone-beam computed tomography scan of alginate impressions.

Tingting JIANG ; Sang Mi LEE ; Yanan HOU ; Xin CHANG ; Hyeon Shik HWANG

The Korean Journal of Orthodontics.2016;46(3):129-136. doi:10.4041/kjod.2016.46.3.129

OBJECTIVE: To investigate the dimensional accuracy of digital dental models obtained from the dental cone-beam computed tomography (CBCT) scan of alginate impressions according to the time elapse when the impressions are stored under ambient conditions. METHODS: Alginate impressions were obtained from 20 adults using 3 different alginate materials, 2 traditional alginate materials (Alginoplast and Cavex Impressional) and 1 extended-pour alginate material (Cavex ColorChange). The impressions were stored under ambient conditions, and scanned by CBCT immediately after the impressions were taken, and then at 1 hour intervals for 6 hours. After reconstructing three-dimensional digital dental models, the models were measured and the data were analyzed to determine dimensional changes according to the elapsed time. The changes within the measurement error were regarded as clinically acceptable in this study. RESULTS: All measurements showed a decreasing tendency with an increase in the elapsed time after the impressions. Although the extended-pour alginate exhibited a less decreasing tendency than the other 2 materials, there were no statistically significant differences between the materials. Changes above the measurement error occurred between the time points of 3 and 4 hours after the impressions. CONCLUSIONS: The results of this study indicate that digital dental models can be obtained simply from a CBCT scan of alginate impressions without sending them to a remote laboratory. However, when the impressions are not stored under special conditions, they should be scanned immediately, or at least within 2 to 3 hours after the impressions are taken.
Adult ; Cone-Beam Computed Tomography* ; Dental Models* ; Humans

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Reader's Forum.

Woo Sun JUNG

The Korean Journal of Orthodontics.2016;46(3):127-128. doi:10.4041/kjod.2016.46.3.127

No abstract available.

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Do customized orthodontic appliances and vibration devices provide more efficient treatment than conventional methods?.

Abdullah M ALDREES

The Korean Journal of Orthodontics.2016;46(3):180-185. doi:10.4041/kjod.2016.46.3.180

The incorporation of technological advances in the field of clinical orthodontics to increase treatment efficiency has led to the development of customized appliances (Insignia®), archwires (Suresmile®), and the production of devices to enhance tooth movement (Acceledent®). This review presents a comprehensive study of the literature concerning these products, and analyzes the available evidence of their efficiency. To date, one pilot study has evaluated the efficiency of the Insignia® system, three retrospective studies have assessed the efficiency of the Suresmile® system, and a few Acceledent® reports have described its effect on treatment time. Critical appraisal of the reviewed papers revealed that the efficiency of the Insignia® system cannot be confirmed based on the available evidence, while the use of Suresmile® can reduce overall treatment time in simple cases. The acceleration of tooth movement by Acceledent® devices has not yet been confirmed.
Acceleration ; Methods* ; Orthodontic Appliances* ; Orthodontics ; Pilot Projects ; Retrospective Studies ; Tooth Movement ; Vibration*

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New prediction equations for the estimation of maxillary mandibular canine and premolar widths from mandibular incisors and mandibular first permanent molar widths: A digital model study.

Fazal SHAHID ; Mohammad Khursheed ALAM ; Mohd Fadhli KHAMIS

The Korean Journal of Orthodontics.2016;46(3):171-179. doi:10.4041/kjod.2016.46.3.171

OBJECTIVE: The primary aim of the study was to generate new prediction equations for the estimation of maxillary and mandibular canine and premolar widths based on mandibular incisors and first permanent molar widths. METHODS: A total of 2,340 calculations (768 based on the sum of mandibular incisor and first permanent molar widths, and 1,572 based on the maxillary and mandibular canine and premolar widths) were performed, and a digital stereomicroscope was used to derive the the digital models and measurements. Mesiodistal widths of maxillary and mandibular teeth were measured via scanned digital models. RESULTS: There was a strong positive correlation between the estimation of maxillary (r = 0.85994, r2 = 0.7395) and mandibular (r = 0.8708, r2 = 0.7582) canine and premolar widths. The intraclass correlation coefficients were statistically significant, and the coefficients were in the strong correlation range, with an average of 0.9. Linear regression analysis was used to establish prediction equations. Prediction equations were developed to estimate maxillary arches based on Y = 15.746 + 0.602 × sum of mandibular incisors and mandibular first permanent molar widths (sum of mandibular incisors [SMI] + molars), Y = 18.224 + 0.540 × (SMI + molars), and Y = 16.186 + 0.586 × (SMI + molars) for both genders, and to estimate mandibular arches the parameters used were Y = 16.391 + 0.564 × (SMI + molars), Y = 14.444 + 0.609 × (SMI + molars), and Y = 19.915 + 0.481 × (SMI + molars). CONCLUSIONS: These formulas will be helpful for orthodontic diagnosis and clinical treatment planning during the mixed dentition stage.
Bicuspid* ; Dentition, Mixed ; Diagnosis ; Incisor* ; Linear Models ; Molar* ; Tooth

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