Comparison of soft tissue changes between incisor tipping and translation after premolar extraction / 대한치과교정학회지

Objective@#This study compared soft tissue changes after extraction of the four premolars followed by maximum retraction of the anterior teeth according to the type of anterior teeth movement: tipping and translation. @*Methods@#Patients who had undergone orthodontic treatment involving the extraction of four premolars were retrospectively selected and divided into either the tipping (n = 27) or translation (n = 26) groups based on the retraction of the incisor root apex and the axis changes of the incisors during the treatment period. Lateral pre- and post-treatment cephalograms were analyzed. @*Results@#There were no significant differences between the tipping and translation groups before treatment. The retraction amounts of the root apex of the upper and lower incisors in the tipping group were 0.33 and 0.26 mm, respectively, and 5.02 and 5.31 mm, respectively, in the translation group (p < 0.001). The posterior movements of soft tissue points A and B in the tipping group were 0.61 and 1.25 mm, respectively, and 1.10 and 3.25 mm, respectively, in the translation group (p < 0.01). The mentolabial sulcus angle increased by 5.89° in the tipping group, whereas it decreased by 8.13° in the translation group (p < 0.001). @*Conclusions@#An increased amount of retraction of the incisor root apex led to the increased posterior movement of soft tissue points A and B, and this appeared more distinct in cases involving the lower incisor and lower lip.

Validation of three-dimensional digital model superimpositions based on palatal structures in patients with maximum anterior tooth retraction following premolar extraction / 대한치과교정학회지

Objective@#This study aimed to evaluate the superimposition accuracy of digital modes for measuring tooth movement in patients requiring anterior retraction after premolar extraction based on the proposed reference regions. @*Methods@#Forty patients treated with bilateral maxillary first premolar extraction were divided into two groups: moderate retraction (< 7.0 mm) and maximum retraction (≥ 7.0 mm). Central incisor displacement was measured using cephalometric superimpositions and three-dimensional (3D) digital superimpositions with the 3rd or 4th ruga as the reference point. The Wilcoxon signed-rank test and linear regression analyses were performed to test the significance of the differences and relationships between the two measurement techniques. @*Results@#In the moderate retraction group, the central incisor anteroposterior displacement values did not differ significantly between 3D digital and cephalometric superimpositions. However, in the maximum-retraction group, significant differences were observed between the anteroposterior displacement evaluated by the 3rd ruga superimposition and cephalometric methods (p < 0.05). @*Conclusions@#This study demonstrated that 3D digital superimpositions were clinically as reliable as cephalometric superimpositions in assessing tooth movements in patients requiring moderate retraction. However, the reference point should be carefully examined in patients who require maximum retraction.

Clinical Validity of Tooth Size Measurements Obtained via Digital Methods with Intraoral Scanning

Purpose@#Dental diagnostic records derived from study models are a popular method of obtaining reliable and vital information. Conventional plaster models are the most common method, however, they are being gradually replaced by digital impressions as technology advances. Moreover, three-dimensional dental models are becoming increasingly common in dental offices, and various methods are available for obtaining them. This study aimed to evaluate the accuracy of the measurement of dental digital models by comparing them with conventional plaster and to determine their clinical validity. @*Materials and Methods@#The study was conducted on 16 patients’ maxillary and mandibular dental models. Tooth size (TS), intercanine width (ICW), intermolar width (IMW), and Bolton analysis were taken by using a digital caliper on a plaster model obtained from each patient, while intraoral scans were manually measured using two digital analysis software. A one-way analysis of variance test was used to compare the dental measurements of the three methods.Result: No significant differences were reported between the TS, the ICW and IMW, and the Bolton analysis through the conventional and two digital groups. @*Conclusion@#Measurements of TS, arch width, and Bolton analysis produced from digital models have shown acceptable clinical validity. No significant differences were observed between the three dental measurement techniques.

Effect of nicotine on orthodontic tooth movement and bone remodeling in rats / 대한치과교정학회지

Objective@#To quantitatively analyze the effect of nicotine on orthodontic tooth movement (OTM) and bone remodeling in rats using micro-computed tomography and tartrate-resistant acid phosphatase immunostaining. @*Methods@#Thirty-nine adult male Sprague–Dawley rats were randomized into three groups: group A, 0.5 mL normal saline (n = 9, 3 per 3, 7, and 14 days); group B, 0.83 mg/kg nicotine (n = 15, 5 per 3, 7, and 14 days); and group C, 1.67 mg/kg nicotine (n = 15, 5 per 3, 7, and 14 days). Each animal received daily intraperitoneal injections of nicotine/saline from the day of insertion of identical 30-g orthodontic force delivery systems. A 5-mm nickel-titanium closed-coil spring was applied between the left maxillary first molar (M1) and the two splinted incisors. The rate of OTM and volumetric bone changes were measured using micro-computed tomography. Osteoclasts were counted on the mesial alveolar bone surface of the distobuccal root of M1. Six dependent outcome variables, including the intermolar distance, bone volume fraction, bone mineral density, trabecular thickness, trabecular volume, and osteoclast number, were summarized using simple descriptive statistics. Nonparametric Kruskal–Wallis tests were used to evaluate differences among groups at 3, 7, and 14 days of OTM. @*Results@#All six dependent outcome variables showed no statistically significant among group-differences at 3, 7, and 14 days. @*Conclusions@#The findings of this study suggest that nicotine does not affect OTM and bone remodeling, although fluctuations during the different stages of OTM in the nicotine groups should be elucidated in further prospective studies.

Achievement of Anterior Teeth Arrangement Using a Single Stage of Clear Aligner

Purpose@#The aim of this study was to evaluate the degree of achievement of anterior tooth movement using a thermoplastic clear aligner by superimposing pretreatment, setup, and post-treatment models and to analyze the factors that influence it. @*Materials and Methods@#Forty patients who underwent clear aligner treatment at the Department of Orthodontics were included in the study. The pretreatment, setup, and post-treatment models were superimposed, and the achievement rates were evaluated. We analyzed the factors that caused changes in achievement rate on each condition.Result: The average achievement rate of total tooth movement was 57.65%. Mesiodistal and anteroposterior displacements were achieved better than vertical displacement and rotation. In each displacement, posterior, mesial, and extrusive movements were better achieved than the rotation. Spacing was better corrected than crowding, especially in the mesiodistal direction. Most of the tooth movements were achieved better when using 3-step thicknesses of aligners were used. @*Conclusion@#The treatment results of clear aligners may differ depending on the type of tooth movement, age and other treatment conditions. Clinicians should consider unfavorable conditions based on the results of this study.

Effect of nicotine on orthodontic tooth movement and bone remodeling in rats / 대한치과교정학회지

Objective@#To quantitatively analyze the effect of nicotine on orthodontic tooth movement (OTM) and bone remodeling in rats using micro-computed tomography and tartrate-resistant acid phosphatase immunostaining. @*Methods@#Thirty-nine adult male Sprague–Dawley rats were randomized into three groups: group A, 0.5 mL normal saline (n = 9, 3 per 3, 7, and 14 days); group B, 0.83 mg/kg nicotine (n = 15, 5 per 3, 7, and 14 days); and group C, 1.67 mg/kg nicotine (n = 15, 5 per 3, 7, and 14 days). Each animal received daily intraperitoneal injections of nicotine/saline from the day of insertion of identical 30-g orthodontic force delivery systems. A 5-mm nickel-titanium closed-coil spring was applied between the left maxillary first molar (M1) and the two splinted incisors. The rate of OTM and volumetric bone changes were measured using micro-computed tomography. Osteoclasts were counted on the mesial alveolar bone surface of the distobuccal root of M1. Six dependent outcome variables, including the intermolar distance, bone volume fraction, bone mineral density, trabecular thickness, trabecular volume, and osteoclast number, were summarized using simple descriptive statistics. Nonparametric Kruskal–Wallis tests were used to evaluate differences among groups at 3, 7, and 14 days of OTM. @*Results@#All six dependent outcome variables showed no statistically significant among group-differences at 3, 7, and 14 days. @*Conclusions@#The findings of this study suggest that nicotine does not affect OTM and bone remodeling, although fluctuations during the different stages of OTM in the nicotine groups should be elucidated in further prospective studies.

Chin Profile Changes in Skeletal Class III Following Bimaxillary Surgery with or without Advancement Genioplasty

Purpose@#This study sought to identify differences in hard and soft tissue chin profile changes in skeletal Class III patients after bimaxillary surgery, with or without advancement genioplasty. @*Materials and Methods@#The retrospective study was conducted based on cephalometric analysis of skeletal and soft tissue variables. Lateral cephalograms taken at 3 different time points were utilized: pre-operation (T0), immediately post-operation (T1), and at least 6 months (11.0±2.6 months) post-operation (T2). The 2 groups were matched for sample size (n=20 each). Data were analyzed using independent t-tests with Bonferroni correction.Result: Group N (bimaxillary surgery alone) and Group G (bimaxillary surgery with an advancement genioplasty by horizontal sliding osteotomy) did not differ significantly in terms of demographic characteristics. The soft tissue chin thickness of Group G increased more after surgery, followed by a greater decrease during the postoperative period, and was eventually not significantly different from Group N at T2. On the other hand, the mentolabial sulcus depth of Group G (5.5±1.3 mm) was significantly greater than that of Group N (4.4±0.9 mm) (P=0.006) at T2. @*Conclusion@#Although Group G showed a statistically significantly greater decrease in soft tissue chin thickness during the postoperative period, there were no significant intergroup differences in the chin profile for at least 6 months after the surgery, except for the mentolabial sulcus depth, which was greater in Group G than in Group N.

Effect of archwire stiffness and friction on maxillary posterior segment displacement during anterior segment retraction: A three-dimensional finite element analysis / 대한치과교정학회지

OBJECTIVE@#Sliding mechanics using orthodontic miniscrews is widely used to stabilize the anchorage during extraction space closure. However, previous studies have reported that both posterior segment displacement and anterior segment displacement are possible, depending on the mechanical properties of the archwire. The present study aimed to investigate the effect of archwire stiffness and friction change on the displacement pattern of the maxillary posterior segment during anterior segment retraction with orthodontic miniscrews in sliding mechanics.@*METHODS@#A three-dimensional finite element model was constructed. The retraction point was set at the archwire level between the lateral incisor and canine, and the orthodontic miniscrew was located at a height of 8 mm from the archwire between the second premolar and first molar. Archwire stiffness was simulated with rectangular stainless steel wires and a rigid body was used as a control. Various friction levels were set for the surface contact model. Displacement patterns for the posterior and anterior segments were compared between the conditions.@*RESULTS@#Both the anterior and posterior segments exhibited backward rotation, regardless of archwire stiffness or friction. Among the conditions tested in this study, the least undesirable rotation was found with low archwire stiffness and low friction.@*CONCLUSIONS@#Posterior segment displacement may be unavoidable but reducing the stiffness and friction of the main archwire may minimize unwanted rotations during extraction space closure.

Three-dimensional comparison of 2 digital models obtained from cone-beam computed tomographic scans of polyvinyl siloxane impressions and plaster models

PURPOSE: This study was performed to evaluate the dimensional accuracy of digital dental models constructed from cone-beam computed tomographic (CBCT) scans of polyvinyl siloxane (PVS) impressions and cast scan models.MATERIALS AND METHODS: A pair of PVS impressions was obtained from 20 subjects and scanned using CBCT (resolution, 0.1 mm). A cast scan model was constructed by scanning the gypsum model using a model scanner. After reconstruction of the digital models, the mesio-distal width of each tooth, inter-canine width, and inter-molar width were measured, and the Bolton ratios were calculated and compared. The 2 models were superimposed and the difference between the models was measured using 3-dimensional analysis.RESULTS: The range of mean error between the cast scan model and the CBCT scan model was −0.15 mm to 0.13 mm in the mesio-distal width of the teeth and 0.03 mm to 0.42 mm in the width analysis. The differences in the Bolton ratios between the cast scan models and CBCT scan models were 0.87 (anterior ratio) and 0.72 (overall ratio), with no significant difference (P>0.05). The mean maxillary and mandibular difference when the cast scan model and the CBCT scan model were superimposed was 53 µm.CONCLUSION: There was no statistically significant difference in most of the measurements. The maximum tooth size difference was 0.15 mm, and the average difference in model overlap was 53 µm. Digital models produced by scanning impressions at a high resolution using CBCT can be used in clinical practice.

Effects of prestretch on stress relaxation and permanent deformation of orthodontic synthetic elastomeric chains / 대한치과교정학회지

OBJECTIVE: This study was performed to investigate an appropriate degree of prestretch for orthodontic synthetic elastomeric chains focusing on time-dependent viscoelastic properties. METHODS: Orthodontic synthetic elastomeric chains of two brands were prestretched to 50, 100, 150, and 200% of the original length in one and three cycles, and the hysteresis areas of the obtained stress-strain curves were determined. Acrylic plates were employed to maintain constant strain during the experiment. A total of 180 samples were classified into nine groups according to brand, and their stresses and permanent deformations were measured immediately after prestretch (0 hour), after 1 hour and 24 hours, and after 1, 2, 3, 4, 5, 6, 7, and 8 weeks. The relationship between stress relaxation and permanent deformation was investigated for various degrees of prestretch, and the estimated stress resulting from tooth movement was calculated. RESULTS: The degree of prestretch and the stress relaxation ratio exhibited a strong negative correlation, whereas no correlation was found between the degree of prestretch and the average normalized permanent strain. The maximal estimated stress was observed when prestretch was performed in three cycles to 200% of the original length. CONCLUSIONS: Although prestretch benefited residual stress, it did not exhibit negative effects such as permanent deformation. The maximal estimated stress was observed at the maximal prestretch, but the difference between prestretch and control groups decreased with time. In general, higher residual stresses were observed for product B than for product A, but this difference was not clinically significant.

Effects of thermoforming on the physical and mechanical properties of thermoplastic materials for transparent orthodontic aligners / 대한치과교정학회지

OBJECTIVE: The aim of this systematic multiscale analysis was to evaluate the effects of thermoforming on the physical and mechanical properties of thermoplastic materials used to fabricate transparent orthodontic aligners (TOAs). METHODS: Specimens were fabricated using four types of thermoplastic materials with different thicknesses under a thermal vacuum. Transparency, water absorption and solubility, surface hardness, and the results of three-point bending and tensile tests were evaluated before and after thermoforming. Data were analyzed using one-way analysis of variance and Student's t-test. RESULTS: After thermoforming, the transparency of Duran and Essix A+ decreased, while the water absorption ability of all materials; the water solubility of Duran, Essix A+, and Essix ACE; and the surface hardness of Duran and Essix A+ increased. The flexure modulus for the 0.5-mm-thick Duran, Essix A+, and eCligner specimens increased, whereas that for the 0.75-/1.0-mm-thick Duran and eClginer specimens decreased. In addition, the elastic modulus increased for the 0.5-mm-thick Essix A+ specimens and decreased for the 0.75-mm-thick Duran and Essix ACE and the 1.0-mm-thick Essix ACE specimens. CONCLUSIONS: Our findings suggest that the physical and mechanical properties of thermoplastic materials used for the fabrication of TOAs should be evaluated after thermoforming in order to characterize their properties for clinical application.

Histomorphometric evaluation of the bone surrounding orthodontic miniscrews according to their adjacent root proximity / 대한치과교정학회지

OBJECTIVE: This study was conducted to perform histomorphometric evaluations of the bone surrounding orthodontic miniscrews according to their proximity to the adjacent tooth roots in the posterior mandible of beagle dogs. METHODS: Four male beagle dogs were used for this study. Six orthodontic miniscrews were placed in the interradicular spaces in the posterior mandible of each dog (n = 24). The implanted miniscrews were classified into no loading, immediate loading, and delayed loading groups according to the loading time. At 6 weeks after screw placement, the animals were sacrificed, and tissue blocks including the miniscrews were harvested for histological examinations. After analysis of the histological sections, the miniscrews were categorized into three additional groups according to the root proximity: high root proximity, low root proximity, and safe distance groups. Differences in the bone–implant contact (BIC, %) among the root proximity groups and loading time groups were determined using statistical analyses. RESULTS: No BIC was observed within the bundle bone invaded by the miniscrew threads. Narrowing of the periodontal ligament space was observed in cases where the miniscrew threads touched the bundle bone. BIC (%) was significantly lower in the high root proximity group than in the low root proximity and safe distance groups. However, BIC (%) showed no significant differences among the loading time groups. CONCLUSIONS: Regardless of the loading time, the stability of an orthodontic miniscrew is decreased if it is in contact with the bundle bone as well as the adjacent tooth root.

Accelerated Bone Formation in Distracted Alveolar Bone after Injection of Recombinant Human Bone Morphogenetic Protein-2 / Шинэ санаа Шинэ нээлт

@#This study was done to evaluate the effect of recombinant human bone morphogenic protein-2 (RhBMP-2) on enhancing the quality and quantity of regenerated bone when injected into distracted alveolar bone. Sixteen adult beagle dogs were assigned to either the control or rhBMP-2 group. After distraction was completed, an rhBMP-2 dose of 330μg in 0.33ml was slowly injected into the distracted alveolar crest of the mesial, middle, and distal parts of the alveolar bone in the experimental group. Histological and micro-computed tomography analyses of regenerated bone were done after 2 and 6 weeks of consolidation. After 6 weeks of consolidation, the vertical defect height of regenerated bone was significantly lower in the rhBMP-2 group (2.2 mm) than in the control group (3.4 mm) (P<0.05). Additionally, the width of the regenerated bone was significantly greater in the rhBMP-2 group (4.3 mm) than in the control group (2.8 mm) (P<0.05). The bone density and volume of regenerated bone in the rhBMP-2 group were denser and greater, respectively, than in the control group after 6 weeks of consolidation (P<0.001). Injection of rhBMP-2 into regenerated bone after a distraction osteogenesis procedure significantly increased bone volume in the dentoalveolar distraction site and improved both the width and height of the alveolar ridge and increased the bone density.

Comparison of changes in the transverse dental axis between patients with skeletal Class III malocclusion and facial asymmetry treated by orthognathic surgery with and without presurgical orthodontic treatment / 대한치과교정학회지

OBJECTIVE: To evaluate transverse skeletal and dental changes, including those in the buccolingual dental axis, between patients with skeletal Class III malocclusion and facial asymmetry after bilateral intraoral vertical ramus osteotomy with and without presurgical orthodontic treatment. METHODS: This retrospective study included 29 patients with skeletal Class III malocclusion and facial asymmetry including menton deviation > 4 mm from the midsagittal plane. To evaluate changes in transverse skeletal and dental variables (i.e., buccolingual inclination of the upper and lower canines and first molars), the data for 16 patients who underwent conventional orthognathic surgery (CS) were compared with those for 13 patients who underwent preorthodontic orthognathic surgery (POGS), using three-dimensional computed tomography at initial examination, 1 month before surgery, and at 7 days and 1 year after surgery. RESULTS: The 1-year postsurgical examination revealed no significant changes in the postoperative transverse dental axis in the CS group. In the POGS group, the upper first molar inclined lingually on both sides (deviated side, −1.8°± 2.8°, p = 0.044; nondeviated side, −3.7°± 3.3°, p = 0.001) and the lower canine inclined lingually on the nondeviated side (4.0°± 5.4°, p = 0.022) during postsurgical orthodontic treatment. There were no significant differences in the skeletal and dental variables between the two groups at 1 year after surgery. CONCLUSIONS: POGS may be a clinically acceptable alternative to CS as a treatment to achieve stable transverse axes of the dentition in both arches in patients with skeletal Class III malocclusion and facial asymmetry.

Effects of recycling on the biomechanical characteristics of retrieved orthodontic miniscrews / 대한치과교정학회지

OBJECTIVE: The aim of this study was to compare recycled and unused orthodontic miniscrews to determine the feasibility of reuse. The comparisons included both miniscrews with machined surfaces (MS), and those with etched surfaces (ES). METHODS: Retrieved MS and ES were further divided into three subgroups according to the assigned recycling procedure: group A, air-water spray; group B, mechanical cleaning; and group C, mechanical and chemical cleaning. Unused screws were used as controls. Scanning electron microscopy, energy-dispersive X-ray spectrometry, insertion time and maximum insertion torque measurements in artificial bone, and biological responses in the form of periotest values (PTV), bone–implant contact ratio (BIC), and bone volume ratio (BV) were assessed. RESULTS: Morphological changes after recycling mainly occurred at the screw tip, and the cortical bone penetration success rate of recycled screws was lower than that of unused screws. Retrieved ES needed more thorough cleaning than retrieved MS to produce a surface composition similar to that of unused screws. There were no significant differences in PTV or BIC between recycled and unused screws, while the BV of the former was significantly lower than that of the latter (p < 0.05). CONCLUSIONS: These results indicate that reuse of recycled orthodontic miniscrews may not be feasible from the biomechanical aspect.

Skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion in young adults: A cone-beam computed tomography study / 대한치과교정학회지

OBJECTIVE: The aim of this study was to evaluate the skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion (MARPE) in young adults by cone-beam computed tomography (CBCT). METHODS: This retrospective study included 14 patients (mean age, 20.1 years; range, 16–26 years) with maxillary transverse deficiency treated with MARPE. Skeletal and dentoalveolar changes were evaluated using CBCT images acquired before and after expansion. Statistical analyses were performed using paired t-test or Wilcoxon signed-rank test according to normality of the data. RESULTS: The midpalatal suture was separated, and the maxilla exhibited statistically significant lateral movement (p < 0.05) after MARPE. Some of the landmarks had shifted forwards or upwards by a clinically irrelevant distance of less than 1 mm. The amount of expansion decreased in the superior direction, with values of 5.5, 3.2, 2.0, and 0.8 mm at the crown, cementoenamel junction, maxillary basal bone, and zygomatic arch levels, respectively (p < 0.05). The buccal bone thickness and height of the alveolar crest had decreased by 0.6–1.1 mm and 1.7–2.2 mm, respectively, with the premolars and molars exhibiting buccal tipping of 1.1°–2.9°. CONCLUSIONS: Our results indicate that MARPE is an effective method for the correction of maxillary transverse deficiency without surgery in young adults.

The effect of fluoride-containing oral rinses on the corrosion resistance of titanium alloy (Ti-6Al-4V) / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to examine the effect of commercially available fluoride-containing oral rinses on the corrosion behavior of titanium alloys, which are the main components of orthodontic miniscrews. METHODS: Four commercially available oral rinses (solution A, pH 4.46/260 ppm fluoride; solution B, pH 4.41/178 ppm fluoride; solution C, pH 6.30/117 ppm fluoride; and solution D, pH 4.17/3.92 ppm fluoride) were tested on titanium alloy (Ti-6Al-4V) circular plates, and saline was used as the control. The open-circuit potential and potentiodynamic polarization of these materials were measured. Thereafter, all samples were evaluated under a field-emission scanning electron microscope. RESULTS: Among the tested oral rinses, except solution D, the more the fluoride content was, the greater was the corrosion potential downtrend; the corrosion resistance of the titanium alloy sample was also lowered significantly (p < 0.05). Field-emission scanning electron microscopic analysis of the surface morphology of the titanium alloy samples revealed that all samples had some defects, crevices, or pitting after exposure to the oral rinses than before treatment. In particular, the samples in solution A showed the most changes. CONCLUSIONS: Commercially available oral rinses having a high fluoride concentration and a low pH may reduce the corrosion resistance of titanium alloys used in dental appliances such as orthodontic titanium miniscrews and brackets.

Effect of Laser Pre-Drilling on Insertion Torque of Orthodontic Miniscrews: A Preliminary Study

PURPOSE: To evaluate the effect of different-sized drill tips and laser irradiation times on the initial stability of orthodontic miniscrews placed in Er,Cr:YSGG-laser pre-drilled holes in an animal model. MATERIALS AND METHODS: Laser pre-drilled holes were made in dog mandibular bone with an Er,Cr:YSGG laser using irradiation times of 5, 7, 9, 11, and 13 seconds, and tip diameters of 0.4 and 0.6 mm. The maximum diameter and depth of the pre-drilled holes was measured with micro computed tomography. The maximum insertion torque was measured during placement the miniscrew. RESULT: Laser pre-drilled holes were conical shaped. The maximum diameter of pre-drilled holes increased with longer laser irradiation times (P>0.05) and larger tip diameters (P < 0.05). The depth of pre-drilled holes increased with longer laser irradiation times and larger tip diameters (P < 0.05). When the 0.4 mm tip, but not the 0.6 mm tip, was used, the insertion torque decreased significantly with longer laser irradiation times (P < 0.05). CONCLUSION: Tip diameter impacted insertion torque more than irradiation time. It takes at least 9 seconds using a 0.6 mm tip to create a 0.8 mm diameter and 1.0 mm depth hole in thick cortical bone.

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

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.

Three-dimensional finite element analysis of unilateral mastication in malocclusion cases using cone-beam computed tomography and a motion capture system

PURPOSE: Stress distribution and mandible distortion during lateral movements are known to be closely linked to bruxism, dental implant placement, and temporomandibular joint disorder. The present study was performed to determine stress distribution and distortion patterns of the mandible during lateral movements in Class I, II, and III relationships. METHODS: Five Korean volunteers (one normal, two Class II, and two Class III occlusion cases) were selected. Finite element (FE) modeling was performed using information from cone-beam computed tomographic (CBCT) scans of the subjects' skulls, scanned images of dental casts, and incisor movement captured by an optical motion-capture system. RESULTS: In the Class I and II cases, maximum stress load occurred at the condyle of the balancing side, but, in the Class III cases, the maximum stress was loaded on the condyle of the working side. Maximum distortion was observed on the menton at the midline in every case, regardless of loading force. The distortion was greatest in Class III cases and smallest in Class II cases. CONCLUSIONS: The stress distribution along and accompanying distortion of a mandible seems to be affected by the anteroposterior position of the mandible. Additionally, 3-D modeling of the craniofacial skeleton using CBCT and an optical laser scanner and reproduction of mandibular movement by way of the optical motion-capture technique used in this study are reliable techniques for investigating the masticatory system.