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New approach of maxillary protraction using modified C-palatal plates in Class III patients.

Yoon Ah KOOK ; Mohamed BAYOME ; Jae Hyun PARK ; Ki Beom KIM ; Seong Hun KIM ; Kyu Rhim CHUNG

The Korean Journal of Orthodontics.2015;45(4):209-214. doi:10.4041/kjod.2015.45.4.209

Maxillary protraction is the conventional treatment for growing Class III patients with maxillary deficiency, but it has undesirable dental effects. The purpose of this report is to introduce an alternative modality of maxillary protraction in patients with dentoskeletal Class III malocclusion using a modified C-palatal plate connected with elastics to a face mask. This method improved skeletal measurements, corrected overjet, and slightly improved the profile. The patients may require definitive treatment in adolescence or adulthood. The modified C-palatal plate enables nonsurgical maxillary advancement with maximal skeletal effects and minimal dental side effects.
Adolescent ; Humans ; Malocclusion ; Masks

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Effect of activation and preactivation on the mechanical behavior and neutral position of stainless steel and beta-titanium T-loops.

Saul Matos DE CASTRO ; Rui MOREIRA ; Ana Cristina BRAGA ; Afonso Pinhao FERREIRA ; Maria Cristina POLLMANN

The Korean Journal of Orthodontics.2015;45(4):198-208. doi:10.4041/kjod.2015.45.4.198

OBJECTIVE: To quantify, for each activation, the effect of preactivations of differing distribution and intensity on the neutral position of T-loops (7-mm height), specifically the horizontal force, moment to force (M/F) ratio, and load to deflection ratio. METHODS: A total 100 loops measuring 0.017 x 0.025 inches in cross-section were divided into two groups (n = 50 each) according to composition, either stainless steel or beta-titanium. The two groups were further divided into five subgroups, 10 loops each, corresponding to the five preactivations tested: preactivations with occlusal distribution (0degrees, 20degrees, and 40degrees), gingival distribution (20degrees), and occlusal-gingival distribution (40degrees). The loops were subjected to a total activation of 6-mm with 0.5-mm iterations. Statistical analysis was performed using comprised ANOVA and Bonferoni multiple comparison tests, with a significance level of 5%. RESULTS: The location and intensity of preactivation influenced the force intensity. For the M/F ratio, the highest value achieved without preactivation was lower than the height of the loop. Without preactivation, the M/F ratio increased with activation, while the opposite effect was observed with preactivation. The increase in the M/F ratio was greater when the preactivation distribution was partially or fully gingival. CONCLUSIONS: Depending on the preactivation distribution, displacement of uprights is higher or lower than the activation, which is a factor to consider in clinical practice.
Analysis of Variance ; Stainless Steel*

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Dentoskeletal features in individuals with ectopic eruption of the permanent maxillary first molar.

Manuela MUCEDERO ; Matteo ROZZI ; Giulia CARDONI ; Maria Rosaria RICCHIUTI ; Paola COZZA

The Korean Journal of Orthodontics.2015;45(4):190-197. doi:10.4041/kjod.2015.45.4.190

OBJECTIVE: The aim of the study was to analyze the prevalence and distribution of ectopic eruption of the permanent maxillary first molar (EEM) in individuals scheduled for orthodontic treatment and to investigate the association of EEM with dental characteristics, maxillary skeletal features, crowding, and other dental anomalies. METHODS: A total of 1,317 individuals were included and randomly divided into two groups. The first 265 subjects were included as controls, while the remaining 1,052 subjects included the sample from which the final experimental EEM group was derived. The mesiodistal (M-D) crown width of the deciduous maxillary second molar and permanent maxillary first molar, maxillary arch length (A-PML), maxillomandibular transverse skeletal relationships (anterior and posterior transverse interarch discrepancies, ATID and PTID), maxillary and mandibular tooth crowding, and the presence of dental anomalies were recorded for each subject, and the statistical significance of differences in these parameters between the EEM and control groups was determined using independent sample t-tests. Chi-square tests were used to compare the prevalence of other dental anomalies between the two groups. RESULTS: The prevalence of maxillary EEM was 2.5%. The M-D crown widths, ATID and PTID, and tooth crowding were significantly greater, while A-PML was significantly smaller, in the EEM group than in the control group. Only two subjects showed an association between EEM and maxillary lateral incisor anomalies, which included agenesis in one and microdontia in the other. CONCLUSIONS: EEM may be a risk factor for maxillary arch constriction and severe tooth crowding.
Chi-Square Distribution ; Constriction ; Crowns ; Incisor ; Malocclusion ; Molar* ; Prevalence ; Risk Factors

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Differences in the mandibular premolar positions in Angle Class I subjects with different vertical facial types: A cone-beam computed tomography study.

Jun DUAN ; Feng DENG ; Wan Shan LI ; Xue Lei LI ; Lei Lei ZHENG ; Gui Yuan LI ; Yan Jie BAI

The Korean Journal of Orthodontics.2015;45(4):180-189. doi:10.4041/kjod.2015.45.4.180

OBJECTIVE: To compare the positions of the mandibular premolars in Angle Class I subjects according to vertical facial type. The results will provide a theoretical basis for predicting effective tooth movement in orthodontic treatment. METHODS: Cephalometric parameters were determined using cone-beam computed tomography in 120 Angle Class I subjects. Subjects were categorized as short, normal, and long face types according to the Frankfort mandibular angle. Parameters indicating the position of the mandibular right premolars and the mandible were also measured. RESULTS: The angle between the mandibular first premolar axis and buccal cortex, the distance between the root apex and buccal cortex, angle of vestibularization, arc of vestibularization, and root apex maximum movable distance were significantly greater in the short face type than in the long and norm face types. The angle between the mandibular second premolar axis and buccal cortex, the distance from root apex to buccal cortex, and the arc of vestibularization were significantly greater in the short face type than in the normal face type. CONCLUSIONS: There are significant differences in the mandibular premolar positions in Class I subjects according to vertical facial type.
Axis, Cervical Vertebra ; Bicuspid* ; Cone-Beam Computed Tomography* ; Malocclusion, Angle Class I* ; Mandible ; Tooth Movement

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Comparative evaluation of molar distalization therapy using pendulum and distal screw appliances.

Alberto CAPRIOGLIO ; Alessandra CAFAGNA ; Mattia FONTANA ; Mauro COZZANI

The Korean Journal of Orthodontics.2015;45(4):171-179. doi:10.4041/kjod.2015.45.4.171

OBJECTIVE: To compare dentoalveolar and skeletal changes produced by the pendulum appliance (PA) and the distal screw appliance (DS) in Class II patients. METHODS: Forty-three patients (19 men, 24 women) with Class II malocclusion were retrospectively selected for the study. Twenty-four patients (mean age, 12.2 +/- 1.5 years) were treated with the PA, and 19 patients (mean age, 11.3 +/- 1.9 years) were treated with the DS. The mean distalization time was 7 months for the PA group and 9 months for the DS group. Lateral cephalograms were obtained at T1, before treatment, and at T2, the end of distalization. A Mann-Whitney U test was used for statistical comparisons of the two groups between T1 and T2. RESULTS: PA and DS were equally effective in distalizing maxillary molars (4.7 mm and 4.2 mm, respectively) between T1 and T2; however, the maxillary first molars showed less distal tipping in the DS group than in the PA group (3.2degrees vs. 9.0degrees, respectively). Moreover, significant premolar anchorage loss (2.7 mm) and incisor proclination (5.0degrees) were noted in the PA group, whereas premolar distal movement (1.9 mm) and no significant changes at the incisor (0.1degrees) were observed in the DS group. No significant sagittal or vertical skeletal changes were detected between the two groups during the distalization phase. CONCLUSIONS: PA and DS seem to be equally effective in distalizing maxillary molars; however, greater distal molar tipping and premolar anchorage loss can be expected using PA.
Bicuspid ; Humans ; Incisor ; Male ; Malocclusion ; Molar* ; Retrospective Studies ; Statistics, Nonparametric

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Comparison of shear bond strength of orthodontic brackets using various zirconia primers.

Ji Yeon LEE ; Jin Seok KIM ; Chung Ju HWANG

The Korean Journal of Orthodontics.2015;45(4):164-170. doi:10.4041/kjod.2015.45.4.164

OBJECTIVE: The aim of this study was to compare the shear bond strength (SBS) of orthodontic brackets bonded to zirconia surfaces using three different zirconia primers and one silane primer, and subjected to thermocycling. METHODS: We designed 10 experimental groups following the surface treatment and thermocycling. The surface was treated with one of the following method: no-primer (NP), Porcelain Conditioner (PC), Z-PRIME Plus (ZP), Monobond Plus (MP) and Zirconia Liner Premium (ZL) (n=20). Then each group was subdivided to non-thermocycled and thermocycled groups (NPT, PC, ZPT, MPT, ZLT) (n=10). Orthodontic brackets were bonded to the specimens using Transbond(TM) XT Paste and light cured for 15 s at 1,100 mW/cm2. The SBS was measured at a 1 mm/min crosshead speed. The failure mode was assessed by examination with a stereomicroscope and the amount of bonding resin remaining on the zirconia surface was scored using the modified adhesive remnant index (ARI). RESULTS: The SBS of all experimental groups decreased after thermocycling. Before thermocycling, the SBS was ZL, ZP > or = MP > or = PC > NP but after thermocycling, the SBS was ZLT > or = MPT > or = ZPT > PCT = NPT (p > 0.05). For the ARI score, both of the groups lacking primer (NP and NPT) displayed adhesive failure modes, but the groups with zirconia primers (ZP, ZPT, MP, MPT, ZL, and ZLT) were associated with mixed failure modes. CONCLUSIONS: Surface treatment with a zirconia primer increases the SBS relative to no-primer or silane primer application between orthodontic brackets and zirconia prostheses.
Adhesives ; Dental Porcelain ; Orthodontic Brackets* ; Prostheses and Implants

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Cone-beam computed tomography based evaluation of rotational patterns of dentofacial structures in skeletal Class III deformity with mandibular asymmetry.

Hyeong Seok RYU ; Ki Yong AN ; Kyung Hwa KANG

The Korean Journal of Orthodontics.2015;45(4):153-163. doi:10.4041/kjod.2015.45.4.153

OBJECTIVE: The purpose of this study was to assess rotational patterns of dentofacial structures according to different vertical skeletal patterns by cone-beam computed tomography (CBCT) and analyze their influence on menton deviation in skeletal Class III deformity with mandibular asymmetry. METHODS: The control group consisted of 30 young adults (15 men, 15 women) without any severe skeletal deformity. The asymmetry group included 55 adults (28 men, 27 women) with skeletal Class III deformity and at least 3-mm menton deviation from the midsagittal plane; it was divided into the hyperdivergent and hypodivergent subgroups using a mandibular plane angle cutoff of 35degrees. Fourteen rotational variables of the dental arches and mandible were measured and compared among the groups. Correlations between menton deviation and the other variables were evaluated. RESULTS: The asymmetry group showed significantly larger measurements of roll and yaw in the mandible than the control group. The hypodivergent subgroup showed significant differences in maxillary posterior measurements of yaw (p < 0.01) and maxillary anterior shift (p < 0.05) compared with the hyperdivergent subgroup. All the mandibular measurements had significant correlations with menton deviation (p < 0.01). Most measurements of roll were positively correlated with one another (p < 0.01). Measurements of yaw and roll in the posterior regions were also positively correlated (p < 0.05). CONCLUSIONS: Menton deviation in skeletal Class III deformity with mandibular asymmetry is influenced by rotation of mandibular posterior dentofacial structures. The rotational patterns vary slightly according to the vertical skeletal pattern.
Adult ; Cone-Beam Computed Tomography* ; Congenital Abnormalities* ; Dental Arch ; Facial Asymmetry ; Humans ; Male ; Mandible ; Young Adult

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Reader's Forum.

Jae Jung YU

The Korean Journal of Orthodontics.2015;45(4):151-152. doi:10.4041/kjod.2015.45.4.151

No abstract available.

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Total intrusion and distalization of the maxillary arch to improve smile esthetics.

Eui Seon BAEK ; Soonshin HWANG ; Kyung Ho KIM ; Chooryung J CHUNG

The Korean Journal of Orthodontics.2017;47(1):59-73. doi:10.4041/kjod.2017.47.1.59

This case report illustrates the successful treatment of a patient with skeletal Class II malocclusion and an unesthetic smile involving excessive gingival display and large buccal corridors. By applying dual buccal interradicular miniscrews, total intrusion of the maxillary dentition along with distalization was induced to improve both the occlusion and smile esthetics. In addition to the conventional cephalometric superimposition, three-dimensional superimposition was performed and evaluated to validate the treatment outcome.
Dentition ; Esthetics* ; Humans ; Malocclusion ; Treatment Outcome

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The genial tubercle: A prospective novel landmark for the diagnosis of mandibular asymmetry.

Seung Youp LEE ; Dong Soon CHOI ; Insan JANG ; Geun Su SONG ; Bong Kuen CHA

The Korean Journal of Orthodontics.2017;47(1):50-58. doi:10.4041/kjod.2017.47.1.50

INTRODUCTION: Identifying menton (Me) on posteroanterior cephalograms and three-dimensional (3D) cone-beam computed tomography (CBCT) images is difficult, because the midpoint of the symphyseal area is not identifiable after the mandibular symphysis fuses at an early age. The aim of this study was to evaluate the reliability of the identification of the genial tubercle (GT) in patients with mandibular asymmetry and to compare it with that of the traditional landmark, Me. METHODS: The samples comprised 20 CBCT images of adults with mandibular asymmetry. Two examiners performed the identifications and measurements. Me and GT were marked, and the anteroposterior, vertical, and transverse distances to the three reference planes were measured on 3D-reconstructed CBCT images. The intra- and inter-examiner reliability of landmark identification of Me and GT were assessed using the intraclass correlation coefficient (ICC) and Bland-Altman plots. RESULTS: The Me and GT landmarks showed excellent reliability (ICC ≥ 0.993) three-dimensionally. In the transverse evaluation, the ICC values of the GT (range, 0.997–0.999) tended to be slightly higher than those of Me (range, 0.993–0.996). In the Bland-Altman plots for the two separate assessments, Me showed a maximum error of 1.76 mm in the transverse direction, whereas the GT showed a maximum error of 0.96 mm in the 95% limit. CONCLUSIONS: Our results suggest that both Me and GT are clinically reliable and equally useful landmarks for the evaluation of mandibular asymmetry on CBCT images.
Adult ; Cone-Beam Computed Tomography ; Diagnosis* ; Humans ; Prospective Studies*

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