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Selvido DI, Wongsirichat N, Arirachakaran P, Rokaya D, Wongsirichat N. Surgical Management of Impacted Lower Second Molars: A Comprehensive Review. Eur J Dent 2022; 16:465-477. [PMID: 35016240 PMCID: PMC9507580 DOI: 10.1055/s-0041-1739443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Impacted lower second molars (ILM2) are rarely reported in the literature, but various studies have been done for its treatment. Apart from solely orthodontic approaches, different surgical management techniques were reported to have successful outcomes. Surgical intervention of ILM2 can help expose the tooth for further orthodontic purposes, simplifying complex treatment methods, and reducing treatment time. This review illustrates the comprehensive evaluation and updated methods of surgical uprighting, repositioning, and transplantation of ILM2 with future directions for better understanding and treatment planning in the clinical setting. The successful outcome of surgical intervention depends on case selection, root development of ILM2, careful surgical manipulation, and adherence to sound biological principles.
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Affiliation(s)
- Diane Isabel Selvido
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Nattharin Wongsirichat
- Department of Preventive Dentistry, Division of Orthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Pratanporn Arirachakaran
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Dinesh Rokaya
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Natthamet Wongsirichat
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
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Jeong DM, Oh SH, Choo H, Choi YS, Kim SH, Lee JS, Hwang EH. Root proximity of the anchoring miniscrews of orthodontic miniplates in the mandibular incisal area: Cone-beam computed tomographic analysis. Korean J Orthod 2021; 51:231-240. [PMID: 34275879 PMCID: PMC8290084 DOI: 10.4041/kjod.2021.51.4.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/02/2021] [Accepted: 03/12/2021] [Indexed: 11/25/2022] Open
Abstract
Objective This outcome analysis study evaluated the actual positions of the orthodontic miniplate and miniplate anchoring screws (MPASs) and the risk factors affecting adjacent anatomic structures after miniplate placement in the mandibular incisal area. Methods Cone-beam computed tomographic images of 97 orthodontic miniplates and their 194 MPASs (diameter, 1.5 mm; length, 4 mm) in patients whose miniplates provided sufficient clinical stability for orthodontic treatment were retrospectively reviewed. For evaluating the actual positions of the miniplates and analyzing the risk factors, including the effects on adjacent roots, MPAS placement height (PH), placement depth (PD), plate angle (PA), mental fossa angle (MA), and root proximity were assessed using the paired t-test, analysis of variance, and generalized linear model and regression analyses. Results The mean PDs of MPASs at positions 1 (P1) and 2 (P2) were 2.01 mm and 2.23 mm, respectively. PA was significantly higher in the Class III malocclusion group than in the other groups. PH was positively correlated with MA and PD at P1. Of the 97 MPASs at P1, 49 were in the no-root area and 48 in the dentulous area; moreover, 19 showed a degree of root contact (19.6%) without root perforation. All MPASs at P2 were in the no-root area. Conclusions Positioning the miniplate head approximately 1 mm lower than the mucogingival junction is highly likely to provide sufficient PH for the P1-MPASs to be placed in the no-root area.
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Affiliation(s)
- Do-Min Jeong
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Song Hee Oh
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - HyeRan Choo
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Craniofacial and Airway Orthodontic Clinic, Stanford University School of Medicine, Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Yong-Suk Choi
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jin-Suk Lee
- Department of Dental Education, Graduate School, Kyung Hee University, Seoul, Korea
| | - Eui-Hwan Hwang
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
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Krishnakumaran M, Krishnan B, Raman R, Rangarajan S, Preethi G, Chinnasamy A. Correlation of Infrazygomatic Bone Thickness With Cervical Vertebrae Maturation Stages. JOURNAL OF INDIAN ORTHODONTIC SOCIETY 2021. [DOI: 10.1177/03015742211016595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Anchorage is one of the most important consideration in the field of orthodontics to achieve a desired tooth movement. In order to eliminate the undesirable side effects such as anchorage loss, skeletal anchorage systems such as mini-implants have been introduced in orthodontics. Aim: To evaluate the bone thickness of the infrazygomatic crest in different cervical vertebrae maturation index (CVMI) and to compare it between male and female subjects, by using cone beam computerized tomography (CBCT) imaging. Materials and Methods: A retrospective study was conducted using CBCT images of 60 patients in the age group of 8–25 years. Cervical vertebra maturation was analyzed using Hassel–Farmann index and divided into 6 groups (n = 10/group). The infrazygomatic crest was divided into horizontal and vertical planes. The horizontal plane passed through the most inferior border of the zygomatic process of maxilla and the vertical plane passed through the most anterior point of the infratemporal fossa parallel to midsagittal plane. Five parallel lines were drawn at 2 mm interval in both horizontal and vertical planes (HB+2, HB+4, HB+6, HB+8, and HB+10) (V-2, V-4, V-6, V-8, and V-10). The bone thickness was measured at the point of intersection of these lines. Results: According to Kruskal–Wallis analysis, statistically significant difference in infrazygomatic crest (IZC) bone thickness was seen in various CVMI stages ( P = .001). Maximum bone thickness was 11 mm and minimum bone thickness was 1 mm. No significant difference was observed between male and female populations. Conclusion: Thus, the superolateral area in infrazygomatic crest is the most appropriate site for miniscrew insertion in all age groups.
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Affiliation(s)
- Mahalakshmi Krishnakumaran
- Department of Orthodontics, Tagore Dental College and Hospital, Rathinamangalam, Chennai, Tamil Nadu, India
| | - Balaji Krishnan
- Department of Orthodontics, Tagore Dental College and Hospital, Rathinamangalam, Chennai, Tamil Nadu, India
| | - Rajesh Raman
- Department of Orthodontics, Tagore Dental College and Hospital, Rathinamangalam, Chennai, Tamil Nadu, India
| | - Sumanth Rangarajan
- Department of Orthodontics, Adhiparasakthi Dental College, Melmaruvathur, Tamil Nadu, India
| | - G. Preethi
- Department of Orthodontics, Tagore Dental College and Hospital, Rathinamangalam, Chennai, Tamil Nadu, India
| | - Anandadevi Chinnasamy
- Department of Orthodontics, Adhiparasakthi Dental College, Melmaruvathur, Tamil Nadu, India
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Park KH, Choi JY, Kim KA, Kim SJ, Chung KR, Kim SH. Critical issues concerning biocreative strategy in contemporary temporary skeletal anchorage device orthodontics: A narrative review. Orthod Craniofac Res 2020; 24 Suppl 1:39-47. [PMID: 33237622 DOI: 10.1111/ocr.12444] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 10/29/2020] [Accepted: 11/18/2020] [Indexed: 01/24/2023]
Abstract
Biocreative Orthodontic Strategy (BOS) is designed to establish a physiologically stable occlusion in harmony with masticatory and TMJ function and healthy supporting tissues with strategic use of temporary skeletal anchorage devices (TSADs). This narrative review surveys current research that demonstrates how BOS with TSADs uses a target approach to overcome the limitations experienced with conventional orthodontic treatment. A narrative review article including research on TSADs orthodontics in the permanent dentition. This review is a brief survey of five BOS principles for contemporary TSAD orthodontics: elegant selection of TSADs, bracket prescription to enhance TSAD orthodontics, antero-posterior dimension control, transverse dimension control and airway control issues. Severe malocclusion and craniofacial dysmorphology can be treated with Biocreative Orthodontic Strategy with a minimum number of TSADs. In order to achieve successful treatment outcome using TSADs, it is critical to understand the key diagnosis and treatment principles of BOS and how to develop a target approach for the tooth and bone movement.
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Affiliation(s)
- Ki-Ho Park
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jin-Young Choi
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Kyung A Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Su-Jung Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Kyu-Rhim Chung
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
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Chung KR, Noh MK, Oh SH, Jeong DM, Kim SH, Nelson G. Treatment of 2 impacted molars in a large dentigerous cyst (expansile cystic lesion) with combined orthodontic and surgical therapy. Am J Orthod Dentofacial Orthop 2020; 158:752-758. [PMID: 32863085 DOI: 10.1016/j.ajodo.2020.06.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 06/01/2020] [Accepted: 06/01/2020] [Indexed: 10/23/2022]
Abstract
Nonmineralized cysts and cyst-like lesions that frequently occur in the mandible include ameloblastomas, odontogenic keratocysts, and dentigerous cysts. They have specific features of well-demarcated, unilocular, and radiolucent lesions that are often associated with tooth impaction. Although it rarely occurs, these cysts can become extremely large. Furthermore, cyst enlargement causes additional symptoms that can challenge the success of tooth recovery through orthodontic treatment. This clinical report presents the successful eruption of 2 impacted molars in a large dentigerous cyst treated with marsupialization and orthodontic traction using an orthodontic miniplate anchorage over a 4-year treatment period.
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Affiliation(s)
- Kyu-Rhim Chung
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Min-Ki Noh
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Song Hee Oh
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Do-Min Jeong
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, South Korea.
| | - Gerald Nelson
- Division of Orthodontics, Department of Orofacial Science, University of California, San Francisco (UCSF), San Francisco, Calif
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Zadeh HH, Borzabadi-Farahani A, Fotovat M, Kim SH. Vestibular Incision Subperiosteal Tunnel Access (VISTA) for Surgically Facilitated Orthodontic Therapy (SFOT). Contemp Clin Dent 2020; 10:548-553. [PMID: 32308335 PMCID: PMC7150560 DOI: 10.4103/ccd.ccd_720_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Surgically Facilitated Orthodontic Therapy (SFOT) in combination with bone augmentation and the placement of anchorage devices installed into bone have been used to accelerate and facilitate orthodontic treatment. This is usually performed after flap surgery, which is associated with moderate morbidity, as well as possible negative sequale such as gingival recession. The present case report illustrates the clinical benefits of vestibular incision subperiosteal tunnel access (VISTA) for SFOT, and tissue augmentation to facilitate orthodontic therapy. VISTA entails making vertical incision(s) in the vestibule followed by subperiosteal elevation of tunnels to provide direct access to the facial alveolar bone. Unlike previously reported vestibular access surgical procedures, VISTA allows for wider elevation of an access tunnel for clear visual and surgical access to perform careful inter-radicular corticotomy. The present report describes VISTA for corticotomy surgery (anterior mandible and maxillary teeth) in combination with the placement of titanium fixation devices and bone augmentation to facilitate orthodontic treatment of an adult female with borderline Class II Division 1 malocclusion, with excessive overjet and deepbite. In view of the fact that VISTA does not require surface incisions in the gingival margins or papillae, it potentially minimizes gingival recession that sometimes accompanies flap surgery.
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Affiliation(s)
- Homayoun H Zadeh
- VISTA Institute for Therapeutic Innovations, Woodland Hills, CA, USA
| | - Ali Borzabadi-Farahani
- Department of Clinical Sciences and Translational Medicine, University of Rome, Rome, Italy.,Department of Orthodontics, Finchley Orthodontics, North Finchley, London, UK
| | - Mehdi Fotovat
- Private Practice Limited to Orthodontics, Valley Village, CA, USA
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
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Meirelles LDS, Haas OL, Scolari N, Pereira M, Favoretto A, de Oliveira R. Debonding Shear Strength of Orthodontic Tubes Bonded to Skeletal Anchorage Miniplates with Different Agents. Open Dent J 2019. [DOI: 10.2174/1874210601913010551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
Most miniplates used for skeletal anchorage lack built-in orthodontic devices. To address this issue, orthodontists must use creative solutions, such as bonding buttons, brackets, or tubes directly to the miniplates, thus making them more versatile devices that provide a wider range of tooth movement possibilities. The purpose of the present study was to ascertain the debonding strength in Megapascals (MPa) of orthodontic accessories bonded to skeletal anchorage miniplates with different bonding agents.
Methods:
Forty specimens were divided into two equal groups by bonding agent: Group 1, resin (Transbond XT®, 3M ESPE); Group 2, cyanoacrylate (Scotchbond®, 3M ESPE). Shear strength testing was performed in an EMIC DL-2000 universal testing machine.
Results:
The results obtained were 2.28 ± 0.44 MPa for Group 1 and 4.90 ± 0.76 MPa for Group 2. The Kolmogorov-Smirnov test was used to assess the normality of data distribution. Student's t-test was used to compare means in the response variable.
Conclusion:
A statistically significant difference was observed between groups. However, both bonding agents provided strength in excess of that needed for secure orthodontic tooth movement.
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Oliveira DD, Brito ADA, Pantuzo MCG, Freitas LRP, Palomo L, Soares RV. Combining planned 3rd molar extractions with corticotomy and miniplate placement to reduce morbidity and expedite treatment. A case report with 3.5-year follow up. Semin Orthod 2019. [DOI: 10.1053/j.sodo.2019.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Rossi M, Bruno G, De Stefani A, Perri A, Gracco A. Évaluation CBCT quantitative des variations d’épaisseur et de densité de l’os cortical maxillaire et mandibulaire en vue du placement de miniplaques orthodontiques. Int Orthod 2017; 15:610-624. [DOI: 10.1016/j.ortho.2017.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rossi M, Bruno G, De Stefani A, Perri A, Gracco A. Quantitative CBCT evaluation of maxillary and mandibular cortical bone thickness and density variability for orthodontic miniplate placement. Int Orthod 2017; 15:610-624. [PMID: 29113844 DOI: 10.1016/j.ortho.2017.09.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess whether cortical bone thickness and density vary in relation to age, sex and skeletal pattern at the maxillary and mandibular areas suitable for miniplates placement for orthodontic purposes. MATERIALS AND METHODS CBCT of 92 subjects (42 males and 50 females) with skeletal class I, II or III malocclusion, divided between adolescents and adults, were examined. InVivoDental® software (Anatomage Inc, USA) was used to measure 34 maxillary areas and 40 mandibular areas per side. Values obtained were then compared between the groups of subjects. Statistical analysis was performed using the non-parametric Wilcoxon-Mann-Whitney rank-sum test for independent samples. RESULTS No significant differences were found in the cortical bone thickness values between the three skeletal patterns, and according to sex and age. Both maxilla and mandible showed an increase in cortical bone thickness from the anterior towards the posterior regions, and from the alveolar boneto the basal bone. Cortical bone density significantly varied in relation to the subject's age, with adults always showing higher values. Slight clinically significant differences were found between the three skeletal patterns and sex. CONCLUSION In terms of cortical bone thickness, age, sex and skeletal pattern do not represent valid decision criteria for the evaluation of the best insertion areas for miniplates, while in terms of cortical bone density, only age is useful as a decision criterion.
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Affiliation(s)
- Margherita Rossi
- University of Padua, Department of Orthodontics, Via Giustiniani 2, 35010 Padua, Italy
| | - Giovanni Bruno
- University of Padua, Department of Orthodontics, Via Giustiniani 2, 35010 Padua, Italy.
| | - Alberto De Stefani
- University of Padua, Department of Orthodontics, Via Giustiniani 2, 35010 Padua, Italy
| | - Alessandro Perri
- University of Padua, Department of Orthodontics, Via Giustiniani 2, 35010 Padua, Italy
| | - Antonio Gracco
- University of Padua, Department of Orthodontics, Via Giustiniani 2, 35010 Padua, Italy
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Paccini JVC, Cotrim-Ferreira FA, Ferreira FV, Freitas KMSD, Cançado RH, Valarelli FP. Efficiency of two protocols for maxillary molar intrusion with mini-implants. Dental Press J Orthod 2017; 21:56-66. [PMID: 27409654 PMCID: PMC4944730 DOI: 10.1590/2177-6709.21.3.056-066.oar] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 11/26/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the efficiency of two protocols for maxillary molar intrusion with two or three mini-implants. METHODS Twenty five maxillary first molars extruded for loss of their antagonists in adult subjects were selected. The sample was divided into two groups, according to the intrusion protocol with two or three mini-implants. Group 1 consisted of 15 molars that were intruded by two mini-implants. Group 2 consisted of 10 molars intruded by three mini-implants. Changes with treatment were analyzed in lateral cephalograms at the beginning and at the end of intrusion of maxillary molars. RESULTS Results showed that there was no difference in efficiency for the two intrusion protocols. It was concluded that extruded maxillary molars can be intruded with two or three mini-implants with similar efficiency.
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Bone condition of the maxillary zygomatic process prior to orthodontic anchorage plate fixation. J Orofac Orthop 2014; 76:3-13. [DOI: 10.1007/s00056-014-0261-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 04/04/2014] [Indexed: 10/24/2022]
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A novel designed screw with enhanced stability introduces new way of intermaxillary fixation. J Craniofac Surg 2014; 25:e555-7. [PMID: 25364969 DOI: 10.1097/scs.0000000000001079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION This article represents new design of a fixation screw-spike screw-for the intermaxillary elastic fixation application after the first surgery in orthognathic surgery. This new type called spike screw is easily placed and provides enough rigidity for the intermaxillary fixation (IMF) with increased stability that was a common problem using screw-type fixation. MATERIALS AND METHODS Spike screw has a unique design: a washer with soldered stainless hook that adds stability and fixation to the screw done by a miniscrew. It increases stability by reducing the high peak stress-often occurs in miniscrew-and obtaining the advantage of miniplate system with miniscrew fixation. It allows noninvasive screw placement unlike miniplate. The 8 spike screws were placed on the posterior lesion to provide secure IMF, and 2 I-type C-tubes were placed on the anterior lesion. RESULTS By modifying the length of the hook attached to a washer can accommodate each patient's IMF length variation like a custom-made screw. The stability of the screw was kept well for 6 weeks even with minor gingival irritation in some of the area. This proved that spike screw could be one of the methods for IMF. The closeness of the hook to the teeth eliminated further gingival irritation around the elastic attachment site. Finally, it provided easy manipulation of the hook to change vectors of the elastic force application. CONCLUSIONS The novel design of the screw permits easy placement and removal for the IMF. In addition, its advantages include increased stability with unique design, less gingival irritation, and simple vector modification of the IMF elastics by adjusting the hook length and shape.
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Modification protocol for an early class III treatment using 3 miniplates for bone-anchored maxillary orthopedic traction. J Craniofac Surg 2014; 25:e440-2. [PMID: 25148617 DOI: 10.1097/scs.0000000000000953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION This article introduces the modification of 4-miniplate-assisted orthopedic protocol for class III correction. Instead of bilateral mandibular miniplates between lateral incisors and canine, the single modified Y-type C-tube with extension arms can replace 2 miniplates for temporary skeletal anchorage with advantages. METHODS Y-type C-tube was modified to have 2 extension arms for the application of class III elastics to replace 2 separate miniplates on either side of the mandible. A patient who declined a facemask therapy was selected to receive the modified protocol using only 3 C-tubes for bone-anchored maxillary orthopedic traction. The modified Y-type C-tube was inserted at the mandibular symphysis, and the bifurcation of the extension arms exited the tissue near the mucogingival junction. RESULTS The modified Y-type C-tube was placed on the mandibular symphysis, and this provided 3 advantages compared with conventional miniplates: (1) 1 C-tube placement warrants less surgical sites than 2-miniplate installation, (2) placing the C-tube in between mandibular incisors prevents damage to developing or erupting permanent canines and allows early treatment start, and (3) the characteristic bendability of extension arms permits easy alteration on position and results in the vertical and sagittal vector controls of class III elastics. When the treatment is finished, it can be also simply removed like any other C-tubes with simple detachment of extension arms. CONCLUSIONS The modification of 4-miniplate-assisted orthopedic protocol for class III correction provides easier surgical placement of miniplates by minimizing complications, early initiation of treatment, and more vector control with bendable extension arms of the modified Y-type C-tube.
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Abstract
Orthodontic traction of impacted teeth has typically been performed using full fixed appliance as anchorage against the traction force. This conventional approach can be difficult to apply in the mixed dentition if the partial fixed appliance offers an insufficient anchor unit. In addition, full fixed appliance can induce unwanted movement of adjacent teeth. This clinical report presents 3 cases where impacted teeth were recovered in the mixed or transitional dentition with skeletal anchorage on the opposite arch without full fixed appliance. Instead, intermaxillary traction was used to bring the impacted teeth into position. With this approach, side effects on teeth and periodontal tissues adjacent to the impaction were minimized.
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Paek J, Jeong DM, Kim Y, Kim SH, Chung KR, Nelson G. Virtually fabricated guide for placement of the C-tube miniplate. Am J Orthod Dentofacial Orthop 2014; 145:694-702. [PMID: 24785934 DOI: 10.1016/j.ajodo.2013.02.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 02/01/2013] [Accepted: 02/01/2013] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This paper introduces a virtually planned and stereolithographically fabricated guiding system that will allow the clinician to plan carefully for the best location of the device and to achieve an accurate position without complications. METHODS The scanned data from preoperative dental casts were edited to obtain preoperative 3-dimensional (3D) virtual models of the dentition. After the 3D virtual models were repositioned, the 3D virtual surgical guide was fabricated. A surgical guide was created onscreen, and then these virtual guides were materialized into real ones using the stereolithographic technique. RESULTS Whereas the previously described guide required laboratory work to be performed by the orthodontist, our technique is more convenient because the laboratory work is done remotely by computer-aided design/computer-aided manufacturing technology. Because the miniplate is firmly held in place as the patient holds his or her mandibular teeth against the occlusal pad of the surgical guide, there is no risk that the miniscrews can slide on the bone surface during placement. The software program (2.5-dimensional software) in this study combines 2-dimensional cephalograms with 3D virtual dental models. This software is an effective and efficient alternative to 3D software when 3D computed tomography data are not available. CONCLUSIONS To confidently and safely place a miniplate with screw fixation, a simple customized guide for an orthodontic miniplate was introduced. The use of a custom-made, rigid guide when placing miniplates will minimize complications such as vertical mislocation or slippage of the miniplate during placement.
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Affiliation(s)
- Janghyun Paek
- Clincal fellow, Department of Prosthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Do-Min Jeong
- Director, Division of Periodontology, Department of Dentistry, National Medical Center of Korea, Seoul, Korea
| | - Yong Kim
- Research assistant, Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Seong-Hun Kim
- Associate professor and chairman, Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea.
| | - Kyu-Rhim Chung
- Professor and chairman, Department of Orthodontics, School of Medicine, Ajou University, Suwon, Korea
| | - Gerald Nelson
- Clinical professor and chair, Division of Orthodontics, Department of Orofacial Science, University of California San Francisco, San Francisco, Calif
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Sugawara J. Temporary skeletal anchorage devices: The case for miniplates. Am J Orthod Dentofacial Orthop 2014; 145:559-65. [DOI: 10.1016/j.ajodo.2014.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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18
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Miniplate with a bendable C-tube head allows the clinician to alter biomechanical advantage without physically moving the skeletal anchorage device. J Craniofac Surg 2014; 25:686-9. [PMID: 24621724 DOI: 10.1097/scs.0000000000000604] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUNDS This article introduces a binary function of a miniplate with a bendable C-tube head used in corticotomy-assisted segment intrusion. The advantage of the device is that the point of force application can be altered without having to move the miniplate or place an additional anchorage device. METHODS Cases for this study were selected from patients who received perisegmental corticotomy with compression osteogenesis (Speedy Surgical Orthodontics) for segmental intrusion. For the skeletal anchorage on patients who received Speedy Surgical Orthodontics for posterior segment intrusion to improve on severe open bite correction, the C-tube was placed on the buccal wall of the maxilla for traction of orthopedic force as a temporary skeletal anchorage. The C-tube head portion is made with titanium grade II, which makes bending easy with a Weingart plier. This adjustment regains distance and range needed to continue intrusion of posterior segment. RESULTS As an alternative to orthognathic surgery to correct a severe open bite, perisegmental corticotomy combined with orthopedic force application from a temporary skeletal anchorage device can be used. The corticotomy-assisted segment intrusion is a 2-stage procedure: first, the corticotomy is performed in the palate and 2 weeks later in the buccal alveolus. A C-plate was placed in the midpalatal area, and a C-tube was placed apical to the buccal corticotomy site. Elastics were used with orthopedic forces to induce compression osteogenesis. As the intrusion took place, the elastic stretched, and resultant force and range in the buccal segment decreased. The C-tube head was adjusted by bending to gain more distance, reviving the elastic force on the posterior segment until desired intrusion was accomplished. CONCLUSIONS The miniplate with a bendable C-tube head serves for temporary skeletal anchorage of orthopedic traction force to achieve segmental intrusion and has the advantage that the bendable head can be adjusted to improve the force application for intrusion without having to move or place another temporary skeletal anchorage device.
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Three-dimensional soft-tissue and hard-tissue changes in the treatment of bimaxillary protrusion. Am J Orthod Dentofacial Orthop 2013; 144:218-28. [PMID: 23910203 DOI: 10.1016/j.ajodo.2013.03.018] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 03/01/2013] [Accepted: 03/01/2013] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Facial convexity related to bimaxillary protrusion is prevalent in many populations. Underlying skeletal protrusion combined with increased dentoalveolar protrusion contributes to facial muscle imbalance and lip incompetence, which is undesirable for many patients. In this study, we evaluated the relationship between soft-tissue and hard-tissue changes in an orthodontically treated Asian population. METHODS Twenty-four consecutive adult Asian patients (mean age, 24 years), diagnosed with severe bimaxillary dentoalveolar protrusion, were evaluated using pretreatment and posttreatment cone-beam computed tomography. The patients were treated with 4 first premolar extractions followed by anterior retraction with either skeletal or intraoral anchorage. Serial cone-beam computed tomography radiographs were registered on the entire cranial base and fossa. Soft-tissue and hard-tissue changes were determined through landmark displacement and color mapping. RESULTS Upper lip retraction was concentrated between the nasolabial folds and commissures. Lower lip retraction was accompanied by significant redistribution of soft tissues at pogonion. Soft-tissue changes correlated well with regional facial muscle activity. Significant retractions (2-4 mm) of the soft tissues occurred beyond the midsagittal region. Use of skeletal anchorage resulted in 1.5 mm greater lower lip retraction than intraoral anchorage, with greater retraction of the maxillary and mandibular incisor root apices. CONCLUSIONS Profound soft-tissue changes accompanied retraction of the anterior dentition with both treatment modalities.
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Lee SJ, Lin L, Kim SH, Chung KR, Donatelli RE. Survival analysis of a miniplate and tube device designed to provide skeletal anchorage. Am J Orthod Dentofacial Orthop 2013; 144:349-56. [DOI: 10.1016/j.ajodo.2013.03.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 03/01/2013] [Accepted: 03/01/2013] [Indexed: 10/26/2022]
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Investigation of bone conditions for orthodontic anchorage plates in the anterior mandible. J Orofac Orthop 2013; 74:409-19. [PMID: 23978904 DOI: 10.1007/s00056-013-0165-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 01/31/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The clinical success of orthodontic anchorage plates depends on the stability of the miniscrews used for fixation. For good stability, the application site must provide bone of good quantity and quality. This study was performed to analyze bone quantity for orthodontic anchorage plates in the anterior mandible. PATIENTS AND METHODS A total of 51 computed tomography (CT) scans of fully dentate patients (mean age 24.0±8.1 years; 27 men and 24 women) were evaluated. Measurements were taken to analyze the total orovestibular and vestibular cortical thickness of the mandibular jawbone at different anterior locations and levels. RESULTS Vestibular cortical thickness is generally thinnest within the incisor area on the apex level. Its thickness increases in basal and distal directions. The total orovestibular thickness is also the least on the level of the anterior mandibular apices, becoming thicker toward more basal levels and the posterior teeth. CONCLUSION We can reasonably assume that the stability of anchorage plates can be optimized by selecting a position well basal to the apices of the lower incisors, as this area offers enhanced cortical and total jawbone thickness.
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Chin plate with a detachable C-tube head serves for both osteotomy fixation and orthodontic anchorage. J Craniofac Surg 2013; 24:e424-8. [PMID: 23851890 DOI: 10.1097/scs.0b013e3182942d40] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUNDS This article reports the dual function of a double-Y miniplate with a detachable C-tube head (C-chin plate; Jin Biomed Co., Bucheon, Korea) used to fixate an anterior segmental osteotomy and provide skeletal anchorage during orthodontic tooth movement. METHODS Cases were selected for this study from patients who underwent anterior segmental osteotomy under local anesthesia. A detachable C-tube head portion was combined with a double-Y chin plate. The double-Y chin plates were fixated between the osteotomy segments and the mandibular base with screws in a conventional way. The C-tube head portion exited the tissue near the mucogingival junction. RESULTS Biocreative Chin Plates were placed on the anterior segmental osteotomy sites. The device allowed 3 points of fixation: 1, minor postosteotomy vertical adjustment of the segment during healing; 2, minor shift of the midline during healing; and 3, to serve as temporary skeletal anchorage device during the post-anterior segmental osteotomy orthodontic treatment. When tooth movement goals are accomplished, the C-tube head of the chin plate can be easily detached from the fixation miniplate by twisting the head using a Weingart plier under local anesthesia. This dual-purpose device spares the patient from the need for 2 separate installations for stabilization of osteotomy segments. CONCLUSIONS The dual-purpose double-Y miniplate combined with a C-tube head (Biocreative Chin Plate) provided versatile application of 3 points of post-osteotomy fixation and of temporary skeletal anchorage for orthodontic tooth movement.
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Nelson G, Ahn HW, Jeong SH, Kim JS, Kim SH, Chung KR. Three-dimensional retraction of anterior teeth with orthodontic miniplates in patients with temporomandibular disorder. Am J Orthod Dentofacial Orthop 2012; 142:720-6. [DOI: 10.1016/j.ajodo.2011.07.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 07/01/2011] [Accepted: 07/01/2011] [Indexed: 10/27/2022]
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Ahn HW, Chung KR, Kang SM, Lin L, Nelson G, Kim SH. Correction of dental Class III with posterior open bite by simple biomechanics using an anterior C-tube miniplate. Korean J Orthod 2012; 42:270-8. [PMID: 23173121 PMCID: PMC3495259 DOI: 10.4041/kjod.2012.42.5.270] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Revised: 07/30/2012] [Accepted: 08/22/2012] [Indexed: 11/29/2022] Open
Abstract
In the correction of dental Class III molar relationship in skeletal Class II patients, uprighting of the mandibular posterior segments without opening the mandible is an important treatment objective. In the case reported herein, a C-tube miniplate fixed to the lower labial symphysis and connected with a nickel-titanium reverse-curved archwire provided effective uprighting of the lower molars, without the need of orthodontic appliances on the mandibular anteriors. Using this approach, an appropriate magnitude of force is exerted on the molars while avoiding any negative effect on the mandibular anteriors.
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Affiliation(s)
- Hyo-Won Ahn
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea
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Chung KR, Ahn HW, Kim SJ, Lee KB, Kim SH. Correction of collapsed occlusion with degenerative joint disease focused on the mandibular arch and timely relocation of a miniplate. Am J Orthod Dentofacial Orthop 2012; 141:e53-e63. [PMID: 22381502 DOI: 10.1016/j.ajodo.2011.05.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 05/01/2011] [Accepted: 05/01/2011] [Indexed: 11/17/2022]
Abstract
This report describes a novel concept of 3-dimensional tooth movement by using biocreative therapy to provide unrestricted distal movement of the full mandibular dentition. The patient was a 26-year-old Korean woman with multiple problems, including a collapsed occlusion, a full-step Class III relationship with posterior open bite, a crossbite, temporomandibular joint pain, and a tendency for root resorption. Two orthodontic miniplates with tubes were initially placed on both retromolar pads for distalization; 1 miniplate was relocated to the anterior region for angulation and vertical control of the anterior teeth. The total treatment period was 13 months. The occlusion was finished in Class I molar and canine relationships with optimal overjet and overbite. Posttreatment records 2.5 years later showed a stable treatment outcome. The results suggest that an orthodontic miniplate is an efficient tool for the treatment of a collapsed occlusion by changing the affected arch only.
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Affiliation(s)
- Kyu-Rhim Chung
- Professor and chairman, Department of Orthodontics, Ajou University, Suwon, Korea
| | - Hyo-Won Ahn
- Clinical fellow, Department of Orthodontics, College of Dentistry, Kyung Hee University, Seoul, Korea
| | - Su-Jung Kim
- Assistant professor, Department of Orthodontics, College of Dentistry, Kyung Hee University, Seoul, Korea
| | - Kye-Bok Lee
- Postgraduate student, Department of Orthodontics, College of Dentistry, Kyung Hee University, Seoul, Korea
| | - Seong-Hun Kim
- Associate professor, Department of Orthodontics, College of Dentistry, Kyung Hee University, Seoul, Korea.
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Chung KR, Jeong DM, Kim SH, Ko YI, Nelson G. En-masse retraction dependent on a temporary skeletal anchorage device without posterior bonding or banding in an adult with severe bidentoalveolar protrusion: Seven years posttreatment. Am J Orthod Dentofacial Orthop 2012; 141:484-94. [DOI: 10.1016/j.ajodo.2010.06.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 06/01/2010] [Accepted: 06/01/2010] [Indexed: 11/28/2022]
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