Horseshoe Expander is one of Slow Maxillary Expansion(SME) which aims to accommodate the contra- lateral expansion and midpalatal suture expansion or the palate. The appliance consists of skeleton type strew embedded in split Horseshoe appliance. It is the objectives of the presentation to manifest the changes in dental & craniofacial components subsequent to the application of Horseshoe Expander. The subjects for this study consisted of 32 patients (mean age : 12.7). frontal, lateral cephalometric headfilm were taken and study casts were fabricated before and after expansion. 24 items were measured, compared preexpansion with postexpansion. Especially, palatal volume was measured by means of 'Hydro-measurement method'. Tooth axis measurement on the dental casts were made with Universal bevel protractor, and Horseshoe Expander group were compared with RME group. This study of changes to maxillary expansion with Horseshoe Expander revealed the following significant results. 1. Triangular-shaped expansion pattern appeared in frontal cephalometric headfilm. 2. Palatal plane, occlusal plane, mandibular plane and upper incisor to FH increased in lateral cephalometrir headfilm. 3. Palatal volume increased significantly. A slight bite opening, reduction of occlusal contact points showed in dental casts. 4. A 2.2:1 ratio of the amount of intermolar width in maxilla(orthodontic movement) to maxillary width (orthopedic movement) was determined. 5. Horseshoe Expander group has less buccal tipping tendency than RME group, by taking high correlation coefficients in the upper second premolar and first molar. It was suggested that Horseshoe Expander showed less orthodontic changes, less buccal tipping tendency. In addition, it was effective in maxillary expansion.
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.
Although the purpose of orthodontic treatment is to increase the function and esthetics of the jaws along with increasing stability, there are many side effects during the treatment itself, such as root resorption and alveolar bone resorption. Such resorption of the apical root Is unpredictable, and may even proceed into the dentin layer. Once the process has begun, it is irreversible. By evaluating the effect of many oral habits, especially that of nail biting, in correlation with the root and the periodontal tissues, the appropriate biomechanics for orthodontic treatment can be taken into consideration, along with the possibility of root resorption and alveolar bone loss during orthodontic treatment, and any legal problems that might occur. Among the male and female patients of the ages $10\~15$ without skeletal deformity, 63 were chosen as the experiment group with known nail biting habits at time of examination, and within the same age group without nail biting habits as the control. After the orthodontic treatment, number of the experiment group was 31 and the control group was 22. The periapical radiographies of anterior teeth were taken and the assesment of the root length and alveolar bone level were taken before(T1) and after(T2) the orthodontic treatment. The results from this study were as follows : 1. Before the orthodontic treatment, average crown-to-root ratio of the experimental group showed noticeably high values in 4 maxillary incisors and mandibular right central incisor. 2. Before the orthodontic treatment, comparing the root length, maxillary and mandibular right central incisors and both mandibular incisors had a smaller value in the experimental group. 3. Before the orthodontic treatment, comparing and evaluating the alveolar bone loss measured from the cemento-enamel junction to the alveolar bone crest, some crestal bone of the experiment group showed greater loss than the control. 4. After the orthodontic treatment, there was shortening of the root length and loss of the crestal bone in both groups. 5. After the orthodontic treatment, the changes of C/R ratio and the shortening of root length were significantly high in the experimental group. 6. After the orthodontic treatment, the level of alveolar crestal bone showed greater loss in the experimental group.
This study was designed to evaluate the frequency and the severity of root resorption of the permanent teeth before orthodontic treatment by means of radiograph in the malocclusion patients. In this study the author analysed the frequency and the severity of root resorption in individual teeth, the relationships of the frequency and the severity of root resorption and age, sex, Angle's classification, overjet, overbite, and maxillary and mandibular incisor inclination, and the relationships of the frequency of root resorption and the characteristics of malocclusion and marked occlusal attrition showed in individual teeth. The results were as follows. 1. All of the persons examined showed some evidence of root resorption in one or more of the permanent teeth, $35.84\%$ of the teeth examined and more frequent in female group than male group(p<0.01). 2. On the susceptibility of the root resorption in individual teeth in this study, the author found the mandibular incisors and the maxillary incisors, in the order named, to be most susceptible in all affected teeth, but maxillary central incisors, maxillary first bicuspids, and maxillary lateral incisors, in the order named, were more susceptible to marked root resolution. 3. The more proclined maxillary Incisors the more affected root resorption in four maxillary incisors and the more proclined mandibular incisors the more affected root resorption in four mandibular incisors. 4. Overbite more affected root resorption than overjet, and the higher tender to openbite the more frequent was root resorption. 5. On the characteristics of malocclusion showed in individual teeth, the openbite teeth combined with crossbite, were most frequent in root resolution.
The Purposes of this study were to investigate the initial tissue changes on the teeth and surrounding tissues under contraction and intrusive force by contraction UTA. A control and experimental dogs, 10-months in age, were studied. Contraction and intrusive force(60gm) were applied at upper four incisors by contraction UTA. Experimental dogs were sacrificed at 2 weeks and 4 weeks after force application, respectively. In this study, 2 experimental groups were designed by the duration of force applied(E1, E2). The specimens were taken around the upper first and second incisor in each groups and were prepared for the H-E and MT stain for light microscopic observation. From the results of the study, the following conclusions may be drown. : 1. In control group, the periodontal ligament width was constant from apical third to cervical third of the root and periodontal fiber arrangement was horizontal or oblique in cervical third, oblique in middle third and apical third. In alveolar bond, smooth appearance was shown with osteoblast. 2. In experimental group 1, in proportion to force was concentrated at labial middle third and apical third of root of the upper first and second incisors, root of these tooth tipped labially and intruded at a time. 3. In experimental group 2, periodontal ligament width and arrangement was similar to control and observed strong calcified response at the labial middle third of root. But, alveolar bond resorption and cementum resorption were as before seen at labial middle third and apical third of root that force was concentrated.
This study was undertaken to investigate the relation between orthodontic force magnitude and the amount of tooth movement. And more light force application for reducing root resorption Twenty-four rats were divided into three experimental groups(A, B, C) based on force magnitude and application method. Springs of 50g force were applied to A group, springs of 100g force were applied to B group and springs of 25g force were applied to C group initially, and after 4 days springs of C group were changed to springs of 50g force. Two kinds of $sentally^{(R)}$(GAC U.S.A.) closed coil spring, 50g and 100g, were used. And we made 25g springs by heat treatment process of 50g springs. Each spring was inserted between the maxillary central incisor and the maxillary left first molar. Amounts of tooth movement were measured everyday by digital caliper($Digimatic^{(R)}$, Mitutoyo, Japan) under inhalation anesthesia for 15 days. After 15 days, all rats were sacrificed and histological samples were obtained with Hematoxyline-Eosin stain and Masson's trichrome stain. Following conclusion were made; 1. Group B showed the mean cumulative tooth movement of $2.19{\pm}0.41mm$ at 15th day, which was greatest among three groups, followed by group C($2.06{\pm}0.10mm$), group A($1.90{\pm}0.49mm$) respectively. however, there was no statistically difference among three groups. 2. All groups showed general tooth movement pattern and A, B, C group finished lag phase at 9th, 8th, 7th day, but there was no statistical significance. 3. Group A,B,C showed root resorption and especially group B showed the most severe root resorption and group C showed milder root resorption than other groups. According to the above results, large initial force with the development of a flirty widespread hyalinized zone may cause severe root resorption, so initial force should be applied lightly to reduce hyalinized area and eventually root resorption and then increased force will induce efficient tooth movement.
The purpose of this study was to compare the bracket shear bond strengths of the crystal growth solutions with those of the $37\%$ phosphric acid etch technique. The 4 crystal growth solutions were made experimentally in the lab, that is, (1) $30\%$ polyacrylic acid solution containing 0.3 M sulfuric acid (ES 1), (2) $30\%$ polyacrylic acid solution containing 0.6M sulfuric acid (ES 2), (3) $30\%$ polyacrylic acid solution containing 0.3 M sulfuric acid and 0.6 M lithium sulfate(ES 3), and (4) $30\%$ polyacrlic acid solution containing 0.3 M sulfuric acid and $5\%$ phosphoric acid(ES4). The $37\%$ phosphoric acid solution used as a control. Bovine lower incisor tooth enamel was treated by the above solutions for 60 sec, washed out for 20 sec with slow water stream, and bonded lower anterior edgewise bracket with the light curing orthodontic composite resin adhesives. The teeth bonded brackets were stored in the distilled water at room temperature for 24 h, and followed to test the bracket shear bond strength. The acid etch technque showed 177.6 kg/$cm^2$ of mean shear bond strength which was the highest among the enamel treatment solutions. ES 1 shown 58.4 kg/$cm^2$ of mean shear bond strength and that of ES 4 showed 66.5 kg/$cm^2$. There was no significant difference between the two(p>0.05). ES2 showed 110.6kg/$cm^2$ of mean shear bond strength which was $62.3\%$ of that of acid etch technique. ES 3 showed 131.1 kg/$cm^2$ of mean shear bond strength which was the highest among experimental crystal growth solutions and which was $74\%$ of that of acid etch technique. The shear bond strengths of the crystal growth solutions were significantly lower that that of acid etch technique(p<0.05). The results sugest that although bracket shear bond strength of $30\%$ polyacrylic acid solution containing 0.3M sulfuric acid and 0.6 M lithium sulfate were showed the highest, it is low for the clinical application of this solution.
The purpose of this study was to evaluate the availability of computer system for the measurement of tooth size in the model analysis through the comparison of two measurements: One was to use a computer; and the other was to use vernier calipers. Twenty sets of casts were used, which showed a moderate degree of crowding and full eruption of all teeth. The mesio-distal width of 12 teeth from the left central incisor to the left first molar at each set of the casts were measured twice with vernier calipers and a computer respectively. This measurement was repeated two weeks later. First, for the reproducibility analysis, the two computer measurements were compared then the vernier calipers measurements were compared. Second, all the teeth were sepapated into the region of mesiodistal contact points and its width was measured by a micrometer to obtain standard measurements. For the accuracy analysis, these standard measurements were compared with the measurements from the dental casts using two methods. The difference between them was defined as the measurement error. To investigate the cause of measurement error, an examination was made for the presence and degree of contact point deviation on each tooth from the upper and lower occlusograms, and the mesio-distal angulation of each tooth was measured with TARG. Following results were obtained through statistical analysis. 1. In the analysis for reproducibility; the measurements with vernier calipers showed significant differences in three out of twelve teeth while the computer measurements showed significant differences in one out of twelve teeth. 2. In the analysis for accuracy; compared with the standard measurements, the measurements with vernier calipers showed significant differences in three out of twelve teeth while the computer measurements showed significant differences in two out of twelve teeth. 3. Compared with the standard measurements, the measurements with vernier calipers were apt to be larger at the upper first molar, and smaller at the lower first molar The computer measurements, however, were apt to be larger at both upper and lower first molars. 4. The measurements with vernier calipers showed the largest error at the lower first molar and the degree of error was variable according to the tooth while the difference of error was small in the computer measurements. 5. In the analysis for the correlation of the degree of measurement errors with the contact point deviation index and the mesio-distal crown angulation of each tooth, the measurements with vernier calipers did not show significant correlation while the measurements with computer showed slight Positive correlations. The results of this study indicate that a computer system may be useful for the measurement of tooth size in the model analysis.
Soft tissue changes that occurred between presurgery to 5-years post-surgery in 49 orthognathic surgery patients whose maxillae were moved upward by Le Fort I osteotomy were examined by lateral cephalometric film. The objective of this paper was to document soft tissue changes at long-term follow-up after superior repositioning of the maxilla and to relate soft tissue and hard tissue changes in this group. The results were as follows. 1. On average, soft tissue landmarks in the nose and the upper lip were not changed statistically significantly except superior movement of superior labial sulcus and forward movement of pronasale between presurgery and 5 years postsurgery. 2. Upward and forward movement of the lower lip were found at 5 years postsurgery in comparison with presurgery and genioplasty added this effects. 3. Upper lip length and vertical dimension of upper vermilion didn't show any significant changes, but increase of lower lip length and decrease of vertical dimension of lower vermilion were statistically significant between presurgery and 5 years post-surgery. 4. The decrease of upper incisor exposure and interlabial distance from presurgery to 1 year were continued from 1 year to 5 years and the amount of the decrease was more than that of vertical movement of the maxilla by surgery. 5. Long term changes in soft tissue landmarks from 1 to 5 years postsurgery exceeded hard tissue changes, meaning soft tissue moved down more than skeletal changes.
The purpose of this study was to investigate the micro-implant height and anterior hook height to prevent maxillary six anterior teeth from lingual tipping and extruding during space closure. We manufactured maxillary dental arch form, bracket and wire, using the computer aided three-dimensional finite element method. Bracket was $.022'{\times}.028'$ slot size and attached to tooth surface. Wire was $.019'{\times}.025'$ stainless steel and $.032'{\times}.032'$ stainless steel hook was attached to wire between lateral incisor and canine. Length of hook was 8mm and force application points were marked at intervals of In. Four micro-implants were implanted on alveolar bone between second premolar and first molar. The heights of them were 4, 6, 8, 10mm starting from wire. We analyzed initial displacement of teeth by various force application point applying force of 150gm to each micro-implant and anterior hook. The conclusions of 4his study are as the following : 1. When the micro-implant height was 4m and the anterior hook height was 5mm and below, anterior teeth were tipped lingually. When the anterior hook height was 6mm and above, anterior teeth were tipped labially. 2. When the micro-implant height was 6mm and the anterior hook height was 6mm and below, the anterior teeth were tipped lingually. When the anterior hook height was 6m and above, the anterior teeth were tipped labially. But lingual tipping of anterior teeth decreased and labial tipping Increased when the micro-implant height was 6mm, compared with 4mm micro-implant height. 3. When the micro-implant height was 8mm and the anterior hook height was 2mm, the anterior teeth were tipped lingually. When the anterior hook height was 3mm and above, labial tipping movement of the anterior teeth increased proportionally. 4. When the micro-implant height was 10mm and the anterior hook height was 2mm and above, labial tipping of the anterior teeth increased proportionally. 5. As the anterior hook height increased, aterior teeth were tipped more labially. But extrusion occurred on canine and premolar area because of the increase of wire distortion. 6. Movement of the posterior teeth was tipped distally during maxillary six anterior teeth retraction using micro-im plant because of the friction between bracket and were Based on the results of this study, we could predict the pattern of the tooth movement according to position of micro-implant and height of anterior hook. It seems that we can find the force application point for proper tooth movement in consideration of inclination of anterior anterior teeth, periodontal condition, overjet and overbite
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