Lever arm on bracket vs. lever arm on archwire: A 3D finite element method study of mechanics of miniscrew-supported lingual en-masse retraction of maxillary anterior teeth.

OBJECTIVE: To compare the deformation of the main archwire and 3D movements of maxillary anterior teeth during miniscrew-supported en-masse retraction with the lever arm on the archwire and on the brackets in lingual orthodontic treatment in finite element analysis (FEM) simulation. MATERIAL AND METHODS: A 3D dental-alveolar model with bonded 0.018×0.025-inch slot lingual brackets and a 0.017×0.025-inch dimension stainless-steel archwire was created. Four FEM models were created based on a 3D dental-alveolar model: in Models A and C, the lever arms were attached to the lingual bracket, while in Models B and D, the lever arms were attached to the archwire. Meanwhile, in Models A and B, the miniscrews were placed in between the molars, while in Models C and D, the miniscrews were positioned on the palatal roof. After a 1.5N retraction force was applied from the miniscrew to the end of the lever arm, the initial movements in the sagittal, transversal, and vertical planes were recorded and analysed for maxillary anterior teeth. RESULTS: In Models B and D, smaller deformation of the main archwire and less prominent bowing effect were noticed in both sagittal and vertical directions compared to their counter groups. In Models C and D, the central incisors showed less torque loss in the sagittal direction and more canine intrusion vertically. CONCLUSIONS: For the same lever arm-miniscrew retraction configuration, the lever arm on the bracket showed less deformation of the main archwire and more body movement of the teeth than the lever arm on the archwire group. With the same level arm height, the transverse and vertical bowing effect is reduced when the lever arm was placed distal to the central incisor and the miniscrews placed next to the palatal suture.

Biomechanical analysis of maxillary anterior teeth movements during different retracting methods with a lever arm miniscrew system in double-slot lingual brackets: A finite element method study.

OBJECTIVE: The objective of the study was to find the most effective retracting method for the six maxillary anterior teeth with double-slot lingual brackets using a lever arm and miniscrew system. METHODS: Six finite element models were constructed: (A) a ribbon-wise archwire with a lever arm; (B) a ribbon-wise archwire with a lever arm and a sectional edgewise archwire; (C) a ribbon-wise archwire and a sectional edgewise archwire with a lever arm; (D) an edgewise archwire with a lever arm; (E) an edgewise archwire with a lever arm and a sectional ribbon-wise archwire; and (F) an edgewise archwire and a sectional ribbon-wise archwire with a lever arm. Initial displacements of maxillary teeth driven by a 1.5 N retraction force to the lever arm were analysed. RESULTS: In models B, C, E and F, anterior torque loss and inter-canine distance increases were significantly lower than that of the models without auxiliary archwires. In models C and F, the main archwire was less likely deformed. In models A, B and C, the displacement of canines in sagittal and vertical directions were less than in models D, E and F. CONCLUSIONS: The combination of edgewise and ribbon-wise archwires in double-slot lingual brackets effectively preserves the anterior arch shape. An edgewise archwire with lever arms on the auxiliary sectional ribbon-wise archwire is recommended for better performance in anterior teeth retraction.

Quantification of orthodontic loads on teeth in the correction of canine overeruption using different archwire designs.

INTRODUCTION: This study quantifies the effects of material, size of the continuous archwires, and level of overeruption on the loads on teeth in the correction of overerupted canines. METHODS: An orthodontic force test (OFT) was used to measure the 3-dimensional loads delivered by the archwires to the brackets attached to the maxillary right incisors, canine, and premolars. Dentoforms simulating canine overeruptions at the 0.5 mm and 1 mm levels were made from computerized tomography scans. Archwires with 2 types of material (stainless steel [SS] and nickel-titanium [NiTi]) and 2 sizes (0.014-in and 0.016-in) were tested, respectively, on the 0.022 × 0.028-in brackets through elastomeric ligatures. RESULTS: The forces were dominantly intrusive on the canines and extrusive on the first premolars and lateral incisors. The magnitudes of the extrusive forces were about 74% and 52% that of intrusive force on the canines, which range from -0.48 ± 0.01 N to -5.70 ± 0.14 N depending on the wire material, size, and severity of overeruption (P <0.01). The canine intrusive forces created by SS wires were about 3 times higher than that of NiTi wires with the same sizes, 0.016-in archwires were about twice higher than that of 0.014-in with the same materials, and 1 mm overeruption level doubled with respect to 0.5 mm. Significant second-order moment as coupled with the intrusive or extrusive forces. CONCLUSIONS: The intrusive and extrusive forces on teeth in the correction of canine overeruption can be quantified by the in vitro orthodontic force test, and the effects of the 3 factors significantly affect the loads on the teeth.

Sagittal Cephalometric Evaluation Without Point Nasion: Sagittal G-Triangle Analysis.

ABSTRACT: This study aims to introduce a new sagittal cephalometric measurement, the sagittal G-triangle analysis, to accurately and reproducibly assess the sagittal jaw relationship. Sagittal G-triangle analysis, which consists of angles AXK and BXK, is based on an equilateral triangle (Bo-X-K) constructed using 5 cephalometric landmarks (Ba, Bo, Po, Or, and G). To test the diagnostic efficiency of this analysis, pretreatment cephalometric radiographs of 120 female and 120 male Chinese patients were randomly selected. For each enlisted subject, angles SNA and SNB as well as angles AXK and BXK were measured and recorded. On the basis of the SNA and SNB results, subjects were categorized into 6 groups: maxillary retrognathism, normal maxilla, maxillary prognathism, mandibular retrognathism, normal mandible, and mandibular prognathism. The diagnostic efficiency of angles AXK and BXK were evaluated using various statistical tests. A high correlation was detected between angles SNA and AXK as well as between angles SNB and BXK. Female patients with angle AXK between -2.255° and 2.860° and male patients with angle AXK between -2.615° and 2.120° were considered to have a normal maxilla position. Female patients with angle BXK between -2.61° and 2.93° and male patients with angle BXK between -2.275° and 0.610° were considered to have a normal mandible position. In conclusion, sagittal G-triangle analysis could be used as an alternative method for the evaluation of the sagittal position of the maxilla and mandible in cephalometric analysis.

Development and verification of a constitutive model for human periodontal ligament based on finite element analysis.

This study aimed to develop a constitutive model for human periodontal ligament (PDL) by combining the hyperelastic and viscosity models. We performed the finite element analysis (FEA) to simulate the experimental processes of the PDL in vitro and in vivo tests to verify the developed model. The FEA results indicated that the simulative curves were consistent with the experimental curves in the PDL in vitro tests. Moreover, for the in vivo measurements, the simulative result of 0.6258 N was similar to the experimental value of 0.65 N. The study results can help orthodontists better understand the biomechanical characteristics of PDL.

Kurtosis, a new variable with possible diagnostic value in analysis of jaw muscle surface EMG.

BACKGROUND: There is a need for methods to compare differences of voltage levels and distribution anomalies in the study of skeletal muscle function. Calculating the kurtosis values has been found to be of value. AIM: The aim was to record and analyse voltage and kurtosis levels of SEMG recorded bilaterally in the masseter and anterior temporalis areas during rest and clenching and to compare the kurtosis levels between controls and patients with TMJ disc dysfunction. MATERIAL AND METHODS: Twenty-three healthy subjects and 21 patients with TMJ disc dysfunction were taken part in this study. Recordings were made with the BioPAK EMG System. Gain was adjusted to record the data within the range of ±2000 µV. SEMG was recorded in four facial areas, the right masseter, left masseter, right anterior temporalis, and left anterior temporalis areas. Kurtosis levels of SEMG, at clenching with maximal force, and mandibular rest, were compared between the control and patient groups. RESULTS: The kurtosis levels of clenches were significantly higher in patients in all four areas with sensitivity, 38.1% to 61.9%, and specificity, 82.6% to 100.0%. No differences were found in kurtosis levels during mandibular rest. CONCLUSION: The results support that kurtosis values of SEMG recorded during clenching have a potential diagnostic interest.

Decellularized matrix could affect the proliferation and differentiation of periodontal ligament stem cells in vitro.

OBJECTIVE AND BACKGROUND: Recently, decellularized matrix (DCM) is considered as a new biomaterial for tissue regeneration. To explore the possible application of DCM in periodontal regeneration, the effect of DCM from three different cells on the proliferation and differentiation of human periodontal ligament stem cells (PDLSCs) was investigated. METHODS: DCM derived from human periodontal ligament cells (PDLCs), dental pulp cells (DPCs), and gingival fibroblasts (GFs) were fabricated using Triton X-100/NH4 OH combined with DNase I. Allogeneic PDLSCs were cultured on PDLC-DCM, DPC-DCM, and GF-DCM, respectively. The proliferative capacity of PDLSCs was evaluated by PicoGreen assay kit. The expression of alkaline phosphatase (ALP), runt-related transcription factor-2 (RUNX2), osteocalcin (OCN), collagen I (COL1), periostin (POSTN), and cementum protein 1 (CEMP1) were detected by qRT-PCR and western blotting. RESULTS: PDLC-DCM, DPC-DCM, and GF-DCM had similar and integrated networks of extracellular matrix, as well as significantly decreased DNA content. Compared with control group in which PDLSCs were directly seeded in culture plates, PDLC-DCM, DPC-DCM, and GF-DCM promoted the proliferation of re-seeded PDLSCs. Additionally, PDLSCs on DCM exhibited higher mRNA and protein expression levels of ALP, RUNX2, OCN, and COL1. The expression of POSTN in PDLC-DCM group was significantly higher than control group at both mRNA and protein levels. CONCLUSIONS: PDLC-DCM, DPC-DCM, and GF-DCM could enhance the proliferation of PDLSCs. PDLC-DCM facilitated osteogenic differentiation and periodontal ligament differentiation of PDLSCs, while DPC-DCM and GF-DCM promoted osteogenic differentiation.

Regeneration potential of decellularized periodontal ligament cell sheets combined with 15-deoxy-Δ12,14-prostaglandin J2 nanoparticles in a rat periodontal defect.

Periodontitis is a chronic inflammatory disease characterized by loss of attachment and destruction of the periodontium. Decellularized sheet, as an advanced tissue regeneration engineering biomaterial, has been researched and applied in many fields, but its effects on periodontal regeneration remain unclear. In this study, the biological properties of decellularized human periodontal ligament cell (dHPDLC) sheets were evaluated in vitro. Polycaprolactone/gelatin (PCL/GE) nanofibers were fabricated as a carrier to enhance the mechanical strength of the dHPDLC sheet. 15-deoxy-[Formula: see text]-prostaglandin J2 (15d-PGJ2) nanoparticles were added for anti-inflammation and regeneration improvement. For in vivo analysis, dHPDLC sheets combined with 15d-PGJ2 nanoparticles, with or without PCL/GE, were implanted into rat periodontal defects. The periodontal regeneration effects were identified by microcomputed tomography (micro-CT) and histological staining, and immunohistochemistry. The results revealed that DNA content was reduced by 96.6%. The hepatocyte growth factor, vascular endothelial growth factor, and basic fibroblast growth factor were preserved but reduced. The expressions or distribution of collagen I and fibronectin were similar in dHPDLC and nondecellularized cell sheets. The dHPDLC sheets maintained the intact structure of the extracellular matrix. It could be recellularized by allogeneic human periodontal stem ligament cells and retain osteoinductive potential. Newly formed bone, cementum, and PDL were observed in dHPDLC sheets combined with 15d-PGJ2 groups, with or without PCL/GE nanofibers, for four weeks post-operation in vivo. Bringing together all these points, this new construct of dHPDLC sheets can be a potential candidate for periodontal regeneration in an inflammatory environment of the oral cavity.

[Effects of different alveolar bone finite element models on the biomechanical responses of periodontal ligament].

In the study of oral orthodontics, the dental tissue models play an important role in finite element analysis results. Currently, the commonly used alveolar bone models mainly have two kinds: the uniform and the non-uniform models. The material of the uniform model was defined with the whole alveolar bone, and each mesh element has a uniform mechanical property. While the material of the elements in non-uniform model was differently determined by the Hounsfield unit (HU) value of computed tomography (CT) images where the element was located. To investigate the effects of different alveolar bone models on the biomechanical responses of periodontal ligament (PDL), a clinical patient was chosen as the research object, his mandibular canine, PDL and two kinds of alveolar bone models were constructed, and intrusive force of 1 N and moment of 2 Nmm were exerted on the canine along its root direction, respectively, which were used to analyze the hydrostatic stress and the maximal logarithmic principal strain of PDL under different loads. Research results indicated that the mechanical responses of PDL had been affected by alveolar bone models, no matter the canine translation or rotation. Compared to the uniform model, if the alveolar bone was defined as the non-uniform model, the maximal stress and strain of PDL were decreased by 13.13% and 35.57%, respectively, when the canine translation along its root direction; while the maximal stress and strain of PDL were decreased by 19.55% and 35.64%, respectively, when the canine rotation along its root direction. The uniform alveolar bone model will induce orthodontists to choose a smaller orthodontic force. The non-uniform alveolar bone model can better reflect the differences of bone characteristics in the real alveolar bone, and more conducive to obtain accurate analysis results.

Continuous archwire technique for the correction of completely transposed maxillary incisors.

Tooth transposition is an uncommon disorder related to ectopic eruption; it can be classified as complete or incomplete on the basis of the position of the crowns and roots of transposed teeth. Aligning the transposed teeth to a normal sequence is always complex and challenging, especially in patients with complete transposition. The segmented archwire technique with cantilever or loops has been used in many transposition patients; however, it requires considerable laboratory work and is sometimes uncomfortable for the patient. In this case report, we present a novel orthodontic treatment for an 8-year-old boy with unilateral complete transposition of the maxillary central incisor and lateral incisor (Mx.I2.I1). During the alignment stage, the lateral incisor was moved palatally to bypass the central incisor, using a 0.012-in nickel-titanium wire continuously. Active orthodontic treatment was conducted for 44 months, and the final outcome was esthetically and functionally effective. Stable and satisfactory results were achieved within 4 years of follow-up.

Numerical simulation of optimal range of rotational moment for the mandibular lateral incisor, canine and first premolar based on biomechanical responses of periodontal ligaments: a case study.

OBJECTIVES: The objective of this study was to investigate the optimal range of rotational moment for the mandibular lateral incisor, canine and first premolar to determine tooth movements during orthodontic treatment using hydrostatic stress and logarithmic strain on the periodontal ligament (PDL) as indicators by numerical simulations. MATERIAL AND METHODS: Teeth, PDL and alveolar bone numerical models were constructed as analytical objects based on computed tomography (CT) images. Teeth were assumed to be rigid bodies, and rotational moments ranging from 1.0 to 4.0 Nmm were exerted on the crowns. PDL was defined as a hyperelastic-viscoelastic material with a uniform thickness of 0.25 mm. The alveolar bone model was constructed using a non-uniform material with varied mechanical properties determined based on Hounsfield unit (HU) values calculated using CT images, and its bottom was fixed completely. The optimal range values of PDL compressive and tensile stress were set as 0.47-12.8 and 18.8-51.2 kPa, respectively, whereas that of PDL logarithmic strain was set as 0.15-0.3%. RESULTS: The rotational tendency of PDL was around the long axis of teeth when loaded. The optimal range values of rotational moment for the mandibular lateral incisor, canine and first premolar were 2.2-2.3, 3.0-3.1 and 2.8-2.9 Nmm, respectively, referring to the biomechanical responses of loaded PDL. Primarily, the optimal range of rotational moment was quadratically dependent on the area of PDL internal surface (i.e. area of PDL internal surface was used to indicate PDL size), as described by the fitting formula. CONCLUSIONS: Biomechanical responses of PDL can be used to estimate the optimal range of rotational moment for teeth. These rotational moments were not consistent for all teeth, as demonstrated by numerical simulations. CLINICAL RELEVANCE: The quantitative relationship between the area of PDL internal surface and the optimal orthodontic moment can help orthodontists to determine a more reasonable moment and further optimise clinical treatment.

Is SEMG recorded "hyperactivity" during mandibular rest a sign of dysfunctional jaw muscle activity and temporomandibular disorders (TMD)?

BACKGROUND: Some authors state that above-normal surface electromyography (SEMG) levels during mandibular rest (MR) are a general sign of temporomandibular disorders (TMD). OBJECTIVE: The aim was to compare SEMG levels in the masseter and anterior temporalis areas during MR between patients with disc displacement (DD) and subjects identified as healthy. The hypothesis was that average SEMG levels would be higher in the patients during MR before and after repeated clenches with maximal effort. METHODS: Thirty-six healthy subjects, and 42 patients with DD, were included. SEMG levels were recorded bilaterally in the temporalis and masseter areas during MR before clenching and after repeated clenches with maximal effort. Multivariate analysis of variance (MANOVA) was used to compare the means of the log-transformed SEMG-values for the subject groups. RESULTS: The mean MR levels in the four areas before clenching ranged from -0.19 log (µV) to 1.20 log(µV) in healthy subjects and from -0.22 log(µV) to 0.96 log(µV) in patients. The mean MR levels in the four areas after repeated clenches ranged from -0.19 log (µV) to 1.04 log(µV) in healthy subjects and from -0.27 log(µV) to 0.93 log(µV) in patients. The MANOVA test showed no significant differences in the means for MR for the four areas between the groups at the 5% significance level. CONCLUSION: The hypothesis that jaw muscle SEMG levels during MR are on average generally higher in TMD patients is not supported. A possible explanation for the previous findings is that activity in other muscles was mislabelled as jaw muscle activity.

Highly Efficient Nanoscale Analysis of Plant Stomata and Cell Surface Using Polyaddition Silicone Rubber.

Stomata control gas exchange and water transpiration and are one of the most important physiological apparatuses in higher plants. The regulation of stomatal aperture is closely coordinated with photosynthesis, nutrient uptake, plant growth, development, and so on. With advances in scanning electron microscopy (SEM), high-resolution images of plant stomata and cell surfaces can be obtained from detached plant tissues. However, this method does not allow for rapid analysis of the dynamic variation of plant stomata and cell surfaces in situ under nondestructive conditions. In this study, we demonstrated a novel plant surface impression technique (PSIT, Silagum-Light as correction impression material based on A-silicones for all two-phase impression techniques) that allows for precise analysis of plant stomata aperture and cell surfaces. Using this method, we successfully monitored the dynamic variation of stomata and observed the nanoscale microstructure of soybean leaf trichomes and dragonfly wings. Additionally, compared with the analytical precision and the time used for preparing the observation samples between PSIT and traditional SEM, the results suggested that the analytical precision of PSIT was the same to traditional SEM, but the PSIT was more easy to operate. Thus, our results indicated that PSIT can be widely applied to the plant science field.