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  Original Article l 2022-09-25

  Clinical effectiveness of different types of bone-anchored maxillary protraction devices for skeletal Class III malocclusion: Systematic review and network meta-analysis

  Jiangwei Wang , Yingying Yang, Yingxue Wang et al.

  https://doi.org/10.4041/kjod21.264

  Abstract : Objective: This study aimed to estimate the clinical effects of different types of bone-anchored maxillary protraction devices by using a network meta-analysis. Methods: We searched seven databases for randomized and controlled clinical trials that compared bone-anchored maxillary protraction with tooth-anchored maxillary protraction interventions or untreated groups up to May 2021. After literature selection, data extraction, and quality assessment, we calculated the mean differences, 95% confidence intervals, and surface under the cumulative ranking scores of eleven indicators. Statistical analysis was performed using R statistical software with the GeMTC package based on the Bayesian framework. Results: Six interventions and 667 patients were involved in 18 studies. In comparison with the tooth-anchored groups, the bone-anchored groups showed significantly more increases in Sella-Nasion-Subspinale (°), Subspinale-Nasion-Supramentale(°) and significantly fewer increases in mandibular plane angle and the labial proclination angle of upper incisors. In comparison with the control group, Sella-Nasion-Supramentale(°) decreased without any statistical significance in all treated groups. IMPA (angle of lower incisors and mandibular plane) decreased in groups with facemasks and increased in other groups. Conclusions: Bone-anchored maxillary protraction can promote greater maxillary forward movement and correct the Class III intermaxillary relationship better, in addition to showing less clockwise rotation of mandible and labial proclination of upper incisors. However, strengthening anchorage could not inhibit mandibular growth better and the lingual inclination of lower incisors caused by the treatment is related to the use of a facemask.

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  Original Article l 2022-09-25

  Common dental anomalies in Korean orthodontic patients: An update

  Ja Hyeong Ku , Byoul Han, Jaehyun Kim et al.

  https://doi.org/10.4041/kjod21.280

  Abstract : Objective: The aim of this study was 1) to investigate the prevalence and pattern of dental anomalies (DAs), 2) to compare DAs according to the type of malocclusion, and 3) to investigate the correlation between tooth impaction and other DAs in the Korean orthodontic population. Methods: A total of 3,240 orthodontic patients were classified as Class I, Class II, or Class III malocclusion groups. The presence and location of common DAs, including impaction, microdontia, agenesis, supernumerary tooth, transposition, and fusion, were identified by examining diagnostic records. Furthermore, samples were classified as Group 1 without impaction or Group 2 with impaction. The prevalence of other DAs concurrent with impaction was investigated and compared to Group 1. Results: Impaction was the most prevalent DA, followed by microdontia, agenesis, and supernumerary. Class I and Class III groups showed the same order of prevalence, but agenesis was more frequent than microdontia in the Class II group. The prevalence of the four DAs was lowest in the Class III group. Overall, 8.6% of patients were classified into Group 2. The incidence of DAs other than impaction and the prevalence of multiple concurrent DAs were significantly higher in Group 2. Impaction showed a significant relationship with supernumerary tooth, transposition, and fusion. Conclusions: The prevalence and pattern of DAs varied depending on the type of malocclusion. As there was a higher risk of other DAs in patients with impacted teeth, early detection of the impacted tooth and a detailed diagnosis of other possible DAs may be essential.

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  Original Article l 2022-09-25

  Effect and stability of miniscrew-assisted rapid palatal expansion: A systematic review and meta-analysis

  Xinyi Huang , Yu Han, Shuangyan Yang

  https://doi.org/10.4041/kjod21.324

  Abstract : Objective: This study aimed to systematically analyze the effect and stability of miniscrew-assisted rapid palatal expansion (MARPE) to provide a reference for the clinical treatment of patients with maxillary transverse deficiency (MTD). Methods: We searched PubMed, Science Direct, Web of Science, Embase, Cochrane Library, CNKI, and Wanfang Database for relevant studies published before February 18, 2021 and selected them according to the eligibility criteria. The Cochrane Handbook for Systematic Reviews (version 5.1.0) criteria were used for the quality assessment of randomized controlled trials, while the scoring protocol of the methodological index for non-randomized studies was used for non-randomized controlled trials. Statistical analysis was performed using the RevMan5.3 software. Results: All the included studies showed a relatively high success rate of expansion. The changes in both the intermolar and alveolar widths after MARPE were statistically significant. MARPE exhibited greater skeletal expansion effects than did conventional RPE. The midpalatal suture was opened in parallel after MARPE. A small amount of relapse was observed 1 year after expansion. MARPE caused tooth inclination and a decrease in alveolar height, but it was less significant than in conventional RPE. Conclusions: MARPE may be an effective treatment modality for patients with MTD. It causes great transverse skeletal expansion in late adolescence. In comparison to conventional RPE, MARPE has lower detrimental periodontal effects and has certain clinical advantages.

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  Original Article l 2022-09-25

  Assessment of pharyngeal airway in Korean adolescents according to skeletal pattern, sex, and cervical vertebral maturation: A cross-sectional CBCT study

  Tassneem Elagib , Hee-Moon Kyung, Bui Quang Hung et al.

  https://doi.org/10.4041/kjod21.267

  Abstract : Objective: To investigate airway volumes using cone-beam computed tomography (CBCT) by skeletal patterns, sex, and cervical vertebral maturation (CVM) stages in Korean adolescents. Methods: The sample consisted of pretreatment CBCT and cephalograms of 95 adolescents (aged 12–19) obtained out of 1,611 patients examined for orthodontic treatment from 2018 to 2020 in Kyungpook National University Dental Hospital. The samples were classified into two sex groups; three skeletal pattern groups, four chronological age groups and four CVM stages. Nasopharyngeal volumes (NPV), oropharyngeal volumes (OPV), total pharyngeal airway volume (TAV) and minimum cross-sectional area (MCA) measurements were taken from the CBCT. Multiple linear regression analyses to find out which one of the independent variables are good predictors for airway variables. Significant factors were analyzed by two-way multivariate analysis of variance (MANOVA) then multiple comparisons were analyzed using a t-test, and Fisher least significant difference. Results: Age, sex, CVM, and Sella-Nasion-B point have significant influence on airway variable. Males and females showed similar patterns of change in chronological age groups 1–3; however, males had larger NPV, OPV, and MCA at CVM in group 4. According to CVM stages, males had larger OPV, TAV, and MCA at CVM stage 6 (p-value: 0.019, 0.021, 0.015, respectively) and no sex differences at CVM stages 3, 4, and 5. Conclusions: Skeletal patterns have an effect on airway volume. Sex differences were found in CVM 6.

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  Original Article l 2022-09-25

  A cone-beam computed tomography study on strategic uprighting of mandibular molars using a biocreative reverse curve system

  Jae-Woo Kim , Jin-Young Choi , Min-Ji Kim et al.

  https://doi.org/10.4041/kjod22.140

  Abstract : Objective: To analyze the overall treatment effects in terms of the amount of uprighting with changes in the three-dimensional positions of the mandibular posterior teeth after applying the biocreative reverse curve (BRC) system. Methods: Thirty-four patients (mean age, 20.5 ± 8.56 years) were treated using the BRC system (mean period, 8.17 ± 2.19 months). Cone-beam computed tomography was performed before treatment and after treatment with the BRC system. The three-dimensional movement of each tooth was analyzed in the coordinate system at points on the crown and root apex. A paired t-test was used to analyze the treatment effects of the BRC system. Results: The application of the BRC system spanning from the first premolar to the second molar resulted not only in buccal and distal uprighting, but also in increased buccal and distal tipping of the teeth. The premolars and the first molar were extruded, and the second molar was intruded. Conclusions: When the BRC system is applied, simultaneous distal and buccal uprighting of the premolars and molars can be achieved bilaterally using a temporary skeletal anchorage device without unnecessary movement of the anterior teeth.

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  Case Report l 2022-09-25

  Camouflage treatment by backward rotation of the mandible for a severe skeletal Class III malocclusion with aplastic anemia: A case report

  Dong-Soon Choi , Dong-Hyun Lee, Insan Jang et al.

  https://doi.org/10.4041/kjod22.023

  Abstract : Orthognathic surgery is the primary treatment option for severe skeletal discrepancy. However, orthodontic camouflage should be considered as an alternative treatment option, considering the risks of surgery. A 19.5-year-old man presented with a severe prognathic mandible with a Class III molar relationship and an anterior crossbite. Orthognathic surgery could be considered because of his severe skeletal discrepancy and mandibular prognathism. However, the anesthetist for orthognathic surgery did not recommend surgery under general anesthesia because of risk factors associated with the patient’s aplastic anemia, including bleeding and infections. Thus, a camouflage treatment to promote backward rotation of the mandible via orthodontic extrusion of the posterior teeth was planned. An anterior bite plate, intermaxillary elastics, and fixed orthodontic appliances were used to extrude the posterior teeth and to align the dentition. After 17 months of nonsurgical orthodontic treatment, normal occlusion was achieved, and the facial profile was dramatically improved. This case report describes the dentoskeletal and soft-tissue effects of mandibular rotation and its long-term stability.

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  Case Report l 2022-09-25

  Clinical application of maxillary tissue bone-borne expander and biocreative reverse curve system in the orthodontic retreatment of severe anterior open bite with transverse discrepancy: A case report

  Jin-Young Choi , Bai Jin , Seong-Hun Kim

  https://doi.org/10.4041/kjod22.158

  Abstract : Anterior open bite and transverse discrepancy are often accompanied by hyperdivergent skeletal patterns. In addition, degenerative joint disorders and vertical maxillary excess contribute to an unfavorable convex facial profile with a retruded chin. Correction of this complex three-dimensional problem with orthodontic treatment alone is considered challenging owing to anatomical limitations. Moreover, a history of orthodontic treatment with premolar extraction makes retreatment difficult. This case report illustrates the application of a maxillary tissue bone-borne expander and biocreative reverse curve system in a 23-year-old female patient with a severe anterior open bite and transverse discrepancy who underwent orthodontic treatment with four premolar extractions. By setting the treatment target under precise diagnosis and using appropriate appliances, a satisfactory treatment result could be achieved without orthognathic surgery.

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  Corrigendum l 2022-09-25

  Correction to: Treatment of anterior open bites using non-extraction clear aligner therapy in adult patients

  Heeyeon Suh, Bella Shen Garnett, Kimberly Mahood et al.

  https://doi.org/10.4041/kjod21.180.r

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