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Multidisciplinary correction of anterior open bite relapse and upper airway obstruction.

Antonio GRACCO ; Alessandro PERRI ; Laura SIVIERO ; Giulio Alessandri BONETTI ; Francesco COCILOVO ; Edoardo STELLINI

The Korean Journal of Orthodontics.2015;45(1):47-56. doi:10.4041/kjod.2015.45.1.47

A 27-year-old man presented an anterior open bite relapse. He had low tongue posture positioned anteriorly at rest and during swallowing and reported chronic difficulty in nose breathing. Head cone-beam computed tomography revealed nasal septum deviation, right turbinate hypertrophy, and left maxillary sinus congestion, which were thought to contribute to the breathing problem, encourage the improper tongue posture, and thereby cause the relapse. Multidisciplinary treatment involving an otorhinolaryngologist, an orthodontist, and a periodontist resolved the upper airway obstruction and corrected the malocclusion. The follow-up examination after 3 years 5 months demonstrated stable results.
Adult ; Airway Obstruction* ; Cone-Beam Computed Tomography ; Deglutition ; Estrogens, Conjugated (USP) ; Follow-Up Studies ; Head ; Humans ; Hypertrophy ; Malocclusion ; Maxillary Sinus ; Nasal Septum ; Nose ; Open Bite* ; Posture ; Recurrence* ; Respiration ; Tongue ; Turbinates

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Early treatment of anterior open bite: Comparison of the vertical and horizontal morphological changes induced by magnetic bite-blocks and adjusted rapid molar intruders.

Mhd Hassan ALBOGHA ; Ichiro TAKAHASHI ; Mhd Naser SAWAN

The Korean Journal of Orthodontics.2015;45(1):38-46. doi:10.4041/kjod.2015.45.1.38

OBJECTIVE: This prospective clinical study aims to determine the differences between two treatment modalities for anterior open bite in growing patients. The treatment modalities involved the use of magnetic bite-blocks (MBBs) or rapid molar intruders (RMIs) applied with posterior bite-blocks. METHODS: Fifteen consecutive patients with a mean age of 11.2 (standard deviation [SD] = 1.6) years and a mean open bite of -3.9 mm were treated with MBBs. Another 15 consecutive patients with a mean age of 10.9 (SD = 1.8) years and a mean open bite of -3.8 mm were treated with RMIs applied on bite-blocks. Cephalometric radiographs were obtained before (T1) and immediately after appliance removal (T2). The treatments lasted four months, during which the appliances were cemented to the teeth. The morphological changes were measured in each group and compared using logistic regression analysis. RESULTS: The MBB group exhibited significantly greater decreases in SNA angle, ANB angle, overjet, and maxillary incisor angle (p < 0.05). The MBBs induced greater effects on the maxilla and maxillary dentition. The MBBs restrained maxillary forward growth and retracted the maxillary incisors more effectively than did the RMIs. Consequently, changes in the intermaxillary relationships and overjets were more distinct in the MBB group. CONCLUSIONS: The anteroposterior differences between the appliances suggest that MBBs should be preferred for the treatment of patients with Class II open bites and maxillary incisor protrusions.
Dentition ; Humans ; Incisor ; Logistic Models ; Maxilla ; Molar* ; Open Bite* ; Overbite ; Prospective Studies ; Tooth

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Comparison of the frictional characteristics of aesthetic orthodontic brackets measured using a modified in vitro technique.

Nursel ARICI ; Berat Serdar AKDENIZ ; Selim ARICI

The Korean Journal of Orthodontics.2015;45(1):29-37. doi:10.4041/kjod.2015.45.1.29

OBJECTIVE: The coefficients of friction (COFs) of aesthetic ceramic and stainless steel brackets used in conjunction with stainless steel archwires were investigated using a modified linear tribometer and special computer software, and the effects of the bracket slot size (0.018 inches [in] or 0.022 in) and materials (ceramic or metal) on the COF were determined. METHODS: Four types of ceramic (one with a stainless steel slot) and one conventional stainless steel bracket were tested with two types of archwire sizes: a 0.017 x 0.025-in wire in the 0.018-in slots and a 0.019 x 0.025-in wire in the 0.022-in slot brackets. For pairwise comparisons between the 0.018-in and 0.022-in slot sizes in the same bracket, an independent sample t-test was used. One-way and two-way analysis of variance (ANOVA) and Tukey's post-hoc test at the 95% confidence level (alpha = 0.05) were also used for statistical analyses. RESULTS: There were significant differences between the 0.022-in and 0.018-in slot sizes for the same brand of bracket. ANOVA also showed that both slot size and bracket slot material had significant effects on COF values (p < 0.001). The ceramic bracket with a 0.022-in stainless steel slot showed the lowest mean COF (micro = 0.18), followed by the conventional stainless steel bracket with a 0.022-in slot (micro = 0.21). The monocrystalline alumina ceramic bracket with a 0.018-in slot had the highest COF (micro = 0.85). CONCLUSIONS: Brackets with stainless steel slots exhibit lower COFs than ceramic slot brackets. All brackets show lower COFs as the slot size increases.
Aluminum Oxide ; Ceramics ; Friction* ; Orthodontic Brackets* ; Stainless Steel

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Distalization pattern of whole maxillary dentition according to force application points.

Eui Hyang SUNG ; Sung Jin KIM ; Youn Sic CHUN ; Young Chel PARK ; Hyung Seog YU ; Kee Joon LEE

The Korean Journal of Orthodontics.2015;45(1):20-28. doi:10.4041/kjod.2015.45.1.20

OBJECTIVE: The purpose of this study was to observe stress distribution and displacement patterns of the entire maxillary arch with regard to distalizing force vectors applied from interdental miniscrews. METHODS: A standard three-dimensional finite element model was constructed to simulate the maxillary teeth, periodontal ligament, and alveolar process. The displacement of each tooth was calculated on x, y, and z axes, and the von Mises stress distribution was visualized using color-coded scales. RESULTS: A single distalizing force at the archwire level induced lingual inclination of the anterior segment, and slight intrusive distal tipping of the posterior segment. In contrast, force at the high level of the retraction hook resulted in lingual root movement of the anterior segment, and extrusive distal translation of the posterior segment. As the force application point was located posteriorly along the archwire, the likelihood of extrusive lingual inclination of the anterior segment increased, and the vertical component of the force led to intrusion and buccal tipping of the posterior segment. Rotation of the occlusal plane was dependent on the relationship between the line of force and the possible center of resistance of the entire arch. CONCLUSIONS: Displacement of the entire arch may be dictated by a direct relationship between the center of resistance of the whole arch and the line of action generated between the miniscrews and force application points at the archwire, which makes the total arch movement highly predictable.
Alveolar Process ; Dental Occlusion ; Dentition* ; Periodontal Ligament ; Tooth ; Weights and Measures

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A new type of clear orthodontic retainer incorporating multi-layer hybrid materials.

Hyo Won AHN ; Kyung A KIM ; Seong Hun KIM

The Korean Journal of Orthodontics.2015;45(5):268-272. doi:10.4041/kjod.2015.45.5.268

Clear thermoplastic retainers have been widely used in daily orthodontics; however, they have inherent limitations associated with thermoplastic polymer materials such as dimensional instability, low strength, and poor wear resistance. To solve these problems, we developed a new type of clear orthodontic retainer that incorporates multi-layer hybrid materials. It consists of three layers; an outer polyethylenterephthalate glycol modified (PETG) hard-type polymer, a middle thermoplastic polyurethane (TPU) soft-type polymer, and an inner reinforced resin core. The resin core improves wear resistance and mechanical strength, which prevent unwanted distortion of the bucco-palatal wall of the retainer. The TPU layer absorbs impact and the PETG layer has good formability, optical qualities, fatigue resistance, and dimensional stability, which contributes to increased support from the mandibular dentition, and helps maintain the archform. This new type of vacuum-formed retainer showed improved mechanical strength and rate of water absorption.
Absorption ; Dentition ; Fatigue ; Orthodontic Retainers* ; Orthodontics ; Polymers ; Polyurethanes ; Water

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Aspartate aminotransferase activity in the pulp of teeth treated for 6 months with fixed orthodontic appliances.

Rita VEBERIENE ; Dalia LATKAUSKIENE ; Vilma RACINSKAITE ; Neringa SKUCAITE ; Vita MACHIULSKIENE

The Korean Journal of Orthodontics.2015;45(5):261-267. doi:10.4041/kjod.2015.45.5.261

OBJECTIVE: To measure aspartate aminotransferase (AST) activity in the pulp of teeth treated with fixed appliances for 6 months, and compare it with AST activity measured in untreated teeth. METHODS: The study sample consisted of 16 healthy subjects (mean age 25.7 +/- 4.3 years) who required the extraction of maxillary premolars for orthodontic reasons. Of these, 6 individuals had a total of 11 sound teeth extracted without any orthodontic treatment (the control group), and 10 individuals had a total of 20 sound teeth extracted after 6 months of orthodontic alignment (the experimental group). Dental pulp samples were extracted from all control and experimental teeth, and the AST activity exhibited by these samples was determined spectrophotometrically at 20degrees C. RESULTS: Mean AST values were 25.29 x 10(-5) U/mg (standard deviation [SD] 9.95) in the control group and 27.54 x 10(-5) U/mg (SD 31.81) in the experimental group. The difference between these means was not statistically significantly (p = 0.778), and the distribution of the AST values was also similar in both groups. CONCLUSIONS: No statistically significant increase in AST activity in the pulp of mechanically loaded teeth was detected after 6 months of orthodontic alignment, as compared to that of teeth extracted from individuals who had not undergone orthodontic treatment. This suggests that time-related regenerative processes occur in the dental pulp.
Aspartate Aminotransferases* ; Aspartic Acid* ; Bicuspid ; Dental Pulp ; Orthodontic Appliances* ; Tooth*

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Evaluation of the facial dimensions of young adult women with a preferred facial appearance.

Sae Yong KIM ; Mohamed BAYOME ; Jae Hyun PARK ; Yoon Ah KOOK ; Ju Hee KANG ; Kang Hyuk KIM ; Hong Beom MOON

The Korean Journal of Orthodontics.2015;45(5):253-260. doi:10.4041/kjod.2015.45.5.253

OBJECTIVE: The aim of this study was to evaluate the facial dimensions of young adult women with a preferred facial appearance and compare the results with those from the general population. METHODS: Twenty-five linear, nine angular, and three area measurements were made and four ratios were calculated using a sample of standardized frontal and lateral photographs of 46 young adult women with a preferred facial appearance (Miss Korea group) and 44 young adult women from the general population (control group). Differences between the two groups were analyzed using multivariate analysis of variance (MANOVA). RESULTS: Compared with the control group, the Miss Korea group exhibited a significantly greater facial height, total facial height (TFH; trichion-menton), facial width (tragus right-tragus left), facial depth (tragus-true vertical line), and trichion-nasion/TFH ratio and smaller subnasale-menton/TFH and facial width/TFH ratios. Furthermore, the control group had smaller intercanthal and interpupillary widths. CONCLUSIONS: The Miss Korea group exhibited longer, wider, and deeper faces compared with those from the general population. Furthermore, the Miss Korea group had larger eyes, longer but less protruded noses, longer and more retruded lower lips and chins, larger lip vermilion areas, and smaller labiomental angles. These results suggest that the latest trends in facial esthetics should be considered during diagnosis and treatment planning for young women with dentofacial abnormalities.
Chin ; Dentofacial Deformities ; Diagnosis ; Esthetics ; Female ; Humans ; Korea ; Lip ; Multivariate Analysis ; Nose ; Young Adult*

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Alveolar bone thickness around maxillary central incisors of different inclination assessed with cone-beam computed tomography.

Yu Lou TIAN ; Fang LIU ; Hong Jing SUN ; Pin LV ; Yu Ming CAO ; Mo YU ; Yang YUE

The Korean Journal of Orthodontics.2015;45(5):245-252. doi:10.4041/kjod.2015.45.5.245

OBJECTIVE: To assess the labial and lingual alveolar bone thickness in adults with maxillary central incisors of different inclination by cone-beam computed tomography (CBCT). METHODS: Ninety maxillary central incisors from 45 patients were divided into three groups based on the maxillary central incisors to palatal plane angle; lingual-inclined, normal, and labial-inclined. Reformatted CBCT images were used to measure the labial and lingual alveolar bone thickness (ABT) at intervals corresponding to every 1/10 of the root length. The sum of labial ABT and lingual ABT at the level of the root apex was used to calculate the total ABT (TABT). The number of teeth exhibiting alveolar fenestration and dehiscence in each group was also tallied. One-way analysis of variance and Tukey's honestly significant difference test were applied for statistical analysis. RESULTS: The labial ABT and TABT values at the root apex in the lingual-inclined group were significantly lower than in the other groups (p < 0.05). Lingual and labial ABT values were very low at the cervical level in the lingual-inclined and normal groups. There was a higher prevalence of alveolar fenestration in the lingual-inclined group. CONCLUSIONS: Lingual-inclined maxillary central incisors have less bone support at the level of the root apex and a greater frequency of alveolar bone defects than normal maxillary central incisors. The bone plate at the marginal level is also very thin.
Adult ; Bone Plates ; Cone-Beam Computed Tomography* ; Humans ; Incisor* ; Prevalence ; Tooth

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Three-dimensional analysis of the distal movement of maxillary 1st molars in patients fitted with mini-implant-aided trans-palatal arches.

Amirfarhang MIRESMAEILI ; Ahmad SAJEDI ; Abbas MOGHIMBEIGI ; Nasrin FARHADIAN

The Korean Journal of Orthodontics.2015;45(5):236-244. doi:10.4041/kjod.2015.45.5.236

OBJECTIVE: The aim of this study was to investigate three-dimensional molar displacement after distalization via miniscrews and a horizontal modification of the trans-palatal-arch (TPA). METHODS: The subjects in this clinical trial were 26 Class II patients. After the preparation of a complete set of diagnostic records, miniscrews were inserted between the maxillary 2nd premolar and 1st molar on the palatal side. Elastic modules connected to the TPA exerting an average force of 150-200 g/side parallel to the occlusal plane were applied. Cone-beam computed tomography was utilized to evaluate the position of the miniscrews relative to the adjacent teeth and maxillary sinus, and the direction of force relative to molar furcation. The distances from the central point of the incisive papilla to the mesiopalatal cusps of the 1st maxillary molars and the distances between the mesiopalatal cusps of the left and right molars were measured to evaluate displacement of the maxillary molars on the horizontal plane. Interocclusal space was used to evaluate vertical changes. RESULTS: Mean maxillary 1st molar distalization was 2.3 +/- 1.1 mm, at a rate of 0.4 +/- 0.2 mm/month, and rotation was not significant. Intermolar width increased by 2.9 +/- 1.8 mm. Molars were intruded relative to the neighboring teeth, from 0.1 to 0.8 mm. CONCLUSIONS: Distalization of molars was possible without extrusion, using the appliance investigated. The intrusive component of force reduced the rate of distal movement.
Bicuspid ; Cone-Beam Computed Tomography ; Dental Models ; Dental Occlusion ; Humans ; Maxillary Sinus ; Molar* ; Orthodontic Anchorage Procedures ; Palate ; Tooth ; Tooth Movement

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A comparative study of frictional force in self-ligating brackets according to the bracket-archwire angulation, bracket material, and wire type.

Souk Min LEE ; Chung Ju HWANG

The Korean Journal of Orthodontics.2015;45(1):13-19. doi:10.4041/kjod.2015.45.1.13

OBJECTIVE: This study aimed to compare the frictional force (FR) in self-ligating brackets among different bracket-archwire angles, bracket materials, and archwire types. METHODS: Passive and active metal self-ligating brackets and active ceramic self-ligating brackets were included as experimental groups, while conventional twin metal brackets served as a control group. All brackets were maxillary premolar brackets with 0.022 inch [in] slots and a -7degrees torque. The orthodontic wires used included 0.018 round and 0.019 x 0.025 in rectangular stainless steel wires. The FR was measured at 0degrees, 5degrees, and 10degrees angulations as the wire was drawn through the bracket slots after attaching brackets from each group to the universal testing machine. Static and kinetic FRs were also measured. RESULTS: The passive self-ligating brackets generated a lower FR than all the other brackets. Static and kinetic FRs generally increased with an increase in the bracket-archwire angulation, and the rectangular wire caused significantly higher static and kinetic FRs than the round wire (p < 0.001). The metal passive self-ligating brackets exhibited the lowest static FR at the 0degrees angulation and a lower increase in static and kinetic FRs with an increase in bracket-archwire angulation than the other brackets, while the conventional twin brackets showed a greater increase than all three experimental brackets. CONCLUSIONS: The passive self-ligating brackets showed the lowest FR in this study. Self-ligating brackets can generate varying FRs in vitro according to the wire size, surface characteristics, and bracket-archwire angulation.
Bicuspid ; Ceramics ; Friction* ; Humans ; Orthodontic Wires ; Stainless Steel ; Torque

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