Orthodontic treatment of an open bite after splint therapy for a patient with idiopathic condylar resorption.

In the treatment of orthodontic patients with idiopathic condylar resorption, symptoms of temporomandibular joint disorders and constantly changing occlusions caused by an instability of mandibular position make it difficult for orthodontists to confirm definitive orthodontic diagnosis and treatment plans. Therefore, these patients' temporomandibular joint (TMJ) structures need to be stabilized with splint therapy before active tooth movement to identify and maintain the true mandibular position. For some idiopathic condylar resorption patients, orthognathic surgery can cause further resorption on the vulnerable condyles of the mandible; thus, effective orthodontic camouflage treatment after joint stabilization should be considered. During the orthodontic camouflage treatment, adverse loads on the TMJ structures, which could change the position of condyles, should be avoided, and TMJ-friendly mechanics must be applied.

Genetic effect of single nucleotide polymorphisms in growth hormone receptor gene on the risk of non-syndromic mandibular prognathism in the Korean population.

OBJECTIVES: To evaluate the association of three single-nucleotide polymorphisms (SNPs) of growth hormone receptor (GHR) gene with mandibular prognathism (MP) and relationships between mandibular morphology and GHR gene SNPs in the Korean population. MATERIALS AND METHODS: A total of 325 subjects were divided into two groups based on sagittal maxillomandibular relationship by the lateral cephalography: the MP and control groups. From the SNPs in the GHR gene, three SNPs (rs6180, rs6182 and rs6184) were selected. SNP genotyping was performed using direct sequencing. The craniofacial measurements of lateral cephalography were analysed. RESULTS: We found a lack of association between GHR and MP. However, in the analysis according to the values of cephalometric measurements, rs6180 was significantly associated with ANB, SNB, effective mandibular length and SNMP in females. Additionally, rs6182 and rs6184 were significantly associated with ramal height in males. CONCLUSION: Growth hormone receptor SNPs may affect not only the sagittal development of mandible but also the vertical development of ramal height, and GHR SNPs may gender-differently influence mandibular morphology. This finding supports that the GHR might be susceptible on mandibular morphogenesis in the Korean population.

Effect of extraction treatment on upper airway dimensions in patients with bimaxillary skeletal protrusion relative to their vertical skeletal pattern.

OBJECTIVE: To investigate dimensional changes in regional pharyngeal airway spaces after premolar extraction in bimaxillary skeletal protrusion (BSP) patients according to vertical skeletal pattern, and to further identify dentoskeletal risk factors to predict posttreatment pharyngeal changes. METHODS: Fifty-five adults showing BSP treated with microimplant anchorage after four premolar extractions were included in this retrospective study. The subjects were divided into two groups according to the mandibular plane steepness: hyperdivergent (Frankfort horizontal plane to mandibular plane [FH-MP] ≥ 30) and nonhyperdivergent groups (FH-MP < 30). The control group consisted of 20 untreated adults with skeletal Class I normodivergent pattern and favorable profile. Treatment changes in cephalometric variables were evaluated and compared. The association between posttreatment changes in the dentoskeletal and upper airway variables were analyzed using linear regression analysis. RESULTS: The BSP patients showed no significant decrease in the pharyngeal dimensions to the lower level in comparison with controls, except for middle airway space (MAS, p < 0.01). The upper airway variable representing greater decrease in the hyperdivergent group than in the nonhyperdivergent group was the MAS (p < 0.01). Posttreatment changes in FH-MP had negative correlation with changes in MAS (ß = -0.42, p < 0.01) and inferior airway space (ß = -0.52, p < 0.01) as a result of multivariable regression analysis adjusted for sagittal skeletal relationship. CONCLUSIONS: Decreased pharyngeal dimensions after treatment in BSP patients showed no significant difference from the normal range of pharyngeal dimensions. However, the glossopharyngeal airway space may be susceptible to treatment when vertical dimension increased in hyperdivergent BSP patients.

Palatal temporary skeletal anchorage devices (TSADs): What to know and how to do?

OBJECTIVES: Since palatal temporary skeletal anchorage devices (TSADs) have become important tools for orthodontic treatment, this narrative review was aimed to provide an updated and integrated guidelines for the clinical application of palatal TSADs. SETTING AND SAMPLE POPULATION: A narrative review article including researches on palatal TSADs in orthodontics related to anatomy, success rate and clinical application. MATERIALS AND METHODS: The anatomical characteristics, success rate and its consideration factors and clinical application of palatal TSADs based on the direction of tooth movement were evaluated. RESULTS: To improve the stability of TSADs, hard tissue factors such as bone depth, cortical bone thickness, bone density and soft tissue thickness were evaluated. Anatomically risky structures, including the nasopalatine foramen, canal and the greater palatine foramen, nerve, vessel need to be identified before placement. The success rate of palatal TSADs was greater than that of the buccal inter-radicular space. Palatal TSADs have been used for various purposes because they can control tooth movement in all directions and, three-dimensionally; their applications include the retraction of anterior teeth, protraction of posterior teeth, distalization, intrusion, expansion and constriction. They can be applied directly or indirectly to the lingual arch or transpalatal arch. Design modifications using splinted 2 miniscrews have been suggested. CONCLUSION: Palatal TSADs allow clinicians to perform minimally invasive and easy placement with good stability by understanding the anatomical characteristics of the palatal region, and they show good control over 3-dimensional tooth movements in various clinical cases.

Clustering-based characterization of clinical phenotypes in obstructive sleep apnoea using severity, obesity, and craniofacial pattern.

OBJECTIVES: To identify and characterize the phenotypes of adult obstructive sleep apnoea (OSA) patients based on clustering using OSA severity, obesity, and craniofacial pattern. MATERIAL AND METHODS: The samples consisted of 89 adult OSA patients whose polysomnography and lateral cephalogram were available. With cluster analysis using apneahypopnea index (AHI, events/hour), body mass index (BMI, kg/m2), ANB (degree), and mandibular plane angle (MPA, degree), three clusters were identified. Cephalometric variables including craniofacial, soft palate, hyoid bone, and pharyngeal space compartments were compared among clusters by one-way analysis of variance or Kruskal-Wallis test. Multivariable linear regression analysis was performed to find contributing factors to OSA severity within each cluster. RESULTS: Cluster-1 (obesity type; 49.4 per cent) exhibited moderate OSA, obesity, and normal sagittal and vertical skeletal pattern (AHI, 22.4; BMI, 25.5; ANB, 3.2 degrees; MPA, 26.3 degrees) without significant upper airway abnormality. Cluster-2 (skeletal type; 33.7 per cent) was characterized by moderate OSA, severe skeletal Class II hyperdivergent pattern with narrow pharyngeal airway spaces, without obesity (AHI, 27.9; BMI, 23.5; ANB, 7.5 degrees; MPA, 36.6 degrees). Cluster-3 (complex type; 16.8 per cent) included severe OSA, obesity, skeletal Class II hyperdivergent pattern (AHI, 52.8; BMI, 28.0; ANB, 4.5 degrees; MPA, 32.2 degrees), with posteriorly displaced hyoid and retroclined soft palate. The main contributing factors to AHI were obesity in Cluster-1; hyperdivergent vertical pattern with narrow pharyngeal space in Cluster-2; and hyperdivergent pattern, obesity, displaced hyoid, and soft palate in Cluster-3. CONCLUSION: Three OSA phenotypes resulted from this study provide a clinical guideline for differential diagnosis and orthodontic intervention in the interdisciplinary treatment for OSA patients.

Three-dimensional alteration of constricted alveolar ridge affected by root thrusting with and without open-flap decortication.

OBJECTIVE: To investigate the morphometric and histological alterations of the constricted alveolar ridge when affected by root thrusting with and without open-flap decortication. MATERIALS AND METHODS: Eight beagles were divided into three groups: C, control without root thrusting; R, root thrusting only; RD, root thrusting with alveolar decortication. The ridge constriction model was prepared in 16 mandibular quadrants after extraction of the third premolars. Reciprocal root thrusting of the second and fourth premolars was performed toward the constricted ridge for 10 weeks, having a moment of 900 g-mm. Open-flap decortication was conducted on the constricted bone surface in group RD. Micro-CT-based histomorphometric analysis and trichrome-staining-based tissue fractional analysis were performed to evaluate morphometric and microstructural changes on the ridge. RESULTS: Group R revealed a higher percentage of bone volume (P < .001), lower bone mineral density (P < .01), and higher trabecular number (P < .001) than did group C, which was supported by a higher bone fraction woven to lamellar bone (P < .05) resulting from histologic fractional analysis. However, group RD showed no significant difference from group C. CONCLUSIONS: Root thrusting toward the constricted ridge induced hypertrophic bone modeling with a high trabecular fraction on the ridge. However, combined open-flap decortication with root thrusting did not improve the volume or quality of the constricted ridge.

Morphological investigation of various orthodontic lingual bracket slots using scanning electron microscopy and atomic force microscopy.

Various labial and lingual orthodontic appliances with aesthetic materials have been developed due to an increased demand in aesthetic orthodontic treatment. However, there are few reports regarding the morphology of lingual orthodontic appliances. Therefore, this study evaluates the roughness of slot surfaces of various orthodontic lingual brackets using field emission scanning electron microscopy (FE-SEM) and atomic force microscopy (AFM). Three types of stainless steel lingual brackets (Stealth® , 7th Generation® , and Clippy L® ) and one gold lingual bracket (Incognito™) with a slot size of 0.018 inches × 0.025 inches (0.457 × 0.635 mm2 ) were selected as representative lingual materials. Both FE-SEM and AFM examinations showed that the Stealth® and Clippy L® brackets had the lowest surface roughness, while the 7th Generation® bracket had the highest surface roughness. There was a significant difference in surface morphology between the types of lingual brackets, even when composed of the same material. The surface roughness of the bracket slot was dependent on the manufacturing process or surface polishing process rather than the fundamental properties of the bracket materials. There was no significant difference in the mean surface roughness of the slot floor between gold and stainless steel lingual brackets. These findings suggest that, although the gold lingual bracket is very expensive, it has great potential for use in patients with nickel allergy.

Morphologic evaluation of dentoalveolar structures of mandibular anterior teeth during augmented corticotomy-assisted decompensation.

INTRODUCTION: Our aim in this study was to evaluate the effect of augmented corticotomy on the decompensation pattern of mandibular anterior teeth, alveolar bone, and surrounding periodontal tissues during presurgical orthodontic treatment. METHODS: Thirty skeletal Class III adult patients were divided into 2 groups according to the application of augmented corticotomy labial to the anterior mandibular roots: experimental group (with augmented corticotomy, n = 15) and control group (without augmented corticotomy, n = 15). Lateral cephalograms and cone-beam computed tomography images were taken before orthodontic treatment and before surgery. The measurements included the inclination and position of the mandibular incisors, labial alveolar bone area, vertical alveolar bone height, root length, and alveolar bone thickness at 3 levels surrounding the mandibular central incisors, lateral incisors, and canines. RESULTS: The mandibular incisors were significantly proclined in both groups (P <0.001); however, the labial movement of the incisor tip was greater in the experimental group (P <0.05). Significant vertical alveolar bone loss was observed only in the control group (P <0.001). The middle and lower alveolar thicknesses and labial alveolar bone area increased in the experimental group. In the control group, the upper and middle alveolar thicknesses and labial alveolar bone area decreased significantly. There were no significant differences in dentoalveolar changes between the 3 kinds of anterior teeth in each group, except for root length in the experimental group (P <0.05). CONCLUSIONS: Augmented corticotomy provided a favorable decompensation pattern of the mandibular incisors, preserving the periodontal structures surrounding the mandibular anterior teeth for skeletal Class III patients.

Corticision: A Flapless Procedure to Accelerate Tooth Movement.

Orthodontic tooth movement results from applied forces to the teeth evoking cellular responses in the teeth and their surrounding tissues, including the periodontal ligament, alveolar bone and gingiva. It is advantageous for the orthodontist to be well informed of the detailed process of the biological events that unfold during tooth movement, since some of these details may differ from one person to another due to biological differences such as periodontal metabolism or alveolar bone density. This led us to emphasize that orthodontics is a field of endeavor where the integration of mechanics and biology is materialized, and to affirm the fact that tooth movement is conducted in individual human beings, each composed of a unique and intricate physiological system. Biological variations may be the foundation of the differences that are frequently observed in the outcomes of orthodontic treatment in particular with reference to treatment duration between patients with similar malocclusions and who were treated identically. A wide diversity of clinical trials has been carried out to control the tissue resistance to facilitate orthodontic tooth movement, which involves biomechanical, pharmaceutical, surgical, electrical regimens or tissue engineering technology. The term 'Corticision' is a neologism which indicates 'cortical bone incision'. It is a minimally invasive periodontal procedure without flap elevation, thus accelerating tooth movement with an enhanced turnover rate of the surrounding structures. This chapter introduces the technical procedure, and the biological background of how such a minor surgical procedure can receive the accelerated tooth movement with impunity and thereby shorten the duration of treatment.

In vitro sliding-driven morphological changes in representative esthetic NiTi archwire surfaces.

OBJECTIVES: This study investigated the effects of sliding on the ultrastructure of three representative esthetic superelastic 0.014 inch nickel-titanium (NiTi) archwires. METHODS: Atomic force microscopy, scanning electron microscopy, and light microscopy were used to estimate the surface roughness of archwires and bracket systems. Energy-dispersive X-ray spectroscopy was used to estimate the molecular differences between coated and uncoated areas. A combination of four different types of 0.014 inch metallic wires and two different types of 0.022 inch × 0.028 inch conventional brackets were evaluated by in vitro sliding tests using a novel self-made tensile-strength tester with a miniature load cell and syringe pump. The NiTi wires included an uncoated NiTi archwire (CO group), epoxy resin-coated NiTi archwire (ER group), Teflon(®) -coated NiTi archwire (TF group), and Ag/biopolymer-coated NiTi archwire (AG group). The brackets included contained stainless steel (SS) and ceramic (CE) brackets. RESULTS: Both ER and TF wire groups exhibited less surface roughness than CO wire groups. The AG group showed the highest surface roughness compared with the others because of its silver particles (P<0.001, ANOVA test). In vitro sliding tests led to a significant increase (P < 0.001, ANOVA test) in the surface roughness of all 0.014 inch NiTi wires regardless of bracket type. The wire groups combined with SS brackets were rougher than those of CE brackets regardless of the coating materials because of exfoliation of the coating materials. The TF-SS group showed the highest increase (fivefold) in surface roughness compared to the others, while the ER groups showed the lowest increase (1.4-fold) in surface roughness compared with the others (P < 0.001, ANOVA test). CONCLUSIONS: The results suggested that the sliding-driven surface roughness of superelastic NiTi archwires is directly affected by coating materials. Although the efficiency of orthodontic treatment was affected by various factors, epoxy resin-coated archwires were best for both esthetics and tooth movement when only considering surface roughness.

Accuracy and precision of integumental linear dimensions in a three-dimensional facial imaging system.

OBJECTIVE: A recently developed facial scanning method uses three-dimensional (3D) surface imaging with a light-emitting diode. Such scanning enables surface data to be captured in high-resolution color and at relatively fast speeds. The purpose of this study was to evaluate the accuracy and precision of 3D images obtained using the Morpheus 3D® scanner (Morpheus Co., Seoul, Korea). METHODS: The sample comprised 30 subjects aged 24-34 years (mean 29.0 ± 2.5 years). To test the correlation between direct and 3D image measurements, 21 landmarks were labeled on the face of each subject. Sixteen direct measurements were obtained twice using digital calipers; the same measurements were then made on two sets of 3D facial images. The mean values of measurements obtained from both methods were compared. To investigate the precision, a comparison was made between two sets of measurements taken with each method. RESULTS: When comparing the variables from both methods, five of the 16 possible anthropometric variables were found to be significantly different. However, in 12 of the 16 cases, the mean difference was under 1 mm. The average value of the differences for all variables was 0.75 mm. Precision was high in both methods, with error magnitudes under 0.5 mm. CONCLUSIONS: 3D scanning images have high levels of precision and fairly good congruence with traditional anthropometry methods, with mean differences of less than 1 mm. 3D surface imaging using the Morpheus 3D® scanner is therefore a clinically acceptable method of recording facial integumental data.

Correlation between frictional force and surface roughness of orthodontic archwires.

Lateral force microscopy measures the lateral bending of the cantilever depending on the frictional force acting between the tip and surface. The aim of this study was to investigate and compare the relationship between the surface roughness and frictional resistance of four archwire and bracket combinations consisting of the 0.016-inch NiTi and 0.019 × 0.025-inch stainless steel archwires interacting clinically with two representative self-ligating brackets, active-type Clippy-C(®) ceramic self-ligating brackets, and passive-type Damon(®) stainless steel self-ligating brackets, using the lateral force microscopy technique. A 0.016-inch NiTi archwire interacting with passive-type Damon(®) stainless steel self-ligating brackets showed the smoothest surface roughness and the lowest frictional resistance compared to other combinations. The archwires interacting with passive-type Damon(®) stainless steel self-ligating brackets showed significantly lower surface roughness and frictional resistance than those interacting with active-type Clippy-C(®) ceramic self-ligating brackets. The frictional force in the in vivo archwire and bracket system increased with increasing surface roughness of the archwire. This positive correlation suggests that surface roughness can be used as an evaluating marker for estimating the efficiency of orthodontic treatment, rather than the direct measurement of frictional force.

Effect of self-ligating bracket type and vibration on frictional force and stick-slip phenomenon in diverse tooth displacement conditions: an in vitro mechanical analysis.

OBJECTIVE: To evaluate the effects of self-ligating bracket (SLB) type and vibration on frictional force and stick-slip phenomenon (SSP) in diverse tooth displacement conditions when a levelling/alignment wire was drawn. MATERIALS AND METHODS: A total of 16 groups were tested (n = 10/group): Two types of SLBs [active SLB (ASLB, In-Ovation R) and passive SLB (PSLB, Damon Q)]; vibration (30 Hz and 0.25 N) and non-vibration conditions; and 4 types of displacement [2mm lingual displacement of the maxillary right lateral incisor (LD), 2mm gingival displacement of the maxillary right canine (GD), combination of LD and GD (LGD), and control]. After applying artificial saliva to the typodont system, 0.018 copper nickel-titanium archwire was drawn by Instron with a speed of 0.5mm/min for 5 minutes at 36.5°C. After static/kinetic frictional forces (SFF/KFF), and frequency/amplitude of SSP were measured, statistical analysis was performed. RESULTS: ASLB exhibited higher SFF, KFF, and SSP amplitude (all P < 0.001) and lower SSF frequency (all P < 0.05) than PSLB in all displacement groups. Vibration decreased SFF, KFF, and SSP amplitude and increased SSP frequency in control and all displacement groups (all P < 0.001). ASLB exhibited lower SSP frequency than PSLB only under non-vibration condition (P < 0.05 in LD and GD, P < 0.01 in LGD). However, regardless of vibration conditions, ASLB demonstrated higher SSP amplitude than PSLB in all displacement groups (all P < 0.001 under non-vibration; all P < 0.01 under vibration). CONCLUSION: Even in tooth displacement conditions, vibration significantly reduced SFF, KFF, SSP amplitude, and increased SPP frequency in both PSLB and ASLB. However, in vivo studies would be needed to confirm the clinical significance.

Effect of tooth displacement and vibration on frictional force and stick-slip phenomenon in conventional brackets: a preliminary in vitro mechanical analysis.

OBJECTIVE: To evaluate the effects of tooth displacement and vibration on frictional force and stick-slip phenomenon (SSP) when conventional brackets were used with a levelling/alignment wire. MATERIALS AND METHODS: The samples consisted of six groups (n = 10 per group) with combinations of tooth displacement (2mm lingual displacement [LD], 2mm gingival displacement [GD], and no displacement [control]) and vibration conditions (absence and presence at 30 Hz and 0.25 N). A stereolithographically made typodont system was used with conventional brackets and elastomeric ligatures. After application of artificial saliva, static/kinetic frictional forces (SFF/KFF) and frequency/amplitude of SSP were measured while drawing a 0.018-inch copper nickel-titanium (Cu-NiTi) archwire at a speed of 0.5mm/min for 5 minutes at 36.5 degree celsius. Two-way analysis of variance and independent t-test were performed. RESULTS: Tooth displacement increased SFF and KFF (control < LD < GD, all P < 0.001) and reduced SSP frequency (control > [LD, GD], P < 0.01). Vibration reduced SFF, KFF, and SSP amplitude in the control group (P < 0.05, P < 0.05, and P < 0.001, respectively), but not in the LD and GD groups. SSP frequency was increased by vibration in the control, LD, and GD groups (all P < 0.001), and it was lower in the LD and GD groups than in the control group (P < 0.01). CONCLUSIONS: When conventional brackets and a 0.018-inch Cu-NiTi archwire were used in the tooth displacement conditions (LD and GD), vibration did not significantly reduce SFF, KFF, or SSP amplitude.

Biochemical characterization of human gingival crevicular fluid during orthodontic tooth movement using Raman spectroscopy.

This study used Raman spectroscopy to report the first human gingival crevicular fluid (GCF) biochemical characterization during the early phase of orthodontic tooth movement. This technique allows for label-free and noninvasive biochemical change monitoring in GCF during orthodontic tooth movement. Ten orthodontic patients (20.8 ± 2.5 years) participated in the study. GCF samples were obtained before (baseline, 0 days) and during orthodontic treatment at 1, 7 and 28 days. For Raman spectroscopic measurement, GCF samples (5 µl) were deposited onto a gold-coated substrate, then dried at room temperature. Raman spectra GCF analysis during orthodontic treatment indicated that the hydroxyapatite to primarily collagen-dominated matrix band (phosphate 984 cm(-1)/amide I 1667 cm(-1)) intensity ratio decreased at day 7 (P < 0.05). The carbonate apatite to hydroxyapatite ratio (carbonate 1088 cm(-1)/phosphate 984 cm(-1)) was significantly higher on day 7 compared to day 0 (P < 0.05). These results indicate that demineralization occurs during the alveolar bone remodeling process. We also found notable peak shifts in the amide I range during orthodontic tooth movement. The 1658 cm(-1) in baseline red shifted to 1667 cm(-1) at orthodontic treatment day 7. Curve fitting in the amide I (1615-1725 cm(-1)) range demonstrated that increased random coil conformation was accompanied by a decrease in ß-sheet structure during orthodontic tooth movement. Thus, we suggest Raman spectroscopy could be used for label-free, non-invasive GCF quality assessment during orthodontic tooth movement. Furthermore, this method may prove to be a powerful diagnostic and prognostic tool for monitoring orthodontic tooth movement in a clinical setting.

Antero-posterior lingual sliding retraction system for orthodontic correction of hyperdivergent Class II protrusion.

BACKGROUND: This report introduces a lingual bonded retraction system (Kinematics of Lingual Bar on Non-Paralleling Technique, KILBON) for efficient sliding mechanics combined with vertical control of the anterior and posterior teeth, which is suitable for Class II hyperdivergent patients. METHODS: Design and biomechanics of the KILBON System were described. Two adults with hyperdivergent class II malocclusion were treated with the KILBON system and temporary skeletal anchorage devices (TSADs) on the palate. The first patient was treated with conventional KILBON system on the upper arch and detailed with lingual appliances. The second patient showed the modified design of the KILBON when applied to a low palatal vault. RESULTS: A large amount of intrusion and retraction of the anterior teeth and simultaneous intrusion of the posterior segment were achieved in short treatment time. Concomitant counterclockwise rotation of the mandible improved the esthetic profile. Periodontal support without dehiscence or bone loss was confirmed on anterior region in spite of large amount of retraction. CONCLUSIONS: This report presented a lingual retraction system that provides simple and effective vertical and sagittal control of both anterior and posterior teeth. The biomechanics are dependable for correcting a dentoalveolar protrusion in a patient with Class II hyperdivergent skeletal pattern.

Timing of force application affects the rate of tooth movement into surgical alveolar defects with grafts in beagles.

INTRODUCTION: The purpose of this study was to investigate the influence of the timing of orthodontic force application on the rates of orthodontic tooth movement into surgical alveolar defects with bone grafts in beagle dogs. METHODS: Twelve beagles were randomly divided into 2 groups according to the surgical procedure: alveolar osteotomy alone (control) or osteotomy with bone graft (experimental group). The maxillary second premolars were protracted for 6 weeks into the surgical sites: immediately, at 2 weeks, and at 12 weeks after surgery. The orthodontic tooth movement rates and alveolar remodeling concomitant with surgical defect healing were evaluated by model measurements and histomorphometry as well as microcomputed tomography and histology. One-way analysis of variance and the Scheffé post hoc comparison were performed for investigating the rates of orthodontic tooth movement and mineralized bone formation. RESULTS: Both the orthodontic tooth movement rate and the mean appositional length of mineralized bone in the tension side of teeth were significantly accelerated when force was applied at 2 weeks in the control group and immediately in the experimental group (P <0.001). The 2-week control group showed a dramatic increase in apposition rate during 4 to 6 weeks after force application, whereas the immediate protraction experimental group did within the first 3 weeks (P <0.001). Decreased orthodontic tooth movement rates and reduced bone remodeling activities were apparent in the 12-weeks groups, especially in nongrafted defects. CONCLUSIONS: A bone graft into the surgical defect can not only allow immediate force application for accelerating orthodontic tooth movement with favorable periodontal regeneration, but also decrease the risk of inhibited orthodontic tooth movement in case of delayed force application after surgery.

Measurement of three-dimensional perioral soft tissue changes in dentoalveolar protrusion patients after orthodontic treatment using a structured light scanner.

OBJECTIVE: To evaluate the three-dimensional (3D) perioral soft tissue changes after orthodontic treatment in patients with dentoalveolar protrusion using structured light-based scanners. MATERIALS AND METHODS: Forty-four Korean adults (19 men and 25 women, 21.4 ± 3.4 years) with dentoalveolar protrusion treated by extraction of all four first premolars and then en masse retraction with maximum anchorage were evaluated. Lateral cephalograms and 3D facial scans were obtained before treatment (T1) and immediately after debonding (T2). Superimposition was performed, and 27 perioral landmarks were identified. The 3D changes in the landmarks and ratio of movement of the soft tissue relative to the horizontal incisal tip were evaluated. A paired t-test and one-way analysis of variance were performed. RESULTS: The upper incisors were retracted 5.76 mm and the lower incisors were retracted 4.62 mm (P < .001). The upper lip moved inferoposteriorly, and the lower lip moved superoposteriorly. In the lower lip, upward movement was greater than backward movement (P < .001). The most prominent changes appeared at the greatest bulge area. The relative ratios were 42%-53% in the upper lip area and 22%-82% in the lower lip area. The lip corners moved superoposteriorly (P < .001). Subnasale moved downward (P < .05) and posteriorly (P < .001), while the landmarks under the nostrils moved upward and posteriorly (P < .001). CONCLUSION: Facial scans from white structured light scanners efficiently evaluated 3D perioral soft tissue in dentoalveolar protrusion patients. Backward movement and significant vertical movement of the lip were observed. The nasal and lip angle areas showed considerable changes.

Assessment of IL-6, IL-8 and TNF-α levels in the gingival tissue of patients with periodontitis.

In periodontal diseases, inflammatory mediators, including interleukin (IL)-6, IL-8 and tumor necrosis factor-α (TNF-α), may promote the degeneration of inflamed periodontal tissues. In previous studies, levels of these three cytokines were demonstrated to be elevated in inflammatory gingival tissues and gingival crevicular fluid. The aim of the present study was to quantify IL-6, IL-8 and TNF-α levels in the human gingival tissues of patients with periodontitis and to assess the correlation of these three cytokines with each other. In this study, human gingival tissues from 19 patients with periodontitis (male, n=14; female, n=5) were collected. The tissues were homogenized, centrifuged and the protein in the supernatant was quantified. Enzyme-linked immunosorbent assay (ELISA) was used in the measurement of the IL-6, IL-8 and TNF-α levels, and the mean levels were observed to be 8.41±0.25, 34.01±1.09 and 20.70±0.31 pg/ml, respectively. The mean levels of IL-8 were higher than those of the other two cytokines. In each sample, the level of TNF-α expression was consistently high, with little difference between the results, which contrasted with the fluctuations in IL-6 and IL-8 levels. The expression of the two ILs (IL-6 and IL-8) showed a positive correlation (r=0.932, P=0.01), whereas TNF-α levels were not correlated with IL-6 or IL-8 levels. These results suggest that IL-6, IL-8 and TNF-α may be relevant in the pathophysiology of periodontitis, and the measurement of these cytokines may be beneficial in the identification of patients with periodontitis.