• The korean journal of orthodontics
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• v.51 no.3
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• pp.217-227
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• 2021

Maxillary transverse deficiency often manifests as a posterior crossbite or edge-to-edge bite and anterior crowding. However, arbitrary arch expansion in mature patients has been considered to be challenging due to the possible periodontal adverse effects such as alveolar bone dehiscence and gingival recession. To overcome these limitations, nonsurgical maxillary expansion of the basal bone has been demonstrated in young adults. However, the age range for successful orthopedic expansion has remained a topic of debate, possibly due to the underlying individual variations in suture maturity. This case report illustrates nonsurgical, miniscrew-assisted rapid palatal expansion (MARPE) in a 60-year-old patient with maxillary transverse deficiency accompanied by anterior and posterior crossbites, crowding, and gingival recession. The use of MARPE allowed relief of crowding and correction of the crossbite without causing significant periodontal adverse effects.

• The korean journal of orthodontics
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• v.46 no.2
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• pp.111-126
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• 2016

Objective: To systematically review previous studies and to assess, via a subgroup meta-analysis, the combined odds ratio (OR) of prognostic factors affecting the success of miniscrew implants (MIs) inserted into the buccal posterior region. Methods: Three electronic searches that were limited to articles on clinical human studies using MIs that were published in English prior to March 2015 were conducted. The outcome measure was the success of MIs. Patient factors included age, sex, and jaw of insertion (maxilla vs. mandible), while the MI factors included length and diameter. A meta-analysis was performed on 17 individual studies. The quality of each study was assessed for non-randomized studies and quantified using the Newcastle-Ottawa Scale. The meta-analysis outcome was a combined OR. Subgroup and sensitivity analyses based on the study design, study quality, and sample size of miniscrews implanted were performed. Results: Significantly higher success rates were revealed for MIs inserted in the maxilla, for patients ${\geq}20$ years of age, and for long MIs (${\geq}8mm$) and MIs with a large diameter (> 1.4 mm). All subgroups acquired homogeneity, and the combined OR of the prospective studies (OR, 3.67; 95% confidence interval [CI], 2.10-6.44) was significantly higher in the maxilla than that in the retrospective studies (OR, 2.10; 95% CI, 1.60-2.74). Conclusions: When a treatment plan is made, these risk factors, i.e. jaw of insertion, age, MI length, and MI diameter, should be taken into account, while sex is not critical to the success of MIs.

• The korean journal of orthodontics
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• v.35 no.1 s.108
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• pp.35-42
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• 2005

There is lack of data for the amount of vertical bone in the midpalatal region for miniscrew implantation. The purpose of this study was to measure the structure of the midpalatal suture area using CT image and V-works 4.0 program (Cybermed Inc, Seoul, Korea). CT images of 14 male and 14 female adults were reconstructed. In detail, it was 1) to measure the length of maxilla on the midsagittal plane 2) to measure vertical bone height in the midpalatal area 3) to establish the zone of safety for miniscrew implantation. The following results were obtained. The mean length of ANS-PNS was 51.08mm in males and 47.34mm in females. There was a statistically significant difference between males and females (p<0.05). The vertical bone height of the midpalatal suture area was above 0mm except for 6mm posterior from the central Point of ANS-PNS in males The zone of safety was located 19.43mm posterior from the ANS in males while it was 17.62mm in females along the palatal plane. These results support that the safety zone of the midpalatal area is suitable for screw implantation. Midpalatal miniscrew implantation is a powerful tool in modern orthodontics Through many applications. it can expand the modern orthodontic field.

• The korean journal of orthodontics
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• v.41 no.6
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• pp.384-398
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• 2011

Objective: The purpose of this study was to analyze the stress distribution and the displacement pattern of mandibular anterior teeth under various intrusive force vectors according to the position of orthodontic miniscrews and hooks, using three-dimensional finite element analysis. Methods: A three-dimensional finite element model was constructed to simulate mandibular teeth, periodontal ligament, and alveolar bone. The displacement of individual tooth on three-dimensional planes and the von Mises stress distribution were compared when various intrusion force vectors were applied. Results: Intrusive forces applied to 4 mandibular anterior teeth largely resulted in remarkable labial tipping of the segment according to the miniscrew position. All 6 mandibular anterior teeth were labially tipped and the stress concentrated on the labiogingival area by intrusive force from miniscrews placed mesial to the canine. The distointrusive force vector led to pure intrusion and the stress was evenly distributed in the whole periodontal ligament when the hook was placed between the central and lateral incisors and the miniscrew was placed distal to the canine. Conclusions: Within the limits of this study, it can be concluded that predictable pure intrusion of the 6 anterior teeth segment may be accomplished using miniscrews placed distal to the canine and hooks located between the central and lateral incisors.

• The korean journal of orthodontics
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• v.47 no.4
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• pp.238-247
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• 2017

Objective: The aim of this study was to compare recycled and unused orthodontic miniscrews to determine the feasibility of reuse. The comparisons included both miniscrews with machined surfaces (MS), and those with etched surfaces (ES). Methods: Retrieved MS and ES were further divided into three subgroups according to the assigned recycling procedure: group A, air-water spray; group B, mechanical cleaning; and group C, mechanical and chemical cleaning. Unused screws were used as controls. Scanning electron microscopy, energy-dispersive X-ray spectrometry, insertion time and maximum insertion torque measurements in artificial bone, and biological responses in the form of periotest values (PTV), bone-implant contact ratio (BIC), and bone volume ratio (BV) were assessed. Results: Morphological changes after recycling mainly occurred at the screw tip, and the cortical bone penetration success rate of recycled screws was lower than that of unused screws. Retrieved ES needed more thorough cleaning than retrieved MS to produce a surface composition similar to that of unused screws. There were no significant differences in PTV or BIC between recycled and unused screws, while the BV of the former was significantly lower than that of the latter (p < 0.05). Conclusions: These results indicate that reuse of recycled orthodontic miniscrews may not be feasible from the biomechanical aspect.

• The korean journal of orthodontics
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• v.49 no.6
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• pp.393-403
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• 2019

Objective: Sliding mechanics using orthodontic miniscrews is widely used to stabilize the anchorage during extraction space closure. However, previous studies have reported that both posterior segment displacement and anterior segment displacement are possible, depending on the mechanical properties of the archwire. The present study aimed to investigate the effect of archwire stiffness and friction change on the displacement pattern of the maxillary posterior segment during anterior segment retraction with orthodontic miniscrews in sliding mechanics. Methods: A three-dimensional finite element model was constructed. The retraction point was set at the archwire level between the lateral incisor and canine, and the orthodontic miniscrew was located at a height of 8 mm from the archwire between the second premolar and first molar. Archwire stiffness was simulated with rectangular stainless steel wires and a rigid body was used as a control. Various friction levels were set for the surface contact model. Displacement patterns for the posterior and anterior segments were compared between the conditions. Results: Both the anterior and posterior segments exhibited backward rotation, regardless of archwire stiffness or friction. Among the conditions tested in this study, the least undesirable rotation was found with low archwire stiffness and low friction. Conclusions: Posterior segment displacement may be unavoidable but reducing the stiffness and friction of the main archwire may minimize unwanted rotations during extraction space closure.

• The korean journal of orthodontics
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• v.33 no.1 s.96
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• pp.11-20
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• 2003

The purpose of the present study is to evaluate the stress distribution on the length and diameter of the miniscrew and cortical bone width. Three dimensional finite element models were made of diameter 1.2mm, 1.6mm, 2.0mm and length 6.0mm, 8.0mm, 10.0mm, 12.0mm and cortical bone width 1.0mm. Also, another three dimensional finite element models were made of diameter 1.2mm, 1.6mm, 2.0mm and length 8.0mm and cortical bone width 1.0mm, 1.5mm, 2.0mm, 2.5mm. Two-hundred grams horizontal force were applied on the center of the miniscrew head and at that stress distribution and its magnitude had been analyzed by ANSYS, which is three dimensional finite element analysis program. The obtained results were as follows : 1. The comparison of the maximum von-Mises stress in the miniscrew showed that as the diameter increases from 1.2mm to 2.0mm stress has been decreased, while on the same diameter stress was not changed regardless of the length change. 2. The comparison of the maximum von-Mises stress in the cortical and cancellous bone showed that as the diameter increases from 1.2mm to 2.0mm stress has been decreased, while on the same diameter stress was not changed regardless of the length change. 3. In the analysis of the stress distribution in the cortical and cancellous bone, the most of the stress had been absorbed in the cortical bone, and did not transmitted much to the cancellous bone. 4. In the analysis of the maximum von-Mises stress according to the cortical bone width, the same diameter of the miniscrew showed a constant stress value regardless of the cortical bone width change. The above results suggest that the maintenance of the miniscrew is more reliable on diameter than length of the miniscrew.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.4
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• pp.427-434
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• 2011

A scissors bite in the posterior teeth occurs when the upper teeth are positioned totally buccal to the lower teeth in centric occlusion, either unilaterally or bilaterally. This malocclusion can result from either excessive width of the maxilla or deficient width of the mandible, or sometimes combination of the both. Scissors bite, when left untreated without a proper dental intervention, interferes with the normal mandibular growth leading to a state where consequent disharmony in dental arch width evokes occlusal disturbances. Therefore, early preventive orthodontic treatment is necessary in patients with scissors bite. Scissors bite rarely involves anterior and posterior sites concuttently across the dental arch but usually affect single tooth. Even in the single tooth scissors bite cases, more likely to be met in the clinical fields, immediate dental intervention is indicated because continuous occlusal forces that exacerbate the already adverse axis of the posterior teeth. In this case study, patients with single tooth scissors bite, each 7, 14, 12, and 16 years old, were each treated with criss-cross elastic, fixed appliance, removable appliance, and miniscrews. With the proper selection of appliances appropriate to each specific cases, good treatment outcome can be achieved without resulting any side effects.

• The korean journal of orthodontics
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• v.48 no.1
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• pp.57-62
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• 2018

Piezoelectric surgery is a novel surgical approach used in orthodontic treatment for rapid tooth movement. This paper presents a case series wherein osseous outgrowths were observed in response to piezosurgery-assisted en-masse retraction. Sixteen patients requiring upper premolar extractions were treated with miniscrew-supported en-masse retraction and received minimally invasive decortication via piezosurgery. Computed tomography (CT) of the maxillary anterior region was performed to investigate the nature of the outgrowths. In 8 of the 16 patients, hemispheric or disc-shaped osseous outgrowths were observed on the sites where piezosurgery was performed during retraction. CT images revealed that these outgrowths were alveolar bone. This case series presents a previously unreported osseous response to piezosurgery-assisted tooth movement during orthodontic treatment. The response is mostly transient and is observed in 50% of the treated patients, suggesting a bone turnover that can be assessed clinically and radiographically.

• The korean journal of orthodontics
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• v.31 no.5 s.88
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• pp.517-523
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• 2001

Titanium miniscrews we being used increasingly as an anchorage for tooth movement, because they ate easy to place and to remove, increase the number of sites available, give minimum strain to patients regarding surgical procedures, and offer uneventful healing alter removal. The use of titanium miniscrews as an orthodontic anchorage has been reported in clinical case reports, but clinicians have experienced screw loosening when using such screws.' To our knowledge, there are no published reports evaluating the stability of miniscrews. Information about the length of miniscrews used in relation to the location is of some importance, as stability will vary depending on bone duality The purpose of this study was to evaluate a variety of Lengths of miniscrews (dimeter: 2mm) which were inserted in maxilla or mandible and to demonstrate in a dog model which miniscrew provides fundamental stability in the jaws. 10 mm long miniscrews in the maxilla and 8mm long: miniscrews in the mandible showed no clinical mobility and retained their position throughout an 8 weeks force (200g) application. The mucosal condition around the screws was healthy in cases in which miniserews were inserted in the alveolar bone between the roots and the head of the screws emerged into the attached gingiva. When the force application was terminated, radiographic analysis revealed neither rent resorption not periodontal pathology around the miniscrews that remained stable during the entire treatment period. This study suggests that if titanium miniscrews with adequate length are properly used depending on the location, they provide sufficient stability for orthodontic anchorage.