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  Reader's Forum l 2021-07-25

  READER'S FORUM

  Seo-Rin Jeong

  https://doi.org/10.4041/kjod.2021.51.4.229

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  Original Article l 2021-07-25

  Root proximity of the anchoring miniscrews of orthodontic miniplates in the mandibular incisal area: Cone-beam computed tomographic analysis

  Do-Min Jeong , Song Hee Oh , HyeRan Choo et al.

  https://doi.org/10.4041/kjod.2021.51.4.231

  Abstract : Objective: This outcome analysis study evaluated the actual positions of the orthodontic miniplate and miniplate anchoring screws (MPASs) and the risk factors affecting adjacent anatomic structures after miniplate placement in the mandibular incisal area. Methods: Cone-beam computed tomographic images of 97 orthodontic miniplates and their 194 MPASs (diameter, 1.5 mm; length, 4 mm) in patients whose miniplates provided sufficient clinical stability for orthodontic treatment were retrospectively reviewed. For evaluating the actual positions of the miniplates and analyzing the risk factors, including the effects on adjacent roots, MPAS placement height (PH), placement depth (PD), plate angle (PA), mental fossa angle (MA), and root proximity were assessed using the paired t-test, analysis of variance, and generalized linear model and regression analyses. Results: The mean PDs of MPASs at positions 1 (P1) and 2 (P2) were 2.01 mm and 2.23 mm, respectively. PA was significantly higher in the Class III malocclusion group than in the other groups. PH was positively correlated with MA and PD at P1. Of the 97 MPASs at P1, 49 were in the no-root area and 48 in the dentulous area; moreover, 19 showed a degree of root contact (19.6%) without root perforation. All MPASs at P2 were in the no-root area. Conclusions: Positioning the miniplate head approximately 1 mm lower than the mucogingival junction is highly likely to provide sufficient PH for the P1- MPASs to be placed in the no-root area.

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  Original Article l 2021-07-25

  Does mini-implant-supported rapid maxillary expansion cause less root resorption than traditional approaches? A micro-computed tomography study

  Rukiye Alcin , Siddik Malkoç

  https://doi.org/10.4041/kjod.2021.51.4.241

  Abstract : Objective: This study aimed to evaluate the volume, amount, and localization of root resorption in the maxillary first premolars using micro-computed tomography (micro-CT) after expansion with four different rapid maxillary expansion (RME) appliances. Methods: In total, 20 patients who required RME and extraction of the maxillary first premolars were recruited for this study. The patients were divided into four groups according to the appliance used: miniimplant- supported hybrid RME appliance, hyrax RME appliance, acrylic-bonded RME appliance, and full-coverage RME appliance. The same activation protocol (one activation daily) was implemented in all groups. For each group, the left and right maxillary first premolars were scanned using micro-CT, and each root were divided into six regions. Resorption craters in the six regions were analyzed using special CTAn software for direct volumetric measurements. Data were statistically analyzed using Kruskal–Wallis one-way analysis of variance and Mann–Whitney U test with Bonferroni adjustment. Results: The hybrid expansion appliance resulted in the lowest volume of root resorption and the smallest number of craters (p < 0.001). In terms of overall root resorption, no significant difference was found among the other groups (p > 0.05). Resorption was greater on the buccal surface than on the lingual surface in all groups except the hybrid appliance group (p < 0.05). Conclusions: The findings of this study suggest that all expansion appliances cause root resorption, with resorption craters generally concentrated on the buccal surface. However, the mini-implant-supported hybrid RME appliance causes lesser root resorption than do other conventional appliances.

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  Original Article l 2021-07-25

  Mandibular skeletal posterior anatomic limit for molar distalization in patients with Class III malocclusion with different vertical facial patterns

  Sung-Ho Kim , Kyung-Suk Cha , Jin-Woo Lee et al.

  https://doi.org/10.4041/kjod.2021.51.4.250

  Abstract : Objective: The aim of this study was to compare the differences in mandibular posterior anatomic limit (MPAL) distances stratified by vertical patterns in patients with skeletal Class III malocclusion by using cone-beam computed tomography (CBCT). Methods: CBCT images of 48 patients with skeletal Class III malocclusion (mean age, 22.8 ± 3.1 years) categorized according to the vertical patterns (hypodivergent, normodivergent, and hyperdivergent; n = 16 per group) were analyzed. While parallel to the posterior occlusal line, the shortest linear distances from the distal root of the mandibular second molar to the inner cortex of the mandibular body were measured at depths of 4, 6, and 8 mm from the cementoenamel junction. MPAL distances were compared between the three groups, and their correlations were analyzed. Results: The mean ages, sex distribution, asymmetry, and crowding in the three groups showed no significant differences. MPAL distance was significantly longer in male (3.8 ± 2.6 mm) than in female (1.8 ± 1.2 mm) at the 8-mm root level. At all root levels, MPAL distances were significantly different in the hypodivergent and hyperdivergent groups (p < 0.001) and between the normodivergent and hyperdivergent groups (p < 0.01). MPAL distances were the shortest in the hyperdivergent group. The mandibular plane angle highly correlated with MPAL distances at all root levels (p < 0.01). Conclusions: MPAL distances were the shortest in patients with hyperdivergent patterns and showed a decreasing tendency as the mandibular plane angle increased. MPAL distances were significantly shorter (~3.16 mm) at the 8-mm root level.

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  Original Article l 2021-07-25

  Quantitative cone-beam computed tomography evaluation of hard and soft tissue thicknesses in the midpalatal suture region to facilitate orthodontic mini-implant placement

  Song-Hee Oh , Sae Rom Lee , Jin-Young Choi et al.

  https://doi.org/10.4041/kjod.2021.51.4.260

  Abstract : Objective: To identify the most favorable sites that optimize the initial stability and survival rate of orthodontic mini-implants, this study measured hard and soft tissue thicknesses in the median and paramedian regions of the palate using cone-beam computed tomography (CBCT) and determined possible sexand age-related differences in these thicknesses. Methods: The study sample comprised CBCT images of 189 healthy subjects. The sample was divided into four groups according to age. A grid area was set for the measurement of hard and soft tissue thicknesses in the palate. Vertical lines were marked at intervals of 0, 1.5, and 3.0 mm lateral to the midpalatal suture, while horizontal lines were marked at 2-mm intervals up to 24 mm from the posterior margin of the incisive foramen. Measurements were made at 65 points of intersection between the horizontal and vertical lines. Results: The palatal hard tissue thickness decreased from the anterior to the posterior region, with a decrease in the medial-to-lateral direction in the middle and posterior regions. While the soft tissue was rather thick around the lateral aspects of the palatal arch, it formed a constant layer that was only 1–2-mm thick throughout the palate. Statistically significant differences were observed according to sex and age. Conclusions: The anterolateral palate as well as the midpalatal suture seem to be the most favorable sites for insertion of orthodontic mini-implants. The thickness of the palate differed by age and sex; these differences should be considered while planning the placement of orthodontic mini-implants.

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  Original Article l 2021-07-25

  Effectiveness of medical coating materials in decreasing friction between orthodontic brackets and archwires

  Nursel Arici , Berat S. Akdeniz, Abdullah A. Oz et al.

  https://doi.org/10.4041/kjod.2021.51.4.270

  Abstract : Objective: The aim of this in vitro study was to evaluate the changes in friction between orthodontic brackets and archwires coated with aluminum oxide (Al₂O₃), titanium nitride (TiN), or chromium nitride (CrN). In addition, the resistance of the coatings to intraoral conditions was evaluated. Methods: Stainless steel canine brackets, 0.016-inch round nickel–titanium archwires, and 0.019 × 0.025-inch stainless steel archwires were coated with Al₂O₃, TiN, and CrN using radio frequency magnetron sputtering. The coated materials were examined using scanning electron microscopy, an X-ray diffractometer, atomic force microscopy, and surface profilometry. In addition, the samples were subjected to thermal cycling and in vitro brushing tests, and the effects of the simulated intraoral conditions on the coating structure were evaluated. Results: Coating of the metal bracket as well as nickel–titanium archwire with Al₂O₃ reduced the coefficients of friction (CoFs) for the bracket–archwire combination (p < 0.01). When the bracket and stainless steel archwire were coated with Al₂O₃ and TiN, the CoFs were significantly lower (0.207 and 0.372, respectively) than that recorded when this bracket–archwire combination was left uncoated (0.552; p < 0.01). The friction, thermal, and brushing tests did not deteriorate the overall quality of the Al₂O₃ coatings; however, some small areas of peeling were evident for the TiN coatings, whereas comparatively larger areas of peeling were observed for the CrN coatings. Conclusions: Our findings suggest that the CoFs for metal bracket–archwire combinations used in orthodontic treatment can be decreased by coating with Al₂O₃ and TiN thin films.

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  Original Article l 2021-07-25

  Effect of nicotine on orthodontic tooth movement and bone remodeling in rats

  Sung-Hee Lee , Jung-Yul Cha, Sung-Hwan Choi et al.

  https://doi.org/10.4041/kjod.2021.51.4.282

  Abstract : Objective: To quantitatively analyze the effect of nicotine on orthodontic tooth movement (OTM) and bone remodeling in rats using micro-computed tomography and tartrate-resistant acid phosphatase immunostaining. Methods: Thirty-nine adult male Sprague–Dawley rats were randomized into three groups: group A, 0.5 mL normal saline (n = 9, 3 per 3, 7, and 14 days); group B, 0.83 mg/kg nicotine (n = 15, 5 per 3, 7, and 14 days); and group C, 1.67 mg/kg nicotine (n = 15, 5 per 3, 7, and 14 days). Each animal received daily intraperitoneal injections of nicotine/saline from the day of insertion of identical 30-g orthodontic force delivery systems. A 5-mm nickel-titanium closed-coil spring was applied between the left maxillary first molar (M1) and the two splinted incisors. The rate of OTM and volumetric bone changes were measured using micro-computed tomography. Osteoclasts were counted on the mesial alveolar bone surface of the distobuccal root of M1. Six dependent outcome variables, including the intermolar distance, bone volume fraction, bone mineral density, trabecular thickness, trabecular volume, and osteoclast number, were summarized using simple descriptive statistics. Nonparametric Kruskal–Wallis tests were used to evaluate differences among groups at 3, 7, and 14 days of OTM. Results: All six dependent outcome variables showed no statistically significant among group-differences at 3, 7, and 14 days. Conclusions: The findings of this study suggest that nicotine does not affect OTM and bone remodeling, although fluctuations during the different stages of OTM in the nicotine groups should be elucidated in further prospective studies.

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  Case Report l 2021-07-25

  Effectiveness of Invisalign^® aligners in the treatment of severe gingival recession: A case report

  Marcio Antonio de Figueiredo , Fábio Lourenço Romano, Murilo Fernando Neuppmann Feres et al.

  https://doi.org/10.4041/kjod.2021.51.4.293

  Abstract : In this report, we demonstrate the effectiveness of the Invisalign^Ⓡ system in the treatment of severe gingival recession and bone dehiscence through torque, translation, and intrusion movements in a young woman. Cone-beam computed tomography was used to assess bone parameters and check the teeth during treatment. The root of the mandibular right central incisor, which was buccally positioned and exhibited bone dehiscence of 9.4 mm, was moved toward the center of the alveolar process by using the Invisalign^Ⓡ system and SmartForce^Ⓡ features. The patient was monitored by a periodontist throughout the orthodontic treatment period. Her gingival recession reduced, while the bone dehiscence reduced from 9.40 mm to 3.14 mm. Thus, movement of the root into the alveolus promoted bone neoformation and treated the gingival recession. The findings from this case suggest that orthodontic treatment using the Invisalign^Ⓡ system, along with periodontal monitoring, can aid in the treatment of gingival recession and alveolar defects.

  Abstract  

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