In order to correct a maxillofacial-skeletal disharmony successfully and achieve a favorable facial profile, orthodontic treatment must begin at pubertal growth spurt. Therefore predicting the pubertal growth pattern and evaluating the growth potential is very important. For an orthodontist, estimating skeletal maturity in relation to one's personal growth spurt is essential and it must be considered into the treatment. The objective of this study was to find out whether there was a difference in menacheal age among different malocclusion groups and to evaluate the skeletal maturity at menarche. The subjects were 64 Class I malocclusion patients, 51 Class II patients and 38 Class III patients. Skeletal maturity was estimated from handwrist radiographs of these patients. Handwrist radiographs were taken between 3 months before and after the menarche. The results were as follows. 1. The mean chronologic age of menarche was $12.50{\pm}1.01$ years. 2. For the Class I malocclusion group the mean age of menarche was $12.36{\pm}1.04$ years, for Class II $12.81{\pm}1.03$ years and for Class III $12.32{\pm}0.82$ years. According to these results Class II malocclusion patients started mensturation later than Class I and Class III malocclusion patients. 3. No difference was found considering the skeletal maturity at menarche among the malocclusion groups. 4. The skeletal maturity index at menarche was SMI 7 for $45.10\%$, SMI 8 for $27.25\%$, SMI 9 for $10.46\%$, SMI 6 for $7.84\%$, SMI 10 for $7.84\%$ and SMI 5 for $1.31\%$ patients. 5. Statistically there was a significant correlation between skeletal maturity estimated by handwrist radiographs and menacheal age(p<0.05, r=0.25430).
Objective: The purposes of this study were to evaluate the force and stress depending on the type, deflection and thickness of the materials and to evaluate the mechanical properties of thermoplastic materials after repeated loading. Methods: Four types of thermoplastic products were tested. Force until the deflections of 2.0 mm and the stress when the materials were restoring to its resting position were evaluated. The mechanical properties of thermoplastic materials evaluated after 5 repeated loading cycles. Results: The interaction was observed between the thickness and the deflection (p < 0.05) from the regression equation. Thickness and amount of deflection rather than products and materials showed the largest effect on force and stress. In all products, at least 159 gf of force was required for more than 1.0 mm deflection or when materials with 1.0 mm thickness were deflected. The stress recorded was more than 19 gf/$mm^2$. During repeated loading, each group showed significant difference on the force and the stress (p < 0.01), 10 - 17% reduction of force and 4 - 7% reduction of stress in average. Conclusions: Proper thickness of thermoplastic materials and deflection level of tooth movement should be decided for the physiologic tooth movement. Force decay after repeated loading should be considered for the efficient tooth movement.
The objective of this study was to evaluate the effects of the topical application of fluoride by iontophoresis on the fluoride concentration in the dental enamel. Eighty-eight healthy teeth were extracted from orthodontic patients and divided into three experimental groups at 0.2 mA and 0.5 mA current and a control group. Each experimental group was further divided into three subgroups according to the application time (1, 3, and 5 min). Five to six teeth were assigned to each subgroup. Inotophoresis was performed using a 2% sodium fluoride solution and each tooth was sliced into a $3{\times}3mm$ specimen on enamel. The fluoride concentration in the enamel was measured using X-ray photoelectron spectroscopy. It was used to estimate the atomic ratio of fluoride on the enamel surface on selected samples. The specimen was observed via scanning electron microscopy as well. This finding was confirmed by the result that the fluoride ratios estimated by x-ray photoelectron spectroscopy was 2.71%, 2.87% and 3.80% after fluoride iontophoresis had been performed using a 2% sodium fluoride solution at 0.5 mA for 1, 3 and 5 min, respectively. In comparison, the fluoride ratio was 0.49% in the control group. As the current became higher and the time lapsed, the formation of irregular particles was strengthened on the enamel surface. Afterwards, the enamel surface was dissolved and new matrix was formed on the enamel. Fluorapatite was observed on the enamel after fluoride iontophoresis was performed at 0.5 mA for 5 min. The fluoride concentration tended to increase with increasing duration of iontophoresis. The study findings indicated that under proper conditions, fluoride iontophoresis has a positive effect in increasing the fluoride concentration in dental enamel.
Kim, Ji-Yeon;Lee, Jae-Ho;Park, Ki-Tae;Kim, Seong-Oh;Choi, Byung-Jai;Son, Heung-Kyu
Journal of the korean academy of Pediatric Dentistry
/
v.32
no.1
/
pp.164-173
/
2005
Mechanical preparation has been introduced to provide the sealant retention. The objective of this study was to compare the fissure penetration and the microleakage of pit and fissure sealant using mechanical preparation(mechanical preparation + acid etching) and acid etching only. An additional objective of this study was to compare the fissure penetration and the microleakage of unfilled and filled sealant in both methods. Sixty human premolars extracted for orthodontic purpose were selected. Thirty teeth were acid etched alone and remaining thirty teeth were prepared with a $\frac{1}{4}$ round bur and then acid etched. One-half of teeth in each surface treatment method were sealed with unfilled sealant and the other half were sealed with filled sealant. All of the teeth were thermocycled for 1200 cycles at $5^{\circ}C\;and\;55^{\circ}C$ and immersed in 5% methylene blue for 24 hours. Each tooth was sectioned bucco-lingually at mesial pit and distal pit and examined under a Measurescope. In the case of mechanical preparation, fissure penetration of sealant was significantly increased compared with the case of acid etching only(P < 0.05). The filled and unfilled sealant using mechanical preparation showed significantly decreased microleakage when compared with the unfilled sealant using acid etching only(P < 0.05). No differences were found in fissure penetration and microleakage between unfilled and filled sealant in both methods. Taken together, the results of this study suggest that mechanical preparation and filled sealant are recommended when placing pit and fissure sealant. However, further clinical studies should be performed in regard to microleakage.
Journal of the korean academy of Pediatric Dentistry
/
v.31
no.1
/
pp.1-10
/
2004
The habit of finger sucking is a reflex occurring in the oral stage, due to nutritive and psychological desire. The habit of finger sucking is considered to be normal till 3 years of age. Dento-skeletal effect on maxillo-mandibular complex including occlusion is naturally correction, when habit stopped before 3 years. If finger sucking continues till $3{\sim}4$ years, Finger sucking leads to severe malocclusion and remarkable discrepancy maxillo-mandibular complex, which is difficult in expectation of natural correction. It is necessary to positive treatment. Treatment of malocclusion, as related to finger sucking is classified two methods. (psychological approach and orthodontic appliance) To stop a habit and to correct severe skeletal discrepancy and malocclusion, $fr\ddot{a}nkel$ appliance is very effective device. This study is to report two cases of treatment of malocclusion, as related to finger sucking. 2 years 10 months old girl with severe overjet, maxillo-mandibular skeletal discrepancy and severe convex facial profile was treated with a FR-II appliance. Finger sucking habit stopped immediately After 16 months, severe overjet, maxillo-mandibular skeletal discrepancy and severe convex facial profile was corrected. 4 years 2 months old girl with midline deviation, mandibular right shift, collateral posterior crossbite and facial asymmetry was treated with a FR-III appliance. Finger sucking habit stopped immediately. After 10 month, Midline deviation, mandibular right shift, collateral posterior crossbite and facial asymmetry were corrected. FR-appliance is a recommendable appliance for a habit breaker and correction of skeletal discrepancy.
One of the various mechanics used to treat unilateral Class II malocclusion is head gear with asymmetric face bow. We made the finite element models of unilateral Class II maxillary dental arch and power arm asymmetric face bow. We designed this experiment to observe stress distribution of periodontal ligament, reaction force, and displacement and to understand force system, so to predict the therapeutic effect. On the basis of computerized tomograph of maxillary dental arch of 25 years old male with normal occlusion without extraction and orthodontic treatment history, we made finite element models of maxillary dental arch and periodontal ligament. Then we modified that model to unilateral maxillary Class II malocclusion model of which maxillary left molar displaced mesially. Also, We made finite element model of asymmetric face bow of which right outer bow shorter than left by 25mm(RMO, Penta-FormTM/Medium size, 0.045 inch iner bow, 0.072 inch outer bow). After that, retraction force of 250g, 300b, 350g were applied to maxillary first molar. We concluded as follow. 1. The Net force that both maxillary first molars were received increased as the retraction force increased. Mesially positioned tooth received more force than normally positioned tooth. But, both tooth were received distal force, so distal movement occured. 2. Both tooth received buccal lateral force. In analysis of force element, as the retraction force were increased, force of X-axis at mesially positioned tooth decreased, and force of X-axis at normally positioned tooth increased. so lateral force component moved to the side received less force from more force. 3. There were rotation, tipping with distal movement in maxillary first molar. As retraction force were increased, rotation and tipping also increased. More tipping and rotation occured at the side received more force, that is, mesially positioned tooth. Though it Is small change, displacement of same pattern occur in normally positioned tooth
Surgical-orthodontic treatment is performed for the skeletal Class III patients with no remaining growth and too big a skeletal discrepancy (or camouflage treatment, and two jaw surgery is needed in order to have maximum effect in such patients. In two jaw surgery cases, surgical alteration of the occlusal plane is necessary to establish optimal function, esthetics and postoperative sability, therefore the establishment of the occlusal plane is essential in diagnosis and treatment. The object of this study is to evaluate the stability of the indiviual ideal occlusal plane bsaed on the architectural and structural craniofacial analysis of Delaires. Thus, the subjects of this study were 48 patients who underwent two jaw surgery, and divided in two groups. Each group were composed of 24patients, A group were operated with ideal occlusal plane and B group were not. Two groups were compared at the preoperative, immediate postoperative (average 4.3days), and long-term postoperative (average 1.3years) lateral cephalometric radiographs. The following results were obtained: 1. There was no significance in occlusal plane angulation between $T_2\;and\;T_3$. Average long term follow-up changes of occlusal Plane angle were $0.24^{\circ}{\pm}2.43$, with FH plane and $0.15{\circ}{\pm}2.16{\circ}$ with SN plane in all 48 patients. These results demonstrated that the occlusal plane after two jaw surgery in skeletal Class III malocclusion was stable. 2. There was no significance in postoperative stability of occlusal plane between A and B group. 3. There was no significance in postoperative stability of occlusal plane depending on surgeon and operative method within each group. 4. The postoperative changes of occlusal plane were correlated to the postoperative changes of jaw rather than tooth position. 5. There was no correlation between the postoperative changes of occlusal plane and maxillary impaction and mandibular setback with surgery.
This study was conducted to investigate the changes in the structural parts of the craniofacial skeleton subsequent to chincap therapy in the juvenile skeletal Class III patients. The subject consisted of 29 Korean children(14 males, 15 females) who had skeletal Class III malocclusion and were undergone chincap therapy from the beginning of the treatment (and an auxilliary upper removable appliance, if necessary). The control group was composed of 21 children(10 males, 11 females) with skeletal Class III malocclusion who had no orthodontic treatment. Cephalometric data at the mean age of 7 and 2 years later were analyized by finite element method, and compared between groups by independent group t-test(p<0.05). The results of the present study were as follows; 1. There were no significant changes in the cranial base, posterior face, upper anterior face, ramus, chin and soft tissues by the chincap therapy. 2. The mandibular body showed significant differences in the minimum extention ratio and the overall shape ratio. This means that the vertical direction of growth was retarded by the chincap therapy. 3. The major direction of the growth in the maxillary basal bone was significantly more horizontal in the experimental group, which suggests that the vertical growth of maxilla was inhibited. 4. There was statistical difference in the major direction of the growth of the anterior face between groups. This may be due to the significant difference in the major direction of growth of the lower anterior face, supposed to be resulted from the mandibular rotation and/or displacement by the chincap therapy. The change in the oral functional space seemed to be caused by the same reason. 5. From the standpoint of these results, the retardation of growth, the changes of the growth direction and the morphological changes could be accepted partly, but the major effect of the chincap seems to be the rotation and the displacement of the mandible.
If a mandibular prognathic patient has an extremely unnatural anteroposterior and vertical maxilla or keen esthetical perception for facial profile, orthognathic surgery must be performed along with orthodontic treatment, which alone cannot provide satisfactory results in this case. Esthetical improvement becomes an important factor in the satisfaction level of the patient's treatment result, but an attempt to objectively measure beauty holds many problems. Therefore, in the end, the patient submits the final esthetical evaluation based on his/her subjective viewpoint. Because Korean people have a tendency to prefer the facial appeareance of westerners, they favor an oval shaped face over the traditional round face. This research was conducted in response to the complaints raised by patients who claim that their face had become more round from widening of facial width after the orthognathic surgery for manidibular prognathism than before the surgery. The following results were obtained on the changes in facial appearance and patient satisfaction level by analyzing the skull P-A analysis of total of 14 patients (8 male and 6 female) who underwent orthognathic surgery primarily chief complaint for manidibular prognathism and from their responses on questionnaires. These results are to be used in the research on the pre- and post- operative changes in facial height and width from orthognatic surgery. 1. Three ($21.4\%$) of 14 patients said that their face had widened. 2. The A group showed no change in mandibular width but B group showed a 0.7mm reduction. The facial width increased by 0.45mm and 0.66mm in groups A and B, respectively, after the orthognathic surgery 3. After the surgery the facial length changed by an 0.52mm increase in upper facial height , 1.19mm reduction in lower facial height, and 0.7mm reduction in mandibular height in group A. In group B group, there was a 0.67mm reduction in upper facial height, 3.66mm reduction in lower facial height, and 5mm reduction in mandibular height. 4. In reference to facial width, the facial height showed $1.5\%$ reduction in group A and $3.6\%$ reduction in group B after the surgery. 5. In reference mandibular height-to-facial width ratio, there was a $1.3\%$ reduction in group A, and $4.4\%$ reduction in group B after the surgery. 6. In reference to the mandibular height-to-width ratio, there was a $1.3\%$ reduction in group A and $4.3\%$ reduction in group B after the surgery. 7. Although the change in the facial width due to surgery can be ignored, sufficient explanation should be Provided to the patient before surgery on the fact that the face can appear to be relatively wide because of the reduced facial length as result of the surgery.
The purpose of this study was to compare the arch width of the hyperdivergent group with that of the neutral group in Class III malocclusion based on the vertical patterns and to compare the arch width of Class III neutral group With that of normal occlusion group based on sagittal patterns. The subjects consisted of 118 pairs of studty casts, divided into three groups , 37 Class III hyperdivergent group(18 males and 19 females, SN-Mn plane angle>39.5$^{\circ}$), 40 Class III neutral group(20 males and 20 females, SN-Mn plane angle : 32 ${\pm}$ 2.5$^{\circ}$) and 41 Class I normal occlusion group(20 males and 21 females). The intercanine, interpremolar, and intermolar width of the maxillary and mandibular study casts were measured, then the ratios of dental width to basal width and mandibular width to maxillary width were obtained. Basal arch width and dental arch width were measured to obtain the pure basal arch relation in transverse plane as ruled out the transverse dental compensation. The results were as follows 1. There were no significant differences in any ratios between Class III hyperdivergent group and Class III neutral group as different vertical pattern. 2. As the ratios of dental arch width to basal arch width between normal occlusion group and Class III neutral group were compared, the maxillary teeth flared buccally to the basal bone, and the mandibular teeth tilted lingually to the basal bone in Class III neutral group. 3. The ratios of mandibular arch width to maxillary arch width in basal arch level were significantly different in all regions. Maxillary basal arch width of Class III neutral group was narrower than that of normal occlusion group. 4. The ratios of mandibular arch width to maxillary arch width in teeth level were not significantly different between normal occlusion group and Class III neutral group. In spite of discrepancies of maxillary and mandibular basal arch width, the dental arch width of Class III malocclusion group compensated very well. At the presurgical orthodontic treatment in clinic, it would not be desirable to decompensate for compensated dental arch width too much, for obtaining an appropriate arch compatibility and good results for orthognathic surgery.
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