• Journal of the Korean Academy of Esthetic Dentistry
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• v.30 no.2
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• pp.91-101
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• 2021

The interdental papilla area is a difficult area for connective tissue graft (CTG) due to its narrow space. So Regeneration of interdental papilla is very challenging work. It is very difficult when the teeth have contact with adjacent teeth, but if there was only 3mm of space between the teeth, CTG was not very difficult. Therefore, through the orthodontic force, a 3mm space between the teeth was intentionally created. The CTG was performed using a microblade, and only one vertical incision was performed off the gingival margin, and the graft was performed by inserting the grafts through here. After a period of maintenance, I was able to gather the teeth again with orthodontic force and regenerate the interdental papilla. I named this technique ELSA Technique (Enlargement of space - Labial graft - Squeezing - for Augmentation of papilla). If interdental papilla is lost due to periodontal disease, ELSA techniques can regenerate interdental papilla very efficiently.

• The korean journal of orthodontics
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• v.26 no.5 s.58
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• pp.581-590
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• 1996

Bone resorptiion was predominate in compression site, bone formation in tension site of periodontal ligament during tooth movement. The biologic response at compressiion site was different from tension site. Thus the CGHP immuno-positive nerve fiber will respond differently to mechanical force according to the area( compression or tension site). The purpose of this study was to investigate this response of CGRP immune-positive nerve fiber in the periodontal ligament according to the duration of applied force and the area (compression or tension site) during experimental tooth movement. The experimental animals were 7 week old male rat (approximately 200 gm). The orthodontic force was applied mesially to the right maxillary molar using the Ni-Ti coil spring during 12hours, 1, 3, 7, and 120days. Immunohistochemical staining using antibody against CGRP was performed after sacrifice. The results were as follows. The CGRP immune-positive nerve bundle showed reduced immunoreactivity and nerve fibers reduced in density after application of orthodontic force for 12 hours and 1day. The CGRP immune-positive nerve fibers showed many thin branches at the apical periodontal ligament after application of force for 3 days as compared with normal. The tension site in the apical periodontal ligament showed more branches than the compression site. In 7 day group, the CGRP immune-positive nerve fibers increased in terms of the number and had many thin branches in the apical periodontal ligament. The tension site had more branches than the compression site. In 12 day group, the CGRP immune-positive nerve fibers showed similar distribution to normal control at compression site of apical periodontal ligament, but the fibers at the tension site increased in number. The CGRP immuno-positive nerve fibers showed more increased at tension site than compression site after application of orthodontic force. Therefore it seems to have some relation to the bone remodeling besides the local inflammatory process.

• The korean journal of orthodontics
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• v.31 no.1 s.84
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• pp.85-95
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• 2001

The purpose of this study was to evaluate the material for fixed type retainer, allowing physiologic tooth movement. and proper remodeling or periodontal tissue during retention period. The Present study was Performed to observe the histologic changes of periodontal tissue after application of different types of fixed type retainer after orthodontic tooth movement in young adult dogs. For this study, 4 young adult dogs were used as a experimental animal and experimental group was divided into three groups : experimental group 1 contained right side maxillayy third incisors and canines, experimental group 2 contained contralateral teeth of same animals, and control group contained mandibular premolars. And each dogs were applied the 4 different types of fixed type retainer to experimental group 1. The experimental teeth were ligated on the Sentalloy closed coil $spring^{\circledR}$(Tomy Co., Japan) from maxillary third incisors and canines and applied orthodontic force at initial 200gm-forced during 1 week. All the experimental animals were sacrificed on the 3rd week after the orthodontic teeth movement and then the specimens were taken, fixed in formalin, embeded in parafin, sectioned $6-8{\mu}m$ in thickness and stained with Hematoxylin-Eosin staining, and Masson's trichrome staining method. Examined under the light microscopy The following results were observed. 1. There were observed that decreased infiltration of giant tells in pressure side and increased the new bone forming in tension side on the specimen of 6-stranded 0.0195' $Respond^{\circledR}$(G&H Co., U.S.A.) group. Periodontal ligament fibers were much compressed or elongated in 3-stranded 0.018', 0.020' $Dentaflex^{\circledR}$(Dentarum Co., Germany), and Superbond $C&B^{\circledR}$(Sun Medical Co., Japan) groups. 2. In experimental group 1, necrotic bone inside the alveolar bone of pressure side, forming of the sharpey's fiber in osteoid tissue, and remodeling of the periodontal ligament were observed in all animals. 3. In experimental group 2, it was observed that the amount of bone resorption was equal or decreased in pressure side, and increased new bone forming and significantly decreased infiltration of giant cell than the experimental group 1. By this results, it considered that 6-stranded $Respond^{\circledR}$(G&H Co., U.S.A.) wire was the most useful material allowing early periodontal tissue remodeling.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.3
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• pp.225-232
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• 2011

Purpose: This study was designed to retrospectively evaluate the postsurgical initial stability of the Le Fort I osteotomy with posterior impaction and rigid internal fixation for the correction of mandibular prognathism with midface deficiency. Particular attention was paid to the magnitude and direction of the initial postsurgical change. Methods: 20 healthy patients with mandibular prognathism and midface deficiency participated in this study. All patients underwent Le Fort I osteotomy with posterior impaction and mandibular setback BSSO by one surgeon. Preoperative (T0), immediate postoperative (T1) and follow-up period (T2) cephalograms were taken and analyzed. Change between T0~T1 and T1~T2 was measured and analyzed. Results: Between T0~T1, significant differences were observed in all measurements except the ANS point and mandibular plane angle. Between T1~T2, only the occlusal plane angle was significantly changed. No significant changes were found in all other measurements. Conclusion: This study indicates that Le Fort I osteotomy with posterior impaction is stable at initial stages. Although changes in the occlusal plane angle were observed, it was caused by tooth movement after post-operative orthodontic treatment. However, more studies with larger samples are required to form definitive conclusions. Conclusion: This study indicates that Le Fort I osteotomy with posterior impaction is stable at initial stages. Although changes in the occlusal plane angle were observed, it was caused by tooth movement after post-operative orthodontic treatment. However, more studies with larger samples are required to form definitive conclusions.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.2
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• pp.102-107
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• 2003

At orthodontic treatment, we have made every effort to get rigid anchorage which is not stirred when teeth move. As a result, the miniscrew that is rigid anchorage was invented recently, and now it is used widely. Concerning the advantage of miniscrew, it is reduced dependence of extraoral anchorage and it shortens treatment time for rapid tooth movement. In contrast, the defect of miniscrew is falling off it resulted from increasing of the mobility. So the purpose of this research is to be of help to prognose clinical use of miniscrew, which is inserted for intraoral anchorage, by investigating and comparing the failure rate of miniscrew for loading time. This study researches the failure rate of miniscrew for teeth movement at the orthodontic treatment. The failure rate of miniscrew in mid course, after inserting 147 miniscrews in 51 patients, is 13%(20/147). It showed no statistically significant differences as compared man with woman, maxilla with mandible, double-head with uni-head miniscrew, and drilling and non-drilling before inserting the miniscrew. In comparison below twenties with over twenties and the times that we give load to miniscrew, it produced that the failure rate of miniscrew is 9.7% higher in the case of below the twenties than over the twenties. Also, the failure rate of loading immediately is 10.8% higher than loading after 7 days. According to using driver for the insertion of miniscrew, the failure rate of miniscrew is higher in the case of using machined driver than in the case of using hand driver when the level of significance is 95%. According to the research, we can suppose that the failure rate has no concern with using miniscrew on man or woman, maxilla or mandible, the shape of head, and drilling or non-drilling before insertion of miniscrew. Therefore, we can choose eclectic miniscrew as demands. In addition, we must notify the patient, below twenties, to be possibility of high failure rate. And It is strongly recommended to give load after $1{\sim}2$ weeks for healing of the insertion area.

• The korean journal of orthodontics
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• v.25 no.3 s.50
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• pp.247-261
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• 1995

The purpose of this study was to quantitate differences in the nature of the correction of Angle's Class II div 1 malocclusion dependent on the patient's age at the time of treatment. The sample consisted of 27 female patients in the adolescent group with a mean initial records age of 11.8 years and 25 female patients in the adult group with a mean starting age of 21.1 yrs. Lateral cephalometric head films were taken before and after orthodontic treatment with four bicuspid extraction. The results were obtained as follows. 1. None of maxillary skeletal parameters exhibited a significantly different in treatment change between adolescents and adults. But, in mandibular skeletal measurements, there were significant differences between two groups. (P<0.05) 2. Measures of vertical dimension in the adults remained unchanged during treatment, reflecting the effective absence of growth. 3. The steepness of occlusal plane in the adults changed significantly.(P<0.05) In contrast, the adolescents displayed stability of the occlusal plane. 4. According to the Johnston analysis, there was a significant difference in the total molar correction between two groups.(P<0.05) 5. According to the Johnston analysis, differential mandibular growth in the adolescents contrubuted $63\%$ of the total molar correction, with orthodontic tooth movement accounting for the remaining $37\%$. In the adults, dental movement comprised $99\%$ of the correction.

• The korean journal of orthodontics
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• v.41 no.4
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• pp.237-254
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• 2011

Objective: The purpose of this study was to compare the displacement patterns shown by finite element analysis when the maxillary anterior segment was retracted from different orthodontic miniscrew positions and different lengths of lever arms in lingual continuous and segmented arch techniques. Methods: A three dimensional model was produced, the translation of teeth in both models was measured and individual displacement was calculated. Results: When traction was carried out from miniscrews in the palatal slope, lingual tipping of crowns and extrusion of the maxillary anterior segment were found in both continuous and segmented arches as the lever arms were made shorter. With miniscrews in the midpalatal suture area, the displacement patterns were similar to the palatal slope, but bodily movement of the upper incisors was observed in both continuous and segmented arches with the lever arm at 20 mm. When lever arms were longer, there was less extrusion of the incisors and more buccal displacement of the canines. Such displacement was shown less in the continuous arch than the segmented arch. The second premolar showed crown mesial tipping and intrusion, and the molars showed distal tipping in the continuous arch. The posterior segment was displaced three dimensionally in the segmented arch, but the amount of displacement was less than the continuous arch. Conclusions: It is recommended that lever arms of 20 mm in length be used for bodily movement of the anterior segment. Use of continuous or segmented arches affect the displacement patterns and induce differences in the amount of displacement.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.1
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• pp.127-133
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• 1998

An impacted tooth is defined pathologically as a tooth that remains under the mucosa of inside bone without eruption of the crown after a specific period of eruption. Clinically, the term includes those teeth, even before eruption period, that are not expected to erupt due to shape, position and alignment of tooth and lack of space. Canine is prone to impaction more than other teeth because it has the longest time to develop and a complex route from the place of formation to the site of eruption. The impaction incidence of maxillary canine is repoted 0.92$\sim$3.3% (Ferguson, 1990). In 1995 Orton reported that the incidence was 0.92$\sim$2.2% and palatal impaction was more frequent than labial impaction(85%:15%). In 1969 Johnston presented it was more common to woman than to man(3:1). The etiology includes systemic disease such as endocrine disorder, cleidocranial dysostosis, irradiation, Crouzon syndrome, ricketts, facial hemihypertrophy and hereditary and local problems such as ectopic position of the tooth, distance of tooth from its place of eruption, malformation of the tooth, presence of supernumerary teeth, trauma of tooth germ, infection of tooth germ, displacement of tooth germ or tooth by a neoplasm, ankylosis, overretention of deciduous predecessor, lack of space for the tooth in the dental arch and mucosal barrier due to gingival fibrosis. The maxillary canine is especially important as it has the longest root, provides guidance for lateral movement of the mandible and masticatory function and assumes an important role esthetically as it is located at mouth angle. If left untreated, it may cause migration and external, internal resorption of adjacent teeth, loss of arch length, formation of dentigerous cyst or tumors, infection and referred pain as well as malposition of the tooth. Therefore, periodic examination of the development and eruption of the maxillary canine is especially important in a growing child. This case study presents the results of treatment of palatally impacted maxillary canine utilizing surgical exposure and orthodontic tooth movement on patients visiting SNUDH dept. of pediatric dentistry.

• The korean journal of orthodontics
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• v.29 no.1 s.72
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• pp.95-106
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• 1999

This study was performed to examine the effect of bisphosphonate, an inhibitor of bone resorption, on the formation of osteoclast and bone resorption during experimental tooth movement. Whether bisphosphonate has a cytotoxicity in high dose was also examined. Eighty-seven male Sprague-Dawley rats, weighing 260-350g, were classified into normal (no appliance + $0.9\%$ NaCl), control (appliance + $0.9\%$ NaCl) and four bisphosphonate-treated (appliance + 0.8, 4, 20 or 100mg/kg) groups. The maxillary left first molar was moved mesially with the tipping movement using 50-70g of force. Bisphosphonate(etidronate disodium) was injected intraperitoneally with a dose of 0.8, 4, 20, or 100 mg/kg simultaneously with the application or the orthodontic force. They were killed at day 1, 3, or 7 after the application or the orthodontic force. The activities of serum acid phosphatase and lactate dehydrogenase (LDH) were assayed, and osteoclasts and the degree of bone resorption were examined histologically. The results obtained were as follows: 1. Acid phosphatase activities were significantly higher in the appliance groups, both control and bisphosphonate-treated (4, 20, and 100 mg/kg) groups, at days 1 and 3 than these in normal. At day 1, bisphosphonate-treated(4, 20mg/kg) groups showed even higher acid phosphatase than control. However, at day 7, no significant difference was noted between the control and bisphosphonate-treated groups. 2. LDH activities in the 4, 20mg/kg bisphosphonate-treated groups were increased during the experimental Periods examined, but there were no significant differences in the 0.8, 100mg/kg bisphosphonate-treated groups. 3. There was no bone resolution at day 1, but severe bone resorption was observed at days 3 and 7 in the control. Bone resorption was reduced by bisphosphonate-treatment at day 3. Bone resolution observed at day 7 was similar between the control and bisphosphonate-treated groups. 4. Few osteoclasts were observed at the alveolar bone in the control and bisphosphonate-treated groups at day 1. At day 3, numerous osteoclasts were shown in the control, the degree of which was reduced in bisphosphonate-treated groups. These results suggest that the inhibition of the osteoclast formation was not the mechanism of bone resorption by the bisphosphonate-treatment during experimenal tooth movement. There was no distinct cytotoxicity with a high dose of bisphosphonate. And the drug should be administrated repeatedly to maintain the inhibitory effect of bone resolution.

• The korean journal of orthodontics
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• v.27 no.4 s.63
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• pp.607-621
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• 1997

GRP was known as the modulator of Pain transmission in central nervous system and local effector to peripheral tissue causing vasodilation, increased blood flow, modulation of immune sysem, stimulation of endothelial cell proliferation, and stimulation of bone formation. Numerous study, therefore, were done to elucidate involvement of CGRP to tooth movement. To investgate the response of CGRP immunoreactive nerve cells according to cell size in trigeminal ganglion during tooth movement, immunohistochemical study was performed using rat. Experimental rats(9 weeks old, 210 gm) were divided as six groups(normal(n=6), 3 hour group(n=5), 12 hour group(n=4), 1 day group(n=5), 3 day group(n=5), 7 day group(n=5)), and were applied orthodontic force (approximately 30 gm) to upper right maxillary molar. After frozen sections of trigeminal ganglions were immunostained using rabbit antisera, the changes of CGRP immunoreactive cells in regard to cell size distribution(small cell(upto $20{\mu}m$), medium cell($20-35{\mu}m$), large cell(above $35{\mu}m$)) were observed. The results were as follows 1. The percentage of CGRP immunoreactive cells to all nerve cells in trigeminal ganglion was 33.0% in normal control group, was decreased to 24.5% in 1 day group, and was increased to 41.8% in 7 day group. 2. The percentage of small, medium, and large cells expressing CGRP immunoreactivity in normal trigeminal ganglion to all CGRP immunoreactive cells were 51.3%, 44.0%, 4.7%, respectively. 3. The percentage of small cells with CGRP immunoreactivity to all CGRP immunopositive cells was increased in 3 hour and 12 hour groups. 4. The percentage of medium cells with CGRP immunoreactivity was increaed in 3 day and 7 day groups. 5. The percentage of large cells with CGRP immunoreactivity was increaed in 7 day group. Conclusively, the small cells with CGRP immunoreactivity in trigeminal ganglion respond to orthodontic force during initial phase of tooth movement, and later the medium and large cells with CGRP immunoreactivity respond