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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 2024-05-25

      Accuracy of orthodontic movements with 3D printed aligners: A prospective observational pilot study

      Marco Migliorati , Sara Drago , Tommaso Castroflorio , Paolo Pesce , Giovanni Battista , Alessandra Campobasso , Giorgio Gastaldi , Filippo Forin Valvecchi , Anna De Mari

      Abstract : Objective: Owing to the availability of 3D software, scanners, and printers, clinicians are encouraged to produce in-office aligners. Recently, a new directprinting resin (Tera Harz TC-85DAC) has been introduced. Studies on its mechanical characteristics and biological effects have been published; however, evidence on its efficacy in orthodontic treatment remains scarce. This pilot study aimed to investigate the accuracy of teeth movement achieved with directprinted aligners. Methods: Seventeen patients (eight males and nine females) with a mean age of 27.67 ± 8.95 years, presenting with dental rotations < 30° and spaces/crowding < 5 mm, were recruited for this study. The teeth movement was planned starting from a T0 digital dental cast. The 3D direct-printed aligners were produced using Tera Harz TC-85DAC resin. Once the orthodontic treatment was completed, a final digital cast was obtained (T1). The planned teeth positions were then superimposed onto the T0 and T1 digital models. The differences between the programmed movements and the achieved overall torque, tip, rotation, and transverse dimensions were assessed using the paired t test or Wilcoxon’s signed rank test. Results: The overall accuracies for torque, tip, and rotation were 67.6%, 64.2%, and 72.0%, respectively. The accuracy of the change in transverse diameter was 99.6%. Conclusions: Within the limits of the present pilot study (difficulties with abnormally shaped teeth and use of attachments), it can be concluded that 3D printed aligners can be successfully printed in-house and utilized for mildly crowded cases, with a comparable accuracy of tooth movement to that of other aligners.

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    • Original Article l 2024-05-25

      Clinical expression of programmed maxillary buccal expansion and buccolingual crown inclination with Invisalign EX30 and SmartTrack aligners and the effect of 1-week vs. 2-week aligner change regimes: A retrospective cohort study

      Joseph O’Connor , Tony Weir , Elissa Freer , Brett Kerr

      Abstract : Objective: This retrospective cohort study aimed to assess and compare the accuracy of 3 different Invisalign® treatment regimens in terms of variations of aligner change frequency and type of aligner material in achieving maxillary dental buccal expansion. Methods: Altogether, 120 adult patients whose treatment involved maxillary dental expansion with Invisalign® were included. The patients were divided into 3 groups, with each group comprising 40 patients as follows: SmartTrack® 1-week changes (ST1), SmartTrack® 2-week changes (ST2), and EX30® 2-week changes (EX2). The groups were assessed by comparing actual changes achieved with those prescribed by ClinCheck®. The rates of clinically significant inaccuracies (CSI) observed for buccal expansion (≥ 0.5 mm) and buccolingual inclination (≥ 2°) during expansion were then determined. Results: In terms of expansion, the ST1 group demonstrated the highest CSI rate at all tooth levels, whereas the ST2 group had the lowest rate of CSI and the lowest mean inaccuracy for each tooth level. In terms of buccolingual inclination, the ST1 group had the highest CSI rate across all tooth levels, whereas the EX2 group had the lowest CSI rate at all tooth levels except for the canine level where the ST2 group had the lowest CSI rate. A tendency toward overexpression of buccal crown inclination, and underexpression of buccal expansion was observed at all tooth levels. Conclusions: Two-week aligner change regimens offer improved accuracy compared with 1-week aligner changes. SmartTrack® 2-week changes were the most accurate for buccal expansion, whereas EX30® 2-week changes were the most accurate for buccolingual inclination.

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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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    • 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 2023-07-25

      Differences in positions of cone-beam computed tomography landmarks in patients with skeletal Class III facial asymmetry according to midsagittal planes

      Hyung-Kyu Noh , Ho-Jin Kim, Hyo-Sang Park

      Abstract : Objective: This study aimed to clarify differences in the positions of cone-beam computed tomography (CBCT) landmarks according to different midsagittal planes (MSPs) in patients with skeletal Class III facial asymmetry. Methods: Pre-treatment CBCT data from 60 patients with skeletal Class III were used. The patients were classified into symmetric (menton deviations of < 2 mm) or asymmetric (menton deviations of > 4 mm) groups. Six MSPs were established based on previous studies, and three-dimensional analyses were performed for the planes in both the groups. The measurement outcomes were compared statistically. Results: A statistically significant interaction (p < 0.01) was observed between MSPs and facial asymmetry. No significant differences were observed among MSPs in the symmetric group. However, significant differences in linear measurements were identified among MSPs in the asymmetric group. Specifically, the upper facial MSP revealed both maxillary and mandibular transverse asymmetries. On the other hand, anterior nasal spine (ANS)-associated MSP could not identify maxillary asymmetry. Furthermore, the menton deviation was approximately 3 mm lower when estimated using the ANS-associated MSP than that using upper facial MSP. Conclusions: The choice of MSP can significantly affect treatment outcomes while diagnosing patients with asymmetry. Therefore, care should be taken when selecting MSP in clinical practice.

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    • Original Article l 2024-03-25

      Cone-beam computed tomographic evaluation of mandibular incisor alveolar bone changes for the intrusion arch technique: A retrospective cohort research

      Lin Lu , Jiaping Si , Zhikang Wang , Xiaoyan Chen

      Abstract : Objective: Alveolar bone loss is a common adverse effect of intrusion treatment. Mandibular incisors are prone to dehiscence and fenestrations as they suffer from thinner alveolar bone thickness. Methods: Thirty skeletal class II patients treated with mandibular intrusion arch therapy were included in this study. Lateral cephalograms and cone-beam computed tomography images were taken before treatment (T1) and immediately after intrusion arch removal (T2) to evaluate the tooth displacement and the alveolar bone changes. Pearson’s and Spearman’s correlation was used to identify risk factors of alveolar bone loss during the intrusion treatment. Results: Deep overbite was successfully corrected (P < 0.05), accompanied by mandibular incisor proclination (P < 0.05). There were no statistically significant change in the true incisor intrusion (P > 0.05). The labial and lingual vertical alveolar bone levels showed a significant decrease (P < 0.05). The alveolar bone is thinning in the labial crestal area and lingual apical area (P < 0.05); accompanied by thickening in the labial apical area (P < 0.05). Proclined incisors, non-extraction treatment, and increased A point-nasion-B point (ANB) degree were positively correlated with alveolar bone loss. Conclusions: While the mandibular intrusion arch effectively corrected the deep overbite, it did cause some unwanted incisor labial tipping/flaring. During the intrusion treatment, the alveolar bone underwent corresponding changes, which was thinning in the labial crestal area and thickening in the labial apical area vice versa. And increased axis change of incisors, non-extraction treatment, and increased ANB were identified as risk factors for alveolar bone loss in patients with mandibular intrusion therapy.

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    • Original Article l 2023-11-25

      Effects of 4-hexylresorcinol on facial skeletal development in growing rats: Considerations for diabetes

      Hannah Jeong , Jwa-Young Kim, Xiangguo Che, Je-Yong Choi, Insan Jang , Seong-Gon Kim

      Abstract : Objective: To investigate the long-term effects of 4-hexylresorcinol (4HR) on facial skeletal growth in growing male rats, with a focus on diabetic animal models. Methods: Forty male rats were used. Of them, type 1 diabetes mellitus was induced in 20 animals by administering 40 mg/kg streptozotocin (STZ), and they were assigned to either the STZ or 4HR-injected group (STZ/4HR group). The remaining 20 healthy rats were divided into control and 4HR groups. We administered 4HR subcutaneously at a weekly dose of 10 mg/kg until the rats were euthanized. At 16 weeks of age, whole blood was collected, and micro-computed tomography of the skull and femur was performed. Results: All craniofacial linear measurements were smaller in the STZ group than in the control group. The mandibular molar width was significantly smaller in the 4HR group than in the control group (P = 0.031) but larger in the STZ/4HR group than in the STZ group (P = 0.011). Among the diabetic animals, the STZ/4HR group exhibited significantly greater cortical bone thickness, bone mineral density, and bone volume than the STZ group. Serum testosterone levels were also significantly higher in the STZ/4HR group than in the STZ group. Conclusions: 4HR administration may have divergent effects on mandibular growth and bone mass in healthy and diabetic rats. In the context of diabetes, 4HR appears to have beneficial effects, potentially through the modulation of mitochondrial respiration.

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    • Original Article l 2023-07-25

      Maxillary alveolar bone evaluation following dentoalveolar expansion with clear aligners in adults: A cone-beam computed tomography study

      Marcio Antonio de Figueiredo, Fábio Lourenço Romano, Murilo Fernando Neuppmann Feres, Maria Bernadete Sasso Stuani, José Tarcísio Lima Ferreira, Ana Carla Raphaelli Nahás, Mírian Aiko Nakane Matsumoto

      Abstract : Objective: To investigate the effects of maxillary orthodontic expansion on the alveolar bone tissue in adult patients treated with aligners by using cone-beam computed tomography. Methods: Thirty patients (22 females and 8 males; mean age: 36.3 years) were treated with Invisalign® aligners. Cone-beam computed tomography and digital models were obtained before (T0) and after (T1) upper arch expansion. The bone thicknesses in the cervical, middle, and apical areas of the incisors, canines, premolar, and first molars were buccally and palatally measured, totaling 96 areas and 2,880 measurements. The buccolingual inclinations and transverse measurements of the teeth were obtained from digital models to correlate them with the bone changes. The statistical tests used were Student’s t-test, analysis of variance, and Pearson’s correlation tests (p < 0.05). Results: From the 96 areas evaluated, 84 revealed an increase or stability in the alveolar bone thickness and twelve displayed significant bone loss. Bone changes did not correlate with the tooth inclination and transverse measurements. Conclusions: Within the limitation of the present study, mild levels of upper arch expansion obtained with Invisalign® aligners in adult patients did not result in any clinically significant loss of alveolar bone thickness.

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    • Original Article l 2023-05-25

      Effect of orthodontic bonding with different surface treatments on color stability and translucency of full cubic stabilized zirconia after coffee thermocycling

      Yasamin Babaee Hemmati , Hamid Neshandar Asli, Alireza Mahmoudi Nahavandi, Nika Safari, Mehran Falahchai

      Abstract : Objective: To assess the color stability and translucency of full cubic stabilized zirconia (FSZ) following orthodontic bonding with different surface treatments and coffee thermocycling (CTC). Methods: This in vitro study was conducted on 120 disc-shaped specimens of FSZ. Thirty specimens were selected as the control group and remained intact. The remaining specimens were randomly divided into three groups based on the type of surface treatment (n = 30): airborne particle abrasion (APA), silica-coating (CoJet), and carbon dioxide (CO2) laser. After metal bracket bonding in the test groups, debonding and polishing were performed. Subsequently, all specimens underwent CTC (10,000 cycles). Color parameters, color difference (ΔE00), and translucency parameter (TP) were measured three times at baseline (t0), after debonding and polishing (t1), and after CTC (t2). Data were statistically analyzed (α = 0.05). Results: Significant difference existed among the groups regarding ΔE00t0t2 (p < 0.001). The APA group showed minimum (ΔE00 = 1.15 ± 0.53) and the control group showed maximum (ΔE00 = 0.19 ± 0.02) color stability, with no significant difference between the laser and CoJet groups (p = 0.511). The four groups were significantly different regarding ΔTPt0t2 (p < 0.001). Maximal increases in TP were noted in the CoJet (1.00 ± 0.18) and APA (1.04 ± 0.38) groups while minimal increase was recorded in the control group (0.1 ± 0.02). Conclusions: Orthodontic treatment makes zirconia restorations susceptible to discoloration and increased translucency. Nonetheless, the recorded ΔE00 and ΔTP did not exceed the acceptability threshold.

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    • Original Article l 2023-09-25

      Evaluation of pain experienced by orthodontic patients following elastomeric separator insertion: A cross-sectional study

      Hareem Sultan , Hana Pervez, Sidra Maqsood, Wajeeh Syed Zeeshan

      Abstract : Objective: Pain following the insertion of separators and archwires varies with age, sex, race, ethnicity, threshold, and health status. This study aimed to evaluate the characteristics of pain in orthodontic patients after the insertion of elastomeric separators, its effects on daily life, and its association with age and sex in a population not previously studied in this regard. Methods: A cross-sectional study of 130 patients undergoing orthodontic treatment included collecting data on demographics, pain experienced following the placement of separators, time of onset, duration, characteristics, change in dietary pattern or chewing side, intake of analgesics, and severity of pain on the Wong Baker’s scale. The results are reported as counts and percentages. Associations between sex and age were evaluated using Pearson’s chi-square test. Results: Among the 130 patients, 56.2% were 9–20 years old, 63.8% experienced pain following the insertion of separators, 22.9% had their first episode of pain at 4 hours, 56.6% experienced intermittent pain, and 37.3% experienced discomfort; 18.1% males and 81.9% females experienced pain following the insertion of separators. Pearson’s chi-square test showed a significant association between pain and sex (P = 0.04). Most patients (37.3%) reported “hurts little more” for pain intensity on Wong Baker’s scale and 21.7% reported all four quadrants as sites of pain. Conclusions: The pain experienced after separator insertion was associated with sex and age. Females experienced more pain than males and patients between the age range of 21 and 36 years suffered more pain during mastication than between 9 and 20 years old.

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November, 2024
Vol.54 No.6

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Clinical Journal of Korean Association of Orthodontists