• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.1
• /
• pp.34-40
• /
• 2004

Unerupted maxillary anterior teeth is not a common case, However it may present practitioners with management problem. The cause of impaction is considered to be multifactorial, and local cause is the most common. These impacted teeth require surgical intervention, removal, transplantation, or surgical exposure, with or without orthodontic traction to align the malpositioned tooth. The preferred option is surgical exposure and orthodontic correction. Surgical intervention and orthodontic correction should not be delayed to avoid unnecessary difficulties in aligning the tooth in the arch. Surgical exposure should be performed with the intent of providing sufficient attached gingiva rather than simply uncovering the crown, which results in only alveolar mucosal attachment. Attached gingiva is essential to secure the gingival tissues to the adjacent teeth at the dentogingival junction. Thus preventing loss of periodontal tissues as a result of the pull of the surrounding soft tissues and facial muscles. Labially impacted maxillary anterior teeth uncovered with an apically positioned flap technique have more un- esthetic sequelae than those uncovered with a closed-eruption technique. In the case of severly displaced impacted teeth, autotransplantation ensures preservation of the alveolar bone and will facilitate future placement of an osseointegrated implant once growth has ceased or if ankylosis/resorption of the transplant occurs.

• The korean journal of orthodontics
• /
• v.34 no.2 s.103
• /
• pp.197-203
• /
• 2004

Tweed-Merrifield directional force technology is a very useful concept, especially for the treatment of Glass II malocclusion. It has contributed to treating a favorable counter-clockwise skeletal change and balanced face, while head gear force using high pull J-hook (HPJH) in an appropriate direction is also essential to influence such results. Clinicians have encountered some problems concerning patients' compliance; however skeletal anchorage has been used widely of late because it does not necessitate patients' compliance, yet produces absolute anchorage. In this case, a good facial balance was obtained by Tweed-Merrifield directional force technology using HPJH together with skeletal anchorage, which provided anchorage control in the maxillary posterior area, torque control in the maxillary anterior area, and mandibular response. This indicates 4hat skeletal anchorage can be used to reinforce sagittal and vortical anchorage in the maxillary posterior area during the retraction of anterior teeth. The author used HPJH for torque control, Intrusion, and the bodily movement of maxillary anterior teeth during on masse movement. However, it is thought that such a result nay also be achieved by substituting mini- or microscrews for HPJH. Consequently, Tweed-Merrifield directional force technology using skeletal anchorage for the treatment of Class II malocclusion not only maximiaes the result of treatment but can also minimize patients' compliance.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.24 no.2
• /
• pp.213-230
• /
• 2008

The aim of this study was to analyze the initial movement and the stress distribution of each tooth and periodontal ligament during the lingual lever-arm retraction of 6 maxillary incisors using FEA. Two kinds of finite element models were produced: 2-properties model (simple model) and 24-properties model (multi model) according to the material property assignment. The subject was an adult male of 23 years old. The DICOM images through the CT of the patient were converted into the 3D image model of a skull using the Mimics (version 10.11, Materialise's interactive Medical Image Control System, Materialise, Belgium). After series of calculating, remeshing, exporting, importing process and volume mesh process was performed, FEA models were produced. FEA models are consisted of maxilla, maxillary central incisor, lateral incisor, canine, periodontal ligaments and lingual traction arm. The boundary conditions fixed the movements of posterior, sagittal and upper part of the model to the directions of X, Y, Z axis respectively. The model was set to be symmetrical to X axis. Through the center of resistance of maxilla complex, a retraction force of 200g was applied horizontally to the occlusal plane. Under this conditions, the initial movements and stress distributions were evaluated by 3D FEA. In the result, the amount of posterior movement was larger in the multi model than in the simple model as well as the amount of vertically rotation. The pattern of the posterior movement in the central incisors and lateral incisors was controlled tipping movement, and the amount was larger than in the canine. But the amount of root movement of the canine was larger than others. The incisor rotated downwardly and the canines upwardly around contact points of lateral incisor and canine in the both models. The values of stress are similar in the both simple and multi model.

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

• The korean journal of orthodontics
• /
• v.29 no.2 s.73
• /
• pp.147-156
• /
• 1999

Skeletal Cl III malocclusion is an orthopedic appliance mainly used for growing children with maxillary undergrowth, which largely entails skeletal Cl III malocclusion. It improves anterior crossbite and maxillary position and thus, enables patients to attain favorable Profile but often involves unfavorable profile with protrusive upper and lower lips. Therefore, if orthodontists have knowledge of which condition helps obtain favorable occlusion and profile, they are able to predict the prognosis and limitation of the treatment. This study was done in order to help obtain favorable Profile after treating growing skeletal Cl III children. In the study, we classified childern into two groups, the one with favorable profile(Group 1, n=12) and the other with unfavorable profile(Group 2, n=14) and, with retrospective study using pre- and post-treatment lateral cephalogram, drew the following conclusions. 1. As patients had more serious labioversion of upper incisors, they were more unlikely to have favorable profiles after the treatment. Protrusion of prosthion, which was related with maxillary incisors, also affected profiles. 2. As the NL-ML angle before the treatment was small, it was more likely to get favorable profile. 3. As the degree of lower lip protrusion was high, it was likely to have bialveolar protrusion after the treatment. 4. As the degree of downward and backward rotation of mandible was high, it was likely to get unfavorable profile.

• The korean journal of orthodontics
• /
• v.37 no.4
• /
• pp.305-314
• /
• 2007

Interdisciplinary treatment of Class III malocclusion with congenital missing of unilateral maxillary canine and anterior crossbite is discussed focusing on a problem-oriented treatment planning, treatment progress, and treatment result. Maxillary mini-implant provided anchorage for distalization of the maxillary right porsterior dentition. Mandibular mini-implants were used to distalize the whole mandibular dentition. Total treatment time was 17 months to achieve a successful treatment goal. Stable occlusion was maintained after 12 months of retention.

• The korean journal of orthodontics
• /
• v.34 no.1 s.102
• /
• pp.33-45
• /
• 2004

The purpose of this experimental study was to determine appropriate magnitude of the Gable bends to produce maximum retraction of the anterior teeth. The Calorific Machine was used to illustrate the tooth movement in three dimension. The experimental teeth except the first premolar were embedded in the artificial alveolar bone part. In a series of experiments, the extraction space was closed using arch wires with bull loops into which the gable bends of $10^{\circ},\;20^{\circ},\;30^{\circ}$ degrees were incorporated. The experiments were repeated three times for each degree of the gable bend. Before and after the space closure, radiographs were taken in the sagittal and occlusal directions using occlusal films. Analysis of variance and Scheffe post hoc test were used to determine significant differences among the three groups. The following results were obtained. 1. As magnitudes of the gable bends increased, more bodily anterior tooth movement was seen and the distance of retraction also increased. 2. As magnitudes of the gable bends increase, the amount of posterior tooth protraction decreased while intrusive and buccal movement increased. 3. The arch was coordinated by distal-in rotation of the canine and mesial-in rotation of the second premolar adjacent to the extraction space.

• The korean journal of orthodontics
• /
• v.34 no.4 s.105
• /
• pp.303-312
• /
• 2004

An unfavorable tipping movement can occur during the retraction of anterior teeth because orthodontic force is loaded by brackets positioned far from the center of resistance. To avoid this unfavorable movement, a compensating curved wire or lingual root torque wire is used. The purpose of this study is to investigate, using photoelastic material, the distribution of initial stress associated with the retraction of the incisors according to the degree of the compensating curve, to model changes associated with tooth ud alveolar bone structure. The following results were obtained by analysis of the polarizing plate of the effects of initial stress resulting from retraction of the anterior teeth: 1. When the incisors were retracted using combination archwire or sliding mechanics, the maximal polarizing pattern of the apical area decreased as the degree of the compensating owe increased from 0 to 15 to 30. 2. When the incisors were retracted by the combination archwire or sliding mechanics, the maximal polarizing pattern of the canine and premolar area increased as the degree of the compensating curve increased from 0to 15to 30. 3. A lower degree of polarizing patterns were associated with the combination archwire technique than the sliding mechanics technique at a given force. The above results indicate that there is no significant difference between the combination loop archwire technique and sliding mechanics, for the retraction of maxillary anterior teeth with decreased lingual tipping tendency by a compensating curve on the arch wire. However, the use of sliding mechanics is more effective for the prevention of lingual inclination of the anterior teeth, because the hook used in sliding mechanics is closer to the center of resistance of the maxillary anterior teeth.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.41 no.4
• /
• pp.306-313
• /
• 2014

Impacted teeth are teeth with a delayed eruption time or that are expected to erupt incompletely. Those teeth can cause a series of potential problems such as root displacement and resorption, periodontal problems in adjacent teeth, referred pain and the formation of cysts and odontogenic tumors. The purpose of this study was to investigate characteristics and treatment of child and adolescent patients younger than 15 years of age that were diagnosed with an impacted tooth who visited the Chosun University Dental Hospital. The impacted tooth, its etiology, treatment and traction period were surveyed through electric medical records, radiographs in 335 patients. We excluded the impacted third molar, supernumerary and deciduous teeth from this study. The most frequently impacted teeth are upper canine, followed by the upper incisor. The most common etiologies of impaction were an abnormal eruption pathway and localized pathologic lesions. The treatment of an impacted tooth was mostly orthodontic traction. The traction period was relatively short in cases with distinct obstacles, with an impacted upper incisor and if patients were younger. An orthodontic traction is considered to be more unfavorable if the patient gets older. Therefore, an early diagnosis and a precise treatment plan through a regular check-ups are mandatory.

• The korean journal of orthodontics
• /
• v.32 no.1 s.90
• /
• pp.9-18
• /
• 2002

The present study hypothesized that the double keyhole looped archwire plays a positive role for the sake of translatory movement and/or controlled tipping of upper 6 anteriors, and secures anchorage control as well. The purposes of the study were to evaluate the changes in lateral cephalograms during orthodontic treatment with DKHLs and to compare the skeletal & dental changes before- & after-treatment. The materials of this study were lateral cephalograms of 20 adult patients with upper dentoalveolar protrusion both in class I and in class II Division1 malocclusion. Lateral cephalograms were taken before and after orthodontic treatment with upper 1st bicuspid extraction and DKHLs. The results were obtained as follows : 1. There were no statistically significant differences in skeletal measurement except SNB and PTFH between before- & after-treatment. The major changes were in dentoalveolar region. 2. After treatment, there were statistically significant decrease in dental measurement except interincisal angle. 3. Both upper & lower lip protrusion was decreased. 4. There were statistically differences in upper anterior crown horizontal & root vertical dimension(7.08 ${\pm}$ 2.14 mm, 2.38 ${\pm}$ 1.15 mm, p<0.01). 5. There were statistically differences in upper posterior dental(both crown & root) horizontal dimension(2.48 ${\pm}$ 0.99 mm, 2.05 ${\pm}$ 0.91 mm, p<0.01).