• The korean journal of orthodontics
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• v.52 no.5
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• pp.372-382
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• 2022

Anterior open bite and transverse discrepancy are often accompanied by hyperdivergent skeletal patterns. In addition, degenerative joint disorders and vertical maxillary excess contribute to an unfavorable convex facial profile with a retruded chin. Correction of this complex three-dimensional problem with orthodontic treatment alone is considered challenging owing to anatomical limitations. Moreover, a history of orthodontic treatment with premolar extraction makes retreatment difficult. This case report illustrates the application of a maxillary tissue bone-borne expander and biocreative reverse curve system in a 23-year-old female patient with a severe anterior open bite and transverse discrepancy who underwent orthodontic treatment with four premolar extractions. By setting the treatment target under precise diagnosis and using appropriate appliances, a satisfactory treatment result could be achieved without orthognathic surgery.

• Journal of Korean Dental Science
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• v.3 no.1
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• pp.5-10
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• 2010

This study sought to compare the amounts of posterior anchorage loss during the en masse retraction of the upper anterior teeth between orthodontic mini-implant (OMI) and conventional anchorage reinforcement (CAR) such as headgear and/or transpalatal arch. The subjects were 52 adult female patients treated with sliding mechanics (MBT brackets, .022" slot, .019X.025" stainless steel wire, 3M-Unitek, Monrovia, CA, USA). They were allocated into Group 1 (N=24, Class I malocclusion (CI), upper and lower first premolar (UP1LP1) extraction, and CAR), Group 2 (N=15, Cl, UP1LP1 extraction and OMI), and Group 3 (N=13, Class II division 1 malocclusion, upper first and lower second premolar extraction, and OMI). Lateral cephalograms were taken before (T0) and after treatment (T1). A total of 11 anchorage variables were measured. Analysis of variance was used for statistical analysis. There was no significant difference in treatment duration and anchorage variables at T0 among the three groups. Groups 2 and 3 showed significantly larger retraction of the upper incisor edge (U1E-sag, 9.3mm:7.3mm, P<.05) and less posterior anchorage loss (U6M-sag, 0.7~0.9mm:2mm, P<.05; U6A-sag, 0.5mm:2mm, P<.01) than Group 1. The ratio of retraction amount of the upper incisor edge per 1 of anchorage loss in the upper molar made for the significant difference between Groups 1 and 2 (4.6mm:7.0mm, P<.05). Group 3 showed a relatively distal inclination of the upper molar (P<.05) and the intrusion of the upper incisor and first molar (U1E-ver, P<.05; U6F-ver, P<.05) compared to Groups 1 and 2. Although OMI could not shorten the treatment duration, it could provide better maximum posterior anchorage than CAR.

• The korean journal of orthodontics
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• v.48 no.4
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• pp.224-235
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• 2018

Objective: The purpose of this study was to compare the skeletal, dental, and soft-tissue treatment effects of nonextraction therapy using the modified C-palatal plate (MCPP) to those of premolar extraction (PE) treatment in adult patients with Class II malocclusion. Methods: Pretreatment and posttreatment lateral cephalographs of 40 adult patients with Class II malocclusion were retrospectively analyzed. The MCPP group comprised 20 patients treated with total arch distalization of the maxillary arch while the PE group comprised 20 patients treated with four PE. Fifty-eight linear and angular measurements were analyzed to assess the changes before and after treatment. Descriptive statistics, paired t-test, and multivariate analysis of variance were performed to evaluate the treatment effects within and between the two groups. Results: The MCPP group presented 3.4 mm of retraction, 1.0 mm of extrusion, and $7.3^{\circ}$ lingual inclination of the maxillary central incisor. In comparison, the PE group displayed greater amount of maxillary central incisor retraction and retroclination, mandibular incisor retraction, and upper lip retraction (5.3 mm, $14.8^{\circ}$, 5.1 mm, and 2.0 mm, respectively; p < 0.001 for all). In addition, the MCPP group showed 4.0 mm of distalization and 1.3 mm of intrusion with $2.9^{\circ}$ distal tipping of the maxillary first molars. Conclusions: These findings suggest the MCPP is an effective distalization appliance in the maxillary arch. The amount of incisor retraction, however, was significantly higher in the PE group. Therefore, four PE may be recommended when greater improvement of incisor position and soft-tissue profile is required.

• The korean journal of orthodontics
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• v.47 no.2
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• pp.100-107
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• 2017

Objective: To analyze the long-term changes in maxillary arch widths and buccal corridor ratios in orthodontic patients treated with and without premolar extractions. Methods: The study included 53 patients who were divided into the extraction (n = 28) and nonextraction (n = 25) groups. These patients had complete orthodontic records from the pretreatment (T1), posttreatment (T2), and postretention (T3) periods. Their mean retention and postretention times were 4 years 2 months and 17 years 8 months, respectively. Dental models and smiling photographs from all three periods were digitized to compare the changes in three dental arch width measurements and three buccal corridor ratios over time between the extraction and nonextraction groups. Data were analyzed using analysis of variance tests. Post-hoc multiple comparisons were made using Bonferroni correction. Results: Soft-tissue extension during smiling increased with age in both groups. The maximum dental width to smile width ratio (MDW/SW) also showed a favorable increase with treatment in both groups (p < 0.05), and remained virtually stable at T3 (p > 0.05). According to the MDW/SW ratio, the mean difference in the buccal corridor space of the two groups was $2.4{\pm}0.2%$ at T3. Additionally, no significant group ${\times}$ time interaction was found for any of the buccal corridor ratios studied. Conclusions: Premolar extractions did not negatively affect transverse maxillary arch widths and buccal corridor ratios. The long-term outcome of orthodontic treatment was comparable between the study groups.

• Journal of Periodontal and Implant Science
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• v.33 no.4
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• pp.705-715
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• 2003

Procedures for treatment of molar furcation invasion defects range from open flap debridement, apically repositioned flap surgery, hemisection, tunneling or extraction, to regenerative therapies using bone grafting or guided tissue regenerative therapy, or a combination of both. Several clinical evaluations using regenerative techniques have reported the potential for osseous repair of treated furcation invasions. Regenerative treatment of maxillary molars are more difficult due to the multiple root anatomy and multiple furcation entrances therefore, purpose of this study was to evaluated histologically compomer and Ketac Silver as a barrier in the treatment of a bi-furcated maxillary premolar. Five adult beagle dogs were used in this experiment. With intrasulcular and crestal incision, mucoperiostcal flap was elevated. Following decortication with 1/2 high speed round bur, furcation defect was made on maxillary premolar. 2 month later one premolar was filled with compomer and the other premolar was filled with Ketac Silver. After 4, 8 weeks, the animals were sacrificed by vascular perfusion. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. Results were as follows. 1. Compomer & Ketac Silver restoration were encapsulated fine connective tissue. 2. In 4 weeks, compomer & Ketac Silver restoration slightly infiltrated inflammatory cells but not disturb the new bone or new cementum formation. 3. In 8 weeks, compomer & Ketac Silver restoration were less infiltrated iflammatory cell and encapsulated fine connective tissue. 4. Therefore, compomer & Ketac Silver filling to the grade III maxillary furcations with multiple root anatomy and multiple furcation entrances is possible clinical method and this technique is useful method for maxillary furcation involvement but it is thought that periodic maintenance should be needed

• Journal of Periodontal and Implant Science
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• v.35 no.2
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• pp.371-381
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• 2005

The masticatory function of tooth is maintained by the periodontal health, and periodontal health is also maintained by the masticatory function. Bite forces are withstanded by the PDL, and this thought to be through the viscoelastic theory. Mobility test and Bite force test are used to evaluate the viscoelastic theory of the PDL. In this study, the bite force test was used. In the same conditions of quantity of the supporting tissue, the maximum bite force according to the quality of the supporting tissue was evaluated. The study was conducted on 40 patients with moderate adult periodontitis, who were indications to the modified widman flap treatment. The maximum bite force in the premolar and molar regions were tested before treatment, 3weeks and 4 weeks after treatment. and the results were as follows. 1. In the premolar region, 3 weeks and 4 weeks after treatment showed higher maximum bite force than before treatment. And in the molar region the maximum bite force decreased 3 weeks after treatment, but increased after 4 weeks, compared to before treatment. 2. In the 1st premolar, there were only significant difference between before and 3 weeks after treatment, and between and 4 weeks after treatment. 3. In the 2nd premolar, there were only significant difference between before and 3 weeks after treatment, and between and 4 weeks after treatment. 4. In the 1st molar, there were no significant difference between before, 3 weeks after treatment, 4 weeks after treatment. 5. In the 2nd molar, there were no significant difference between before, 3 weeks after treatment, 4 weeks after treatment. From the results above, it shows that there were improvements in the maximum bite force through specific periodontal treatments, and thus it can be considered in clinical situations, that selection of the prosthodontic material, decisions of extraction, evaluation of the prognosis after periodontal treatment is a helpful method.

• The korean journal of orthodontics
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• v.40 no.3
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• pp.176-183
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• 2010

Objective: This study was performed to evaluate functional changes of occlusion after orthodontic treatment by measuring the occlusal force (OcFr) and occlusal contact area (OcAr), and to compare OcFr and OcAr change according to premolar extractions. Methods: Data were obtained from 74 patients who had finished orthodontic treatment using fixed appliance aged between 18 and 40 years. Subjects were divided into groups who had four premolars extractions or non-extraction (Male extraction-16, Male nonextraction-18, Female extraction-19, Female nonextraction-21). All subjects were asked to bite pressure-sensitive sheets into maximum intercuspation with maximum bite force, and OcFr and OcAr were evaluated by measuring the sheet with a CCD camera. Records were taken right after debonding, 1 week, 1 month, 3 months, 6 months and 1 year after debonding. Results: OcFr and OcAr increased gradually in all groups during the 1 year retention period (p < 0.05). Male groups showed higher OcFr and OcAr than female groups throughout the retention periods (p < 0.05). There were no statistically significant differences of OcFr and OcAr between extraction and non-extraction groups in both males and females (p > 0.05). Conclusions: Occlusion was improved functionally throughout the 1 year retention, and premolar extraction did not induce a decline in the functional aspect of occlusion.

• The korean journal of orthodontics
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• v.31 no.2 s.85
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• pp.199-207
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• 2001

The segmented TMA T-loop spring, used for reciprocal space closure and described by Burstone, was used to achievebodily movement of canine. Photoelastic analysis is a technique for the transformation of internal stress into visible light patterns. The two-dimensional photoelastic stress analysis was performed, and stress distribution was recorded by photography. The purpose of this study was to visualize photoelastically the distribution of forces transmitted to the alveolus and surrounding structures using new segmented TMA T-loop spring for canine retraction. The results were as follows: 1. Decreased activation produced decreased stress of upper 1st. premolar extraction site and increased intrusive stress of upper 1st. molar, regardless of T-loop position. 2. At 5mm activation, More posterior positioning of T-loop Produced an increased stress in upper 1st. premolar extraction site. 3. At 3mm activation, More posterior positioning of T-loop produced an increased stress in upper 1st. premolar extraction site and mesial lower half of upper 1st. molar mesio-buccal root. 4. At 1mm activation, More anterior positioning of T-loop produced an increased stress in upper mesial and blew apex area of upper canine root. 5. 0.25 B/L ratio and 3mm activation produced bodily movement of canine. To summarize, desired tooth movement and anchorage requirement is possible by altering the activation and mesio-distal position of the T-loop spring.

• The korean journal of orthodontics
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• v.26 no.5 s.58
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• pp.487-495
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• 1996

The purpose of this study was to evaluate the dentofacial characteristics and the fost-treatment dentofacial changes of those treated by four premolar extractions and to investigate the factors affecting extraction decision. The sample consisted of 35 patients (27 females, and 8 males) with no more than 7.0mm crowding, diagnosed as Class I protrusion. Pre-treatment and post-treatment lateral cephalograms were evaluated. Computerized statistical analysis was carried out using SPSS/PC+ program. The results were as follows. 1. There was no significant change in skeletal pattern after treatment while there was significant change in dentoalveolar and soft tissue pattern. 2. In pre-treatment skeletal pattern, a tendency toward vertical discrepancy was found. 3. In pre-treatment dental pattern, interincisal angle was $113.11^{\circ}$, U1 to FH was $117.78^{\circ}$ and L1 to A-Pog was 7.94mm. Pre-treatment upper and lower lip position was 2.88mm and 5.43mm to E line. 4. After treatment, interincisal angle increased $14.46^{\circ}$ and upper and lower lip moved back 2.45mm and 3.2mm to E line.(p<0.001) 5. The EI was 138.71 before treatment and 148.2 after treatment.

• The korean journal of orthodontics
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• v.27 no.6 s.65
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• pp.905-916
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• 1997

The purpose of this investigation were to evaluate facial vortical changes occurring in patients treated orthodontically with first premolar, second remolar and second molar extractions : to compare these changes with those occurring in patients treated orthodontically without extractions : and finally, to evaluate the effects of extractions in facial vortical changes. Cephalometric records of 50 male & female nonextraction patients and 88 male & female extraction patients were obtained from the department of orthodontics at Chosun University, College of Dentistry. The second molar fully erupted pPatients to have little variation according to growth were chosen as the sample for this investigation. For comparisons, the samples of 88 male & female extraction patients were subdivided into 42 first premolar extraction, 24 second premolar extraction, and 22 second molar extraction patients. Fourteen cephalometric measurements were selected to examine whether orthodontic extraction treatment led to vertical changes or not. The pretreatment and posttreatment lateral cephalographs were taken on the same radiographic unit. $SPSS/PC^+$ statistical program was used to compare and to analyze the changes between 'before & after' orthodontic treatment. The results of this study were as follows. 1. There were no statistical significances in any cephalometric measurements between 'before & after' orthodontic treatment regardless of orthodontic extractions for each group. 2. On average, the upper 6 to palatal Plane and the lower 6 to mandibular plane after orthodontic treatment were increased in all group. This means most of orthodontic mechanics are extrusive in nature. Especially, in orthodontic extraction. cases, it may be caused by orthodontic mechanics for space closure and alignments. 3. On average, in the second molar extraction group, the facial vertical dimension was increased after orthodontic treatment. It nay be induced as a result of moving the molars distally to gain enough space to correct the molar relationship and to simultaneously improve the deep bite. 4. There was no statistical significance between orthodontic extractions and facial vertical changes. This means that orthodontic extractions have no influence on facial vortical changes. 5. The cephalometric measurements with statistical significance in ficial vertical changes for each group were PP-MP, Op-MP, $\underline{1}$ to PP and $\overline{1}$ to MP.