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Wang Y, Zhou S, Zheng J, Yan L, Ngan P, Hua F, He H. Comparison of treatment effects between clear aligners and fixed appliances in patients treated with miniscrew-assisted molar distalization. Eur J Orthod 2024; 46:cjae021. [PMID: 38733349 DOI: 10.1093/ejo/cjae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2024]
Abstract
OBJECTIVES The biomechanics in achieving molar distalization may differ between fixed appliances and clear aligners in the control of tooth movement. The objective of this study was to compare the treatment effects between clear aligners (CA) and fixed appliances (FA) in patients treated with miniscrew-assisted molar distalization. METHODS The sample consisted of 46 subjects with mild-to-moderate crowding. A total of 22 patients treated with clear aligners (age, 25.66 ± 6.11 years old) and 24 patients treated with fixed appliances (age, 24.04 ± 4.95 years old) for miniscrew-assisted molar distalization were included in this study. The dental and skeletal changes were evaluated by the pre- and post-treatment lateral cephalograms. RESULTS Significant changes were found with the vertical variables SN-OP angle (2.24 ± 3.22°, P < .05) and SN-MP angle (0.73 ± 1.15°, P < .05) for the FA group when compared with the CA group (SN-OP angle 0.41 ± 2.26° and SN-MP angle -0.21 ± 1.38°, P > .05). Both treatment groups achieved a 2-3 mm. molar distalization with significant intrusion of the upper molars. The CA group showed significantly less distal tipping of molars (U6^PP angle -2.29 ± 3.29° and L6^MP angle -2.92 ± 2.49°, P < .05) compared to the FA group (-5.24 ± 4.28° and -5.53 ± 5.03°, P < .05). In addition, significant retraction and lingual inclination of the upper and lower incisors were found in both groups. LIMITATIONS The changes of tooth position were evaluated by 2D lateral cephalograms, not 3D measurements. CONCLUSIONS Compared to fixed appliances, clear aligners seemed to have better control of vertical dimension and distal tipping of molars in patients treated with miniscrew-assisted molar distalization.
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Affiliation(s)
- Yunlei Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Shunquan Zhou
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jie Zheng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lin Yan
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Peter Ngan
- Department of Orthodontics, West Virginia University, Morgantown, WV, United States
| | - Fang Hua
- Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Hong He
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Kook YA, Choi TH, Park JH, Kim SH, Lee NK. Comparison of posttreatment stability after total mandibular arch distalization with mini-implants and mandibular setback surgery. Angle Orthod 2024; 94:159-167. [PMID: 38195065 PMCID: PMC10893925 DOI: 10.2319/062723-447.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 11/01/2023] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVES To compare posttreatment stability in skeletal Class III patients between those treated by total mandibular arch distalization (TMAD) with buccal mini-implants and those by mandibular setback surgery (MSS). MATERIALS AND METHODS The samples included 40 Class III adults, 20 treated by TMAD using buccal interradicular mini-implants and 20 treated with MSS. Lateral cephalograms were taken at pretreatment, posttreatment, and at least 1-year follow-up, and 24 variables were compared using statistical analysis. RESULTS Mandibular first molars moved distally 1.9 mm with intrusion of 1.1 mm after treatment in the TMAD group. The mandibular incisors moved distally by 2.3 mm. The MSS group exhibited a significant skeletal change of the mandible, whereas the TMAD group did not. During retention, there were no skeletal or dental changes other than 0.6 mm labial movement of the mandibular incisors (P < .05) in the MSS group. There was 1.4° of mesial tipping (P < .01) and 0.4 mm of mesial movement of the mandibular molars and 1.9° of labial tipping (P < .001) and 0.8 mm of mesial movement of the mandibular incisors in the TMAD group. These dental changes were not significantly different between the two groups. CONCLUSIONS The TMAD group showed a slightly decreased overjet with labial tipping of the mandibular incisors and mesial tipping of the first molars during retention. Posttreatment stability of the mandibular dentition was not significantly different between the groups. It can be useful to plan camouflage treatment by TMAD with mini-implants in mild-to-moderate Class III patients.
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Fang X, Ding H, Fan C, Pang L, Xu T, Liu J, Jiang C. Comparison of mandibular buccal shelf morphology between adolescents and adults with different vertical patterns using CBCT. Oral Radiol 2024; 40:58-68. [PMID: 37773481 DOI: 10.1007/s11282-023-00710-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: 01/17/2023] [Accepted: 09/04/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVE This retrospective study aimed to analyze the anatomical structure of the mandibular buccal shelf (MBS) in adolescents and adults with different vertical patterns to determine the optimal location for miniscrew insertion in orthodontic treatment. METHODS Cone-beam computed tomography (CBCT) scans of 230 patients were utilized for measurements. The morphology and thickness of alveolar bone at the MBS were measured. Two-way ANOVA and regression analysis were conducted to analyze the influencing factors on alveolar bone and cortical bone thickness. RESULTS Age had a significant effect on alveolar bone thickness (level I: F = 62.449, level II: F = 18.86, p < 0.001), cortical bone thickness (level II: F = 18.86, p < 0.001), alveolar bone tilt (F = 6.267, p = 0.013), and second molar tilt (F = 6.693, p = 0.01). Different vertical patterns also influenced alveolar bone thickness (level I: F = 20.950, level II: F = 28.470, p < 0.001), cortical bone thickness (level I: F = 23.911, level II: F = 23.370, p < 0.001), and alveolar bone tilt (F = 27.046, p < 0.001). As age increased, the alveolar bone thickness at level I decreased by 0.096 mm and at level II decreased by 0.073 mm. Conversely, the thickness of alveolar bone at level I and level II increased by 0.06 mm and 0.075 mm, respectively. The cortical bone thickness at level I and level II increased by 0.024 mm and 0.29 mm, respectively. However, the alveolar bone thickness decreased by 0.931 mm and 1.545 mm at level I and level II, and the cortical bone thickness decreased by 0.542 mm and 0.640 mm at level I and level II, respectively. CONCLUSION Age, different vertical patterns, alveolar bone inclination, and different shapes of MBS significantly affected the thickness of alveolar bone and cortical bone in the MBS area. Notably, only alveolar bone thickness and cortical bone thickness at level II were affected by age and different vertical patterns simultaneously. These findings can provide valuable insights for orthodontic practitioners in selecting the most suitable location for miniscrew insertion during treatment planning.
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Affiliation(s)
- Xiaoxu Fang
- Qingdao Stomatological Hospital Affiliated to Qingdao University, The Affiliated Hospital of Qingdao University, School of Stomatology, Qingdao University, Qingdao, 266003, China
| | - Hong Ding
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Cunhui Fan
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
| | - Lei Pang
- The Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Tao Xu
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Jialin Liu
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, School of Stomatology, Qingdao University, Qingdao, 266003, China
| | - Chunmiao Jiang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, School of Stomatology, Qingdao University, Qingdao, 266003, China.
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Rajamanickam P, Sundari SK. Mandibular Posterior Anatomic Limit for Distalization in Patients With Various Patterns of Third Molar Impactions: A Three-Dimensional Cone Beam CT (CBCT) Study. Cureus 2023; 15:e50165. [PMID: 38192921 PMCID: PMC10772357 DOI: 10.7759/cureus.50165] [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: 11/08/2023] [Accepted: 12/08/2023] [Indexed: 01/10/2024] Open
Abstract
AIM The aim was to compare and evaluate the variation in the mandible's posterior anatomic limits (MPAL) stratified by different third molar impaction patterns utilizing cone-beam CT (CBCT) in individuals with skeletal Class III malocclusion. METHODOLOGY The sample consisted of CBCT records of 80 samples of Class III patients categorized based on the pattern of their third molar impaction. The shortest linear distances from the distal root of the second mandibular molar to the inner cortex of the mandibular body were measured at the crown level, at the cementoenamel junction (CEJ), and at the depths of 4, 6, and 8mm from the CEJ, all parallel to the posterior occlusal line. The MPAL of the four groups were compared. The Shapiro-Wilk test for normality was performed. The Kruskal-Wallis test was performed to compare the MPAL distances between the groups. RESULTS Significant differences were noted between the four groups at every level. MPAL distances decreased towards apex in all the groups and was least at the 8mm root level. The greatest MPAL distances were noted in the no-impaction group followed by the horizontal. At 8mm, the MPAL were 4.2+/-1.3 in Group 3 (Control), 3.3+/-0.9 in Group 1 and 2.7+/-0.05 mm in Group 2. Though the amount of space available for distalization was greatest for the mesioangular group at the crown level, it was least at the 8mm level compared to other groups. CONCLUSION MPAL distances were shortest at the root level in Class III patients who had mesioangularly impacted third molars and care should be taken before attempting distalization in them.
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Affiliation(s)
- Preethi Rajamanickam
- Orthodontics and Dentofacial Orthopedics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Shantha K Sundari
- Orthodontics and Dentofacial Orthopedics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Seol J, Bayome M, Kook YA, Kang SJ, Oh J, Ham LK, Park JH. A 3-dimensional evaluation of available retromolar space for the application of ramal plates. Am J Orthod Dentofacial Orthop 2023; 164:628-635. [PMID: 37269257 DOI: 10.1016/j.ajodo.2023.03.020] [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: 10/01/2022] [Revised: 03/01/2023] [Accepted: 03/01/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION This study aimed to evaluate the available retromolar space for ramal plates in patients with Class I and III malocclusions and compare that space with and without third molars using cone-beam computed tomography. METHODS Cone-beam computed tomography images of 30 patients (17 males, 13 females; mean age, 22.2 ± 4.5 years) with Class III malocclusion and 29 subjects (18 males, 11 females; mean age, 24.3 ± 3.7 years) with Class I malocclusion were analyzed. Available retromolar space at 4 axial levels of the second molar root and the volume of the retromolar bone were evaluated. Two-way repeated measures analysis of covariance (repeated measures analysis of covariance) was applied to compare the variables between Class I and III malocclusions and the presence of third molars. RESULTS Patients with Class I and III relationships showed up to 12.7 mm of available retromolar space at 2 mm apical from the cementoenamel junction (CEJ). At 8 mm apical from CEJ, patients with Class III malocclusion had 11.1 mm of space, whereas those with a Class I relationship showed 9.8 mm of available space. When patients had third molars, the amount of available retromolar space was significantly greater in patients with a Class I and III relationship. However, patients with Class III malocclusion exhibited greater available retromolar space than those with a Class I relationship (P = 0.028). In addition, the bone volume was significantly greater in patients with Class III malocclusion than in patients with a Class I relationship and those with third molars than in those without them (P <0.001). CONCLUSIONS Class I and III groups showed the availability of at least 10.0 mm of retromolar space 2 mm apical to the CEJ for molar distalization. Based on this information, it is suggested that clinicians consider available retromolar space for molar distalization in diagnosing and planning treatment for patients with Class I and III malocclusion.
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Affiliation(s)
- Jungeun Seol
- Garak Samsung Dental Clinic, Seoul, South Korea; Department of Orthodontics, King Faisal University College of Dentistry, King Faisal University, Alhofof, Saudi Arabia
| | - Mohamed Bayome
- Department of Orthodontics, King Faisal University College of Dentistry, King Faisal University, Alhofof, Saudi Arabia; Department of Postgraduate Studies, Universidad Autonóma del Paraguay, Asunción, Paraguay
| | - Yoon-Ah Kook
- Dr. Kook's Hanmaum Bubu Dental Clinic, Seoul, South Korea.
| | | | - Jiyoung Oh
- Department of Orthodontics, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Lyun Kwang Ham
- Department of Orthodontics, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Ariz; Graduate School of Dentistry, Kyung Hee University, Seoul, South Korea
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Ferrillo M, Nucci L, Gallo V, Bruni A, Montrella R, Fortunato L, Giudice A, Perillo L. Temporary anchorage devices in orthodontics: a bibliometric analysis of the 50 most-cited articles from 2012 to 2022. Angle Orthod 2023; 93:591-602. [PMID: 37200455 PMCID: PMC10575636 DOI: 10.2319/010923-18.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/01/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVES To identify and analyze the 50 most cited articles on temporary anchorage devices (TADs) and investigate the achievement and development of scientific research about the topic through a bibliometric analysis. MATERIALS AND METHODS On August 22, 2022, a computerized database search was performed to detect papers published in the scientific literature about TADs from 2012 to 2022. Metrics data were identified using the Incites Journal Citation Reports (Clarivate Analytics) data set. The Scopus database was used to obtain information on the authors' affiliations, country of origin, and h-index. Key words were automatically harvested from the selected articles to implement the visualized analysis. RESULTS From a total of 1858 papers screened by searching the database, a list of the top 50 most cited articles was created. The total number of citations collected by the 50 most cited articles in TADs was 2380. Among the 50 most cited articles on TADs, 38 were original research papers (76.0%) and 12 were reviews (24.0%). As shown by the key word-network analysis, Orthodontic anchorage procedure was identified as the larger node. CONCLUSIONS Findings of this bibliometric study showed an increasing number of citations for papers on TADs, accompanied by a simultaneous rise in scientific interest in this topic in the past decade. The present work identifies the most influential articles, emphasizing the journals, the authors, and the topics addressed.
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Affiliation(s)
- Martina Ferrillo
- Corresponding author: Dr Martina Ferrillo, Dentistry Unit, Department of Health Sciences, University of Catanzaro “Magna Graecia,” Viale Europa, 88100 Catanzaro, Italy (e-mail: )
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Zhou Y, Wang S, Xu L, Si J, Chen X. Implications of occlusal plane in diagnosis and treatment of malocclusion. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:237-242. [PMID: 37283109 DOI: 10.3724/zdxbyxb-2022-0694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Occlusal plane (OP) is one of the essential factors affecting craniofacial morphology and function. The OP not only assists in diagnosing malocclusion but also serves as an important reference for making treatment plans. Patients with different types of malocclusions have different forms of OP. Compared with patients with standard skeletal facial type, the occlusal plane of patients with skeletal class Ⅱ and high angle is steeper, while that of patients with skeletal class Ⅲ and low angle is more even. In orthodontic treatment, adjusting and controlling the OP can promote the normal growth and development of the mandible in most patients with malocclusion during the early stage of growth, while causing favorable rotation of the mandible in some adults with mild-to-moderate malocclusion. For moderate-to-severe malocclusion, the OP rotation by orthodontic-orthognathic treatment can achieve better long-term stability. This article reviews the evolution of the definition of OP and its implications for diagnosing and the guiding treatment of malocclusion.
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Affiliation(s)
- Yu Zhou
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University Cancer Center, Hangzhou 310006, China.
| | - Sijie Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University Cancer Center, Hangzhou 310006, China
| | - Lehan Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University Cancer Center, Hangzhou 310006, China
| | - Jiaping Si
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University Cancer Center, Hangzhou 310006, China
| | - Xiaoyan Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University Cancer Center, Hangzhou 310006, China.
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Assessment of mandibular retromolar space in adults with regard to third molar eruption status. Clin Oral Investig 2023; 27:671-680. [PMID: 36374353 DOI: 10.1007/s00784-022-04782-6] [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: 01/05/2022] [Accepted: 11/06/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to compare the difference in length and width of the mandibular retromolar space (RMS) stratified by the different eruption and impaction statuses of the third molars in patients with skeletal Class I malocclusion. MATERIALS AND METHODS The right mandibular RMS in 186 adult patients categorized according to the different statuses of the third molar was analyzed by using cone-beam computed tomography (CBCT). The shortest distances between the inner lingual cortex of the mandibular body and second molar root were measured parallel to the posterior occlusal line (POL) at depths of 2, 4, 6, 8, and 10 mm (mandibular retromolar space length in root level, RLin2,4,6,8,10) on the axial slices with the cementoenamel junction (CEJ) as the reference level. The width of the RMS and second molar root was measured vertical to the POL at the terminal point of the molar distalization at depths of 2, 4, 6, 8, and 10 mm (width of the mandibular retromolar space, BW2,4,6,8,10/ width of the second molar distal root, TW2,4,6,8,10) from the CEJ. RESULTS RL in different measurement planes was 2.72 ± 2.22 ~ 3.74 ± 2.26 for Group A, 5.27 ± 1.68 ~ 9.10 ± 2.04 for Group B, 1.94 ± 2.34 ~ 5.71 ± 4.37 for Group C, 1.83 ± 2.95 ~ 5.05 ± 4.24 for Group D, and 5.93 ± 3.97 ~ 10.52 ± 2.16 for Group E. The BW measurement results for A ~ E group were 9.71 ± 1.41 ~ 10.51 ± 1.81, 9.83 ± 1.39 ~ 12.55 ± 2.11, 9.96 ± 1.21 ~ 12.17 ± 1.62, 9.82 ± 1.47 ~ 12.28 ± 2.77, and 10.02 ± 1.20 ~ 12.75 ± 0.82, respectively. There was no significant difference between men and women in any measurements (P > 0.05). Patients with normal third molars erupted and those vertically impacted possessed larger RMS lengths than those in which the third molars were missing, horizontally impacted or mesially impacted (P < 0.05). In each measurement plane, TW was significantly smaller than BW (P < 0.05). CONCLUSIONS Sex had no effect on the length or width of the mandibular RMS. Different statuses of third molars can also differentially affect the mandibular RMS. The mandibular RMS width is not a limit for mandibular molar distalization. CLINICAL RELEVANCE When considering the distalization of mandibular molars, more attention should be directed to the lingual cortex of the mandible, and CBCT scans are recommended for patients who require significant mandibular molar distalization. The mandible buccal shelf and retromolar area maybe a safe zone to insert the miniscrew for molar distalization.
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Garg H, Ahluwalia R, Grewal SB, Pandey SK, Mahesh A, Saini N. Stainless steel vs. titanium miniscrew implants: Evaluation of stability during retraction of maxillary and mandibular anterior teeth. J Orthod Sci 2022; 11:49. [PMID: 36411809 PMCID: PMC9674937 DOI: 10.4103/jos.jos_198_21] [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: 12/22/2021] [Revised: 05/10/2022] [Accepted: 05/30/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES This study was aimed to compare the stability of stainless steel and titanium miniscrew implants of the same diameter and length during en masse retraction of maxillary and mandibular anterior teeth. MATERIALS AND METHODS Forty miniscrew implants (1.3 mm diameter and 8 mm length) were placed in 10 patients (20 titanium and 20 stainless steel). Stability was checked at insertion (T0), at one month (T1), and at sixth months (T2) and the amount of retraction was recorded in millimeters. RESULTS Titanium and stainless steel implants were equally stable at the time of insertion. At T1, three titanium miniscrew implants showed grade 2 mobility, whereas seven stainless steel miniscrew implants showed grade 2 mobility. For T2, none of the titanium miniscrew implants had grade 2 mobility while four stainless steel miniscrew implants resulted in grade 2 mobility. Both had an equal frequency of grade 3 and grade 4 mobility. However, the difference in the stability was not statistically significant. No statistical significance was found when the amount of retraction achieved by titanium and stainless steel miniscrew implants was compared between the maxillary and mandibular arches. CONCLUSION Both titanium and stainless steel miniscrew implants provide good anchorage and remain stable during en masse retraction of maxillary and mandibular anterior teeth. Thus, both miniscrews are clinically effective.
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Affiliation(s)
- Himanshu Garg
- Department of Dentistry, Government Institute of Medical Sciences, Greater Noida, India
| | - Rajiv Ahluwalia
- Department of Orthodontics and Dentofacial Orthopedics, Santosh Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Stutee Bali Grewal
- Grewal Dental Practice, Aster Avenue, Phase 4, DLF, Gurgaon, Haryana, India
| | - Sandeep Kumar Pandey
- Department of Dentistry, Government Institute of Medical Sciences, Greater Noida, India,Address for correspondence: Dr. Sandeep Kumar Pandey, Department of Dentistry, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India. E-mail:
| | - Ankit Mahesh
- Department of Orthodontics and Dentofacial Orthopedics, Santosh Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Nidhi Saini
- Department of Orthodontics and Dentofacial Orthopedics, Santosh Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
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Bono AE, Learreta J. Effects of an intraoral device (IOD) on electromyographic activity on the masseter and temporal muscles in Class III patients. Cranio 2022:1-10. [PMID: 35942847 DOI: 10.1080/08869634.2022.2106709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVE Class III malocclusion is characterized by a loss of vertical dimension associated with muscle imbalance. The present study was designed to determine electromyographic amplitude changes in temporal (T) and masseter (M) at rest and during clenching in Class III patients treated with an intraoral device (IOD) over a 24-hour period for 30 days with transcutaneous electrical nerve stimulation (TENS). METHODS Twelve patients with Class III (mean age 27.7 ± 1.2 years) were treated with TENS and IOD. Ten untreated patients composed the control group. Data were analyzed using Wilcoxon test and ANOVA. RESULTS Patients treated with TENS and IOD showed a marked decrease in hyperactivity of M and T at rest (p = 0.001) and an increase during clenching (p = 0.001). The control group maintained similar activity in both positions. CONCLUSION This study confirms that using TENS and IOD in patients improves muscle activity of T and M.
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Affiliation(s)
- Andrea E Bono
- Department of Orthodontics UNLP, Master Orthodontics UBA, National University of La Plata (UNLP), La Plata, Argentina
| | - Jorge Learreta
- Department of Dentistry and Dento-Facial Orthopedics, Nova Southeastern University, College of Medical Dentistry, Fort Lauderdale, FL, USA
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Fan Z, Zhang Q, Jiang Y, Qin Q, Huang S, Guo J. Mandibular retromolar space in adults with different sagittal skeletal patterns. Angle Orthod 2022; 92:483764. [PMID: 35849081 PMCID: PMC9374353 DOI: 10.2319/112021-854.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 04/01/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To analyze the mandibular retromolar space among normal-divergent adult patients with different sagittal skeletal patterns by cone-beam computed tomography (CBCT). MATERIALS AND METHODS CBCTs of a total of 120 normal-divergent adult patients were investigated. Patients were categorized into the following three groups according to their ANB angle: skeletal Class I (48 patients), skeletal Class II (36 patients), and skeletal Class III (36 patients). Four different planes parallel to the mandibular occlusal plane were used to measure the retromolar space. The retromolar space was measured by two reference lines and then compared between different sagittal skeletal patterns groups. The incidence of root contact with the inner lingual cortex was compared among the three groups. RESULTS The retromolar space of the Class III patients was significantly larger than that of Class I patients and Class II patients. Compared with Class I and Class III patients, Class II patients had a smaller retromolar space and higher incidence of contact with the inner cortex of the mandible. CONCLUSIONS Class III patients had a larger retromolar space than Class I patients and Class II patients in four different planes. The mandibular retromolar space should be evaluated by CBCT in patients who need mandibular molar distalization.
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Hui VLZ, Xie Y, Zhang K, Chen H, Han W, Tian Y, Yin Y, Han X. Anatomical limitations and factors influencing molar distalization. Angle Orthod 2022; 92:481994. [PMID: 35604682 PMCID: PMC9374358 DOI: 10.2319/092921-731.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/01/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To analyze the anatomical limitations and characteristics of maxillary and mandibular retromolar regions affecting molar distalization using cone-beam computed tomography (CBCT). MATERIALS AND METHODS A total of 120 qualifying patients were classified into equal groups of skeletal Class II and Class III and stratified by vertical growth pattern, age, sex, and third molar presence. The available distance along the axis of distalization and cortical bone thickness (CBT) were measured in the maxillary and mandibular retromolar regions of Class II and Class III patients, respectively. One-way analysis of variance was used to examine the effects of the factors on the measured data. RESULTS The minimum available distance of the Class II maxilla was observed at a level 3 mm from the cementoenamel junction (CEJ), while that of the Class III mandible was at a level 9 mm from the CEJ. The average available distance at the limit level was 4.06 ± 1.93 mm in the Class II maxilla, and the average corresponding CBT was 1.00 mm. The average available distance at the limit level in the Class III mandible was 2.80 ± 1.96 mm, and the corresponding CBT was 2.24 mm. In both skeletal Class II and Class III patients, hyperdivergent groups had the least available distance for molar distalization. CONCLUSIONS The limit for available distance in the Class II maxilla is closer to the coronal level, while that of the Class III mandible is closer to the apical level. A hyperdivergent growth pattern in a patient is indicative of less potential for molar distalization. Axial slices of CBCT images provide valuable evaluation for molar distalization regarding limit levels.
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Auladell A, De La Iglesia F, Quevedo O, Walter A, Puigdollers A. The efficiency of molar distalization using clear aligners and mini-implants: Two clinical cases. Int Orthod 2022; 20:100604. [PMID: 35039240 DOI: 10.1016/j.ortho.2021.100604] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/24/2021] [Accepted: 11/28/2021] [Indexed: 11/30/2022]
Abstract
When using clear aligners, if distalization greater than 3mm is required, there is no real predictable procedure to follow. The aim of this article is to show with two clinical cases the biomechanics of distalizing lower molars with mini-implant anchorage and aligners.
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Affiliation(s)
- Anna Auladell
- Department of Orthodontics, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.
| | - Fernando De La Iglesia
- Department of Orthodontics, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Oriol Quevedo
- Department of Orthodontics, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Andre Walter
- Department of Orthodontics, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Andreu Puigdollers
- Department of Orthodontics, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
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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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Sun Q, Lu W, Zhang Y, Peng L, Chen S, Han B. Morphological changes of the anterior alveolar bone due to retraction of anterior teeth: a retrospective study. Head Face Med 2021; 17:30. [PMID: 34271939 PMCID: PMC8284009 DOI: 10.1186/s13005-021-00277-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 06/23/2021] [Indexed: 11/21/2022] Open
Abstract
Backgroud To analyze the morphological changes of the anterior alveolar bone after the retraction of incisors in premolar extraction cases and the relationship between incisor retraction and remodeling of the alveolar base represented by points A and B displacements. Methods Pre- (T0) and post-treatment (T1) lateral cephalograms of 308 subjects in the maxilla and 154 subjects in the mandible who underwent the orthodontic treatment with extraction of 2 premolars in upper or lower arches were included. Alveolar bone width and height in both the maxillary and mandible incisor area were measured at T0 and T1 respectively. By superimposing the T0 and T1 cephalometric tracings, changes of points A and B, and the movement of the incisors were also measured. Then the correlation between incisor movement and the displacements of points A and B was analyzed. Results The alveolar bone width (ABW) showed a significant decrease in both maxilla and mandible (P < 0.001) except the labial side of the mandible (P > 0.05). The alveolar bone height (ABH) showed a significant increase in the labial side of maxilla and a significant decrease in the lingual side of maxilla and mandible. A strong positive correlation was verified between incisor movement and position changes of points A and B in both horizontal and vertical directions. Conclusions Anterior alveolar bone width and height generally decreased after orthodontic treatment. Incisor retraction led to significant position changes of points A and B. The decrease of anterior alveolar bone due to significant incisor retraction should be taken into account in treatment planning.
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Affiliation(s)
- Qiannan Sun
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Wenhsuan Lu
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Yunfan Zhang
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Liying Peng
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Si Chen
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.
| | - Bing Han
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.
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Comparison of the Stability of Sandblasted, Large-Grit, and Acid-Etched Treated Mini-Screws With Two Different Surface Roughness Values: A Histomorphometric Study. J Craniofac Surg 2021; 33:41-47. [PMID: 34267129 DOI: 10.1097/scs.0000000000007837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To evaluate the effects of 2 different surface roughness values produced by sandblasted, large-grit, and acid-etched treatments at different loading conditions on the stability of mini-screws. MATERIAL AND METHODS A total of 56 mini-screws (Group 1; 28 with Ra value of 1 μm, Group 2; 28 with Ra value of 1.5 μm) were inserted into the tibia of fourteen New Zealand rabbits. Surface analysis was performed before the placement of the miniscrews using multi-technique characterization. The mini-screws were loaded with 500 grf after different healing times: unloaded, immediate, 4 and 8 weeks. Resonance frequency analyses were performed immediately after mini-screw placement and at the end of loading. Biomechanical and histomorphometric analyses were also performed at the end of the loading period. RESULTS All mini-screws preserved their stability at the end of the loading period. However, the resonance frequency analyses showed higher implant stability quotient scores for 8-week group, unlike the immediate loading and unloaded groups (P < 0.05). According to the infinite focus microscopy results, prolongation of healing time resulted in a greater bone area on the loaded mini-screws in Group 2 (P < 0.05). Similarly, the histomorphometric analysis revealed higher bone-to-implant contact values in the 8-week group. There was no significant difference in the stability between the miniscrews with the Ra values of 1 and 1.5 μm. CONCLUSIONS Sandblasted, large-grit, and acid-etched treated mini-screws showed significantly higher stability with healing time under heavy forces. Sandblasted, large-grit, and acid-etched treated mini-screws can be removed without fracture of the screw or the bone surfaces.
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Zhao M, Wang P, Wang H, Li X, Bai D, Tian Y. Diagnostic and treatment protocol for a patient with temporomandibular disorder using a stabilization splint and temporary anchorage devices. Am J Orthod Dentofacial Orthop 2021; 159:666-681.e2. [PMID: 33653641 DOI: 10.1016/j.ajodo.2020.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 05/01/2020] [Accepted: 05/01/2020] [Indexed: 02/08/2023]
Abstract
Treatment of orthodontic patients with temporomandibular disorder (TMD) is challenging for orthodontists because of the TMD signs and symptoms and unstable mandible position, which may lead to improper diagnosis and treatment design. This case report presents a 22-year-old woman with proclined maxillary incisors and TMD. First, stabilization splint therapy was implemented to eliminate temporomandibular joint pain and to obtain the stable adapted centric posture. Subsequently, orthodontic treatment was initiated on the basis of a definitive diagnosis made from the postsplint records. Temporary anchorage devices were used to intrude maxillary molars and distalize the maxillary dental arch. Favorable soft tissue, skeletal, and dental relationship were accomplished after 12 months of comprehensive orthodontic treatment. Functional occlusion was established with teeth as well as vacuum-formed retainers. Excellent posttreatment stability was maintained after a 20-month retention.
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Affiliation(s)
- Mengyuan Zhao
- Institute of Dental Research, and Department of Orthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Peiqi Wang
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics and Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Hongzhe Wang
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics and Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xiaoqing Li
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Oral Anatomy and Physiology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ding Bai
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics and Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ye Tian
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics and Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Nonsurgical treatment of an adult with skeletal Class III malocclusion, anterior crossbite, and an impacted canine. Am J Orthod Dentofacial Orthop 2021; 159:522-535. [PMID: 33485716 DOI: 10.1016/j.ajodo.2020.01.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/01/2020] [Accepted: 01/01/2020] [Indexed: 10/22/2022]
Abstract
Class III malocclusion presents some complexity in terms of diagnosis and treatment and affects not only the jaws but the whole craniofacial complex. Besides, functional forward displacement of the mandible may be diagnosed in a patient presenting Class III malocclusion, as the 2 entities are not incompatible or mutually exclusive. This case report describes the multidisciplinary, nonsurgical, orthodontic treatment of an adult patient with a skeletal Class III malocclusion, anterior crossbite, and a palatally impacted canine, treated with fixed appliances and skeletal anchorage. To upright the mandibular molars, distalize the whole mandibular arch, and avoid excessive inclination of maxillary incisors to improve dentofacial esthetics, miniscrews were placed in the retromolar area. The treatment results were very satisfactory and remained stable after a reasonable retention period.
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19
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Zhao Z, Wang Q, Yi P, Huang F, Zhou X, Gao Q, Tsay TP, Liu C. Quantitative evaluation of retromolar space in adults with different vertical facial types. Angle Orthod 2020; 90:857-865. [PMID: 33378518 DOI: 10.2319/121219-787.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 06/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate the differences in mandibular retromolar space among skeletal Class I subjects with different vertical divergence using cone-beam computed tomography (CBCT). MATERIALS AND METHODS A total of 123 skeletal Class I patients (aged 20-40 years) were categorized into hypodivergent, normodivergent, and hyperdivergent groups based on S-N/Go-Me and facial height index (FHI). Mandibular retromolar space was measured at four planes parallel to the occlusal plane along the sagittal line and molar cuspal line, respectively. The mandibular retromolar space was compared among the three vertical groups. RESULTS The hyperdivergent group had a significantly smaller mandibular retromolar space compared with the other two groups, while the hypodivergent group had the largest retromolar space. In addition, the hyperdivergent group had a larger number of subjects whose roots contacted the lingual cortex of the mandibular body. CONCLUSIONS The hyperdivergent group tends to exhibit the smallest mandibular retromolar space and highest risk of cortex contact. Clinicians should keep in mind that successful molar distalization requires sufficient retromolar space, especially for hyperdivergent subjects, which should be verified with CBCT.
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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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21
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Management of the Vertical Dimension in the Camouflage Treatment of an Adult Skeletal Class III Malocclusion. Case Rep Dent 2020; 2020:8854588. [PMID: 32850154 PMCID: PMC7441420 DOI: 10.1155/2020/8854588] [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: 06/10/2020] [Revised: 07/08/2020] [Accepted: 07/23/2020] [Indexed: 11/26/2022] Open
Abstract
Treating skeletal class III malocclusions is one of the biggest challenges in Orthodontics. Given the complexity of these cases, orthognathic surgery is often the best treatment option. However, many patients refuse this treatment due to its risks, morbidity, and costs involved. Alternatively, dental compensation can be planned for some of these skeletal problems. This case report presents a dentoalveolar compensation in the orthodontic treatment of a 20-year-old female patient with class III malocclusion, concave profile, anterior crossbite, mandibular prognathism, maxillary retrusion, and a vertical deficiency in the posterior region. Treatment planning involved a multiloop edgewise archwire (MEAW) associated with intermaxillary elastics with counterclockwise rotation of the occlusal plane in the posterior region of the maxilla aiming at obtaining an increased posterior vertical dimension. After 24 months of treatment, the severe anterior crossbite was corrected, and the skeletal class III relationship was camouflaged. At the end of the orthodontic treatment, it was possible to observe an improved facial profile, a nice smile, and a functional occlusion. The results remained stable at a three-year follow-up. The MEAW, associated with the use of elastics, seems to be an effective treatment option for class III camouflage with reduced posterior vertical dimension with no need for additional anchoring devices but requiring adequate bending of wires and patient compliance.
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Jang W, Shin C, Hwang S, Kim KH, Jackson T, Nguyen T, Chung CJ. Nonsurgical treatment of an adult with a skeletal Class III malocclusion combined with a functional anterior shift, severely overclosed vertical dimension, and a reverse smile. Am J Orthod Dentofacial Orthop 2020; 157:561-570. [PMID: 32241363 DOI: 10.1016/j.ajodo.2019.01.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 12/01/2018] [Accepted: 01/01/2019] [Indexed: 11/16/2022]
Abstract
This case report illustrates the successful nonsurgical treatment of an adult with a skeletal Class III malocclusion exacerbated by a functional anterior shift that resulted in a severe overclosure of the mandible and a reverse smile line. To maximize the soft tissue and smile esthetics while idealizing the occlusion, active clockwise rotation of the mandible was induced along with mandibular molar uprighting and sequential leveling. In the maxilla, full arch distalization was achieved after second molar extraction. The treatment provided a satisfying esthetic and functional outcome and has remained stable.
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Affiliation(s)
- Woowon Jang
- Department Orthodontics, Gangnam Severance Hospital, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Cheolhong Shin
- Department Orthodontics, Gangnam Severance Hospital, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Soonshin Hwang
- Department Orthodontics, Gangnam Severance Hospital, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Kyung-Ho Kim
- Department Orthodontics, Gangnam Severance Hospital, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Tate Jackson
- Department of Orthodontics, University of North Carolina School of Dentistry, Chapel Hill, NC
| | - Tung Nguyen
- Department of Orthodontics, University of North Carolina School of Dentistry, Chapel Hill, NC
| | - Chooryung J Chung
- Department Orthodontics, Gangnam Severance Hospital, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea; Department of Orthodontics, University of North Carolina School of Dentistry, Chapel Hill, NC.
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Liu H, Wu X, Tan J, Li X. Safe regions of miniscrew implantation for distalization of mandibular dentition with CBCT. Prog Orthod 2019; 20:45. [PMID: 31814037 PMCID: PMC6900385 DOI: 10.1186/s40510-019-0297-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/01/2019] [Indexed: 12/04/2022] Open
Abstract
Background To assess the anatomy of the mandibular buccal shelf (MBS) with cone-beam computed tomography (CBCT) and to identify the region of miniscrew implantation for the distalization of mandibular dentition. Materials and methods The MBS was assessed in 80 patients at four regions as follows: (i) between the buccal root of the mandibular second premolar and the mesiobuccal root of the first molar (L5b–L6mb), (ii) between the mesiodistal root of the first molar (L6mb–L6db), (iii) between the distobuccal root of the first molar and the mesiobuccal root of the second molar (L6db–L7mb), and (iv) between the mesiodistal roots of the second molar (L7mb–L7db). The buccal alveolar bone thickness, the narrowest inter-radicular space at the buccal side of the roots, and the distance between the implantation site and the mandibular neural tube were measured at horizontal planes of 3, 5, 7, and 9 mm from the alveolar crest. Results The buccal alveolar bone thickness increased from the premolar to the molar and from the crest edge to the mandibular roots. The L7mb–L7db region had the thickest buccal alveolar bone of 7.61 mm at a plane of 9 mm. The buccal inter-radicular spaces were smallest in the L7mb–L7db region and greatest in the L6db–L7mb region. The distances from the implantation site to the mandibular neural tube at planes of 3, 5, 7, and 9 mm were all > 13 mm from the L6 region to the L7 region. Conclusions The L6db–L7mb region should be the first choice for miniscrew implantation in the MBS for the distalization of mandibular dentition.
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Affiliation(s)
- Haibo Liu
- Department of Stomatology, General Hospital of Southern Theater Command of the Chinese People's Liberation Army (Guangzhou Liuhuaqiao Hospital), No.111, Liuhua road, Guangzhou, 510016, Guangdong, China
| | - Xiaoxue Wu
- Department of Orthodontics, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510140, Guangdong, China
| | - Jun Tan
- Department of Stomatology, General Hospital of Southern Theater Command of the Chinese People's Liberation Army (Guangzhou Liuhuaqiao Hospital), No.111, Liuhua road, Guangzhou, 510016, Guangdong, China
| | - Xiao Li
- Department of Stomatology, General Hospital of Southern Theater Command of the Chinese People's Liberation Army (Guangzhou Liuhuaqiao Hospital), No.111, Liuhua road, Guangzhou, 510016, Guangdong, China.
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Effects of Twin Inclined Plane Device on Adaptation and Ultrastructure Variations in Condyle of Growing Rats. BIOMED RESEARCH INTERNATIONAL 2019; 2019:3069347. [PMID: 31815128 PMCID: PMC6877931 DOI: 10.1155/2019/3069347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/21/2019] [Accepted: 10/23/2019] [Indexed: 11/17/2022]
Abstract
Objective This study investigates the effects of using a twin inclined plane device (TIPD) on the remolding and ultrastructure variation of mandibular condyle in growing rats. Materials and Methods Forty-eight male Wistar rats (six weeks old, body weight of approximately 190–210 g) were divided into experimental group (wearing appliance, n = 32) and control group (no appliance, n = 16). Samples were collected on days 3, 14, 30, and 60. The immunohistochemical analysis for vascular endothelial growth factor (VEGF) and type II collagen was carried out. Tartrate-resistant acid phosphatase (TRAP) reaction was performed to evaluate the osteoclastic activity. Three-dimensional morphometric images were reconstructed for morphometric analysis by microcomputed tomography (micro-CT). The ultrastructure of the condylar surface was observed by scanning electron microscopy (SEM). Results The expression of VEGF significantly increased, while the expression of type II collagen decreased in the experimental group at days 30 and 60. Furthermore, the enhanced osteoclast activity was observed under the subchondral bone, which was highest at day 30, and decreased to the lowest at day 60 in the experimental group. In addition, adaptive subchondral bone remolding in the posterior part of the condyle was observed at day 60 in the experimental group, and the SEM revealed the ultrastructure variations after installation of the TIPD. However, these changes began to reverse after 30 days. Conclusion Condylar tissue changes point to the osteoclastic activity in the posterior region of the condyle. These adaptive changes point to bone resorption in the posterior condyle. Type II collagen and VEGF contribute to the MCC remolding induced by the TIPD. The ultrastructural changes in the posterior condylar area in response to mechanical stresses are recoverable at the initial stage.
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Dhar S. Camouflage of Skeletal Class III Malocclusion in an Adult Male Using Miniscrew Anchorage From the External Oblique Ridge in Conjunction With Face Mask Wear. JOURNAL OF INDIAN ORTHODONTIC SOCIETY 2019. [DOI: 10.1177/0301574219865358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This article reports the successful camouflage of skeletal Class III malocclusion in a 20-year-old man through distalization of the mandibular dentition using miniscrew anchorage from the external oblique ridges of the mandible. In addition, maxillary face mask wear assisted in the closure of maxillary spacing without retroclination of maxillary incisors. This combination may be effective in the management of adult Class III skeletal malocclusions that are amenable to camouflage therapy.
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Aslan BI, Küçükkaraca E. Nonextraction Treatment of a Class III Malocclusion Case Using Mini-Screw-Assisted Lower Molar Distalization. Turk J Orthod 2019; 32:119-124. [PMID: 31294416 DOI: 10.5152/turkjorthod.2018.18026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/02/2018] [Indexed: 11/22/2022]
Abstract
Mini-screw assisted lower molar distalization was planned for a present mild Class III malocclusion case. Two mini-screws were inserted into the available inter-root area: one on the left, and the other on the right side in the posterior region in the mandible. Distalization of lower molars, premolars and canines were achieved. Orthodontic treatment lasted approximately 2.5 years with 1 year of molar distalization. Minimal relapse was seen in the postretention period. Dentoalveolar changes with mini-screw assisted lower molar distalization are reported in the present case.
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Affiliation(s)
- Belma Işık Aslan
- Department of Orthodontics, Gazi University School of Dentistry, Ankara, Turkey
| | - Ebru Küçükkaraca
- Department of Orthodontics, Dr. Rıdvan Ege Training and Research Hospital, Ankara, Turkey
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Oliveira DD, Brito ADA, Pantuzo MCG, Freitas LRP, Palomo L, Soares RV. Combining planned 3rd molar extractions with corticotomy and miniplate placement to reduce morbidity and expedite treatment. A case report with 3.5-year follow up. Semin Orthod 2019. [DOI: 10.1053/j.sodo.2019.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chae JM, Park JH, Kojima Y, Tai K, Kook YA, Kyung HM. Biomechanical analysis for total distalization of the mandibular dentition: A finite element study. Am J Orthod Dentofacial Orthop 2019; 155:388-397. [DOI: 10.1016/j.ajodo.2018.05.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 05/01/2018] [Accepted: 05/01/2018] [Indexed: 11/28/2022]
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Kim YB, Bayome M, Park JH, Lim HJ, Mo S, Lee NK, Kook Y. Displacement of mandibular dentition during total arch distalization according to locations and types of
TSAD
s: 3D Finite element analysis. Orthod Craniofac Res 2018; 22:46-52. [DOI: 10.1111/ocr.12256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 10/27/2018] [Accepted: 10/29/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Yu B. Kim
- Graduate schoolThe Catholic university of Korea Seoul Korea
| | - Mohamed Bayome
- Department of Preventive Dental SciencesCollege of DentistryKing Faisal University Al‐Hufof Saudi Arabia
| | - Jae H. Park
- Arizona School of Dentistry & Oral HealthA.T. Still University Mesa Arizona
- Graduate School of DentistryKyung Hee University Seoul Korea
| | - Hee J. Lim
- Department of OrthodonticsSeoul St. Mary's HospitalCollege of MedicineThe Catholic University of Korea Seoul Korea
| | - Sung‐Seo Mo
- Department of DentistrySt. Paul’s HospitalCollege of MedicineThe Catholic University of Korea Seoul Korea
| | - Nam K. Lee
- Department of OrthodonticsSection of DentistrySeoul National University Bundang HospitalSeongnam Gyeonggi Province Korea
| | - Yoon‐Ah Kook
- Department of OrthodonticsSeoul St. Mary's HospitalCollege of MedicineThe Catholic University of Korea Seoul Korea
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Kim DH, Sung SJ. Nonsurgical correction of a Class III skeletal anterior open-bite malocclusion using multiple microscrew implants and digital profile prediction. Am J Orthod Dentofacial Orthop 2018; 154:283-293. [PMID: 30075930 DOI: 10.1016/j.ajodo.2017.03.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 02/01/2017] [Accepted: 02/01/2017] [Indexed: 10/28/2022]
Abstract
A 20-year-old woman had a severe anterior skeletal open bite and a moderate skeletal Class III relationship with a prognathic mandible and a straight profile. She declined surgery. However, molar intrusion in a Class III patient with a straight profile can cause forward mandibular rotation and deterioration of the profile to a concave pattern. We used digital facial profile prediction software to determine whether the orthodontic compensation treatment would be acceptable to the patient. The final treatment plan consisted of extraction of the third molars, maxillary molar intrusion, and total distalization of the mandibular dentition with multiple microscrew implants. The patient cooperated with the use of Class III interarch elastics. The active treatment period was 20 months. Proper overbite and overjet, good occlusion, and an acceptable facial profile were achieved.
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Affiliation(s)
- Do-Hoon Kim
- Private practice, Seoul, Korea; Division of Orthodontics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
| | - Sang-Jin Sung
- Division of Orthodontics, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
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Chang CCH, Lin JSY, Yeh HY. Extra-Alveolar Bone Screws for Conservative Correction of Severe Malocclusion Without Extractions or Orthognathic Surgery. Curr Osteoporos Rep 2018; 16:387-394. [PMID: 29959724 DOI: 10.1007/s11914-018-0465-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Evaluate management of challenging malocclusions conservatively (no extractions or orthognathic surgery). RECENT FINDINGS Most malocclusions have a predominately environmental etiology. Optimal esthetics and function are restored by aligning the dentition over the apical base of bone at the appropriate vertical dimension of occlusion (VDO). Extra-alveolar (E-A) anchorage is achieved at three intraoral sites: mandibular buccal shelf (MBS), infrazygomatic crest (IZC), and anterior ramus. MBS and IZC bone screws effectively anchor the conservative correction of severe dental and skeletal malocclusions. All bone screw sites are effective for anchoring lever arms to recover impacted teeth. Rather than extracting teeth, E-A anchorage corrects crowding by retracting the posterior segments to increase arch length. Skeletal malocclusion is corrected by aligning teeth over the apical base of bone and restoring the VDO by retracting and posteriorly rotating the dental arches as segments. Challenging dental and skeletal malocclusions can be treated routinely via determinate mechanics anchored with E-A bone screws.
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Affiliation(s)
- Chris C H Chang
- Beethoven Orthodontic Center, No. 6, Ln.59, Jiangong 1st Rd., East Dist, Hsinchu City, 300, Taiwan.
| | - Joshua S Y Lin
- Beethoven Orthodontic Center, No. 6, Ln.59, Jiangong 1st Rd., East Dist, Hsinchu City, 300, Taiwan
| | - H Y Yeh
- Beethoven Orthodontic Center, No. 6, Ln.59, Jiangong 1st Rd., East Dist, Hsinchu City, 300, Taiwan
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Elshebiny T, Palomo JM, Baumgaertel S. Anatomic assessment of the mandibular buccal shelf for miniscrew insertion in white patients. Am J Orthod Dentofacial Orthop 2018; 153:505-511. [PMID: 29602342 DOI: 10.1016/j.ajodo.2017.08.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 08/01/2017] [Accepted: 08/01/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Cortical bone thickness, bone width, insertion depth, and proximity to nerves are important factors when planning and placing orthodontic miniscrews. The objective of this study was to anatomically assess the mandibular buccal shelf in a white patient population as the insertion site for orthodontic miniscrews by investigating these 4 variables. METHODS Measurements were made on cone-beam computed tomography scans of 30 white patients (18 girls, 12 boys; mean age, 14.5 ± 2 years). All measurements were taken adjacent to the distobuccal cusp of the first molar, and the mesiobuccal and distobuccal cusps of the second molar. Additionally, bone depth was measured at 2 height levels, 4 and 8 mm from the cementoenamel junction. Stereolithographic models of patients were superimposed on the cone-beam computed tomography volumes to virtually create an outline of the soft tissue on the cone-beam computed tomography image to allow identification of the purchase point height (mucogingival junction). The inferior alveolar nerve was digitally traced. Miniscrews (1.6 × 10 mm) were virtually placed at the buccal shelf, and their insertion depths and relationships to the nerve were assessed. Analysis of variance with post hoc analysis was used for data analysis. RESULTS Insertion sites and measurement levels had significant impacts on both cortical bone thickness and bone width. Cortical bone thickness was typically greatest at the distobuccal cusp of the second molar. Bone width was also greatest at the distobuccal cusp of the second molar 8 mm from the cementoenamel junction. The greatest insertion depth was found again at the distobuccal cusp to the second molar, whereas the miniscrews had the greatest proximity to the nerve at this site also. CONCLUSIONS The distobuccal cusp level of the mandibular second molar is the most appropriate site for miniscrew insertion at the buccal shelf in white patients.
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Affiliation(s)
- Tarek Elshebiny
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Juan Martin Palomo
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Sebastian Baumgaertel
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio.
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Kim H, Cha KS. Evaluation of the stability of maxillary expansion using cone-beam computed tomography after segmental Le Fort I osteotomy in adult patients with skeletal Class III malocclusion. Korean J Orthod 2018; 48:63-70. [PMID: 29423378 PMCID: PMC5799308 DOI: 10.4041/kjod.2018.48.1.63] [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] [Received: 10/20/2017] [Revised: 12/29/2017] [Accepted: 12/29/2017] [Indexed: 11/10/2022] Open
Abstract
Objective The aim of this study is to quantitatively evaluate the stability of the skeletal and dental widths using cone-beam computed tomography (CBCT) after segmental Le Fort I osteotomy in adult patients with skeletal Class III malocclusion requiring maxillary expansion. Methods In total, 25 and 36 patients with skeletal Class III malocclusion underwent Le Fort I osteotomy (control group) and segmental Le Fort I osteotomy (experimental group), respectively. Coronal CBCT images were used to measure the dental and skeletal widths before (T1) and after (T2) surgery and at the end of treatment (T3). The correlation between the extent of surgery and the amount of relapse in the experimental group was also determined. Results In the control group, the dental width exhibited a significant decrease of 0.70 ± 1.28 mm between T3 and T2. In the experimental group, dental and skeletal expansion of 1.83 ± 1.66 and 2.55 ± 1.94 mm, respectively, was observed between T2 and T1. The mean changes in the dental and skeletal widths between T3 and T2 were -1.41 ± 1.98 and -0.67 ± 0.72 mm, respectively. There was a weak correlation between the amount of skeletal expansion during segmental Le Fort I osteotomy and the amount of postoperative skeletal relapse in the experimental group. Conclusions Maxillary expansion via segmental Le Fort I osteotomy showed good stability, with a skeletal relapse rate of 26.3% over approximately 12 months. Our results suggest that a greater amount of expansion requires greater efforts for the prevention of relapse.
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Affiliation(s)
| | - Kyung-Suk Cha
- Department of Orthodontics, Dankook University College of Dentistry, Cheonan, Korea
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Choi YT, Kim YJ, Yang KS, Lee DY. Bone availability for mandibular molar distalization in adults with mandibular prognathism. Angle Orthod 2017; 88:52-57. [PMID: 28949768 DOI: 10.2319/040617-237.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To investigate the retromolar space available for molar distalization in patients with mandibular prognathism. MATERIALS AND METHODS Using cone-beam computed tomography, the posterior mandibular dimensions in 110 consecutive patients with Class I or Class III malocclusion were measured (mean age, 27.0 ± 7.1 years). The shortest linear distances from the distal root of the right mandibular second molar to the inner border of the mandibular cortex were measured at the level of root furcation and 2, 4, and 6 mm apical to the furcation along the sagittal line and the posterior line of occlusion. The retromolar distances were compared between the Class I and Class III malocclusion groups using general linear mixed models. RESULTS The retromolar space measured through the sagittal line showed no significant intergroup difference. Among the distances measured through the posterior line of occlusion, the space measured at depths 0 and 2 mm to the furcation were significantly greater in the Class III group than in the Class I group. CONCLUSIONS Patients with Class III malocclusion have greater retromolar space for mandibular molar distalization along the posterior line of occlusion only at the level of the second molar furcation.
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Nakamura M, Kawanabe N, Kataoka T, Murakami T, Yamashiro T, Kamioka H. Comparative evaluation of treatment outcomes between temporary anchorage devices and Class III elastics in Class III malocclusions. Am J Orthod Dentofacial Orthop 2017; 151:1116-1124. [PMID: 28554457 DOI: 10.1016/j.ajodo.2016.10.040] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 10/01/2016] [Accepted: 10/01/2016] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Our objective was to elucidate the differences in treatment outcomes caused by the different mechanics of temporary anchorage devices (TADs) and Class III elastics in patients with Class III malocclusions. METHODS Records of 23 patients with Angle Class III malocclusion were selected retrospectively. All had been treated with nonextraction comprehensive orthodontic treatment; 11 were treated with TADs and 12 with Class III elastics. Pretreatment and posttreatment lateral cephalograms were used for evaluation of the treatment outcomes. A paired t test and a Student t test were used for statistical analysis. RESULTS In both groups, proper overjet and Class I molar relationships were achieved, and the occlusal plane was rotated counterclockwise. In the elastics group, distal tipping of the mandibular molars, extrusion of the mandibular incisors and maxillary molars, clockwise rotation of the mandibular plane angle, and increased ANB angle were observed. In the TADs group, distal tipping and intrusion of the mandibular molars, bodily movement of the mandibular incisors, and reduced mandibular plane angle were observed. CONCLUSIONS In nonextraction treatment for Class III malocclusions, the mandibular plane angle was increased in the elastics group, whereas it was decreased in TADs group. Thus, we suggest that Class III elastics are preferred for low-angle, short-face patients, whereas TADs are preferred for high-angle, long-face patients.
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Affiliation(s)
- Masahiro Nakamura
- Department of Orthodontics, Okayama University Hospital, Okayama, Japan.
| | - Noriaki Kawanabe
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hospital, Okayama, Japan.
| | - Tomoki Kataoka
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hospital, Okayama, Japan
| | - Takashi Murakami
- Department of Orthodontics, Okayama University Hospital, Okayama, Japan
| | - Takashi Yamashiro
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Okayama University Hospital, Okayama, Japan
| | - Hiroshi Kamioka
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hospital, Okayama, Japan
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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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Jo AR, Mo SS, Lee KJ, Sung SJ, Chun YS. Finite-element analysis of the center of resistance of the mandibular dentition. Korean J Orthod 2016; 47:21-30. [PMID: 28127536 PMCID: PMC5266128 DOI: 10.4041/kjod.2017.47.1.21] [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: 01/14/2016] [Revised: 07/01/2016] [Accepted: 07/05/2016] [Indexed: 11/16/2022] Open
Abstract
Objective The aim of this study was to investigate the three-dimensional (3D) position of the center of resistance of 4 mandibular anterior teeth, 6 mandibular anterior teeth, and the complete mandibular dentition by using 3D finite-element analysis. Methods Finite-element models included the complete mandibular dentition, periodontal ligament, and alveolar bone. The crowns of teeth in each group were fixed with buccal and lingual arch wires and lingual splint wires to minimize individual tooth movement and to evenly disperse the forces onto the teeth. Each group of teeth was subdivided into 0.5-mm intervals horizontally and vertically, and a force of 200 g was applied on each group. The center of resistance was defined as the point where the applied force induced parallel movement. Results The center of resistance of the 4 mandibular anterior teeth group was 13.0 mm apical and 6.0 mm posterior, that of the 6 mandibular anterior teeth group was 13.5 mm apical and 8.5 mm posterior, and that of the complete mandibular dentition group was 13.5 mm apical and 25.0 mm posterior to the incisal edge of the mandibular central incisors. Conclusions Finite-element analysis was useful in determining the 3D position of the center of resistance of the 4 mandibular anterior teeth group, 6 mandibular anterior teeth group, and complete mandibular dentition group.
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Affiliation(s)
- A-Ra Jo
- Department of Orthodontics, Graduate School of Clinical Dental Science, The Catholic University of Korea, Seoul, Korea
| | - Sung-Seo Mo
- Division of Orthodontics, Department of Dentistry, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kee-Joon Lee
- Department of Dentistry, Yonsei University, Seoul, Korea
| | - Sang-Jin Sung
- Division of Orthodontics, Department of Dentistry, Asan Medical Center, Seoul, Korea
| | - Youn-Sic Chun
- Department of Orthodontics, Ewha Womans University Mokdong Hospital, Seoul, Korea
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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: 15] [Impact Index Per Article: 1.9] [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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Asymmetric molar distalization with miniscrews to correct a severe unilateral Class III malocclusion. Am J Orthod Dentofacial Orthop 2016; 149:729-39. [PMID: 27131255 DOI: 10.1016/j.ajodo.2015.07.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 07/01/2015] [Accepted: 07/01/2015] [Indexed: 11/20/2022]
Abstract
Asymmetries are among the most challenging problems in orthodontics. Proper diagnosis is critical to discern first whether the asymmetry is dental or skeletal. If it is dental, one must then determine whether one dental arch or both are at fault. Once diagnosed, the next challenge is determining not only an appropriate treatment plan, but also the appropriate mechanics plan. This aim of this article is to present a patient with a severe asymmetry to emphasize the importance of a problem-based differential diagnosis to develop both a sound treatment plan and a mechanics plan that successfully integrates miniscrews from the start of the process. An 18-year-old woman had a Class III subdivision left malocclusion, an asymmetric lower facial third, and a deviated midline. The treatment plan consisted of asymmetric distalization of the maxillary right and mandibular left posterior dentitions to create space to resolve the deviated midlines, correct the canted occlusal plane, and obtain an ideal occlusion. Active treatment with Clarity ceramic 0.022 × 0.028-in appliances (3M Unitek, Monrovia, Calif), temporary anchorage devices, and a pendulum appliance lasted 22 months. The final result and the 2-year retention records demonstrate that a harmonious facial balance, an attractive smile, ideal occlusal relationships, and a stable outcome were achieved. This case report shows that with proper planning, asymmetric use of temporary anchorage devices in multiple posterior quadrants can be used to obtain molar distalization, and this approach is an effective alternative to dental extraction therapy.
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Biology of biomechanics: Finite element analysis of a statically determinate system to rotate the occlusal plane for correction of a skeletal Class III open-bite malocclusion. Am J Orthod Dentofacial Orthop 2015; 148:943-55. [DOI: 10.1016/j.ajodo.2015.10.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 10/01/2015] [Accepted: 10/01/2015] [Indexed: 11/22/2022]
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Dental compensation for skeletal Class III malocclusion by isolated extraction of mandibular teeth. Part 1: Occlusal situation 12 years after completion of active treatment. J Orofac Orthop 2015; 76:251-64. [PMID: 25929712 DOI: 10.1007/s00056-015-0287-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The purpose of this work was to statistically evaluate the outcomes achieved by isolated extraction of mandibular teeth (second premolars or first molars) for Class III compensation. MATERIALS AND METHODS Part A of the study dealt with the quality of outcomes at the end of active treatment, using weighted Peer Assessment Rating (PAR) scores determined on the basis of casts for 25 (14 female and 11 male) consecutive patients aged 16 ± 1.7 years at the time of debonding. These results were compared to the scores in a randomly selected control group of 25 (14 female and 11 male) patients who were 14.7 ± 1.9 years old at debonding. Part B evaluated the long-term stability of the outcomes based on 12 (all of them female) patients available for examination after a mean of 11.8 years. The mean weighted PAR scores obtained in both study parts were analyzed for statistical differences using a two-tailed paired Student's t-test at a significance level of p ≤ 0.05. RESULTS Mean weighted PAR scores of 4.76 ± 3.94 and 3.92 ± 3.44 were obtained in the Class III extraction group and the control group, respectively, at the end of active treatment. This difference was not significant (p = 0.49). Among the 12 longitudinal patients, the mean score increased from 4 ± 3.46 at debonding to 6.25 ± 3.67 by the end of the 11.8-year follow-up period. This difference was significant (p = 0.0008). CONCLUSION Treatment of Class III anomalies by isolated extraction of lower premolars or molars can yield PAR scores similar to those achieved by standard therapies. These scores, while increasing significantly, remained at a clinically acceptable level over 11.8 years. Hence this treatment modality--intended for cases that border on requiring orthognathic surgery--may also be recommended from a long-term point of view.
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Konermann A, Appel T, Wenghoefer M, Sirokay S, Dirk C, Jäger A, Götz W. Impact of radiation history, gender and age on bone quality in sites for orthodontic skeletal anchorage device placement. Ann Anat 2014; 199:67-72. [PMID: 25271067 DOI: 10.1016/j.aanat.2014.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 07/22/2014] [Accepted: 08/13/2014] [Indexed: 11/18/2022]
Abstract
AIMS Stability of orthodontic miniscrew implants is prerequisite to their success and durability in orthodontic treatment. As investigations revealed a positive correlation of miniscrew stability to periimplant bone quality, it has been the aim of this study to analyze the bone structure of resection preparations of human mandibles histologically by investigating the samples according to age, gender and exposure to radiotherapy. METHODS Inflammation- and tumor-free alveolar bone sections from human mandibles (n = 31) with previously diagnosed carcinoma, chronic osteomyelitis or cysts were analyzed histomorphologically and histomorphometrically as to the dimension of trabeculae in cancellous areas. Group A investigated the impact of a history of radiation therapy, group B of gender and group C contrasted biopsies from individuals aging under 60 or over 60 years. Statistics were performed using the Kruskal-Wallis-test. RESULTS Radiation, gender and age did not significantly influence bone density. The mean bone density averaged 40.7 ± 15.0% of spongiosa for the total collective with a median age of 58.4 years ± 14.7 years. CONCLUSIONS Our findings provide new information on bone quality, thus contributing to a more precise evaluation of the parameters affecting and those not affecting miniscrew implant stability. On the basis of these results, the formulation of clinical guidelines for risk assessment of therapeutic approaches in patients prior to insertion of orthodontic skeletal anchorage devices seems to be conceivable.
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Affiliation(s)
- A Konermann
- Department of Orthodontics, University of Bonn, Bonn, Germany.
| | - T Appel
- Department of Oral and Maxillofacial Surgery, University of Bonn, Bonn, Germany
| | - M Wenghoefer
- Department of Oral and Maxillofacial Surgery, University of Bonn, Bonn, Germany
| | - S Sirokay
- Private Dental Practice, Alfter, Germany
| | - C Dirk
- Endowed Chair of Oral Technology, University of Bonn, Bonn, Germany
| | - A Jäger
- Department of Orthodontics, University of Bonn, Bonn, Germany
| | - W Götz
- Department of Orthodontics, University of Bonn, Bonn, Germany
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Camouflage treatment of severe skeletal Class III malocclusion with miniscrew anchorage. J World Fed Orthod 2014. [DOI: 10.1016/j.ejwf.2014.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Seo YJ, Chung KR, Kim SH, Nelson G. Camouflage treatment of skeletal class III malocclusion with asymmetry using a bone-borne rapid maxillary expander. Angle Orthod 2014; 85:322-34. [PMID: 25032737 DOI: 10.2319/031314-189.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This case report presents the successful use of palatal mini-implants for rapid maxillary expansion and mandibular distalization in a skeletal Class III malocclusion. The patient was a 13-year-old girl with the chief complaint of facial asymmetry and a protruded chin. Camouflage orthodontic treatment was chosen, acknowledging the possibility of need for orthognathic surgery after completion of her growth. A bone-borne rapid expander (BBRME) was used to correct the transverse discrepancy and was then used as indirect anchorage for distalization of the lower dentition with Class III elastics. As a result, a Class I occlusion with favorable inclination of the upper teeth was achieved without any adverse effects. The total treatment period was 25 months. Therefore, BBRME can be considered an alternative treatment in skeletal Class III malocclusion.
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Affiliation(s)
- Yu-Jin Seo
- a Clinical Fellow, Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, South Korea
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