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  Reader's Forum l 2021-09-25

  READER'S FORUM

  Seong Ho Han

  https://doi.org/10.4041/kjod.2021.51.5.301

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  Original Article l 2021-09-25

  Comparison of the effects of horizontal and vertical micro-osteoperforations on the biological response and tooth movement in rabbits

  Seok-gon Kim , Yoon-Ah Kook , Hee Jin Lim et al.

  https://doi.org/10.4041/kjod.2021.51.5.304

  Abstract : Objective: This study aimed to compare the amount of tooth movement after multiple horizontal (MH) and single vertical (SV) micro-osteoperforations (MOPs), and evaluate the histological changes after orthodontic force application in rabbits. Methods: The mandibles of 24 white rabbits were subjected to two experimental interventions: MH and SV MOPs. Defect volume of the MOPs between the two groups was kept similar. A force of 100 cN was applied via a coil spring between the incisor teeth and the first premolars. The amount of tooth movement was measured. Differences in the amount of tooth movement and bone variables at three time points and between the two groups were evaluated using repeated-measures analysis of variance. Results: The first premolar showed a mesial movement of 1.47 mm in the MH group and 1.84 mm in the SV group, which was significantly different at Week 3 (p < 0.05). No significant difference was observed in bone volume and bone fraction between the groups. Tartrate-resistant acidic phosphatase-positive cell count was also significantly greater at Week 3 than at Week 1 in both the SV and MH groups. Conclusions: The amount of tooth movement showed significant differences between Weeks 1 and 3 in the SV and MH MOP groups, but showed no differences between the two groups. Therefore, SV MOP could be considered an effective tool for enhancing tooth movement, especially for molar distalization, uprighting, and protraction to an edentulous area.

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  Original Article l 2021-09-25

  Effectiveness of low-level laser therapy and chewing gum in reducing orthodontic pain: A randomized controlled trial

  Fatih Celebi , Ali Altug Bicakci, Ufuk Kelesoglu

  https://doi.org/10.4041/kjod.2021.51.5.313

  Abstract : Objective: The purpose of this study was to evaluate the effects of chewing gum and low-level laser therapy in alleviating orthodontic pain induced by the initial archwire. Methods: Patients with 3–6 mm maxillary crowding who planned to receive non-extraction orthodontic treatment were recruited for the study. Sixty-three participants (33 females and 30 males) were randomly allocated into three groups: laser, chewing gum, and control. In the laser group, a gallium aluminum arsenide (GaAlAs) diode laser with a wavelength of 820 nm was used to apply a single dose immediately after orthodontic treatment began. In the chewing gum group, sugar-free gum was chewed three times for 20 minutes— immediately after starting treatment, and at the twenty-fourth and forty-eighth hours of treatment. Pain perception was measured using a visual analog scale at the second, sixth, and twenty-fourth hours, and on the second, third, and seventh days. Results: There were no statistically significant differences between the groups at any measured time point (p > 0.05). The highest pain scores were detected at the twenty-fourth hour of treatment in all groups. Conclusions: Within the limitations of the study, we could not detect whether low-level laser therapy and chewing gum had any clinically significant effect on orthodontic pain. Different results may be obtained with a higher number of participants or using lasers with different wavelengths and specifications. Although the study had a sufficient number of participants according to statistical analysis, higher number of participants could have provided more definitive outcomes.

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  Original Article l 2021-09-25

  Accurate transfer of bimaxillary orthognathic surgical plans using computer-aided intraoperative navigation

  Chen Chen , Ningning Sun, Chunmiao Jiang et al.

  https://doi.org/10.4041/kjod.2021.51.5.321

  Abstract : Objective: To examine the accuracy of computer-aided intraoperative navigation (Ci-Navi) in bimaxillary orthognathic surgery by comparing preoperative planning and postoperative outcome. Methods: The study comprised 45 patients with congenital dentomaxillofacial deformities who were scheduled to undergo bimaxillary orthognathic surgery. Virtual bimaxillary orthognathic surgery was simulated using Mimics software. Intraoperatively, a Le Fort I osteotomy of the maxilla was performed using osteotomy guide plates. After the Le Fort I osteotomy and bilateral sagittal split ramus osteotomy of the mandible, the mobilized maxilla and the distal mandibular segment were fixed using an occlusal splint, forming the maxillomandibular complex (MMC). Realtime Ci-Navi was used to lead the MMC in the designated direction. Osteoplasty of the inferior border of the mandible was performed using Ci-Navi when facial symmetry and skeletal harmony were of concern. Linear and angular distinctions between preoperative planning and postoperative outcomes were calculated. Results: The mean linear difference was 0.79 mm (maxilla: 0.62 mm, mandible: 0.88 mm) and the overall mean angular difference was 1.20°. The observed difference in the upper incisor point to the Frankfort horizontal plane, midfacial sagittal plane, and coronal plane was < 1 mm in 40 cases. Conclusions: This study demonstrates the role of Ci-Navi in the accurate positioning of bone segments during bimaxillary orthognathic surgery. Ci-Navi was found to be a reliable method for the accurate transfer of the surgical plan during an operation.

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  Original Article l 2021-09-25

  External apical root resorption 6 months after initiation of orthodontic treatment: A randomized clinical trial comparing fixed appliances and orthodontic aligners

  Katia Cristina Toyokawa-Sperandio , Ana Cláudia de Castro Ferreira Conti, Thais Maria Freire Fernandes et al.

  https://doi.org/10.4041/kjod.2021.51.5.329

  Abstract : Objective: To compare the magnitude of external apical root resorption (EARR) 6 months after starting orthodontic treatment using orthodontic aligners (OAs) and fixed appliances (FAs). Methods: This parallel randomized clinical trial included 40 patients randomized into two groups: OA group (n = 20, 160 incisors) and FA group (n = 20, 160 incisors). For evaluation of the tooth length, periapical radiographs and standardized linear measurements of the maxillary and mandibular incisors were acquired before (T0) and 6 months after treatment initiation (T1). EARR was calculated through the difference in length between the two time points (T1–T0). Statistical comparisons were performed by means of using t-tests, chi-squared test and covariance analysis (a = 5%). Results: Rounding of the root apex was observed in both groups; the resorption involved 2.88% of the root length, so 97.12% of the tooth length remained intact. Intragroup comparisons between the two time points revealed a significant difference, with (T1–T0) ranging from −0.52 to −0.88 mm in the FA group and from −0.52 to −0.85 mm in the OA group. In the intergroup comparisons, only tooth #21 presented a statistically significant difference (OA: −0.52 ± 0.57 mm, FA: −0.86 ± 0.60 mm); however, the overall differences between groups were not clinically relevant, ranging from 0.03 to 0.35 mm. Conclusions: OA and FA treatment resulted in a similar degree of EARR in the maxillary and mandibular incisors at 6 months after treatment initiation. However, the amount of resorption was small and does not impair tooth longevity.

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  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 et al.

  https://doi.org/10.4041/kjod.2021.51.5.337

  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.

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  Original Article l 2021-09-25

  Chewing gum as a non-pharmacological alternative for orthodontic pain relief: A randomized clinical trial using an intention-to-treat analysis

  Diego Junior da, Silva Santos, Jonas Capelli Jr.

  https://doi.org/10.4041/kjod.2021.51.5.346

  Abstract : Objective: To compare the effectiveness of ibuprofen, acetaminophen, and chewing gum for orthodontic pain relief and to assess if chewing gum can be a non-pharmacological alternative for orthodontic pain relief. Methods: The study enrolled 106 patients of both sexes, aged ≥ 12 years, with body weight > 50 kg, and mild-to-moderate dental crowding in the upper arch. After randomization and allocation concealment, the intervention groups were either administered with ibuprofen (400 mg) or acetaminophen (500 mg) or chewed sugar-free chewing gum immediately after initial archwire placement and every 6 hours for 1 week if the pain persisted. The control group did not receive any pain relief. The pain was assessed on a 100-mm visual analog scale at rest and while biting down at T1 (2 hours), T2 (24 hours), T3 (2 days), T4 (3 days), T5 (7 days), and T6 (21 days). Statistical analyses were performed using the Kruskal–Wallis and post-hoc Mann–Whitney U tests (α = 0.05). Results: The chewing gum group experienced more pain relief than the ibuprofen group at while biting down at T3 (p = 0.04) and at rest at T4 (p < 0.001). The chewing gum group reported more pain relief than the acetaminophen and control groups while biting down at T3 (p = 0.03 and p = 0.0006, respectively) and T4 (both p < 0.001). Conclusions: Chewing gum can be a non-pharmacological alternative for orthodontic pain relief at 2 and 3 days after initial archwire placement.

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  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

  https://doi.org/10.4041/kjod.2021.51.5.355

  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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