• The korean journal of orthodontics
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• v.52 no.6
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• pp.451-460
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• 2022

Moebius syndrome (MBS) is a congenital neurologic disorder that causes cranio-facial abnormalities. It involves paralysis of the VI and VII cranial nerves and causes bilateral or unilateral facial paralysis, eye movement disorder, and deformation of the upper and lower limbs. The orofacial dysfunctions include microstomia, micrognathia, hypotonic mimetic and lip muscles, dental enamel hypoplasia, tongue deformity, open bite or deep overbite, maxillary hypoplasia, high arched palate, mandibular hyperplasia or features indicating mandibular hypoplasia. This case report presents a 7-year-old male patient who was diagnosed with MBS at the age 2 years. The patient displayed typical clinical symptoms and was diagnosed with Class II malocclusion with a large overjet/overbite, tongue deformity and motion limitation, and lip closure incompetency. Treatment was initiated using a removable appliance for left scissor bite correction. After permanent tooth eruption, fixed appliance treatment was performed for correction of the arch width discrepancy and deep overbite. A self-ligation system and wide-width arch form wire were used during the treatment to expand the arch width. After 30 months of phase II treatment, the alignment of the dental arch and stable molar occlusion was achieved. Function and occlusion remained stable with a Class I canine and molar relationship, and a normal overjet/overbite was maintained after 9.4 years of retainer use. In MBS patients, it is important to achieve an accurate early diagnosis, and implement a multidisciplinary treatment approach and long-term retention and follow-up.

• The korean journal of orthodontics
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• v.50 no.2
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• pp.136-144
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• 2020

Hemifacial microsomia (HFM) patients may experience emotional withdrawal during their growth period due to their abnormal facial appearance. Distraction osteogenesis at an early age to improve their appearance can encourage these patients. Some abnormalities of the affected side can be overcome by distraction osteogenesis at an early age. However, differences in the growth rate between the affected and unaffected sides during the rest of the growth period are inevitable due to the characteristics of HFM. Therefore, re-evaluation should be performed after completion of growth in order to achieve stable occlusion through either orthognathic surgery or camouflage orthodontic treatment. An eight-year-old patient visited the clinic exhibiting features of HFM with slight mandibular involvement. He received phase I treatment with distraction osteogenesis and a functional appliance. Distraction osteogenesis was performed at the right ramus, which resulted in an open bite at the right posterior dentition. After distraction osteogenesis, a functional appliance and partial fixed appliance were used to achieve extrusion of the affected posterior dentition and settlement of the occlusion adjustment on the unaffected posterior dentition. The patient visited the clinic regularly for follow-up assessments, and at the age of 20 years, he showed facial asymmetry of the mandible, which had deviated to the right side. He received orthodontic treatment to improve the occlusion of his posterior dentition after the growth period. Without orthognathic surgery, stable occlusion and a satisfactory facial appearance were obtained through camouflage orthodontic treatment.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.2
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• pp.311-316
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• 2006

A scissors bite in the posterior teeth occurs when the upper teeth are positioned totally or unilaterally buccal to the lower teeth in centric occlusion. This malocclusion can result from either excessive width of maxilla, deficient width mandible, or combination of both. The malocclusion can lead to hindered growth of jaws or to asymmetry between the jaws, Besides, the severe lingual inclination of the mandibular posterior teeth prevents adequate mastication. Thus, the scissors bite is in need of immediate interceptive orthodontic intervention. The common treatments of the scissors bite is to expand the mandibular arch: fixed or removable appliances. In our clinic, we made a success in treatment of the scissors bite using the Schwarz appliance. We treated the scissors bite using the lower Schwarz appliance for a mean observation period of 21 months. The subjects were 2 boys, aged 4 years.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.4
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• pp.479-484
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• 2000

The conventional treatment of skeletal class III malocclusion has been focused on the application of orthopedic forrce primarily to the mandible. Thus moderate Class III malocclusions can be corrected by the anterior displacement of the maxilla and maxillary dentition, possibly by restricting the growth of the mandible or by changing its direction. The patients having skeletal Class III malocclusion were treated with removable appliance & fixed appliance for detailed tooth movement and the following results were observed: 1. The anterior crossbite was corrected. 2. The forward and downward growth of the maxillary complex was obtained. 3. The lingual tipping of the mandiblar incisors was performed and the mandible was rotated in the clockwise direction.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.1
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• pp.134-143
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• 1998

Twin Blocks are simple bite-blocks that effectively modify the occlusal inclined plane to induce favorably directed occlusal forces by causing a functional mandibular displacement. These devices use upper and lower bite-blocks that engage on occlusal inclined planes. Twin Blocks use the forces of occlusion as the functional mechanism to correct the malocclusion. To get an excellent result in the treatment by using the Twin Block appliances, proper case selection must be needed. Twin Block treatment is performed in two stages. Twin Blocks are used in the active phase to correct the anteroposterior relationship and establish the correct vertical dimension. Once this phase is accomplished, the Twin Blocks are replaced with an upper Hawley type of appliance with an anterior inclined plane, which is then used to support the corrected position as the posterior teeth settle fully into occlusion. The Twin Block is the most comfortable, the most esthetic ane the most efficient of all the functional appliances. Twin Blocks have many advantages compared to other functional appliances. Patients can wear Twin Blocks 24 hours per day and can eat comfortably with the appliances in place. From the moment Twin Blocks are fitted, the appearance is noticeably improved. There is less interference with normal function. Integration with conventional fixed appliances is simpler than with any other functional appliance. Twin Blocks allow independent control of upper and lower arch width. Appliance design is easily modified for transverse and sigittal arch development. The authors treated Class II malocclusion with Twin Blocks. and the results as follows; 1. Rapid profile improvement was achieved in 2-3 months. 2. There was excellent patient cooperation. 3. Severe overjet and overbite were reduced. 4. Class II molar relationship was changed to Class I.

• The korean journal of orthodontics
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• v.48 no.5
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• pp.326-332
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• 2018

Objective: This study was performed to compare the perception of pain between patients treated with passive self-ligating fixed appliances and those treated with Invisalign aligners. Methods: This prospective study conducted in Saudi Arabia used an estimated sample of 64 patients from a private dental clinic. After obtaining written informed consent, the patients were divided into two groups; one group (n = 32) was treated using passive self-ligating fixed appliances and the other group (n = 32) using $Invisalign^{(R)}$ aligners. Immediately after fitting the appliances, the patients' perception of pain was evaluated through a close-ended and coded self-administrated questionnaire by using a visual analog scale (VAS). Their responses were recorded at 4 hours, 24 hours, day 3, and day 7. Mann-Whitney U-test, Kruskal-Wallis test, and Pearson's chi-square test were performed for statistical analysis. Results: A lower percentage of patients treated with Invisalign aligners reported pain than did patients treated with passive self-ligating fixed appliances, and these differences were statistically significant (p = 0.001). Similarly, the mean VAS score for the Invisalign group was significantly lower than that for the passive self-ligating fixed appliance group at different intervals during the first week of treatment. The intensity of pain with both appliances peaked at 24 hours (mean VAS score, 3.87) and was lowest (mean VAS score, 1.62) on day 7. Conclusions: During the first week of orthodontic treatment, patients treated with Invisalign aligners reported lower pain than did those treated with passive self-ligating fixed appliances.

• The korean journal of orthodontics
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• v.29 no.3 s.74
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• pp.361-374
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• 1999

Intraoral filled type of orthodontic appliance can cause reversible or irreversible damages such as gingivitis, periodontitis, enamel decalcification, dental caries, root resorption, and pulpal changes. Such adverse effects are brought by increase in dental plaque as well as oral flora. Such an increase causes gingival inflammation and enamel decalcification. The purpose of this study is to get klowledge on initial changes in dental plaque, gingivitis, and enamel decalcification after bonding fixed orthodontic appliances according to time flow, gender, and sides(right/left) of premolar region. For control group, 48 students of dental college, Yonsei university(26 males, 22 females) were chosen; for experimental group, 73 orthodontic patients(36 males, 37 females) who will be treated with fixed appliances were chosen. All the subjects had no systemic disease, juvenile periodontitis and all the females had passed their ,menarche. Tooth brushing instruction was given to all the subjects prior to the experiment. For control group, plaque index, gingival index, and decalcification index were measured twice at 3 weeks interval ; for experimental group, the same was done prior to, 3, 6, 9 weeks after bonding fixed appliances. The following results were obtained: 1. In plaque index 3 weeks after placement of appliances, and it showed gradual increase afterwards. 2. In gingival index3 weeks after placement of appliances, and afterwards it showed increase at a faster rate than plaque index. 3. Enamel decalcification began to show between 3 and 6 weeks after bonding fixed appliances. Decalcification index began to increase 6 weeks after appliance placement, but there was no statistical significance. 4. When the comparison was made between two sides of premolar region, the right side showed greater index in plaque and gingival index of experimental group.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.1
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• pp.93-98
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• 2020

Lesch-Nyhan syndrome is a rare X-linked, recessively inherited disorder of purine metabolism, caused by complete absence of the enzyme hypoxanthine-guanine phosphoribosyl transferase. This syndrome is characterized by 3 major features: neurological dysfunction, hyperuricemia, and cognitive and behavioral disturbances (e.g., self-mutilation, which begins at 2 to 3 years of age). Uncontrollable self-mutilation begins with biting of the perioral tissues and extends into patterns such as finger biting and head hitting. This report describes the case of a 31-month-old boy who was diagnosed with Lesch-Nyhan syndrome with severe lip injuries caused by self-mutilative behaviors. The behaviors were blocked with a semi-fixed lip bumper for a short period. The device was applied to the patient on the day of the visit without the requirement for an oral impression. It was easy to manage oral hygiene and adjust the device because it was detachable by clinicians and guardians. Therefore, a semi-fixed lip bumper may be useful as an interim appliance to block selfmutilative behaviors in children with Lesch-Nyhan syndrome.

• The korean journal of orthodontics
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• v.39 no.6
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• pp.383-392
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• 2009

Objective: The purpose of this study was to evaluate the efficacy of a slim bristled toothbrush compared with a V-shaped orthodontic toothbrush in patients with fixed orthodontic appliances. Methods: Thirty four orthodontic patients receiving edgewise treatment were randomly assigned to two groups, a slim bristled toothbrush (Nano silver slim care) and a V-shaped toothbrush (Oral-B). Plaque index, gingival index and bleeding index were recorded at the beginning of the study (baseline), 2 weeks, 4 weeks and 6 weeks after new toothbrushes were supplied and the results were analyzed statistically. Results: No statistically significant differences were found for plaque index, gingival index and bleeding index between toothbrush groups during the 6 weeks. Plaque and gingival indices were decreased at 2 weeks and 4 weeks but increased at 6 weeks in both toothbrush groups. Bleeding index in the V-shaped toothbrush group showed the lowest value at 2 weeks then increased at 4 weeks and 6 weeks but in the slim bristled toothbrush group decreased from 2 weeks through 6 weeks to under baseline levels. Patients in their twenties had significantly lower values than teenagers in the slim bristled toothbrush group (p < 0.013). Conclusions: The results would suggest that both of the toothbrushes are equally effective but the use of a slim bristled toothbrush may be of benefit in promoting gingival health for fixed orthodontic appliance patients in their twenties and over.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.4
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• pp.568-573
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• 2002

The purpose of study was to investigate the caries activity factors of children during orthodontic treatment. Fifty children with fixed or removable intraoral orthodontic appliances were examined for their Cariostat caries activity test scores, gender, age, duration of treatment, appliance type, treatment site, Angle's classification of malocclusion, and the number of teeth with caries experience. The mean age of the high caries activity group was significantly higher than that of the low caries activity group(P<0.01). The duration of treatment of the high caries activity group was longer than that of the low caries activity group, but the difference was not significant(P>0.05). The fixed appliance group showed higher caries activity than the removable appliance group(P<0.01). The caries activity of Angle Class III group was lower than that of Angle Class I group, not significant statistically(P>0.05). The number of teeth with caries experience in the high caries activity group was lower than that in the low caries activity group, not significant statistically(P>0.05).