• The korean journal of orthodontics
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• v.49 no.3
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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.

• The korean journal of orthodontics
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• v.53 no.4
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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.

• The korean journal of orthodontics
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• v.49 no.5
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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.

• The korean journal of orthodontics
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• v.49 no.6
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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]).

• The korean journal of orthodontics
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• v.51 no.1
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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.

• The korean journal of orthodontics
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• v.32 no.3 s.92
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• pp.165-174
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• 2002

The purpose of this study was to compare on masse retraction of six anterior teeth with separate canine retraction in the amount of the anchorage loss and the retraction of the anterior teeth. The subjects consisted of 30 adult female patients with Angle Class 1 malocclusions who were treated by .022' straight wire appliance with 4 first permolar extraction. They were composed of two groups. Group 1 consisted of 15 subjects, whose six anterior teeth were retracted by on masse retraction. Group 2 consisted of 15 subjects, whose canines were retracted separately. Pre-treatment and post-treatment lateral cephalometric radiographs were analyzed. All data were processed statistically with independent samples t-test, and the conclusions were as follows. 1. There was no significant difference in the amount of the anchorage loss between two groups(p>0.05). 2. There was no significant difference in the amount of the retraction of the anterior teeth between two groups(p>0.05). 3. There was a significant difference in the amount of the inclinational change of the upper incisors between two groups. It was greater in Group 2. 4. There was a significant difference in the vertical positional change of the upper incisal edges between two groups. The upper incisal edges in Group 2 were more extruded than Group 1 by about 1mm. 5. There was no significant difference in the vertical positional change of the root apex of the upper incisors between two groups(p>0.05). And there was no significant difference in the vertical positional change of the upper molar(p>0.05).

• The korean journal of orthodontics
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• v.47 no.3
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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.

• The korean journal of orthodontics
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• v.43 no.1
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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.

• The korean journal of orthodontics
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• v.45 no.6
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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.

• The korean journal of orthodontics
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• v.25 no.5 s.52
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• pp.525-541
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• 1995

This study was designed to investigate force systems and tooth movements produced by retraction archwire during retraction of four maxillary incisors after the maxillary canine retraction into the maxillary first premolar extraction space using the computer-aided three-dimensional finite element method. A three-dimensional finite element model, consisting of 2248 elements and 3194 nodes, was constructed. The model consisted of maxillary teeth and surrounding periodontal membranes, .022'$\times$.028'-slot brackets, and 5 types of retraction archwires(.019'$\times$.025' stainless steel archwire) modeled using the beam elements. The contact between the wire and the bracket slot was modeled using the gap elements because of the non-linear elastic behaviors of the contact between them. The forces and moments, End displacements produced by retraction archwire were measured at various conditions to investigate the difference according to types of loops, magnitudes of activation force, gable angle, and anterior lingual root torque. The results were expressed quantitative and visual ways in the three-dimensional method. The following conclusions can be drawn from this study.1. When the tear-drop loop archwire was activated, the mesio-distal and lingual translational movements of the teeth helped to close the extraction space, but unwanted movements of the teeth including intrusions and extrusions, and rotational movements in each direction occurred. 2. Activation of T-loop archwire compared with those of other types of retraction archwires produced the least translational movements of the teeth helped to space closure and also the least unwanted movements of the teeth. 3. Increasing amount of activation in the tear-drop archwire led not only to increase of translational movements of the teeth helped to space closure, but also to increase of unwanted movements of the teeth. 4. Addition of gable bend in the tear-drop archwire helped anterior teeth to translational movements in the mesio-distal direction, but increased unwanted movements of the teeth 5. Addition of anterior lingual root torque in the tear-drop archwire helped central and lateral incisor to improve their facio-lingual inclination, but increased unwanted movements of the teeth.