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KJO Korean Journal of Orthodontics

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pISSN 2234-7518
eISSN 2005-372X
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    • Original Article l 2020-11-25

      Innovative customized CAD/CAM nickel-titanium lingual retainer versus standard stainless-steel lingual retainer: A randomized controlled trial

      Emilie Gelin , Laurence Seidel, Annick Bruwier, Adelin Albert, Carole Charavet

      Abstract : Objective: To compare computer-aided design and computer-aided manufacturing (CAD/CAM) customized nitinol retainers with standard stainlesssteel fixed retainers over a 12-month study period. Methods: This randomized controlled trial (RCT) was conducted on 62 patients randomly allocated to a control group that received stainless-steel retainers or a test group that received customized CAD/CAM nickel-titanium retainers. Four time points were defined: retainer placement (T0) and 1-month (T1), 6-month (T2), and 12-month (T3) follow-up appointments. At each time point, Little’s irregularity index (LII) (primary endpoint) and dental stability measurements such as intercanine width were recorded in addition to assessment of periodontal parameters. Radiological measurements such as the incisor mandibular plane angle (IMPA) were recorded at T0 and T3. Failure events (wire integrity or debonding) were assessed at each time point. Results: From T0 to T3, LII and other dental measurements showed no significant differences between the two groups. The data for periodontal parameters remained stable over the study period, except for the gingival index, which was slightly, but significantly, higher in the test group at T3 (p = 0.039). The IMPA angle showed no intergroup difference. The two groups showed no significant difference in debonding events. Conclusions: This RCT conducted over a 12-month period demonstrated no significant difference between customized CAD/CAM nickel-titanium lingual retainers and standard stainlesssteel lingual retainers in terms of dental anterior stability and retainer survival. Both retainers eventually appeared to be equally effective in maintaining periodontal health.

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    • Original Article l 2020-05-25

      Periodontal ligament proliferation and expressions of bone biomolecules upon orthodontic preloading: Clinical implications for tooth autotransplantation

      Sasathorn Phutinart , Suttichai Krisanaprakornkit, Anupong Makeudom, Boonsiva Suzuki, Eduardo Yugo Suzuki

      Abstract : Objective: Preservation of the periodontal ligament (PDL) is vital to the success of tooth autotransplantation (TAT). Increased PDL volumes and facilitated tooth extraction have been observed upon orthodontic preloading. However, it is unclear whether any changes occur in the expressions of bone biomolecules in the increased PDL volumes. This study aimed to determine the expressions of runt-related transcription factor 2 (RUNX2), alkaline phosphatase (ALP), receptor activator of nuclear factor kappa-B ligand (RANKL), and osteoprotegerin (OPG) in PDL upon preloading. Methods: Seventy-two premolars from 18 patients were randomly assigned to experimental groups that received a leveling force for 1, 2, or 4 weeks or to a control unloaded group. Following extraction, PDL volumes from 32 premolars of eight patients (21.0 ± 3.8 years) were evaluated using toluidine blue staining. The expressions of the biomolecules in the PDL from 40 premolars of ten patients (21.4 ± 4.0 years) were analyzed via immunoblotting. Results: The median percentage of stained PDL was significantly higher at 2 and 4 weeks after preloading than in the unloaded condition (p < 0.05). The median RUNX2 and ALP expression levels were significantly higher at 2 and 4 weeks after preloading than in the unloaded condition (p < 0.05), whereas the median RANKL/OPG ratios were significantly higher at 1 and 4 weeks after preloading (p < 0.05). Conclusions: Orthodontic preloading for 4 weeks enhances PDL volumes as well as the expressions of RUNX2, ALP and the RANKL/OPG ratio in the PDL, suggesting this loading period is suitable for successful TAT.

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    • Case Report l 2020-07-25

      Camouflage treatment of posterior bite collapse in a patient with skeletal asymmetry by using posterior maxillary segmental osteotomy

      Haitham Badr , Soo-Yeon Lee, Hong-Sik Park, Joo-Young Ohe, Yoon-Goo Kang, Hyo-Won Ahn

      Abstract : Orthodontic treatment of posterior bite collapse due to early loss of molars and the consequent drift of adjacent teeth is complicated. When the posterior bite collapse occurs in patients with facial asymmetry, both transverse and vertical compensation are necessary for camouflage orthodontic treatment. In such cases, posterior maxillary segmental osteotomy (PMSO) can be an effective alternative procedure that simplifies the orthodontic treatment and shows long-term stability through dental compensation within the alveolar bone housing. This case report aimed to describe the orthodontic treatment of maxillary occlusal plane canting caused by severely extruded maxillary teeth in a patient with skeletal facial asymmetry that was corrected with PMSO along with protraction of the lower second molar to replace the space of the extracted first molar. The treatment duration was 18 months, and stable results were obtained after 2 years of retention.

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    • Original Article l 2020-09-25

      Three-dimensional surgical accuracy between virtually planned and actual surgical movements of the maxilla in two-jaw orthognathic surgery

      Mihee Hong , Myung-Jin Kim, Hye Jung Shin, Heon Jae Cho, Seung-Hak Baek

      Abstract : Objective: To investigate the three-dimensional (3D) surgical accuracy between virtually planned and actual surgical movements (SM) of the maxilla in twojaw orthognathic surgery. Methods: The sample consisted of 15 skeletal Class III patients who underwent two-jaw orthognathic surgery performed by a single surgeon using a virtual surgical simulation (VSS) software. The 3D cone-beam computed tomography (CBCT) images were obtained before (T0) and after surgery (T1). After merging the dental cast image onto the T0 CBCT image, VSS was performed. SM were classified into midline correction (anterior and posterior), advancement, setback, anterior elongation, and impaction (total and posterior). The landmarks were the midpoint between the central incisors, the mesiobuccal cusp tip (MBCT) of both first molars, and the midpoint of the two MBCTs. The amount and direction of SM by VSS and actual surgery were measured using 3D coordinates of the landmarks. Discrepancies less than 1 mm between VSS and T1 landmarks indicated a precise outcome. The surgical achievement percentage (SAP, [amount of movement in actual surgery/ amount of movement in VSS] × 100) (%) and precision percentage (PP, [number of patients with precise outcome/number of total patients] × 100) (%) were compared among SM types using Fisher’s exact and Kruskal–Wallis tests. Results: Overall mean discrepancy between VSS and actual surgery, SAP, and PP were 0.13 mm, 89.9%, and 68.3%, respectively. There was no significant difference in the SAP and PP values among the seven SM types (all p > 0.05). Conclusions: VSS could be considered as an effective tool for increasing surgical accuracy.

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    • Original Article l 2020-05-25

      Assessment of bone density changes following two-jaw surgery using multidetector computed tomography: A pilot study

      Youngjoo Lee , Jae Hyun Park, Na-Young Chang, Mi-Young Lee, Bong Chul Kim, Hye Young Seo, Utkarsh Mangal, Jong-Moon Chae

      Abstract : Objective: The aim of this retrospective study was to evaluate the pre- and postsurgical bone densities at alveolar and extra-alveolar sites following twojaw orthognathic surgery. Methods: The sample consisted of 10 patients (mean age, 23.2 years; range, 18.0?27.8 years; 8 males, 2 females) who underwent two-jaw orthognathic surgery. A three-dimensional imaging program (Invivo 5) was used with multidetector computed tomography images taken preand postoperatively (obtained 32.3 ± 6.0 days before surgery and 5.8 ± 2.6 days after surgery, respectively) for the measurement of bone densities at the following sites: (1) alveolar bone in the maxilla and mandible, (2) extra-alveolar sites, such as the top of the head, menton (Me), condyle, and the fourth cervical vertebrae (C4). Results: When pre- and postsurgical bone densities were compared, an overall tendency of decrease in bone density was noted. Statistically significant reductions were observed in the densities of cancellous bone at several areas of the maxillary alveolar bone; cortical and cancellous bone in most areas of the mandibular alveolar bone; cortical bone in Me; and cancellous bone in C4. There was no statistically significant difference in bone density in relation to the depth of the alveolar bone. In a comparison of the bone densities between groups with and without genioplasty, there was almost no statistically significant difference. Conclusions: Accelerated tooth movement following orthognathic surgery may be confirmed with reduced bone density. In addition, this study could offer insights into bone metabolism changes following orthognathic surgery, providing direction for further investigations in this field.

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    • Original Article l 2020-03-25

      Short-term impact of microimplant-assisted rapid palatal expansion on the nasal soft tissues in adults: A three-dimensional stereophotogrammetry study

      Seung-Ryeol Lee, Jin-woo Lee, Dong-Hwa Chung and Sang-min Lee

      Abstract : ObjectiveThe aim of this study was to evaluate changes in the nasal soft tissues, including movements of landmarks, changes in linear distances, and volumetric changes, using three-dimensional (3D) stereophotogrammetry after microimplant-assisted rapid palatal expansion (MARPE) in adult patients.MethodsFacial data were scanned using a white light scanner before and after MARPE in 30 patients. In total, 7 mm of expansion was achieved over a 4-week expansion period. We determined 10 soft tissue landmarks using reverse engineering software and measured 3D vector changes at those points. In addition, we calculated the distances between points to determine changes in the width of the nasal soft tissues. The volumetric change in the nose was also measured.ResultsAll landmarks except pronasale and subnasale showed statistically significant movement on the x-axis. Pronasale, subnasale, alar right, and alar left showed significant movement on the y-axis, while all landmarks except subnasale showed significant movement on the z-axis. The alar base width, alar width, and alar curvature width increased by 1.214, 0.932, and 0.987 mm, respectively. The average volumetric change was 993.33 mm3, and the amount of increase relative to the average initial volume was 2.96%.ConclusionsThe majority of soft tissue landmarks around the nasal region show significant positional changes after MARPE in adults. The nose tends to widen and move forward and downward. The post-treatment nasal volume may also exhibit a significant increase relative to the initial volume. Clinicians should thoroughly explain the anticipated changes to patients before MARPE initiation.

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    • Original Article l 2020-11-25

      Part I. What drives Korean adults to seek orthodontic treatment: Reliability and validity of a measurement instrument for the perception of orthodontic treatment

      Min-Hee Oh , Eun-A Kim , Ae-Hyun Park, MinSoo Kim, Jin-Hyoung Cho

      Abstract : Objective: To develop a standardized instrument to measure the level of cognition for orthodontic treatment in adults, and verify its reliability and validity for assessing perceptions of orthodontic treatment in adults. Methods: A total of 406 adults aged 19–64 years were surveyed by an internet research system. A tool was developed through the instrument development and verification stages. The data were analyzed by correlation analysis, exploratory factor analysis, confirmatory factor analysis, and Cronbach’s α test. Results: The instrument consisted of 11 items covering four factors related to orthodontic treatment. Three items were related to general perception, four described the perception of the treatment for adults, two related to the treatment effects, and two related to the retention of orthodontic treatment. In the reliability test, Cronbach’s α was 0.845 for the 11 items. In assessments for individual components, Cronbach’s α was 0.764 for the general perception of orthodontic treatment, 0.705 for the perception of this treatment for adults, 0.707 for the effects of the treatment, and 0.701 for the retention of orthodontic treatment. Finally, a measurement instrument for the perception of orthodontic treatment in adults was designed to assess the 11 items on a four-point Likert scale. Conclusions: This study developed a standard measurement instrument for assessing the perception of orthodontic treatment in adults. The proposed instrument will enable additional studies on the influence of an adult’s perception of orthodontic treatment on the decision to undergo treatment.

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    • Original Article l 2021-01-25

      Evaluation of mandibular buccal shelf characteristics in the Colombian population: A cone-beam computed tomography study

      Natalia Escobar-Correa , Maria Antonia Ramírez-Bustamante, Luis Alejandro Sánchez-Uribe, Juan Carlos Upegui-Zea, Patricia Vergara-Villarreal, Diana Milena Ramírez-Ossa

      Abstract : Objective: To evaluate the mandibular buccal shelf (MBS) in terms of the angulation and bone depth and thickness according to sex, age, and sagittal and vertical skeletal patterns in a Colombian population using cone-beam computed tomography (CBCT). Accordingly, the optimal site for miniscrew insertion in this area was determined. Methods: This descriptive, retrospective study included 64 hemi-arches of 34 patients. On CBCT images, the angulation, buccal bone depth (4 and 6 mm from the cementoenamel junction [CEJ] of MBS), and buccal bone thickness (6 and 11 mm from the CEJ of MBS) were measured at the mesial and distal roots of the mandibular first and second molars. Results: There were no statistically significant differences in the angulation, depth, and thickness of MBS between male and female patients. The values for the bone around the distal root of the mandibular second molar were significantly greater than the other values. The osseous characteristics were significantly better in participants aged 16–24 years. Class III patients exhibited the best osseous characteristics, with the bone depth at 6 mm being significantly different from that in Class I and Class II patients. Although values tended to be greater in patients with low angles, the difference was not statistically significant. Conclusions: MBS provides an optimal bone surface for miniscrew insertion, with better osseous characteristics at the distal root of the mandibular second molar, 4 mm from CEJ. Adolescent patients, Class III patients, and patients with a low angle exhibit the most favorable osseous characteristics in the MBS area.

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    • Case Report l 2020-05-25

      Surgical approach and orthodontic treatment of mandibular condylar osteochondroma

      So Jin Yang , Nam Hyung Chung, Jong Ghee Kim, Young-Mi Jeon

      Abstract : Osteochondroma is a common benign tumor of bones, but it is rare in the mandibular condyle. With its outgrowth it manifests clinically as deviation of the mandible limitation of mouth opening, and facial asymmetry. After the tumor is diagnosed on the basis of clinical symptoms and radiographic examination including cone-beam computed tomography (CBCT) analysis, an appropriate surgery and treatment plan should be formulated. Herein, we present the case of a 44-year-old female patient who visited our dental hospital because her chin point had been deviating to the left side slowly but progressively over the last 3 years and she had difficulty masticating. Based on CBCT, she was diagnosed with skeletal Class III malocclusion accompanied by osteochondroma of the right mandibular condyle. Maxillary occlusal cant with the right side down was observed, but it was confirmed to be an extrusion of the molars associated with dental compensation. Therefore, after intrusion of the right molars with the use of temporary anchorage devices, sagittal split ramus osteotomy was used to remove the tumor and perform orthognathic surgery simultaneously. During 6 months after the surgery, continuous bone resorption and remodeling were observed in the condyle of the affected side, which led to a change in occlusion. During the postoperative orthodontic treatment, intrusive force and buccal torque were applied to the molars on the affected side, and a proper buccal overjet was created. After 18 months, CBCT revealed that the rate of bone absorption was continuously reduced, bone corticalization appeared, and good occlusion and a satisfying facial profile were achieved.

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Journal Info.

March, 2021
Vol.51 No.2

Frequency: 6 times

Journal Impact Factor

  • 1.476
    2018 IF

  • 1.523
    5-Year IF

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Clinical Journal of Korean Association of Orthodontists