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KJO Korean Journal of Orthodontics

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pISSN 2234-7518
eISSN 2005-372X
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    • Reader's Forum l 2020-05-25

      READER’S FORUM

      Seo-Rin Jeong,?Hyein Kim
    • Original Article l 2022-01-25

      Proposed parameters of optimal central incisor positioning in orthodontic treatment planning: A systematic review

      Linda Sangalli , Domenico Dalessandri, Stefano Bonetti, Gualtiero Mandelli, Luca Visconti, Fabio Savoldi

      Abstract : Objective: Planning of incisal position is crucial for optimal orthodontic treatment outcomes due to its consequences on facial esthetics and occlusion. A systematic summary of the proposed parameters is presented. Methods: Studies on Google Scholar©, PubMed©, and Cochrane Library, providing quantitative information on optimal central incisor position were included. Results: Upper incisors supero-inferior position (4–5 mm to upper lip, 67–73 mm to axial plane through pupils), antero-posterior position (3–4 mm to Nasion-A, 3–6 mm to A-Pogonion, 9–12 mm to true vertical line, 5 mm to A-projection, 9–10 mm to coronal plane through pupils), bucco-lingual angulation (4–7° to occlusal plane perpendicular on models, 20–22° to Nasion-A, 57–58° to upper occlusal plane, 16–20° to coronal plane through pupils, 108–110° to anterior-posterior nasal spine), mesio-distal angulation (5° to occlusal plane perpendicular on models). Lower incisors supero-inferior position (41–48 mm to soft-tissue mandibular plane), antero-posterior position (3–4 mm to Nasion-B, 1–3 mm to A-Pogonion, 12–15 mm to true vertical line, 6–8 mm to coronal plane through pupils), bucco-lingual angulation (1-4° to occlusal plane perpendicular on models, 87–94° to mandibular plane, 68° to Frankfurt plane, 22–25° to Nasion-B, 105° to occlusal plane, 64° to lower occlusal plane, 21° to A-Pogonion), mesio-distal angulation (2° to occlusal plane perpendicular on models). Conclusions: Although these findings can provide clinical guideline, they derive from heterogeneous studies in terms of subject characteristics and reference methods. Therefore, the optimal incisal position remains debatable.

      Abstract  
    • Original Article l 2021-09-25

      Prevalence and patterns of tooth agenesis among patients aged 12?22 years: A retrospective study

      Basak Kiziltan Eliacik , Cafer Atas, Gunseli Guven Polat

      Abstract : Objective: This study aimed to establish the prevalence and patterns of nonsyndromic tooth agenesis in patients referred to a tertiary health care facility. Methods: The intraoral records and panoramic radiographs of 9,874 patients aged 12?22 years were evaluated. The study group included 716 patients (371 male, 345 female) with non-syndromic agenesis of at least one tooth (except the third molars). The study data were assessed using descriptive statistics, chisquare test, and Mann?Whitney U test, while patterns were evaluated using a tooth agenesis code (TAC) tool. Results: A total of 1,627 congenitally missing teeth, were found in patients with non-syndromic tooth agenesis, with an average of 2.27 missing teeth per patient. The prevalence of tooth agenesis was 7.25%, and the most commonly missing teeth were the left mandibular second premolars (10.17%). The age group comparison revealed no significant difference in the median number of missing teeth per patient according to the cutoff values for ages between 12 and 22 years. When the missing teeth were examined separately according to quadrants, 114 different tooth agenesis patterns (upper right quadrant = 28, upper left quadrant = 27, lower left quadrant = 31, and lower right quadrant = 28) were identified, and 81 of these patterns appeared only once. Conclusions: This study highlights the benefits of applying the TAC tool in a large sample population. The application of the TAC tool in such studies will enable the development of template treatment plans by determining homogenous patterns of tooth agenesis in certain populations.

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    • Original Article l 2022-01-25

      Comparison of one-jaw and two-jaw orthognathic surgery in patients with skeletal Class III malocclusion using data from 10 multi-centers in Korea: Part I. Demographic and skeletodental characteristics

      Seung-Weon Lim , Minsoo Kim, Mihee Hong, Kyung-Hwa Kang, Minji Kim, Su-Jung Kim, Yoon-Ji Kim, Young Ho Kim, Sung-Hoon Lim, Sang Jin Sung, Seung-Hak Baek, Jin-Hyoung Cho

      Abstract : Objective: To investigate demographic and skeletodental characteristics of one-jaw (1J-OGS) and two-jaw orthognathic surgery (2J-OGS) in patients with skeletal Class III malocclusion. Methods: 750 skeletal Class III patients who underwent OGS at 10 university hospitals in Korea between 2015 and 2019 were investigated; after dividing them into the 1J-OGS (n = 186) and 2J-OGS groups (n = 564), demographic and skeletodental characteristics were statistically analyzed. Results: 2J-OGS was more frequently performed than 1J-OGS (75.2 vs. 24.8%), despite regional differences (capital area vs. provinces, 86.6 vs. 30.7%, p < 0.001). Males outnumbered females, and their mean operation age was older in both groups. Regarding dental patterns, the most frequent maxillary arch length discrepancy (ALD) was crowding in the 1J-OGS group (52.7%, p < 0.001) and spacing in the 2J-OGS group (40.4%, p < 0.001). However, the distribution of skeletal pattern was not significantly different between the two groups (all p > 0.05). The most prevalent skeletal patterns in both groups were hyper-divergent pattern (50.0 and 54.4%, respectively) and left-side chin point deviation (both 49.5%). Maxillary spacing (odds ratio [OR], 3.645; p < 0.001) increased the probability of 2J-OGS, while maxillary crowding (OR, 0.672; p < 0.05) and normo-divergent pattern (OR, 0.615; p < 0.05) decreased the probability of 2J-OGS. Conclusions: In both groups, males outnumbered females, and their mean operation age was older. The most frequent ALD was crowding in the 1J-OGS group, and spacing in the 2J-OGS group, while skeletal characteristics were not significantly different between the two groups.

      Abstract  
    • Original Article l 2022-03-25

      Use of automated artificial intelligence to predict the need for orthodontic extractions

      Alberto Del Real , Octavio Del Real, Sebastian Sardina, Rodrigo Oyonarte

      Abstract : Objective: To develop and explore the usefulness of an artificial intelligence system for the prediction of the need for dental extractions during orthodontic treatments based on gender, model variables, and cephalometric records. Methods: The gender, model variables, and radiographic records of 214 patients were obtained from an anonymized data bank containing 314 cases treated by two experienced orthodontists. The data were processed using an automated machine learning software (Auto-WEKA) and used to predict the need for extractions. Results: By generating and comparing several prediction models, an accuracy of 93.9% was achieved for determining whether extraction is required or not based on the model and radiographic data. When only model variables were used, an accuracy of 87.4% was attained, whereas a 72.7% accuracy was achieved if only cephalometric information was used. Conclusions: The use of an automated machine learning system allows the generation of orthodontic extraction prediction models. The accuracy of the optimal extraction prediction models increases with the combination of model and cephalometric data for the analytical process.

      Abstract  
    • Original Article l 2021-09-25

      Characterization of phenotypes and predominant skeletodental patterns in pre-adolescent patients with Pierre?Robin sequence

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

      Abstract : Objective: To investigate the phenotypes and predominant skeletodental pattern in pre-adolescent patients with Pierre?Robin sequence (PRS). Methods: The samples consisted of 26 Korean pre-adolescent PRS patients (11 boys and 15 girls; mean age at the investigation, 9.20 years) treated at the Department of Orthodontics, Seoul National University Dental Hospital between 1998 and 2019. Dental phenotypes, oral manifestation, cephalometric variables, and associated anomalies were investigated and statistically analyzed. Results: Congenitally missing teeth (CMT) were found in 34.6% of the patients (n = 9/26, 20 teeth, 2.22 teeth per patient) with 55.5% (n = 5/9) exhibiting bilaterally symmetric missing pattern. The mandibular incisors were the most common CMT (n = 11/20). Predominant skeletodental patterns included Class II relationship (57.7%), posteriorly positioned maxilla (76.9%) and mandible (92.3%), hyper-divergent pattern (92.3%), high gonial angle (65.4%), small mandibular body length to anterior cranial base ratio (65.4%), linguoversion of the maxillary incisors (76.9%), and linguoversion of the mandibular incisors (80.8%). Incomplete cleft palate (CP) of hard palate with complete CP of soft palate (61.5%) was the most frequently observed, followed by complete CP of hard and soft palate (19.2%) and CP of soft palate (19.2%) (p < 0.05). However, CP severity did not show a significant correlation with any cephalometric variables except incisor mandibular plane angle (p < 0.05). Five craniofacial and 15 extra-craniofacial anomalies were observed (53.8% patients); this implicated the need of routine screening. Conclusions: The results might provide primary data for individualized diagnosis and treatment planning for pre-adolescent PRS patients despite a single institution-based data.

      Abstract  
    • Original Article l 2022-01-25

      Incidence and management of condylar resorption after orthognathic surgery: An overview

      Selene Barone , Giorgio Cosentini, Francesco Bennardo, Alessandro Antonelli, Amerigo Giudice

      Abstract : Objective: Condylar resorption (CR) is one of the major post-surgical complications of orthognathic surgery. This systematic review (SR) aimed to evaluate epidemiological data, risk factors, and therapeutical management of CR. Methods: Six databases were screened by two investigators until September 2020 to obtain all SRs. After reading the titles and abstracts, eligible SRs were determined and data extraction was performed. Using the latest version of A Measurement Tool to Assess Systematic Reviews, the methodological quality of the included SRs was determined. Results: Ten SRs with low or critically-low methodological quality were included in this review. Mandibular hypoplasia on the sagittal plane and hyperdivergent growth pattern on the vertical plane were the most common skeletal alterations in which CR could occur after orthognathic surgery. Post-operative condylar changes were analyzed both on two-dimensional and three-dimensional (3D) radiographic examinations. The incidence of CR was not related to the fixation method. Based on the severity of the pathological conditions, management of CR can include conservative or surgical therapy. Conclusions: Despite the limited evidence in literature, CR is considered a consequence of orthognathic surgery. However, an accurate diagnosis of CR and a better orthognathic surgical planning must include 3D radiographic examinations to improve pre- and post-surgical comparison. Well-designed studies with long-term follow-up and 3D data are needed to clarify the findings of this analysis..

      Abstract  
    • Brief Report l 2022-01-25

      Micro-computed tomographic evaluation of the effect of fluoride agents on white spot lesions: An in vitro study

      Sook-Chan Hong , Dong-Yul Lee, Yae-Jin Kim

      Abstract : Objective: To investigate remineralizing effect of three fluoride regimens on artificially demineralized enamel around orthodontic bracket by analyzing mineral density (MD) acquired from micro-computed tomography (micro-CT). Methods: Forty-eight bracket bonded bovine incisors were prepared to create demineralized enamel (DE) surface. The samples were divided into four groups according to the fluoride regimen: 1) no fluoridation, 2) 1.23% acidulated phosphate fluoride (APF) gel, 3) fluoridated toothpaste, and 4) 0.05% sodium fluoride mouthwash. Micro-CT was scanned after demineralization (T0), and 2 weeks (T1) and 4 weeks (T2) of fluoridation. Results: APF gel showed highest remineralization of DE during T1–T0 interval among the groups (p < 0.05); followed by toothpaste, mouthwash and no fluoridation. APF gel and toothpaste demonstrated significant increase in MD after 4 weeks of application (p < 0.05). Conclusions: Remineralization effects of three fluoride regimens were depicted through micro-CT analysis, of which APF gel was most effective.

      Abstract  
    • Original Article l 2022-03-25

      Remote digital monitoring during the retention phase of orthodontic treatment: A prospective feasibility study

      Linda Sangalli , Fabio Savoldi , Domenico Dalessandri, Luca Visconti, Francesca Massetti, Stefano Bonetti

      Abstract : Objective: To evaluate if a remote digital monitoring system added at the end of orthodontic treatment could positively influence the retention phase by reducing the occurrence of misfit of removable appliances, number of emergency appointments (EA), and orthodontic relapse. Methods: Twenty-seven patients who completed active orthodontic treatment were divided into the study and control groups. In addition to the standard chairside follow-up appointments at month 1 (T1), month 3 (T2), month 6 (T3), the study group patients were monitored using Dental Monitoring? with monthly intra-oral scans. Occurrence of misfit of removable retainers, number of EAs, and intercanine width change were recorded for both groups. Differences in EAs and retainer fit were assessed using the chi-square test. Intra-group and inter-group differences in the intercanine width were assessed with Friedman test and Mann?Whitney U test, respectively (α = 0.05). Results: The study group showed a significantly lower occurrence of misfit of removable retainers (p = 0.027) compared to the control group. No significant inter- and intra-group difference was found in the EAs and intercanine width change at each time-point. Conclusions: Integrating remote monitoring systems, such as Dental Monitoring?, to the retention phase of the orthodontic treatment may lower the occurrence of misfit of removable retainers. However, a small sample size and a short observation period limit the strength of this evidence. These preliminary results tentatively suggest that remote monitoring technologies may be beneficial, especially during the COVID-19 pandemic, when the regularity of in-office visits might be disrupted.

      Abstract  
    • Original Article l 2022-03-25

      Deep learning for the classification of cervical maturation degree and pubertal growth spurts: A pilot study

      Hossein Mohammad-Rahimi , Saeed Reza Motamadian, Mohadeseh Nadimi, Sahel Hassanzadeh-Samani, Mohammad A. S. Minabi, Erfan Mahmoudinia, Victor Y. Lee, Mohammad Hossein Rohban

      Abstract : Objective: This study aimed to present and evaluate a new deep learning model for determining cervical vertebral maturation (CVM) degree and growth spurts by analyzing lateral cephalometric radiographs. Methods: The study sample included 890 cephalograms. The images were classified into six cervical stages independently by two orthodontists. The images were also categorized into three degrees on the basis of the growth spurt: pre-pubertal, growth spurt, and post-pubertal. Subsequently, the samples were fed to a transfer learning model implemented using the Python programming language and PyTorch library. In the last step, the test set of cephalograms was randomly coded and provided to two new orthodontists in order to compare their diagnosis to the artificial intelligence (AI) model’s performance using weighted kappa and Cohen’s kappa statistical analyses. Results: The model’s validation and test accuracy for the six-class CVM diagnosis were 62.63% and 61.62%, respectively. Moreover, the model’s validation and test accuracy for the three-class classification were 75.76% and 82.83%, respectively. Furthermore, substantial agreements were observed between the two orthodontists as well as one of them and the AI model. Conclusions: The newly developed AI model had reasonable accuracy in detecting the CVM stage and high reliability in detecting the pubertal stage. However, its accuracy was still less than that of human observers. With further improvements in data quality, this model should be able to provide practical assistance to practicing dentists in the future.

      Abstract  

Journal Info.

May, 2022
Vol.52 No.3

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