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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

      Stability of bimaxillary surgery involving intraoral vertical ramus osteotomy with or without presurgical miniscrew-assisted rapid palatal expansion in adult patients with skeletal Class III malocclusion

      Yoon-Soo Ahn , Sung-Hwan Choi , Kee-Joon Lee, Young-Soo Jung, Hyoung-Seon Baik, Hyung-Seog Yu

      Abstract : Objective: The aim of this study was to evaluate the stability of bimaxillary surgery involving bilateral intraoral vertical ramus osteotomy performed with or without presurgical miniscrew-assisted rapid palatal expansion (MARPE) in adult patients with skeletal Class III malocclusion. Methods: A total of 40 adult patients with skeletal Class III malocclusion were retrospectively divided into two groups (n = 20 each) according to the use of MARPE for the correction of transverse maxillomandibular discrepancy during presurgical orthodontic treatment. Serial lateral cephalograms and dental casts were analyzed until 6 months after surgery. Results: Before presurgical orthodontic treatment, there was no significant differences in terms of sex and age between groups. However, the difference of approximately 3.1 mm in the maxillomandibular intermolar width was statistically significant (p < 0.001). Two days after surgery, the mandible had moved backward and upward without any significant intergroup difference. Six months after surgery, the maxillary intercanine (2.7 ± 2.1 mm), interpremolar (3.6 ± 2.4 mm), and intermolar (2.0 ± 1.3 mm) arch widths were significantly increased (p < 0.001) relative to the values before presurgical orthodontic treatment in the MARPE group; these widths were maintained or decreased in the control group. However, there was no significant difference in surgical changes and the postsurgical stability between the two groups. No significant correlations existed between the amount of maxillary expansion and postsurgical mandibular movement. Conclusions: MARPE is useful for stable and nonsurgical expansion of the maxilla in adult patients with skeletal Class III malocclusion who are scheduled for bimaxillary surgery.

      Abstract  
    • 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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    • 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 2021-05-25

      Complications reported with the use of orthodontic miniscrews: A systematic review

      Antonino Lo Giudice , Lorenzo Rustico , Miriam Longo, Giacomo Oteri, Moschos A. Papadopoulos, Riccardo Nucera

      Abstract : Objective: The aim of this systematic review was to evaluate the complications and side effects associated with the clinical use of orthodontic miniscrews by systematically reviewing the best available evidence. Methods: A survey of articles published up to March 2020 investigating the complications associated with miniscrew insertion, in both the maxilla and mandible, was performed using 7 electronic databases. Clinical studies, case reports, and case series reporting complications associated with the use of orthodontic miniscrew implants were included. Two authors independently performed study selection, data extraction, and risk-of-bias assessment. Results: The database survey yielded 24 articles. The risk-of-bias assessment revealed low methodological quality for the included studies. The most frequent adverse event reported was root injury with an associated periradicular lesion, vitality loss, pink discoloration of the tooth, and transitory loss of pulp sensitivity. Chronic inflammation of the soft tissue surrounding the miniscrew with mucosal overgrowth was also reported. The other adverse events reported were lesion of the buccal mucosa at the insertion site, soft-tissue necrosis, and perforation of the floor of the nasal cavity and maxillary sinus. Adverse events were also reported after miniscrew removal and included secondary bleeding, miniscrew fracture, scars, and exostosis. Conclusions: These findings highlight the need for clinicians to preliminarily assess generic and specific insertion site complications and side effects.

      Abstract  
    • Original Article l 2020-09-25

      Short-term treatment effects produced by rapid maxillary expansion evaluated with computed tomography: A systematic review with meta-analysis

      Antonino Lo Giudice , Paola Spinuzza, Lorenzo Rustico, Gabriele Messina, Riccardo Nucera

      Abstract : Objective: To identify the available evidence on the effects of rapid maxillary expansion (RME) with three-dimensional imaging and provide meta-analytic data from studies assessing the outcomes using computed tomography. Methods: Eleven electronic databases were searched, and prospective case series were selected. Two authors screened all titles and abstracts and assessed full texts of the remaining articles. Seventeen case series were included in the quantitative synthesis. Seven outcomes were investigated: nasal cavity width, maxillary basal bone width, alveolar buccal crest width, alveolar palatal crest width, inter-molar crown width, inter-molar root apex width, and buccopalatal molar inclination. The outcomes were investigated at two-time points: postexpansion (2–6 weeks) and post-retention (4–8 months). Mean differences and 95% confidence intervals were used to summarize and combine the data. Results: All the investigated outcomes showed significant differences postexpansion (maxillary basal bone width, +2.46 mm; nasal cavity width, +1.95 mm; alveolar buccal crest width, +3.90 mm; alveolar palatal crest width, +3.09 mm; intermolar crown width, +5.69 mm; inter-molar root apex width, +2.85 mm; and dental tipping, +3.75°) and post-retention (maxillary basal bone width, +2.21 mm; nasal cavity width, +1.55 mm; alveolar buccal crest width, +3.57 mm; alveolar palatal crest width, +3.32 mm; inter-molar crown width, +5.43 mm; inter-molar root apex width, +4.75 mm; and dental tipping, 2.22°) compared to pre-expansion. Conclusions: After RME, skeletal expansion of the nasomaxillary complex was greater in most caudal structures. Maxillary basal bone showed 10% post-retention relapse. During retention period, uprighting of maxillary molars occurred.

      Abstract  
    • Original Article l 2021-05-25

      Evaluation of strategic uprighting of the mandibular molars using an orthodontic miniplate and a nickel-titanium reverse curve arch wire: Preliminary cephalometric study

      Jae-Hyun Park , HyeRan Choo , Jin-Young Choi, Kyu-Rhim Chung, Seong-Hun Kim

      Abstract : Objective: To evaluate the overall treatment effects in terms of the amount of uprighting with changes in the sagittal and vertical positions of mandibular molars after applying an orthodontic miniplate with a nickel-titanium (NiTi) reverse curve arch wire (biocreative reverse curve [BRC] system). Methods: A total of 30 female patients (mean age, 25.99 ± 8.96 years) were treated with the BRC system (mean BRC time, 10.3 ± 4.07 months). An I-shaped C-tube miniplate (Jin Biomed) was placed at the labial aspect for the alveolar bone of the mandibular incisors. A 0.017 × 0.025-inch NiTi reverse curve arch wire was engaged at the C-tube mini-plate anteriorly and the first and second premolars and molars posteriorly in the mandibular arch. Pre- and post-BRC lateral cephalograms were analyzed. A paired t-test was used to analyze the treatment effects of BRC. Results: The mandibular second molars were intrusively uprighted successfully by the BRC system. Distal uprighting with a controlled vertical dimension was noted on the first molars when they remained engaged in the BRC and the distal ends of the arch wire were laid on the second molars. The mandibular first and second premolars showed a slight extrusion. The changes in the mandibular incisors were unremarkable, while the mandibular molar angulation improved significantly. The lower occlusal plane rotated counterclockwise (MP-LOP: 1.13° ± 2.60°). Conclusions: The BRC system can provide very effective molar uprighting without compromising the position of the mandibular anterior teeth.

      Abstract  
    • 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.

      Abstract  
    • 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.

      Abstract  
    • Original Article l 2021-05-25

      Effect of extraction treatment on upper airway dimensions in patients with bimaxillary skeletal protrusion relative to their vertical skeletal pattern

      Ha-Nul Cho , Hyun Joo Yoon, Jae Hyun Park, Young-Guk Park, Su-Jung Kim

      Abstract : Objective: To investigate dimensional changes in regional pharyngeal airway spaces after premolar extraction in bimaxillary skeletal protrusion (BSP) patients according to vertical skeletal pattern, and to further identify dentoskeletal risk factors to predict posttreatment pharyngeal changes. Methods: Fifty-five adults showing BSP treated with microimplant anchorage after four premolar extractions were included in this retrospective study. The subjects were divided into two groups according to the mandibular plane steepness: hyperdivergent (Frankfort horizontal plane to mandibular plane [FH-MP] ≥ 30) and nonhyperdivergent groups (FH-MP < 30). The control group consisted of 20 untreated adults with skeletal Class I normodivergent pattern and favorable profile. Treatment changes in cephalometric variables were evaluated and compared. The association between posttreatment changes in the dentoskeletal and upper airway variables were analyzed using linear regression analysis. Results: The BSP patients showed no significant decrease in the pharyngeal dimensions to the lower level in comparison with controls, except for middle airway space (MAS, p < 0.01). The upper airway variable representing greater decrease in the hyperdivergent group than in the nonhyperdivergent group was the MAS (p < 0.01). Posttreatment changes in FH-MP had negative correlation with changes in MAS (β = –0.42, p < 0.01) and inferior airway space (β = –0.52, p < 0.01) as a result of multivariable regression analysis adjusted for sagittal skeletal relationship. Conclusions: Decreased pharyngeal dimensions after treatment in BSP patients showed no significant difference from the normal range of pharyngeal dimensions. However, the glossopharyngeal airway space may be susceptible to treatment when vertical dimension increased in hyperdivergent BSP patients.

      Abstract  

Journal Info.

November, 2021
Vol.51 No.6

Frequency: 6 times

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Journal Impact Factor

  • 1.372
    2020 IF

  • 1.737
    5-Year IF

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Clinical Journal of Korean Association of Orthodontists