The purpose of this study was to investigate the pretreatment and posttreatment dentofacial characteristics of non-extraction patients with Class I malocclusion. And to compare this result with matched non-orthodontic normal occlusion and Class I premolar extraction patients. Such comparison might help identify morphologic characteristics of the non-extraction patients. Initial and final cephalometric evaluation were compared in a sample of 22 patients with Class I malocclusions treated in non-extraction manner with edgewise appliance and MEAW The mean age of the total population was 14 years 9 months and the average treatment time was 2 years 8 months. 32 landmarks were located and digitized on each cephalogram. From these landmarks, 24 linear and angular dimension were obtained. Student's t-test were used to compare the pretreatment - posttreatment results, Nonextraction - Normal groups, and nonextraction Extraction groups. Significance was predetermined at $p{\leq}0.05$. The results were as follows. 1. Before treatment, the mean value of the $ODI\;was\;69.9^{\circ},\;APDI\;was\;82.1^{\circ},\;CF\;was\;152^{\circ},\;EI\;was\;152^{\circ}$ in the non-extraction groups. 2. The skeletal pattern of the non-extraction groups were similar with non-orthodontic normal groupsr, but the non-extraction groups had larger interincisal angle. 3. Comparison between groups treated with and without extraction indicated at pretreatment, the extraction groups had more protrusive lips, smaller interincisal angle, and EI. 4. After treatment, there was no significant changes in the skeletal pattern of the non-extraction groups, but uprighting of the maxillary and mandibular first molar and decrease of the interincisal angle were seen.
Purpose: The main purpose of this study was to investigate bone thickness on the buccal and palatal aspects of the maxillary canine and premolars using cone-beam computed tomography (CBCT). The differences between left- and right-side measurements and between males and females were also analyzed. Methods: The sample consisted of 20 subjects (9 males and 11 females; mean age, $21.9{\pm}3.0$) selected from the normal occlusion sample data in the Department of Orthodontics, The Catholic University of Korea. The thickness of the buccal and palatal bone walls, perpendicular to the long axis of the root were evaluated at 3 mm and 5 mm apical to cemento-enamel junction (CEJ) and at root apex. Results: At the canines and first premolars regions, mean buccal bone thickness of at 3 mm and 5 mm apical to CEJ were less than 2 mm. In contrast, at the second premolar region, mean buccal bone thickness at 3 mm and 5 mm apical from CEJ were greater than 2 mm. Frequency of thick bone wall (${\geq}2mm$) increased from the canine to the second premolar. Conclusions: This result should be considered before tooth extraction and planning of rehabilitation in the canine and premolar area of maxilla. Careful preoperative analysis with CBCT may be beneficial to assess local risk factors and to achieve high predictability of success in implant therapy.
Dental arch expansion is one of the method used to solve the dental crowding problem by non-extraction. Many formulae using tooth size have been suggested to predict ideal inter-premolar and inter-molar width. The purpose of this study was to evaluate the adequacy of some upper dental arch width prediction methods, namely Pont's method, Schmuth's method and Cha's method. The sample consisted of the casts of 119 Korean young adults who had no muscular abnormality, no skeletal discrepancy, and Angle's Class I molar relationships. Measurements were obtained directly from plaster casts; they Included mesiodistal crown diameters of the four maxillary incisors, as well as maxillary inter-first-premolar and inter-first-molar arch widths as specified by Pont. The correlation coefficients between the sum of incisors(SI) and upper dental arch width were calculated. The differences between predicted width and actual width were classified as overestimated, properestimated, and underestimated. The data obtained from each group were analyzed for statistical differences. The results were as follows : 1. Upper dental arch width indices were calculated from SI in normal occlusion (81.96 : premolar index, 62.55 : molar index). 2. Low correlations between SI and arch width were noted in normal occlusion (0.50 in the inter-premolar width, 0.39 in the inter-molar width). 3. Pont's formula and Schmuth's formula tended to overestimate the inter-premolar width. A more even distribution of estimates was noted in Cha's fomula. 4. Cases within $\pm$1 mm range of observed inter-premolar width were $45\%$ in the Cha's formula, $40\%$ in the Pont's formula, and $39\%$ in the Schmuth's formula. 5. All formulae had a tendency to underestimate the inter-molar width, but Cha's formula had better predictability than others. 6. Cases within $\pm$1 mm range of observed inter-molar width were $40\%$ in the Cha's formula, $29\%$ in the Pont's formula, and $13\%$ of Schmuth's formula. The data presented in this study does not support the clinical usefulness of ideal arch width prediction methods using the mesiodistal width of maxillary incisors.
Objective: The aim of this study was to analyze tooth movement and arch width changes in maxillary dentition following nonextraction treatment with orthodontic mini-implant (OMI) anchorage in Class II division 1 malocclusions. Methods: Seventeen adult patients diagnosed with Angle's Class II division 1 malocclusion were treated by nonextraction with OMIs as anchorage for distalization of whole maxillary dentition. Three-dimensional virtual maxillary models were superimposed with the best-fit method at the pretreatment and post-treatment stages. Linear, angular, and arch width variables were measured using Rapidform 2006 software, and analyzed by the paired t -test. Results: All maxillary teeth showed statistically significant movement posteriorly (p < 0.05). There were no significant changes in the vertical position of the maxillary teeth, except that the second molars were extruded (0.86 mm, p < 0.01). The maxillary first and second molars were rotated distal-in ($4.5^{\circ}$, p < 0.001; $3.0^{\circ}$, p < 0.05, respectively). The intersecond molar width increased slightly (0.1 mm, p > 0.05) and the intercanine, interfirst premolar, intersecond premolar, and interfirst molar widths increased significantly (2.2 mm, p < 0.01; 2.2 mm, p < 0.05; 1.9 mm, p < 0.01; 2.0 mm, p < 0.01; respectively). Conclusions: Nonextraction treatment with OMI anchorage for Class II division 1 malocclusions could retract the whole maxillary dentition to achieve a Class I canine and molar relationship without a change in the vertical position of the teeth; however, the second molars were significantly extruded. Simultaneously, the maxillary arch was shown to be expanded with distal-in rotation of the molars.
Purpose: Autogenous transplantation of teeth can be defined as transplantation of teeth from one site to another in the same individual, involving transfer of impacted or erupted teeth into extraction sites or surgically prepared sockets". Successful autogenous transplantation of teeth depends upon a complex variety of factors. Such factors include damage to the periodontal ligament of the donor tooth, residual bone height of the recipient site, extra-oral time of tooth during surgery. Schwartz and Andreasen previously reported that autogenous transplantation of teeth with incomplete root formation demonstrated higher success rate than that of teeth with complete root formation. Gault and Mejare yielded similar rate of successful autogenous transplantation both in teeth with complete root formation and in teeth with incomplete root formation when appropriate cases were selected. This case report was aimed at the clinical and radiographic view in autogenous transplantation of teeth with complete root formation. Materials and Methods: Patients who presented to the department of periodontics, Chonnam National University Hospital underwent autogenous transplantation of teeth. One patient had vertical root fracture in a upper right second molar and upper left third molar was transplanted. And another patient who needed orthodontic treatment had residual root due to caries on upper right first premolar. Upper right premolar was extracted and lower right second premolar was transplanted. Six months later, orthodontic force was applied. Results: 7 months or 11/2 year later, each patient had clinically shallow pocket depth and normal tooth mobility. Root resorption and bone loss were not observed in radiograph and function was maintained successfully. Conclusion: Autogenous transplantation is considered as a predictive procedure when it is performed for the appropriate indication and when maintenance is achieved through regular radiographic taking and follow-up.
The objective of this study was to evaluate the changes that occurred over time in the distracted periodontal ligament space following the rapid retraction of a tooth by periodontal distraction after bone undermining surgery had been conducted in the dogs. The upper second premolars were extracted on the left and right side in 4 male beagle dogs. Immediately after extraction, the interseptal bone distal to the upper first premolar was thinned and undermined by grooving to decrease the bone resistance. Activating an individualized distraction appliance at the rate of 0.225mm twice a day, the upper first premolar was retracted rapidly toward the extraction socket. Periodontal distractions were performed for 5, 10, and 20 days, and 20-day-distraction cases were followed by maintenance periods of 0, 14, 28, and 56 days. After 20 days of rapid retraction, the average distal movement of the upper first premolar was 5.02mm, and the average mesial movement of the upper third premolars serving as an anchorage unit was 0.18 mm. On histological examination, the regeneration of bone occurred in a highly organized pattern. Distracted periodontal ligament space was filled with newly formed bone oriented in the direction of the distraction, and this was followed by extensive bone remodeling. This result was similar to those observed in other bones after distraction osteogenesis. In the periodontal ligament, the relationship between collagen fibers and cementum began to be restored 2 weeks after the distraction was completed, and showed almost normal features 8weeks after the completion of the periodontal distraction. However, on the alveolar side, the new bone formation was still in process and collagen fiber bundles and Sharpey's fibers were not present 8 weeks after the completion of the periodontal distraction. Reactions in the periodontal ligament of the anchorage tooth represented bone resorption on the compressed side and new bone deposition on the tension side as occurred in conventional orthodontic tooth movement. In conclusion, the results of this study showed that periodontal structures on the distracted side of the periodontal ligament were regenerated well histologically following rapid tooth movement.
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.
Journal of the korean academy of Pediatric Dentistry
/
v.28
no.3
/
pp.421-429
/
2001
Since Non-Extraction treatment in some orthodontic case shows unstable result and unfavorable profile, extraction is selected as inevitable treatment option for the harmonious profile, facial skeleton, and the stable dentition on both arches. For the achievement of proper goal, premolars, molars, sometimes incisors or canines are selected to be extracted. The first Premolar is usually extracted for relieving the crowded dentition with which the molar relations are class I to gain stable dentition and proper profile, but often results in the depression of profile or the loss of vortical dimension. On the contrary, the extracton of the second molar helps maintaining the fullness of profile and the vertical dimension, prevents additional space closural procedures which often make the procedures complicated, relieves both anterior and posterior crowding, and substitutes the extraction fossae for newly erupting 3rd molars. From the point of recurrence, the second molar extraction procedure, therefore, is more beneficial. This cases showed the good results of second molar extraction procedures in the patients with class I crowding.
This case report demonstrates two different uprighting mechanics separately applied to mesially tipped mandibular first and second molars. The biomechanical considerations for application of these mechanisms are also discussed. For repositioning of the first molar, which was severely tipped and deeply impacted, a novel cantilever mechanics was used. The molar tube was bonded in the buccolingual direction to facilitate insertion of a cantilever from the buccal side. By twisting the distal end of the cantilever, sufficient uprighting moment was generated. The mesial end of the cantilever was hooked over the miniscrew placed between the canine and first premolar, which could prevent exertion of an intrusive force to the anterior portion of the dentition as a side effect. For repositioning of the second molar, an uprighting mechanics using a compression force with two step bends incorporated into a nickel-titanium archwire was employed. This generated an uprighting moment as well as a distal force acting on the tipped second molar to regain the lost space for the first molar and bring it into its normal position. This epoch-making uprighting mechanics could also minimize the extrusion of the molar, thereby preventing occlusal interference by increasing interocclusal clearance between the inferiorly placed two step bends and the antagonist tooth. Consequently, the two step bends could help prevent occlusal interference. After 2 years and 11 months of active treatment, a desirable Class I occlusion was successfully achieved without permanent tooth extraction.
Natural Killer/T-cell(NK/TC) lymphoma is a rare disease of oral and maxillofacial region with an aggressive clinical course, showed unusual clinical manifestations. Prognosis is generally poor and the disease is invariably fatal after systemic dissemination. A case of nasal NK/TC non-Hodgkin's lymphoma in the left maxilla that showed unusual clinical manifestations and a fulminant course of disease, are described with literature reviews. A 81-year-old female patient presented with rapidly growing ulceration and general malaise after extraction of right upper second premolar NK/TC lymphoma was subsequently detected by biopsy. rapid and wide invasion from maxilla to mandible developed within 10 days and multiple metastasis to whole body was after a few weeks. Although the time relationship is not clear, local invasion and multiple metastasis could be dissemination from localized disease of NK/TC. As seen in my case, the course can be excessively aggressive and fulminant even though it first appeared as a localized ulceractive lesion. She is expired 2 months after biopsy. Positivity of immunohistochemical stain (CD56, LCA, UCHL-1, CD3), which is a specific characteristic of NK/TC, may serve as a factor showing a poor prognosis of a malignant lymphoma
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