Optimal orthodontic treatment could be possible when a orthodontist can predict and control tooth movement by applying a planned force system to the dentition. The moment to force(M/F) ratio at the bracket, has been shown to be a primary determinate of the pattern of tooth movement. As various n/F ratios are applied to the bracket on the tooth crown, strain distribution in periodontium can be changed, and the center of rotation in tooth movement can be determined. It is, therefore, so important in clinicalorthodontics to know the strain distribution in a force system of a M/F ratio. The purpose of this study was to analyze the strain distribution in orthodontic force system by strain gauge attached to tooth root, and to evaluate the usage of the method. For this study, an experimental upper anterior arch model was constructed, where upper central incisors, on the root surface of which, 8 strain gauges were attached, were implanted In the photoelastic resin, as in the case of 4mm midline diastema. Three types of closing of upper midline diastema closure were compared : 1. with elastomeric chain(100g force) in no arch wire, 2. elastomeric chain in .016“ round steel wire, 3. elastomeric chain in .016”x.022“ rectangular steel wire. The results were as follows. 1. Strain distributions on labial, lingual, mesial and distal root surface of tooth were able to be evaluated with the strain gauge method, and the patterns of tooth rotation were understood by presuming the location of moment arm. 2. Extrusion and tipping movement of tooth was seen in closing in no arch wire, and intrusion and bodily movement was seen with steel arch wire inserted.
Electoromyographic studies were performed on the action of the muscles of the temporomandibular joints following exfoliation of the deciduous teeth. The subjects examined, being 50 children. between the age of 6 and 13 years, divided into 5 groups. They were; 1) Deciduous dentition were complete in the first group. 2) Deciduous incisors were missing in either upper or lower jaw in the second group. 3) Deciduous canine and molars were missing in the left side of either upper or lower jaw in the third group. 4) Deciduous canine and molars were missing in the right side of either upper or lower jaw in the fourth group. 5) Permanent dentition completed in the fifth group(except third molars). Electromyogram was recorded with 4 channel polygraph (Grass model VII modified for 7P3). Electrodes which were the cup-typed gold discs, 9 millimeters in the diameter, were located on the anterior, middle and posterior lobes of the temporal muscles, and also on the superficial and deep layers of the masseter muscles. Paired electrodes were held by electrode cream so that they were pressed on the skin surface at right angle, adhesive tape being used to anchor them. The distance of the pair electrodes was about 5 millimeters. The results obtained were as follow: 1) In rest position of mandible; All groups showed slight, electrical activities in the muscles involved, but in the middle lobe of temporal muscle they were slightly higher. 2) In molar occlusion of mandible; High activity-anterior lobe of temporal muscle and superficial layer of masseter muscle. Moderate activity-deep layer of masseter muscle. Low activity-middle and posterior lobes of masseter muscle. There were no differences among the first, the second and the fifth groups. In the third group the muscle activity was weaker than that of the right, and in the fourth group opposite characteristics was revealed. 3) In incisal bite of mandreble; Hight activity-superficial layer of masseter muscle. Modertae activity-deep layer of masseter muscle. Low activity-anterior, middle and posterior lobes of temporal muscle. The first, the third, the fourth and the fifth groups showed no differences but the second group showed less activity than those of others. 4) In protrusion of mandible; High activity-deep layer of masseter muscle Moderate activity-superficial layer of masseter muscle. Low activity-anterior, middle and posterior lobes of temporal muscle. In the first, the fourth and the fifth groups, there were no differences in the activities, but the second group showed less activity than the others. 5) In retrusion of mandible; High activity-deep layer of masseter muscle. Moderate activity-superficial layer of masseter muscle. Low activity-anterior, middle and posterior lobes of temporal muscle. In the first, the third, the fourth and the fifth groups, there were no differences but the second group showed less activity than the others. 6) In lateral excursion of the mandible (either direction); High activity-posterior lobe of temporal muscle. Moderate activity-anterior and middle lobes of temporal muscle. Low activity-superficial and deep layers of masseter muscle. The muscle action potentials were weaker than those of the right side in the third group and vice ver'sa in the fourth group. 7) In chewing movement; Temporal muscle activities were higher than those of masseter, especially in the middle lobe of temporal muscle the activity was highest. Right side muscle activities were higher than those of the left in the third group and, on the contrary, the left side was dominant over the right in the fourth group.
The purpose of this study was to investigate the changes of the pharyngeal space when the following appliances were inserted: the mandibular advancement appliance (MAA), tongue retaining appliance (TRA), and mandibular advancement-tongue retaining appliance (MATRA). Nine male dental students exhibiting Class I occlusion, normal body mass index (BMI), and no signs and symptoms of snoring were selected for this study. The three kinds of snoring appliances (MAA, TRA and MATRA) were fabricated for each subject. The mandibular advancement of the MAA and MATRA was set at a distance of 5 mm, and the TRA and MATRA were made to hold the tongue in front of the maxillary incisors by 10 to 20 mm. Lateral cephalometric radiographs of the following four states - with no appliance, MAA, TRA, and MATRA - were taken to examine any anatomical changes resulting from the application of the appliances. All four radiographs were traced and analyzed for twenty selected variables related to the pharyngeal space, cranio-cervical posture, and position of the soft palate and hyoid bone. According to the results of this study, there were significant increases in both the upper and lower oropharyngeal spaces when the mandible and tongue were protruded simultaneously, although there was a significant increase only in upper oropharyngeal space when the mandible or tongue was advanced separately. In conclusion, it is suggested that the MATRA may result in more positive effect on the control of snoring and OSA compared to a single use of the MAA or TRA, especially for the patients whose upper airway obstruction occurs in the lower oropharynx.
An unfavorable tipping movement can occur during the retraction of anterior teeth because orthodontic force is loaded by brackets positioned far from the center of resistance. To avoid this unfavorable movement, a compensating curved wire or lingual root torque wire is used. The purpose of this study is to investigate, using photoelastic material, the distribution of initial stress associated with the retraction of the incisors according to the degree of the compensating curve, to model changes associated with tooth ud alveolar bone structure. The following results were obtained by analysis of the polarizing plate of the effects of initial stress resulting from retraction of the anterior teeth: 1. When the incisors were retracted using combination archwire or sliding mechanics, the maximal polarizing pattern of the apical area decreased as the degree of the compensating owe increased from 0 to 15 to 30. 2. When the incisors were retracted by the combination archwire or sliding mechanics, the maximal polarizing pattern of the canine and premolar area increased as the degree of the compensating curve increased from 0to 15to 30. 3. A lower degree of polarizing patterns were associated with the combination archwire technique than the sliding mechanics technique at a given force. The above results indicate that there is no significant difference between the combination loop archwire technique and sliding mechanics, for the retraction of maxillary anterior teeth with decreased lingual tipping tendency by a compensating curve on the arch wire. However, the use of sliding mechanics is more effective for the prevention of lingual inclination of the anterior teeth, because the hook used in sliding mechanics is closer to the center of resistance of the maxillary anterior teeth.
Journal of Dental Rehabilitation and Applied Science
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v.24
no.2
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pp.213-230
/
2008
The aim of this study was to analyze the initial movement and the stress distribution of each tooth and periodontal ligament during the lingual lever-arm retraction of 6 maxillary incisors using FEA. Two kinds of finite element models were produced: 2-properties model (simple model) and 24-properties model (multi model) according to the material property assignment. The subject was an adult male of 23 years old. The DICOM images through the CT of the patient were converted into the 3D image model of a skull using the Mimics (version 10.11, Materialise's interactive Medical Image Control System, Materialise, Belgium). After series of calculating, remeshing, exporting, importing process and volume mesh process was performed, FEA models were produced. FEA models are consisted of maxilla, maxillary central incisor, lateral incisor, canine, periodontal ligaments and lingual traction arm. The boundary conditions fixed the movements of posterior, sagittal and upper part of the model to the directions of X, Y, Z axis respectively. The model was set to be symmetrical to X axis. Through the center of resistance of maxilla complex, a retraction force of 200g was applied horizontally to the occlusal plane. Under this conditions, the initial movements and stress distributions were evaluated by 3D FEA. In the result, the amount of posterior movement was larger in the multi model than in the simple model as well as the amount of vertically rotation. The pattern of the posterior movement in the central incisors and lateral incisors was controlled tipping movement, and the amount was larger than in the canine. But the amount of root movement of the canine was larger than others. The incisor rotated downwardly and the canines upwardly around contact points of lateral incisor and canine in the both models. The values of stress are similar in the both simple and multi model.
This study was to evaluate the nature of traumatic injuries on anterior teeth of 530 patients and the prognosis of stabilized cases of 102 patients, including possible 18-follow up cases among them, treated at Dental Hospital, Yonsei Medical Center from Mar. 1983 to Feb. 1988. The obtained results were as follows. 1. The peak of monthly distribution of trauma to the anteriors was June and was the lowest in November. The ratio of male to female was 2.6 : 1. The most common incidence of the trauma to the anteriors was seen in the 3rd decades. The most chiefly involved teeth were central incisors in both upper and lower jaws. The causes of trauma were as followed in descending order by first blows, traffic accidents, falls, slip downs, and sports. The types of traumatic injuries of anterior teeth consisted of periodontal tissue injuries(55.9%), the injuries to the hard dental tissues and pulp(31.3%), and alveolar bone injuries(12.8%). 2. 35.1% stabilized anteriors were treated with root canal therapy. The success rate of stabilization was 95.3%, and 92.3% in replantation of avulsed teeth. 3. External root resorption, internal root resorption with calcification of pulp chamber or root canal, ankylosis of root, and other periapical pathosis were seen in follow-up radiographic findings. 4. Success rate of stabilization of the traumatized anteriors after 3 years showed 71.4% average.
Objective : To evaluate the relationship between the dose of Clodronate and serum level of alkaline phosphatase (ALP), calcium (Ca), and phosphate (PO4) during orthodontic tooth movement MaterialS and MethodS: A total of 18 sex-matched Wistar rats (weight=180~230g, mean age=8 weeks) were allocated into the 2.5mM Clodronate (2.5C) group, 10mM Clodronate (10C) group, or control group (n=6 for each group). After the application of a nickel-titanium closed coil spring (force of 60g) between the upper central incisors and first molars (UFM), 2.5C, 10C, or saline was injected every third day into the subperiosteum of the alveolar bone adjacent to UFM for the experimental and control groups. The animals were sacrificed 17 days later. Trunk blood was quickly collected into a heparinized tube and centrifuged at 2,000 rpm for 20 min. The plasma was used for the biochemical assays of the serum level of ALP, Ca, and PO4. Kruskall-Wallis test and Mann-Whitney test with Bonferroni correction were performed for the statistical analyses. Results : Dose-dependent increase in the level of ALP (P<0.01) and decrease in the level of Ca (P<0.001) were observed among the control, 2.5C, and 10C groups. Although there was no significant difference in PO4 between the 2.5C and 10C groups, the 10C group showed a significantly higher level of PO4 than the control group (P<0.01). Conclusion : Since Clodronate induced significant dose-dependent change in the serum level of ALP, Ca, and PO4 during orthodontic tooth movement, orthodontists should consider these biochemical markers not only as a diagnostic tool for bone turnover rate but also as a monitoring tool for orthodontic tooth movement.
Arango-Gomez, Edison;Nino-Barrera, Javier Laureano;Nino, Gustavo;Jordan, Freddy;Sossa-Rojas, Henry
Restorative Dentistry and Endodontics
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v.44
no.4
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pp.35.1-35.10
/
2019
Pulp revascularization is an alternative treatment in immature traumatized teeth with necrotic pulp. However, this procedure has not been reported in horizontal root fractures. This is a case report of a 9-year-old patient with multiple horizontal root fractures in 2 upper central incisors that were successfully treated with pulp revascularization. The patient presented for treatment 2 years after the initial trauma, and revascularization was attempted after the initial treatment with calcium hydroxide had failed. Prior to pulp revascularization, cone-beam computed tomography and autoradiograms demonstrated multiple horizontal fractures in the middle and apical thirds of the roots of the 2 affected teeth. Revascularization was performed in both teeth; platelet-rich plasma (PRP) was used in one tooth (#11) and the conventional method (blood clot) was used in the other tooth (#21). Clinical and radiographic follow-up over 4 years demonstrated pulp calcification in the PRP-treated tooth. Neither of the 2 teeth were lost, and the root canal calcification of tooth #11 was greater than that of tooth #21. This case suggests that PRP-based pulp revascularization may be an alternative for horizontal root fractures.
Purpose: The purpose of the present study was to evaluate the postoperative skeletal stability of two-jaw surgery (Le Fort I osteotomy and bilateral sagittal split ramus osteotomy) via surgery first orthodontic treatment (SFOT) in class III malocclusion. Methods: Thirty-two patients who had two-jaw surgery via SFOT were included in this study. Serial lateral cephalograms were obtained before (T0), immediately after (T1), and six months after (T2) surgery. Twelve variables were measured for horizontal and vertical skeletal stability as well as for dental change. All measurements were evaluated statistically by a paired t-test ($P$ <0.05). Results: The mean skeletal changes were $0.1{\pm}2.5$ mm at point A and $-12.0{\pm}7.4$ mm at the pogonion. The mean horizontal relapse was 11.6% at the pogonion, and the mean vertical surgical changes included an upward displacement of $2.1{\pm}7.1$ mm and a forward displacement of $1.4{\pm}4.6$ mm at the pogonion. Upper incisor inclination decreased after surgery and was maintained at T2, and lower incisors were proclined from T1 to T2 by postsurgical orthodontic treatment. Conclusion: Postoperative skeletal stability of two-jaw surgery via surgery first orthodontic treatment in class III malocclusion was clinically acceptable.
Kim, Soo-Nam;Lee, Dong-Keun;Min, Seung-Ki;Oh, Sung-Hwan;Choi, Moon-Gi;Park, Hwa-Kyu
Maxillofacial Plastic and Reconstructive Surgery
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v.21
no.3
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pp.277-283
/
1999
This study was aimed at furnishing the data of Naso-orbito-ethmoidal fractures and aiding treatmenting Naso-orbito-ethmoidal fractures A 5-year review of Naso-orbito-ethmoidal fractures and concomitant injuries is presented. The patients were treated in the Dept. of Oral and Maxillofacial Surgery of Wankwang University Hospital from Jan. 1, 1993 to Dec. 31, 1997. The results were as followes: Male predominated over female by a ratio of 4.6 : 1. The most common reasons is traffic accident(88.2%). The elapsed time from injury to operation is average 9.2 days, and the mean admission days were 79 days and removal of plates were average 217.3 days. The most associated facial bone fractures is Zygomatico-Maxillary complex fracture(20%). Associated injuries were neurologic injury(29.4%), orthopedic injury(23.5%), opthalmologic injury(17.6%), body injury(5.8%), neuropsychologic injury(5.8%) and otolaryngologic injury(5.8%) in this order. The most injured teeth were upper and lower incisors. The intubation methods for surgery were orotracheal(29.57%), submental(29.5%), and nasotracheal technique(41%). Most patients had complications, that were post-traumatic telecanthus, nasal depression, scar formation. This results suggest that early diagnosis and treatment is prerequisits to satisfactory result. Aggressive management of NOE fracture with direct or bicoronal exposure with aid of CT is now an accepted norm.
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