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KJO Korean Journal of Orthodontics

Open Access

pISSN 2234-7518
eISSN 2005-372X

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    • Original Article l 2024-01-25

      Role of vitamin D for orthodontic tooth movement, external apical root resorption, and bone biomarker expression and remodeling: A systematic review

      Martina Ferrillo , Dario Calafiore , Lorenzo Lippi , Francesco Agostini , Mario Migliario , Marco Invernizzi , Amerigo Giudice , Alessandro de Sire

      Abstract : Objective: This systematic review aimed to evaluate the correlation between vitamin D levels and the rate of tooth movement, external apical root resorption, bone biomarker expression, and bone remodeling. Methods: Three databases (PubMed, Scopus, and Web of Science) were systematically searched from inception until 14th March 2023 to identify studies investigating the correlation between orthodontic tooth movement and vitamin D in animals and humans. The quality assessment was made in accordance with the Joanna Briggs Institute Critical Appraisal Checklist. Results: Overall, 519 records were identified, and 19 were selected for the qualitative synthesis. Eleven studies investigated the effect of local administration (injections in the periodontal ligament, to the gingiva distal to the teeth, or submucosae palatal area) and systemic administration (oral supplementation) of vitamin D on tooth movement, external apical root movement, pro-inflammatory cytokines, and bone remodeling factors. The remaining eight studies investigated the correlation between serum vitamin D levels and salivary vitamin D levels on bone turnover markers and tooth movement. Conclusions: The findings of this systematic review support that vitamin D3 local injections might increase the rate of tooth movement via the receptor activator of the nuclear factor-kB/osteoprotegerin axis. However, the non-uniform study designs and the different protocols and outcome methods make it challenging to draw reliable conclusions.

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    • Original Article l 2022-11-25

      Crown-root angulations of the maxillary anterior teeth according to malocclusions: A cone-beam computed tomography study in Korean population

      Kyoung-Hoon Lee , Dong-Soon Choi , Insan Jang, Bong-Kuen Cha

      Abstract : Objective: To compare crown-root angulations of the permanent maxillary anterior teeth in skeletal Class I, Class II, and Class III Korean malocclusion patients using cone-bean computed tomography (CBCT) images. Methods: Sixty CBCT images were collected from orthodontic patients archive based on skeletal Class I (0˚< A point-nasion-B point angle [ANB] < 4˚), Class II (ANB ≥ 4˚), and Class III (ANB ≤ 0˚) to have 20 samples in each group. Mesiodistal crown-root angulation (MDCRA) and labiolingual crown-root angulation (LLCRA) were evaluated after orientation of images. Crown-root angulations were compared among Class I, Class II, and Class III groups and among the maxillary anterior teeth in each group. Results: LLCRAs of the maxillary central incisor and the lateral incisor were significantly lower in Class III group than those in Class I group. However, those of the canine showed no significant differences among groups. MDCRAs of the maxillary anterior teeth did not significantly differ among groups either. Conclusions: Our results suggest that skeletal Class III malocclusion might affect LLCRA of the maxillary incisors, especially the central incisor.

    • Original Article l 2023-07-25

      Pattern of lip retraction according to the presence of lip incompetence in patients with Class II malocclusion

      Mei Ling Fang , Sung-Hwan Choi, Yoon Jeong Choi, Kee-Joon Lee

      Abstract : Objective: The aim of this retrospective study was to compare changes in hard tissue and soft tissue after the four first premolars were extracted with anterior teeth retraction according to the presence or absence of lip incompetence. Methods: Patients who underwent the four first premolars were extracted with anterior teeth retraction were divided into competent (n = 20) and incompetent lip (n = 20) groups. Cephalometric measurements for hard tissue and soft tissue changes were performed pre-treatment and post-treatment. Results: In the competent group, the upper and lower lips retreated by 2.88 mm and 4.28 mm, respectively, and in the incompetent group by 4.13 mm and 5.57 mm, respectively; the differences between the two groups were significant (p < 0.05). A strong positive correlation between retraction of the upper lip and upper incisors was observed in both groups (p < 0.05), whereas a correlation between retraction of the lower lip and lower incisors was only found in the incompetent group. A simple linear regression analysis showed that the pattern of lip retraction following the retraction of the anterior teeth was more predictable in the incompetent group than in the competent group. Conclusions: These findings suggest that the initial evaluation of lip incompetence in patients with skeletal Class II is essential for the accurate prediction of the soft tissue changes following retraction of the anterior teeth in premolar extraction treatment. Therefore, sufficient explanation should be provided during patient consultations.

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    • Review Article l 2024-01-25

      Orthodontic tooth movement after periodontal regeneration of intrabony defects

      Conchita Martin , Mariano Sanz

      Abstract : The prevalence of intrabony defects in patients with advanced periodontitis stages III and IV is high. These patients usually need both periodontal treatment and orthodontic therapy, including tooth movement through bone defects, to improve masticatory function, aesthetics, and overall quality of life. Clinical practice guidelines recommend periodontal regenerative surgical interventions to resolve these defects and propose initiating orthodontic tooth movement (OTM) once periodontal therapy goals have been met. Surgical interventions using various regenerative technologies like barrier membranes and enamel matrix proteins, combined or not with bone replacement grafts, have proven effective in regenerating lost periodontal tissues. However, the combination of periodontal and orthodontic treatments requires consideration of how periodontal regenerative therapies influence OTM. Studies suggest that regenerated bone may differ in density, composition, vascularity, and cellular activity, potentially affecting the speed and efficiency of OTM, and potential root resorption of moved teeth. Understanding the sequence and timing of implementing OTM after regenerative periodontal interventions is crucial due to their interlinked processes of bone resorption and formation. This narrative review aims to uncover scientific evidence regarding these combined treatments, examining the impacts of different regenerative technologies on OTM and delineating their advantages, limitations, and best practices.

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    • Original Article l 2023-09-25

      Pattern of microimplant displacement during maxillary skeletal expander treatment: A cone-beam computed tomography study

      Ney Paredes , Ausama Gargoum, Ramon Dominguez-Mompell, Ozge Colak, Joseph Bui, Tam Duong, Maya Giannetti, Fernanda Silva, Kendra Brooks, Won Moon ,

      Abstract : Objective: To analyze the microimplant (MI) displacement pattern on treatment with a maxillary skeletal expander (MSE) using cone-beam computed tomography (CBCT). Methods: Thirty-nine participants (12 males and 27 females; mean age, 18.2 ± 4.2 years) were treated successfully with the MSE II appliance. Their pre- and post-expansion CBCT data were superimposed. The pre- and post-expansion anterior and posterior inter-MI angles, neck and apical inter-MI distance, plate angle, palatal bone thickness at the MI positions, and suture opening at the MI positions were measured and compared. Results: The jackscrew plate was slightly bent in both anterior and posterior areas. There was no significant difference in the extent of suture opening between the anterior and posterior MIs (p > 0.05). The posterior MI to hemiplate line was greater than that anteriorly (p < 0.05). The apical distance between the posterior MIs was greater than that anteriorly (p < 0.05). The palatal thickness at the anterior MIs was significantly greater than that posteriorly (p > 0.01). Conclusions: In the coronal plane, the angulation between the anterior MIs in relation to the jackscrew plate was greater than that between the posterior MIs owing to the differential palatal bone thickness.

    • Original Article l 2022-11-25

      Periodontal parameters in orthodontically tractioned teeth: A systematic review and meta-analysis

      Paola Marques de Mattos , Flavio Magno Gonçalves, Isabela Bittencourt Basso, Aline Xavier Ferraz, Bianca Simone Zeigelboim, José Stechman-Neto, Rosane Sampaio Santos, Cristiano Miranda de, Araujo, Odilon Guariza-Filho

      Abstract : Objective: This systematic review aimed to evaluate periodontal parameters in orthodontically tractioned teeth compared with the respective non-tractioned contralateral teeth. Methods: Search strategies were developed for six electronic databases and gray literature. Random-effects meta-analyses were performed for the outcomes of interest. Furthermore, the certainty of the evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool. Results: Overall, 2,082 articles were identified, of which 24 were selected for the qualitative synthesis. A significant difference was observed between the impacted and contralateral teeth (mean difference [MD] = 0.25; 95% confidence interval [CI] = 0.10–0.40; I2 = 0%) when the gingival index was evaluated. Additionally, impacted teeth showed a greater probing depth, with a significant mean difference between the groups (MD = 0.14; 95% CI = 0.07–0.20; I2 = 6%). Most studies had a low risk of bias; however, the certainty of the evidence was very low owing to the design of existing studies. Conclusions: The evidence in the literature indicated that tractioned teeth might show worsening of periodontal parameters related to the gingival index and probing depth; however, the evidence remains uncertain about this outcome. Furthermore, probing depth should be considered regarding its clinical significance because of the small effect size observed.

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    • Original Article l 2023-01-25

      Associations between body dysmorphic disorder (BDD) with the dental health component of the index of orthodontic treatment need (IOTN-DHC) and other BDD risk factors in orthodontic patients: A preliminary study

      Farhad Sobouti , Foruzan Elyasi, Reza Alizadeh Navaei, Farbod Rayatnia, Nika Rezaei Kalantari, Sepideh Dadgar , Vahid Rakhshan

      Abstract : Objective: Body dysmorphic disorder (BDD) is a form of obsessive-compulsive disorder that may be negatively associated with the self-image. It might be associated with orthodontic treatment demand and outcome, and therefore is important. Thus, this study was conducted. Methods: The Yale-Brown Obsessive-Compulsive Scale modified for Body Dysmorphic Disorder (BDD-YBOCS) questionnaire was used in 699 orthodontic patients above 12 years of age (222 males, 477 females), at seven clinics in two cities (2020–2021). BDD diagnosis and severity were calculated based on the first 3 items and all 12 items of the questionnaire. The dental health component of the index of orthodontic treatment need (IOTN-DHC) was assessed by orthodontists. Multivariable and bivariable statistical analyses were performed on ordinal and dichotomized BDD diagnoses to assess potentially associated factors (IOTN-DHC, age, sex, marital status, education level, and previous orthodontic consultation) (α = 0.05). Results: IOTN-DHC scores 1–5 were seen in 13.0%, 39.9%, 29.8%, 12.4%, and 4.9% of patients. Age/sex/marital status/education were not associated with IOTN-DHC (p > 0.05). Based on 3-item questionnaire, 17.02% of patients had BDD (14.02% mild). Based on 12-item questionnaire, 2.86% had BDD. BDD was more prevalent or severer in females, married patients, patients with a previous history of orthodontic consultation, and patients with milder IOTN-DHCs (p < 0.05). Conclusions: IOTN-DHC was negatively/slightly associated with BDD in orthodontic patients. Being female and married may increase BDD risk.

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    • Original Article l 2023-03-25

      Development and validation of a novel screening instrument to prioritize the orthodontic referral of developing malocclusion in children: The index for interceptive orthodontics referral

      Saraswathy Devi Sinniah , Annapurny Venkiteswaran, Najiyatu Nazihah Zakaria

      Abstract : Objective: The absence of a guideline to refer developing malocclusions appropriately, may be a contributing factor to the inadequacy of timely interceptive orthodontics provision. This study aimed to develop and validate a new orthodontic grading and referral index to be used by dental frontliners to prioritize the orthodontic referral of developing malocclusion in children based on its severity. Methods: A cross-sectional study involving clinical assessment with 413 schoolchildren aged between 8.1 and 11.9 years was conducted in 2018. All the presenting malocclusion was listed and graded based on a few dental guidelines to produce the draft index. The validity and reliability of the draft index were tested using twenty study models. Face and content validation was carried out using the content validation index and Modified Kappa Statistics. Results: Fourteen dental and occlusal anomalies were identified as components of malocclusion and three grades of referral (monitor, standard, urgent) were included in the final index. The scale-level content validity index average value of 0.86 and 0.87 was obtained for content and face validation, respectively. There was moderate to excellent agreement in the Modified Kappa Statistics for both validations. Excellent inter- and intra-assessor agreement was obtained. The new index displayed valid and reliable scores. Conclusions: The Index for Interceptive Orthodontics Referral was developed and validated for the dental frontliners to identify and prioritize the developing malocclusion in children based on its severity and refer for orthodontic consultation to increase the possibility for interceptive orthodontics.

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    • Original Article l 2023-11-25

      Risk factors for orthodontic fixed retention failure: A retrospective controlled study

      Kaat Verschueren , Amit Arvind Rajbhoj, Giacomo Begnoni, Guy Willems, Anna Verdonck, Maria Cadenas de Llano-Pérula

      Abstract : Objective: To investigate the potential correlation between fixed orthodontic retention failure and several patient- and treatment-related factors. Methods: Patients finishing treatment with fixed appliances between 2016 and 2017 were retrospectively included in this study. Those not showing fixed retention failure were considered as control group. Patients with fixed retention failure were considered as the experimental group. Additionally, patients with failure of fixed retainers in the period of June 2019 to March 2021 were prospectively identified and included in the experimental group. The location of the first retention failure, sex, pretreatment dental occlusion, facial characteristics, posttreatment dental occlusion, treatment approach and presence of oral habits were compared between groups before and after treatment separately by using a Fisher exact test and a Mann–Whitney U test. Results: 206 patients with fixed retention failure were included, 169 in the mandibular and 74 in the maxillary jaws. Significant correlations were observed between retention failure in the mandibular jaws and mandibular arch length discrepancy (P = 0.010), post-treatment growth pattern (P = 0.041), nail biting (P < 0.001) and abnormal tongue function (P = 0.002). Retention failure in the maxillary jaws was more frequent in patients with IPR in the mandibular jaws (P = 0.005) and abnormal tongue function (P = 0.021). Conclusions: This study suggests a correlation between fixed retention failure and parafunctional habits, such as nail biting and abnormal tongue function. Prospective studies with larger study populations could further confirm these results.

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Clinical Journal of Korean Association of Orthodontists