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Kim I, Park SH, Choi YJ, Lee JH, Chung CJ, Kim KH. Factors influencing the successful eruption of the maxillary third molar after extraction of the maxillary second molar. Am J Orthod Dentofacial Orthop 2023; 164:636-645. [PMID: 37269256 DOI: 10.1016/j.ajodo.2023.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/01/2023] [Accepted: 03/01/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION This study evaluated the occlusal status of the maxillary third molars that erupted spontaneously after extraction of the maxillary second molars and investigated the factors that influenced the occlusal status of the maxillary third molars. METHODS We assessed 136 maxillary third molars in 87 patients. Alignment, marginal ridge discrepancy, occlusal contact, interproximal contact, and buccal overjet were used to score the occlusal status. Occlusal status was classified as good (G group), acceptable (A group), and poor (P group) for the maxillary third molar at its full eruption (T1). The Nolla's stage, long axis angle, the vertical and horizontal position of the maxillary third molar, and the maxillary tuberosity space were assessed at the time of maxillary second molar extraction (T0) and T1 to identify factors influencing the eruption of the maxillary third molar. RESULTS G, A, and P groups comprised 47.8%, 17.6,% and 34.6% of the sample, respectively. Age was the lowest in the G group at both T0 and T1. The maxillary tuberosity space at T1 and the amount of the change of maxillary tuberosity space were the largest in the G group. There was a significant difference in the distribution of the Nolla's stage at T0. The proportions of the G group were 60.0% in stage 4, 46.8% in stages 5 and 6, 70.4% in stage 7, and 15.0% in stages 8-10. According to multiple logistic regression analysis, stages 8-10 for the maxillary third molar at T0 and the amount of the change of maxillary tuberosity were negatively associated with the G group. CONCLUSIONS Good-to-acceptable occlusion was seen in 65.4% of the maxillary third molars after maxillary second molar extraction. Insufficient increase in the maxillary tuberosity space and Nolla stage 8 or higher at T0 negatively influenced the maxillary third molar eruption.
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Affiliation(s)
- Insil Kim
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Sun-Hyung Park
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University, College of Dentistry, Seoul, South Korea
| | - Yoon Jeong Choi
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University, College of Dentistry, Seoul, South Korea
| | - Ji Hyun Lee
- Department of Orthodontics, The Institute of Craniofacial Deformity, Gangnam Severance Dental Hospital, Yonsei University, College of Dentistry, Seoul, South Korea
| | - Chooryung J Chung
- Department of Orthodontics, The Institute of Craniofacial Deformity, Gangnam Severance Dental Hospital, Yonsei University, College of Dentistry, Seoul, South Korea
| | - Kyung-Ho Kim
- Department of Orthodontics, The Institute of Craniofacial Deformity, Gangnam Severance Dental Hospital, Yonsei University, College of Dentistry, Seoul, South Korea.
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Class III malocclusion with traumatic unilateral maxillary central incisor loss treated using orthodontic miniscrews: a case report. AUSTRALASIAN ORTHODONTIC JOURNAL 2022. [DOI: 10.2478/aoj-2022-032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
The present article reports the successful non-extraction orthodontic treatment using miniscrew anchorage in a patient who presented with maxillary left central incisor loss and unstable jaw movements. The chief complaints of the 23-year-old female patient were her protruding teeth and crowding of the mandibular anterior segment. The patient lost her maxillary left central incisor as a result of a traumatic injury during childhood. However, the crown was saved and attached to the adjacent teeth. The patient was diagnosed with a skeletal Class III and Angle Class III dental malocclusion. The jaw movements determined by a 6 degrees of freedom jaw movement recording system were unstable and irregular. Miniscrew anchorage was applied for distalisation of the maxillary right dentition and the mandibular dentition during non-extraction treatment. The maxillary left dentition was mesialised using miniscrew anchorage to close the space as a result of the lost maxillary left central incisor. After an active treatment duration of 36 months, the patient achieved a Class II molar relationship on the left side, a Class I on the right side, an optimal overjet and overbite, and a pleasing facial profile. Despite the asymmetric molar relationships, functionally stable and smooth jaw movements were established. The skeletal, occlusal and functional stability remained satisfactory after a 2-year retention period. In conclusion, miniscrew anchorage was valuable in supporting asymmetric tooth movement during non-extraction appliance treatment in a patient who presented with traumatic unilateral tooth loss.
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Liu R, Hou WB, Yang PZ, Zhu L, Zhou YQ, Yu X, Wen XJ. Severe skeletal bimaxillary protrusion treated with micro-implants and a self-made four-curvature torquing auxiliary: A case report. World J Clin Cases 2021; 9:722-735. [PMID: 33553414 PMCID: PMC7829714 DOI: 10.12998/wjcc.v9.i3.722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 11/23/2020] [Accepted: 12/06/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Bimaxillary protrusion is a clinically common dentofacial deformity, particularly among Chinese patients. This kind of malformation can severely affect facial esthetics and, even in mild cases, is difficult to correct without surgery. Unfortunately, many patients abandon treatment because of fear of surgery. Here, we describe a case of severe skeletal bimaxillary protrusion treated with nonsurgical orthodontic treatments, highlighting an alternative treatment option.
CASE SUMMARY A 31-year-old woman wished to address a severe protrusion profile (approximately 8 mm overbite) and gummy smile. Cephalometric analysis and superimposition showed a severe skeletal class II pattern with a mandibular retrusion, and proclined and protrusive mandibular incisors. Panoramic radiograph showed a missing mandibular right third molar. A diagnosis of severe bimaxillary dentoalveolar protrusion was made. Taking into account the patient’s fear of orthognathic surgery, she accepted the proposed alternative treatment using micro-implants and a self-made four-curvature torquing auxiliary. The treatment allowed for maximal en masse anterior tooth retraction, proper relocation of incisors, and alleviation of the skeletal class II pattern. Esthetically, the patient’s lip protrusion was significantly decreased as was the overjet (from 10.5 mm to 1.8 mm), and the results remained stable throughout the 2-year follow-up.
CONCLUSION Nonsurgical treatment using micro-implants and a four-curvature torquing auxiliary may benefit severe cases of skeletal bimaxillary protrusion in adults.
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Affiliation(s)
- Rui Liu
- Department of Stomatology, Daping Hospital, Third Military Medical University (Army Military Medical University), Chongqing 400042, China
| | - Wan-Bang Hou
- Department of Stomatology, Daping Hospital, Third Military Medical University (Army Military Medical University), Chongqing 400042, China
| | - Ping-Zhu Yang
- Department of Stomatology, Daping Hospital, Third Military Medical University (Army Military Medical University), Chongqing 400042, China
| | - Lin Zhu
- Department of Stomatology, Daping Hospital, Third Military Medical University (Army Military Medical University), Chongqing 400042, China
| | - Yong-Quan Zhou
- Department of Stomatology, Daping Hospital, Third Military Medical University (Army Military Medical University), Chongqing 400042, China
| | - Xia Yu
- Department of Orthodontics, Hospital of Stomatology, Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Xiu-Jie Wen
- Department of Stomatology, Daping Hospital, Third Military Medical University (Army Military Medical University), Chongqing 400042, China
- Department of Orthodontics, Hospital of Stomatology, Southwest Medical University, Luzhou 646000, Sichuan Province, China
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Mo SS, Noh MK, Kim SH, Chung KR, Nelson G. Finite element study of controlling factors of anterior intrusion and torque during Temporary Skeletal Anchorage Device (TSAD) dependent en masse retraction without posterior appliances: Biocreative hybrid retractor (CH-retractor). Angle Orthod 2019; 90:255-262. [PMID: 31589469 DOI: 10.2319/050619-315.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate, using the finite element method (FEM), the factors that allow control of the anterior teeth during en masse retraction with the Biocreative hybrid retractor (CH-retractor) using different sizes of nickel-titanium (NiTi) archwires and various gable bends on the stainless-steel (SS) archwires. MATERIALS AND METHODS Using FEM, the anterior archwire section, engaged on the anterior dentition, was modeled in NiTi, and another assembly, the posterior guiding archwire, was modeled in SS. Two dimensions (0.016 × 0.022- and 0.017 × 0.025-inch NiTi) of the anterior archwires and different degrees (0°, 15°, 30°, 45°, and 60°) of the gable bends on the guiding wire were applied to the CH-retractor on the anterior segment to evaluate torque and intrusion with 100-g retraction force to TSADs. Finite element analysis permitted sophisticated analysis of anterior tooth displacement. RESULTS With a 0° gable bend all anterior teeth experienced extrusion. The canines showed a larger amount of extrusion than did the central and lateral incisors. With a gable bend of >15°, all anterior teeth exhibited intrusion. Bodily movement of the central incisor required a 30°∼45° gable bend when using anterior segments of 0.016 × 0.022-inch NiTi and 15°∼30° gable bend with the 0.017 × 0.025-inch NiTi. CONCLUSIONS With the CH-retractor, varying the size of the NiTi archwire and/or varying the amount of gable bend on the SS archwire affects control of the anterior teeth during en masse retraction without a posterior appliance.
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Li J, Zhao Y, Li H, Li H, Lei L. Effects of force magnitude on torque control in the correction of bimaxillary protrusion with mass retraction. J Orthod Sci 2018; 7:13. [PMID: 29963508 PMCID: PMC6004741 DOI: 10.4103/jos.jos_65_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES: This study was designed to explore whether force magnitude would influence incisor torque control and the overall outcome in patients with bimaxillary protrusion who need mass incisor retraction. MATERIALS AND METHODS: Forty-one female patients (aged > 15 years) with bimaxillary protrusion requiring mass incisor retraction were selected. Two sliding mechanics were utilized, with the elastic group receiving a light force of ~100 g by wearing elastics and the power chain group receiving a moderate force of ~250 g by power chain. Lateral cephalograms obtained before and after treatment were traced and measured. RESULTS: Patients in both groups displayed maxillary protrusion with a similar skeletal class II tendency. A longer treatment time was found in the elastic group. No difference in the distance of incisor tip movement was observed between the two groups; however, a larger inclination of upper incisors was found in the elastic group, indicating less loss of torque. In addition, larger reduction in Sella-Nasion-A and A-Nasion-B angle was observed in the elastic group, which was accompanied by a larger ratio of upper lip retraction to upper incisor retraction as well as more upper lip retraction. CONCLUSIONS: Sliding mechanics with elastics to generate light forces can achieve better torque control with more reduction in skeletal and soft tissue protrusion.
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Affiliation(s)
- Jiao Li
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yunhe Zhao
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Houxuan Li
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Huang Li
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Lang Lei
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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Pithon MM. Nonsurgical treatment of severe Class II malocclusion with anterior open bite using mini-implants and maxillary lateral incisor and mandibular first molar extractions. Am J Orthod Dentofacial Orthop 2017; 151:964-977. [PMID: 28457275 DOI: 10.1016/j.ajodo.2016.04.035] [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: 09/01/2015] [Revised: 04/01/2016] [Accepted: 04/01/2016] [Indexed: 11/18/2022]
Abstract
This clinical case report presents the nonsurgical orthodontic treatment of a patient with skeletal Class II malocclusion, posterior crossbite, anterior open bite, accentuated dental discrepancies in both arches, and an odontoma. The proposed treatment involved maxillary expansion, extraction of atypical maxillary lateral incisors and mandibular first molars, and intrusion of maxillary teeth with the aid of mini-implants. The results obtained with these procedures included good tooth alignment, normal overbite and overjet, removal of the odontoma, and a harmonious smile. In complex cases, an accurate diagnosis is the key to a favorable outcome.
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Affiliation(s)
- Matheus Melo Pithon
- Southwest Bahia State University, Vitória da Conquista, Bahia, Brazil; School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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Jee JH, Ahn HW, Seo KW, Kim SH, Kook YA, Chung KR, Nelson G. En-masse retraction with a preformed nickel-titanium and stainless steel archwire assembly and temporary skeletal anchorage devices without posterior bonding. Korean J Orthod 2014; 44:236-45. [PMID: 25309863 PMCID: PMC4192525 DOI: 10.4041/kjod.2014.44.5.236] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 11/13/2013] [Accepted: 12/17/2013] [Indexed: 11/22/2022] Open
Abstract
Objective To evaluate the therapeutic effects of a preformed assembly of nickel-titanium (NiTi) and stainless steel (SS) archwires (preformed C-wire) combined with temporary skeletal anchorage devices (TSADs) as the sole source of anchorage and to compare these effects with those of a SS version of C-wire (conventional C-wire) for en-masse retraction. Methods Thirty-one adult female patients with skeletal Class I or II dentoalveolar protrusion, mild-to-moderate anterior crowding (3.0-6.0 mm), and stable Class I posterior occlusion were divided into conventional (n = 15) and preformed (n = 16) C-wire groups. All subjects underwent first premolar extractions and en-masse retraction with pre-adjusted edgewise anterior brackets, the assigned C-wire, and maxillary C-tubes or C-implants; bonded mesh-tube appliances were used in the mandibular dentition. Differences in pretreatment and post-retraction measurements of skeletal, dental, and soft-tissue cephalometric variables were statistically analyzed. Results Both groups showed full retraction of the maxillary anterior teeth by controlled tipping and space closure without altered posterior occlusion. However, the preformed C-wire group had a shorter retraction period (by 3.2 months). Furthermore, the maxillary molars in this group showed no significant mesialization, mesial tipping, or extrusion; some mesialization and mesial tipping occurred in the conventional C-wire group. Conclusions Preformed C-wires combined with maxillary TSADs enable simultaneous leveling and space closure from the beginning of the treatment without maxillary posterior bonding. This allows for faster treatment of dentoalveolar protrusion without unwanted side effects, when compared with conventional C-wire, evidencing its clinical expediency.
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Affiliation(s)
- Jeong-Hyun Jee
- Department of Orthodontics, Postgraduate School of Dentistry, The Catholic University of Korea, Seoul, Korea
| | - Hyo-Won Ahn
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Kyung-Won Seo
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Seong-Hun Kim
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Yoon-Ah Kook
- Department of Orthodontics, Postgraduate School of Dentistry, The Catholic University of Korea, Seoul, Korea
| | - Kyu-Rhim Chung
- Department of Orthodontics, Ajou University School of Medicine, Suwon, Korea
| | - Gerald Nelson
- Division of Orthodontics, Department of Orofacial Science, University of California, San Francisco, CA, USA
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Moresca R. Class I malocclusion with severe double protrusion treated with first premolars extraction. Dental Press J Orthod 2014; 19:127-38. [PMID: 25162577 PMCID: PMC4296619 DOI: 10.1590/2176-9451.19.3.127-138.bbo] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 04/15/2014] [Indexed: 11/23/2022] Open
Abstract
Angle Class I malocclusion with bymaxillary protrusion is characterized by severe buccal tipping of incisors, which causes upper and lower lip protrusion. First premolars extraction is recommended to reduce facial convexity as a result of anterior teeth retraction, which keeps canines and first molars in key to occlusion. In order to yield orthodontic results that are compatible with ideal esthetic and cephalometric outcomes, the space closure phase needs to be carried out with overbite and incisors torque control. The majority of cases also requires maximum anchorage of posterior teeth. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) as a requirement for the title of certified by the BBO.
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Affiliation(s)
- Ricardo Moresca
- PhD in Orthodontics, School of Dentistry - University of São Paulo.
MSc in Orthodontics, Methodist University of São Paulo (UMESP). Specialist in
Orthodontics, Federal University of Paraná (UFPR). Adjunct professor, Department of
Orthodontics, Federal University of Paraná (UFPR). Full Professor and Head of the
Postgraduate program in Orthodontics, Positivo University. Certified by the Brazilian
Board of Orthodontics and Facial Orthopedics (BBO)
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Wiechmann D, Grauer D, Swift EJ. Current status of skeletal anchorage dental applications in orthodontics, part II. J ESTHET RESTOR DENT 2014; 26:79-87. [PMID: 24589364 DOI: 10.1111/jerd.12094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Dirk Wiechmann
- Department of Orthodontics, Hannover Medical School, Hannover, Germany; Bad Essen, Germany
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Kim MA, Park YH. Does Upper Premolar Extraction Affect the Changes of Pharyngeal Airway Volume After Bimaxillary Surgery in Skeletal Class III Patients? J Oral Maxillofac Surg 2014; 72:165.e1-10. [DOI: 10.1016/j.joms.2013.09.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 09/11/2013] [Accepted: 09/13/2013] [Indexed: 10/25/2022]
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Choi B, Lee DO, Mo SS, Kim SH, Park KH, Chung KR, Nelson G, Han SH. Three-dimensional finite element analysis for determining the stress distribution after loading the bone surface with two-component mini-implants of varying length. Korean J Orthod 2011. [DOI: 10.4041/kjod.2011.41.6.423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Bohm Choi
- Clinical Assistant Professor, Department of Prosthodontics, Yeouido St. Mary's Hospital, The Catholic University of Korea, Korea
| | | | - Sung-Seo Mo
- Associate Professor, Department of Orthodontics, Yeouido St. Mary's Hospital, The Catholic University of Korea, Korea
| | - Seong-Hun Kim
- Associate Professor, Department of Orthodontics, Yeouido St. Mary's Hospital, The Catholic University of Korea, Korea
| | - Ki-Ho Park
- Assistant Professor, Department of Orthodontics, School of Dentistry, Kyung Hee University, Korea
| | - Kyu-Rhim Chung
- Professor, Department of Orthodontics, School of Clinical Dental Scinece, Ajou University, Korea
| | - Gerald Nelson
- Clinical Professor, Department of Orofacial Science, University of California in San Francisco, USA
| | - Seong Ho Han
- Clinical Assistant Professor, Department of Orthodontics, St. Vincent Hospital, The Catholic University of Korea, Korea
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