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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 2019-11-25

      Effect of archwire stiffness and friction on maxillary posterior segment displacement during anterior segment retraction: A three-dimensional finite element analysis

      Choon-Soo Park, Hyung-Seog Yu, Jung-Yul Cha, Sung-Seo Mo, and Kee-Joon Lee

      Abstract : ObjectiveSliding mechanics using orthodontic miniscrews is widely used to stabilize the anchorage during extraction space closure. However, previous studies have reported that both posterior segment displacement and anterior segment displacement are possible, depending on the mechanical properties of the archwire. The present study aimed to investigate the effect of archwire stiffness and friction change on the displacement pattern of the maxillary posterior segment during anterior segment retraction with orthodontic miniscrews in sliding mechanics.MethodsA three-dimensional finite element model was constructed. The retraction point was set at the archwire level between the lateral incisor and canine, and the orthodontic miniscrew was located at a height of 8 mm from the archwire between the second premolar and first molar. Archwire stiffness was simulated with rectangular stainless steel wires and a rigid body was used as a control. Various friction levels were set for the surface contact model. Displacement patterns for the posterior and anterior segments were compared between the conditions.ResultsBoth the anterior and posterior segments exhibited backward rotation, regardless of archwire stiffness or friction. Among the conditions tested in this study, the least undesirable rotation was found with low archwire stiffness and low friction.ConclusionsPosterior segment displacement may be unavoidable but reducing the stiffness and friction of the main archwire may minimize unwanted rotations during extraction space closure.

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    • Original Article l 2019-07-25

      Short-term changes in muscle activity and jaw movement patterns after orthognathic surgery in skeletal Class III patients with facial asymmetry

      Kyung-A Kim, Hong-Sik Park, Soo-Yeon Lee, Su-Jung Kim, Seung-Hak Baek, and Hyo-Won Ahn

      Abstract : ObjectiveTo evaluate the short-term changes in masticatory muscle activity and mandibular movement patterns after orthognathic surgery in skeletal Class III patients with facial asymmetry.MethodsTwenty-seven skeletal Class III adult patients were divided into two groups based on the degree of facial asymmetry: the experimental group (n = 17 [11 male and 6 female]; menton deviation ≥ 4 mm) and control group (n = 10 [4 male and 6 female]; menton deviation < 1.6 mm). Cephalography, electromyography (EMG) for the anterior temporalis (TA) and masseter muscles (MM), and mandibular movement (range of motion [ROM] and average chewing pattern [ACP]) were evaluated before (T0) and 7 to 8 months (T1) after the surgery.ResultsThere were no significant postoperative changes in the EMG potentials of the TA and MM in both groups, except in the anterior cotton roll biting test, in which the masticatory muscle activity had changed into an MM-dominant pattern postoperatively in both groups. In the experimental group, the amount of maximum opening, protrusion, and lateral excursion to the non-deviated side were significantly decreased. The turning point tended to be shorter and significantly moved medially during chewing in the non-deviated side in the experimental group.ConclusionsIn skeletal Class III patients with facial asymmetry, the EMG activity characteristics recovered to presurgical levels within 7 to 8 months after the surgery. Correction of the asymmetry caused limitation in jaw movement in terms of both ROM and ACP on the non-deviated side.

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    • Original Article l 2019-03-25

      In-vitro investigation of the mechanical friction properties of a computer-aided design and computer-aided manufacturing lingual bracket system under diverse tooth displacement condition

      Do-Yoon Kim, Sang-Woon Ha, Il-Sik Cho, Il-Hyung Yang, and Seung-Hak Baek

      Abstract : ObjectiveThe purpose of this study was to compare the static (SFF) and kinetic frictional forces (KFF) of a computer-aided design and computer-aided manufacturing lingual bracket (CAD/CAM-LB) with those of conventional LB (Con-LB) and Con-LB with narrow bracket width (Con-LB-NBW) under 3 tooth displacement conditions.MethodsThe samples were divided into 9 groups according to combinations of 3 LB types (CAD/CAM-LB [Incognito], Con-LB [7th Generation, 7G], and Con-LB-NBW [STb]) with 3 displacement conditions (no displacement [control], maxillary right lateral incisor with 1-mm palatal displacement [MXLI-PD], and maxillary right canine with 1-mm gingival displacement [MXC-GD]; n = 6/group). While drawing a 0.016-inch copper or super-elastic nickel-titanium archwire with 0.5 mm/min for 5 minutes in a chamber maintained at 36.5℃, SFF and KFF were measured. The Kruskal-Wallis method with Bonferroni correction was performed.ResultsThe Incognito group demonstrated the highest SFF, followed by the 7G and STb groups ([STb-control, STb-MXLI-PD, Stb-MXC-GD] < [7G-MXC-GD, 7G-MXLI-PD, 7G-control] < [Incognito-MXLI-PD, Incognito-control, Incognito-MXC-GD]; p < 0.001). However, there were no significant differences in SFF among the 3 displacement conditions within each bracket group. Within each displacement condition, the Incognito group demonstrated the highest KFF, followed by the 7G and STb groups ([STb-control, STb-MXLI-PD] < Stb-MXC-GD < 7G-MXLI-PD < [7G-control, 7G-MXC-GD] < [7G-MXC-GD, Incognito-MXLI-PD, Incognito-control] < [Incognito-control, Incognito-MXC-GD]; p < 0.001). MXC-GD exhibited higher KFFs than MXLI-PD in the same bracket group.ConclusionsThe slot design and ligation method of the CAD/CAM-LB system should be modified to reduce SFF and KFF during the leveling/alignment stage.

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    • Original Article l 2019-03-25

      Reliability of cone-beam computed tomography for temporomandibular joint analysis

      Hande Gorucu-Coskuner, Ezgi Atik and Hakan El

      Abstract : ObjectiveThe aim was to assess the intraobserver and interobserver reliabilities of temporomandibular joint linear measurements and condylar shape classifications performed with cone-beam computed tomography (CBCT).MethodsCBCT images of 30 patients were measured at two different time points by two orthodontists using the Dolphin 3D program (n = 60). Anterior, posterior, and superior joint space measurements and sagittal joint morphology classification in the sagittal view and medial and lateral joint space and mediolateral width measurements and coronal joint morphology classification in the coronal view were recorded. Intraclass-interclass correlation coefficients (ICC) and kappa statistics were used to assess intraobserver and interobserver reliability for the measurements and morphology classifications, respectively.ResultsThe ICC values were good for measurements of the posterior joint space by observer I and for measurements of the posterior, medial, and lateral joint spaces by observer II, while the other intraobserver measurements were excellent. Only the mediolateral width measurements showed excellent interobserver ICC values, while the other measurements showed good interobserver ICC values. Intraobserver agreement for the sagittal morphology classifications was moderate (κ = 0.479) and almost perfect (κ = 0.858) for observers I and II, respectively, while the corresponding agreement for the coronal morphology classifications was substantial for both observers. The interobserver agreement values for sagittal and coronal morphology classifications were slight (κ = 0.181) and fair (κ = 0.265), respectively.ConclusionsLinear temporomandibular joint measurements were reproducible and reliable in both intraobserver and interobserver evaluations. However, interobserver agreement for assessments of condylar shape was low.

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    • Case Report l 2019-11-25

      Longitudinal management of recurrent temporomandibular joint ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment

      Seung-Weon Lim, Jin-Young Choi, and Seung-Hak Baek

      Abstract : This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.

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    • Original Article l 2019-09-25

      Predisposing factors for external apical root resorption associated with orthodontic treatment

      Luciana Quintanilha Pires Fernandes, Natália Couto Figueiredo, Carina Cristina Montalvany Antonucci, Elizabeth Maria Bastos Lages, Ildeu Andrade, Jr, and Jonas Capelli Junior

      Abstract : ObjectiveThis study aimed to identify possible risk factors for external apical root resorption (EARR) in the maxillary incisors after orthodontic treatment.MethodsThe root length of 2,173 maxillary incisors was measured on periapical radiographs of 564 patients who received orthodontic treatment. The Kappa test was performed to evaluate intraexaminer and interexaminer reproducibility. Multiple binary logistic regression was used to determine the association between EARR and various factors. Odds ratios and 95% confidence intervals were reported.ResultsThe risk of developing EARR was 70% higher in orthodontic treatment with maxillary premolar extraction (p = 0.004), 58% higher in patients with increased overjet (p = 0.012), 41% lower in two-phase orthodontic treatment (p = 0.037), and 33% lower in patients with deep bite (p = 0.039). The lateral incisors were 54% more likely to develop EARR (p < 0.001), dilacerated roots were 2.26 times more likely to develop EARR (p < 0.001), and for each additional millimeter of root length, the risk of EARR increased by 29% (p < 0.001).ConclusionsThe potential risk factors for EARR after orthodontic treatment included treatment with maxillary premolar extraction, increased overjet at the beginning of treatment, and dilacerated roots.

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    • Original Article l 2019-09-25

      Effects of pre-applied orthodontic force on the regeneration of periodontal tissues in tooth replantation

      Won-Young Park, Min Soo Kim, Min-Seok Kim, Min-Hee Oh, Su-Young Lee, Sun-Hun Kim, and Jin-Hyoung Cho

      Abstract : ObjectiveThis study aimed to investigate the effect of pre-applied orthodontic force on the regeneration of periodontal ligament (PDL) tissues and the underlying mechanisms in tooth replantation.MethodsOrthodontic force (50 cN) was applied to the left maxillary first molars of 7-week-old male Sprague–Dawley rats (n = 32); the right maxillary first molars were left untreated to serve as the control group. After 7 days, the first molars on both sides were fully luxated and were immediately replanted in their original sockets. To verify the effects of the pre-applied orthodontic force, we assessed gene expression by using microarray analysis and real-time reverse transcription polymerase chain reaction (RT-PCR), cell proliferation by using proliferating cell nuclear antigen (PCNA) immunofluorescence staining, and morphological changes by using histological analysis.ResultsApplication of orthodontic force for 7 days led to the proliferation of PDL tissues, as verified on microarray analysis and PCNA staining. Histological analysis after replantation revealed less root resorption, a better arrangement of PDL fibers, and earlier regeneration of periodontal tissues in the experimental group than in the control group. For the key genes involved in periodontal tissue remodeling, including CXCL2, CCL4, CCL7, MMP3, PCNA, OPG, and RUNX2, quantitative RT-PCR confirmed that messenger RNA levels were higher at 1 or 2 weeks in the experimental group.ConclusionsThese results suggest that the application of orthodontic force prior to tooth replantation enhanced the proliferation and activities of PDL cells and may lead to higher success rates with fewer complications.

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    • Original Article l 2019-07-25

      Three-dimensional changes in lip vermilion morphology of adult female patients after extraction and non-extraction orthodontic treatment

      Zhi-Yu Liu, Jie Yu, Fan-Fan Dai, Ruo-Ping Jiang, and Tian-Min Xu

      Abstract : ObjectiveTo investigate the three-dimensional lip vermilion changes after extraction and non-extraction orthodontic treatment in female adult patients and explore the correlation between lip vermilion changes and incisor changes.MethodsForty-seven young female adult patients were enrolled in this study (skeletal Class III patients were excluded), including 34 lip-protruding patients treated by extraction of four first premolars (18 patients requiring mini-implants for maximum anchorage control and 16 patients without mini-implants) and 13 patients requiring non-extraction treatment. Nine angles, seven distances, and the surface area of the lip vermilion were measured by using pre- and post-treatment three-dimensional facial scans. Linear and angular measurements of incisors were performed on lateral cephalograms.ResultsThere were no significant changes in the vermilion measurements in the non-extraction group. The vermilion angle, vermilion height, central bow angle, height/width ratio, and vermilion surface area decreased significantly after the orthodontic treatment in the extraction groups, but the upper/lower vermilion proportion remained unchanged. Significant correlations were found between the changes in incisor position and those in vermilion angles, vermilion height, and surface area.ConclusionsExtraction of the four first premolars probably produced an aesthetic improvement in lip vermilion morphology. However, the upper/lower vermilion proportion remained unchanged. The variations in the vermilion were closely related to incisor changes, especially the upper incisor inclination changes.

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    • Case Report l 2020-01-25

      Comprehensive orthodontic treatment of a young girl with an odontogenic keratocyst and impacted teeth in the mandible

      Won-Kyeong Baik, Hyoung-Seon Baik, and Sung-Hwan Choi

      Abstract : Odontogenic keratocysts (OKCs) are one of the most aggressive cysts in the oral and maxillofacial area because of their high recurrence rate and infiltrative behavior. In growing patients with OKCs, a radical treatment approach might cause numerous complications, including the disturbance of jaw growth and loss of the involved tooth. This case report describes successful comprehensive orthodontic treatment combined with marsupialization of the cyst in a young girl who exhibited an OKC with impacted teeth. The 10-year-old girl presented with an OKC extending from the mandibular symphysis through the left mandibular body, with ectopic impaction of the mandibular left canine and first premolar, as well as congenitally missing bilateral mandibular second premolars. Interestingly, spontaneous improvement of the positions of the ectopic impacted teeth, along with a reduction in the size of the cyst, occurred during marsupialization. The sequential use of removable and fixed appliances enabled orthodontic traction of the impacted teeth. The treatment outcome was stable at 2.5 years after the end of the treatment. We speculate that comprehensive orthodontic treatment combined with marsupialization can be an effective treatment strategy for patients with OKCs, especially when they are encountered in young, growing patients with impacted teeth.

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    • Original Article l 2019-05-25

      Cone-beam computed tomography-guided three-dimensional evaluation of treatment effectiveness of the Frog appliance

      Mujia Li, Xiaoxia Su, Yang Li, Xianglin Li, and Xinqin Si

      Abstract : ObjectiveTo evaluate the effectiveness of the Frog appliance in three dimensions by using cone-beam computed tomography (CBCT) images.MethodsForty patients (21 boys and 19 girls), averaged 11.7 years old, with an Angle Class II division 1 malocclusion were included in our study. They had either late mixed dentition or early permanent dentition, and the maxillary second molars had not yet erupted. All patients underwent CBCT before and after the treatment for measuring changes in the maxillary first molars, second premolars, central incisors, and profile. Paired-samples t-test was used to compare the mean difference in each variable before treatment and after the first phase of treatment.ResultsThe maxillary first molars were effectively distalized by 4.25 mm (p < 0.001) and 3.53 mm (p < 0.05) in the dental crown and root apex, respectively. The tipping increased by 2.25°, but the difference was not significant. Moreover the teeth moved buccally by 0.84 mm (p < 0.05) and 2.87 mm (p < 0.01) in the mesiobuccal and distobuccal cusps, respectively, whereas no significant changes occurred in the root apex. Regarding the anchorage parts, the angle of the maxillary central incisor's long axis to the sella-nasion plane increased by 2.76° (p < 0.05) and the distance from the upper lip to the esthetic plane decreased by 0.52 mm (p = 0.01).ConclusionsThe Frog appliance effectively distalized the maxillary molars with an acceptable degree of tipping, distobuccal rotation, and buccal crown torque, with only slight anchorage loss. Furthermore, CBCT image demonstrated that it is a simple and reliable method for three-dimensional analysis.

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Journal Info.

January, 2021
Vol.51 No.1

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