Abstract : Objective: This study aimed to investigate the effect of micro-osteoperforations (MOPs) on external apical root resorption (EARR) during the initial orthodontic alignment phase of maxillary anterior crowding. Methods: Thirty patients (25 females, 5 males; mean age, 22.66 ± 3.27 years) who presented with moderate crowding of the upper labial segment and underwent extraction-based fixed appliance treatment were recruited. They were randomly allocated to receive adjunctive therapy with MOPs (n = 15) or treatment with fixed appliances only (control group; n = 15). EARR was measured from long-cone periapical radiographs taken at the start and the sixth month of treatment. A correction factor for the enlargement difference was used to calculate EARR. Data were analyzed with descriptive statistics and repeated-measures analysis of variance. Results: The mean root lengths of 168 teeth were measured and showed no statistically significant difference (p > 0.05) after six months of fixed appliance treatment in the MOP (mean difference [MD] = 0.13 mm; 95% confidence interval [CI] = −0.10–0.35) and control group (MD = 0.14 mm; 95% CI = −0.10–0.37). Most of the roots in the MOP and control groups (42.86% and 52.38%, respectively) showed only mild resorption. Less than 8% of the roots in both groups (7.14% in the MOP group and 4.76% in the control group) showed moderate resorption. Conclusions: Acceleration of orthodontic tooth movement with adjunctive MOPs therapy during the alignment phase does not exacerbate EARR in patients with moderate crowding of the upper labial segment in comparison with controls.
Abstract : Objective: The purpose of this study was to examine the effectiveness and mechanism of clear aligner therapy for the correction of anterior open bite in adult nonextraction cases. Methods: Sixty-nine adult patients with anterior open bite were enrolled and classified into Angle’s Class I, II, and III groups. Fifty patients presented with skeletal open bite (mandibular plane angle [MPA] ≥ 38°), whereas 19 presented with dental open bite. Fifteen cephalometric landmarks were identified before (T1) and after (T2) treatment. The magnitudes of planned and actual movements of the incisors and molars were calculated. Results: Positive overbite was achieved in 94% patients, with a mean final overbite of 1.1 ± 0.8 mm. The mean change in overbite was 3.3 ± 1.4 mm. With clear aligners alone, 0.36 ± 0.58 mm of maxillary molar intrusion was achieved. Compared with the Class I group, the Class II group showed greater maxillary molar intrusion and MPA reduction. The Class III group showed greater mandibular incisor extrusion with no significant vertical skeletal changes. Conclusions: Clear aligners can be effective in controlling the vertical dimension and correcting mild to moderate anterior open bite in adult nonextraction cases. The treatment mechanism for Class III patients significantly differed from that for Class I and Class II patients. Maxillary incisor extrusion in patients with dental open bite and MPA reduction with mandibular incisor extrusion in patients with skeletal open bite are the most significant contributing factors for open bite closure.
Abstract : Objective: The purpose of this study was to evaluate the relationship between rotational disk displacement (DD) of the temporomandibular joint (TMJ) and the dentoskeletal morphology. Methods: Women aged > 17 years were included in this study. Each subject had a primary complaint of malocclusion and underwent routine cephalometric examinations. They were divided into five groups according to the findings on sagittal and coronal magnetic resonance images of their TMJs: bilateral normal disk position, bilateral anterior DD with reduction (ADDR), bilateral rotational DD with reduction (RDDR), bilateral anterior DD without reduction (ADDNR), and bilateral rotational DD without reduction (RDDNR). Twenty-three cephalometric variables were analyzed, and the Kruskal–Wallis test was used to evaluate differences in the dentoskeletal morphology among the five groups. Results: Patients with TMJ DD exhibited a hyperdivergent pattern with a retrognathic mandible, unlike those with a normal disk position. These specific skeletal characteristics were more severe in patients exhibiting DD without reduction than in those with reduction, regardless of the presence of rotational DD. Rotational DD significantly influenced horizontal and vertical skeletal patterns only in the stage of DD with reduction, and the mandible exhibited a more backward position and rotation in patients with RDDR than in those with ADDR. However, there were no significant dentoskeletal differences between ADDNR and RDDNR. Conclusions: The results of this study suggest that rotational DD of TMJ plays an important role in the dentoskeletal morphology, particularly in patients showing DD with reduction.
Abstract : Objective: To estimate the projected cancer risk attributable to diagnostic cone-beam computed tomography (CBCT) performed under different exposure settings for orthodontic purposes in children and adults. Methods: We collected a list of CBCT machines and their specifications from 38 orthodontists. Organ doses were estimated using median and maximum exposure settings of 105 kVp/156.8 mAs and 130 kVp/200 mAs, respectively. The projected cancer risk attributable to CBCT procedures performed 1–3 times within 2 years was calculated for children (aged 5 and 10 years) and adult (aged 20, 30, and 40 years) male and female patients. Results: For maximum exposure settings, the mean lifetime fractional ratio (LFR) was 14.28% for children and 0.91% for adults; this indicated that the risk to children was 16 times the risk to adults. For median exposure settings, the mean LFR was 5.25% and 0.58% for children and adults, respectively. The risk of cancer decreased with increasing age. For both median and maximum exposure settings, females showed a higher risk of cancer than did males in all age groups. Cancer risk increased with an increase in the frequency of CBCT procedures within a given period. Conclusions: The projected dental CBCT-associated cancer risk spans over a wide range depending on the machine parameters and image acquisition settings. Children and female patients are at a higher risk of developing cancer associated with diagnostic CBCT. Therefore, the use of diagnostic CBCT should be justified, and protective measures should be taken to minimize the harmful biological effects of radiation.
Abstract : Objective: This study investigated the impact of a single piezocision in the maxillary alveolar process on the speed of tooth movement. The null hypothesis was that the speed of tooth movement will be equal with and without piezocision. Methods: All maxillary molars on one side were moved against the combined incisors in 10 ten-week-old male Wistar rats. Under general anesthesia, a force of 25 cN was applied on either side using a Sentalloy closed coil spring. After placing the orthodontic appliance, vertical corticision was performed using a piezotome under local anesthesia, 2 mm mesial from the mesial root of the first molar on a randomly selected side; the other side served as the control. At the beginning of the treatment, and 2 and 4 weeks later, skull micro-computed tomography was performed. After image reconstruction, the distance between the mesial root of the first molar and the incisive canal, and the length of the mesial root of the first maxillary molar were measured. Moreover, the root resorption score was determined as described by Lu et al. Results: Significantly higher speed of tooth movement was observed on the corticision side; thus, the null hypothesis was rejected. The loss of root length and root resorption score were significantly more pronounced after piezocision than before. A strong correlation was observed between the speed of tooth movement and root resorption on the surgical side, but the control side only showed a weak correlation. Conclusions: Piezocision accelerates orthodontic tooth movement and causes increased root resorption.
Abstract : Objective: To evaluate the accuracy of a one-piece bracket jig system fabricated using computer-aided design and manufacturing (CAD/CAM) by employing three-dimensional (3D) digital superimposition. Methods: This in vitro study included 226 anterior teeth selected from 20 patients undergoing orthodontic treatment. Bracket position errors from each of the 40 arches were analyzed quantitatively via 3D digital superimposition (best-fit algorithm) of the virtual bracket and actual bracket after indirect bonding, after accounting for possible variables that may affect accuracy, such as crowding and presence of the resin base. Results: The device could transfer the bracket accurately to the desired position of the patient’s dentition within a clinically acceptable range of ± 0.05 mm and 2.0° for linear and angular measurements, respectively. The average linear measurements ranged from 0.029 to 0.101 mm. Among the angular measurements, rotation values showed the least deviation and ranged from 0.396° to 0.623°. Directional bias was pronounced in the vertical direction, and many brackets were bonded toward the occlusal surface. However, no statistical difference was found for the three angular measurement values (torque, angulation, and rotation) in any of the groups classified according to crowding. When the teeth were moderately crowded, the mesio-distal, bucco-lingual, and rotation measurement values were affected by the presence of the resin base. Conclusions: The characteristics of the CAD/CAM one-piece jig system were demonstrated according to the influencing factors, and the transfer accuracy was verified to be within a clinically acceptable level for the indirect bracket bonding of anterior teeth.
Abstract : Objective: To identify the most favorable sites that optimize the initial stability and survival rate of orthodontic mini-implants, this study measured hard and soft tissue thicknesses in the median and paramedian regions of the palate using cone-beam computed tomography (CBCT) and determined possible sexand age-related differences in these thicknesses. Methods: The study sample comprised CBCT images of 189 healthy subjects. The sample was divided into four groups according to age. A grid area was set for the measurement of hard and soft tissue thicknesses in the palate. Vertical lines were marked at intervals of 0, 1.5, and 3.0 mm lateral to the midpalatal suture, while horizontal lines were marked at 2-mm intervals up to 24 mm from the posterior margin of the incisive foramen. Measurements were made at 65 points of intersection between the horizontal and vertical lines. Results: The palatal hard tissue thickness decreased from the anterior to the posterior region, with a decrease in the medial-to-lateral direction in the middle and posterior regions. While the soft tissue was rather thick around the lateral aspects of the palatal arch, it formed a constant layer that was only 1–2-mm thick throughout the palate. Statistically significant differences were observed according to sex and age. Conclusions: The anterolateral palate as well as the midpalatal suture seem to be the most favorable sites for insertion of orthodontic mini-implants. The thickness of the palate differed by age and sex; these differences should be considered while planning the placement of orthodontic mini-implants.