Current Issue

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  Editorial l 2022-05-25

  From eminence to evidence and back to presence: lessons learned from the evolution of scientific information dissemination and the case of KJO

  Prof. Theodore Eliades, DDS, MS et al.

  https://doi.org/10.4041/kjod.2022.52.3.161

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  Reader's Forum l 2022-05-25

  READER’S FORUM

  Hyo-Won Ahn

  https://doi.org/10.4041/kjod21.304

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  Original Article l 2022-05-25

  Occlusal deviations in adolescents with idiopathic and congenital scoliosis

  Hao Zhang , Jingbo Ma , Zhicheng Zhang et al.

  https://doi.org/10.4041/kjod21.259

  Abstract : Objective: This cross-sectional study aimed to investigate the characteristics of malocclusions in scoliotic patients through clinical examinations. Methods: Fifty-eight patients with idiopathic scoliosis (IS) and 48 patients with congenital scoliosis (CS) participated in the study. A randomly selected group of 152 orthopedically healthy children served as the control group. Standardized orthodontic and orthopedic examination protocols were used to record the occlusal patterns and type of scoliosis. Assessments were made by three experienced orthodontists and a spinal surgery team. The differences in the frequency distribution of occlusal patterns were evaluated by the chi-squared test. Results: In comparison with patients showing IS, patients with CS showed a higher incidence of Cobb angle ≥ 45° (p = 0.020) and included a higher proportion of patients receiving surgical treatments (p < 0.001). The distribution of the Angle Class II subgroup was significantly higher in the IS (p < 0.001) and CS (p = 0.031) groups than in the control group. In comparison with the healthy controls, the CS and IS groups showed significantly higher (p < 0.05) frequencies of asymmetric molar and asymmetric canine relationships, upper and lower middle line deviations, anterior deep overbite, unilateral posterior crossbite, and canted occlusal plane, with the frequencies being especially higher in CS patients and to a lesser extent in IS patients. Conclusions: Patients with scoliosis showed a high frequency of malocclusions, which were most obvious in patients with CS.

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  Original Article l 2022-05-25

  Comparison of the bite force and occlusal contact area of the deviated and non-deviated sides after intraoral vertical ramus osteotomy in skeletal Class III patients with mandibular asymmetry: Two-year follow-up

  Hyejin Kwon , Sun-Hyung Park , Hoi-In Jung et al.

  https://doi.org/10.4041/kjod21.236

  Abstract : Objective: The objectives of this study were to compare the time-dependent changes in occlusal contact area (OCA) and bite force (BF) of the deviated and non-deviated sides in mandibular prognathic patients with mandibular asymmetry before and after orthognathic surgery and investigate the factors associated with the changes in OCA and BF on each side. Methods: The sample consisted of 67 patients (33 men and 34 women; age range 15?36 years) with facial asymmetry who underwent 2-jaw orthognathic surgery. OCA and BF were taken before presurgical orthodontic treatment, within 1 month before surgery, and 1 month, 3 months, 6 months, 1 year, and 2 years after surgery. OCA and BF were measured using the Dental Prescale System. Results: The OCA and BF decreased gradually before surgery and increased after surgery on both sides. The OCA and BF were significantly greater on the deviated side than on the non-deviated side before surgery, and there was no difference after surgery. According to the linear mixed-effect model, only the changes in the mandibular plane angle had a significant effect on BF (p < 0.05). Conclusions: There was a difference in the amount of the OCA and BF between the deviated and non-deviated sides before surgery. The change in mandibular plane angle affects the change, especially on the non-deviated side, during the observation period.

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  Original Article l 2022-05-25

  Effectiveness of miniscrew assisted rapid palatal expansion using cone beam computed tomography: A systematic review and meta-analysis

  Patchaya Siddhisaributr , Kornkanok Khlongwanitchakul, Niwat Anuwongnukroh et al.

  https://doi.org/10.4041/kjod21.256

  Abstract : Objective: This study aims to examine the effectiveness of miniscrew assisted rapid palatal expansion (MARPE) treatment in late adolescents and adult patients using cone-beam computed tomography (CBCT). Methods: Literature search was conducted in five electronic databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) based on the PICOS keyword design focusing on MARPE. Out of the 18 CBCT screened outcomes, only nine parameters were sufficient for the quantitative meta-analysis. The parameters were classified into three main groups: 1) skeletal changes, 2) alveolar change, and 3) dental changes. Heterogeneity test, estimation of pooled means, publication bias, sensitivity analysis and risk of bias assessment were also performed. Results: Upon database searching, only 14 full-text articles were qualified from the 364 obtained results. Heterogeneity test indicated the use of the random-effects model. The pooled mean estimate were as follows: 1) Skeletal expansion: zygomatic width, 2.39 mm; nasal width, 2.68 mm; jugular width, 3.12 mm; and midpalatal suture at the posterior nasal spine and anterior nasal spine, 3.34 mm and 4.56 mm, respectively; 2) Alveolar molar width expansion, 4.80 mm; and 3) Dental expansion: inter-canine width, 3.96 mm; inter-premolar width, 4.99 mm and inter-molar width, 5.99 mm. The percentage of expansion demonstrated a skeletal expansion (PNS) of 55.76%, alveolar molar width expansion of 24.37% and dental expansion of 19.87%. Conclusions: In the coronal view, the skeletal and dental expansion created by MARPE was of the pyramidal pattern. MARPE could successfully expand the constricted maxilla in late adolescents and adult patients.

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  Original Article l 2022-05-25

  Influence of late removal after treatment on the removal torque of microimplants

  Ho-Jin Kim , Hyo-Sang Park

  https://doi.org/10.4041/kjod21.217

  Abstract : Objective: To compare the removal torque of microimplants upon post-use removal and post-retention removal and to assess the influencing factors. Methods: The sample group included 241 patients (age, 30.25 ± 12.2 years) with 568 microimplants. They were divided into the post-use (microimplants removed immediately after use or treatment) and post-retention (microimplants removed during the retention period) removal groups. The removal torque in both groups was assessed according to sex, age, placement site and method, and microimplant size. Pearson correlation and multiple linear regression analyses were performed for evaluating variables influencing the removal torque. Results: The mean period of total in-bone stay of microimplants in the postretention removal group (1,237 days) was approximately two times longer than that in the post-use removal group (656.28 days). The removal torques in the post-retention removal group (range, 4?5 N cm) were also higher than those in the post-use removal group. The mandible and pre-drilling groups demonstrated higher placement and removal torques than did the maxilla and no-drilling groups, respectively. In the no-drilling post-use removal group, the placement torque and microimplant length positively correlated with the removal torque. In the post-retention removal group, unloading in-bone stay period and microimplant diameter positively correlated with the removal torque in the no-drilling and pre-drilling methods, respectively. Conclusions: The removal torques differed according to the orthodontic loading and removal time of microimplants. With prolonged retention of microimplants inserted using the no-drilling method, the removal torque was clinically acceptable and positively correlated with the unloading in-bone stay period.

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  Original Article l 2022-05-25

  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

  Abstract : Objective: The purpose of this study was to examine the effectiveness and mechanism of clear aligner therapy for the correction of anterior open bite in adult nonextraction cases. Methods: Sixty-nine adult patients with anterior open bite were enrolled and classified into Angle’s Class I, II, and III groups. Fifty patients presented with skeletal open bite (mandibular plane angle [MPA] ≥ 38°), whereas 19 presented with dental open bite. Fifteen cephalometric landmarks were identified before (T1) and after (T2) treatment. The magnitudes of planned and actual movements of the incisors and molars were calculated. Results: Positive overbite was achieved in 94% patients, with a mean final overbite of 1.1 ± 0.8 mm. The mean change in overbite was 3.3 ± 1.4 mm. With clear aligners alone, 0.36 ± 0.58 mm of maxillary molar intrusion was achieved. Compared with the Class I group, the Class II group showed greater maxillary molar intrusion and MPA reduction. The Class III group showed greater mandibular incisor extrusion with no significant vertical skeletal changes. Conclusions: Clear aligners can be effective in controlling the vertical dimension and correcting mild to moderate anterior open bite in adult nonextraction cases. The treatment mechanism for Class III patients significantly differed from that for Class I and Class II patients. Maxillary incisor extrusion in patients with dental open bite and MPA reduction with mandibular incisor extrusion in patients with skeletal open bite are the most significant contributing factors for open bite closure.

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  Original Article l 2022-05-25

  Which anchorage device is the best during retraction of anterior teeth? An overview of systematic reviews

  Yassir A. Yassir , Sarah A. Nabbat, Grant T. McIntyre et al.

  https://doi.org/10.4041/kjod21.153

  Abstract : Objective: To evaluate the available evidence regarding the clinical effectiveness of different types of anchorage devices. Methods: A comprehensive literature search of different electronic databases was conducted for systematic reviews investigating different anchorage methods published up to April 15, 2021. Any ongoing systematic reviews were searched using PROSPERO, and a grey literature search was undertaken using Google Scholar and OpenGrey. No language restriction was applied. Screening, quality assessment, and data extraction were performed independently by two authors. Information was categorized and narratively synthesized for the key findings from moderate- and high-quality reviews. Results: Fourteen systematic reviews were included (11 were of moderate/high quality). Skeletal anchorage with miniscrews was associated with less anchorage loss (and sometimes with anchorage gain). Similarly, skeletal anchorage was more effective in retracting anterior teeth and intruding incisors and molars, resulting in minor vertical skeletal changes and improvements in the soft tissue profile. However, insufficient evidence was obtained for the preference of any anchorage method in terms of the duration of treatment, number of appointments, quality of treatment, patient perception, or adverse effects. The effectiveness of skeletal anchorage can be enhanced when: directly loaded, used in the mandible rather than the maxilla, used buccally rather than palatally, using dual rather than single miniscrews, used for en-masse retraction, and in adults. Conclusions: The level of evidence regarding anchorage effectiveness is moderate. Nevertheless, compared to conventional anchorage, skeletal anchorage can be used with more anchorage preservation. Further high-quality randomized clinical trials are required to confirm these findings.

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  Case Report l 2022-05-25

  Maxillary space closure using a digital manufactured Mesialslider in a single appointment workflow

  Lynn Wilhelmy , Jan H. Willmann, Nour Eldin Tarraf et al.

  https://doi.org/10.4041/kjod21.203

  Abstract : New digital technologies, many involving three-dimensional printing, bring benefits for clinical applications. This article reports on the clinical procedure and fabrication of a skeletally anchored mesialization appliance (Mesialslider) using computer-aided design/computer-aided manufacturing (CAD/CAM) for space closure of a congenitally missing lateral incisor in a 12-year-old female patient. The insertion of the mini-implants and appliance was performed in a single appointment. Bodily movement of the molars was achieved using the Mesialslider. Anchorage loss, such as deviation of the anterior midline or palatal tilting of the anterior teeth, was completely avoided. CAD/CAM facilitates safe and precise insertion of mini-implants. Further, mini-implants can improve patient comfort by reducing the number of office visits and eliminating the need for orthodontic bands and physical impressions.

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