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Tang Y, Lu W, Zhang Y, Wu W, Sun Q, Zhang Y, Liu X, Liang W, Chen S, Han B. Variations in the alveolar bone morphology in maxillary molar area: a retrospective CBCT study. BMC Oral Health 2024; 24:872. [PMID: 39090625 PMCID: PMC11295338 DOI: 10.1186/s12903-024-04588-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 07/08/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND This study quantitatively analyzed the anatomic structure of the alveolar bone in the maxillary molar region at three potential locations for Temporary Anchorage Device (TAD) placement. Additionally, the study compared the variability in this region across different age groups, sagittal skeletal patterns, vertical facial types, and sexes. METHODS In this retrospective cone-beam computed tomography study, the buccal alveolar bone was analyzed in the posterior molar area of 200 patients, the measurement items include buccal alveolar bone height, alveolar bone thickness, interradicular distance, and maxillary retromolar space. RESULTS Buccal alveolar height was greatest in the U56 region. The interradicular space was largest in the U56 region and increased from the alveolar crest to the sinus floor. Buccal alveolar bone thickness was highest in the U67 region and generally increased from the alveolar crest to the sinus floor. The maxillary retromolar space gradually increased from the alveolar crest to the root apex. CONCLUSIONS TADs are safest when placed in the buccal area between the maxillary second premolar and the first molar, particularly at the 9 mm plane. The U67 region is the optimal safe zone for TAD placement for maxillary dentition distalization. TADs placement in adolescents can be challenging. Maxillary third molar extraction can be considered for maxillary dentition distalization.
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Affiliation(s)
- Yao Tang
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China
- Stomatology Hospital, School of Stomatology Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Wenhsuan Lu
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Yunfan Zhang
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Weiqiang Wu
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Qiannan Sun
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Yuning Zhang
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Xiaomo Liu
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Wei Liang
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China.
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China.
| | - Si Chen
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China.
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China.
| | - Bing Han
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China.
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China.
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Ikenaka R, Koizumi S, Park H, Shimura M, Seimiya K, Fuchida S, Yamaguchi T. Accuracy of Orthodontic Anchor Screw Placement Using a 3D-Printed Surgical Guide. Cureus 2024; 16:e67431. [PMID: 39310565 PMCID: PMC11415297 DOI: 10.7759/cureus.67431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2024] [Indexed: 09/25/2024] Open
Abstract
Background Although radiographs and computed tomography (CT) images are reviewed before temporary anchorage device (TAD) implantation, implantation of TADs exactly as planned is difficult. This study aimed to evaluate the accuracy of TAD implantation using an original surgical guide fabricated using cone-beam CT data and computer-aided design software. Methodology The study participants included six experienced orthodontists who had implanted ≥20 TADs, and six inexperienced orthodontists who had never implanted a TAD. Maxillary dental typodont models with radiopaque tooth crowns and roots were used. A total of four TADs were implanted on the buccal sides: between the second bicuspid and first molars and between the first and second molars bilaterally. The accuracy of TAD implantation was examined in two groups: in 12 dental typodont models, TAD implantation was performed using a surgical guide (guide group), and in 12 dental typodont models, TAD implantation was performed without a surgical guide (freehand group). All dental typodont models implanted a total of 96 TADs. The TAD position was evaluated using the CT coordinate system and 3D image measurement software. Using the long axis of the TAD as a reference, the distance between the coronal and apical ends of the implanted TAD and those of the planned TAD, i.e., the ideal implantation position, was measured in both groups along the x, y, and z axes. The medians of the values were compared between the groups. Additionally, the presence of root contact was compared between the experienced and inexperienced orthodontists. Results On the x-axis, the linear deviations (median) of the coronal and apical ends of the TAD in the freehand group were 1.06 mm and 1.36 mm, respectively. In contrast, in the guide group, the deviations were 0.65 mm and 0.90 mm, respectively, and the difference was statistically significant (p = 0.002 and p = 0.005, respectively). On the y-axis, the deviations in the freehand group were 1.13 mm and 1.08 mm, respectively. In contrast, the deviations in the guide group were 0.71 mm and 0.79 mm, respectively, and only the coronal deviations were significantly different between the groups (p = 0.006). On the z-axis, the deviations in the freehand group were 1.44 mm and 1.86 mm, respectively. In contrast, the deviations in the guide group were 0.75 mm and 1.16 mm, respectively, and the difference was statistically significant (p = 0.006 and p = 0.002, respectively). Conclusions The use of a surgical guide allowed for more accurate TAD implantation. Additionally, TAD implantation using a guide prevented root damage.
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Affiliation(s)
- Ryosuke Ikenaka
- Department of Orthodontics, School of Dentistry, Kanagawa Dental University, Yokosuka, JPN
| | - So Koizumi
- Department of Orthodontics, School of Dentistry, Kanagawa Dental University, Yokosuka, JPN
| | - Heetae Park
- Department of Orthodontics, School of Dentistry, Kanagawa Dental University, Yokosuka, JPN
| | - Masatoshi Shimura
- Division of Dental Practice Support, Department of Dental Technology, Kanagawa Dental University, Yokosuka, JPN
| | - Kazuhide Seimiya
- Division of Dental Practice Support, Department of Dental Technology, Kanagawa Dental University, Yokosuka, JPN
| | - Shinya Fuchida
- Department of Education Planning, School of Dentistry, Kanagawa Dental University, Yokosuka, JPN
| | - Tetsutaro Yamaguchi
- Department of Orthodontics, School of Dentistry, Kanagawa Dental University, Yokosuka, JPN
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Pan Y, Wei L, Zheng Z, Bi W. An evaluation of bone depth at different three-dimensional paths in infrazygomatic crest region for miniscrew insertion: A cone beam computed tomography study. Heliyon 2024; 10:e25827. [PMID: 38352741 PMCID: PMC10863323 DOI: 10.1016/j.heliyon.2024.e25827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
Objective To investigate the difference and distribution of bone depth at different three-dimensional simulated paths to help optimize the insertion path for miniscrew placement in the infrazygomatic crest. Methods Cone beam computed tomography scans of 80 adults (38 males and 42 females; mean age, 27.0 years) were assessed. For each subject, bone depth of 81 simulated insertion paths at different insertion points and three-dimensional angulations was measured in 160 infrazygomatic crests; the differences were evaluated using the adjusted Friedman test. The bone deficiency ratio for each path was calculated. Distributions of measurements were analyzed and reported as specially designed colormaps. Results Bone depth increased, and bone deficiency ratio reduced mesially to distally (P < 0.001), apically to coronally (P < 0.01), and at a greater gingival and distal inclination (P < 0.05). The maximum bone depth (10.72 mm) was observed 13 mm above the maxillary occlusal plane in the mesiobuccal root of the maxillary second molar. The minimum bone depth (3.4 mm) was observed 17 mm above the maxillary occlusal plane in the distobuccal root of the maxillary first molar. No bone deficiency was detected at the paths of 13 mm above the maxillary occlusal plane at a gingival inclination of 70° and distal inclination of 30° in the mesiobuccal root of the maxillary second molar. The highest bone deficiency ratio is present 17 mm above the maxillary occlusal plane at a gingival inclination of 60° and a distal inclination of 0° in the distobuccal root of the maxillary first molar (89/160). Conclusion Insertion paths located at 13 mm above the maxillary occlusal plane in the mesiobuccal root of the maxillary second molar were optimal. A gingival inclination of 70° and a distal inclination of 30° could be beneficial. The distobuccal root of the maxillary first molar region or above the 17 mm insertion plane may not be recommended.
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Affiliation(s)
- Yingdan Pan
- Department of Stomatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
| | - Lijun Wei
- Department of Stomatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
| | - Zhanglong Zheng
- Department of Stomatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
| | - Wei Bi
- Department of Stomatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
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Zhu F, Ji L, Zhou C, Cao Y, Chen Z, Wu X, Zou J, Gao Y. Accuracy of Microimplant Placement Using a 3D Guide Plate for Orthodontic Anchorage. Appl Bionics Biomech 2023; 2023:9060046. [PMID: 37404956 PMCID: PMC10317578 DOI: 10.1155/2023/9060046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 03/31/2023] [Accepted: 06/07/2023] [Indexed: 07/06/2023] Open
Abstract
This study aimed to design a three-dimensional (3D) guide plate using computer-aided design and a 3D printing system for precise implantation of microimplants for orthodontic treatment and investigate the accuracy and feasibility of a 3D guide plate in clinical practice. A total of 30 microimplants were placed in 15 patients in the Department of Stomatology, Affiliated Hospital of Jiangnan University. Before surgery, DICOM data from cone-beam computed tomography (CBCT) scans and STereoLithography data from the 3D model scan were imported to 3Shape Dental System. Data fitting and matching were performed, and 3D guide plates were designed primarily focusing on the thickness of guide plates, amount of concave compensation, and dimensions of the ring. Assist implantation method was used to place the microimplants, and postoperative CBCT images were used to evaluate the position and implantation angle. The feasibility of placing microimplants and precise implantation guided by the 3D guide plate. CBCT data before and after the placement of microimplants were compared. Regarding the secure positioning of microimplants based on CBCT data, 26 implants were categorized as Grade i, four as Grade ii, and none as Grade iii. No loosening of microimplants 1 and 3 months after surgery was reported. The implantation of microimplants is more accurate under the guidance of a 3D guide plate. This technology can achieve accurate implant positioning, thus ensuring safety, stability, and improved success rates after implantation.
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Affiliation(s)
- Fangyong Zhu
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Lian Ji
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Chen Zhou
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Yannan Cao
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Zhifei Chen
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Xiangbing Wu
- Department of Stomatology, Wuxi People's Hospital, 214000 Wuxi, China
| | - Jianming Zou
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Yufeng Gao
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
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Gill G, Shashidhar K, Kuttappa M, Kushalappa P B D, Sivamurthy G, Mallick S. Failure rates and factors associated with infrazygomatic crestal orthodontic implants - A prospective study. J Oral Biol Craniofac Res 2023; 13:283-289. [PMID: 36880016 PMCID: PMC9984842 DOI: 10.1016/j.jobcr.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 01/29/2023] [Accepted: 02/17/2023] [Indexed: 02/27/2023] Open
Abstract
Objective Infrazygomatic crestal (IZC) implants have gained increased popularity over the past few years. Hardly any studies have been done to assess the rate and reasons for failure of IZCs. This prospective study was planned and designed with the primary objective of assessing the rate of failure of bone-screws (BS) placed in the infrazygomatic crest. In continuation, the secondary objective was to assess the factors that were associated with the failure. Materials and methods The study was carried out by taking a detailed case history, (age, gender, vertical skeletal pattern, medical history), photographic records, radiographs, and clinical examination of a total of 32 randomly selected. patients of south indian origin who required infrazygomatic implants bilaterally as the choice of anchorage conservation to retract their incisors. All selected subjects were required to take a PA Cephalogram after the implant placement. The age of the patients ranged from 18 to 33 with an average age of 25 years. The patient log was maintained which included the treatment mechanics, status of oral hygiene, stability of implants, time of loading of the implant, presence of inflammation and time of failure of implant. The angulation of implant was measured on a digital PA cephalogram using Nemoceph software. These parameters were examined to evaluate independent and dependent variables using the Chi-Square test and Fischer's exact test. Result A failure rate 28.1% for IZC placed in the infrazygomatic crest region was observed. Patients with a high mandibular plane angle, poor oral hygiene, immediately loaded implant, peri-implantitis, and severe clinical mobility showed higher failure rates. Variables such as age, gender, sagittal skeletal pattern, length of the implant, type of movement, occluso-gingival position, method of force application, and angle of placement were not significantly associated with implant failure. Conclusion Oral hygiene and peri-screw inflammation must be controlled to minimize the failure of bone screws placed in the infrazygomatic crest region. Loading of the implant should be done after a latent period of two weeks. A higher failure rate was observed in patients with vertical growth pattern.
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Affiliation(s)
- Gauri Gill
- Gills Multispecialty Dental Solutions, Chandigarh, India
| | - Keerthan Shashidhar
- Department of Orthodontics and Dentofacial Orthodontics, NITTE Deemed to Be University, AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - M.N. Kuttappa
- Department of Orthodontics and Dentofacial Orthodontics, NITTE Deemed to Be University, AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Dhyan Kushalappa P B
- Department of Dentistry, Kodagu Institute of Medical Sciences, Madikeri, Karnataka, India
| | | | - Soham Mallick
- Dr Soham's Dental Clinic, Mumbai, Maharashtra, India
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Neves AM, Nascimento MDCCD, de Almeida Cardoso M, Meloti F, Silva E, An TL. Finite element analysis of a newly designed miniplate for orthodontic anchorage in the maxillary anterior region. Am J Orthod Dentofacial Orthop 2022; 162:656-667. [PMID: 35948464 DOI: 10.1016/j.ajodo.2021.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Multiple force vector applications may be indicated when an arch segment or en masse intrusion is needed. This finite element method study aimed to evaluate the total deform the stress yielded in the bone and the miniplate when forces with different directions and magnitudes were applied. METHODS First, the prototyped skull model was fabricated on the basis of computed tomography (CT) scans. On this model, the miniplate was fixed, and orthodontic appliances were attached. Then, a 3-dimensional finite element model was constructed by reproducing the characteristics of the physical model. Seven situations were investigated, which diverged in the point of force application, the direction and the number of force vectors, and the force magnitudes. RESULTS When the force was applied at 1 point, similar behavior could be observed concerning the deformation and the stress in the miniplate, the maxilla, and the screw holes. Most deformation and stress appeared in the transmucosal arm below the step bend and at the force application point. The angled vectors (-45° and 30°) presented smaller values concerning the vertical vectors. Similar or better performances could be observed when the forces were simultaneously applied at the 2 points. CONCLUSIONS The newly designed miniplate showed similar or improved performances when multiple vectors were applied at the 2 points simultaneously compared with the force applied at 1 point. This newly designed miniplate may present improved performance in a clinical situation when multiple forces are demanded.
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Affiliation(s)
- Alexandre Maêda Neves
- Master Degree Program Student, Dental School of São Leopoldo Mandic, Campinas, São Paulo, Brazil.
| | | | | | - Fernanda Meloti
- Master Degree Program Professor, Dental School of São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Ertty Silva
- Private Practice, Brasília, Distrito Federal, Brazil
| | - Tien-Li An
- Department of Dentistry, Health Science School, University of Brasília, Brasília, Distrito Federal, Brazil
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Choi JY, Park JJ, Park KH, Park YG, Park JH. Torque and vertical control of maxillary incisors for an esthetic smile using TSADs implanted in various areas: Biomechanical considerations. Semin Orthod 2022. [DOI: 10.1053/j.sodo.2022.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Muacevic A, Adler JR. The Relationship Between Vertical Facial Type and Maxillary Anterior Alveolar Angle in Adults Using Cone-Beam Computed Tomography. Cureus 2022; 14:e30356. [PMID: 36258803 PMCID: PMC9573689 DOI: 10.7759/cureus.30356] [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] [Accepted: 10/16/2022] [Indexed: 11/06/2022] Open
Abstract
Background Cone-beam computed tomography (CBCT) imaging provides detailed and thorough information about the dentofacial complex. However, not all aspects have been yet explored among different types of malocclusion. The maxillary anterior alveolus is one of the components of the maxillary bone which affects the upper lip position and the esthetics of the smile. The inclination of this alveolus may vary between the different vertical growth patterns of patients who may seek orthodontic treatment. The objective of this study was to investigate possible differences in maxillary anterior alveolar angle (MAAA) among orthodontically untreated adults with different vertical facial types in a Syrian sample. Methods CBCT images of 84 orthodontically untreated adult patients were included. Three groups of vertical facial type (n=28 for each group; 14 males, 14 females) were created using disproportionate multi-stratified random sampling. CBCT-derived lateral cephalograms were used to categorize the patients into three groups. Measurements were made at three regions (region 1 (R1), region 2 (R2), and region 3 (R3)), located in the maxillary anterior alveolar bone using OnDemand3D™ software (Cypermed Inc., Seoul, South Korea). Results No significant differences in the mean MAAA were detected between females and males for the three measured regions in all groups. Analysis of variance showed significant inter-group differences in the MAAA (p<0.05) for all measured regions. The hyperdivergent facial type group had the greatest MAAA mean value of 68.72° (± 6.01), 67.30° (± 4.15), and 68.01° (± 5.12) at R1 in the female, male, and the entire sample of both sexes respectively. Whereas the hypodivergent facial type group had the least mean MAAA values of 58.47° (± 5.34) at R3, 59.83° (± 6.23) at R2, and 59.23° (± 5.75) at R3 in the female, male, and the entire sample of both sexes respectively. Conclusions The maxillary anterior alveolar bone was more buccally inclined in the hypodivergent facial type. The MAA bone inclination did not differ between females and males in the same vertical facial type group.
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Cone-beam computed tomography and digital model analysis of maxillary buccal alveolar bone thickness for vertical temporary skeletal anchorage device placement. Am J Orthod Dentofacial Orthop 2022; 161:e429-e438. [DOI: 10.1016/j.ajodo.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 11/19/2022]
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Ikenaka R, Koizumi S, Otsuka T, Yamaguchi T. Effects of root contact length on the failure rate of anchor screw. J Oral Sci 2022; 64:232-235. [DOI: 10.2334/josnusd.21-0536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
| | - So Koizumi
- Department of Orthodontics, Kanagawa Dental University
| | - Takero Otsuka
- Department of Orthodontics, Kanagawa Dental University
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Yeon BM, Lee NK, Park JH, Kim JM, Kim SH, Kook YA. Comparison of treatment effects after total mandibular arch distalization with miniscrews vs ramal plates in patients with Class III malocclusion. Am J Orthod Dentofacial Orthop 2021; 161:529-536. [PMID: 34953658 DOI: 10.1016/j.ajodo.2020.09.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 11/01/2022]
Abstract
INTRODUCTION This study aimed to compare treatment effects after total mandibular arch distalization with buccal interradicular miniscrews vs ramal plates in patients with Class III malocclusion. METHODS The sample consisted of 40 patients with Class III malocclusion; 20 were treated with distalization via buccal miniscrews (age, 25.8 ± 7.9 years), whereas 20 were treated with ramal plates (age, 26.4 ± 6.1 years). Twenty-three linear and angular measurements were analyzed on pretreatment and posttreatment lateral cephalograms. The changes in each group and differences in treatment effects between the 2 groups were evaluated. RESULTS The mean amount of distalization at the crown and root levels of the mandibular first molars and the amount of distal tipping was 1.8 mm, 0.6 mm, and 5.4° in the buccal miniscrew group vs 3.6 mm, 2.0 mm, and 6.8° in the ramal plate group, respectively. In addition, 2.2° of counterclockwise rotation of the occlusal plane was observed in the buccal miniscrew group after 1.3 mm of molar intrusion (P <0.001). The distal movement of the lower lip was 0.6 mm in the buccal miniscrew group vs 2.3 mm in the ramal plate group. CONCLUSIONS The buccal miniscrew group showed more molar intrusion and counterclockwise rotation of the occlusal plane than in the ramal plate group. The ramal plate produced more distalization of the mandibular dentition with clockwise rotation of the mandible. Therefore, these results can be useful when selecting the type of temporary skeletal anchorage devices to treat patients with Class III malocclusion, depending on their vertical pattern.
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Affiliation(s)
- Byong Moo Yeon
- Graduate school, The Catholic University of Korea, Seoul, South Korea
| | - Nam-Ki Lee
- Department of Orthodontics, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Ariz; International Scholar, Graduate School of Dentistry, Kyung Hee University, Seoul, South Korea
| | | | | | - Yoon-Ah Kook
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
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Heimes D, Schiegnitz E, Kuchen R, Kämmerer PW, Al-Nawas B. Buccal Bone Thickness in Anterior and Posterior Teeth-A Systematic Review. Healthcare (Basel) 2021; 9:1663. [PMID: 34946389 PMCID: PMC8700878 DOI: 10.3390/healthcare9121663] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Immediate dental implant placement has been a subject of great interest over the last decade. Here, information regarding the anatomy and bone thickness of the jaw prior to dental implant placement is crucial to increase the surgery's success and the patient's safety. The clinical premises for this approach have been controversially discussed. One of those heavily discussed premises is a buccal bone thickness of at least 1 mm thickness. This meta-analysis aims to systematically review buccal bone thickness (BBT) in healthy patients. Thus, the feasibility of immediate dental implant placement in daily practice can be assessed. (2) Methods: A search in the electronic databases was performed to identify articles reporting on BBT that was measured by computed tomography in adults. (3) Results: We were able to find 45 studies, including 4324 patients with 25,452 analyzed teeth. The analysis showed a BBT at the alveolar crest of 0.76 ± 0.49 mm in the maxillary frontal and of 1.42 ± 0.74 mm in the maxillary posterior region. In the mandible, the average measured values were similar to those in the maxilla (front: 0.95 ± 0.58 mm; posterior: 1.20 ± 0.96 mm). In the maxillary frontal region 74.4% and in the mandibular frontal region 61.2% of the crestal buccal bones showed widths <1 mm. (4) Conclusions: In more than 60% of the cases, the BBT at the alveolar crest is <1 mm in maxillary and mandibular frontal regions. This anatomic data supports careful pre-surgical assessment, planning of a buccal graft, and critical selection of indication for immediate implant placement, especially in the maxillary and mandibular frontal and premolar region.
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Affiliation(s)
- Diana Heimes
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Robert Kuchen
- Institute for Medical Statistics, Epidemiology and Informatics, University Medical Center of the Johannes-Gutenberg-University Mainz, 55131 Mainz, Germany;
| | - Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
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13
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Zago H, Navarro RDL, Laranjeira V, Fernandes TMF, Conti ACDCF, Oltramari PVP. 3-D Evaluation of temporary skeletal anchorage sites in the maxilla. J Clin Exp Dent 2021; 13:e1131-e1139. [PMID: 34824700 PMCID: PMC8601705 DOI: 10.4317/jced.57574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 08/10/2020] [Indexed: 11/18/2022] Open
Abstract
Background The selection of temporary anchorage device (TAD) site can be a challenging task since one should not only consider the 2-D distances between roots, but also the entire 3-D space. Thus, the aim of this study was to evaluate the posterior maxillary region areas available for the insertion of temporary anchorage devices in reconstructed images from cone beam computed tomography (CBCT).
Material and Methods Sample consisted of 72 patients with indication for orthodontic treatment, grouped into three distinct age groups: 11 to 14 years (age group 1), 15 to 19 years (age group 2) and aged 20 years or older (age group 3), which were further subdivided as to the type of malocclusion (Angle Class I, II and III). Orthopantomographic reconstructions and cross sections were obtained with the Dolphin Imaging software. The distance between the roots of maxillary teeth (canines, premolars and first molars) was determined at 5 mm of the cementoenamel junction, as well as the depth of bone availability at different insertion angles (90°, 75°, 60°, 45°). The influence of different angulations, age, and malocclusion on bone availability was evaluated by ANOVA, followed by the Bonferroni post-test. For the evaluation of the interaction of these factors, 2-way ANOVA was used.
Results Bone availability was found to be poor between roots in the molar region. There was a reduction in bone availability with increasing age. With regard to angulations, greater bone availability was found in depth for 45° angulation in the canine and first premolar regions and for angulation of 75° or 90° in the molar region. However, there was no difference between bone availability in the region of the second premolars.
Conclusions According to applied methodology it can be concluded that the region between canines and premolars accepts better vertical angular variations for TADs insertion. Key words:Cone-Beam Computed Tomography, Orthodontic Anchorage Procedures.
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Affiliation(s)
- Humberto Zago
- DDS, MSc. Former Graduate Student, Department of Orthodontics, UNOPAR - University of North Paraná, Brazil
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Golshah A, Salahshour M, Nikkerdar N. Interradicular distance and alveolar bone thickness for miniscrew insertion: a CBCT study of Persian adults with different sagittal skeletal patterns. BMC Oral Health 2021; 21:534. [PMID: 34657622 PMCID: PMC8522110 DOI: 10.1186/s12903-021-01891-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/07/2021] [Indexed: 11/20/2022] Open
Abstract
Background This study aimed to assess the interradicular distance and alveolar bone thickness of Persian adults with different sagittal skeletal patterns for miniscrew insertion using cone-beam computed tomography (CBCT). Methods This cross-sectional study was conducted on maxillary and mandibular CBCT scans of 60 patients (18–35 years) in three groups (n = 20) of class I, II and III sagittal skeletal pattern. Anatomical and skeletal parameters were measured at 2, 4 and 6 mm apical to the cementoenamel junction (CEJ) by one examiner. The intra- and inter-class correlation coefficients were calculated to assess the intra, and interobserver reliability. Data were analyzed by ANOVA and Tukey’s test (alpha = 0.05). Results The intra- and interobserver reliability were > 0.9 for all parameters. The largest inter-radicular distance in the maxilla was between the central incisors (1–1) in classes I and III, and between premolars (4–5) in class II patients. The largest inter-radicular distance in the mandible was between molar teeth (6–7) in all three classes. The buccal cortical plate thickness was maximum at the site of mandibular first and second molars (6–7). The posterior maxilla and mandible showed the maximum thickness of cancellous bone and alveolar process. Wide variations were noted in this respect between class I, II and III patients. Conclusions The area with maximum inter-radicular distance and optimal alveolar bone thickness for miniscrew insertion varies in different individuals, depending on their sagittal skeletal pattern.
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Affiliation(s)
- Amin Golshah
- Department of Orthodontic, School of Dentistry, Kermanshah University of Medical Sciences, Shariati Street, Kermanshah, 67139546581, Iran
| | - Mahya Salahshour
- School of Dentistry, Kermanshah University of Medical Sciences, Shariati Street, Kermanshah, 67139546581, Iran.
| | - Nafiseh Nikkerdar
- Department of Maxillofacial Radiology, School of Dentistry, Kermanshah University of Medical Sciences, Shariati Street, Kermanshah, 67139546581, Iran
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Noh HK, Park HS. Does maxillary yaw exist in patients with skeletal Class III facial asymmetry? Am J Orthod Dentofacial Orthop 2021; 160:573-587. [PMID: 34332794 DOI: 10.1016/j.ajodo.2020.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 04/01/2020] [Accepted: 05/01/2020] [Indexed: 10/20/2022]
Abstract
INTRODUCTION This study aimed to evaluate maxillary skeletal and dental yaw in patients with skeletal Class III facial asymmetry and investigate its correlation with menton deviation. METHODS Initial cone-beam computed tomography data from 60 patients with skeletal Class III malocclusion were used. There were 30 patients in both the symmetrical group (menton deviation <2 mm) and the asymmetrical group (menton deviation >4 mm). After reconstruction of 3-dimensional (3D) cone-beam computed tomography data, maxillary yaw and 3D positions of skeletal and dental landmarks were measured and compared between the groups. After that, correlations between menton deviation and the other variables were assessed. RESULTS No significant difference was noted in maxillary skeletal and dental yaw between the 2 groups. In the assessment of 3D positions, translation of the maxillary bone and maxillary dentition toward the menton deviation was observed (P <0.01). Maxillary skeletal and dental yaw was not significantly correlated with menton deviation in the asymmetrical group. CONCLUSIONS Maxillary skeletal and dental yaw was not evident in either group. Therefore, when planning maxillary surgery for patients with skeletal Class III facial asymmetry malocclusion, it may be appropriate to shift the focus of decompensation from maxillary yaw to maxillary translation.
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Affiliation(s)
- Hyung-Kyu Noh
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Hyo-Sang Park
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea.
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Lee JA, Ahn HW, Oh SH, Park KH, Kim SH, Nelson G. Evaluation of interradicular space, soft tissue, and hard tissue of the posterior palatal alveolar process for orthodontic mini-implant, using cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2021; 159:460-469. [PMID: 33526299 DOI: 10.1016/j.ajodo.2020.01.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/01/2019] [Accepted: 01/01/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION To investigate the anatomy of the posterior palatal alveolar process, which is often used for placement of the orthodontic mini-implant (OMI), and to suggest simple guidelines for safe placement of OMI. METHODS Cone-beam computed tomography (CBCT) scans of 60 patients (30 men, 30 women; age range, 18-39 years; average age, 25.8 years) was used to measure the palatal interradicular distance, the palatal bone thickness, and the palatal soft-tissue thickness. Measurements were performed on the area from the maxillary canine to the maxillary second molar based on the vertical distance apical from the cementoenamel junction. The CBCT data were analyzed by Bonferroni correction for multiple testing and the multivariable mixed linear model. RESULTS The palatal interradicular distance was the widest between the second premolar and the first molar and the narrowest between the first and second premolars. The palatal bone thickness at interdental sites was the thickest between the first and second premolars and the thinnest between the first and second molars. The interdental palatal soft-tissue thickness from the canine to the second premolar was thicker than any other area. There were minor measurement differences between genders and positive correlations between vertical distance from the cementoenamel junction plane and all of the parameters. CONCLUSION In this study, we evaluated the anatomy of the posterior palatal area using CBCT scans of adult patients. The data will provide guidelines to the clinicians before OMI placement in the posterior palatal alveolar process.
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Affiliation(s)
- Jeong-Ah Lee
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Hyo-Won Ahn
- 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
| | - Ki-Ho Park
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, South Korea.
| | - Gerald Nelson
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, South Korea
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Tepedino M, Cattaneo PM, Niu X, Cornelis MA. Interradicular sites and cortical bone thickness for miniscrew insertion: A systematic review with meta-analysis. Am J Orthod Dentofacial Orthop 2020; 158:783-798.e20. [PMID: 33077369 DOI: 10.1016/j.ajodo.2020.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/01/2020] [Accepted: 05/01/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Safe zone maps are useful for the clinician to plan miniscrew insertion and possibly reduce radiation exposure. This study aimed to investigate the available evidence regarding the presence of sufficient interradicular space and adequate cortical bone thickness in patients with a complete permanent dentition, in the vestibular and palatal or lingual interradicular sites, mesial to the second molar. METHODS PubMed, Scopus, Web of Science, Cochrane Library, and OpenGrey databases were searched up to January 2019 for observational studies involving patients with fully erupted second molars that investigated the amount of interradicular space and/or the cortical thickness of the alveolar processes using 3-dimensional data sets. A custom tool was prepared and used to assess the risk of bias in individual studies. A meta-analysis was performed when at least 4 different studies evaluated 1 identical parameter homogeneously. Publication bias was assessed with the Egger linear regression test. RESULTS Twenty-seven observational articles were included in the qualitative synthesis. Only 11 articles were at low risk of bias. Fifteen articles were included in the meta-analysis. The results were graphically reported in "safe-zone" maps. CONCLUSIONS In the maxilla, the most suitable insertion sites are those from mesial to the first molar to distal to the first premolar, and between the canine and the lateral incisor, all at 6 mm from the cementoenamel junction. In those areas, the cortical bone has adequate thickness, not requiring predrilling. In the mandible, the preferable vestibular interradicular spaces are those between first and second molars and between first and second premolars, both at 5 mm from the cementoenamel junction, and predrilling is suggested in these areas. TRIAL REGISTRATION NUMBER PROSPERO CRD42016042081.
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Affiliation(s)
- Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Paolo M Cattaneo
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Dentistry and Health Sciences, Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - Xiaowen Niu
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Marie A Cornelis
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Dentistry and Health Sciences, Melbourne Dental School, University of Melbourne, Melbourne, Australia
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Abdulwhab A, Ku JH, Alfawaz F, Park JH, Kook YA. Adjunctive surgery after total arch distalization to optimize esthetics. APOS TRENDS IN ORTHODONTICS 2020. [DOI: 10.25259/apos_43_2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
This case report presents surgically assisted orthodontic treatment for an adult patient due to labial exostosis, prominent malar, and unesthetic chin. Her treatment was total arch distalization with modified C-palatal plate for maxillary arch and miniscrews for mandibular arch. In addition, she was treated with alveoloplasty, malarplasty, and genioplasty to improve the consistency of her profile. The total treatment duration was 28 months.
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Affiliation(s)
- Ahmad Abdulwhab
- Department of Orthodontics, Catholic University of Korea, Seocho-Gu, Seoul, Korea,
| | - Ja Hyeong Ku
- Department of Orthodontics, Catholic University of Korea, Seocho-Gu, Seoul, Korea,
| | - Fawaz Alfawaz
- Department of Orthodontics, Catholic University of Korea, Seocho-Gu, Seoul, Korea,
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, A.T. Still University, Arizona, United States,
| | - Yoon-Ah Kook
- Department of Orthodontics, Catholic University of Korea, Seocho-Gu, Seoul, Korea,
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19
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Dharmadeep G, Naik MK, Reddy YM, Cheruluri S, Praveen Raj K, Reddy BR. Three-dimensional Evaluation of Interradicular Areas and Cortical Bone Thickness for Orthodontic Miniscrew Implant Placement Using Cone-beam Computed Tomography. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2020; 12:S99-S104. [PMID: 33149438 PMCID: PMC7595513 DOI: 10.4103/jpbs.jpbs_36_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/24/2020] [Accepted: 03/13/2020] [Indexed: 11/04/2022] Open
Abstract
Background Factors that influence anchorage of the orthodontic miniscrew implants are interradicular areas and cortical bone thickness. Aims and Objectives The aim of this study was to evaluate the three-dimensional interradicular areas and the buccal cortical bone thickness in Indian patients using cone beam computed tomography (CBCT) images, and to find the suitable and safe sites for orthodontic miniscrew implant placement. Materials and Methods CBCT images of 20 patients were divided into three planes as axial, coronal, and sagittal. Measurements, that is, mesiodistal distance and buccal cortical bone thickness were taken at five different heights from the cementoenamel junction (CEJ) toward apical region. Results In the maxilla, the safe sites for placing miniscrew implant were between the second premolar and first molar at 10-mm height, whereas in the mandible, the safe sites for placing miniscrew implant were between the first and second premolar at 6-, 8-, and 10-mm height, between the second premolar and first molar at 10-mm height, and between the first and second molar at 8- and 10-mm height. Conclusion CBCT can be effectively used to evaluate interradicular areas and cortical bone thickness in predicting the safe and suitable sites for placing orthodontic miniscrew implants.
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Affiliation(s)
- Garadappagari Dharmadeep
- Department of Orthodontics and Dentofacial Orthopedics, G. Pulla Reddy Dental College and Hospital, Kurnool, Andhra Pradesh, India
| | - Moode Kaladhar Naik
- Department of Orthodontics and Dentofacial Orthopedics, Government Dental College and Hospital, Kadapa, Andhra Pradesh, India
| | - Yellampalli Muralidhar Reddy
- Department of Orthodontics and Dentofacial Orthopedics, G. Pulla Reddy Dental College and Hospital, Kurnool, Andhra Pradesh, India
| | - Sreekanth Cheruluri
- Department of Orthodontics and Dentofacial Orthopedics, G. Pulla Reddy Dental College and Hospital, Kurnool, Andhra Pradesh, India
| | - Kranthi Praveen Raj
- Department of Orthodontics and Dentofacial Orthopedics, G. Pulla Reddy Dental College and Hospital, Kurnool, Andhra Pradesh, India
| | - Badepalli Reddeppa Reddy
- Department of Orthodontics and Dentofacial Orthopedics, G. Pulla Reddy Dental College and Hospital, Kurnool, Andhra Pradesh, India
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Murugesan A, Sivakumar A. Comparison of bone thickness in infrazygomatic crest area at various miniscrew insertion angles in Dravidian population - A cone beam computed tomography study. Int Orthod 2020; 18:105-114. [PMID: 31926867 DOI: 10.1016/j.ortho.2019.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 11/30/2019] [Accepted: 12/02/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Infrazygomatic crest miniscrews are an important advancement in the field of orthodontics for anchorage reinforcement. The size of the miniscrews and the site of placement depend on the bone thickness in the infazygomatic crest area. The bone morphology and the thickness vary among different ethnicities of population. OBJECTIVES To assess the bone thickness in the infrazygomatic crest area around the distobuccal root of the maxillary first molar using cone beam computed tomography and determine the best possible site and angulation for the placement of the miniscrew. Therefore, to determine the size of the implant that will suit the Dravidian population. METHODS The infrazygomatic crest bone thickness was evaluated on 10 patients using cone beam computed tomography. The measurements were made along the distobuccal root of maxillary first molar at different angulations ranging from 75° to 40° to the occlusal surface of the molar. RESULTS The infrazygomatic crest bone thickness was of 4.5mm to 9mm for the Dravidian population, when measured at an angle of 40° to 75° to the maxillary first molar occlusal plane and of 11 to 17mm above the occlusal plane. Student t-test (confidence interval 95%) was done to determine gender variation and compare the bone thickness of right and left side. ANOVA and post-hoc test were done to find the statistical difference between the bone thickness measured at different insertion angles. CONCLUSIONS The best possible site for miniscrew insertion is 12 to 17mm above the occlusal plane at an angle of 65° to 70°, with no injury to the adjacent anatomical structures, no mucosal irritation and adequate stability for the miniscrew. The ideal infrazygomatic crest screw length for Dravidian population is 9 to 11mm.
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Affiliation(s)
- Arathi Murugesan
- Saveetha Institute of Medical and Technical Sciences, Saveetha University, Saveetha Dental College and Hospitals, Department of Orthodontics, Chennai 600077, India.
| | - Arvind Sivakumar
- Saveetha Institute of Medical and Technical Sciences, Saveetha University, Saveetha Dental College and Hospitals, Department of Orthodontics, Chennai 600077, India
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Wang X, Cao Y, Liu Z, Wang Z, Chu X, Wang L, Hu X, Zhao H, Diao Z, Peng F, Ye H, Cao Z. Alveolar Bone Density Reduction in Rats Caused by Unilateral Nasal Obstruction. Balkan Med J 2019; 36:311-319. [PMID: 31290639 PMCID: PMC6835169 DOI: 10.4274/balkanmedj.galenos.2019.2018.12.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Oral breathing can cause morphological changes in the oral and maxillofacial regions. Aims To investigate whether oral breathing affected structural changes in bone tissues. Study Design Animal experimentation. Methods A total of 48 8-day-old male Sprague−Dawley rats were divided into two groups: a breathing group and a sham (control) group. All Sprague−Dawley rats were killed at 7 weeks after unilateral nostril obstruction modeling. Then, structural changes in bone tissues were detected by micro-computed tomography, and the expression levels of receptor activator of nuclear factor-κB, osteoprotegerin, and receptor activator of nuclear factor-κB ligand in the signal pathway of bone metabolism within the local alveolar bone and serum of rats were detected by reverse transcription-quantitative polymerase chain reaction and Western blotting. Results The results showed that receptor activator of nuclear factor-κB ligand and receptor activator of nuclear factor-κB levels in bone tissues and serum in the oral breathing group were higher than those in the control group [Maxillary alveolar bone: receptor activator of nuclear factor-κB ligand (pRNA=0.009, pprotein=0.008), receptor activator of nuclear factor-κB (pRNA=0.008, pprotein=0.009); Mandibular alveolar bone: receptor activator of nuclear factor-κB ligand (pRNA=0.047, pprotein=0.042), receptor activator of nuclear factor-κB (pRNA=0.041, pprotein=0.007); Serum: receptor activator of nuclear factor-κB ligand (pRNA<0.001, pprotein<0.001), receptor activator of nuclear factor-κB (pRNA<0.001, pprotein<0.001)], along with decreased osteoprotegerin expression (Maxillary alveolar bone: pRNA=0.038, pprotein=0.048; Mandibular alveolar bone: pRNA<0.001, pprotein<0.001; Serum: pRNA=0.009, pprotein=0.006) and elevated receptor activator of nuclear factor-κB ligand/osteoprotegerin. Micro-computed tomography analysis indicated a significant difference in the level of bone volume fraction, as well as trabecular thickness in maxillary alveolar bone between the experimental and control groups (p=0.049, p=0.047). Meanwhile, trabecular thickness, and cortical thickness levels in mandibular alveolar bone also differed significantly between the experimental and control groups (p=0.043, p=0.024). Conclusion Structural changes of the respiratory system affect the alveolar bone structure and unilateral nasal obstruction may lead to a change in regional specific bone density.
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Affiliation(s)
- Xue Wang
- Department of Biochemistry, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yongge Cao
- Haiyuan College, Kunming Medical University, Kunming, Yunnan, China
| | - Zhenhua Liu
- Department of Biochemistry, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zihan Wang
- School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaoying Chu
- Department of Biochemistry, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lei Wang
- School of the Second Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xuanxuan Hu
- Department of Biochemistry, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Han Zhao
- School of the Second Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhanqiu Diao
- School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Fengting Peng
- School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hui Ye
- Department of Biochemistry, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhensheng Cao
- School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Jung MH. Total arch distalization with interproximal stripping in a patient with severe crowding. Korean J Orthod 2019; 49:194-201. [PMID: 31149610 PMCID: PMC6533184 DOI: 10.4041/kjod.2019.49.3.194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/19/2018] [Accepted: 09/19/2018] [Indexed: 11/10/2022] Open
Abstract
When a patient shows severe crowding, premolar extraction should be considered to provide required available space for alignment. If the third molars have already erupted and demonstrate a poor prognosis, third molar extraction and distalization of the posterior dentition can be used instead of premolar extraction to obtain space. Interproximal stripping (IPS) may also be used to gain space in cases of crowding. This case report describes the treatment of a 25-year-old man with severe crowding and mild lip protrusion. Although the crowding in the lower arch was severe enough to require first premolar extraction, distalization of the entire lower dentition with orthodontic mini-implants, extraction of the lower third molars, and IPS could successfully resolve the crowding and lip protrusion.
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Affiliation(s)
- Min-Ho Jung
- Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea.,Private Practice, Seoul, Korea
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Coşkun İ, Kaya B. Relationship between alveolar bone thickness, tooth root morphology, and sagittal skeletal pattern : A cone beam computed tomography study. J Orofac Orthop 2019; 80:144-158. [PMID: 30980091 DOI: 10.1007/s00056-019-00175-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/11/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE The goal of this work was to examine the relationship between sagittal facial pattern and thickness of alveolar bone in conjunction with root morphology of teeth by using cone beam computed tomography (CBCT). METHODS The study was carried out on the CBCT scans from 3 group of patients (n = 20 in each group). The first group involved skeletal class 1, the second group involved skeletal class 2, and the third group involved skeletal class 3 patients. In all, 14 permanent teeth and interdental regions in the maxilla and mandible were evaluated. Root length and root width were measured on each tooth. Buccal cortical bone thickness, cancellous bone thickness, and lingual cortical bone thicknesses were measured in each interdental region. Analysis of variance, Kruskall-Wallis H and Mann-Whitney U tests were used for statistical comparisons. RESULTS No significant difference was found between the groups for root length, root width, buccal cortical bone and lingual cortical bone thickness. A significant difference was observed between the groups for cancellous bone thickness as it was thicker in skeletal class 2 group. Cortical bone was thicker in the mandible compared to maxilla on both buccal and lingual sides and it was thicker in the posterior region compared to the anterior region on the buccal side. CONCLUSIONS Differences in cancellous bone thickness between different sagittal facial patterns and differences in cortical bone thickness between different alveolar regions should be taken into consideration when planning orthodontic tooth movements and anchorage mechanics.
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Affiliation(s)
- İpek Coşkun
- Orthodontist, Private Practice, İstanbul, Turkey
| | - Burçak Kaya
- Department of Orthodontics, Faculty of Dentistry, Baskent University, Ankara, Turkey.
- Dis Hekimligi Fakultesi, Ortodonti Anabilim Dali, Baskent Universitesi, 1. Cad No: 107, 06490, Bahcelievler-Ankara, Turkey.
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Manzanera E, Llorca P, Manzanera D, García-Sanz V, Sada V, Paredes-Gallardo V. Anatomical study of the maxillary tuberosity using cone beam computed tomography. Oral Radiol 2018; 34:56-65. [PMID: 30484092 DOI: 10.1007/s11282-017-0284-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/21/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To examine the dimensions (width, length, and height) of the maxillary tuberosity (MT) and their correlations with age and sex, and to identify different anatomical types for adequate positioning of miniscrews in this area. METHODS The study enrolled 39 patients attending the University of Valencia. The patients comprised 21 males and 18 females with a mean age of 39.7 ± 8.4 years. The dimensions of all 78 MTs were measured on cone beam computed tomography (CBCT) images using Invivo Dental 5 software. RESULTS The intraobserver and interobserver errors were good for all measurements. A total of 858 MT measurements were taken. The widths were greater in men than in women, with significant differences. The MT dimensions showed correlations with patient age, whereby older patients presented with greater widths and lengths, but reduced heights. Three different anatomical types were detected according to patient age. CONCLUSIONS The dimensions (width, length, and height) of the MT vary according to patient age and sex. The MT dimensions conform to particular anatomical types, which should be taken into account when placing miniscrews in this region.
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Affiliation(s)
- Ester Manzanera
- Department of Orthodontics, Dentistry and Medicine Faculty, University of Valencia, C/Gasco Oliag nº1, 46010, Valencia, Spain
| | - Paula Llorca
- Department of Orthodontics, Dentistry and Medicine Faculty, University of Valencia, C/Gasco Oliag nº1, 46010, Valencia, Spain
| | - David Manzanera
- Department of Orthodontics, Dentistry and Medicine Faculty, University of Valencia, C/Gasco Oliag nº1, 46010, Valencia, Spain
| | - Verónica García-Sanz
- Department of Orthodontics, Dentistry and Medicine Faculty, University of Valencia, C/Gasco Oliag nº1, 46010, Valencia, Spain
| | - Vicente Sada
- Private Practice, 26 San Fermín Street, 31003, Pamplona, Navarra, Spain
| | - Vanessa Paredes-Gallardo
- Department of Orthodontics, Dentistry and Medicine Faculty, University of Valencia, C/Gasco Oliag nº1, 46010, Valencia, Spain.
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Atik E, Gorucu-Coskuner H, Taner T. COMPARISION AND EVALUATION OF ALVEOLAR BONE AROUND LOWER CENTRAL INCISORS IN CLASS III AND CLAS I PATIENTS. CUMHURIYET DENTAL JOURNAL 2018. [DOI: 10.7126/cumudj.406846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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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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Maya RR, Pinzan-Vercelino CRM, Gurgel JDA. Effect of vertical placement angle on the insertion torque of mini-implants in human alveolar bone. Dental Press J Orthod 2017; 21:47-52. [PMID: 27901228 PMCID: PMC5125170 DOI: 10.1590/2177-6709.21.5.047-052.oar] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 05/20/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: The aim of the present ex-vivo study was to evaluate the effect of the vertical placement angle of mini-implants on primary stability by analyzing maximum insertion torque (MIT). Methods: Mini-implants were placed in 30 human cadavers, inserted at either a 90° or 60° angle to the buccal surface of the maxillary first molar. Out of 60 self-drilling mini-implants used, half were of the cylindrical type and half were of the conical type. Primary stability was assessed by means of measuring the MIT. Data were subjected to analysis of variance (ANOVA) and Newman-Keuls tests. A significance level of 5% was adopted. Results: The MIT was higher for both mini-implant types when they were placed at a 90° angle (17.27 and 14.40 Ncm) compared with those placed at a 60° angle (14.13 and 11.40 Ncm). Conclusions: MIT values were differed according to the vertical mini-implant placement angle in the maxillary posterior area. Regardless of the type of mini-implant used, placement at a 90° angle resulted in a higher MIT.
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Affiliation(s)
- Rafael Ribeiro Maya
- MSc in Orthodontics, Universidade Ceuma (UNICEUMA), São Luís, Maranhão, Brazil
| | | | - Julio de Araujo Gurgel
- Professor, Universidade Ceuma (UNICEUMA), Masters Program in Dentistry, São Luis, Maranhão, Brazil
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Maxillary arch distalization using interradicular miniscrews and the lever-arm appliance: A case report. J World Fed Orthod 2017. [DOI: 10.1016/j.ejwf.2017.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abstract
INTRODUCTION We aimed to evaluate the associations between the craniofacial growth pattern with interradicular distances (IRDs), cortical widths (CWs), and jaw heights (JHs). Also, we mapped safe zones for miniscrew implantation. METHODS Cone-beam computerized tomography data pertaining to 60 Class-I patients were divided into 3 growth groups: normal, horizontal, and vertical. IRDs and CWs were measured for bimaxillary canines to second molars, on buccal and lingual sides, at 3 transverse planes (1, 3, and 5 mm apically to the alveolar crest). JHs were measured in both jaws, between canines and second molars. The role of growth patterns and other variables were analyzed; also, safe zones were mapped with statistical substantiation. RESULTS IRDs were greater in the mandible, males, at points more distant from the ridge crest, and on the lingual side. Cortexes were thicker in the horizontal growth pattern, mandible, males, older patients, and lingual sides. JHs were greater in vertical growth pattern, mandible, and males. CONCLUSIONS The cortex might be thicker in patients with a horizontal growth pattern. The height might be greater in vertical growth pattern. IRDs might not be affected by growth pattern.
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Sendyk M, de Paiva JB, Abrão J, Rino Neto J. Correlation between buccolingual tooth inclination and alveolar bone thickness in subjects with Class III dentofacial deformities. Am J Orthod Dentofacial Orthop 2017; 152:66-79. [DOI: 10.1016/j.ajodo.2016.12.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 12/01/2016] [Accepted: 12/01/2016] [Indexed: 10/19/2022]
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Kook YA, Park JH, Bayome M, Kim S, Han E, Kim CH. Distalization of the mandibular dentition with a ramal plate for skeletal Class III malocclusion correction. Am J Orthod Dentofacial Orthop 2017; 150:364-77. [PMID: 27476370 DOI: 10.1016/j.ajodo.2016.03.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 03/01/2016] [Accepted: 03/01/2016] [Indexed: 11/25/2022]
Abstract
The retromolar fossa is an anatomically suitable skeletal anchorage site. The aim of this report was to introduce a novel appliance for the correction of skeletal Class III malocclusions with mandibular dentition distalization. The placement site and the procedure of the ramal plate are described. The resulting force vectors are parallel to the functional occlusal plane leading to efficient molar distalization. This approach is demonstrated with 2 adult patients who refused a surgical treatment option. This ramal plate may be indicated for total arch distalization for nonextraction and nonsurgical cases.
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Affiliation(s)
- Yoon-Ah Kook
- Professor, Department of Orthodontics, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea.
| | - Jae Hyun Park
- Professor and chair, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A. T. Still University, Mesa, Ariz; adjunct professor, Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Mohamed Bayome
- Research assistant professor, College of Medicine, Catholic University of Korea, Seoul, Korea; visiting professor, Department of Postgraduate Studies, Universidad Autonóma del Paraguay, Asunción, Paraguay
| | - Sungkon Kim
- Resident, Department of Orthodontics, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea
| | - Eugene Han
- Resident, Department of Orthodontics, University of Southern California, Los Angeles, Calif
| | - Chang Hyen Kim
- Associate professor, Department of Oral and Maxillofacial Surgery, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea
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Sadek MM, Sabet NE, Hassan IT. Three-dimensional mapping of cortical bone thickness in subjects with different vertical facial dimensions. Prog Orthod 2016; 17:32. [PMID: 27667817 PMCID: PMC5065941 DOI: 10.1186/s40510-016-0145-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 09/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine differences in cortical bone thickness among subjects with different vertical facial dimensions using cone beam computed tomography (CBCT). METHODS From 114 pre-treatment CBCT scans, 48 scans were selected to be included in the study. CBCT-synthesized lateral cephalograms were used to categorize subjects into three groups based on their vertical skeletal pattern. Cortical bone thickness (CBT) at two vertical levels (4 and 7 mm) from the alveolar crest were measured in the entire tooth-bearing region in the maxilla and mandible. RESULTS Significant group differences were detected with high-angle subjects having significantly narrower inter-radicular CBT at some sites as compared to average- and low-angle subjects. CONCLUSIONS Inter-radicular cortical bone is thinner in high-angle than in average- or low-angle subjects in few selected sites at the vertical height in which mini-implants are commonly inserted for orthodontic anchorage.
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Affiliation(s)
| | - Noha Ezat Sabet
- Department of Orthodontics, Ain Shams University, Cairo, Egypt
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Tseng YC, Ting CC, Du JK, Chen CM, Wu JH, Chen HS. Insertion torque, resonance frequency, and removal torque analysis of microimplants. Kaohsiung J Med Sci 2016; 32:469-74. [PMID: 27638407 DOI: 10.1016/j.kjms.2016.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/15/2016] [Accepted: 07/19/2016] [Indexed: 01/24/2023] Open
Abstract
This study aimed to compare the insertion torque (IT), resonance frequency (RF), and removal torque (RT) among three microimplant brands. Thirty microimplants of the three brands were used as follows: Type A (titanium alloy, 1.5-mm × 8-mm), Type B (stainless steel, 1.5-mm × 8-mm), and Type C (titanium alloy, 1.5-mm × 9-mm). A synthetic bone with a 2-mm cortical bone and bone marrow was used. Each microimplant was inserted into the synthetic bone, without predrilling, to a 7 mm depth. The IT, RF, and RT were measured in both vertical and horizontal directions. One-way analysis of variance and Spearman's rank correlation coefficient tests were used for intergroup and intragroup comparisons, respectively. In the vertical test, the ITs of Type C (7.8 Ncm) and Type B (7.5 Ncm) were significantly higher than that of Type A (4.4 Ncm). The RFs of Type C (11.5 kHz) and Type A (10.2 kHz) were significantly higher than that of Type B (7.5 kHz). Type C (7.4 Ncm) and Type B (7.3 Ncm) had significantly higher RTs than did Type A (4.1 Ncm). In the horizontal test, both the ITs and RTs were significantly higher for Type C, compared with Type A. No significant differences were found among the groups, and the study hypothesis was accepted. Type A had the lowest inner/outer diameter ratio and widest apical facing angle, engendering the lowest IT and highest RF values. However, no significant correlations in the IT, RF, and RT were observed among the three groups.
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Affiliation(s)
- Yu-Chuan Tseng
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthodontics, Dental Clinics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chun-Chan Ting
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Je-Kang Du
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Ming Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Oral and Maxillofacial Surgery, Dental Clinics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ju-Hui Wu
- Faculty of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hong-Sen Chen
- Faculty of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Yu J, Park JH, Bayome M, Kim S, Kook YA, Kim Y, Kim CH. Treatment effects of mandibular total arch distalization using a ramal plate. Korean J Orthod 2016; 46:212-9. [PMID: 27478798 PMCID: PMC4965592 DOI: 10.4041/kjod.2016.46.4.212] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 01/11/2016] [Accepted: 01/19/2016] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate treatment effects after distalization of the mandibular dentition using ramal plates through lateral cephalograms. METHODS Pre- and post-treatment lateral cephalograms and dental casts of 22 adult patients (11 males and 11 females; mean age, 23.9 ± 5.52 years) who received ramal plates for mandibular molar distalization were analyzed. The treatment effects and amount of distalization of the mandibular molars were calculated and tested for statistical significance. The significance level was set at p < 0.001. RESULTS The mandibular first molar distalization at the crown and root were 2.10 mm (p < 0.001) and 0.81 mm (p = 0.011), respectively. In the evaluation of skeletal variables, there was a significant increase in the Wits appraisal (p < 0.001). In the evaluation of the soft tissue, there was no significant effect on upper lip position, but the lower lips showed a significant retraction of 2.2 mm (p < 0.001). CONCLUSIONS The mandibular molars showed a significant amount of distalization accompanied by limited extrusion and mesiobuccal rotation of the crowns. A ramal plate may be a viable device for mandibular total arch distalization in Class III patients who are reluctant to undergo orthognathic surgery.
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Affiliation(s)
- Jonghan Yu
- Department of Orthodontics, Graduate School of Clinical Dental Science, The Catholic University of Korea, Seoul, Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ, USA.; Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Mohamed Bayome
- Department of Dentistry, Graduate School, The Catholic University of Korea, Seoul, Korea.; Department of Postgraduate Studies, the Universidad Autonóma del Paraguay, Asunción, Paraguay
| | - Sungkon Kim
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoon-Ah Kook
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoonji Kim
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang-Hyen Kim
- Department of Oral and Maxillofacial Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Khumsarn N, Patanaporn V, Janhom A, Jotikasthira D. Comparison of interradicular distances and cortical bone thickness in Thai patients with Class I and Class II skeletal patterns using cone-beam computed tomography. Imaging Sci Dent 2016; 46:117-25. [PMID: 27358819 PMCID: PMC4925648 DOI: 10.5624/isd.2016.46.2.117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 03/18/2016] [Accepted: 04/02/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose This study evaluated and compared interradicular distances and cortical bone thickness in Thai patients with Class I and Class II skeletal patterns, using cone-beam computed tomography (CBCT). Materials and Methods Pretreatment CBCT images of 24 Thai orthodontic patients with Class I and Class II skeletal patterns were included in the study. Three measurements were chosen for investigation: the mesiodistal distance between the roots, the width of the buccolingual alveolar process, and buccal cortical bone thickness. All distances were recorded at five different levels from the cementoenamel junction (CEJ). Descriptive statistical analysis and t-tests were performed, with the significance level for all tests set at p<0.05. Results Patients with a Class II skeletal pattern showed significantly greater maxillary mesiodistal distances (between the first and second premolars) and widths of the buccolingual alveolar process (between the first and second molars) than Class I skeletal pattern patients at 10 mm above the CEJ. The maxillary buccal cortical bone thicknesses between the second premolar and first molar at 8 mm above the CEJ in Class II patients were likewise significantly greater than in Class I patients. Patients with a Class I skeletal pattern showed significantly wider mandibular buccolingual alveolar processes than did Class II patients (between the first and second molars) at 4, 6, and 8 mm below the CEJ. Conclusion In both the maxilla and mandible, the mesiodistal distances, the width of the buccolingual alveolar process, and buccal cortical bone thickness tended to increase from the CEJ to the apex in both Class I and Class II skeletal patterns.
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Affiliation(s)
| | - Virush Patanaporn
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Apirum Janhom
- Division of Oral and Maxillofacial Radiology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Dhirawat Jotikasthira
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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Lee MY, Park JH, Kim SC, Kang KH, Cho JH, Cho JW, Chang NY, Chae JM. Bone density effects on the success rate of orthodontic microimplants evaluated with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2016; 149:217-24. [PMID: 26827978 DOI: 10.1016/j.ajodo.2015.07.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 07/01/2015] [Accepted: 07/01/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the effect of bone densities on the success rate of orthodontic microimplants with cone-beam computed tomography images. METHODS We examined 127 orthodontic microimplants implanted into the maxillary buccal alveolar bone of 71 patients (53 female, 18 male; mean age, 19.2 years) with malocclusion. The cortical, cancellous, and total bone densities were measured with Simplant Pro 2011 software (version 13; Materialise, Leuven, Belgium), and the correlations between these measurements and the orthodontic microimplant success rates were evaluated with cone-beam computed tomography. RESULTS The overall success rate was 85.0% (108 of 127). Sex, age, and side of placement were not significant factors for success in the results (P >0.05). The density of the cortical bone increased apically (3, 5, and 7 mm) from the alveolar crest, but in the cancellous bone it decreased. Whereas the orthodontic microimplant success rates significantly increased as cancellous bone density and total bone density increased (P <0.01), cortical bone density did not have a significant effect on the success rate (P >0.05). CONCLUSIONS The success rate of orthodontic microimplants significantly increased with higher cancellous and total bone densities, whereas cortical bone density did not have a significant effect.
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Affiliation(s)
- Mi-Young Lee
- Graduate student, Department of Orthodontics, School of Dentistry, Wonkwang University, Iksan, Korea
| | - Jae Hyun Park
- Professor and chair, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A. T. Still University, Mesa, Ariz; adjunct professor, Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Sang-Cheol Kim
- Professor, Department of Orthodontics, School of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, Korea
| | - Kyung-Hwa Kang
- Professor, Department of Orthodontics, School of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, Korea
| | - Jin-Hyoung Cho
- Professor, Department of Orthodontics, School of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, Korea
| | - Jin-Woo Cho
- Clinical associate professor, Department of Orthodontics, School of Dentistry, Wonkwang University, Daejeon Dental Hospital, Daejeon, Korea
| | - Na-Young Chang
- Assistant professor, Department of Orthodontics, School of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, Korea
| | - Jong-Moon Chae
- Professor, Department of Orthodontics, School of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, Korea; visiting scholar, Postgraduate Orthodontic Program, Arizona School of Dentistry and Oral Health, A. T. Still University, Mesa, Ariz; instructor, The Charles H. Tweed International Foundation, Tucson, Ariz.
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Mah SJ, Kim JE, Ahn EJ, Nam JH, Kim JY, Kang YG. Analysis of midpalatal miniscrew-assisted maxillary molar distalization patterns with simultaneous use of fixed appliances: A preliminary study. Korean J Orthod 2016; 46:55-61. [PMID: 26877983 PMCID: PMC4751302 DOI: 10.4041/kjod.2016.46.1.55] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 10/21/2015] [Accepted: 11/17/2015] [Indexed: 11/29/2022] Open
Abstract
Skeletal anchorage-assisted upper molar distalization has become one of the standard treatment modalities for the correction of Class II malocclusion. The purpose of this study was to analyze maxillary molar movement patterns according to appliance design, with the simultaneous use of buccal fixed orthodontic appliances. The authors devised two distinct types of midpalatal miniscrew-assisted maxillary molar distalizers, a lingual arch type and a pendulum type. Fourteen patients treated with one of the two types of distalizers were enrolled in the study, and the patterns of tooth movement associated with each type were compared. Pre- and post-treatment lateral cephalograms were analyzed. The lingual arch type was associated with relatively bodily upper molar distalization, while the pendulum type was associated with distal tipping with intrusion of the upper molar. Clinicians should be aware of the expected tooth movement associated with each appliance design. Further well designed studies with larger sample sizes are required.
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Affiliation(s)
- Su-Jung Mah
- Department of Orthodontics, Dental Hospital, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Ji-Eun Kim
- Department of Orthodontics, Dental Hospital, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Eun Jin Ahn
- Department of Orthodontics, College of Dentistry, Kyung Hee University, Seoul, Korea
| | | | | | - Yoon-Goo Kang
- Department of Orthodontics, College of Dentistry, Kyung Hee University, Seoul, Korea
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Migliorati M, Drago S, Gallo F, Amorfini L, Dalessandri D, Calzolari C, Benedicenti S, Silvestrini-Biavati A. Immediate versus delayed loading: comparison of primary stability loss after miniscrew placement in orthodontic patients-a single-centre blinded randomized clinical trial. Eur J Orthod 2016; 38:652-659. [PMID: 26728036 DOI: 10.1093/ejo/cjv095] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 11/30/2015] [Accepted: 12/01/2015] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The aim of this randomized clinical trial was to compare torque recordings at insertion time and 1 week post-placement between immediately loaded orthodontic miniscrews and an unloaded control group. TRIAL DESIGN This RCT was designed as parallel with an allocation ratio of 1:1. METHODS Eligibility criteria to enroll patients were: needs of fixed orthodontic treatment, no systemic disease, absence of using drugs altering bone metabolism. All patients were consecutively treated in a private practice and the miniscrews were placed by the same author. Patients received ORTHOImplant (3M Unitek) miniscrews and they were blindly divided in two groups: group 1 screws were unloaded between T0 and T1, group 2 received immediately loaded screws with NiTi coil. For each patient, maximum insertion torque (MIT) was evaluated at T0. After 1 week, without loading, the screw torque was measured again (T1) and at the end of the treatment maximal removal torque was evaluated (T2). Torque variation in the first week was considered as the primary outcome. RANDOMIZATION A randomization list was created for the group assignment, with an allocation ratio of 1:1. BLINDING The study was single blinded in regard of the statistical analysis. RESULTS Patients enrolled in the clinical trial were 51 for a total of 81 miniscrews. The recruitment started in November 2012 and the observation period ended in August 2014. Twenty-six and twenty-five patients were analysed in group 1 and 2, respectively. The MIT mean in each placement time was 18.25 Ncm (SD = 3.00), 11.41 Ncm (SD = 3.51) and 10.52 Ncm (SD = 5.14) at T0, T1, and T2 time, respectively. In group 1, the torque decrease between T1 and T0 was statistically higher compared to group 2 (P value = 0.003). Statistically significant effects of the placement times on MIT were found (P value <0.0001). No serious harm was observed. LIMITATIONS This study was performed using only direct force on the miniscrew and not using the miniscrew as an indirect anchorage. It was not possible to obtain quantitative data on bone quality or root proximity to miniscrews. CONCLUSIONS A significant stability loss was observed in the first week in both groups; Group 1 showed a statistically higher torque loss in the first week when compared to the immediately loaded group. There were statistically significant effects of the measurement times on MIT and of the miniscrew location on MIT. The overall failure rate was 7.4%. TRIAL REGISTRATION This trial was not registered. PROTOCOL The protocol was not published before trial commencement.
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Affiliation(s)
- Marco Migliorati
- *Orthodontics Department, School of Dentistry, University of Genova, Italy,
| | - Sara Drago
- *Orthodontics Department, School of Dentistry, University of Genova, Italy
| | - Fabio Gallo
- **Section of Biostatistics, Department of Health Sciences, University of Genova, Italy
| | | | - Domenico Dalessandri
- ****Department of Orthodontics, School of Dentistry, University of Brescia, Italy, and
| | - Chiara Calzolari
- *Orthodontics Department, School of Dentistry, University of Genova, Italy
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Aykaç V, Ulusoy Ç, Türköz Ç. Effects of a newly designed orthodontic miniplate platform for elevating the miniplate over the gingiva: A 3-dimensional finite element analysis. Am J Orthod Dentofacial Orthop 2015; 148:110-22. [PMID: 26124034 DOI: 10.1016/j.ajodo.2015.02.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 02/01/2015] [Accepted: 02/01/2015] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Miniplates are the treatment of choice for complex orthodontic and orthopedic problems. However, they require surgical placement and removal, and complications such as infection and mobility can occur. The aim of this finite element analysis was to investigate the effects of a newly designed miniplate platform to elevate the miniplate above the gingiva. METHODS A bone block was modeled in 3 dimensions, and 2 N of force was applied on miniplates in 2 scenarios. In scenario 1, the miniplate was fixed with 2 miniscrews on both ends; in scenario 2, miniplate platforms were first seated on the cortical bone surface with their spikes fully penetrating, and then the miniplate was fixed on top with 2 miniscrews. RESULTS The highest von Mises stress on the cortical bone decreased from 0.5 to 0.3 MPa when miniplate platforms were used. In scenario 2, the principal maximum stresses on the cortical bone around the miniscrews decreased from 0.42 and 0.48 MPa to 0.20 and 0.22 MPa, and the principal minimum stresses decreased from -0.45 and -0.48 MPa to -0.01 MPa. CONCLUSIONS Miniplate platforms used to elevate the miniplate lowered the stresses generated on cortical bone around the miniscrews by distributing the stresses on the cortical bone surface. Patients can clean the miniplate more readily because it is elevated above the soft tissues. Placing the miniplate platforms requires only removing the gingiva with a punch, and their removal does not require flap surgery.
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Affiliation(s)
| | - Çağrı Ulusoy
- Associate professor, Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey.
| | - Çağrı Türköz
- Associate professor, Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Kang HK, Chu TM, Dechow P, Stewart K, Kyung HM, Liu SSY. Laser-treated stainless steel mini-screw implants: 3D surface roughness, bone-implant contact, and fracture resistance analysis. Eur J Orthod 2015; 38:154-62. [PMID: 25908868 DOI: 10.1093/ejo/cjv017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND/OBJECTIVES This study investigated the biomechanical properties and bone-implant intersurface response of machined and laser surface-treated stainless steel (SS) mini-screw implants (MSIs). MATERIAL AND METHODS Forty-eight 1.3mm in diameter and 6mm long SS MSIs were divided into two groups. The control (machined surface) group received no surface treatment; the laser-treated group received Nd-YAG laser surface treatment. Half in each group was used for examining surface roughness (Sa and Sq), surface texture, and facture resistance. The remaining MSIs were placed in the maxilla of six skeletally mature male beagle dogs in a randomized split-mouth design. A pair with the same surface treatment was placed on the same side and immediately loaded with 200 g nickel-titanium coil springs for 8 weeks. After killing, the bone-implant contact (BIC) for each MSI was calculated using micro computed tomography. Analysis of variance model and two-sample t test were used for statistical analysis with a significance level of P <0.05. RESULTS The mean values of Sa and Sq were significantly higher in the laser-treated group compared with the machined group (P <0.05). There were no significant differences in fracture resistance and BIC between the two groups. LIMITATION animal study CONCLUSIONS/IMPLICATIONS Laser treatment increased surface roughness without compromising fracture resistance. Despite increasing surface roughness, laser treatment did not improve BIC. Overall, it appears that medical grade SS has the potential to be substituted for titanium alloy MSIs.
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Affiliation(s)
- He-Kyong Kang
- Department of Orthodontics, University of Detroit Mercy School of Dentistry, MI, Department of Orthodontics and Oral Facial Genetics
| | - Tien-Min Chu
- Department of Restorative Dentistry, Division of Dental Biomaterials, Indiana University School of Dentistry, Indiana University-Purdue University, Indianapolis, IN
| | - Paul Dechow
- Department of Biomedical Sciences, Baylor College of Dentistry, Texas A&M Health Science Center, Dallas, TX
| | - Kelton Stewart
- Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indiana University-Purdue University, Indianapolis, IN, USA, and
| | - Hee-Moon Kyung
- Department of Orthodontics, School of Dentistry, Kyung-Pook National University, Daegu, Korea
| | - Sean Shih-Yao Liu
- Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indiana University-Purdue University, Indianapolis, IN, USA, and
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Kim SJ, Kim JW, Choi TH, Lee KJ. Restoration of a vertical alveolar bone defect by orthodontic relocation of a mesially impacted mandibular first molar. Am J Orthod Dentofacial Orthop 2015; 147:S122-32. [PMID: 25836343 DOI: 10.1016/j.ajodo.2014.04.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 04/01/2014] [Accepted: 04/01/2014] [Indexed: 11/16/2022]
Abstract
An impacted mandibular first molar tends to cause serious bone defects of the adjacent teeth. When choosing between the 2 typical treatment options-extraction or orthodontic relocation of the impacted tooth-the decision should be based on assessment of the prognosis. A 22-year-old man with severe mesioangulation and impaction of the mandibular first molar and a related vertical bone defect on the distal side of the second premolar was treated with extraction of the second molar and orthodontic relocation of the first molar with a retromolar miniscrew. Comprehensive orthodontic treatment involving premolar extraction was conducted. Strategic extraction of the molar and adequate orthodontic movement helped to restore the bone structure on the affected side. This case report suggests the effectiveness of restoration of bone defects by using viable periodontal tissues around the impacted tooth for the longevity of the periodontium.
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Affiliation(s)
- Sung-Jin Kim
- Lecturer, Department of Orthodontics, School of Dentistry, Yonsei University, Seoul, South Korea
| | - Jin-Wook Kim
- Postgraduate student, Department of Orthodontics, School of Dentistry, Yonsei University, Seoul, South Korea
| | - Tae-Hyun Choi
- Lecturer, Department of Orthodontics, School of Dentistry, Yonsei University, Seoul, South Korea
| | - Kee-Joon Lee
- Professor, Department of Orthodontics, School of Dentistry, Yonsei University, Seoul, South Korea.
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Holmes PB, Wolf BJ, Zhou J. A CBCT atlas of buccal cortical bone thickness in interradicular spaces. Angle Orthod 2015; 85:911-9. [PMID: 25760885 DOI: 10.2319/082214-593.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To provide a road map of buccal cortical bone thickness in interradicular locations where miniscrew implants are commonly placed. MATERIALS AND METHODS Cone-beam computed tomography images from 100 study quadrants (50 maxillary and 50 mandibular) were studied. Cortical bone thickness was measured at the most mesial point, the midpoint, and the most distal point in interradicular areas from the canine to the first molar in both arches at 4 mm and 6 mm from the alveolar ridge. Indicator variables of whether the cortical bone thickness was thinner than 1 mm and thicker than 1.5 mm were constructed and analyzed in a general linear mixed model. RESULTS Buccal cortical bone was significantly thinner at a point bisecting two teeth than the bone adjacent to the teeth (P < .0001). The site with the greatest percentage of measurements <1 mm (20%) was at the midpoint bisecting the mandibular canine and the first premolar. The site with the highest percentage of measurements >1.5 mm (50%) was in the mandible adjacent to the first molar (distal to the midpoint of the second premolar and first molar) at 6 mm from the alveolar crest. CONCLUSION Cortical bone thickness is significantly thinner centrally between two teeth than in the areas adjacent to the roots.
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Affiliation(s)
| | - Bethany J Wolf
- b Assistant Professor, Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC
| | - Jing Zhou
- c Assistant Professor and Interim Director, Orthodontics Postgraduate Program, Department of Pediatric Dentistry and Orthodontics, College of Dental Medicine, Medical University of South Carolina, Charleston, SC
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Sabec RDC, Fernandes TMF, de Lima Navarro R, Oltramari-Navarro PVP, Conti ACDCF, de Almeida MR, Poleti ML. Can Bone Thickness and Inter-Radicular Space Affect Miniscrew Placement in Posterior Mandibular Sites? J Oral Maxillofac Surg 2015; 73:333-9. [DOI: 10.1016/j.joms.2014.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 08/06/2014] [Accepted: 08/06/2014] [Indexed: 11/29/2022]
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Takahashi M, Yamaguchi M, Tanimoto Y, Yao-Umezawa E, Kasai K. Biological Evaluation of a Prototype Material made of Polyglycolic Acid and Hydroxyapatite. J HARD TISSUE BIOL 2015. [DOI: 10.2485/jhtb.24.375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Momoko Takahashi
- Departments of Orthodontics, Nihon University School of Dentistry at Matsudo
| | - Masaru Yamaguchi
- Departments of Orthodontics, Nihon University School of Dentistry at Matsudo
| | - Yasuhiro Tanimoto
- Dental Biomaterials, Nihon University School of Dentistry at Matsudo
| | - Eriko Yao-Umezawa
- Departments of Orthodontics, Nihon University School of Dentistry at Matsudo
| | - Kazutaka Kasai
- Departments of Orthodontics, Nihon University School of Dentistry at Matsudo
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Taing-Watson E, Katona TR, Stewart KT, Ghoneima A, Chu GTM, Kyung HM, Liu SS. Microdamage generation by tapered and cylindrical mini-screw implants after pilot drilling. Angle Orthod 2014; 85:859-67. [PMID: 25469670 DOI: 10.2319/062314-452.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate the relationship between mini-screw implant (MSI) diameter (1.6 vs 2.0 mm) and shape (tapered vs cylindrical) and the amount of microdamage generated during insertion. MATERIALS AND METHODS Thirty-six cylindrical and 36 tapered MSIs, 6 mm long, were used in this study. Half of each shape was 1.6 mm in diameter, while the other half was 2.0 mm. After pilot drilling, four and five MSIs were inserted, respectively, into fresh cadaveric maxillae and mandibles of dogs. Bone blocks containing the MSIs were sectioned and ground parallel to the MSI axis. Epifluorescent microscopy was used to measure overall cortical thickness, crack length, and crack number adjacent to the MSI. Crack density and total microdamage burden per surface length were calculated. Three-way analysis of variance (ANOVA) was used to test the effects of jaw, and MSI shape and diameter. Pairwise comparisons were made to control the overall significance level at 5%. RESULTS The larger (2.0 vs 1.6 mm) cylindrical MSIs increased the numbers, lengths, and densities of microcracks, and the total microdamage burden. The same diameter cylindrical and tapered MSIs generated a similar number of cracks and crack lengths. More total microdamage burden was created by the 2.0-mm cylindrical than the 2.0-mm tapered MSIs. Although higher crack densities were produced by the insertion of 1.6-mm tapered MSIs, there was no difference in total microdamage burden induced by 1.6-mm tapered and 1.6-mm cylindrical MSIs. CONCLUSIONS Pilot drilling is effective in reducing microdamage during insertion of tapered MSIs. To prevent excessive microdamage, large diameter and cylindrical MSIs should be avoided.
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Affiliation(s)
- Emily Taing-Watson
- a Former resident, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indiana University - Purdue University Indianapolis, Indianapolis, Ind
| | - Thomas R Katona
- b Associate Professor, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry; Department of Mechanical Engineering, School of Engineering and Technology, Indiana University - Purdue University Indianapolis, Indianapolis, Ind
| | - Kelton T Stewart
- c Assistant Professor, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indiana University - Purdue University Indianapolis, Indianapolis, Ind
| | - Ahmed Ghoneima
- c Assistant Professor, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indiana University - Purdue University Indianapolis, Indianapolis, Ind
| | - Gabriel T M Chu
- d Associate Professor, Department of Restorative Dentistry, Division of Dental Biomaterials, Indiana University School of Dentistry, Indiana University - Purdue University Indianapolis, Indianapolis, Ind
| | - Hee-Moon Kyung
- e Professor and Chair, Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Sean S Liu
- c Assistant Professor, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indiana University - Purdue University Indianapolis, Indianapolis, Ind
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Kalra S, Tripathi T, Rai P, Kanase A. Evaluation of orthodontic mini-implant placement: a CBCT study. Prog Orthod 2014; 15:61. [PMID: 25406652 PMCID: PMC4234895 DOI: 10.1186/s40510-014-0061-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 10/24/2014] [Indexed: 11/25/2022] Open
Abstract
Background Optimal positioning of orthodontic mini-implants is essential for a successful treatment with skeletal anchorage. This study aims to compare the accuracy of two-dimensional radiographs with a cone beam computed tomography (CBCT) for mini-implant placement. Methods An ideal site for mini-implant placement at the buccal interradicular space between the second premolar and the first molar was determined for 40 sites (in 13 patients aged 14 to 28 years) by using CBCT data. The mini-implant placement procedure was then divided into two groups. In CBCT group, mini-implants were placed at the sites determined from CBCT data. In RVG group, mini-implants were placed with the help of two-dimensional digital radiographs and a custom made guide. Postplacement CBCT scans were obtained to determine the accuracy of the mini-implant placement. The results were statistically analyzed with a Mann-Whitney test. Results A statistically significant difference (p value = 0.02) was observed between the two groups for deviation from an ideal height of placement of the mini-implants. Deviations in mesiodistal positioning and angular deviation showed a statistically non-significant difference. Three out of twenty mini-implants in the RVG group showed root contact in the mandibular arch that may be attributed to the narrower interradicular space and reduced accessibility in the mandibular posterior region. Conclusions Although CBCT provides an accurate three-dimensional visualization of the interradicular space, the two-dimensional intraoral radiograph of the interradicular area provides sufficient information for mini-implant placement. Considering the amount of radiation exposure and cost with the two techniques, it is recommended to use two-dimensional radiographs with a surgical guide for a routine mini-implant placement.
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Affiliation(s)
- Shilpa Kalra
- Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, New Delhi 110002, India.
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Veli I, Uysal T, Baysal A, Karadede I. Buccal cortical bone thickness at miniscrew placement sites in patients with different vertical skeletal patterns. J Orofac Orthop 2014; 75:417-29. [PMID: 25344123 DOI: 10.1007/s00056-014-0235-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2012] [Accepted: 07/10/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Cortical bone thickness plays an important role in the primary stability of miniscrews. The purpose of this study was to evaluate the buccal cortical bone thickness in adolescent subjects with different vertical skeletal patterns using cone-beam computed tomography (CBCT). MATERIALS AND METHODS We examined the CBCT images of 75 patients (30 males, 45 females; mean age 16.5 years; range 15.3-17.7 years) in the present study. High-, average- and low-angle subgroups were generated according to SN-GoMe angle. On volumetric images, we measured the buccal cortical bone thickness from canine to the second molar teeth at heights of 5, 7 and 9 mm from cemento-enamel junction (CEJ). For statistical evaluation, the Wilcoxon signed rank, Kruskal-Wallis and Tukey HSD tests were applied at the p < 0.05 level. RESULTS Buccal cortical bone was thickest in the low-angle group. We observed statistically significant differences in the maxilla between the high- and low-angle groups at all levels. In the mandible, we noted statistically significant differences between high-angle and low-angle groups in the canine-first premolar regions at heights of 5 and 7 mm, and in the second premolar-first molar region at 7 mm height from CEJ. Significant differences were also present between the first and second premolars at heights of 7 and 9 mm. Average cortical bone thickness ranged from 1.10-1.37 mm in the maxilla and 1.20-3.28 mm in the mandible for all groups. CONCLUSION Buccal cortical bone thickness in adolescents varied in different vertical skeletal patterns and was greater in the mandible than in the maxilla, with the distance increasing from the CEJ to the apex. As the buccal cortical bone is thinner in high-angle patients, patient-specific measures should be taken when performing miniscrew treatment.
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Affiliation(s)
- Ilknur Veli
- Department of Orthodontics, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
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Kwon HY, Mah SJ, Kang YG. Asymmetric transverse control of maxillary dentition with two midpalatal orthodontic miniscrews. Angle Orthod 2014; 85:525-34. [PMID: 25112171 DOI: 10.2319/042514-302.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
There have been several orthodontic modalities for maxillary transverse control with most addressing symmetric control. The asymmetric transverse control of maxillary dentition is challenging to orthodontists due to the lack of certain modalities and possible dental side effects. Skeletal anchorages provide biomechanics without orthodontic side effects, but reports of their utilization for transverse control of maxillary dentition are scarce. The purpose of this article is to introduce a novel method utilizing two midpalatal orthodontic miniscrews and a connecting wire system for the asymmetric transverse control of maxillary dentition. Records of two patients consecutively treated with this system are reported, and the related biomechanical considerations are presented.
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Affiliation(s)
- Hye-Young Kwon
- a Resident, Department of Orthodontics, Dental Hospital, Kyung Hee University Hospital at Gangdong, Seoul, Korea
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Choi JH, Yu HS, Lee KJ, Park YC. Three-dimensional evaluation of maxillary anterior alveolar bone for optimal placement of miniscrew implants. Korean J Orthod 2014; 44:54-61. [PMID: 24696821 PMCID: PMC3971126 DOI: 10.4041/kjod.2014.44.2.54] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Revised: 08/21/2013] [Accepted: 08/21/2013] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE This study aimed to propose clinical guidelines for placing miniscrew implants using the results obtained from 3-dimensional analysis of maxillary anterior interdental alveolar bone by cone-beam computed tomography (CBCT). METHODS By using CBCT data from 52 adult patients (17 men and 35 women; mean age, 27.9 years), alveolar bone were measured in 3 regions: between the maxillary central incisors (U1-U1), between the maxillary central incisor and maxillary lateral incisor (U1-U2), and between the maxillary lateral incisor and the canine (U2-U3). Cortical bone thickness, labio-palatal thickness, and interdental root distance were measured at 4 mm, 6 mm, and 8 mm apical to the interdental cementoenamel junction (ICEJ). RESULTS The cortical bone thickness significantly increased from the U1-U1 region to the U2-U3 region (p < 0.05). The labio-palatal thickness was significantly less in the U1-U1 region (p < 0.05), and the interdental root distance was significantly less in the U1-U2 region (p < 0.05). CONCLUSIONS The results of this study suggest that the interdental root regions U2-U3 and U1-U1 are the best sites for placing miniscrew implants into maxillary anterior alveolar bone.
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Affiliation(s)
| | - Hyung Seog Yu
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kee Joon Lee
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea
| | - Young Chel Park
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea
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