• 대한치과교정학회지
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• 제49권3호
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• pp.188-193
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• 2019

Objective: The aim of this finite element study was to clarify the mechanics of tooth movement in palatal en-masse retraction of segmented maxillary anterior teeth by using anchor screws and lever arms. Methods: A three-dimensional finite element method was used to simulate overall orthodontic tooth movements. The line of action of the force was varied by changing both the lever arm height and anchor screw position. Results: When the line of action of the force passed through the center of resistance (CR), the anterior teeth showed translation. However, when the line of action was not perpendicular to the long axis of the anterior teeth, the anterior teeth moved bodily with an unexpected intrusion even though the force was transmitted horizontally. To move the anterior teeth bodily without intrusion and extrusion, a downward force passing through the CR was necessary. When the line of action of the force passed apical to the CR, the anterior teeth tipped counterclockwise during retraction, and when the line of action of the force passed coronal to the CR, the anterior teeth tipped clockwise during retraction. Conclusions: The movement pattern of the anterior teeth changed depending on the combination of lever arm height and anchor screw position. However, this pattern may be unpredictable in clinical settings because the movement direction is not always equal to the force direction.

• 대한치과교정학회지
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• 제53권4호
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• pp.276-285
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• 2023

Objective: The aim of this retrospective study was to compare changes in hard tissue and soft tissue after the four first premolars were extracted with anterior teeth retraction according to the presence or absence of lip incompetence. Methods: Patients who underwent the four first premolars were extracted with anterior teeth retraction were divided into competent (n = 20) and incompetent lip (n = 20) groups. Cephalometric measurements for hard tissue and soft tissue changes were performed pre-treatment and post-treatment. Results: In the competent group, the upper and lower lips retreated by 2.88 mm and 4.28 mm, respectively, and in the incompetent group by 4.13 mm and 5.57 mm, respectively; the differences between the two groups were significant (p < 0.05). A strong positive correlation between retraction of the upper lip and upper incisors was observed in both groups (p < 0.05), whereas a correlation between retraction of the lower lip and lower incisors was only found in the incompetent group. A simple linear regression analysis showed that the pattern of lip retraction following the retraction of the anterior teeth was more predictable in the incompetent group than in the competent group. Conclusions: These findings suggest that the initial evaluation of lip incompetence in patients with skeletal Class II is essential for the accurate prediction of the soft tissue changes following retraction of the anterior teeth in premolar extraction treatment. Therefore, sufficient explanation should be provided during patient consultations.

• 대한치과교정학회지
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• 제49권5호
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• pp.279-285
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• 2019

Objective: This study evaluated the efficiency of anchorage provided by temporary anchorage devices (TADs) in maxillary bicuspid extraction cases during retraction of the anterior teeth using a fixed appliance. Methods: Patients aged 12 to 50 years with malocclusion for which bilateral first or second maxillary bicuspid extractions were indicated were included in the study and randomly allocated to the TAD or control groups. Retraction of the anterior teeth was achieved using skeletal anchorage in the TAD group and conventional dental anchorage in the control group. A computed tomography (CT) scan was performed after alignment of teeth, and a second CT scan was performed at the end of extraction space closure in both groups. A three-dimensional superimposition was performed to visualize and quantify the maxillary first molar movement during the retraction phase, which was the primary outcome, and the stability of TAD movement, which served as the secondary outcome. Results: Thirty-four patients (17 in each group) underwent the final analysis. The two groups showed a significant difference in the movement of the first maxillary molars, with less significant anchorage loss in the TAD group than that in the control group. In addition, TAD movement showed only a slight mesial movement on the labial side. On the palatal side, the mesial TAD movement was greater. Conclusions: In comparison with conventional dental anchorage, TADs can be considered an efficient source of anchorage during retraction of maxillary anterior teeth. TADs remain stable when correctly placed in the bone during the anterior tooth retraction phase.

• 대한치과교정학회지
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• 제49권6호
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• pp.381-392
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• 2019

Objective: The objective of this two-arm parallel trial was to compare the type of tooth movement during en masse retraction of the maxillary anterior teeth using labial versus lingual biocreative therapy. Methods: Twenty-eight subjects were randomized in a 1 : 1 ratio to either the labial or lingual group. En masse anterior retraction was performed using labial biocreative therapy in group A and lingual biocreative therapy in group B. Cone beam computed tomography scans were taken before and after retraction and the primary outcome was the type of tooth movement during anterior retraction. Data were analyzed using paired t-tests for comparisons within each group and independent-sample t-test for comparison of the mean treatment changes between the two groups. Results: Significant differences were found between the two groups in relation to the type of tooth movement (labiolingual inclination of the central incisor; mean difference, $5.85{\pm}1.85^{\circ}$). The canine showed significant distal tipping in the lingual group (mean difference, $6.98{\pm}1.25^{\circ}$). The canine was significantly more intruded in the lingual group (mean difference, $1.67{\pm}0.49mm$). Good anchorage control and significant soft tissue changes occurred in both groups. No serious adverse effects were detected. Conclusions: With a 10-mm retraction hook, the labial biocreative technique with the reverse curve overlay provided anterior retraction with good torque control, while in the lingual group, anterior retraction occurred with controlled tipping movement with significant distal tipping and intrusion of the canine (trial registration: The trial was registered at ClinicalTrials.gov [NCT03239275]).

• 대한치과교정학회지
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• 제51권1호
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• pp.32-42
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• 2021

Objective: To investigate the three-dimensional forces created by clear aligners on mandibular teeth during differential activation with en-masse retraction and/or intrusion in vitro. Methods: Six sets of clear aligners were designed for differential en-masse retraction and/or intrusion procedures in a first premolar extraction model. Group A0 was a control group with no activation. Groups A1-5 underwent different degrees of retractions and/or intrusions. Each group consisted of 10 aligners. Aligner forces were measured on a multi-axis force/torque transducer measurement system in real-time. Results: In the en-masse retraction groups (A1 and A2), lingual and extrusive forces were observed on the incisors; the canines mainly received distal forces; intrusive forces were seen on the second premolars; and the molars received mesial forces. In the en-masse retraction and intrusion groups (A3, A4, and A5), incisors also received lingual and extrusive forces; canines received distal and intrusive forces; mesial and extrusive forces were seen on the second premolars; and the second molars received distal and intrusive forces. The vertical forces on the incisors did not differ significantly among groups A1, A3, and A5. However, the vertical forces on the second premolars reversed from intrusion in group A1 to extrusion in groups A3 and A5. Conclusions: With clear aligners, the "bowing effect" is seen during en-masse anterior teeth retraction and can be partially relieved by performing en-masse retraction accompanied by anterior teeth intrusion. Vertical control of incisors remained unsolved during en-masse retraction, even when intrusive activation was added to the anterior teeth.

• 대한치과교정학회지
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• 제32권3호
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• pp.165-174
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• 2002

본 연구의 목적은 상하악 제 1소구치를 발거하고, 6전치 일괄(en masse)견인과, 견치 견인 후 4전치 견인 시, 구치부의 고정원 소실과 전치부의 후방이동량, 치축변화량, 전치부와 구치부의 수직적변화에 대해 비교하는 것이다. 만 17세 이상의 성인 여자이며, 1급 구치 관계이고, 상하악 밀생(crowding)이 각각 4mm이하인 전돌(protrusion) 환자이며, 상하악 제 1소구치를 발거하고 .022" straight wire appliance로 치료하였으며, TPA를 사용하지 않았고, head gear와 같은 구외고정원을 사용하지 않은 총 30명의 환자를 대상으로 하였다. 그중 6전치 일괄(on masse) 견인을 시행한 제 1군 15명과 견치 견인 후4전치 견인을 시행한 제 2군 15명에 대해, 치료전후의 두부방사선 계측사진을 투사하여 비교 분석하였다. 각 군에 대한 치료 전 후의 변화를 independent samples t-test를 이용하여 통계처리 하였으며, 다음과 같은 결론을 얻었다. 1. 두 군에서 구치부의 고정원 소실량에는 차이가 없었다. 2. 두 군에서 전치부의 후방이동량에는 차이가 없었다. 3. 두 군에서 전치부의 치축변화량은 제 2군에서 다소 컸다. 4. 두 군에서 전치부 절단연의 수직적 변화는, 제 2군에서 약 1mm 정도의 정출이 더 나타났다. 5. 두 군에서 전치부 치근첨과 구치부의 수직적 변화에는 차이가 없었다.

• 대한치과교정학회지
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• 제47권3호
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• pp.158-166
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• 2017

Objective: To investigate how bracket slot size affects the direction of maxillary anterior tooth movement when en-masse retraction is performed in sliding mechanics using an induction-heating typodont simulation system. Methods: An induction-heating typodont simulation system was designed based on the Calorific Machine system. The typodont included metal anterior and resin posterior teeth embedded in a sticky wax arch. Three bracket slot groups (0.018, 0.020, and 0.022 inch [in]) were tested. A retraction force of 250 g was applied in the posterior-superior direction. Results: In the anteroposterior direction, the cusp tip of the canine in the 0.020-in slot group moved more distally than in the 0.018-in slot group. In the vertical direction, all six anterior teeth were intruded in the 0.018-in slot group and extruded in the 0.020- and 0.022-in slot groups. The lateral incisor was significantly extruded in the 0.020- and 0.022-in slot groups. Significant differences in the crown linguoversion were found between the 0.018- and 0.020-in slot groups and 0.018- and 0.022-in slot groups for the central incisor and between the 0.018- and 0.022-in slot groups and 0.020- and 0.022-in slot groups for the canine. In the 0.018-in slot group, all anterior teeth showed crown mesial angulation. Significant differences were found between the 0.018- and 0.022-in slot groups for the lateral incisor and between the 0.018- and 0.020-in slot groups and 0.018- and 0.022-in slot groups for the canine. Conclusions: Use of 0.018-in slot brackets was effective for preventing extrusion and crown linguoversion of anterior teeth in sliding mechanics.

• 대한치과교정학회지
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• 제43권1호
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• pp.3-14
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• 2013

Objective: To evaluate the factors that affect torque control during anterior retraction when utilizing the C-retractor with a palatal miniplate as an exclusive source of anchorage without posterior appliances. Methods: The C-retractor was modeled using a 3-dimensional beam element (0.9-mm-diameter stainless-steel wire) attached to mesh bonding pads. Various vertical heights and 2 attachment positions for the lingual anterior retraction hooks (LARHs) were evaluated. A force of 200 g was applied from each side hook of the miniplate to the splinted segment of 6 or 8 anterior teeth. Results: During anterior retraction, an increase in the LARH vertical height increased the amount of lingual root torque and intrusion of the incisors. In particular, with increasing vertical height, the tooth displacement pattern changed from controlled tipping to bodily displacement and then to lingual root displacement. The effects were enhanced when the LARH was located between the central and lateral incisors, as compared to when the LARH was located between the lateral incisors and canines. Conclusions: Three-dimensional lingual anterior retraction of the 6 or 8 anterior teeth can be accomplished using the palatal miniplate as the only anchorage source. Using LARHs at different heights or positions affects the quality of torque and intrusion.

• 대한치과교정학회지
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• 제45권6호
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• pp.289-298
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• 2015

Objective: To evaluate and compare the effects of two appliances on the en masse retraction of the anterior teeth anchored by temporary skeletal anchorage devices (TSADs). Methods: The sample comprised 46 nongrowing hyperdivergent adult patients who planned to undergo upper first premolar extraction using lingual retractors. They were divided into three groups, based on the lingual appliance used: the C-lingual retractor (CLR) group (group 1, n = 16) and two antero-posterior lingual retractor (APLR) groups (n = 30, groups 2 and 3). The APLR group was divided by the posterior tube angulation; posterior tube parallel to the occlusal plane (group 2, n = 15) and distally tipped tube (group 3, n = 15). A retrospective clinical investigation of the skeletal, dental, and soft tissue relationships was performed using lateral cephalometric radiographs obtained pretreatment and post en masse retraction of the anterior teeth. Results: All groups achieved significant incisor and canine retraction. The upper posterior teeth did not drift significantly during the retraction period. The APLR group had less angulation change in the anterior dentition, compared to the CLR group. By changing the tube angulation in the APLR, the intrusive force significantly increased in the distally tipped tube of group 3 patients and remarkably reduced the occlusal plane angle. Conclusions: Compared to the CLR, the APLR provides better anterior torque control and canine tipping while achieving bodily translation. Furthermore, changing the tube angulation will affect the amount of incisor intrusion, even in patients with similar palatal vault depth, without the need for additional TSADs.

• 대한치과교정학회지
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• 제25권5호
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• pp.525-541
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• 1995

상악치열에서 제 1 소구치를 발거하고, 이 위치로 견치를 후방이동시킨 상태에서 retraction archwire를 사용하여 상악 4절치를 한 묶음으로 후방견인시켰을 때 초기에 나타나는 모든 힘 체계와 개개치아의 이동양상을 살펴보고 바람직하지 않은 치아이동을 감소시키기 위한 방안을 모색하고자 본 연구를 시행하였다. 먼저 유한요소법을 이용하여 상악 치아와 치근막의 해부학적 형태 및 생체적 특성을 컴퓨터로 재현시키고 모형화된 브라켓을 부착시킨 후, beam요소를 사용하여 5종의 retraction loop를 하나씩 부여한 다섯 가지의 탄선을 모형화하고, 브라켓과 탄선간에는 gap요소를 사용하여 모형화함으로써 전체 유한요소 모형을 완성하였다. loop의 형태, activation 의 양, gable bend와 torque의 조건에 따른 차이를 검토하기 위해, 각 조건을 변화시켜 loop를 activation시켰을 때 탄선이 발휘하는 힘과 모멘트, 치아이동의 변위를 3차원적으로 정량적 및 가시적으로 평가하고 비교, 분석한 결과 다음과 같은 결론을 얻었다. 1. tear-drop loop archwire사용시 각 치아의 근원심이동 및 설측이동이 발치공간 폐쇄에 도움이 되었으나, 바람직하지 못한 상하이동과 각 방향으로의 회전이동이 부가적으로 나타났다. 2.다섯 가지의 retraction archwire중 T-loop archwire에서 공간폐쇄에 도움이 되는 치아이동이 가장 작게 나타났으며, 각 방향으로의 회전이동 역시 가장 작게 나타났다. 3. tear-drop loop archwire에서 activation양을 증가시킴에 따라 공간폐쇄에 도움이 되는 치아이동이 점차 증가했으나, 바람직하지 못한 상하이동과 각 방향으로의 회전이동이 함께 증가했다. 4. tear-drop loop archwire에서 loop의 전후방에 gable bend부여시 전치에서 근원심방향의 치체이동에 도움이 되었으나, 모든 치아에서 상하이동과 각 방향으로의 회전이동이 함께 증가했다. 5. tear-drop loop aichwire의 절치부에 치근 설측 torque 부여시 이들 치아의 순설경사를 개선시키는 효과를 얻었으나, 그 반작용으로 견치 치관의 설측회전이 크게 증가했으며, 전치의 상하이동과 모든 치아에서 각 방향으로의 회전이동이 증가했다.