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Magdi S, Abdelsayed FA, Aboulfotouh MH, Fahim FH. Friction versus frictionless mechanics during maxillary en-masse retraction in adult patients with Class I bimaxillary dentoalveolar protrusion: a randomized clinical trial. Eur J Orthod 2024; 46:cjae034. [PMID: 39011819 DOI: 10.1093/ejo/cjae034] [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: 07/17/2024]
Abstract
BACKGROUND Extraction space closure is a challenging phase during orthodontic treatment that affects not only the total treatment duration but also the whole treatment outcome. OBJECTIVE To compare the efficiency of friction and frictionless mechanics during en-masse retraction of maxillary anterior teeth in adult patients with bimaxillary dentoalveolar protrusion. TRIAL DESIGN Two-arm parallel group, single-center randomized clinical trial. MATERIALS AND METHODS Thirty-two adult patients with bimaxillary protrusion were recruited and randomly allocated to two different retraction mechanics. A friction group, using NiTi coil springs and a frictionless group using closing T-loops for en-masse retraction. Randomization in a 1:1 ratio was generated by Microsoft Excel. The randomization numbers were secured in opaque sealed envelopes for allocation concealment. Retraction started in all patients following first premolars extraction using miniscrews as a source of indirect anchorage. Activation was done on a monthly basis until complete retraction of anterior segment. The rate of retraction, amount of anchorage loss, the dental, and soft tissue changes were analyzed on digital models and lateral cephalograms taken before retraction and after space closure. BLINDING The outcome assessor was blinded through data concealment during assessment. RESULTS Two patients were lost to follow up, so 30 patients completed the trial. The rate of anterior segment retraction was 0.88 ± 0.66 mm/month in the frictionless group compared to 0.72 ± 0.36 mm/month in the friction group which was statistically significant. Anchorage loss of 1.18 ± 0.72 mm in the friction group compared to 1.29 ± 0.55 mm in the frictionless group with no significant difference. Comparable dental and soft tissue changes following en-masse retraction were reported in both groups, with no statistically significant difference. HARM one patient complained of soft tissue swelling following miniscrew insertion, but the swelling disappeared after one week of using mouth wash. LIMITATION The study focused only on the maxillary arch. CONCLUSION Both mechanics have successfully achieved the required treatment objectives in patients with bimaxillary dentoalveolar protrusion. Frictionless group showed a faster rate of retraction than the friction group, which was statistically but not clinically significant. TRIAL REGISTRATION Clinicaltrials.gov with the identifier NCT03261024.
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Affiliation(s)
- Sally Magdi
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Fatma A Abdelsayed
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mai H Aboulfotouh
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Fady H Fahim
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Liaw JJL, Wang SH, Tsai BMY. An unusual extraction pattern for retreatment in a patient with dental protrusion and a deficient soft-tissue chin. Am J Orthod Dentofacial Orthop 2022; 162:554-567. [PMID: 35753892 DOI: 10.1016/j.ajodo.2021.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 11/01/2022]
Abstract
A patient with dental protrusion and deficient soft-tissue chin, previously treated with maxillary first premolar extraction, sought retreatment to improve his facial profile. Orthognathic surgery was proposed as the ideal treatment option, but the patient declined. Therefore, other orthodontic options were considered. The combined intrusion and retraction force systems supported with skeletal anchorage on both arches and a midpalatal miniscrew successfully reduced the protrusion and rotated the mandible counterclockwise to improve the facial profile and chin projection. Sagittal correction enhanced by active vertical control with skeletal anchorage and de-wedging with posterior extraction was illustrated. In addition, advancement genioplasty was performed after orthodontic treatment to improve the chin projection further. The mechanics and results of this retreatment case were discussed.
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Affiliation(s)
- Johnny J L Liaw
- Department of Orthodontics, National Taiwan University Hospital, and Beauty Forever Dental Clinic, Taipei, Taiwan.
| | | | - Betty M Y Tsai
- Department of Orthodontics, National Taiwan University Hospital, and Beauty Forever Dental Clinic, Taipei, Taiwan
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Is It Possible to Achieve Favorable Accelerated Dental Changes with No Periodontal Complications When Retracting Upper Anterior Teeth Assisted by Flapless Corticotomy Compared to Traditional Corticotomy? A Two-Arm Randomized Controlled Trial. ScientificWorldJournal 2022; 2022:4261248. [PMID: 35295761 PMCID: PMC8920673 DOI: 10.1155/2022/4261248] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 02/17/2022] [Indexed: 12/01/2022] Open
Abstract
Objectives The objective of this trial was to evaluate the dental changes, periodontal health, and tooth vitality in mini-screw-supported en-masse retraction with two corticotomy-based acceleration techniques. Study Design. The sample included 38 adult patients presenting with class II division 1 malocclusion (three males, 35 females; age range between 18 and 30 years), needing the extraction of upper first premolars followed by en-masse retraction. The sample was divided randomly and equally into two groups. Randomization was carried out by random numbers generated by the computer with a 1 : 1 allocation ratio. The allocation concealment was carried out by sequentially numbered, opaque, sealed envelopes. The interventions were traditional corticotomy (TC) versus flapless corticotomy (FC). Mini-screws were inserted between the upper second premolar and first molar, bilaterally. The primary outcome was evaluating dental changes. Secondary outcomes were the periodontal health and pulp vitality of the maxillary teeth. Mann–Whitney U test and two-sample t-test with Bonferroni correction were used to analyze the data. Results The en-masse retraction rate in the first three months was higher in the TC group than the FC group (1.82, 1.66, and 1.39 mm/month vs 1.60, 1.42, and 1.22 mm/month, respectively) with statistically significant differences (P < 0.001, P < 0.001, P=0.001, respectively). The en-masse retraction amount was greater in the TC group than the FC group (6.84 mm vs 6.18 mm, respectively) with statistically significant differences (P=0.002). There was an increase in the inter-canine and inter-molar widths with a minor distal movement of the upper first molar in the two groups, with no significant differences between them (P > 0.008). The values of gingival, papillary bleeding and plaque indices in the TC group were significantly greater than those in the FC group after performing the corticotomy (P < 0.001, P < 0.003, P=0.002, respectively). No gingival recession was found on any of the examined teeth in both groups. All teeth maintained their vitality at all measurement times in both groups. No severe harms were noticed in any group. Conclusions Both traditional and flapless corticotomy techniques resulted in clinically similar rates of the en-masse retraction of upper anterior teeth, with similar dental changes and no significant periodontal complications or tooth vitality loss. The minimally invasive flapless corticotomy appeared to be a good alternative to the more invasive traditional corticotomy. This trial is registered with https://www.clinicaltrials.gov (Identification code: NCT04847492), retrospectively registered.
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Miyazawa K, Shibata M, Tabuchi M, Kawaguchi M, Shimura N, Goto S. Optimal sites for orthodontic anchor screw placement using panoramic images: risk of maxillary sinus perforation and contact with adjacent tooth roots during screw placement. Prog Orthod 2021; 22:46. [PMID: 34878627 PMCID: PMC8655055 DOI: 10.1186/s40510-021-00393-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/22/2021] [Indexed: 11/11/2022] Open
Abstract
Objectives This study investigated the safety of orthodontic anchor screw (OAS) placement by examining the morphology and degree of depression of the maxillary sinus adjacent to the alveolar bone between the maxillary molars. Methods We reviewed panoramic and CT imaging data of 25 patients. First, the morphology of the maxillary sinus adjacent to the alveolar bone between the maxillary molars on panoramic images was classified into three types: non-depressed sinus, funnel-like sinus depression, and sawtooth-like sinus depression. Then, the distance from the maxillary buccal bone to the maxillary sinus or to the maxillary lingual bone and the distance between the roots of the maxillary second premolar and first molar at heights of 5, 6.5, and 8 mm from the alveolar crest were measured on CT images and compared between the three sinus morphology groups. Results The sawtooth-like depression group had significantly smaller bone thickness than the other two groups, with mean thickness of < 4 mm at any height from the alveolar crest. The funnel-like depression and non-depression groups had mean bone thickness of > 8 mm at any height from the alveolar crest. Conclusions Sawtooth-like sinus depression had increased risk of maxillary sinus perforation, suggesting that OAS placement in this region should be avoided. In contrast, OAS placement between 6.5 and 8 mm from the alveolar crest is advisable in patients with funnel-like sinus depression and at a site > 8 mm from the alveolar crest in those with a non-depressed sinus.
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Affiliation(s)
- Ken Miyazawa
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Momoko Shibata
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Masako Tabuchi
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan.
| | - Misuzu Kawaguchi
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Noriko Shimura
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Shigemi Goto
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
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Ghafari JG, Ammoury MJ. Overcoming compact bone resistance to tooth movement. Am J Orthod Dentofacial Orthop 2020; 158:343-348. [PMID: 32709579 DOI: 10.1016/j.ajodo.2020.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/01/2020] [Accepted: 02/01/2020] [Indexed: 11/25/2022]
Abstract
The general boundaries to tooth movement are within the adjacent compact and trabecular bones, gingiva, mucosa, and muscular envelope. Findings from finite element analysis of maxillary posterior teeth distalization against mini-implants suggest that stiff outer and interproximal compact bone resists tooth movement, regardless of bone thickness, and that teeth should be steered away from this bone during orthodontic treatment. However, individual variation in the tooth-bone interface dictates the course and outcome of treatment, offering the basis for inferences on the limits of mini-implant anchorage and the presumed influence of the regional acceleratory phenomenon through decortication and microperforation, 2 modalities advocated to effect faster tooth movement.
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Affiliation(s)
- Joseph G Ghafari
- Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon; Department of Orthodontics, University of Pennsylvania, Philadelphia, PA.
| | - Makram J Ammoury
- Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon
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Khlef HN, Hajeer MY, Ajaj MA, Heshmeh O. Evaluation of Treatment Outcomes of En masse Retraction with Temporary Skeletal Anchorage Devices in Comparison with Two-step Retraction with Conventional Anchorage in Patients with Dentoalveolar Protrusion: A Systematic Review and Meta-analysis. Contemp Clin Dent 2019; 9:513-523. [PMID: 31772456 PMCID: PMC6868609 DOI: 10.4103/ccd.ccd_661_18] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective The main objective is to evaluate the effectiveness of en masse retraction with temporary skeletal anchorage devices (TSADs) versus two-step retraction with conventional anchorage (CA) in terms of the skeletal, dental, and soft-tissue variables, as well as the duration of retraction or overall orthodontic treatment. Materials and Methods An electronic search of PubMed and nine other major databases for prospective, randomized controlled trials (RCTs) and clinical controlled trials (CCTs) was carried out between January 1990 and April 2018. The bibliography in each identified article was checked out. In addition, manual searching was performed in the same time frame in five major orthodontic journals. Adult patients undergoing fixed orthodontic treatment with extraction of maxillary premolars followed by an en masse retraction in the experimental group and two-step retraction of upper anterior teeth in the control group. Methodological index for nonrandomized studies for CCTs and Cochrane's risk of bias tool for RCTs were applied. Results Four articles (two RCTs and two CCTs) were included in this review and all articles were appropriate for the quantitative synthesis. There was no significant difference between the en masse retraction and two-step retraction groups in terms of SNA, SNB, ANB, and MP-SN angles. Using TSADs gave significantly better results in terms of posterior anchorage and incisors inclination, and greater anterior teeth retraction in comparison with CA (standardized mean difference [SMD] = -3.03 mm, P < 0.001; SMD = 0.74°, P = 0.003; SMD = -0.46 mm, P = 0.03, respectively). En masse/TSAD combination caused a significantly greater increase in nasolabial angle, higher decrease in facial convexity angle, and greater lower lip retraction in comparison with two-step/CA combination (weighted mean difference = 4.73°, P = 0.007; P = 0.0435; SMD = -0.95 mm, P = 0.01, respectively). Conclusion There is weak-to-moderate evidence that using either en masse/TSAD combination or two-step/CA combination would lead to similar skeletal improvement. There is a very weak-to-moderate evidence that using TSADs with en masse retraction would cause better posterior anchorage and incisors inclination, and greater anterior teeth retraction than using CA with two-step retraction. There is weak-to-moderate evidence that using en masse/TSAD combination would lead to a better improvement in the facial profile. According to the quality of evidence, we confirm the need for more well-conducted RCTs in the en masse retraction field.
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Affiliation(s)
- Hanin Nizar Khlef
- Department of Orthodontics, University of Damascus Dental School, Damascus, Syria
| | | | - Mowaffak A Ajaj
- Department of Orthodontics, University of Damascus Dental School, Damascus, Syria
| | - Omar Heshmeh
- Department of Oral and Maxillofacial Surgery, University of Damascus Dental School, Damascus, Syria
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Inami T, Ito G, Miyazawa K, Tabuchi M, Goto S. Ribbon-wise customized lingual appliance and orthodontic anchor screw for the treatment of skeletal high-angle maxillary protrusion without bowing effect. Angle Orthod 2018; 88:830-840. [PMID: 29717632 PMCID: PMC8174079 DOI: 10.2319/072717-498.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 03/01/2018] [Indexed: 11/23/2022] Open
Abstract
This case report demonstrates the treatment of a skeletal Class II high-angle adult patient with bimaxillary protrusion, angle Class I occlusion, and crowded anterior teeth. A ribbon-wise arch wire and a customized lingual appliance with anterior vertical slots were used to achieve proper torque control of the maxillary anterior teeth. An orthodontic anchor screw and a palatal bar were used for vertical control to avoid increasing the Frankfort-mandibular plane angle (FMA) by maxillary molar extrusion. Through the combined use of the ribbon-wise customized lingual appliance, palatal bar, and orthodontic anchor screw, vertical control and an excellent treatment result were achieved without the vertical and horizontal bowing effects peculiar to conventional lingual treatment.
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Rajan RR, Muddappa SC, Rajendran P, Sukumaran Nair A. Management of Cervically Fractured Central Incisors: A Multidisciplinary Approach. Open Dent J 2018; 12:238-245. [PMID: 29760816 PMCID: PMC5897962 DOI: 10.2174/1874210601812010238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 02/25/2018] [Accepted: 03/14/2018] [Indexed: 11/22/2022] Open
Abstract
Introduction: Fracture of tooth structure at or below the gingival margin compromises rehabilitation and hampers esthetics and function. Management: Management of such cases by a post-core and crown restoration, or periodontal surgery or orthodontic extrusion alone may not always suffice in attaining a good result. Case Report: A multi-disciplinary approach which includes all of the above mentioned procedures helps in long term success. Conclusion: Careful case evaluation, treatment planning and meticulous attention to detail are the keys to the best treatment outcome.
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Affiliation(s)
- Rakesh R Rajan
- Amrita School of Dentistry, Amrita University, Aims Campus, Kochi - Conservative Dentistry & Endodontics, Ernakulam, Kerala, India
| | - Sapna Chandira Muddappa
- Amrita School of Dentistry, Amrita University, Aims Campus, Kochi - Conservative Dentistry & Endodontics, Ernakulam, Kerala, India
| | - Priya Rajendran
- Department of Conservative Dentistry & Endodontics, Malabar Dental College, Malapuram, Kerala, India
| | - Ashok Sukumaran Nair
- Amrita School of Dentistry, Amrita University, Aims Campus, Kochi - Conservative Dentistry & Endodontics, Ernakulam, Kerala, India
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Inami T, Nakano Y, Miyazawa K, Tabuchi M, Goto S. Adult skeletal Class II high-angle case treated with a fully customized lingual bracket appliance. Am J Orthod Dentofacial Orthop 2017; 150:679-691. [PMID: 27692426 DOI: 10.1016/j.ajodo.2015.10.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 10/01/2015] [Accepted: 10/01/2015] [Indexed: 10/20/2022]
Abstract
To achieve optimum occlusal and facial results in a patient with high-angle maxillary protrusion, it is important to move Point A back with retraction of the anterior teeth and prevent clockwise rotation of the mandible through good vertical control. A woman, aged 42 years 5 months, with a protrusive profile sought lingual orthodontic treatment. She had a skeletal Class II high-angle pattern with maxillary protrusion and mandibular retrusion. The extraction of the 4 first premolars was indicated to correct the problems. The vertical bowing effect, a side effect known to occur with conventional lingual bracket systems owing to torque loss, would preclude adequate retraction of Point A and compromise the facial results. To prevent this issue, a fully customized lingual bracket system with vertical slots for the anterior teeth using ribbon-wise archwires was selected. A midpalatal miniscrew was used to prevent molar extrusion. As a result, the bodily retraction of the maxillary incisors and Point A was achieved, obtaining an attractive facial profile.
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Affiliation(s)
- Toru Inami
- Clinical professor, Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan; private practice, Kyoto, Japan.
| | | | - Ken Miyazawa
- Professor, Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Masako Tabuchi
- Associate professor, Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Shigemi Goto
- Professor and chairman, Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
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Kim JY, Yu WJ, Koteswaracc PNK, Kyung HM. Effects of bracket slot size during en-masse retraction of the six maxillary anterior teeth using an induction-heating typodont simulation system. Korean J Orthod 2017; 47:158-166. [PMID: 28523242 PMCID: PMC5432437 DOI: 10.4041/kjod.2017.47.3.158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 03/09/2015] [Accepted: 03/26/2015] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To investigate how bracket slot size affects the direction of maxillary anterior tooth movement when en-masse retraction is performed in sliding mechanics using an induction-heating typodont simulation system. METHODS An induction-heating typodont simulation system was designed based on the Calorific Machine system. The typodont included metal anterior and resin posterior teeth embedded in a sticky wax arch. Three bracket slot groups (0.018, 0.020, and 0.022 inch [in]) were tested. A retraction force of 250 g was applied in the posterior-superior direction. RESULTS In the anteroposterior direction, the cusp tip of the canine in the 0.020-in slot group moved more distally than in the 0.018-in slot group. In the vertical direction, all six anterior teeth were intruded in the 0.018-in slot group and extruded in the 0.020- and 0.022-in slot groups. The lateral incisor was significantly extruded in the 0.020- and 0.022-in slot groups. Significant differences in the crown linguoversion were found between the 0.018- and 0.020-in slot groups and 0.018- and 0.022-in slot groups for the central incisor and between the 0.018- and 0.022-in slot groups and 0.020- and 0.022-in slot groups for the canine. In the 0.018-in slot group, all anterior teeth showed crown mesial angulation. Significant differences were found between the 0.018- and 0.022-in slot groups for the lateral incisor and between the 0.018- and 0.020-in slot groups and 0.018- and 0.022-in slot groups for the canine. CONCLUSIONS Use of 0.018-in slot brackets was effective for preventing extrusion and crown linguoversion of anterior teeth in sliding mechanics.
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Affiliation(s)
- Ji-Yong Kim
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Won-Jae Yu
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Prasad N. K. Koteswaracc
- Department of Orthodontics, Faculty of Dental Science, Sri Ramachandra University, Chennai, India
| | - Hee-Moon Kyung
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Korea
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Root resorption of maxillary incisors retracted with and without skeletal anchorage. Am J Orthod Dentofacial Orthop 2017; 151:397-406. [DOI: 10.1016/j.ajodo.2016.06.048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 06/01/2016] [Accepted: 06/01/2016] [Indexed: 01/16/2023]
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Cha BK, Choi DS, Jang I, Choe BH, Choi WY. Orthodontic tunnel miniscrews with and without TiO2 nanotube arrays as a drug-delivery system: In vivo study. Biomed Mater Eng 2016; 27:375-387. [PMID: 27689571 DOI: 10.3233/bme-161597] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Orthodontic tunnel miniscrews with and without TiO2 nanotube arrays were fabricated to improve the induction of new bone formation and osseointegration. To inject the drug of recombinant human bone morphogenetic protein, tunnels in a conventional machined miniscrew were machined by a computer-numerical-control lathe. TiO2 nanotube arrays to load the drug were also formed on the surface of the tunnel miniscrew by anodic oxidation. To obtain clean TiO2 nanotube arrays, two-step anodic oxidation was conducted. The diameters of TiO2 nanotube window and TiO2 nanotube were ∼70 nm and ∼110 nm, respectively. Three groups, i.e., a conventional machined miniscrew, a tunnel miniscrew without TiO2 nanotube arrays, and a tunnel miniscrew with TiO2 nanotube arrays, were prepared and inserted in the legs of five New Zealand White rabbits. In a histomorphometric analysis, the bone implant contact ratios of the tunnel miniscrews with the TiO2 nanotube arrays and without the TiO2 nanotube arrays were 5.84% and 5.88%, respectively. These values were higher than the value of 4.30% for the conventional machined miniscrew. The bone surface ratios in the tunnel miniscrew with and without the TiO2 nanotube were also higher than those of the conventional machined miniscrew. The measured values of the tunnel miniscrew with and without the nanotube and the conventional miniscrew were 76.75%, 73.41%, and 44.82%, respectively, although the differences were statistically insignificant. New bone at three weeks and six weeks after the operations were found in the tunnel miniscrews in fluorescent images. Both the tunnel miniscrews with and without the TiO2 nanotube arrays demonstrated greater bone formation compared to the conventional miniscrews. However, TiO2 nanotube arrays was not likely to provide additional benefit to the tunnel miniscrew. An in vivo study suggested that the tunnel fabricated in the miniscrew can be efficient drug-delivery systems to improve osseointegration.
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Affiliation(s)
- Bong-Kuen Cha
- Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, South Korea.,Research Institute for Dental Engineering, Gangneung-Wonju National University, Gangneung, South Korea
| | - Dong-Soon Choi
- Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, South Korea.,Research Institute for Dental Engineering, Gangneung-Wonju National University, Gangneung, South Korea
| | - Insan Jang
- Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, South Korea.,Research Institute for Dental Engineering, Gangneung-Wonju National University, Gangneung, South Korea
| | - Byung-Hak Choe
- Department of Metal and Materials Engineering, Gangneung-Wonju National University, Gangneung, South Korea.,Research Institute for Dental Engineering, Gangneung-Wonju National University, Gangneung, South Korea
| | - Won-Youl Choi
- Department of Metal and Materials Engineering, Gangneung-Wonju National University, Gangneung, South Korea.,Research Institute for Dental Engineering, Gangneung-Wonju National University, Gangneung, South Korea
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Kang JM, Park JH, Bayome M, Oh M, Park CO, Kook YA, Mo SS. A three-dimensional finite element analysis of molar distalization with a palatal plate, pendulum, and headgear according to molar eruption stage. Korean J Orthod 2016; 46:290-300. [PMID: 27668192 PMCID: PMC5033768 DOI: 10.4041/kjod.2016.46.5.290] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 02/04/2016] [Accepted: 02/16/2016] [Indexed: 12/12/2022] Open
Abstract
Objective This study aimed to (1) evaluate the effects of maxillary second and third molar eruption status on the distalization of first molars with a modified palatal anchorage plate (MPAP), and (2) compare the results to the outcomes of the use of a pendulum and that of a headgear using three-dimensional finite element analysis. Methods Three eruption stages were established: an erupting second molar at the cervical one-third of the first molar root (Stage 1), a fully erupted second molar (Stage 2), and an erupting third molar at the cervical one-third of the second molar root (Stage 3). Retraction forces were applied via three anchorage appliance models: an MPAP with bracket and archwire, a bone-anchored pendulum appliance, and cervical-pull headgear. Results An MPAP showed greater root movement of the first molar than crown movement, and this was more noticeable in Stages 2 and 3. With the other devices, the first molar showed distal tipping. Transversely, the first molar had mesial-out rotation with headgear and mesial-in rotation with the other devices. Vertically, the first molar was intruded with an MPAP, and extruded with the other appliances. Conclusions The second molar eruption stage had an effect on molar distalization, but the third molar follicle had no effect. The application of an MPAP may be an effective treatment option for maxillary molar distalization.
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Affiliation(s)
- Ju-Man Kang
- Department of Dentistry, Graduate School, 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
| | - Moonbee Oh
- Department of Orthodontics, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chong Ook Park
- Private Practice, Seoul, Korea.; Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea
| | - Yoon-Ah Kook
- Department of Orthodontics, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Seo Mo
- Department of Orthodontics, Graduate School of Clinical Dental Science, The Catholic University of Korea, Seoul, Korea
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Diar-Bakirly S, Feres MFN, Saltaji H, Flores-Mir C, El-Bialy T. Effectiveness of the transpalatal arch in controlling orthodontic anchorage in maxillary premolar extraction cases: A systematic review and meta-analysis. Angle Orthod 2016; 87:147-158. [PMID: 27504820 DOI: 10.2319/021216-120.1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of the transpalatal arch (TPA) as an anchorage device in preventing maxillary molar mesialization during retraction of the anterior teeth after premolar extraction. MATERIALS AND METHODS This systematic review intended to include patients indicated for upper premolar bilateral extraction and subsequent retraction of anterior teeth, considering the use of TPA as an anchorage tool in one of the treatment groups. The search was systematically performed, up to April 2015, in the following electronic databases: Medline, Embase, and all evidence-based medicine reviews via OVID, Cochrane Library, Scopus, PubMed, and Web of Science. Risk of bias assessment was performed using Cochrane's Risk of Bias Tool for randomized clinical trials (RCTs) and Methodological Index for Nonrandomized Studies (MINORS) for non-RCTs. RESULTS Fourteen articles were finally included. Nine RCTs and five non-RCTs presented moderate to high risk of bias. Only one study investigated the use of TPA in comparison with no anchorage, failing to show significant differences regarding molar anchorage loss. A meta-analysis showed a significant increase in anchorage control when temporary anchorage devices were compared with TPA (mean difference [MD] 2.09 [95% confidence interval {CI} 1.80 to 2.38], seven trials), TPA + headgear (MD 1.71 [95% CI 0.81 to 2.6], four trials), and TPA + utility arch (MD 0.63 [95% CI 0.12 to 1.15], 3 trials). CONCLUSION Based on mostly moderate risk of bias and with some certainty level, TPA alone should not be recommended to provide maximum anchorage during retraction of anterior teeth in extraction cases.
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Alhadlaq A, Alkhadra T, El-Bialy T. Anchorage condition during canine retraction using transpalatal arch with continuous and segmented arch mechanics. Angle Orthod 2016; 86:380-5. [PMID: 26258898 DOI: 10.2319/050615-306.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare anchorage condition in cases in which transpalatal arch was used to enhance anchorage in both continuous and segmented arch techniques. MATERIALS AND METHODS Twenty cases that required first premolar extraction for orthodontic treatment and transpalatal arch to enhance anchorage were included in this study. Ten cases were treated using the continuous arch technique, while the other 10 cases were treated using 0.019 × 0.025-inch TMA T-loops with posterior anchorage bend according to the Burstone and Marcotte description. Lateral cephalometric analysis of before and after canine retraction was performed using Ricketts analysis to measure the anteroposterior position of the upper first molar to the vertical line from the Pt point. Data were analyzed using an independent sample t-test. RESULTS There was a statistically significant forward movement of the upper first molar in cases treated by continuous arch mechanics (4.5 ± 3.0 mm) compared with segmented arch mechanics (-0.7 ± 1.4 mm; P = .01). CONCLUSIONS The posterior anchorage bend to T-loop used to retract the maxillary canine can enhance anchorage during maxillary canine retraction.
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Affiliation(s)
- Adel Alhadlaq
- a Associate Professor, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Thamer Alkhadra
- a Associate Professor, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Tarek El-Bialy
- b Associate Professor, Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton, Canada
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16
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Mah SJ, Kim JE, Ahn EJ, Nam JH, Kim JY, Kang YG. Analysis of midpalatal miniscrew-assisted maxillary molar distalization patterns with simultaneous use of fixed appliances: A preliminary study. Korean J Orthod 2016; 46:55-61. [PMID: 26877983 PMCID: PMC4751302 DOI: 10.4041/kjod.2016.46.1.55] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 10/21/2015] [Accepted: 11/17/2015] [Indexed: 11/29/2022] Open
Abstract
Skeletal anchorage-assisted upper molar distalization has become one of the standard treatment modalities for the correction of Class II malocclusion. The purpose of this study was to analyze maxillary molar movement patterns according to appliance design, with the simultaneous use of buccal fixed orthodontic appliances. The authors devised two distinct types of midpalatal miniscrew-assisted maxillary molar distalizers, a lingual arch type and a pendulum type. Fourteen patients treated with one of the two types of distalizers were enrolled in the study, and the patterns of tooth movement associated with each type were compared. Pre- and post-treatment lateral cephalograms were analyzed. The lingual arch type was associated with relatively bodily upper molar distalization, while the pendulum type was associated with distal tipping with intrusion of the upper molar. Clinicians should be aware of the expected tooth movement associated with each appliance design. Further well designed studies with larger sample sizes are required.
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Affiliation(s)
- Su-Jung Mah
- Department of Orthodontics, Dental Hospital, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Ji-Eun Kim
- Department of Orthodontics, Dental Hospital, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Eun Jin Ahn
- Department of Orthodontics, College of Dentistry, Kyung Hee University, Seoul, Korea
| | | | | | - Yoon-Goo Kang
- Department of Orthodontics, College of Dentistry, Kyung Hee University, Seoul, Korea
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17
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Abstract
OBJECTIVE To study patients' acceptance of corticotomy-assisted orthodontics as a treatment option. METHODS Adult patients seeking orthodontic treatment were asked to complete two sets of questionnaires; the first set included questions about age, sex, and level of education and general questions about orthodontic treatment; and the second set was related to the corticotomy-assisted orthodontics. Before answering the corticotomy questions, a brief description of the clinical procedure was explained and photographs of an actual procedure were shown. RESULTS A total of 150 subjects were approached and 129 (86%) agreed to answer the questionnaires (72 male and 57 female patients). Of these, only 3.1% did hear about corticotomy and 7.8% selected corticotomy instead of extraction. Fear from the surgery (53.2%) was the most frequent reason for not selecting corticotomy followed by fear from pain (36.9%). The acceptance of corticotomy between males and females was similar. No relationship was found between the level of education and prior knowledge of the procedure, P=0.857. Prior knowledge about corticotomy was not a factor in selecting it as a treatment option (P=0.556) to reduce the treatment time (P=0.427). CONCLUSION The acceptance of corticotomy-assisted orthodontics as a treatment option was low. Fear from the surgery was the main reason for not selecting it. The acceptance of corticotomy-assisted orthodontics was not related to patient's level of education or sex.
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Affiliation(s)
- Khalid H Zawawi
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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18
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Kook YA, Bayome M, Park JH, Kim KB, Kim SH, Chung KR. New approach of maxillary protraction using modified C-palatal plates in Class III patients. Korean J Orthod 2015; 45:209-14. [PMID: 26258067 PMCID: PMC4524960 DOI: 10.4041/kjod.2015.45.4.209] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 04/01/2015] [Accepted: 04/06/2015] [Indexed: 12/02/2022] Open
Abstract
Maxillary protraction is the conventional treatment for growing Class III patients with maxillary deficiency, but it has undesirable dental effects. The purpose of this report is to introduce an alternative modality of maxillary protraction in patients with dentoskeletal Class III malocclusion using a modified C-palatal plate connected with elastics to a face mask. This method improved skeletal measurements, corrected overjet, and slightly improved the profile. The patients may require definitive treatment in adolescence or adulthood. The modified C-palatal plate enables nonsurgical maxillary advancement with maximal skeletal effects and minimal dental side effects.
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Affiliation(s)
- Yoon-Ah Kook
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Mohamed Bayome
- Department of Dentistry, College of Medicine, The Catholic University of Korea, Seoul, Korea. ; Department of Postgraduate Studies, the Universidad Autonóma del Paraguay, Asunción, Paraguay
| | - 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
| | - Ki Beom Kim
- Department of Orthodontics, Center for Advanced Dental Education, Saint Louis University, St. Louis, MO, USA
| | - Seong-Hun Kim
- Department of Orthodontics, School of Dentistry, Kyunghee University, Seoul, Korea
| | - Kyu-Rhim Chung
- Department of Orthodontics, Ajou University, Suwon, Korea
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19
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Nosouhian S, Rismanchian M, Sabzian R, Shadmehr E, Badrian H, Davoudi A. A Mini-review on the Effect of Mini-implants on Contemporary Orthodontic Science. J Int Oral Health 2015. [PMID: 26225113 PMCID: PMC4516069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The purpose of this literature review was to screen the valuable published articles regarding to the impacts of mini-implants on orthodontic science, briefly. The searching category was performed on the Pubmed using MeSH words such as "dental (mini) implants, orthodontic anchorage procedures, and orthodontic appliances." After preliminary sketch, they were grouped as follow: Those evaluating (a) common appliances for providing orthodontic anchorage, (b) biomechanical details of mini-implants and their insertion, (c) clinical application of mini-implants for orthognathic treatments, (d) limitations and possible complications. In conclusion, mini-implant evolved the orthodontic treatment plans and compromised the required orthognathic surgery. Malocclusion treatment and pure orthodontic or orthopedic movements in the three-dimensions have become recently possible by using mini-implant to provide skeletal anchorage.
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Affiliation(s)
- Saeid Nosouhian
- Assistant Professor, Dental Implants Research Center and Department of Prosthodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mansour Rismanchian
- Associate Professor, Department of Prosthodontics, Dental Implants Research Center and Department of Prosthodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Sabzian
- Dentistry Student, Dental Students Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Shadmehr
- Assistant Professor, Torabinejad Research Center and Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Badrian
- Post-graduate Student, Department of Operative Dentistry, Dental School, Shahid Sadoughi University of Medical sciences, Yazd, Iran
| | - Amin Davoudi
- Dentistry Student, Dental Students Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran,Correspondence: Davoudi A, Dental Implant Research Center, Hezarjarib Street, Isfahan, Iran. Phone: +959132949318.
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