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, Jun Li, Youjian Peng Abstract : This case report describes the treatment of an adult female patient with a history of periodontal disease, Class I malocclusion with extrusion, dental spaces, and pathologic tooth migration. The patient was treated with clear aligners, which effectively controlled the strength and direction of orthodontic forces after 3 months of systematic periodontal treatment. The Peer Assessment Rating (PAR) index was calculated from study models before and after treatment. The pretreatment PAR score was 24, and the posttreatment PAR score was 4. The PAR score for this patient changed by 83%. Satisfactory appearance and good function were achieved for this patient.
, Saeed Reza Motamadian, Mohadeseh Nadimi, Sahel Hassanzadeh-Samani, Mohammad A. S. Minabi, Erfan Mahmoudinia, Victor Y. Lee, Mohammad Hossein Rohban Abstract : Objective: This study aimed to present and evaluate a new deep learning model for determining cervical vertebral maturation (CVM) degree and growth spurts by analyzing lateral cephalometric radiographs. Methods: The study sample included 890 cephalograms. The images were classified into six cervical stages independently by two orthodontists. The images were also categorized into three degrees on the basis of the growth spurt: pre-pubertal, growth spurt, and post-pubertal. Subsequently, the samples were fed to a transfer learning model implemented using the Python programming language and PyTorch library. In the last step, the test set of cephalograms was randomly coded and provided to two new orthodontists in order to compare their diagnosis to the artificial intelligence (AI) model’s performance using weighted kappa and Cohen’s kappa statistical analyses. Results: The model’s validation and test accuracy for the six-class CVM diagnosis were 62.63% and 61.62%, respectively. Moreover, the model’s validation and test accuracy for the three-class classification were 75.76% and 82.83%, respectively. Furthermore, substantial agreements were observed between the two orthodontists as well as one of them and the AI model. Conclusions: The newly developed AI model had reasonable accuracy in detecting the CVM stage and high reliability in detecting the pubertal stage. However, its accuracy was still less than that of human observers. With further improvements in data quality, this model should be able to provide practical assistance to practicing dentists in the future.
, Fabio Savoldi , Domenico Dalessandri, Luca Visconti, Francesca Massetti, Stefano BonettiAbstract : Objective: To evaluate if a remote digital monitoring system added at the end of orthodontic treatment could positively influence the retention phase by reducing the occurrence of misfit of removable appliances, number of emergency appointments (EA), and orthodontic relapse. Methods: Twenty-seven patients who completed active orthodontic treatment were divided into the study and control groups. In addition to the standard chairside follow-up appointments at month 1 (T1), month 3 (T2), month 6 (T3), the study group patients were monitored using Dental Monitoring® with monthly intra-oral scans. Occurrence of misfit of removable retainers, number of EAs, and intercanine width change were recorded for both groups. Differences in EAs and retainer fit were assessed using the chi-square test. Intra-group and inter-group differences in the intercanine width were assessed with Friedman test and Mann–Whitney U test, respectively (α = 0.05). Results: The study group showed a significantly lower occurrence of misfit of removable retainers (p = 0.027) compared to the control group. No significant inter- and intra-group difference was found in the EAs and intercanine width change at each time-point. Conclusions: Integrating remote monitoring systems, such as Dental Monitoring®, to the retention phase of the orthodontic treatment may lower the occurrence of misfit of removable retainers. However, a small sample size and a short observation period limit the strength of this evidence. These preliminary results tentatively suggest that remote monitoring technologies may be beneficial, especially during the COVID-19 pandemic, when the regularity of in-office visits might be disrupted.
, Inhwan Kim , Jin-Hyoung Cho, Kyung-Hwa Kang, Minji Kim, Su-Jung Kim, Yoon-Ji Kim, Sang-Jin Sung, Young Ho Kim, Sung-Hoon Lim, Namkug Kim , Seung-Hak Baek Abstract : Objective: To investigate the pattern of accuracy change in artificial intelligence-assisted landmark identification (LI) using a convolutional neural network (CNN) algorithm in serial lateral cephalograms (Lat-cephs) of Class III (C-III) patients who underwent two-jaw orthognathic surgery. Methods: A total of 3,188 Lat-cephs of C-III patients were allocated into the training and validation sets (3,004 Lat-cephs of 751 patients) and test set (184 Lat-cephs of 46 patients; subdivided into the genioplasty and non-genioplasty groups, n = 23 per group) for LI. Each C-III patient in the test set had four Lat-cephs: initial (T0), pre-surgery (T1, presence of orthodontic brackets [OBs]), post-surgery (T2, presence of OBs and surgical plates and screws [S-PS]), and debonding (T3, presence of S-PS and fixed retainers [FR]). After mean errors of 20 landmarks between human gold standard and the CNN model were calculated, statistical analysis was performed. Results: The total mean error was 1.17 mm without significant difference among the four time-points (T0, 1.20 mm; T1, 1.14 mm; T2, 1.18 mm; T3, 1.15 mm). In comparison of two time-points ([T0, T1] vs. [T2, T3]), ANS, A point, and B point showed an increase in error (p < 0.01, 0.05, 0.01, respectively), while Mx6D and Md6D showeda decrease in error (all p < 0.01). No difference in errors existed at B point, Pogonion, Menton, Md1C, and Md1R between the genioplasty and non-genioplasty groups. Conclusions: The CNN model can be used for LI in serial Lat-cephs despite the presence of OB, S-PS, FR, genioplasty, and bone remodeling.
, Yingcheng Zheng , Zhenzhen Zhang, Zihan Zhang, Lina Wu, Jiaqi Liu, Wenke Yang, Jun Wang Abstract : Objective: To provide reliable prediction models based on dentoskeletal and soft tissue variables for customizing maxillary incisor positions and to optimize digitalized orthodontic treatment planning. Methods: This study included 244 Chinese women (age, 18–40 years old) with esthetic profiles after orthodontic treatment with fixed appliances (133 in group I: 1° ≤ The angle between the nasion [N]-A point [A] plane and the N-B point [B] plane [ANB] ≤ 4°; 111 in group II: 4° < ANB ≤ 7°). Dental, skeletal, and soft tissue measurements were performed on lateral cephalograms of the participants. Correlation and multiple linear regression analyses were used to determine the influence of dentoskeletal and soft tissue variables on maxillary incisor position. Results: The ideal anteroposterior position of the maxillary incisor varied between sagittal skeletal patterns. The position of the maxillary incisor correlated with the sagittal discrepancy between the maxilla and the mandible (ANB), protrusion of the midface, nasal tip projection, development of the chin, and inclination of both the maxillary and mandibular incisors. Distance from the maxillary central incisor to nasion-pogonion plane predicted using multiple linear regression analysis was accurate and could be a practical measurement in orthodontic treatment planning. Conclusions: Instead of using an average value or norm, orthodontists should customize a patient’s ideal maxillary incisor position using dentoskeletal and soft tissue evaluations.
Abstract : This case report describes skeletal anchorage-supported maxillary protraction performed with the Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC) protocol over a treatment duration of 14 months in a 16-year-old female patient who was in the late growth-development period. Miniplates were applied to the patient's aperture piriformis area to apply force from the protraction appliance. After 9 weeks of following the Alt-RAMEC protocol, miniplates were used to transfer a unilateral 500-g protraction force to a Petit-type face mask. A significant improvement was observed in the soft tissue profile in measurements made both cephalometrically and in three dimensional photographs. Subsequently, the second phase of fixed orthodontic treatment was started and the treatment was completed with the retention phase. Following treatment completion, occlusion, smile esthetics, and soft tissue profile improved significantly in response to orthopedic and orthodontic treatment.
, Jin-Young Choi , Min-Ji Kim, Xu Bin, Seong-Hun Kim Abstract : Objective: To analyze the overall treatment effects in terms of the amount of uprighting with changes in the three-dimensional positions of the mandibular posterior teeth after applying the biocreative reverse curve (BRC) system. Methods: Thirty-four patients (mean age, 20.5 ± 8.56 years) were treated using the BRC system (mean period, 8.17 ± 2.19 months). Cone-beam computed tomography was performed before treatment and after treatment with the BRC system. The three-dimensional movement of each tooth was analyzed in the coordinate system at points on the crown and root apex. A paired t-test was used to analyze the treatment effects of the BRC system. Results: The application of the BRC system spanning from the first premolar to the second molar resulted not only in buccal and distal uprighting, but also in increased buccal and distal tipping of the teeth. The premolars and the first molar were extruded, and the second molar was intruded. Conclusions: When the BRC system is applied, simultaneous distal and buccal uprighting of the premolars and molars can be achieved bilaterally using a temporary skeletal anchorage device without unnecessary movement of the anterior teeth.
, Minsoo Kim, Mihee Hong, Kyung-Hwa Kang, Minji Kim, Su-Jung Kim, Yoon-Ji Kim, Young Ho Kim, Sung-Hoon Lim, Sang Jin Sung, Seung-Hak Baek, Jin-Hyoung Cho Abstract : Objective: To investigate demographic and skeletodental characteristics of one-jaw (1J-OGS) and two-jaw orthognathic surgery (2J-OGS) in patients with skeletal Class III malocclusion. Methods: 750 skeletal Class III patients who underwent OGS at 10 university hospitals in Korea between 2015 and 2019 were investigated; after dividing them into the 1J-OGS (n = 186) and 2J-OGS groups (n = 564), demographic and skeletodental characteristics were statistically analyzed. Results: 2J-OGS was more frequently performed than 1J-OGS (75.2 vs. 24.8%), despite regional differences (capital area vs. provinces, 86.6 vs. 30.7%, p < 0.001). Males outnumbered females, and their mean operation age was older in both groups. Regarding dental patterns, the most frequent maxillary arch length discrepancy (ALD) was crowding in the 1J-OGS group (52.7%, p < 0.001) and spacing in the 2J-OGS group (40.4%, p < 0.001). However, the distribution of skeletal pattern was not significantly different between the two groups (all p > 0.05). The most prevalent skeletal patterns in both groups were hyper-divergent pattern (50.0 and 54.4%, respectively) and left-side chin point deviation (both 49.5%). Maxillary spacing (odds ratio [OR], 3.645; p < 0.001) increased the probability of 2J-OGS, while maxillary crowding (OR, 0.672; p < 0.05) and normo-divergent pattern (OR, 0.615; p < 0.05) decreased the probability of 2J-OGS. Conclusions: In both groups, males outnumbered females, and their mean operation age was older. The most frequent ALD was crowding in the 1J-OGS group, and spacing in the 2J-OGS group, while skeletal characteristics were not significantly different between the two groups.
, Junjie Ye , Akram Al-Nasri, Catherine Chu, Wei-Bing Zhang , Lin-WangAbstract : Objective: Morphometric and morphological evaluation of the mandibular condyle in adults and to identify its correlation with skeletal malocclusion patterns. Methods: Cone-beam computed tomography scans of 135 adult patients were used in this study and classified into groups according to four criteria: (1) sex (male and female); (2) sagittal skeletal discrepancy (Class I, Class II, and Class III); (3) vertical skeletal discrepancy (hyperdivergent, normodivergent, and hypodivergent); and age (group 1 ≤ 20 years, 21 ≤ group 2 < 30, and group 3 ≥ 30 years). The morphometrical variables were mandibular condyle height and width, and the morphological variable was the mandibular condyle shape in coronal and sagittal sections. Three-dimensional standard tessellation language files were created using itk-snap (open-source software), and measurements were performed using Meshmixer (open-source software). Results: The mandibular condyle height was significantly greater (p < 0.05) in patients with class III malocclusion than in those with class I or II malocclusion; the mandibular condyle width was not significantly different among different sexes, age groups, and sagittal and vertical malocclusions. There were no statistical associations between various mandibular condyle shapes and the sexes, age groups, and skeletal malocclusions. Conclusions: The condylar height was greatest in patients with class III malocclusion. The condylar height and width were greater among males than in females. The mandibular condyle shapes observed in sagittal and coronal sections did not affect the skeletal malocclusion patterns.
1.9
2022 IF
2.3
5-Year IF
