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Poghosyan D, Grigoryan D, Ter-Poghosyan D, Gunaveerasekaran G, Dara S, Ter-Poghosyan H. The efficiency of a customized distalizer with Variety SP® screws anchored on palatal miniscrews for upper molar distalization. Dental Press J Orthod 2024; 29:e2423253. [PMID: 38865515 PMCID: PMC11163959 DOI: 10.1590/2177-6709.29.2.e2423253.oar] [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: 11/29/2023] [Accepted: 03/25/2024] [Indexed: 06/14/2024] Open
Abstract
OBJECTIVE To assess the effectiveness of a customized distalizer with Variety SP® screws anchored on palatal miniscrews for upper molar distalization. METHODS Seventeen patients aged between 12.5 and 24 years underwent distalization with a customized distalizer. Lateral cephalogram and cast analysis were performed before and after distalization. Linear and angular parameters of the upper first molar, first premolar, and central incisor were assessed. RESULTS Distalization with the force passing near the center of resistance (CRes) of the upper first molars resulted in distal movement, with minimal distal tipping (2.8 ± 0.45°, p< 0.05). However, distalization passing occlusal to the CRes led to greater distal tipping (13.6 ± 1.63°, p< 0.05). Statistically significant spontaneous distal tipping and distal movement of the upper first premolars occurred, with a mean of 6.2 ± 1.24° (p< 0.05) and 0.68 ± 0.34 mm (p< 0.05), respectively. The positional change of the upper central incisors presented a mean of -0.23 ± 0.1 mm (p> 0.05) and 2.65 ± 1.1° (p< 0.05). Upper first molar intrusion was statistically significant, with a mean of 0.88 ± 0.2 mm (p< 0.05). Upper right and left first molars rotation towards palatal midline presented mean of 4.1 ± 0.19° (p< 0.05) and 3.4 ± 0.1° (p< 0.05), respectively. Additionally, the distance between upper right and left first molars increased significantly, with a mean of 2.54 ± 0.01 mm (p< 0.05). CONCLUSION The study successfully demonstrated the efficiency of molar distalization without anchorage loss using a customized distalizer anchored on palatal miniscrews.
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Affiliation(s)
- Davit Poghosyan
- Yerevan State Medical University, Department of Pediatric Dentistry and Orthodontics (Yerevan, Armenia)
| | - Davit Grigoryan
- Yerevan State Medical University, Department of Pediatric Dentistry and Orthodontics (Yerevan, Armenia)
| | - Diana Ter-Poghosyan
- Yerevan State Medical University, Department of Pediatric Dentistry and Orthodontics (Yerevan, Armenia)
| | - Gokulraj Gunaveerasekaran
- Yerevan State Medical University, Department of Pediatric Dentistry and Orthodontics (Yerevan, Armenia)
| | - Swasa Dara
- Yerevan State Medical University, Department of Pediatric Dentistry and Orthodontics (Yerevan, Armenia)
| | - Hrant Ter-Poghosyan
- Yerevan State Medical University, Department of Pediatric Dentistry and Orthodontics (Yerevan, Armenia)
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Mehta S, Arqub SA, Vishwanath M, Upadhyay M, Yadav S. Biomechanics of conventional and miniscrew-assisted rapid palatal expansion. J World Fed Orthod 2024; 13:105-112. [PMID: 38697910 DOI: 10.1016/j.ejwf.2024.03.002] [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: 11/19/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 05/05/2024]
Abstract
Posterior Crossbite is a common condition resulting because of transverse maxillary deficiency. The growth of the craniofacial complex finishes first in the transverse dimension, followed by sagittal and vertical dimensions. Conventional rapid palatal expansion (RPE) appliances are commonly used to correct transverse maxillary deficiency. Although RPE is efficient in correcting posterior crossbite, it results in dental side effects such as buccal tipping of maxillary molars, root resorption, bone dehiscence, and relapse. Mini-implant-assisted RPE has been introduced to increase the skeletal effects of expansion especially in patients with increased maturation and greater interdigitation of midpalatal suture. This article will review the biomechanics of RPE and mini-implant-assisted RPE. Additionally, the different designs of MARPE and the long-term clinical effects of expansion appliances will also be discussed in detail.
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Affiliation(s)
- Shivam Mehta
- Department of Orthodontics, Texas A&M University School of Dentistry, Dallas, Texas
| | - Sarah Abu Arqub
- Division of Orthodontics, University of Florida Health, Gainesville, Florida
| | - Meenakshi Vishwanath
- Program Director, Orthodontic Section, Department of Growth and Development, UNMC College of Dentistry, Lincoln, Nebraska
| | - Madhur Upadhyay
- Division of Orthodontics, Program Director, Orthodontic Fellowship Program, University of Connecticut Health, Farmington, Connecticut
| | - Sumit Yadav
- Henry and Anne Cech Professor of Orthodontics, UNMC College of Dentistry and Children's Hospital and Medical Center, Lincoln, Nebraska.
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Kuharattanachai K, Jotikasthira D, Rangsri W, Tripuwabhrut K. Effect of occlusal hypofunction on centre of resistance in maxillary central incisor using the finite element method. J Orthod 2024; 51:19-27. [PMID: 37269106 DOI: 10.1177/14653125231176575] [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: 06/04/2023]
Abstract
OBJECTIVES To determine differences in the location of centre of resistance (Cres) between functional and hypofunctional teeth and to evaluate the relationship between the pulp cavity volume and locations of the Cres, using the finite element (FE) method. DESIGN Retrospective cohort study. PARTICIPANTS FE models of right maxillary central incisor, derived from cone-beam computed tomography (CBCT) images of 46 participants, were divided into normal function (n = 23) and hypofunction (n = 23) groups using anterior overbite and cephalometric measurements. METHODS Measurements of the tooth and pulp cavity volume were made from the CBCT. Cres levels were presented as percentages of the root length from the root's apex. All data were analysed and compared using the independent t-test (P < 0.05). The relationship between the location of Cres and volume ratios were evaluated statistically. RESULTS The means of the pulp cavity/tooth volume and root canal/ root volume ratio of the maxillary central incisor in the anterior open bite group were significantly greater than those in the normal group. The average location of Cres in the anterior open bite group was 0.6 mm (3.7%) apically from the normal group, measured from root apex. The difference was statistically significant (P < 0.01). There was a significant correlation between root canal/root volume ratio and locations of Cres (r = -0.780, P < 0.001). CONCLUSIONS The Cres in the hypofunctional group was located more apical than the functional group. As the pulp cavity volume increased, the level of Cres shifted apically.
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Affiliation(s)
- Kachaphol Kuharattanachai
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Dhirawat Jotikasthira
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Wetchayan Rangsri
- Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai, Thailand
| | - Kanich Tripuwabhrut
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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Terada K, Kameda T, Sakamoto M. Three-dimensional positions of the center of resistance of the maxillary canine distal movement under orthodontic force loading. Dent Mater J 2024; 43:44-51. [PMID: 38044144 DOI: 10.4012/dmj.2023-160] [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: 12/05/2023]
Abstract
Using finite-element analysis, we aimed to determine the center of resistance (CRes) of the maxillary canine for setting orthodontic forces. The inclination of the canine was measured by first loading from the mesial to the distal side of the mesial root surface, then the position and direction of the load that minimized the inclination were investigated. The CRes was defined as the set of midpoints of the minimum distances between two inclination lines. Twenty-one CRes values were calculated from a set of seven lines. These CRes data were then aggregated as a 95% confidence ellipsoid of width 0.170×0.016×0.009 mm with center points 4.269, 0.224, and 4.315 mm in the apical, mesial, and lingual directions from the origin, respectively. Further studies are required to effectively apply the CRes identified in this study to clinical applications.
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Affiliation(s)
- Kazuto Terada
- Orthodontic Dentistry, The Nippon Dental University Niigata Hospital
| | - Takashi Kameda
- Department of Orthodontics, The Nippon Dental University at Niigata
| | - Makoto Sakamoto
- Department of Health Sciences, Niigata University School of Medicine
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Liu X, Wu J, Cheng Y, Gao J, Wen Y, Zhang Y, Luo H, Jin Z, Ma Y. Effective contribution ratio of the molar during sequential distalization using clear aligners and micro-implant anchorage: a finite element study. Prog Orthod 2023; 24:35. [PMID: 37806991 PMCID: PMC10560653 DOI: 10.1186/s40510-023-00485-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/03/2023] [Indexed: 10/10/2023] Open
Abstract
INTRODUCTION This study aims to investigate the biomechanical effects of anchorage reinforcement using clear aligners (CAs) with microimplants during molar distalization. And also explores potential clinical strategies for enhancing anchorage in the sequential distalization process. METHODS Finite element models were established to simulate the CAs, microimplants, upper dentition, periodontal ligament (PDL), and alveolar bone. In group set I, the 2nd molars underwent a distal movement of 0.25 mm in group set II, the 1st molars were distalized by 0.25 mm after the 2nd molars had been placed to a target position. Each group set consisted of three models: Model A served as the control model, Model B simulated the use of microimplants attached to the aligner through precision cuts, and Model C simulated the use of microimplants attached by buttons. Models B and C were subjected to a series of traction forces. We analyzed the effective contribution ratios of molar distalization, PDL hydrostatic stress, and von Mises stress of alveolar bone. RESULTS The distalization of the 2nd molars accounted for a mere 52.86% of the 0.25-mm step distance without any reinforcement of anchorage. The remaining percentage was attributed to the mesial movement of anchorage teeth and other undesired movements. Models B and C exhibited an increased effective contribution ratio of molar distalization and a decreased loss of anchorage. However, there was a slight increase in the undesired movement of molar tipping and rotation. In group set II, the 2nd molar displayed a phenomenon of mesial relapse due to the reciprocal force produced by the 1st molar distalization. Moreover, the efficacy of molar distalization in terms of contribution ratio was found to be positively correlated with the magnitude of force applied. In cases where stronger anchorage reinforcement is required, precision cuts is the superior method. CONCLUSIONS The utilization of microimplants in conjunction with CAs can facilitate the effective contribution ratio of molar distalization. However, it is important to note that complete elimination of anchorage loss is not achievable. To mitigate undesired movement, careful planning of anchorage preparation and overcorrection is recommended.
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Affiliation(s)
- Xulin Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China
| | - Junjie Wu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China
| | - Yuxun Cheng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China
| | - Jie Gao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China
| | - Yi Wen
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China
| | - Yubohan Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China
| | - Houzhuo Luo
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China
| | - Zuolin Jin
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China.
| | - Yanning Ma
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China.
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China.
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Liu X, Wang W, Gao J, Qin W, Wen Y, Luo H, Ma Y, Jin Z. Actual contribution ratio of maxillary and mandibular molars for total molar relationship correction during maxillary molar sequential distalization using clear aligners with Class II elastics: A finite element analysis. Am J Orthod Dentofacial Orthop 2023; 164:e106-e120. [PMID: 37610384 DOI: 10.1016/j.ajodo.2023.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 07/01/2023] [Accepted: 07/01/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION Class II elastics, in combination with clear aligners (CA), are efficient for molar distalization. However, the effects of this combination on intermaxillary molar relationship correction have yet to be investigated. This study aimed to investigate the actual contribution ratio of the maxillary and mandibular molars for total molar relationship correction during maxillary molar distalization using Class II elastics with CA and further explore therapeutic recommendations for clinical practice. METHODS Finite element models (FEMs) were established, including the distalization of the second molars (Set I), followed by the distalization of the first molars (Set II). Model A simulated elastics attached by precision cutting, whereas Model B simulated elastics attached to buttons. Force magnitudes of 100 g, 150 g, and 200 g of force were applied. We recorded the contribution ratio of the maxillary and mandibular molars for total molar relationship correction, effective distalizing distance in 0.25 mm step distance, tipping and rotation angles, and the hydrostatic stress in the periodontal ligament. RESULTS During maxillary molar distalization, mesialization of the mandibular molar had a notable contribution ratio for molar relationship correction. The mandibular first molar was mesialized with mesiolingual rotation tendency. Approximately half of the 0.25 mm step distance was occupied by maxillary molar distalization; the remainder was occupied by anchorage teeth mesialization and tipping or rotation. When traction forces increased, the total molar relationship correction and effective distalization increased; the mandibular molars mesialization contribution ratio also increased, as did rotation and inclination tendency. Precision cutting had a higher total molar relationship correction and more effective distalization than a button but also had a larger contribution ratio of mandibular molar mesialization and inclination or rotation. CONCLUSIONS Mandibular molar mesialization should be considered when correcting the molar relationship using CA with intermaxillary elastics during maxillary molar distalization. It is also important to consider the anchorage teeth mesialization and undesired tipping or rotation.
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Affiliation(s)
- Xulin Liu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, China
| | - Wei Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Jie Gao
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, China
| | - Wen Qin
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, China
| | - Yi Wen
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, China
| | - Houzhuo Luo
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, China
| | - Yanning Ma
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, China; Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China.
| | - Zuolin Jin
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, China.
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Schmid JQ, Gerberding E, Hohoff A, Kleinheinz J, Stamm T, Middelberg C. Non-Surgical Transversal Dentoalveolar Compensation with Completely Customized Lingual Appliances versus Surgically Assisted Rapid Palatal Expansion in Adults-Tipping or Translation in Posterior Crossbite Correction? J Pers Med 2023; 13:jpm13050807. [PMID: 37240977 DOI: 10.3390/jpm13050807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/04/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
The aim of this study was to investigate buccolingual tooth movements (tipping/translation) in surgical and nonsurgical posterior crossbite correction. A total of 43 patients (f/m 19/24; mean age 27.6 ± 9.5 years) treated with surgically assisted rapid palatal expansion (SARPE) and 38 patients (f/m 25/13; mean age 30.4 ± 12.9 years) treated with dentoalveolar compensation using completely customized lingual appliances (DC-CCLA) were retrospectively included. Inclination was measured on digital models at canines (C), second premolars (P2), first molars (M1), and second molars (M2) before (T0) and after (T1) crossbite correction. There was no statistically significant difference (p > 0.05) in absolute buccolingual inclination change between both groups, except for the upper C (p < 0.05), which were more tipped in the surgical group. Translation, i.e., bodily tooth movements that cannot be explained by pure uncontrolled tipping, could be observed with SARPE in the maxilla and with DC-CCLA in both jaws. Dentoalveolar transversal compensation with completely customized lingual appliances does not cause greater buccolingual tipping compared to SARPE.
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Affiliation(s)
- Jonas Q Schmid
- Department of Orthodontics, University of Münster, 48149 Münster, Germany
| | - Elena Gerberding
- Department of Orthodontics, Hannover Medical School (MHH), 30625 Hannover, Germany
- Private Practice, 49152 Bad Essen, Germany
| | - Ariane Hohoff
- Department of Orthodontics, University of Münster, 48149 Münster, Germany
| | - Johannes Kleinheinz
- Department of Cranio-Maxillofacial Surgery, University of Münster, 48149 Münster, Germany
| | - Thomas Stamm
- Department of Orthodontics, University of Münster, 48149 Münster, Germany
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Terada K, Kameda T, Sakamoto M. Three-dimensional location and distribution of the center of resistance in the maxillary first molar applied to occlusal force. Dent Mater J 2023; 42:133-139. [PMID: 36351599 DOI: 10.4012/dmj.2022-136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We aimed to investigate the center of resistance (CRes) of the maxillary first molar to set the occlusal force through finite element analysis. The inclination of the molar was measured, with loading to the root on the crown, and the position and direction of the load that minimized the inclination were investigated. The CRes was defined as the set of midpoints of the minimum distances between the two lines. Nine hundred and ninety CRes points were estimated from forty-five lines. The CRes was estimated as the point 1.22 mm (Z), -0.74 mm (X), and 0.23 mm (Y) from the origin in the apical, distal, and buccal side directions, respectively, with an ellipsoid area of 1.578 (Z) mm×0.097 (X) mm×0.100 (Y) mm. Further research is required to make effective use of the CRes identified in this study for clinical applications.
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Affiliation(s)
| | - Takashi Kameda
- Department of Orthodontics, The Nippon Dental University at Niigata
| | - Makoto Sakamoto
- Department of Health Sciences, Niigata University School of Medicine
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