Evaluation of alveolar bone loss following rapid maxillary expansion using cone-beam computed tomography / 대한치과교정학회지

OBJECTIVE: To evaluate the changes in cortical bone thickness, alveolar bone height, and the incidence of dehiscence and fenestration in the surrounding alveolar bone of posterior teeth after rapid maxillary expansion (RME) treatment using cone-beam computed tomography (CBCT). METHODS: The CBCT records of 20 subjects (9 boys, mean age: 13.97 +/- 1.17 years; 11 girls, mean age: 13.53 +/- 2.12 year) that underwent RME were selected from the archives. CBCT scans had been taken before (T1) and after (T2) the RME. Moreover, 10 of the subjects had 6-month retention (T3) records. We used the CBCT data to evaluate the buccal and palatal aspects of the canines, first and second premolars, and the first molars at 3 vertical levels. The cortical bone thickness and alveolar bone height at T1 and T2 were evaluated with the paired-samples t-test or the Wilcoxon signed-rank test. Repeated measure ANOVA or the Friedman test was used to evaluate the statistical significance at T1, T2, and T3. Statistical significance was set at p < 0.05. RESULTS: The buccal cortical bone thickness decreased gradually from baseline to the end of the retention period. After expansion, the buccal alveolar bone height was reduced significantly; however, this change was not statistically significant after the 6-month retention period. During the course of the treatment, the incidence of dehiscence and fenestration increased and decreased, respectively. CONCLUSIONS: RME may have detrimental effects on the supporting alveolar bone, since the thickness and height of the buccal alveolar bone decreased during the retention period.

Alveolar bone thickness and lower incisor position in skeletal Class I and Class II malocclusions assessed with cone-beam computed tomography / 대한치과교정학회지

OBJECTIVE: To evaluate lower incisor position and bony support between patients with Class II average- and high-angle malocclusions and compare with the patients presenting Class I malocclusions. METHODS: CBCT records of 79 patients were divided into 2 groups according to sagittal jaw relationships: Class I and II. Each group was further divided into average- and high-angle subgroups. Six angular and 6 linear measurements were performed. Independent samples t-test, Kruskal-Wallis, and Dunn post-hoc tests were performed for statistical comparisons. RESULTS: Labial alveolar bone thickness was significantly higher in Class I group compared to Class II group (p = 0.003). Lingual alveolar bone angle (p = 0.004), lower incisor protrusion (p = 0.007) and proclination (p = 0.046) were greatest in Class II average-angle patients. Spongious bone was thinner (p = 0.016) and root apex was closer to the labial cortex in high-angle subgroups when compared to the Class II average-angle subgroup (p = 0.004). CONCLUSIONS: Mandibular anterior bony support and lower incisor position were different between average- and high-angle Class II patients. Clinicians should be aware that the range of lower incisor movement in high-angle Class II patients is limited compared to average- angle Class II patients.

Effects of demineralizaton-inhibition procedures on the bond strength of brackets bonded to demineralized enamel surface / 대한치과교정학회지

OBJECTIVE: To study and compare the effects of different demineralization-inhibition methods on the shear bond strength (SBS) and fracture mode of an adhesive used to bond orthodontic brackets to demineralized enamel surfaces. METHODS: Eighty freshly extracted, human maxillary premolars were divided into 4 equal groups and demineralized over the course of 21 days. Brackets were bonded to the demineralized enamel of teeth in Group 1. In Group 2, bonding was performed following resin infiltration (ICON(R), DMG, Hamburg, Germany). Before bonding, pre-treatment with acidulated phosphate fluoride (APF) or solutions containing casein phosphopeptide-amorphous calcium phosphate with 2% neutral sodium fluoride (CPP-ACP/wF) was performed in Groups 3 and 4, respectively. The SBS values of the brackets were measured and recorded following mechanical shearing of the bracket from the tooth surface. The adhesive remnant index (ARI) scores were determined after the brackets failed. Statistical comparisons were performed using one-way ANOVA, Tukey's post-tests, and G-tests. RESULTS: Significant differences were found in some of the intergroup comparisons of the SBS values (F = 39.287, p < 0.001). No significant differences were found between the values for the APF-gel and control groups, whereas significantly higher SBS values were recorded for the resin-infiltrated and CPP-ACP/wF-treated groups. The ARI scores were also significantly different among the 4 groups (p < 0.001). CONCLUSIONS: Tooth surfaces exposed to resin infiltration and CPP-ACP/wF application showed higher debonding forces than the untreated, demineralized surfaces.

Comparison of three different orthodontic wires for bonded lingual retainer fabrication / 대한치과교정학회지

OBJECTIVE: We evaluated the detachment force, amount of deformation, fracture mode, and pull-out force of 3 different wires used for bonded lingual retainer fabrication. METHODS: We tested 0.0215-inch five-stranded wire (PentaOne, Masel; group I), 0.016 x 0.022-inch dead-soft eight-braided wire (Bond-A-Braid, Reliance; group II), and 0.0195-inch dead-soft coaxial wire (Respond, Ormco; group III). To test detachment force, deformation, and fracture mode, we embedded 94 lower incisor teeth in acrylic blocks in pairs. Retainer wires were bonded to the teeth and vertically directed force was applied to the wire. To test pull-out force, wires were embedded in composite that was placed in a hole at the center of an acrylic block. Tensile force was applied along the long axis of the wire. RESULTS: Detachment force and mode of fracture were not different between groups. Deformation was significantly higher in groups II and III than in group I (p < 0.001). Mean pull-out force was significantly higher for group I compared to groups II and III (p < 0.001). CONCLUSIONS: Detachment force and fracture mode were similar for all wires, but greater deformations were seen in dead-soft wires. Wire pull-out force was significantly higher for five-stranded coaxial wire than for the other wires tested. Five-stranded coaxial wires are suggested for use in bonded lingual retainers.

Comparison of craniofacial morphology, head posture and hyoid bone position with different breathing patterns

The aim of this study was to evaluate differences in craniofacial morphology, head posture and hyoid bone position between mouth breathing [MB] and nasal breathing [NB] patients. Mouth breathing patients comprised 34 skeletal Class I subjects with a mean age of 12.8 +/- 1.5 years [range: 12.0-15.2 years]. Thirty-two subjects with skeletal Class I relationship were included in the NB group [mean 13.5 +/- 1.3 years; range: 12.2-14.8 years]. Twenty-seven measurements [15 angular and 12 linear] were used for the craniofacial analysis. Additionally, 12 measurements were evaluated for head posture [eight measurements] and hyoid bone position [four measurements]. Student's /-test was used for the statistical analysis. Probability values <0.05 were accepted as significant. Statistical comparisons showed that sagittal measurements including SNA [p < 0.01], ANB [p < 0.01], A to N perp [p < 0.05], convexity [p < 0.05], IMPA [p < 0.05] and overbite [p < 0.05] measurements were found to be lower in MB patients compared to NB. Vertical measurements including SN-MP [p < 0.01] and PP-GoGn [p < 0.01], S-N [p <0.05] and anterior facial height [p < 0.05] were significantly higher in MB patients, while the odontoid proses and palatal plane angle [OPT-PP] was greater and true vertical line and palatal plane angle [Vert-PP] was smaller in MB patients compared to NB group [p < 0.05 for both]. No statistically significant differences were found regarding the hyoid bone position between both groups. The maxilla was more retrognathic in MB patients. Additionally, the palatal plane had a posterior rotation in MB patients. However, no significant differences were found in the hyoid bone position between MB and NB patients

Effects of a new desensitizing paste containing 8% arginine and calcium carbonate on the shear bond strength of orthodontic brackets / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to evaluate shear bond strength (SBS) and failure site location of brackets bonded to enamel with or without desensitizer application. METHODS: Sixty-six freshly extracted human premolar teeth were randomly divided into 3 groups of 22. Group 1 served as the control. Desensitizer was applied to the remaining teeth at two time intervals (Group 2, bonded immediately after Pro-Relief(TM) (Colgate-Palmolive Co., New York, NY, USA) application and Group 3, bonded 30 days after Pro-Relief(TM) application with the teeth stored in artificial saliva during the 30 days). Orthodontic brackets were bonded with a light cure composite resin and cured with a halogen light. After bonding, the SBS of the brackets was tested using a universal testing device. Adhesive remnant index (ARI) scores were determined after the brackets failed. Data were analyzed with analysis of variance, Tukey's HSD, and G tests. RESULTS: The SBS was significantly lower in Group 2 than in Groups 1 (p = 0.024) and 3 (p = 0.017). Groups 1 and Group 3 did not differ (p = 0.991). ARI scores did not differ significantly among groups. CONCLUSIONS: The Pro-Relief(TM) desensitizer agent applied immediately before bonding significantly reduces bond strength, but the SBS values still exceed the minimum 5.9 - 7.8 MPa required for adequate clinical performance. Immersing the teeth in artificial saliva for 30 days after applying the Pro-Relief(TM) desensitizer agent and before bonding increased the SBS to control levels.

Changes in mandibular transversal arch dimensions after rapid maxillary expansion procedure assessed through cone-beam computed tomography / 대한치과교정학회지

OBJECTIVE: This study aimed at evaluating the changes in mandibular arch widths and buccolingual inclinations of mandibular posterior teeth after rapid maxillary expansion (RME). METHODS: Baseline and post-expansion cone-beam computed tomographic (CBCT) images of patients who initially had bilateral posterior cross-bite and underwent RME with a banded-type expander were assessed in this study. The patients included 9 boys (mean age: 13.97 +/- 1.17 years) and 11 girls (mean age: 13.53 +/- 2.12 years). Images obtained 6 months after retention were available for 10 of these patients. Eighteen angular and 43 linear measurements were performed for the maxilla and mandible. The measurements were performed on frontally clipped images at the following time points; before expansion (T1), after expansion (T2), and after retention (T3). Statistical significance was assessed with paired sample t-test at p < 0.05. RESULTS: T1-T2 comparisons showed statistically significant post-RME increases for all measurements; similarly, T2-T1 and T3-T1 comparisons showed statistically significant changes. The maxillary linear and angular measurements showed decreases after expansion, and mandibular linear and angular measurements increased after retention. CONCLUSION: All mandibular arch widths increased and mandibular posterior teeth were uprighted after RME procedure.

Low-shrinking composites. Are they reliable for bonding orthodontic retainers? / 대한치과교정학회지

OBJECTIVE: To evaluate the shear bond strength (SBS), fracture mode, wire pull out (WPO) resistance and microleakage between low-shrinking and conventional composites used as a lingual retainer adhesive. METHODS: A total of 120 human mandibular incisor teeth, extracted for periodontal reasons, were collected. Sixty of them were separated into two groups. To determine the SBS, either Transbond-LR (3M-Unitek) or Silorane (3M-Espe) was applied to the lingual surface of the teeth by packing the material into standard cylindrical plastic matrices (Ultradent) to simulate the lingual retainer bonding area. To test WPO resistance, 20 samples were prepared for each composite where the wire was embedded in the composite materialand cured. Then tensile stress was applied until failure of the composite occurred. The remaining 60 teeth were divided into two groups and multi-stranded 0.0215-inch diameter wire was bonded with the same composites. Microleakage was evaluated by the dye penetration method. Statistical analyses were performed by Wilcoxon, Pearson chi-square, and Mann-Whitney-U tests at p < 0.05 level. RESULTS: The SBS and WPO results were not statistically significant between the two groups. Significant differences were found between the groups in terms of fracture mode (p < 0.001). Greater percentages of the fractures showed mix type failure (85%) for Silorane and adhesive (60%) for Transbond-LR. Microleakage values were lower in low-shrinking composite than the control and this difference was found to be statistically significant (p < 0.001). CONCLUSIONS: Low-shrinking composite produced sufficient SBS, WPO and microleakage values on the etched enamel surfaces, when used as a lingual retainer composite.

Cone-beam computed tomography assessment of mandibular asymmetry in unilateral cleft lip and palate patients / 대한치과교정학회지

OBJECTIVE: To determine whether there is any difference between the cleft and non-cleft sides of the mandible in unilateral cleft lip and palate (UCLP) patients, or the right and left sides in control patients; and to determine if there is any difference between the mandibular asymmetry of UCLP patients and that of control patients. METHODS: We examined cone-beam computed tomography (CBCT) scans of 15 patients with UCLP and 15 age- and gender-matched control patients. We evaluated 8 linear, 3 surface, and 3 volumetric measurements and compared the cleft/non-cleft sides of UCLP patients and the right/left sides of controls. RESULTS: There were no statistically significant gender differences in any linear, surface, or volumetric measurement. The single significant side-to-side difference in UCLP patients was a longer coronoid unit on the cleft side than on the non-cleft side (p = 0.046). Body volume was significantly lower in the UCLP group than in the control group (p = 0.008). CONCLUSIONS: In general, UCLP patients have symmetrical mandibles, although the coronoid unit length is significantly longer on the cleft side than on the non-cleft side. UCLP patients and controls differed only in body volume.

Effects of conventional and modified facemask therapies on dentofacial structures / 대한치과교정학회지

OBJECTIVE: The purpose of this prospective study was to evaluate the dentofacial effects of conventional and modified facemask therapies with rapid maxillary expansion, in a group of Class III patients; and compared with an untreated control group. METHODS: The conventional facemask group (Group 1) comprised of 24 patients, 13 girls and 11 boys (mean age, 9.2 +/- 1.4 years); the modified facemask treatment group (Group 2) comprised of 24 patients, 12 girls and 12 boys (mean age, 9.3 +/- 1.6 years); and the control group (Group 3) comprised of 21 subjects, 11 girls and 10 boys (mean age, 9.8 +/- 1.9 years). Treatment and control changes within the groups and the differences between the groups were analyzed statistically. Intra-group comparisons were evaluated using the non-parametric Wilcoxon's test and intergroup changes were analyzed using the Kruskal-Wallis test. The statistical significance of intergroup differences was further assessed with the Mann-Whitney test for independent samples and applying Bonferroni's correction (p < 0.016). RESULTS: In group 1, SNB changes were less than the control. There were increases in SNA, ANB, SN-MP, A to N perp and Upper lip to E plane. In group 2, SNB, U1-NA (mm) U1-NA (degrees) and Pog to N perp (mm) changes were less than the control. There were increases in SNA, ANB, SN-MP, A to N perp and Upper lip to E plane. CONCLUSIONS: Modified facemask appliance can be used effectively in Class III patients with a retrognathic maxilla. Facemask therapies with expansion resulted in an anterior advancement and translation of maxilla without rotation; and the mandible moved downward and backward in both treatment groups.

Stimulation of bone formation by direct electrical current in an orthopedically expanded suture in the rat / 대한치과교정학회지

OBJECTIVE: The aim of this experimental study was to evaluate the effects of direct electrical current stimulation (DECS) on bone regeneration in response to an expansion of the inter-premaxillary suture in the rat. METHODS: Sixteen 50 - 60 days old Wistar male rats were separated into two equal groups (control and experimental). Both groups were subjected to expansion, and 30-gram of force was applied to the maxillary incisors with helical-spring. In the experimental group, two metallic-screws were placed at lateral parts of the maxillary segments. Electrodes were connected to the screws. The device was activated with current adjustment to measure 10 microA continuously and the current was monitored daily during the expansion and early-retention phase. Bone regeneration in the sutural area was histomorphometrically evaluated including new-bone area (micrometer2), bone perimeter (micrometer), feret's diameter (micrometer) and newly formed bone (%) parameters. Kruskal-Wallis rank and Mann-Whitney U tests were used for statistical evaluation at p < 0.05 level. RESULTS: Statistical analysis showed significant differences between groups for all investigated histomorphometric parameters. New bone area (p = 0.002), bone perimeter (p = 0.004), feret's diameter (p = 0.002) and newly formed bone percentage (p = 0.002) measurements were significantly higher in the experimental group than the control group. Bone histomorphometric measurements revealed that bone architecture in the DECS group was improved. CONCLUSIONS: The application of DECS to an orthopedically expanded inter-premaxillary suture area during the early retention phase stimulated the formation of new bone.

Effects of conventional and self-etching adhesive systems on bond strength of orthodontic attachments bonded to erupted and unerupted teeth / 대한치과교정학회지

OBJECTIVE: The aim of this study was to evaluate and compare the shear bond strength (SBS) and failure-mode of orthodontic buttons bonded to erupted and unerupted teeth with conventional and self-etching adhesive systems. METHODS: Eighty-four erupted and 84 unerupted, human third-molar teeth were used. For both groups, the buccal surfaces of each tooth were assigned one of the following type of adhesive systems (n = 12). A, Conventional systems: 1, Transbond XT (3M Unitek, Monrovia, CA, USA); 2, Prime & Bond NT (Dentsply/Caulk, Milford, USA); 3, Single Bond (3M ESPE, Minnesota, USA); and B, Self-etching adhesives; 4, Clearfil SE Bond (Kuraray, Okayama, Japan); 5, Transbond Plus (3M Unitek, Monrovia, CA, USA); 6, Clearfil S3 (Kuraray, Tokyo, Japan); 7, G Bond (GC, Tokyo, Japan). The SBSs of the attachments and the adhesive remnant index (ARI) scores were recorded. Data were analyzed with analysis of variance (ANOVA), independent-sample t-test and chi-square tests. RESULTS: When the SBSs of erupted and unerupted teeth were compared, only the Clearfil-SE Bond and G-Bond were significantly different. Bond strengths of all adhesive systems were higher in unerupted teeth than erupted teeth, except the Single-Bond system. CONCLUSIONS: When using conventional adhesives, bonding to erupted and unerupted teeth may not be significantly different. However, clinicians need to take into consideration the types of self-etching systems before usage.

Stimulation of bone formation in the expanding inter-premaxillary suture by vitamin E, in rat / 대한치과교정학회지

OBJECTIVE: The aim of this study was to evaluate the effects of vitamin E (alpha-tocopherol) administration on bone formation in response to expansion of the inter-premaxillary suture, in rats, histomorphometrically. METHODS: Thirty 50 - 60 day old Wistar rats were separated into five equal groups (one control and four experimental). All groups were subjected to inter-premaxilla expansion with 50-gram of force. Six control animals received saline solution (Group I) and three experimental groups were treated with a single dose of alpha-tocopherol injected into the inter-premaxillary suture after one day after appliance placement (Group II: 2 mg/kg; Group III: 10 mg/kg; and Group IV: 50 mg/kg). A further group of six animals received three injections of 10 mg/kg alpha-tocopherol, one each on days 3, 6, and 9 (Group V). Bone formation in the suture was evaluated by bone histomorphometry. Kruskal-Wallis rank and Mann-Whitney U tests were used for statistical evaluation at p<0.05 level. RESULTS: New bone area, bone perimeter, feret's diameter and newly formed bone measurements were significantly higher in the experimental groups than the control (p<0.001). Bone architecture in alpha-tocopherol administrated groups was improved, and bone formation during the expansion period was stimulated significantly, in a dose-dependent manner. CONCLUSIONS: The application of alpha-tocopherol during the early stages to orthopedically expanded inter-premaxillary suture areas may stimulate bone formation and shorten the retention period, in rats.