Studies for diagnostic analysis using three-dimensional (3D) CT images are recently in progress and needs for 3D craniofacial analysis are increasing in the fields of orthodontics. It is especially essential to analyze the facial soft tissue after orthodontic treatment and orthognathic surgery. In this study 3D CT images of adults with normal occlusion were taken to analyze the facial soft tissue. Norms were obtained from CT images of adults with normal occlusion (12 males, 11 females) using a computer program named V works 4.0 program. 3D coordinate planes were established using soft tissue Nasion as the reference point and a total of 20 reproducible landmarks of facial soft tissue were obtained using the multiple reconstructive sectional images (axial, sagittal and coronal images) of the V works 4.0 program: soft tissue Nasion, Pronasale, Subnasale, Upper lip center, Lower lip center, soft tissue B, soft tissue Pogonion, soft tissue Menton, Endocanthion (Rt/Lt), Alare lateralis (Rt/Lt), Cheilion (Rt/Lt), soft tissue Gonion (Rt/Lt), Tragus (Rt/Lt), and Zygomatic point (Rt/Lt). According to the established landmarks and measuring method, the 3D CT images of adults with normal occlusion were measured and the normal positional measurements and their Net (${\delta}=\sqrt{{X^2}+{Y^2}+{Z^2}}$) values were obtained using V surgery program, In the linear measurement between landmarks, there was a significant difference between males and females except Na' -Sn and En(Rt)-En(Lt). The normal ranges of Na'-Zy, Na'-Ch and Na'-Go' (facial depth) were obtained, which was difficult to measure by two-dimensional (2D) cephalometric analysis and facial photographs. These data may be used as references for 3D diagnosis and treatment planning for patients with malocclusion and dentofacial deformity.
The purpose of this study was to investigate the initial tissue change, to repair on the teeth & surrounding tissue under the intrusive orthodontic forces by use of elastic chain, through the microscopic findings. For this study, three young adult mongrel dogs were used, and were divied into three group : the control group was deliveried only casting crown and the experimental group 1 was equipped with energy chain during 1 week and experimental 2 group was deliveried using energy chain during 1 week and 3 weeks observation. All experimental groups and control groups were sacrificed to make the samples for microscopic findings on premolar teeth. All samples were examed and compared the histologic changes through the microscopic with H-E stain. The obtained results were as follows. 1. In hematoxylin-eosin stain of the control group, the periodontal ligament was constant width from apical third to cervical third of the root, and the periodontal fiber arrangement was horizontal or oblique in cervical third, oblique in middle and apical third of the root. 2. In Masson Trichrome stain of the control group, osteoblast and osteoclast appeared in cervical third of root, and bone resorption and new bone formation was observed in middle and apical third of the root. 3. In experimental 1, osteoclasts were increased highly, and hyperemia of blood vessels and new bone formation and bone resorption by reversal line in apical third of the root were seen. PDL width was increased apprarently from crest to apex of the root and more in apical third. 4. In experimental 2, osteoclasts and hyperemia of blood vessels were more increased than control material in apical third of the root. PDL width was increased more than control group in root apex, and was seen less than experimental 1. PDL arrangement was similar to experimental 1 and was mixed only in root apex. Therefore, in premolar intrusion of the young adult dog, there were increased osteoclast, hyperemia and dilation of blood vessel, resorption of alveolar bone and cementum and different arrangement of PDL in initial tissue change. There was not observed complete repair after remove intrusive force.
Tooth movement, the phenomena and mechanisms of which are still controversial, can be considered as part of the result of the inflammatory processes. The purpose of this study was to examine the activity of macrophage and T-cell, playing important roles in the immune reaction, in the periodontal ligament of dog, in which experimental tooth movement was performed. Six one and half year-old dogs, a control and 5 experimentals, were studied. Light force (50-75g) was applied by placing open-coil spring between left mandibular premolars ; heavy force (250-300g), between right mandibular premolars. Experimental dogs were sacrificed at 12 hours, 1, 3, 7 and 14 days since force application, respectively. And the histologic and the immunohistochemical evaluation on the obtained tissue were performed, using $\alpha$-1-antichymotrypsin and CD3 antibodies. The results were as follows : 1. There were more inflammatory cell infiltrations in heavy force group than in light force group until 3 days. But from 7 dsays on, no difference was not observed between groups ; Such an infiltration was more evident at pressure side than at tension side. 2. Osteoclastic activity at pressure side began to be seen in 12 hours, increasing until 7 days. After then it decreased ; Such an activity was more evident in heavy force group than in light force group. 3. Tearing of periodontal ligament and vascular dilatation at tension side began to be seen in 12 hours, increasing until 3 days. After then it decreased ; Such an observation was more evident in heavy force group than in light force group, but there was no difference between groups in 14 days. 4. $\alpha$-1-antichymotrypsin expression in control group was positive, mainly in sulcular epithelium, but negative in periodontal membrane, pulp, bone cells. 5. $\alpha$-1-antichymotrypsin expression in experimental group was more positive in pressure side than in tension side ; The expression was a little more positive in cervical area of tooth until 3 days, but after 7days, it was more positive in apical area. 6. $\alpha$-1-antichymotrypsin expression in light force group began to be observed in 12 hours and reached to the greatest level in 7 days, after which it decreased ; In heavy force group, it was the greatest in 3 days, after which it decreased. 3 Expression in the periodontium was almost negative.
It is important to understand the operating mechanism and force system of fixed appliance that most effective for individual tooth movement in various orthodontic appliances. The archwire system of fixed appliance is devided into 3 types, which is continuous arch, segmented arch and sectional arch. The last two types have longer interbracket distance and simple force operating points, so it is easy to control force system by operator. But the continuous arch has shorter interbracket distance and various bracket geometry, so it is hard to control and anaylze the force system. The purpose of this study was three dimentional force and moment analysis of continuous arch system by finite element method, which is similar situation to three dimentional elastic beam in structural engineering. Several sample form of various bracket geometry and artificial lower crowding typodont made by author were constructed, analyzed and compared each other. The results were as follows : 1. The force magnitude is linear proportional to the degree of displacement or tilting of the bracket. 2. The force magnitude is inversely non-linear proportional to the interbracket distance. 3. In three dimensional typodont model, while the force can be compared with that of the sample form in the area where adjacent bracket geometry is simple, the force is much more than the expected value in the area where adjacent bracket geometry is complex.
Tooth movement by orthodontic force effects great tissue changes within the periodontium, especially by shifting the blood flow in the pressure side and resulting in a hypoxic state of low oxygen tension. The aim of this study is to elucidate the possible mechanism of apoptosis in response to hypoxia in MC3T3El osteoblasts, the main cells in bone remodeling during orthodontic tooth movement. MC3T3El osteoblasts under hypoxic conditions ($2\%$ orygen) resulted in apoptosis in a time-dependent manner as estimated by DNA fragmentation assay and nuclear morphology stained with fluorescent dye, Hoechst 33258. Pretreatment with Z-VAD-FMK, a pancaspase inhibitor, or Z-DEVD-CHO, a specific caspase-3 inhibitor, completely suppressed the DNA ladder in response to hypoxia. An increase in caspase-3-like protease (DEVDase) activity was observed during apoptosis, but no caspase-1 activity (YVADase) was detected. To confirm what caspases are involved in apoptosis, Western blot analysis was performed using anti-caspase-3 or -6 antibodies. The 10-kDa protein, corresponding to the active products of caspase-3, and the 10-kDa protein of the active protein of caspase-6 were generated in hypoxia-challenged cells in which the processing of the full length form of caspase-3 and -6 was evident. While a time course similar to this caspase-3 and -6 activation was evident, hypoxic stress caused the cleavage of lamin A, which was typical of caspase-6 activity. In addition, the stress elicited the release of cytochrome c into the cytosol during apoptosis. Furthermore, we observed that pre-treatment with SB203580, a selective p38 mitogen activated protein kinase inhibitor, attenuated the hypoxia-induced apoptosis. The addition of SB203S80 suppressed caspase-3 and -6-like protease activity by hypoxia up to $50\%$. In contrast, PD98059 had no effect on the hypoxia-induced apoptosis. To confirm the involvement of MAP kinase, JNK/SAPK, ERK, or p38 kinase assay was performed. Although p38 MAPK was activated in response to hypoxic treatment, the other MAPK -JNK/SAPK or ERK- was either only modestly activated or not at all. These results suggest that p38 MAPK is involved in hypoxia-induced apoptosis in MC3T3El osteoblasts.
The purpose of this study was to investigate if there were a significant difference between cephalometric measurements of mandibular position derived from a centric occlusion tracing compared to those of a converted centric relation tracing in the Class III malocclusion. The sample consisted of 25 Class III malocclusion and 25 normal occlusion persons who had no orthodontic treatment. The records included an lateral cephalometrics in centric occlusion, centric relation and centric occlusion bite registration and diagnostic casts mounted on the SAM II articulator in CR. The amount of CR-CO discrepancy of condyle was recorded using a MPI(Mandibular Position Indicator, MPI $200^{(R)}$, Great Lakes Orthodontics, USA). The conversion of the CO cephalogram to CR using the MPI readings was performed on the Conversion work sheet. Measures of mandibular position were chosen for the purpose of this study. The comparison of the difference between CO and CR cephalometric measurements in the normal occlusion and Class III malocclusion group were studied. The results were as follows: 1. In the features of CR-CO discrepancy of the condyle, the condyle was displaced posterior and inferior when the teeth were in centric occlusion. The horizontal component(${\Delta}X$) in Class HI malocclusion group was greater than the vertical component(${\Delta}Z$) and also greater than the horizontal component(${\Delta}X$) in normal occlusion group. There was no statistically significant correlation between MPI measurements and the groups of normal occlusion and Class III malocclusion group. 2. In the comparison of the cephalometric measurements in each group, Normal occlusion group showed significant difference in measurements such as ANB, Facial angle, Facial convexity and ODI. Class HI malocclusion group showed significant difference in measurements such as ANB, Facial angle, Facial convexity, ODI, SNB, APDI, L1-FP and it had more significance than the normal occlusion group. 3. The Value of cephalometric measurements was significantly different between CO and CR but there were no differences between the groups of normal occlusion and Class III malocclusion. The results of this study suggest that if the discrepancies are greater than the amount of normal displacement from clinically captured centric relation, centric relation should be considered as the starting point for proper diagnosis and treatment planning.
Objective: The purpose of this study was to compare the difference in three dimensional tooth movement using three different wire sizes($0.018{\times}0.025-in,\;0.016{\times}0.022-in$ 0.016-in) on a NiTi scissors-bite corrector. Methods: Computed tomography(CT) images of the experimental model before and after tooth movement were taken and reconstructed into three dimensional models for superimposition. The direction and the amount of tooth movement were measured and analyzed statistically. Results: The lingual and intrusive movements of the crown of the maxillary second molar were increased as the size of the NiTi wire increased. The roots of the maxillary second metals moved buccally except for the 0.016-in group. The intrusive movement of the roots of the maxillary second molars was increased as the size of the NiTi wire increased. Due to the use of orthodontic mini-implants, anchorage loss was under 0.2 mm on average. Conclusions: The $0.018{\times}0.025-in$ NiTi wire was most effective in lingual and intrusive movement of the maxillary second molar which was in scissors-bite position. Indirect skeletal anchorage with a single orthodontic mini-implant was rigid enough to prevent anchorage loss.
Cleft lip and/or palate (CLP) is one of the most common congenital craniofacial anomalies and occurs more frequently in Asian people. Dental abnormalities in number, size, shape, and eruption of teeth are frequently associated with CLP. The purposes of this study were to investigate the effects of CLP on number, size, shape and eruption of teeth and to provide basic clinical data for diagnosis and treatment of the CLP patients. With the orthodontic and cleft charts, diagnostic models, orthopantomograms and intraoral x-ray films from 241 CLP patients who visited Dept. of Orthodontics, Seoul National University Dental Hospital, we evaluated the frequency of congenital missing teeth, supernumerary teeth, Impacted teeth, and microdontia. The results were as fellows ; 1. Frequency of congenital missing was relatively high up to $56.8\%$. Congenital missing occurred frequently in the maxillary lateral incisor and the maxillary second premolar. Among the CLP types, frequencies of congenital missing in cleft lip and Palate group and cleft lip and alveolus group were higher than those of cleft lip group and cleft palate group. And bilateral cleft showed higher frequencies than unilateral ones. 2. Supernumerary tooth was shown in $11.2\%$ of CLP patients. It occurred frequently in the area between the maxillary lateral Incisors and the maxillary canine. Among the CLP types, cleft lip group showed relatively most highest frequency. 3. Impaction was shown in $18.3\%$ of CLP patients. It occurred most frequently In the maxillary lateral incisor and the maxillary canine than other teeth. Among the CLP types, cleft lip group and cleft lip and palate group showed most highest frequencies. 4. Microdontia was shown in $15.8\%$ of CLP patients. It occurred the most frequently In the maxillary lateral incisors and maxillary canines. Among the CLP types, cleft lip and alveolus group and cleft lip and palate group showed relatively higher frequencies. There was no microdontia in cleft palate group.
Acidic primer is the bonding agent which combines the conditioning and priming agent into the single solution and was originally developed for the dentin bonding system. It is less harmful to the tooth structure and more convenient to manipulate than the traditional etching procedure. The Purpose of this study is to evaluate the shear bond strength of various bonding materials when the enamel is treated with acidic primer for the bracket bonding procedure. Fifty recently extracted human premolars were randomly separated into five groups -Group I using Clearfil Liner Bond 2 adhesive system to the enamel treated with acidic primer, Group II using Transbond XT adhesive system to the enamel treated with acidic primer, Group III using panavia 21 adhesive system to the enamel treated with acidic primer, Group IV using Fuji-Ortho LC adhesive system to the enamel treated with acidic primer, Group V using Transbond XT adhesive system to the enamel treated with 37$\%$ phosphoric acid. The shear bond strength was measured with Instron universal testing machine after storing in $37^{\circ}C$ water bath for 48 hours. After debonding, the teeth and brackets were examined under scanning electron microscope (SEM) and assessed with the adhesive remnant index (ARI). The results were as follows : 1. There were no significant differences in shear bond strength between group III ($8.69{\pm}2.72MPa$), group IV (9.7 ± 3.16 MPa), and group V ($10.48{\pm}2.60MPa$) (p>0.05). 2. The shear bond strength of group III and group IV was significantly higher than that of group I ($1.09{\pm}0.53MPa$), and Group II ($2.70{\pm}1.46MPa$) (p<0.05). 3. The ARI of group IV ($2.1{\pm}1.1$) and group V ($2.9{\pm}0.3$) was significantly higher than that of group I ($0.2{\pm}0.4$), group II ($0.3{\pm}0.9$) and group III ($0.2{\pm}0.4$) (p<0.05). 4. There were no significant difference between the ARI of group IV and group V (p>0.05). This result suggests that the combination of acidic primer and some bonding adhesive can provide sufficient shear bond strength for clinical orthodontics.
For the total treatment of skeletal malocclusions, 3-dimensional evaluation and diagnosis are essential. Although anteroposterior discrepancies can be evaluated through various methods, the satisfactory methods for evaluations of facial asymmetry and transverse discrepancies are yet to be found. The adequate diagnosis and treatment of transverse discrepancies may be more important in the maintenance of functional occlusion as well as for the stability of results obtained from orthognathic surgery than the anteroposterior or vertical discrepancies. Since the soft tissue effects from the transverse discrepancies may not be pronounced, especially when combined with anteroposterior or vertical discrepancies which have prominent characteristics, the differentiation of their effects may be difficult from visual inspection alone. Therefore it is essential that the normal facial proportions would be established from the posteroanterior cephalometry as a reference for the accurate diagnosis and treatment. The present study evaluates 76 subjects from Yonsei University freshmen with normal facial symmetry and occlusion. Posteroanterior cephalograms were taken from the subjects and the normal values and facial proportions are obtained. The results are as follows. 1. The transverse and vortical values from posteroanterior cephalometry and their ratio, with means and standard deviations are calculated. 2. The ratio of vertical values to transverse values is 0.837 (male 0.836, female 0.841). 3. The Proportion of maxillary and mandibular widths is 0.747 (male 0.745, female 0.752), with statistically significant correlation. 4. Various degree of significant correlations are observed in the following craniofacial widths; (Cranial width, Bizygomaticofrontal suture width, Facial width, Maxillary width, Upper & Lower Intermolar width, Mandibular width). 5. Although the facial height as well as other line measurements increase as the facial widths increase, angle measurement ($Bj\ddot{o}rk$ Sum, Mandibular Plane Angle, Gonial Angle), decreases and posterior to anterior facial height ratio increases, therefore indicating the tendency for a brachycephalic facial type. These results may be used as references for the treatment planning in orthognathic and orthodontic treatments for the dentofacial deformity patients.
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