• 대한치과교정학회지
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• 제46권3호
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• pp.180-185
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• 2016

The incorporation of technological advances in the field of clinical orthodontics to increase treatment efficiency has led to the development of customized appliances (Insignia$^{(R)}$), archwires (Suresmile$^{(R)}$), and the production of devices to enhance tooth movement (Acceledent$^{(R)}$). This review presents a comprehensive study of the literature concerning these products, and analyzes the available evidence of their efficiency. To date, one pilot study has evaluated the efficiency of the Insignia$^{(R)}$ system, three retrospective studies have assessed the efficiency of the Suresmile$^{(R)}$ system, and a few Acceledent$^{(R)}$ reports have described its effect on treatment time. Critical appraisal of the reviewed papers revealed that the efficiency of the Insignia$^{(R)}$ system cannot be confirmed based on the available evidence, while the use of Suresmile$^{(R)}$ can reduce overall treatment time in simple cases. The acceleration of tooth movement by Acceledent$^{(R)}$ devices has not yet been confirmed.

• Journal of Korean Dental Science
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• 제16권2호
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• pp.115-127
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• 2023

The demand for orthodontic clear aligner therapy (CAT) has increased significantly over the last decade, offering advantages over the fixed appliances (FA) including enhanced aesthetics, better hygiene and comfort, along with minimal restrictions on the patient's diet. Moreover, a marked improvement in the efficacy of tooth movement using aligners has been documented. On the contrary, there have been known limitations of CAT including the compliances issues and the apparent lack of efficacy for certain types of tooth movement such as closure of extraction space compared to FA. Thus, evidence-based evaluation of the accuracy of prediction of tooth movement with clear aligners and their ability to effectively perform major tooth and root movements compared to FA are crucial. Although several systematic reviews have investigated various aspects of the effectiveness of CAT, we are yet to obtain a rather conclusive answer to this question. The current review attempted to summarize the evidence-based findings of most systematic reviews about CAT available to date. Major issues regarding the predictability of tooth movement, the role of attachments and auxiliaries in improving the effectiveness of CAT, and the treatment outcomes in comparison to FA were investigated. Clinical recommendation have been also elaborated based on the interpretation of the findings of all systematic reviews included in this study.

• 대한치과교정학회지
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• 제51권3호
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• pp.199-216
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• 2021

Objective: The aim of this systematic review was to evaluate the complications and side effects associated with the clinical use of orthodontic miniscrews by systematically reviewing the best available evidence. Methods: A survey of articles published up to March 2020 investigating the complications associated with miniscrew insertion, in both the maxilla and mandible, was performed using 7 electronic databases. Clinical studies, case reports, and case series reporting complications associated with the use of orthodontic miniscrew implants were included. Two authors independently performed study selection, data extraction, and risk-of-bias assessment. Results: The database survey yielded 24 articles. The risk-of-bias assessment revealed low methodological quality for the included studies. The most frequent adverse event reported was root injury with an associated periradicular lesion, vitality loss, pink discoloration of the tooth, and transitory loss of pulp sensitivity. Chronic inflammation of the soft tissue surrounding the miniscrew with mucosal overgrowth was also reported. The other adverse events reported were lesion of the buccal mucosa at the insertion site, soft-tissue necrosis, and perforation of the floor of the nasal cavity and maxillary sinus. Adverse events were also reported after miniscrew removal and included secondary bleeding, miniscrew fracture, scars, and exostosis. Conclusions: These findings highlight the need for clinicians to preliminarily assess generic and specific insertion site complications and side effects.

• 대한치과교정학회지
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• 제54권2호
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• pp.89-107
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• 2024

Objective: This systematic review aimed to provide a comparative analysis of the treatment outcomes, including hard and soft tissues, postoperative stability, temporomandibular disorders (TMD), and quality of life (QoL), in patients with facial asymmetry who underwent orthognathic surgery. Methods: The primary objective was to address the question, "How do different factors related to surgery affect the outcomes and stability of orthognathic surgery in the correction of facial asymmetry?" A meta-analysis was conducted on the outcome parameters, such as skeletal, dental, and soft tissue symmetry, TMD, QoL, and relapse, using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Subgroup analyses were conducted considering surgery-related factors such as surgical techniques (one-jaw vs. two-jaw), use of the surgery-first approach, utilization of computer simulation, and analytical methods employed to evaluate asymmetry (2D vs. 3D). Results: Forty-nine articles met the inclusion criteria. The metaanalysis demonstrated a significant improvement in the symmetry of hard and soft tissues. The subgroup analysis indicated that the treatment outcomes showed significant improvement, regardless of the factors related to surgery. Changes in TMD signs and symptoms varied according to the surgical technique used. Quality of life improved in the facial, oral, and social domains. Skeletal relapse was observed during the follow-up. Conclusions: Our findings support the positive outcomes of orthognathic surgery in the treatment of facial asymmetry in terms of skeletal and soft tissue improvements, stability, relief of TMD symptoms, and enhancement of QoL. However, most of the included studies showed a low certainty of evidence and high heterogeneity.

• 대한치과교정학회지
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• 제52권3호
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• pp.182-200
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• 2022

Objective: This study aims to examine the effectiveness of miniscrew assisted rapid palatal expansion (MARPE) treatment in late adolescents and adult patients using cone-beam computed tomography (CBCT). Methods: Literature search was conducted in five electronic databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) based on the PICOS keyword design focusing on MARPE. Out of the 18 CBCT screened outcomes, only nine parameters were sufficient for the quantitative meta-analysis. The parameters were classified into three main groups: 1) skeletal changes, 2) alveolar change, and 3) dental changes. Heterogeneity test, estimation of pooled means, publication bias, sensitivity analysis and risk of bias assessment were also performed. Results: Upon database searching, only 14 full-text articles were qualified from the 364 obtained results. Heterogeneity test indicated the use of the random-effects model. The pooled mean estimate were as follows: 1) Skeletal expansion: zygomatic width, 2.39 mm; nasal width, 2.68 mm; jugular width, 3.12 mm; and midpalatal suture at the posterior nasal spine and anterior nasal spine, 3.34 mm and 4.56 mm, respectively; 2) Alveolar molar width expansion, 4.80 mm; and 3) Dental expansion: inter-canine width, 3.96 mm; inter-premolar width, 4.99 mm and inter-molar width, 5.99 mm. The percentage of expansion demonstrated a skeletal expansion (PNS) of 55.76%, alveolar molar width expansion of 24.37% and dental expansion of 19.87%. Conclusions: In the coronal view, the skeletal and dental expansion created by MARPE was of the pyramidal pattern. MARPE could successfully expand the constricted maxilla in late adolescents and adult patients.

• 대한치과교정학회지
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• 제34권1호
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• pp.23-31
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• 2004

본 연구의 목적은 다수의 연구들로부터 추출한 각각의 결과를 체계적이고 객관적인 방법으로 병합, 개관하는 통계분석법인 메타분석을 이용하여 상악확장술에서의 견치간 폭경과 대구치간 폭경의 확장 및 급속과 완속 확장에서의 확장량과 재발량을 비교하는 것이었다. 메드라인 검색을 통해 1979년부터 2000년까지의 문헌들 중 사람을 대상으로 상악확장술의 효과에 관해 조사한 문헌 388개를 찾은 후 논문 선택 및 제외 범주에 따라 최종적으로 7개의 문헌을 선정하여 메타분석을 시행하여 다음과 같은 결과를 얻었다. 1. 상악확장술에 의한 상악 제 1대구치간 폭경은 평균 6.0mm의 확장되었으며, 보정 후 측정에서 평균 4.8mm가 유지되어 평균 $20.0\%(1.2mm)$의 재발경향을 보였다. 2. 상악 견치간 폭경은 제 1대구치간 폭경의 확장보다 2.3mm적은 평균 3.7mm확장되었으며, 보정 후 측정에서 평균 2.6mm가 유지되어 평균 $29.7\%(1.1mm)$의 재발경향을 보였다. 3. 급속 상악확장술과 완속 상악확장술의 치료효과의 차이는 확장량과 보정 후 재발량 및 유지량에서 $6\%$ 미만(0.1-0.3mm)이었다. 그러나 상악 견치간 및 제1대구치간 폭경 변화에 있어서 두 방법 간에 골격성 및 치성 확장량의 비율에서 차이가 있을 수 있다.

• 대한치과교정학회지
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• 제48권6호
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• pp.395-404
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• 2018

Objective: To date, only a few studies have investigated the relationships between genetic polymorphisms and external apical root resorption (EARR). Hence, the aim of this systematic review was to explore the relationship between different gene polymorphisms and their association with EARR. Methods: A complete literature search was conducted by two independent reviewers. The PubMed, Science Direct, and Scopus databases were searched. In addition, the bibliographies of all textbooks and relevant articles were searched manually. A meta-analysis was performed using data entered into the electronic databases until February 28, 2017. Results: On the basis of the search, we identified 17 and 7 publications for the systematic review and meta-analysis, respectively. Odds ratio (OR) was used to evaluate the association of the interleukin 1B (+3954) polymorphism and the risk of EARR. The overall OR from the studies was used to estimate the risk of EARR. However, no association was found and no publication bias was apparent for the risk of EARR in patients receiving orthodontic treatment. Conclusions: More research on the relationship between gene polymorphism and EARR is necessary to determine better specificity of possible interactions.

• 대한치과교정학회지
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• 제52권5호
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• pp.313-323
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• 2022

Objective: This study aimed to estimate the clinical effects of different types of bone-anchored maxillary protraction devices by using a network meta-analysis. Methods: We searched seven databases for randomized and controlled clinical trials that compared bone-anchored maxillary protraction with tooth-anchored maxillary protraction interventions or untreated groups up to May 2021. After literature selection, data extraction, and quality assessment, we calculated the mean differences, 95% confidence intervals, and surface under the cumulative ranking scores of eleven indicators. Statistical analysis was performed using R statistical software with the GeMTC package based on the Bayesian framework. Results: Six interventions and 667 patients were involved in 18 studies. In comparison with the tooth-anchored groups, the bone-anchored groups showed significantly more increases in Sella-Nasion-Subspinale (°), Subspinale-Nasion-Supramentale(°) and significantly fewer increases in mandibular plane angle and the labial proclination angle of upper incisors. In comparison with the control group, Sella-Nasion-Supramentale(°) decreased without any statistical significance in all treated groups. IMPA (angle of lower incisors and mandibular plane) decreased in groups with facemasks and increased in other groups. Conclusions: Bone-anchored maxillary protraction can promote greater maxillary forward movement and correct the Class III intermaxillary relationship better, in addition to showing less clockwise rotation of mandible and labial proclination of upper incisors. However, strengthening anchorage could not inhibit mandibular growth better and the lingual inclination of lower incisors caused by the treatment is related to the use of a facemask.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권3호
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• pp.145-159
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• 2024

Dental injections are routinely performed and can result in pain and anxiety in patients. This systematic review aimed to evaluate the efficacy of photobiomodulation therapy (PBMT) in dental injections for pain management in patients undergoing dental treatment. Indexed databases, including PubMed, EMBASE, Scopus, ISI Web of Knowledge, and Cochrane Library, were electronically searched without a time limit up to February 2024. A risk of bias evaluation was performed using the Cochrane tool. A preliminary investigation using electronic and manual methods yielded 4,920,881 manuscripts. Based on the eligibility requirements, 13 randomized control trials (RCTs) were included. Self-assessed pain was determined using the visual analog scale, Face, Legs, Activity, Cry, Controllability scale, or Wong-Baker face pain scale. Eight RCTs demonstrated a notable decrease in needle pain in patients undergoing dental needle injections using PBMT. Based on current evidence, PBMT may help reduce needle pain related to dental anesthesia. Further standardized studies are needed to assess the significance of PBMT for postoperative pain in patients undergoing dental injections.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권3호
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• pp.107-113
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• 2023

Bimaxillary transverse width discrepancies are commonly encountered among patients with dentofacial deformities. Skeletal discrepancies should be diagnosed and managed appropriately with possible surgical corrections. Transverse width deficiencies can present in varieties of combinations involving the maxilla and mandible. We observed that in a significant proportion of cases, the maxilla is normal, and the mandible showed deficiency in the transverse dimension after pre-surgical orthodontics. We designed novel osteotomy techniques to enhance mandibular transverse width correction, as well as simultaneous genioplasty. Chin repositioning along any plane is applicable concomitant with mandibular midline arch widening. When there is a requirement for larger widening, gonial angle reduction may be necessary. This technical note focuses on key points in management of patients with transversely deficient mandible and the factors affecting the outcome and stability. Further research on the maximum amount of stable widening will be conducted. We believe that developing evidence-based additional modifications to existing conventional surgical procedures can aid precise correction of complex dentofacial deformities.