• The korean journal of orthodontics
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• v.48 no.6
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• pp.367-376
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• 2018

Objective: This study was performed to investigate the changes in alveolar bone after maxillary incisor intrusion and to determine the related factors in deep-bite patients. Methods: Fifty maxillary central incisors of 25 patients were evaluated retrospectively. The maxillary incisors in Group I (12 patients; mean age, $16.51{\pm}1.32years$) were intruded with a base-arch, while those in Group II (13 patients; mean age, $17.47{\pm}2.71years$) were intruded with miniscrews. Changes in the alveolar envelope were assessed using pre-intrusion and post-intrusion cone-beam computed tomography images. Labial, palatal, and total bone thicknesses were evaluated at the crestal (3 mm), midroot (6 mm), and apical (9 mm) levels. Buccal and palatal alveolar crestal height, buccal bone height, and the prevalence of dehiscence were evaluated. Two-way repeated measure ANOVA was used to determine the significance of the changes. Pearson's correlation coefficient analysis was performed to assess the relationship between dental and alveolar bone measurement changes. Results: Upper incisor inclination and intrusion changes were significantly greater in Group II than in Group I. With treatment, the alveolar bone thickness at the labial bone thickness (LBT, 3 and 6 mm) decreased significantly in Group II (p < 0.001) as compared to Group I. The LBT change at 3 mm was strongly and positively correlated with the amount of upper incisor intrusion (r = 0.539; p = 0.005). Conclusions: Change in the labial inclination and the amount of intrusion should be considered during upper incisor intrusion, as these factors increase the risk of alveolar bone loss.

• The korean journal of orthodontics
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• v.33 no.4 s.99
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• pp.259-277
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• 2003

This study was designed to investigate the position of anteroposterior center of resistance for genuine intrusion and the mode of change of the minimum distal force for simultanous intrusion and retraction of the upper and lower incisors according to the increase of labial inclination. For this purpose, we used the three-piece intrusion arch appliance and three-dimensional finite element models of upper and lower incisors. 1. Positions of the center of resistance in upper incisors according to the increase of the labial inclination were as follows; 1) In normal inclination situation, the center of resistance was located in 6m behind the distal surface of the lateral incisor bracket. 2) In $10^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 9mm behind the distal surface of the lateral incisor bracket. 3) In $20^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 12m behind the distal surface of the lateral incisor bracket. 4) In $30^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 16m behind the distal surface of the lateral incisor bracket. 2. Positions of the center of resistance in lower incisors according to the increase of the labial inclination were as follows; 1) In normal inclination situation, the center of resistance was located in 10mm behind the distal surface of the lateral incisor bracket. 2) In $10^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 13m behind the distal surface of the lateral incisor bracket. 3) In $20^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 15m behind the distal surface of the lateral incisor bracket. 4) In $30^{\circ}$ increase of the labial inclination situation, the center of resistance was located in 18m behind the distal surface of the lateral incisor bracket. 3. The patterns of stress distribution were as follows; 1) There were even compressive stresses In and periodontal ligament when intrusion force was applied through determined center of resistance. 2) There were gradual increase of complexity in compressive stress distribution pattern with Increase of the labial inclination when intrusion and retraction force were applied simultaneously. 4. With increase of the labial inclination of the upper and lower incisors, the position of the center of resistance moved posteriorly. And the distal force for pure intrusion was increased until $20^{\circ}$increase of the labial inclination.

• The korean journal of orthodontics
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• v.54 no.2
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• pp.79-88
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• 2024

Objective: Alveolar bone loss is a common adverse effect of intrusion treatment. Mandibular incisors are prone to dehiscence and fenestrations as they suffer from thinner alveolar bone thickness. Methods: Thirty skeletal class II patients treated with mandibular intrusion arch therapy were included in this study. Lateral cephalograms and cone-beam computed tomography images were taken before treatment (T1) and immediately after intrusion arch removal (T2) to evaluate the tooth displacement and the alveolar bone changes. Pearson's and Spearman's correlation was used to identify risk factors of alveolar bone loss during the intrusion treatment. Results: Deep overbite was successfully corrected (P < 0.05), accompanied by mandibular incisor proclination (P < 0.05). There were no statistically significant change in the true incisor intrusion (P > 0.05). The labial and lingual vertical alveolar bone levels showed a significant decrease (P < 0.05). The alveolar bone is thinning in the labial crestal area and lingual apical area (P < 0.05); accompanied by thickening in the labial apical area (P < 0.05). Proclined incisors, non-extraction treatment, and increased A point-nasion-B point (ANB) degree were positively correlated with alveolar bone loss. Conclusions: While the mandibular intrusion arch effectively corrected the deep overbite, it did cause some unwanted incisor labial tipping/flaring. During the intrusion treatment, the alveolar bone underwent corresponding changes, which was thinning in the labial crestal area and thickening in the labial apical area vice versa. And increased axis change of incisors, non-extraction treatment, and increased ANB were identified as risk factors for alveolar bone loss in patients with mandibular intrusion therapy.

• The korean journal of orthodontics
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• v.46 no.4
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• pp.242-252
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• 2016

Objective: Orthodontic mini-implants (OMI) generate various horizontal and vertical force vectors and moments according to their insertion positions. This study aimed to help select ideal biomechanics during maxillary incisor retraction by varying the length in the anterior retraction hook (ARH) and OMI position. Methods: Two extraction models were constructed to analyze the three-dimentional finite element: a first premolar extraction model (Model 1, M1) and a residual 1-mm space post-extraction model (Model 2, M2). The OMI position was set at a height of 8 mm from the arch wire between the second maxillary premolar and the first molar (low OMI traction) or at a 12-mm height in the mesial second maxillary premolar (high OMI traction). Retraction force vectors of 200 g from the ARH (-1, +1, +3, and +6 mm) at low or high OMI traction were resolved into X-, Y-, and Z-axis components. Results: In M1 (low and high OMI traction) and M2 (low OMI traction), the maxillary incisor tip was extruded, but the apex was intruded, and the occlusal plane was rotated clockwise. Significant intrusion and counter-clockwise rotation in the occlusal plane were observed under high OMI traction and -1 mm ARH in M2. Conclusions: This study observed orthodontic tooth movement according to the OMI position and ARH height, and M2 under high OMI traction with short ARH showed retraction with maxillary incisor intrusion.

• The Journal of the Korean dental association
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• v.57 no.6
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• pp.333-343
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• 2019

Many orthodontists face difficulties in aligning incisors in an esthetically critical position, because the individual perception of beauty fluctuates with time and trend. Temporary anchorage device (TAD) can aid in attaining this critical incisor position, which determines an attractive smile, the amount of incisor display, and lip contour. Borderline cases can be treated without extraction and the capricious minds of patients can be satisfied with regard to the incisor position through whole dentition distalization using TAD. Mild to moderate bimaxillary protrusion cases can be treated with TAD-driven en masse retraction without premolar extraction. Patients with Angle's Class III malocclusion can be the biggest beneficiaries because both sufficient maxillary incisal display, through intrusion of mandibular incisors, and distalization of the mandibular dentition are successfully achieved. In addition, TAD can be used to correct various other malocclusions, such as canting of the occlusal plane and dental/alveolus asymmetry.

• The korean journal of orthodontics
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• v.44 no.2
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• pp.54-61
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• 2014

Objective: This study aimed to propose clinical guidelines for placing miniscrew implants using the results obtained from 3-dimensional analysis of maxillary anterior interdental alveolar bone by cone-beam computed tomography (CBCT). Methods: By using CBCT data from 52 adult patients (17 men and 35 women; mean age, 27.9 years), alveolar bone were measured in 3 regions: between the maxillary central incisors (U1-U1), between the maxillary central incisor and maxillary lateral incisor (U1-U2), and between the maxillary lateral incisor and the canine (U2-U3). Cortical bone thickness, labio-palatal thickness, and interdental root distance were measured at 4 mm, 6 mm, and 8 mm apical to the interdental cementoenamel junction (ICEJ). Results: The cortical bone thickness significantly increased from the U1-U1 region to the U2-U3 region (p < 0.05). The labio-palatal thickness was significantly less in the U1-U1 region (p < 0.05), and the interdental root distance was significantly less in the U1-U2 region (p < 0.05). Conclusions: The results of this study suggest that the interdental root regions U2-U3 and U1-U1 are the best sites for placing miniscrew implants into maxillary anterior alveolar bone.

• The korean journal of orthodontics
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• v.28 no.3 s.68
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• pp.431-440
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• 1998

While periodontal disease results in the extrusion of upper incisors with interdental spacing in adult patient, the intrusive movement should be executed for the rehabilitation in terms of esthetics and function. The present study was peformed to investigate the periodontal response following orthodontic intrusion of teeth with infrabony pocket. Bone defect and periodontal disease were produced adjacent to the both maxillary second lateral incisors in four adult dogs. Four weeks later, a flap operation was performed to eliminate inflammation and a reference notch was made on the root surface at the level of bottom of each defect. Two weeks after periodontal surgery, 4 weeks of intrusion and subsequent another 4 weeks of retention was executed on the right side of incisors while left incisors served as the control. Through the histologic analysis, following results were obtained. 1. Histologic section of control side showed the reduction of pocket depth after flap operation. However, the status of long junctional epithelium was observed while new connective tissue attachment occurred in a small area adjacent newly formed cementum 2. Epithelial attachment was less around the intruded incisor while new connective tissue attachment was much more compared to the control side. 3. Plenty of cells were observed in the connective tissue around the reference notch of the intruded incisor and the degree of the new cementum formation was higher in the intruded incisor than the control. The results of the present study suggested that an orthodontic intrusion of periodontally involved and extruded incisors could be carried out with a desirable periodontal response, provided that inflammation is under control.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.1
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• pp.43-46
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• 2017

Patients with cerebral palsy have higher risk of traumatic dental injuries because of clinical characteristics, such as, ataxia, large overjet and lip incompetency. Especially, intrusive luxation has rare occurrence but higher incidence of complications. It can be treated by expecting re-eruption, orthodontic reposition, and surgical reposition. Clinicians should be aware of management and follow-up in dealing with cerebral palsy patients who are exposed by intrusive luxation, due to their involuntary movement. This case report describes a 9-year-old male patient with cerebral palsy and epilepsy who experienced intrusion of maxillary permanent central incisor. After one-month follow-up, waiting for spontaneous eruption, pulp necrosis on maxillary permanent central incisor had proceeded. Therefore, surgical reposition with resin wire splint and apexification was performed under conscious sedation with midazolam. After two months, removal of resin wire splint was done. Gutta percha filling and composite resin restoration were performed after sixteen months. During five-year follow-up ankylosis and partial root resorption were observed. But there was no significant complications.

• The korean journal of orthodontics
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• v.52 no.3
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• pp.210-219
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• 2022

Objective: The purpose of this study was to examine the effectiveness and mechanism of clear aligner therapy for the correction of anterior open bite in adult nonextraction cases. Methods: Sixty-nine adult patients with anterior open bite were enrolled and classified into Angle's Class I, II, and III groups. Fifty patients presented with skeletal open bite (mandibular plane angle [MPA] ≥ 38°), whereas 19 presented with dental open bite. Fifteen cephalometric landmarks were identified before (T1) and after (T2) treatment. The magnitudes of planned and actual movements of the incisors and molars were calculated. Results: Positive overbite was achieved in 94% patients, with a mean final overbite of 1.1 ± 0.8 mm. The mean change in overbite was 3.3 ± 1.4 mm. With clear aligners alone, 0.36 ± 0.58 mm of maxillary molar intrusion was achieved. Compared with the Class I group, the Class II group showed greater maxillary molar intrusion and MPA reduction. The Class III group showed greater mandibular incisor extrusion with no significant vertical skeletal changes. Conclusions: Clear aligners can be effective in controlling the vertical dimension and correcting mild to moderate anterior open bite in adult nonextraction cases. The treatment mechanism for Class III patients significantly differed from that for Class I and Class II patients. Maxillary incisor extrusion in patients with dental open bite and MPA reduction with mandibular incisor extrusion in patients with skeletal open bite are the most significant contributing factors for open bite closure.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.293-297
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• 2009

Traumatic intrusion is a type of injury that involves axial displacement of a tooth toward the alveolar bone. Its occurance is relatively rare compared to other types of luxation in permanent dentition. It is more common in boys than in girls, and most common etiology of intrusion is fallen down. Various complication may occur following traumatic intrusion, such as pulp necrosis, root resorption, pulp obliteration and marginal bone loss. In addition, traumatic intrusion is commonly combined with hard or soft tissue injuries. Therefore, it is difficult to establish proper treatment plan. Choice of treatment for an intruded tooth by trauma include waiting for spontaneous re-eruption, orthodontic repositioning, and surgical repositioning. In this case, we repositioned the intruded central incisor using orthodontic traction, in a six-year old girl, which failed to re-erupt spontaneously.