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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 2020-09-25

      Positional changes in the mandibular proximal segment after intraoral vertical ramus osteotomy: Surgery-first approach versus conventional approach

      Seoyeon Jung , Yunjin Choi, Jung-Hyun Park, Young-Soo Jung, Hyoung-Seon Baik

      Abstract : Objective: To compare postoperative positional changes in the mandibular proximal segment between the conventional orthognathic surgery (CS) and the surgery-first approach (SF) using intraoral vertical ramus osteotomy (IVRO) in patients with Class III malocclusion. Methods: Thirty-eight patients with skeletal Class III malocclusion who underwent bimaxillary surgery were divided into two groups according to the use of preoperative orthodontic treatment: CS group (n = 18) and SF group (n = 20). Skeletal changes in both groups were measured using computed tomography before (T0), 2 days after (T1), and 1 year after (T2) the surgery. Three-dimensional (3D) angular changes in the mandibular proximal segment, condylar position, and maxillomandibular landmarks were assessed. Results: The mean amounts of mandibular setback and maxillary posterior impaction were similar in both groups. At T2, the posterior portion of the mandible moved upward in both groups. In the SF group, the anterior portion of the mandible moved upward by a mean distance of 0.9 ± 1.0 mm, which was statistically significant (p < 0.001). There were significant between-group differences in occlusal changes (p < 0.001) as well as in overjet and overbite. However, there were no significant between-group differences in proximal segment variables. Conclusions: Despite postoperative occlusal changes, positional changes in the mandibular proximal segment and the position of the condyles were similar between CS and SF, which suggested that SF using IVRO achieved satisfactory postoperative stability. If active physiotherapy is conducted, the proximal segment can be adapted in the physiological position regardless of the occlusal changes.

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    • Original Article l 2020-09-25

      Treatment modalities for Korean patients with unilateral hemifacial microsomia according to Pruzansky–Kaban types and growth stages

      Il-Hyung Yang , Jee Hyeok Chung , Sunjin Yim, Il-Sik Cho, Sukwha Kim, Jin-Young Choi, Jong-Ho Lee, Myung-Jin Kim, Seung-Hak Baek

      Abstract : Objective: To investigate the treatment modalities (Tx-Mods) for patients with unilateral hemifacial microsomia (UHFM) according to Pruzansky–Kaban types and growth stages. Methods: The samples consisted of 82 Korean UHFM patients. Tx-Mods were defined as follows: Tx-Mod-1, growth observation due to mild facial asymmetry; Tx-Mod-2, unilateral functional appliance; Tx- Mod-3, fixed orthodontic treatment; Tx-Mod-4, growth observation due to a definite need for surgical intervention; Tx-Mod-5, unilateral mandibular or bimaxillary distraction osteogenesis (DO); Tx-Mod-6, maxillary fixation using LeFort I osteotomy and mandibular DO/sagittal split ramus osteotomy; Tx- Mod-7, orthognathic surgery; and Tx-Mod-8, costochondral grafting. The type and frequency of Tx-Mod, the number of patients who underwent surgical procedures, and the number of surgeries that each patient underwent, were investigated. Results: The degree of invasiveness and complexity of Tx-Mod increased, with an increase in treatment stage and Pruzansky–Kaban type (initial < final; [I, IIa] < [IIb, III], all p < 0.001). The percentage of patients who underwent surgical procedures increased up to 4.2 times, with an increase in the Pruzansky–Kaban type (I, 24.1%; IIa, 47.1%; IIb, 84.4%; III, 100%; p < 0.001). However, the mean number of surgical procedures that each patient underwent showed a tendency of increase according to the Pruzansky–Kaban types (I, n = 1.1; IIa, n = 1.5; IIb, n = 1.6; III, n = 2.3; p > 0.05). Conclusions: These findings might be used as basic guidelines for successful treatment planning and prognosis prediction in UHFM patients.

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    • Original Article l 2020-11-25

      Antifibrotic effects of sulforaphane treatment on gingival elasticity reduces orthodontic relapse after rotational tooth movement in beagle dogs

      Kyong-Nim Kim , Jue-Young Kim, Jung-Yul Cha, Sung-Hwan Choi, Jin Kim, Sung-Won Cho, Chung-Ju Hwang

      Abstract : Objective: Increased gingival elasticity has been implicated as the cause of relapse following orthodontic rotational tooth movement and approaches to reduce relapse are limited. This study aimed to investigate the effects of sulforaphane (SFN), an inhibitor of osteoclastogenesis, on gene expression in gingival fibroblasts and relapse after rotational tooth movement in beagle dogs. Methods: The lower lateral incisors of five beagle dogs were rotated. SFN or dimethylsulfoxide (DMSO) were injected into the supra-alveolar gingiva of the experimental and control group, respectively, and the effect of SFN on relapse tendency was evaluated. Changes in mRNA expression of extracellular matrix components associated with gingival elasticity in beagles were investigated by real-time polymerase chain reaction. Morphology and arrangement of collagen fibers were observed on Masson’s trichrome staining of buccal gingival tissues of experimental and control teeth. Results: SFN reduced the amount and percentage of relapse of orthodontic rotation. It also decreased the gene expression of lysyl oxidase and increased the gene expression of matrix metalloproteinase (MMP) 1 and MMP 12, compared with DMSO control subjects. Histologically, collagen fiber bundles were arranged irregularly and were not well connected in the SFN-treated group, whereas the fibers extended in parallel and perpendicular directions toward the gingiva and alveolar bone in a more regular and well-ordered arrangement in the DMSO-treated group. Conclusions: Our findings demonstrated that SFN treatment may be a promising pharmacologic approach to prevent orthodontic rotational relapse caused by increased gingival elasticity of rotated teeth in beagle dogs.

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    • Brief Report l 2021-03-25

      Micro-computed tomography evaluation of general trends in aligner thickness and gap width after thermoforming procedures involving six commercial clear aligners: An in vitro study

      Mario Palone , Mattia Longo, Niki Arveda, Michele Nacucchi, Fabio De Pascalis, Giorgio Alfredo Spedicato, Giuseppe Siciliani, Luca Lombardo

      Abstract : Objective: To assess the effects of thermoforming on aligner thickness and gap width in six aligner systems with the same nominal thickness. Methods: Six passive upper aligners of different brands were adapted to a single printed cast. Each sample was evaluated with high-resolution micro-computed tomography. To investigate aligner thickness and gap width, two-dimensional (2D) analysis was conducted assessing the effects of the following variables: tooth type (central incisor, canine, and first molar), 2D reference points, and aligner type. Data were analyzed and compared using analysis of variance and Tukey’s post-hoc tests (p < 0.05). Results: Tooth type, dental region, and aligner type affected both the gap width and aligner thickness. The aligner thickness remained moderately stable across the arch only in the F22. Conclusions: All thermoformed samples displayed smaller aligner thickness and gap width at anterior teeth and both gingival and coronal centers than at posterior teeth and occlusal surfaces.

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    • Original Article l 2020-11-25

      Distribution, side involvement, phenotype and associated anomalies of Korean patients with craniofacial clefts from single university hospitalbased data obtained during 1998–2018

      Jee Hyeok Chung , Sunjin Yim, Il-Sik Cho, Seung-Weon Lim, Il-Hyung Yang, Jeong Hyun Ha, Sukwha Kim, Seung-Hak Baek

      Abstract : Objective: To investigate the distribution, side involvement, phenotype, and associated anomalies of Korean patients with craniofacial clefts (CFC). Methods: The samples consisted of 38 CFC patients, who were treated at Seoul National University Dental Hospital during 1998–2018. The Tessier cleft type, sex, side involvement, phenotype, and associated anomalies were investigated using nonparametric statistical analysis. Results: The three most common types were #7 cleft, followed by #0 cleft and #14 cleft. There was no difference between the frequency of male and female. Patients with #0 cleft exhibited nasal deformity, bony defect, and missing teeth in the premaxilla, midline cleft lip, and eye problems. A patient with #3 cleft (unilateral type) exhibited bilateral cleft lip and alveolus. All patients with #4 cleft were the bilateral type, including a combination of #3 and #4 clefts, and had multiple missing teeth. A patient with #5 cleft (unilateral type) had a posterior openbite. In patients with #7 cleft, the unilateral type was more prevalent than the bilateral type (87.0% vs. 13.0%, p < 0.001). Sixteen patients showed hemifacial microsomia (HFM), Goldenhar syndrome, and unilateral cleft lip and palate (UCLP). There was a significant match in the side involvement of #7 cleft and HFM (87.5%, p < 0.01). Patients with #14 cleft had plagiocephaly, UCLP, or hyperterorbitism. A patient with #30 cleft exhibited tongue tie and missing tooth. Conclusions: Due to the diverse associated craniofacial anomalies in patients with CFC, a multidisciplinary approach involving a well-experienced cooperative team is mandatory for these patients.

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    • Original Article l 2020-03-25

      Three-dimensional cone beam computed tomography analysis of temporomandibular joint response to the Twin-block functional appliance

      Yuan-yuan Jiang, Lian Sun, Hua Wang, Chun-yang Zhao, and Wei-Bing Zhang

      Abstract : ObjectiveTo propose a three-dimensional (3D) method for evaluating temporomandibular joint (TMJ) changes during Twin-block treatment.MethodsSeventeen patients with Class II division 1 malocclusion treated using Twin-block and nine untreated patients with a similar malocclusion were included in this research. We collected their cone beam computed tomography (CBCT) data from before and 8 months after treatment. Segmentations were constructed using ITK-SNAP. Condylar volume and superficial area were measured using 3D Slicer. The 3D landmarks were identified on CBCT images by using Dolphin software to assess the condylar positional relationship. 3D models of the mandible and glenoid fossa of the patients were constructed and registered via voxel-based superimposition using 3D Slicer. Thereafter, skeletal changes could be visualized using 3DMeshMetric in any direction of the superimposition on a color-coded map. All the superimpositions were measured using the same scale on the distance color-coded map, in which red color represents overgrowth and blue color represents resorption.ResultsSignificant differences were observed in condylar volume, superficial area, and condylar position in both groups after 8 months. Compared with the control group (CG), the Twin-block group exhibited more obvious condyle-fossa modifications and joint positional changes. Moreover, on the color-coded map, more obvious condyle-fossa modifications could be observed in the posterior and superior directions in the Twin-block group than in the CG.ConclusionsWe successfully established a 3D method for measuring and evaluating TMJ changes caused by Twin-block treatment. The treatment produced a larger condylar size and caused condylar positional changes.

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    • Original Article l 2021-01-15

      Force changes associated with differential activation of en-masse retraction and/or intrusion with clear aligners

      Ye Zhu , Wei Hu , Shuo Li

      Abstract : Objective: To investigate the three-dimensional forces created by clear aligners on mandibular teeth during differential activation with en-masse retraction and/or intrusion in vitro. Methods: Six sets of clear aligners were designed for differential en-masse retraction and/or intrusion procedures in a first premolar extraction model. Group A0 was a control group with no activation. Groups A1–5 underwent different degrees of retractions and/or intrusions. Each group consisted of 10 aligners. Aligner forces were measured on a multi-axis force/ torque transducer measurement system in real-time. Results: In the en-masse retraction groups (A1 and A2), lingual and extrusive forces were observed on the incisors; the canines mainly received distal forces; intrusive forces were seen on the second premolars; and the molars received mesial forces. In the enmasse retraction and intrusion groups (A3, A4, and A5), incisors also received lingual and extrusive forces; canines received distal and intrusive forces; mesial and extrusive forces were seen on the second premolars; and the second molars received distal and intrusive forces. The vertical forces on the incisors did not differ significantly among groups A1, A3, and A5. However, the vertical forces on the second premolars reversed from intrusion in group A1 to extrusion in groups A3 and A5. Conclusions: With clear aligners, the “bowing effect” is seen during en-masse anterior teeth retraction and can be partially relieved by performing en-masse retraction accompanied by anterior teeth intrusion. Vertical control of incisors remained unsolved during en-masse retraction, even when intrusive activation was added to the anterior teeth.

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    • Original Article l 2020-11-25

      Comparison of slot sizes and parallelism of metal brackets manufactured through metal injection molding and computerized numerical control

      Jae-Sung Park , In-Tae Song, Jae-Hee Bae, Soo-Min Gil, Kyung-Hwa Kang

      Abstract : Objective: To investigate and compare the slot sizes and parallelism of metal injection molding (MIM) and computerized numerical control (CNC) brackets. Methods: The following four MIM bracket series with 0.022-inch (in) slots were selected for investigation: Di MIM mini Twin (Ortho Organizers), Mini Diamond Roth (Ormco), Gemini MBT (3M Unitek), and Formula R Roth (Tomy). The following four CNC bracket series with 0.022-in slots were selected for investigation: Econoline MBT (Adenta), Legend mini MBT (GC Orthodontics), Crown mini MBT (Adenta), and Evolve MBT (DB Orthodontics). The slot dimensions were measured using an optical microscope (XTCam-D310M; Mitutoyo) with a resolution of 1 μm. The results were statistically analyzed using one-way analysis of variance and the Tukey post-hoc test with a significance level of 0.05. Results: The results indicated that all the investigated slot sizes were oversized with respect to the manufacturers’ specifications (0.022 in). Among the eight bracket series, the Di MIM bracket (MIM) was the most oversized by 10.4%, whereas the Evolve bracket (CNC) was the least oversized by 2.6%. The slots in seven of the bracket series had divergent walls instead of parallel ones. The Evolve bracket alone had parallel slot walls. Conclusions: Regardless of the manufacturing method, all the slot sizes of the brackets investigated in this study were significantly oversized; most of the slot walls were nonparallel, except for those of the Evolve bracket. This study could not establish that the CNC method was more accurate than the MIM method in manufacturing bracket slots.

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    • Original Article l 2019-11-25

      Three-dimensional analysis of tooth movement in Class II malocclusion treatment using arch wire with continuous tip-back bends and intermaxillary elastics

      Ji-Yea Lee, Sung-Kwon Choi, Tae-Hoon Kwon, Kyung-Hwa Kang and Sang-Cheol Kim

      Abstract : ObjectiveThe aim of this study was to analyze three-dimensional (3D) changes in maxillary dentition in Class II malocclusion treatment using arch wire with continuous tip-back bends or compensating curve, together with intermaxillary elastics by superimposing 3D virtual models.MethodsThe subjects were 20 patients (2 men and 18 women; mean age 20 years 7 months ± 3 years 9 months) with Class II malocclusion treated using 0.016 × 0.022-inch multiloop edgewise arch wire with continuous tip-back bends or titanium molybdenum alloy ideal arch wire with compensating curve, together with intermaxillary elastics. Linear and angular measurements were performed to investigate maxillary teeth displacement by superimposing pre- and post-treatment 3D virtual models using Rapidform 2006 and analyzing the results using paired t-tests.ResultsThere were posterior displacement of maxillary teeth (p < 0.01) with distal crown tipping of canine, second premolar and first molar (p < 0.05), expansion of maxillary arch (p < 0.05) with buccoversion of second premolar and first molar (p < 0.01), and distal-in rotation of first molar (p < 0.01). Reduced angular difference between anterior and posterior occlusal planes (p < 0.001), with extrusion of anterior teeth (p < 0.05) and intrusion of second premolar and first molar (p < 0.001) was observed.ConclusionsClass II treatment using an arch wire with continuous tip-back bends or a compensating curve, together with intermaxillary elastics, could retract and expand maxillary dentition, and reduce occlusal curvature. These results will help clinicians in understanding the mechanism of this Class II treatment.

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    • Original Article l 2021-03-25

      Differences in mandibular condyle and glenoid fossa morphology in relation to vertical and sagittal skeletal patterns: A cone-beam computed tomography study

      Kyoung Jin Noh , Hyoung-Seon Baik, Sang-Sun Han, Woowon Jang, Yoon Jeong Choi

      Abstract : Objective: This study aimed to evaluate the following null hypothesis: there are no differences in the morphology of the temporomandibular joint (TMJ) structures in relation to vertical and sagittal cephalometric patterns. Methods: This retrospective study was performed with 131 participants showing no TMJ symptoms. The participants were divided into Class I, II, and III groups on the basis of their sagittal cephalometric relationships and into hyperdivergent, normodivergent, and hypodivergent groups on the basis of their vertical cephalometric relationships. The following measurements were performed using cone-beam computed tomography images and compared among the groups: condylar volume, condylar size (width, length, and height), fossa size (length and height), and condyle-to-fossa joint spaces at the anterior, superior, and posterior condylar poles. Results: The null hypothesis was rejected. The Class III group showed larger values for condylar width, condylar height, and fossa height than the Class II group (p < 0.05). Condylar volume and superior joint space in the hyperdivergent group were significantly smaller than those in the other two vertical groups (p < 0.001), whereas fossa length and height were significantly larger in the hyperdivergent group than in the other groups (p < 0.01). The hypodivergent group showed a greater condylar width than the hyperdivergent group (p < 0.01). The sagittal and vertical cephalometric patterns showed statistically significant interactions for fossa length and height. Conclusions: TMJ morphology differed across diverse skeletal cephalometric patterns. The fossa length and height were affected by the interactions of the vertical and sagittal skeletal patterns.

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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