• 대한치과교정학회지
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• 제52권4호
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• pp.298-307
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• 2022

Glossectomy combined with radiotherapy causes different levels of tongue function disorders and leads to severe malocclusion, with poor periodontal status in cancer survivors. Although affected patients require regular access to orthodontic care, special considerations are crucial for treatment planning. This case report describes the satisfactory orthodontic management for the correction of severe dental crowding in a 43-year-old female 6 years after treatment for tongue cancer with total glossectomy combined with radiotherapy, to envision the possibility of orthodontic care for oral cancer survivors. Extraction was performed to correct dental crowding and establish proper occlusion following alignment, after considering the possibility of osteoradionecrosis. Orthodontic mini-implants were used to provide skeletal anchorage required for closure of the extraction space and intrusion of the anterior teeth. The dental crowding was corrected, and Class I occlusal relationship was established after 36 months of treatment. The treatment outcome was sustained after 15 months of retention, and long-term follow-up was recommended.

• 대한치과의사협회지
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• 제57권11호
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• pp.654-663
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• 2019

This case report describes the management of a 30-year-old woman with hopeless mandibular first molars and right maxillary second premolar. The treatment plan included mandibular second and third molar protraction after extraction of mandibular first molars. Mini-implants were placed between roots of first and second premolar. Sliding mechanics with lever arm was used to prevent inclination of molars. A good functional occlusion was achieved in 38 months without clinically significant side effects. Most of the extraction space of mandibular first molar was closed by protraction of second and third molars. The skeletal Class II pattern was improved by counterclockwise rotation of mandible through reduction of wedge effect. Mandibular molar protraction with orthodontic mini-implants in adequate cases would be a great alternative to prosthetic implant and reduce the financial and surgical burden of patients.

• 대한치과교정학회지
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• 제44권5호
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• pp.236-245
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• 2014

Objective: To evaluate the therapeutic effects of a preformed assembly of nickel-titanium (NiTi) and stainless steel (SS) archwires (preformed C-wire) combined with temporary skeletal anchorage devices (TSADs) as the sole source of anchorage and to compare these effects with those of a SS version of C-wire (conventional C-wire) for en-masse retraction. Methods: Thirty-one adult female patients with skeletal Class I or II dentoalveolar protrusion, mild-to-moderate anterior crowding (3.0-6.0 mm), and stable Class I posterior occlusion were divided into conventional (n = 15) and preformed (n = 16) C-wire groups. All subjects underwent first premolar extractions and en-masse retraction with preadjusted edgewise anterior brackets, the assigned C-wire, and maxillary C-tubes or C-implants; bonded mesh-tube appliances were used in the mandibular dentition. Differences in pretreatment and post-retraction measurements of skeletal, dental, and soft-tissue cephalometric variables were statistically analyzed. Results: Both groups showed full retraction of the maxillary anterior teeth by controlled tipping and space closure without altered posterior occlusion. However, the preformed C-wire group had a shorter retraction period (by 3.2 months). Furthermore, the maxillary molars in this group showed no significant mesialization, mesial tipping, or extrusion; some mesialization and mesial tipping occurred in the conventional C-wire group. Conclusions: Preformed C-wires combined with maxillary TSADs enable simultaneous leveling and space closure from the beginning of the treatment without maxillary posterior bonding. This allows for faster treatment of dentoalveolar protrusion without unwanted side effects, when compared with conventional C-wire, evidencing its clinical expediency.

• 대한소아치과학회지
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• 제21권2호
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• pp.510-517
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• 1994

It is a relatively common clinical experience to see a impacted maxillary central incisor. This is apparent at the dental age of about eight years and over, when the patient is in the early mixed dentition stage. The adjacent teeth may tilt toward the site of the missing tooth with resulting space closure and midline deviation. Most often, the central incisor is impacted labially. The labial impaction has been indicated as the most difficult to manage. Each of the current articles describing labial impactions shows at least one case with mucogingival recession or a minimal zone of attached gingiva. This report described the surgical uncovering and orthodontic-physiologic positioning methods with labially impacted maxillary central incisors. Through surgical exposure and direct bonding of lingual botton, the central incisors were brought into proper eruption path with elastic traction. The case 1 and 2 were treated with the physiologic erupting forces. The case 3 was applied with continuous orthodontic force. The case 1 and 2 resulted in good positioning, good esthetics and adequate width of keratinised gingiva. The case 3 resulted in local inflammation and inadequate width of keratinised gingiva.

• Journal of Periodontal and Implant Science
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• 제53권1호
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• pp.2-19
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• 2023

Purpose: Surgical techniques in orthodontics have received widespread attention in recent years. Meanwhile, biomaterials with high molecular content have been introduced, such as platelet concentrates (PCs), which may accelerate orthodontic tooth movement (OTM) and reduce periodontal damage. The present systematic review aimed to answer the following PICO question: "In patients in whom orthodontic surgical techniques are performed (P), what is the effectiveness of using PCs over the surgical site (I) when compared to not placing PCs (C) to achieve faster tooth movement (O)?" Methods: A search was performed in 6 databases. The criteria employed were those described in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses declaration. The present review included studies with a control group that provided information about the influence of PCs on the rate of OTM. Results: The electronic search identified 10 studies that met the established criteria. Conclusions: The included studies were very diverse, making it difficult to draw convincing conclusions. However, a tendency was observed for OTM to be accelerated when PCs were used as an adjuvant for canine distalization after premolar extraction when distalization was started in the same session. Likewise, studies seem to indicate an association between PC injection and the amount of canine retraction. However, it is not possible to affirm that the use of PCs in corticotomy shortens the overall treatment time, as this question has not been studied adequately.

• 대한치과교정학회지
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• 제27권6호
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• pp.905-916
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• 1997

본 연구는 교정치료시 발치가 안모의 수직 변화에 어떠한 영향을 미치는지 규명하기 위해서 비발치군과 발치군으로 구분하였고, 발치군은 비교분석을 위해 제1소구치 발치군, 제2소구치 발치군, 제2대구치 발치군으로 구분하여 교정치료 전, 후의 안모의 수직변화 여부를 평가함으로서 발치가 안모의 수직변화에 미치는 영향을 규명하고자 했다. 연구대상은 조선대학교 부속치과병원 교정과에 내원하여 교정치료를 받은 환자 중, 제2대구치까지 맹출하여 성장에 의한 변화요인이 적다고 인정되는 비발치군 남녀 50명, 발치군 남녀 88명으로 하였으며, 비발치군은 비교분석을 위해 42명의 제1소구치 발치군, 24명의 제2소구치 발치군, 22명의 제2대구치 발치군으로 구분하였다. 안모의 수직변화 여부를 규명할 수 있는 14개의 두부방사선 계측항목을 선정하여 교정치료 전, 후의 안모의 수직변화량을 측정하였고, $SPSS/PC^+$ 통계프로그램을 이용하여 교정치료 전, 후의 안모의 수직변화여부를 비교 분석함으로 써 다음과 같은 결과를 얻었다. 1. 교정적 발치여부에 관계없이 모든 군에서 교정치료 전,후의 두부방사선 계측치 사이에 통계학적인 유의성이 없었다. 2. 상, 하악 구치는 모든 군에서 교정치료에 의해 정출되었다. 이는 대부분의 교정치료의 역계 자체가 치아를 정출시키는 기전을 지니고 있음을 의미하며, 특히 발치에 의한 교정치료시 발치공간 폐쇄 및 치아배열을 위해 작용되는 역계로 인해 일어나는 결과로 보인다. 3. 제 2재구치 발치군에서 안모의 수직고경은 교정치료 후에 모두 증가되었다. 이는 치아배열 공간을 확보하기 위해 치열이 후방이동된 결과로 보인다. 4. 교정적 발치와 안모의 수직변화 사이에는 통계학적인 유의성이 없었다. 이는 안모의 수직변화와 교정적 발치는 아무런 관련이 없음을 나타낸다. 5. 두부방사선 계측항목 중 안모의 수직변화에 있어서 각 군 사이에 통계학적으로 유의성 있는 영향을 미치는 항목은 PP-MP, OP-MP, $\underline{1}$ to PP, $\overline{1}$ to MP였다.

• 대한치과교정학회지
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• 제33권1호
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• pp.21-29
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• 2003

최근 컴퓨터 소프트웨어의 발전으로 환자의 모형을 scanning하여 3차원 가상 모델을 만드는 것이 가능하게 되었다. 이러한 모델은 컴퓨터로 처리되어 치료 시작부터 끝까지 여러 단계의 치아 이동이 이루어지고, 치아 이동의 각 단계별로 stereolithographic model이 만들어 지는데, 이는 일련의 투명하고 얇은 overlay 장치를 제작하는 기초가 된다. 계획된 치아 이동의 단계에 따라 치아를 움직이기 위해서는 환자가 장치를 항상 사용해야 하며, 중정도의 crowding과 공간 폐쇄는 이 장치로 치료가 용이하다는 것이 입증되었다. 지금까지 이 장치를 경험해 본 결과, 고정성 교정장치에 비해 환자가 불편을 덜 느끼고 심미성과 구강 청결이 좋아 환자의 협조도가 뛰어 났다. 이 장치는 완전히 맹출된 영구치열 환자에서 부정교합에 대한 또 하나의 유용한 접근법이라 할 수 있다.

• 대한치과교정학회지
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• 제24권4호
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• pp.759-772
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• 1994

Orthodontists have experienced the treatment of cases with three lower incisors. Occasionally a lower incisor was either congenitally missing or so seriously damaged by injury or disease that its removal presented the best prospect for the patient. Sometimes the intentional extraction of a lower incisor is needed to produce enhanced functional and esthetic results with minimal orthodontic manipulation. Such cases have unfavorable anterior tooth size discrepancies and present difficulties in achieving good occlusal results. However such difficulties can be overcome by the sensible diagnosis and treatment plan. Three different cases are presented and the conclusions are listed. 1. It is important for orthodontist who tries to treat three lower incisor cases to measure and calculate accurately the degree of deviation of tooth size and morphology and the anterior tooth size ratio. 2. A diagnostic setup model should be made to determine whether the incisor extraction is appropriate and space closure is needed or not. It is the best way to be sure that the occlusal results, including overbite and overjet, will be acceptable and how far the degree of midline deviation is. It also shows the amount of interproximal reduction to achieve an acceptable occlusal result. 3. The class I relationship between the upper canine and the lower one must be obtained to establish the canine rise during eccentric movement by the concept of mutually protective occlusion. It also helps to maintain the stable occlusal result.

• Journal of Korean Dental Science
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• 제16권2호
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• pp.115-127
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• 2023

The demand for orthodontic clear aligner therapy (CAT) has increased significantly over the last decade, offering advantages over the fixed appliances (FA) including enhanced aesthetics, better hygiene and comfort, along with minimal restrictions on the patient's diet. Moreover, a marked improvement in the efficacy of tooth movement using aligners has been documented. On the contrary, there have been known limitations of CAT including the compliances issues and the apparent lack of efficacy for certain types of tooth movement such as closure of extraction space compared to FA. Thus, evidence-based evaluation of the accuracy of prediction of tooth movement with clear aligners and their ability to effectively perform major tooth and root movements compared to FA are crucial. Although several systematic reviews have investigated various aspects of the effectiveness of CAT, we are yet to obtain a rather conclusive answer to this question. The current review attempted to summarize the evidence-based findings of most systematic reviews about CAT available to date. Major issues regarding the predictability of tooth movement, the role of attachments and auxiliaries in improving the effectiveness of CAT, and the treatment outcomes in comparison to FA were investigated. Clinical recommendation have been also elaborated based on the interpretation of the findings of all systematic reviews included in this study.

• 대한심미치과학회지
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• 제10권1호
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• pp.30-45
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• 2001

In recent years, clinicians' and dentists' esthetic demands in dentistry have increased rapidly. The ultimate goal in modern restorative dentistry is to achieve "white" and "pink" esthetics in the esthetically important zones. Therefore, modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. Interdental space are filled by interdental papilla in the healthy gingiva, preventing plaque deposition and protecting periodontal tissue from infection. This also inhibits impaction of food remnants and whistling through the teeth during speech. These functional aspects are obviously important, but esthetic aspects are important as well. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. One of the most challenging and least predictable problems is the reconstruction of the lost interdental papilla. The interdental papilla, as a structure with minor blood supply, was left more or less untouched by clinicians. Most of the reconstructive techniques to rebuild lost interdental papillae focus on the maxillary anterior region, where esthetic defects appear interproximally as "black triangle". Causes for interdental tissue loss are, for example, commom periodontal diseases, tooth extraction, excessive surgical periodontal treatment, and localized progressive gingiva and periodontal diseases. If an interdental papilla is absent because of a diastema, orthodontic closure is the treatment of choice. "Creeping" papilla formation has been described by closing the interdental space and creating a contact area. In certain cases this formation can also be achieved with appropriate restorative techniques and alteration of the mesial contours of the adjacent teeth. The presence of an interdental papilla depends on the distance between the crest of bone and the interproximal contact point, allowing it to fill interdental spaces with soft tissue by altering the mesial contours of the adjacent teeth and positioning the contact point more apically. The interdental tissue can also be conditioned with the use of provisional crowns prior to the definitive restoration. If all other procedures are contraindicated or fail, prosthetic solutions have to be considered as the last possibility to rebuild lost interdental papillae. Interdental spaces can be filled using pink-colored resin or porcelain, and the use of a removable gingival mask might be the last opportunity to hide severe tissue defects.