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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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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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Objective@#To investigate the treatment modalities (Tx-Mods) for patients with unilateral hemifacial microsomia (UHFM) according to Pruzansky–Kaban types and growth stages. @*Methods@#The samples consisted of 82 Korean UHFM patients. Tx-Mods were defined as follows: Tx-Mod-1, growth observation due to mild facial asymmetry; Tx-Mod-2, unilateral functional appliance; TxMod-3, fixed orthodontic treatment; Tx-Mod-4, growth observation due to a definite need for surgical intervention; Tx-Mod-5, unilateral mandibular or bimaxillary distraction osteogenesis (DO); Tx-Mod-6, maxillary fixation using LeFort I osteotomy and mandibular DO/sagittal split ramus osteotomy; TxMod-7, orthognathic surgery; and Tx-Mod-8, costochondral grafting. The type and frequency of Tx-Mod, the number of patients who underwent surgical procedures, and the number of surgeries that each patient underwent, were investigated. Results: The degree of invasiveness and complexity of Tx-Mod increased, with an increase in treatment stage and Pruzansky–Kaban type (initial 0.05). @*Conclusions@#These findings might be used as basic guidelines for successful treatment planning and prognosis prediction in UHFM patients.
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Objective@#To investigate the distribution, side involvement, phenotype, and associated anomalies of Korean patients with craniofacial clefts (CFC). @*Methods@#The samples consisted of 38 CFC patients, who were treated at Seoul National University Dental Hospital during 1998–2018. The Tessier cleft type, sex, side involvement, phenotype, and associated anomalies were investigated using nonparametric statistical analysis. @*Results@#The three most common types were #7 cleft, followed by #0 cleft and #14 cleft. There was no difference between the frequency of male and female. Patients with #0 cleft exhibited nasal deformity, bony defect, and missing teeth in the premaxilla, midline cleft lip, and eye problems. A patient with #3 cleft (unilateral type) exhibited bilateral cleft lip and alveolus. All patients with #4 cleft were the bilateral type, including a combination of #3 and #4 clefts, and had multiple missing teeth. A patient with #5 cleft (unilateral type) had a posterior openbite. In patients with #7 cleft, the unilateral type was more prevalent than the bilateral type (87.0% vs. 13.0%, p < 0.001). Sixteen patients showed hemifacial microsomia (HFM), Goldenhar syndrome, and unilateral cleft lip and palate (UCLP). There was a significant match in the side involvement of #7 cleft and HFM (87.5%, p < 0.01). Patients with #14 cleft had plagiocephaly, UCLP, or hyperterorbitism. A patient with #30 cleft exhibited tongue tie and missing tooth. @*Conclusions@#Due to the diverse associated craniofacial anomalies in patients with CFC, a multidisciplinary approach involving a well-experienced cooperative team is mandatory for these patients.
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OBJECTIVE@#To investigate the distribution and phenotypes of hemifacial microsomia (HFM) and its association with other anomalies.@*METHODS@#This study included 249 Korean patients with HFM, whose charts, photographs, radiographs, and/or computed tomography scans acquired during 1998–2018 were available from Seoul National University Hospital and Dental Hospital. Prevalence according to sex, side involvement, degree of mandibular deformity, compensatory growth of the mandibular body, and Angle's classification, and its association with other anomalies were statistically analyzed.@*RESULTS@#Prevalence was not different between male and female patients (55.0% vs. 45.0%, p > 0.05). Unilateral HFM (UHFM) was more prevalent than bilateral HFM (BHFM) (86.3% vs. 13.7%, p 0.05). Among patients with BHFM, prevalence of different Pruzansky–Kaban types on the right and left sides was greater than that of the same type on both sides (67.6% vs. 32.4%, p < 0.05). Despite hypoplasia of the condyle/ramus complex, compensatory growth of the mandibular body on the ipsilateral side occurred in 35 patients (14.1%). Class I and II molar relationships were more prevalent than Class III molar relationships (93.2% vs. 6.8%, p < 0.001). Forty-eight patients (19.3%) had other anomalies, with 50.0% and 14.4% in the BHFM and UHFM groups (p < 0.001).@*CONCLUSIONS@#Patients with HFM require individualized diagnosis and treatment planning because of diverse phenotypes and associations with other anomalies.
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OBJECTIVE@#The purpose of this study was to compare the static (SFF) and kinetic frictional forces (KFF) of a computer-aided design and computer-aided manufacturing lingual bracket (CAD/CAM-LB) with those of conventional LB (Con-LB) and Con-LB with narrow bracket width (Con-LB-NBW) under 3 tooth displacement conditions.@*METHODS@#The samples were divided into 9 groups according to combinations of 3 LB types (CAD/CAM-LB [Incognito], Con-LB [7th Generation, 7G], and Con-LB-NBW [STb]) with 3 displacement conditions (no displacement [control], maxillary right lateral incisor with 1-mm palatal displacement [MXLI-PD], and maxillary right canine with 1-mm gingival displacement [MXC-GD]; n = 6/group). While drawing a 0.016-inch copper or super-elastic nickel-titanium archwire with 0.5 mm/min for 5 minutes in a chamber maintained at 36.5℃, SFF and KFF were measured. The Kruskal-Wallis method with Bonferroni correction was performed.@*RESULTS@#The Incognito group demonstrated the highest SFF, followed by the 7G and STb groups ([STb-control, STb-MXLI-PD, Stb-MXC-GD] < [7G-MXC-GD, 7G-MXLI-PD, 7G-control] < [Incognito-MXLI-PD, Incognito-control, Incognito-MXC-GD]; p < 0.001). However, there were no significant differences in SFF among the 3 displacement conditions within each bracket group. Within each displacement condition, the Incognito group demonstrated the highest KFF, followed by the 7G and STb groups ([STb-control, STb-MXLI-PD] < Stb-MXC-GD < 7G-MXLI-PD < [7G-control, 7G-MXC-GD] < [7G-MXC-GD, Incognito-MXLI-PD, Incognito-control] < [Incognito-control, Incognito-MXC-GD]; p < 0.001). MXC-GD exhibited higher KFFs than MXLI-PD in the same bracket group.@*CONCLUSIONS@#The slot design and ligation method of the CAD/CAM-LB system should be modified to reduce SFF and KFF during the leveling/alignment stage.
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OBJECTIVE: To investigate the effects of frontal facial type (FFT) and sex on preferred chin projection (CP) in three-dimensional (3D) facial images. METHODS: Six 3D facial images were acquired using a 3D facial scanner (euryprosopic [Eury-FFT], mesoprosopic [Meso-FFT], and leptoprosopic [Lepto-FFT] for each sex). After normal CP in each 3D facial image was set to 10° of the facial profile angle (glabella–subnasale-pogonion), CPs were morphed by gradations of 2° from normal (moderately protrusive [6°], slightly protrusive [8°], slightly retrusive [12°], and moderately retrusive [14°]). Seventy-five dental students (48 men and 27 women) were asked to rate the CPs (6°, 8°, 10°, 12°, and 14°) from the most to least preferred in each 3D image. Statistical analyses included the Kolmogorov-Smirnov test, Kruskal-Wallis test, and Bonferroni correction. RESULTS: No significant difference was observed in the distribution of preferred CP in the same FFT between male and female evaluators. In Meso-FFT, the normal CP was the most preferred without any sex difference. However, in Eury-FFT, the slightly protrusive CP was favored in male 3D images, but the normal CP was preferred in female 3D images. In Lepto-FFT, the normal CP was favored in male 3D images, whereas the slightly retrusive CP was favored in female 3D images. The mean preferred CP angle differed significantly according to FFT (Eury-FFT: male, 8.7°, female, 9.9°; Meso-FFT: male, 9.8°, female, 10.7°; Lepto-FFT: male, 10.8°, female, 11.4°; p < 0.001). CONCLUSIONS: Our findings might serve as guidelines for setting the preferred CP according to FFT and sex.
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Female , Humans , Male , Chin , Sex Characteristics , Students, DentalABSTRACT
OBJECTIVE: The purpose of this study was to evaluate the relation between idiopathic scoliosis and facial deformity in the horizontal, vertical, and anteroposterior planes. METHODS: A total of 123 female patients aged 14 years or older, who visited the Spine Clinic at the Department of Orthopedics, Korea University Guro Hospital for treatment of idiopathic scoliosis, were enrolled. Whole-spine anteroposterior and lateral radiographs were taken with the patient in a naturally erect position, and frontal and lateral cephalograms were taken in an erect position with the Frankfort horizontal line parallel to the floor. Scoliosis was classified according to the Cobb angle and Lenke classification of six curve types. Cephalometric tracing in all cases was carried out with V-Ceph 5.5 by the same orthodontist. The Kruskal-Wallis test was performed to determine whether any relation existed between each group of the idiopathic scoliosis classification and the cephalometric measurements of frontal and lateral cephalograms. RESULTS: The measurements did not reveal any significant association between the Cobb angle and cephalometric measurements and between the curve type based on the Lenke classification and cephalometric measurements. CONCLUSIONS: Based on the results of this study, no apparent relation was observed between the severity of scoliosis and facial form variations in idiopathic scoliosis patients.
Subject(s)
Female , Humans , Classification , Congenital Abnormalities , Korea , Orthopedics , Scoliosis , SpineABSTRACT
OBJECTIVE: A national survey was conducted to assess orthodontic residents' current concepts and knowledge of cleft lip and palate (CLP) management in Korea. METHODS: A questionnaire consisting of 7 categories and 36 question items was distributed to 16 senior chief residents of orthodontic department at 11 dental university hospitals and 5 medical university hospitals in Korea. All respondents completed the questionnaires and returned them. RESULTS: All of the respondents reported that they belonged to an interdisciplinary team. Nineteen percent indicated that they use presurgical infant orthopedic (PSIO) appliances. The percentage of respondents who reported they were 'unsure' about the methods about for cleft repair operation method was relatively high. Eighty-six percent reported that the orthodontic treatment was started at the deciduous or mixed dentition. Various answers were given regarding the amount of maxillary expansion for alveolar bone graft and the estimates of spontaneous or forced eruption of the upper canine. Sixty-seven percent reported use of a rapid maxillary expansion appliance as an anchorage device for maxillary protraction with a facemask. There was consensus among respondents regarding daily wearing time, duration of treatment, and amount of orthopedic force. Various estimates were given for the relapse percentage after maxillary advancement distraction osteogenesis (MADO). Most respondents did not have sufficient experience with MADO. CONCLUSIONS: These findings suggest that education about the concepts and methods of PSIO and surgical repair, consensus regarding orthodontic management protocols, and additional MADO experience are needed in order to improve the quality of CLP management in Korean orthodontic residents.
Subject(s)
Humans , Infant , Cleft Lip , Consensus , Surveys and Questionnaires , Dentition, Mixed , Hospitals, University , Korea , Orthodontic Extrusion , Orthopedics , Osteogenesis, Distraction , Palatal Expansion Technique , Palate , Surveys and Questionnaires , Recurrence , TransplantsABSTRACT
OBJECTIVE: To investigate the effects of different pilot-drilling methods on the biomechanical stability of self-tapping mini-implant systems at the time of placement in and removal from artificial bone blocks. METHODS: Two types of artificial bone blocks (2-mm and 4-mm, 102-pounds per cubic foot [102-PCF] polyurethane foam layered over 100-mm, 40-PCF polyurethane foam) were custom-fabricated. Eight mini-implants were placed using the conventional motor-driven pilot-drilling method and another 8 mini-implants were placed using a novel manual pilot-drilling method (using a manual drill) within each of the 2-mm and 4-mm layered blocks. The maximum torque values at insertion and removal of the mini-implants were measured, and the total energy was calculated. The data were statistically analyzed using linear regression analysis. RESULTS: The maximum insertion torque was similar regardless of block thickness or pilot-drilling method. Regardless of the pilot-drilling method, the maximum removal torque for the 4-mm block was statistically higher than that for the 2-mm block. For a given block, the total energy at both insertion and removal of the mini-implant for the manual pilot-drilling method were statistically higher than those for the motor-driven pilot-drilling method. Further, the total energies at removal for the 2-mm block was higher than that for the 4-mm block, but the energies at insertion were not influenced by the type of bone blocks. CONCLUSIONS: During the insertion and removal of mini-implants in artificial bone blocks, the effect of the manual pilot-drilling method on energy usage was similar to that of the conventional, motor-driven pilot-drilling method.
Subject(s)
Foot , Linear Models , Polyurethanes , TorqueABSTRACT
Orthodontic mini-implants, despite its usefulness as anchorage, have some limits such as loosening. Therefore, various shapes and lengths have been studied. The aim of this study is to analyze the shape and length of mini-implants mechanically. The shapes of mini-implants (1.6 mm, Dual Top, Jeil Medical Co., Seoul, Korea) were cylindrical and taper. The lengths of mini-implants were 6 mm and 8 mm. The tested groups were 5 groups (cylindrical 6 mm, cylindrical 8 mm, taper 6 mm, taper 8 mm and taper 8 mm modified whose thread is reduced from the middle to upper part). All were inserted and removed on the polyurethane foam with the torque measured. During insertion and removal, the taper shape needed higher torque than the cylindrical shape, and the 8 mm length than the 6 mm length (p < 0.001). The taper 6 mm group showed superior insertion torque (p < 0.001) and similar removal torque to the cylindrical 8 mm group. The taper 8 mm modified group with gradually reduced threads, showed continuous high removal torque after the peak. The initial mechanical stability can be provided by the tapered shape and also, affected by length and thread design.
Subject(s)
Polyurethanes , Seoul , TorqueABSTRACT
OBJECTIVE: Small orthodontic mini-implants are useful as anchorage. However they have some weaknesses such as loosening. This study was carried out to analyze the mechanical effects of the dual pitch and diameter on the insertion and removal torque of mini-implants. METHODS: The threads of mini-implants were mono and dual pitch. The diameters of mini-implants were 1.4 mm and 1.6 mm. Four groups were tested (mono 1.4 mm, mono 1.6 mm, dual 1.4 mm and dual 1.6 mm). All were inserted and removed on polyurethane foam with the torques being measured. RESULTS: The maximum torque of the dual pitch groups was higher than the mono pitch groups during removal but lower during insertion. The maximum torque of the 1.6 mm diameter groups was higher than the 1.4 mm diameter groups during insertion and removal. The dual pitch 1.4 mm group showed the lowest insertion torque but had similar or superior levels of removal torque to that of the mono pitch 1.6 mm group. CONCLUSIONS: The dual pitch especially showed a continuous high removal torque after the peak. Despite the small diameter, the dual pitch might improve the initial mechanical stability.