• Title/Summary/Keyword: Fixed appliance

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ORTHODONTIC TREATMENT OF AN IMPACTED MANDIBULAR FIRST MOLAR USING MINIPLATE AS A SKELETAL ANCHORAGE: A CASE REPORT (Miniplate를 골격성 고정원으로 이용한 매복된 하악 제1대구치의 교정치료 증례)

  • Jang, Yoon-Hyoung;Kim, Eun-Young;Kim, Kwang-Chul;Park, Jae-Hong;Lee, Baek-Soo;Choi, Sung-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.2
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    • pp.246-251
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    • 2010
  • Impactions can occur because of malpositioning of the tooth bud or obstruction in the path of eruption. However, the exact mechanism is still unknown. The impaction of mandibular first molar is rare with prevalence rates of 0.01~0.25%, but it is important to deimpact the tooth as soon as possible to avoid complications such as dental caries, root resorption, and periodontal problems on the adjacent teeth. Several biomechanical strategies have been proposed for uprighting mesially tipped mandibular first molars. However, most of these have had problems with movement of the anchorage unit because of the reciprocal force. The recent development of skeletal anchorage system(SAS) allows direct application of precise force systems to the target tooth or segment, producing efficient tooth movement in a short time. In this case, an impacted mandibular left first molar with dilacerated roots was treated with a miniplate, which provided skeletal anchorage to upright the tooth. The miniplate was installed in the mandibular ramus, and 10 months after the application of orthodontic force, the impacted tooth was exposed in the oral cavity and uprighted. At this point, the mandibular left first molar was included in the orthodontic appliance with fixed mechanotherapy, the tooth could achieve a normal occlusion. Therefore, the use of SAS simplified the orthodontic procedures and reduced the orthodontic treatment period, and had few side effects.

Treatment modalities for Korean patients with unilateral hemifacial microsomia according to Pruzansky-Kaban types and growth stages

  • Yang, Il-Hyung;Chung, Jee Hyeok;Yim, Sunjin;Cho, Il-Sik;Kim, Sukwha;Choi, Jin-Young;Lee, Jong-Ho;Kim, Myung-Jin;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.50 no.5
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    • pp.336-345
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    • 2020
  • Objective: To investigate the treatment modalities (Tx-Mods) for patients with unilateral hemifacial microsomia (UHFM) according to Pruzansky-Kaban types and growth stages. Methods: The samples consisted of 82 Korean UHFM patients. Tx-Mods were defined as follows: Tx-Mod-1, growth observation due to mild facial asymmetry; Tx-Mod-2, unilateral functional appliance; Tx-Mod-3, fixed orthodontic treatment; Tx-Mod-4, growth observation due to a definite need for surgical intervention; Tx-Mod-5, unilateral mandibular or bimaxillary distraction osteogenesis (DO); Tx-Mod-6, maxillary fixation using LeFort I osteotomy and mandibular DO/sagittal split ramus osteotomy; Tx-Mod-7, orthognathic surgery; and Tx-Mod-8, costochondral grafting. The type and frequency of Tx-Mod, the number of patients who underwent surgical procedures, and the number of surgeries that each patient underwent, were investigated. Results: The degree of invasiveness and complexity of Tx-Mod increased, with an increase in treatment stage and Pruzansky-Kaban type (initial < final; [I, IIa] < [IIb, III], all p < 0.001). The percentage of patients who underwent surgical procedures increased up to 4.2 times, with an increase in the Pruzansky-Kaban type (I, 24.1%; IIa, 47.1%; IIb, 84.4%; III, 100%; p < 0.001). However, the mean number of surgical procedures that each patient underwent showed a tendency of increase according to the Pruzansky-Kaban types (I, n = 1.1; IIa, n = 1.5; IIb, n = 1.6; III, n = 2.3; p > 0.05). Conclusions: These findings might be used as basic guidelines for successful treatment planning and prognosis prediction in UHFM patients.

ORTHODONTIC TRACTION OF A TRANSPOSED IMPACTED MAXILLARY CANINE OF A DOWN SYNDROME PATIENT WITH CONGENITAL HEART DISEASE (심장질환이 있는 Down 증후군 환자의 전위 매복 치아 교정 치료 증례 보고)

  • Lee, Hyon Joo;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.8 no.2
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    • pp.118-121
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    • 2012
  • Down syndrome (DS) is a genetic disease known as trisomy 21. Congenital cardiac anomalies are present in about 40% of DS patients. Dental anomalies are also common among DS patients. In DS patients, canine impaction is 10 times more frequent and transposition of maxillary canine and first premolar is 50 times more common than in general population. A female DS patient with congenital heart disease was diagnosed as having a transposed impacted maxillary canine. Sectional fixed appliance with Nance holding arch was used for the orthodontic treatment. After space was regained for the eruption of the canine, orthodontic button was attached using flap operation with closed technique. Traction and alignment of the tooth followed. To prevent endocarditis, prophylactic antibiotics were prescribed for the recommended dental procedures. Total treatment time was 25 months and no complication was found.

The effect of NaF on bone and tooth resorption around an anchor tooth during a rapid maxillary expansion procedure (급속상악확대술 시행 후 지대치와 지지골 표면에 나타나는 치근흡수의 불화나트륨 단독투여를 통한 예방에 대하여)

  • Min, Seungki;Chung, Kyu-Rhim
    • The korean journal of orthodontics
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    • v.34 no.6 s.107
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    • pp.526-536
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    • 2004
  • This study was undertaken to determine the effect of a 2.2mg/Kg/day intraoral administration of NaF on the amount of root resorption and osteoclastic activity during or after a rapid maxillary expansion procedure. Ten puerile female dogs were divided into two groups: a control group and a NaF-treated group. A fixed type maxillary expansion device was delivered to all dogs. The appliance was activated twice daily throughout a 20-day period, causing a 5-mm expansion of maxillary bone. After the expansion procedure, the animals were sacrificed at days 0, 15, 30, 45, and 60 of the retention period. The buccal surface of the root of each maxillary canine was examined by means of a surface electron microscope (SEM). Using SEM, web-like resorption lacunae were observed on the bone or the tooth surface at the site of osteoclastic activity; these observations were verified by histological methods. No peculiar resorption lacunae were found in the apical tip of the roots of either the control group or the NaF-treated group animals. The NaF-treated retention group was found to have less resorption lacunae formation on day 45 and day 60. The preventative effect of NaF on resorption lacunae formation on the surface of the bone covering the anchor tooth was confirmed. Larger areas of resorption lacunae were found on the surface of the bone covering the canines in the control group animals, as compared to those of the NaF-treated group, especially on day 30 and day 60. Using SEM, the present study revealed a difference between the control group and the NaF-treated group in the prevalence and the size of the resorption lacunae formation on the cemental root surface. The preventative effect of NaF on bone resorption was confirmed. Further studies concerned with the optimum concentration of NaF that has an effect in vivo are necessary.

Current trends in orthodontic patients in private orthodontic clinics (교정전문치과에 내원한 부정교합환자의 최근 경향)

  • Jung, Min-Ho
    • The korean journal of orthodontics
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    • v.39 no.1
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    • pp.36-42
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    • 2009
  • Objective: The purposes of this study were to provide an epidemiologic data base related to the orthodontic treatment need and to know the changing trends about treatment modality of private orthodontic clinics. Methods: Distribution, trends and orthodontic treatment plan of malocclusion patients were investigated in 1,620 consecutive patients who had been visited and examined in 4 private orthodontic clinics located in Seoul from 2003-2006. Results: Percentage of male and female patients was 26.9% and 73.1% respectively Age distribution had shown that percentage of the patients above 13 years was 78.9%, and above 19 years was 59.0%. Average age of whole patients was 20.5 years. With regard to Angle classification, each percentage of Class I, Class II division 1, Class II division 2 and Class III malocclusion was 38.9%, 34.8%, 2.3% and 24.0%. The percentage of extraction cases(00.9%) outnumbered nonextraction cases(39.1%) and 46% of extraction cases were upper and lower 1st premolar extraction cases. Patients who had chose treatment with fixed appliance and orthognathic surgery was 10.2%. Conclusions: Because the high percentage of adult, Class II malocclusion and orthognathic surgery cases in patients of private orthodontic clinics were shown in this study, orthodontic education program and national health policy in Korea need reformation.

Changes in occlusal force and occlusal contact area after orthodontic treatment (교정 치료 후 교합력, 교합면적의 변화)

  • Choi, Yoon-Jeong;Chung, Choo-Ryung J.;Kim, Kyung-Ho
    • The korean journal of orthodontics
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    • v.40 no.3
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    • pp.176-183
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    • 2010
  • Objective: This study was performed to evaluate functional changes of occlusion after orthodontic treatment by measuring the occlusal force (OcFr) and occlusal contact area (OcAr), and to compare OcFr and OcAr change according to premolar extractions. Methods: Data were obtained from 74 patients who had finished orthodontic treatment using fixed appliance aged between 18 and 40 years. Subjects were divided into groups who had four premolars extractions or non-extraction (Male extraction-16, Male nonextraction-18, Female extraction-19, Female nonextraction-21). All subjects were asked to bite pressure-sensitive sheets into maximum intercuspation with maximum bite force, and OcFr and OcAr were evaluated by measuring the sheet with a CCD camera. Records were taken right after debonding, 1 week, 1 month, 3 months, 6 months and 1 year after debonding. Results: OcFr and OcAr increased gradually in all groups during the 1 year retention period (p < 0.05). Male groups showed higher OcFr and OcAr than female groups throughout the retention periods (p < 0.05). There were no statistically significant differences of OcFr and OcAr between extraction and non-extraction groups in both males and females (p > 0.05). Conclusions: Occlusion was improved functionally throughout the 1 year retention, and premolar extraction did not induce a decline in the functional aspect of occlusion.

The Occlusal Evaluation and Treatment Planning for Prosthodontic Full Mouth Rehabilitation (보철학적 교합 재구성을 위한 교합진단과 치료계획)

  • Lee, Seung-Kyu;Lee, Sung-Bok;Choi, Dae-Gyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.16 no.2
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    • pp.149-159
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    • 2000
  • Occlusal disease is comparable to periodontitis in that it is generally not reversible. Occlusal disease, however, like periodontitis, often maintainable. It does itself to treatment and when restorative dentistry is utilized it becomes, in that sense, reversible. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. An integrated treatment plan is first developed on one set of diagnostic casts, properly mounted on a semiadjustable articulator using jaw relationship records. This is accomplished by using wax to make reconstructive modifications to the casts. These modified casts become the blueprint for planned occlusal changes and the fabrication of provisional restorations. The treatment goals are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. This report shows the treatment procedures for a patient whose mandibular position has been altered due to posterior bite collapse. Migration of the maxillary anterior teeth had occurred, and the posterior occlusal contacts showed pathologic interference. Precise diagnosis using mounted casts was executed and prosthodontic reconstruction by the aid of an unconventional orthodontic correction on maxillary flaring was planned. An unconventional orthodontic correction can be accomplished by using preexisting natural teeth, which can be modified for use in active tooth movement or splinted together for orthodontic anchorage. This technique has an advantage over conventional fixed appliance orthodontic therapy because it can accomplish tooth movement concurrently with restorative and periodontal therapy. On occasion, minor tooth movement can be necessary to achieve the optimum occlusal scheme, crown form, and tooth position for the forces of occlusion to be displaced down the long axis of the periodontally compromised teeth. Once the occlusion, periodontal health, and crown contours for the provisional splinted restoration are acceptable, the final splinted restoration can be similarly fabricated, and it becomes an excellent orthodontic retainer.

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Occlusal Adjustment and Prosthodontic Reconstruction on the Open-bite Patient. - Intentional Decrease of Occlusal Vertical Dimension - (자연치 교합조정에 의한 전치, 구치 개교합의 보철적 수복 - 수직고경의 의도적 감소증례)

  • Lee, Seung-Kyu;Kwon, Kung-Rock;Lee, Sung-Bok;Choi, Dae-Gyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.16 no.2
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    • pp.133-147
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    • 2000
  • A well-planned, precise occlusal adjustment of natural teeth has some distinct advantages over other forms of occlusal therapy. It should be emphasized, however, that an occlusal adjustment is an irreversible procedure and has definite contraindications in some mouths. Generally, the treatment methods for the patients that has open-bite will be following as below. : (1) Use of removable orthopedic repositioning appliance, (2) Orthodontics, (3) Full or partial reconstruction of the dentition, (4) Orthognathic surgical procedure, (5) Occlusal adjustment of the existing natural teeth, (6) Any combination of the above. Above all, the advantages of occlusal adjustment of natural teeth are : (1) the patient is more able to adapt to the changes in jaw position and posture; (2) the phonetic or speaking ability of the patient is not significantly changed and usually is improved; (3) the esthetics of the natural teeth is not altered and often is better; (4) the hygiene of the individual teeth is easily maintained; and (5) the functional usage of the teeth as cutting and chewing devices is markedly improved. The objective of an occlusal adjustment, as with any form of occlusal therapy, is to correct or remove the occlusal interferences, or premature contacts, on the occluding parts of the teeth which prevent a centric relation closure of the mandible. A systematic, disciplined approach can be followed in treatment, the objectives should be listed. They are : (1) Centric relation occlusion of the posterior teeth. (2) Proper "coupling" of the anterior teeth. (3) An acceptable disclusive angle of the anterior teeth in harmony with the condylar movement patterns. (4) Stability of the corrected occlusion. (5) Resolution of the related symptoms. For the patient with open-bite on anterior and posterior teeth, this case report shows the treatment methods in combination the fixed prosthesis with the selective cutting of the natural teeth. Occlusal adjustment is no longer an elective procedure but a mandatory one for patients requiring restorations and those in treatment for TMD dysfunctions or those whose dentitions show signs of occlusal trauma. Occlusal adjustment is essential for all who do not display the above lists.

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Trends in Malocclusion Patients of Yeungnam University Hospital (영남대학교병원 치과에 내원한 부정교합환자의 특성)

  • Chung, Sung-Ho;Lee, Hee-Kyung
    • Journal of Yeungnam Medical Science
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    • v.23 no.1
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    • pp.71-81
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    • 2006
  • Background: This study was done to better understand patterns, trends and local distribution patterns of malocclusion so that we can provide adequate information to patients, to help make the appropriate diagnosis and therapeutic plans, and to assess the future directions of malocclusion treatment. Materials and Methods: Malocclusion patterns, distribution and trends of visiting patients were examined in 993 malocclusion patients who had been evaluated and diagnosed at the Department of Dentistry, Yeungnam University Hospital over a 10-year period from 1995 to 2004. Results: The number of visiting patients per year showed an increasing trend and the visit rate was 1.28 time-higher in females(56.1%) than in males(43.9%). 1) Age distribution showed that the 7-12 year-old group was the largest (36.7%). Geographic distribution showed the majority of patients were from the Dalseo district(28.2%). Angle's malocclusion classification revealed that class III was the largest(38.4%). Crowding was the chief complaint in the highest percentage of patients(33.9%). The therapeutic method used was the fixed appliance in 61% of cases and a combination with extraction in 30.8%. Conclusions: The availability of dental services can accommodate orthodontic needs adequately as well as obtain reliable quantitative information regarding the characteristics of orthodontic patients.

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Current trends in orthodontic patients in Seoul National University Dental Hospital (서울대학교 치과병원 교정과에 내원한 부정교합 환자의 최근 경향)

  • Im, Dong-Hyuk;Kim, Tae-Woo;Nahm, Dong-Seok;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.33 no.1 s.96
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    • pp.63-72
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    • 2003
  • Over the Past decades, the number of Patients seeking orthodontic treatment has increased markedly with socioeconomic development and change of recognition on appearance. The purpose of this study was to provide an epidemiologic data base related to the orthodontic treatment need. We could take an adequate information regarding the characteristics of orthodontic patients, and the changing trends about treatment mordality. Distrubution and treands were Investigated in 676 patients who had been examined and diagnosed at Department of orthodontics, Dental Hospital, Seoul National University from January to June in 1992 and 2002. 1. Sex distribution of patients changed from 1:2.1 to 1:1.5 (male female). 2. In 2002, are distribution had shown $7\~12$ year-old group being the largest$(32.0\%)$ and percentage of $19\~24,\;13\~18,\;over\;25,\;4\~6,\;0\~3$ year-old group were $24.0\%,\;21.6\%,\;14.2\%,\;5.8\%,\;2.4\%$ respctively. Compared with data in 1992, the number of adult patients highly increased. 3. With regard to Angle classification, each percentage of Class I, Class II div 1, Class II div 2, and Class III malocclusion were $25.0\%,\;20.9\%,\;3.4\%,\;and\;48.1\%$ respectively in 2002. 4. Geographic distribution showed that most of the patients visited $(37.0\%)$ lived in northeast of Seoul in 2002. 5. Mandibular prognathism showed the highest percentage in chief complaints. The percentages of crowding and facial asymmetry were $14.2\%\;and\;11.8\%$ in 2002. Patients with facial asymmetry increased significantly. 6. Percentages of patients treated with fixed appliance and orthognathic surgery were $38.0\%\;and\;25.0\%$ in 2002. Patients needed to observe the growth pattern comprised $13.0\%$ with increasing trends. The use of chin cap reduced and the percentage of ortognathic surgery and growth observation increased significantly.