The midpalatal suture area has some advantages for supporting miniscrews : it has no specific anatomical structure, it is composed of thick cortical bone, and covered with attached gingiva. So it is suitable area for inserting miniscrews. However, the midpalatal suture area appears thinner when seen in ceph. As a result, Clinicians can misunderstand that inserting miniscrews cause the problem, both the risk of perforation and the decrease of stability. The purpose of this article is measuring the vertical bone thickness of the midpalatal suture area for inserting miniscrews. The total of 25patient (male : 13, female : 12), who are in their twenties, were taken CT. The vertical bone thickness of the midpalatal suture area was measures from the transverse section of CT. As a result, We reached a conclusion from the differences of each area. It is as follows: 1. There is no significant difference between the thickness of male group and that of female group. 2. In coronal section, Bone thickness becomes thinner from the midpalatal suture to Left & Right side, in sagittal section, Bone thickness becomes thinner from incisive foramen to PNS. 3. The area that is within 3mm of left and right from the midpalatal suture area transversely and within 25mm backward from the incisive foramen sagittaly is enough for inserting miniscrews.
The purpose of this study was to find out some relationship between the positional change of mandible during treatment and the prognosis after treatment of ClassIII malocclusion. The patients selected for this study were sucessfully treated two patients, and three patients who wert also sucessful in active treatment but showed relapse during observation. Serial Cephalograms, photos, models, treatment record of these patients were analysed in each term of treatment and observation period. The results might be summarized as follows: The patient with swing back type in which mandible rotated posteroinferiorly during active treatment showed good dental md skeletal relationship during observation. Among the patients with Y-axis type, one who had harmonious growth between maxilla and mandible showed stable dental relationship during observation, the other who had not showed relapse. The swing back type was not changed during and after treatment but the patients who had Y-axis type were unchanged in some patients, and changed into forward type in the others. During active treatment, was lower facial height(ANS-Me) increased in all 5 patients, and in observation period the patients showing increase in lower facial height had stable occlusion but the others having decrease showed unstable dental relationship.
Seo, Hyun-Soo;Lee, Young-Joo;Byeon, Kwang-Seob;Hong, Soon-Min;Park, Jun-Woo;Hong, Ji-Sook;Park, Yang-Ho
Maxillofacial Plastic and Reconstructive Surgery
/
v.33
no.1
/
pp.55-61
/
2011
Conventional slinding genioplsty has the risk of mental nerve injury after operation and difficult to correct vertical asymmetry of chin. So, authors propose a new genioplasty to correct asymmetry of chin. Switching genioplasty is a modification method of conventional genioplasty. Between mandibular right and left canine, osteotomy line of triangular shape make until mandibular lower border. In large side, osteotome line of wedge shape is added to reduction. After osteotomy, segment of wedge shape was separated from chin. Distal segment was rotated to reduction side. Because of rotation of distal segment, space is made in opposite side. Seperated segement of wedge shape from large side is switched this space to fill. So, stability of distal segment is achieved. Authors applied to swiching genioplasty the patients who was remained the chin asymmetry after both sagittal split ramus osteotome was done because mandible asymmetry. After operation, patient and operator were satisfied with excellent esthetic results without any other complication. The switching genioplasty is effective surgical technique for chin asymmetry because it has more advantages than conventional sliding genioplasty. First, other donor side does not need for bone graft. Second, the switching genioplasty can reduce infection, bone resroption, dehiscence, capsular contraction after allograft. Third, have little mental nerve damage. Forth, anteroposterior correction is possible. Fifth, operation time is less than other genioplasty for chin asymmetry.
As people are more concerned about their health and medical care, there have been an increasing number of medical disputes due to increased medical demand. In order to prevent and provide solution to currently surging medical accidents and disputes related to orthodontic treatment, in July 1998, the Korean Association Of Orthdontists surveyed 2,200 members of Korean Association of orthodontists on 30 items to recognize the pattern of medical accidents and prevent them. The survey was about accident-related items including personal profiles of members and patients who have undergone medical accidents or disputes, the cause and solution to the accidents, cautions related to members orthodontic treatment, and medical recording and archival. Based on the survey result, we analyzed characteristics of medical accidents and disputes in orthodontic area. It is more important to predict and prevent possible medical accidents or disputes based on current situation than to solve them after disputes occur. For this, we should not be negligent in raising treatment proficiency level based on patient-doctor trust and in obtaining new medical information. We should also provide medical environment where Patients themselves can decide whether to get treatment after they are offered detailed explanation on diagnosis, treatment procedure, complication, and possible hazard. We should take caution when treating patients and pay attention to charting and maintenance, which is the most fundamental, as well. Also at the Korean Association of orthodontists level, it is desired to provide education program on prevention and solution to medical accidents and disputes, and actions and organizations that can help when accidents and disputes occur.
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.
Cooperation of the patients in orthodontic treatment is an essential element. This study examines the internal and external restriction factors and level of cooperation for orthodontic treatment of adolescent orthodontic treatment patients, and the factors that impart influence on the level of cooperation for orthodontic treatment. 'Form for students' among the indices of internal and external restrictions for orthodontics, which is an adaption of 'Orthodontic Locus of Control Scale' was used as survey tool, and 'Reliability and Stability of the Orthodontic Patient Cooperation Scale' was used as survey tool for the level of cooperation of orthodontic patients. As the result of examination of the effect of internal and external restriction factors on level of cooperation for orthodontic treatment by compensating the general characteristics in the multiple regression analysis, it was found that the level of cooperation for orthodontic treatment is higher for the patients who believe there is strong influence of external restrictions-patents-on the events that determines orthodontic treatment. In order to enhance the level of cooperation for orthodontic treatment of adolescent orthodontic patients, there is a need to assess the relationship between the patient and parents as well as the attitude or psychological state of the patients on orthodontic treatment.
The purpose of this study is to develop the basic algorithm for the finite element method modeling of individual malocclusions. Usually, a great deal of time is spent in preprocessing. To reduce the time required, we developed a standardized procedure for measuring the position of each tooth and a program to automatically preprocess. The following procedures were carried to complete this study. 1. Twenty-eight teeth morphologies were constructed three-dimensionally for the finite element analysis and saved as separate files. 2. Standard brackets were attached so that the FA points coincide with the center of the brackets. 3. The study model of a patient was made. 4. Using the study model, the crown inclination, angulation, and the vertical distance from the tip of a tooth was measured by using specially designed tools. 5. The arch form was determined from a picture of the model with an image processing technique. 6. The measured data were input as a rotational matrix. 7. The program provides an output file containing the necessary information about the three-dimensional position of teeth, which is applicable to several finite element programs commonly used. The program for a basic algorithm was made with Turbo-C and the subsequent outfile was applied to ANSYS. This standardized model measuring procedure and the program reduce the time required, especially for preprocessing and can be applied to other malocclusions easily.
The purpose of this study was to amount of the frictional forces with the brackets and wires, ligation methods, dry/wet, offsets, interbracket distances, velocity and to compare them each other by different conditions. This study tested 0.018'x0.025' slot sized 8 types of orthodontic bracket systems and 0.016', 0.016'x0.022' sized stainless steel, NiTi, Cu-NiTi orthodontic wires. One cuspid bracket were positioned on the slide glass and archwire was engaged into bracket and ligated with elastomeric modules. The values of frictional forces were measured with the instron universal testing machine. The results were as follows; 1. Polycrystalline ceramic bracket had the highest mean frictional forces and followed and by ceramic reinforced plastic bracket, metal bracket, plastic bracket with metal slot, monocrystalline ceramic bracket, single bracket, self-ligating bracket, friction free bracket in descending order. The self-ligating bracket showed low frictional forces in the round wires and high frictional forces in the rectangular wires. 2. Stainless steel wires had the least frictional forces and followed by NiTi, Cu-NiTi wires in descending order. Round wires had lower frictional forces then that of rectangular wires. 3. The stainless steel ligation method had significantly greater mean frictional forces them the elastomeric module ligation method. 4. Artificial saliva statistically increased the frictional forces in stainless steel wire, NiTi wire and Cu-NiTi wire. 5. There was a statistically significant difference with offset change 6. There was no statistically significant difference with interbracket distance in stainless steel wires but a significant difference in NiTi wires as the interbracket was decreased. 7 There was no statistically significant difference with velocity change. From the above findings, self-ligating bracket, stainless steel wires and the elastomeric module ligation method might be effective than any other materials to reduce the frictional forces in the orthodontic treatment and can be correlated to clinical situations seen in orthodontic patient care.
Treatment mechanics should be individualized to be suitable for each patient's personal teeth and anatomic environment to get a best treatment result with the least harmful effects to teeth and surrounding tissues. Especially, the change of biomechanical reaction associated with that of the centers of resistance of teeth should be considered when crown-to-root ratio changed due to problematic root resorption and/or periodontal disease during adult orthodontic treatment. At the present study, in order to investigate patterns of initial displacements of anterior teeth under certain orthodontic force when crown-to-root ratio changed in not only normal periodontal condition but also abnormal periodontal and/or teeth condition, the changes of the centers of resistance for maxillary and mandibular 6 anterior teeth as a segment were studied using the laser reflection technique, the lever & pulley force applicator and the photodetector with these quantified variables reducing alveolar bone 2mm by 2mm for each of maxillary 6 anterior teeth until the total amount of 8mm and root 2mm by 2mm for each of mandibular 6 anterior ones until the total amount of 6mm. The results were as follows: 1. Under unreduced condition, the center of resistance during initial displacement of maxillary 6 anterior teeth was located at the point of about $42.4\%$ apically from cemento-enamel junction(CEJ) of the averaged tooth of them and kept shifting to about $76.7\%$ with alveolar bone reduction. 2. The distance from the averaged alveolar crest level of maxillary 6 anterior teeth to the center of resistance for the averaged tooth of them kept decreasing with alveolar bone reduction, but the ratio to length of the averaged root embedded in the alveolar bone was stable at around $33\%$ regardless of that. 3. Under unreduced condition, the center of resistance during initial displacement of mandibular 6 anterior teeth was located at the Point of about $43\%$ apically from CEJ of the averaged tooth of them and this ratio kept increasing to about $54\%$ with root reduction. But the distance from CEJ to the center of resistance decreased from around 5.3mm to around 3.3mm, that is to say, the center of resistance kept shifting toward CEJ with the shortening of root length. 4. A unit reduction of alveolar bone had greater effects on the change of the centers of resistance than that of root did during initial Phase of each reduction. But both of them had similar effects at the middle region of whole length of the averaged root.
As one of the variations in growth and development of the craniofacial complex. malocclusion shows lack of concordance In the recognition and severity of malocclusion for dentists as well as the acceptance and need of orthodontic treatment for the patient The purposes of this study were 1) to examine the relationships between objective malocclusion severity aid subjective treatment difficulty. 2) to evaluate the effect of malocclusion components to the subjective perceived difficulty of treatment. 3) to establish the weighted values of malocclusion components to reflect the treatment difficulty 100 pairs of dental casts with the general characteristics of malocclusion. were selected from the orthodontic departments of Kyunghee University and Samsuug Medical Center. The severity of malocclusion was evaluated by the author with the PAR index The perceived treatment difficulty and the estimated treatment duration on these dental models were evaluated by 8 experienced orthodontists. The relationships between the objective malocclusion severity and the subjective treatment difficulty were statistically evaluated. and the weighted values of malocclusion components to reflect treatment difficulty were statistically formulated. There were significant relationships between objective malocclusion severity and subjective treatment difficulty The malocclusion components which significantly affected the treatment difficulty and their weighted values in parentheses were as follows upper anterior alignment(1). overbite (2). buccal occlusion (3) middline (4), and overjet (5). This study Provides the fundamental principle to evaluate the objective malocclusion severity which is reflected by the subjective treatment difficulty of Korean orthodontists.
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