• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.2
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• pp.233-239
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• 2010

Space loss of dental arch can appear when the proper position of teeth within the dental arch changes by a certain cause, because the balance of force makes changes about tooth position as well as alignment. The causes of space loss include proximal caries, early extraction, congenital missing of a tooth and hypodontia, etc. Among those causes of space loss, congenital missing of a tooth is more rarely observed in the primary dentition than in the permanent dentition. Congenital missing in the primary dentition is associated with that in the permanent dentition. Furthermore, it can cause space problem, such as mesial tilting or drift of adjacent teeth, space loss for permanent successors and dental arch constriction, etc. Primary lateral incisors is the most commonly involved, in the maxilla rather than in the mandible, but primary canine is rarely reported. In this patient, who visited the department of pediatric dentistry at Yonsei university dental hospital, it was observed that the maxillary right primary canine was congenitally missing and an odontoma was found insteadly. However, neither the space loss for the congenitally missing primary canine nor midline deviation is remarkable during the 2-year-10-month observation period. In addition, any clinical or radiographical symptom did not occur in spite of odontoma. Therefore, surgical enucleation of odontoma is planned according to the eruption of permanent lateral incisor or canine, unless eruption failure of permanent lateral incisor or canine nor cystic change around the odontoma is occurred. Through further evaluation, space maintainer or orthodontic treatment may be necessary.

• The korean journal of orthodontics
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• v.37 no.2 s.121
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• pp.98-113
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• 2007

Objective: The purpose of this study was to evaluate the displacement pattern and the stress distribution shown on a finite element model 3-D visualization of a dry human skull using CT during the retraction of upper anterior teeth. Methods: Experimental groups were differentiated into 8 groups according to corticotomy, anchorage (buccal: mini implant between the maxillary second premolar and first molar and second premolar reinforced with a mini Implant, palatal: mini implant between the maxillary first molar and second molar and mini implant on the midpalatal suture) and force application point (use of a power arm or not). Results: In cases where anterior teeth were retracted by a conventional T-loop arch wire, the anterior teeth tipped more postero-inferiorly and the posterior teeth moved slightly in a mesial direction. In cases where anterior teeth were retracted with corticotomy, the stress at the anterior bone segment was distributed widely and showed a smaller degree of tipping movement of the anterior teeth, but with a greater amount of displacement. In cases where anterior teeth were retracted from the buccal side with force applied to the mini implant placed between the maxillary second premolar and the first molar to the canine power arm, it showed that a smaller degree of tipping movement was generated than when force was applied to the second premolar reinforced with a mini implant from the canine bracket. In cases where anterior teeth were retracted from the palatal side with force applied to the mini implant on the midpalatal suture, it resulted in a greater degree of tipping movement than when force was applied to the mini implant between the maxillary first and second molars. Conclusion: The results of this study verifies the effects of corticotomies and the effects of controlling orthodontic force vectors during tooth movement.

• The korean journal of orthodontics
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• v.31 no.3 s.86
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• pp.335-346
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• 2001

The purpose of this study was to investigate the ideal clinical torque(In the SWA rectangular wire, the torque by the angle between the plane part and twisted part to move the tooth) of the orthodontic rectangular wire which produce the proper labiolingual movement of the single tooth during finishing stage of the orthodontic treatment. The clinical torque is the sum of the play and the active torque which generates the moment at the bracket. The play is calculated by the formula and the active torque is calculated by the computer aided three-dimensional finite element method. The finite element model was consist of the three brackets which formed a row and 3 kinds of orthodontic rectangular wire(stainless steel, TMA, NiTi) which inserted in brackets. Both sides of the model were twisted and the moment generated in the center bracket was calculated. The sizes of seven wires which were used commonly were .016'X.022', .017'X.022', .017'X.025', .018'X.025', .019'X.025', .020'X.025', .021'X.025'. In 018' bracket, 016'X.022', .017'X.022', .017'X.025' wires were inserted and in 022' bracket, all the sizes of wires except .016'X.022' were inserted and tested. The following conclusions could be drawn from this study. 1. The moments generated on the same size of the wires by the same active torque were equal regardless of the bracket slot size. 2. The moments were increased with the size of the wires. The moment generated on the .021'X.025' wire was about 1.75 times as large as that on the .016'X.022' wire regardless of the material. 3. The moments were increased in the order of the NiTi, TMA stainless steel. The moment of the TMA wire was 0.35 times as small as that of the stainless steel wire and the moment of the NiTi was0.16 times as small as that of the stainless steel wire. 4. The moment was decreased as the interbracket distance was increased. 5. To get a desired moment with the specific size and material of the wire on the specific bracket slot, the formula and the results were displayed.

• The korean journal of orthodontics
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• v.23 no.2 s.41
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• pp.217-227
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• 1993

Preadjusted appliance, following the original concept of the Andrews Straight-Wire appliance, became increasingly common in the 1980s. In six phases of treatment, anchorage control, leveling and aligning, overbite control, overjet reduction, space closure, and finishing are very effective with using the preadjusted appliances. Space closure is the phase of treatment in which the difference between standard edgewise and preadjusted mechanics is most noticeable. Orthodontists have been able to reduce the use of closing loops and, because of the level slot lineup, enjoy the advantages of sliding mechanics. In 1990, Dr. John C. Bennett and Richard P. McLaughlin introduced the new space closure system, namely, elastic 'tiebacks'. They found an $.019'\times.025'$ working archwire most effective in an .022'-slot system. Hooks of .024' stainless steel or .028' brass wire are soldered to the upper and lower archwires. The force required for space closure is delivered by elastic 'tiebacks'. An elastic modulo stretched by 2-3mm(to twice its normal length) usually delivers 0.5-1.5mm of space closure per month. Group movement and sliding mechanics are combined for gentle, controlled space closure, so that about 0.5mm of incisor retraction and 0.5mm of mesial molar movement can be seen each month. The tiebacks are replaced every four to six weeks. By using the elastic 'tiebacks', the next two cases were treated during space closure. Even though we found some clinical problems of this mechanics, long treatment time, hard to control of vertical dimension and anchorage, the application method of this system is so simple that orthodontists can manage many patients during short chair time. But we must apply this mechanics after perfect understanding of the biomechanics in tooth movement.

• The korean journal of orthodontics
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• v.28 no.2 s.67
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• pp.311-327
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• 1998

The purpose of this study was to evaluate the effects of Transforming Growth Factor-${\beta}$ (TGF-${\beta}$) on the viability of human periodontal ligament cells, in-vitro and on the experimental tooth movement in rat, in-vivo. Human periodontal ligaments were cultured from the first premolar tooth extracted for the purpose of the orthodontic treatment. 0.1, 1, 5 and 10ng/m1 of TGF-${\beta}$ was given to the cultured wells, respectively and the viability was evaluated by MTT assay. Twenty Sprague-Dawley rats were divided into 5 experimental groups(4 rats in each) where 100g of force was applied from helical spring across the maxillary incisors. TGF-${\beta}$ was injected via Hamilton syringe into the periodontal ligament at the mesial and the distal surface of a maxillary incisor of 2 rats in each experimental group. Phosphate buffer saline(PBS) was injected in 2 other rats as controls. Experimental groups were sacrificed at 1, 3, 7, 14 and 28 days after force application, respectively. The obtained tissues were evaluated histologically. The obtained results were as follows: 1. The viability of periodontal ligament cells in 0.1ng/ml of TGF-${\beta}$ was not significantly different from that of control at 1-, 2- and 3-day of cultivation. 2. The viability of periodontal ligament cells was significantly increased at 3-day in 1ng/ml or 5ng/ml of TGF-${\beta}$, and at 2-,3-day in 10ng/ml of of TGF-${\beta}$. 3. The zone of hyalinization in periodontal ligament in pressure side was smaller in TGF-${\beta}$ injection group than that in control group at 3-day after the application of experimental force in rat. But no difference was seen after 7-day. 4. Osteoclastic activity and capillary prolieferation in pressure side were greater in TGF-${\beta}$ injection group than that in control group at 3-day to 7-day. 5. Osteoblastic activity and new bone fomation in tension side were greater in TGF-${\beta}$ injection group than that in control group at 3-day to 14-day.

• The korean journal of orthodontics
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• v.31 no.4 s.87
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• pp.467-477
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• 2001

This investigation was designed to determine the effects of wire size, bracket width and the number of bracket on bracket-wire dynamic frictional resistance during simulating arch wire-guided tooth movement in vitro. For simulation of an arch wire-guided tooth movement, we simulated tooth, periodontal ligament and cancellous bone. Maxillary premolar and 1st molar were simulated as real sized resin teeth, the simulated resin teeth which its root was coated by polyether impression material which its elastic modulus is similar to periodontal ligament were embedded in steel housing with inlay wax which its elastic modulus is similar to cancellous bone. Stainless steel wires in four wire size (0.016, 0.018, $0.016\;{\times}\;0.022,\;0.019\;{\times}\;0.025$ inch) were examined with respect to three (stainless steel) bracket widths (2.4, 3.0, 4.3mm) and the number of medium bracket(one, two, three) included in the experimental assembly under dry condition. The wires were ligated into the brackets with elastomeric module. The results were as follows : 1. In all the brackets, frictional resistance increased with increase in wire size. But, statistically similar levels of frictional resistance were observed between 0.018 inch and $0.016\;{\times}\;0.022$ inch wires in narrow bracket and also between 0.016 inch and 0.018 inch wire in wide backet. 2. The frictional forces produced by 0.016 inch wire were statistically similar levels in all the brackets. In 0.018 inch round wire, wide bracket was associated with lower amounts of friction than both narrow and medium brackets. In $0.016\;{\times}\;0.022,\;0.019\;{\times}\;0.025$ inch rectangular wire, wide bracket produced target friction than both narrow and medium brackets. In all the wirer, narrow and medium bracket demonstrated no statistical difference in levels of frictional resistance. 3. Frictional resistance increased with increase In number of medium bracket. 0.016 inch round wire demonstrated the greatest increment in frictional resistance, followed by $0.019\;{\times}\;0.025,\;0.016\;{\times}\;0.022$ inch rectangular wire which were similar level in increment of frictional resistance, 0.018 inch wire demonstrated the least increment. The increments of frictional resistance were not constantly direct proportion to number of bracket.

• The korean journal of orthodontics
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• v.31 no.1 s.84
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• pp.121-136
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• 2001

This study was performed to analyse the expression of VEGF and it's receptor(VEGFR) in the tension side of the periodontal ligament following orthodontic tooth movement. Upper first molars of Sprague-Dawley rats were moved medially using closed coil spring for 1, 2, 24 hours and 3, 7, 14 days. H&E staining, immunohistochemical staining and in situ hybridization methods were used to analyse the change of the expression of VEGF and VEGFR. The results from this study were as follows : 1. Following tensional force, periodontal ligament showed elongation of fibers, compression and congestion of vessels and regional hemorrhage. These tissue changes were recovered within 3 days of force application. New bone formation was seen after 3 days of force application and continued for the remaining experimental periods. 2. Following tensional force, VEGF and VEGF mRNA expression was increased in the periodontal ligament cells, osteoblasts and cementoblasts. This change was followed by increased vasculature in the periodontal ligament. 3. After 3 days of tensional force, VEGF and VEGF mRNA expression was confined mainly to the osteopaths and the periodontal ligament cells adjacent to the alveolar bone. After 2 weeks of force application, VEGF and VEGF mRNA expression was reduced to the level of control sample. 4. VEGFRs(Flt-1, Flk-1) showed similar expression pattern and it's expression was mainly seen in the endothelial cells and osteoblasts. Following tensional force VEGFR expression was increased in the endothelial cells and osteoblasts. In conclusion, in the tension side of the penodontal ligament, ligament cells, osteoblast and cementoblast showed increased expression of VEGF & VEGF mRNA. It preceded the increase of vasculature and new bone formation. The increased expression of VEGF mRNA in cementoblast may induce periodontal vessels, which distribute mainly the bone side half of periodontal ligament, grow in the direction of tensional force. Increased expression of VEGFR & VEGFR mRNA not only in endothelial cell but in osteoblast, osteocyte and periodontal cells showed VEGF acts not only in paracrine manner but in autocrine one.

• The korean journal of orthodontics
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• v.30 no.6 s.83
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• pp.687-698
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• 2000

The purpose of this study was to evaluate the changes of skeletodental patterns during Class II treatment and its retention period. Forty two patients of Class II malocclusion, which was treated with nonextraction or first premolar-extraction were selected and their lateral cephalograms were examined in this study. Various skeletodental changes in lateral cephalograms of pre-treatment, post-treatment and retention were measured by superimposition in reference to the cranial base for jaws, the palatal plane for maxillary teeth, and mandibular plane for mandibular teeth. The data were analyzed by paired t-test. In this study, occlusal plane showed the significant anterior downward steepening after active treatment, and remained during retention period. In the nonextraction group, maxillary incisors were retracted and extruded during treatment. Maxillary molars were extended, and mandibular molar were uprighted, with no mesial movement. In the extraction group, both maxillary and mandibular incisors were retracted and extruded. Maxillary molars were extruded and moved mesially, and mandibular molars were extruded and moved mesially with no mesial tilting. During retention period in both groups, there were tendencies of labial tipping of maxillary incisor, and mesial tipping of maxillary and mandibular molar. But the changes were not significant and most of teeth showed no change in vortical and horizontal direction.

• The korean journal of orthodontics
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• v.36 no.4
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• pp.308-320
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• 2006

Rapid canine retraction, first introduced by Liou, is a distraction osteogenesis applied to the periodontal ligament tissue. Rapid tooth movement was facilitated by establishing minimal bony resistance on the distal surface of the canine by socket preparation and by osteogenesis on the mesial side in response to the periodontal distraction. Since undesired buccal tipping or extrusion of the canine during retraction tends to occur, it is crucial to maintain the firm path of movement and the axis of the canine during retraction. In order to improve the predictability of the canine movement, lingually extended distraction screws with heavy labial guiding wires were designed. Prefabricated plastic canine models for the estimation of socket depth and miniscrew implants for anchorage reinforcement were also devised. Applying these devices to a female patient with Class II anterior protrusion, the whole treatment was effectively finished in 13 months. Loss of vitality or periodontal problems did not occur throughout treatment, and stable occlusion was maintained during 10 months of retention. This case report demonstrates that a predictable rapid canine retraction can be achieved through the use of this modified technique.

• The korean journal of orthodontics
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• v.31 no.2 s.85
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• pp.209-223
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• 2001

At intrusion of upper anterior teeth in patient with periodontal defect, the use of three-piece base arch appliance for pure intrusion is required. To investigate the change of the center of resistance and of the distal traction force according to alveolar bone height at intrusion of upper anterior teeth using this appliance, three-dimensional finite element models of upper six anterior teeth, periodontal ligament and alveolar bone were constructed. At intrusion of upper anterior teeth by three-piece base arch appliance, the following conclusions were drawn to the locations of the center of resistance according to the number of teeth, the change of distal traction force for pure intrusion and the correlation to the change of vertical, horizontal location of the center of resistance according to alveolar bone loss. 1. When the axial inclination and alveolar bone height were normal, the anteroposterior locations of center of resistance of upper anterior teeth according to the number of teeth contained were as follows : 1) In 2 anterior teeth group, the center of located in the mesial 1/3 area of lateral incisor bracket. 2) In 4 anterior teeth group. the center of resistance was located in the distal 2/3 of the distance between the bracket of lateral incisor and canine. 3) In 6 anterior teeth group, the center of resistance was located in the central area of first premolar bracket .4) As the number of teeth contained in anterior teeth group increased, the center of resistance shifted to the distal side. 2. When the alveolar bone height was normal, the anteroposterior position of the point of application of the intrusive force was the same position or a bit forward position of the center of resistance at application of distal traction force for pure intrusion. 3. When intrusion force and the point of application of the intrusive force were fixed, the changes of distal traction force for pure intrusion according to alveolar bon loss were as follows :1) Regardless of the alveolar bone loss, the distal traction force of 2, 4 anterior teeth groups were lower than that of 6 anterior teeth group. 2) As the alveolar bone loss increased, the distal traction forces of each teeth group were increased. 4. The correlations of the vertical, horizontal locations of the center of resistance according to maxillary anterior teeth groups and the alveolar bone height were as follows : 1) In 2 anterior teeth group, the horizontal position displacement to the vortical position displacement of the center of resistance according to the alveolar bone loss was the largest. As the number of teeth increased, the horizontal position displacement to the vertical position displacement of the center of resistance according to the alveolar bone loss showed a tendency to decrease. 2) As the alveolar bone loss increased, the horizontal position displacement to the vertical position displacement of the center of resistance regardless of the number of teeth was increased.