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KJO Korean Journal of Orthodontics

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pISSN 2234-7518
eISSN 2005-372X
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    • Case Report l 2019-07-25

      Maxillomandibular advancement surgery after long-term use of a mandibular advancement device in a post-adolescent patient with obstructive sleep apnea

      Keun-Ha Lee, Kyung-A Kim, Yong-Dae Kwon, Sung-Wan Kim, and Su-Jung Kim

      Abstract : Patients with obstructive sleep apnea (OSA) whose phenotype belongs to a craniofacial vulnerability are referred from sleep doctors to orthodontists. In adults, for osseo-pharyngeal reconstruction (OPR) treatment, permanent maxillomandibular advancement (MMA) surgery and use of a temporary mandibular advancement device (MAD) are applied. This case report demonstrates successful treatment of OSA through application of phased MAD and MMA in a 16-year-old male with craniofacial deformity and residual growth potential. This patient showed skeletal and dentoalveolar changes after 7-year MAD use throughout post-adolescence, which affected the design and timing of subsequent MMA surgery, as well as post-surgical orthodontic strategy. This case report suggests that OPR treatment can be useful for treatment of OSA in post-adolescent patients, from an orthodontic point of view, in close collaboration with sleep doctors for interdisciplinary diagnosis and treatment.

      Abstract  
    • Original Article l 2019-05-25

      Investigation of the association between orthodontic treatment and temporomandibular joint pain and dysfunction in the South Korean population

      Hye-Young Sim, Hee-Sun Kim, Da-Un Jung, Ho Lee, Yoon-Sic Han, Kyungdo Han, and Kyoung-In Yun

      Abstract : ObjectiveThis study investigated the relationship between orthodontic treatment and temporomandibular disorders (TMD) in South Korean population.MethodsThis study obtained data from the 2012 Korean National Health and Nutrition Examination Survey. The final sample size was 5,567 participants who were ≥ 19 years of age. Logistic regression analysis was performed to evaluate the relationship between orthodontic treatment and TMD.ResultsParticipants who underwent orthodontic treatment showed higher educational level, lower body mass index, reduced chewing difficulty, and reduced speaking difficulty. The adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) for orthodontic treatment and TMD were 1.614 (1.189–2.190), 1.573 (1.162–2.129) and 1.612 (1.182–2.196) after adjusting for age, sex and psychosocial factors. Adjusted ORs and their 95% CIs for orthodontic treatment and clicking were 1.778 (1.289–2.454), 1.742 (1.265–2.400) and 1.770 (1.280–2.449) after adjusting for confounding factors. However, temporomandibular joint pain and functional impairment was not associated with orthodontic treatment.ConclusionsTemporomandibular joint pain and dysfunction was not associated with orthodontic treatment.

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    • Original Article l 2020-01-25

      Accuracy and reliability of measurements performed using two different software programs on digital models generated using laser and computed tomography plaster model scanners

      Leonardo T. Camardella, Edwin M. Ongkosuwito, E. Willemijn Penning, Anne Marie Kuijpers-Jagtman, Oswaldo V. Vilella, and K. Hero Breuning

      Abstract : ObjectiveThe aim of this study was to compare the accuracy and reliability of measurements performed using two different software programs on digital models generated using two types of plaster model scanners (a laser scanner and a computed tomography [CT] scanner).MethodsThirty plaster models were scanned with a 3Shape laser scanner and with a Flash CT scanner. Two examiners performed measurements on plaster models by using digital calipers and on digital models by using Ortho Analyzer (3Shape) and Digimodel® (OrthoProof) software programs. Forty-two measurements, including tooth diameter, crown height, overjet, overbite, intercanine and intermolar distances, and sagittal relationship, were obtained.ResultsStatistically significant differences were not found between the plaster and digital model measurements (ANOVA); however, some discrepancies were clinically relevant. Plaster and digital model measurements made using the two scanning methods showed high intraclass coefficient correlation values and acceptable 95% limits of agreement in the Bland-Altman analysis. The software used did not influence the accuracy of measurements.ConclusionsDigital models generated from plaster casts by using laser and CT scanning and measured using two different software programs are accurate, and the measurements are reliable. Therefore, both fabrication methods and software could be used interchangeably.

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    • Reader's Forum l 2020-05-25

      READER’S FORUM

      Seo-Rin Jeong, Hyein Kim
    • Original Article l 2019-09-25

      Evaluation of skeletal maturity in the cervical vertebrae and hand-wrist in relation to vertical facial types

      Ye-Seul Lee, Sung-Hwan Choi, Kyung-Ho Kim, and Chung-Ju Hwang

      Abstract : ObjectiveTo evaluate differences in skeletal maturity in relation to vertical facial types and to compare differences in the skeletal maturity of the cervical vertebrae and hand-wrist in females.MethodsThis study included 59 females aged 7 to 9 years with skeletal Class I malocclusion. The participants were categorized into three groups (low, normal, and high) according to the mandibular plane angle. Skeletal maturity was measured using skeletal maturity indicators (SMIs) and the Tanner–Whitehouse III (TW3) method on hand-wrist radiographs and by using cervical vertebrae maturation indicators (CVMIs) on lateral cephalometric radiographs.ResultsThe SMI was higher in the high-angle group than in the low-angle group (p = 0.014). The median TW3 bone age was 11.4 months higher in the high-angle group than in the low-angle group (p = 0.032). There was no significant difference in CVMI among the three groups. Skeletal maturity showed a weakly positive correlation with the mandibular plane angle (SMI, r = 0.391; TW3, r = 0.333; CVMI, r = 0.259).ConclusionsThe skeletal maturity of the hand-wrist in females with a high mandibular plane angle was higher than that in females with a low mandibular plane angle. Obtaining additional hand-wrist radiographs may facilitate evaluation of skeletal maturity of females. In females with a high mandibular angle, the time to commence orthodontic treatment may be earlier than that in females with a low mandibular angle.

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    • Original Article l 2020-01-25

      Distribution and phenotypes of hemifacial microsomia and its association with other anomalies

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

      Abstract : ObjectiveTo investigate the distribution and phenotypes of hemifacial microsomia (HFM) and its association with other anomalies.MethodsThis study included 249 Korean patients with HFM, whose charts, photographs, radiographs, and/or computed tomography scans acquired during 1998–2018 were available from Seoul National University Hospital and Dental Hospital. Prevalence according to sex, side involvement, degree of mandibular deformity, compensatory growth of the mandibular body, and Angle's classification, and its association with other anomalies were statistically analyzed.ResultsPrevalence was not different between male and female patients (55.0% vs. 45.0%, p > 0.05). Unilateral HFM (UHFM) was more prevalent than bilateral HFM (BHFM) (86.3% vs. 13.7%, p < 0.001). Although distribution of the Pruzansky–Kaban types differed significantly in patients with UHFM (I, 53.0%; IIa, 18.6%; IIb, 24.7%; III, 3.7%; p < 0.001), no difference was observed in occurrence between the right and left sides (52.6% vs. 47.4%, p > 0.05). Among patients with BHFM, prevalence of different Pruzansky–Kaban types on the right and left sides was greater than that of the same type on both sides (67.6% vs. 32.4%, p < 0.05). Despite hypoplasia of the condyle/ramus complex, compensatory growth of the mandibular body on the ipsilateral side occurred in 35 patients (14.1%). Class I and II molar relationships were more prevalent than Class III molar relationships (93.2% vs. 6.8%, p < 0.001). Forty-eight patients (19.3%) had other anomalies, with 50.0% and 14.4% in the BHFM and UHFM groups (p < 0.001).ConclusionsPatients with HFM require individualized diagnosis and treatment planning because of diverse phenotypes and associations with other anomalies.

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    • Case Report l 2020-09-25

      Maxillary protraction using customized mini-plates for anchorage in an adolescent girl with skeletal Class III malocclusion

      Shuran Liang , Xianju Xie, Fan Wang, Qiao Chang, Hongmei Wang, Yuxing Bai

      Abstract : The treatment of skeletal Class III malocclusion in adolescents is challenging. Maxillary protraction, particularly that using bone anchorage, has been proven to be an effective method for the stimulation of maxillary growth. However, the conventional procedure, which involves the surgical implantation of mini-plates, is traumatic and associated with a high risk. Three-dimensional (3D) digital technology offers the possibility of individualized treatment. Customized miniplates can be designed according to the shape of the maxillary surface and the positions of the roots on cone-beam computed tomography scans; this reduces both the surgical risk and patient trauma. Here we report a case involving a 12-year-old adolescent girl with skeletal Class III malocclusion and midface deficiency that was treated in two phases. In phase 1, rapid maxillary expansion and protraction were performed using 3D-printed mini-plates for anchorage. The mini-plates exhibited better adaptation to the bone contour, and titanium screw implantation was safer because of the customized design. The orthopedic force applied to each mini-plate was approximately 400–500 g, and the plates remained stable during the maxillary protraction process, which exhibited efficacious orthopedic effects and significantly improved the facial profile and esthetics. In phase 2, fixed appliances were used for alignment and leveling of the maxillary and mandibular dentitions. The complete two-phase treatment lasted for 24 months. After 48 months of retention, the treatment outcomes remained stable.

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    • 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 2019-05-25

      Palatal en-masse retraction of segmented maxillary anterior teeth: A finite element study

      Jae Hyun Park, Yoon-Ah Kook, Yukio Kojima, Sunock Yun, and Jong-Moon Chae

      Abstract : ObjectiveThe aim of this finite element study was to clarify the mechanics of tooth movement in palatal en-masse retraction of segmented maxillary anterior teeth by using anchor screws and lever arms.MethodsA three-dimensional finite element method was used to simulate overall orthodontic tooth movements. The line of action of the force was varied by changing both the lever arm height and anchor screw position.ResultsWhen the line of action of the force passed through the center of resistance (CR), the anterior teeth showed translation. However, when the line of action was not perpendicular to the long axis of the anterior teeth, the anterior teeth moved bodily with an unexpected intrusion even though the force was transmitted horizontally. To move the anterior teeth bodily without intrusion and extrusion, a downward force passing through the CR was necessary. When the line of action of the force passed apical to the CR, the anterior teeth tipped counterclockwise during retraction, and when the line of action of the force passed coronal to the CR, the anterior teeth tipped clockwise during retraction.ConclusionsThe movement pattern of the anterior teeth changed depending on the combination of lever arm height and anchor screw position. However, this pattern may be unpredictable in clinical settings because the movement direction is not always equal to the force direction.

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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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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