The purpose of this study is to understand using of antithrombotic agents in clinical settings. The number of patients receiving antithrombotic therapy is increasing in the long term due to the increased prevalence of cardiovascular disease in the elderly. There is a guideline for discontinuation of antithrombotic treatment before dental treatment, but the present study shows that there is a difference from the actual clinical situation. We used an online survey methodology to involve 1000 participants. The questionnaires were asked about general items and Clinical experience such as history of antithrombotic history, experience of complications due to antithrombotics, discontinuation of use, reasons for discontinuing use. The result is as follows. The incidence of delayed bleeding was found to be 55.1%, and discontinuation of antithrombotic therapy before withdrawal was 87.8%. Among respondents 98.3% responded that they stopped antithrombotics because of delayed bleeding and 57.4% responded that they would stop for three to five days. Korean dentists maybe cope with delayed bleeding considering the emotional problem of the patient, the relationship with the patient's physician, and the additional socioeconomic problems.
The objective of this study was to evaluate the changes that occurred over time in the distracted periodontal ligament space following the rapid retraction of a tooth by periodontal distraction after bone undermining surgery had been conducted in the dogs. The upper second premolars were extracted on the left and right side in 4 male beagle dogs. Immediately after extraction, the interseptal bone distal to the upper first premolar was thinned and undermined by grooving to decrease the bone resistance. Activating an individualized distraction appliance at the rate of 0.225mm twice a day, the upper first premolar was retracted rapidly toward the extraction socket. Periodontal distractions were performed for 5, 10, and 20 days, and 20-day-distraction cases were followed by maintenance periods of 0, 14, 28, and 56 days. After 20 days of rapid retraction, the average distal movement of the upper first premolar was 5.02mm, and the average mesial movement of the upper third premolars serving as an anchorage unit was 0.18 mm. On histological examination, the regeneration of bone occurred in a highly organized pattern. Distracted periodontal ligament space was filled with newly formed bone oriented in the direction of the distraction, and this was followed by extensive bone remodeling. This result was similar to those observed in other bones after distraction osteogenesis. In the periodontal ligament, the relationship between collagen fibers and cementum began to be restored 2 weeks after the distraction was completed, and showed almost normal features 8weeks after the completion of the periodontal distraction. However, on the alveolar side, the new bone formation was still in process and collagen fiber bundles and Sharpey's fibers were not present 8 weeks after the completion of the periodontal distraction. Reactions in the periodontal ligament of the anchorage tooth represented bone resorption on the compressed side and new bone deposition on the tension side as occurred in conventional orthodontic tooth movement. In conclusion, the results of this study showed that periodontal structures on the distracted side of the periodontal ligament were regenerated well histologically following rapid tooth movement.
This study was designed to investigate the stress intensity and distribution produced by 1mm activation of retraction archwire with $0^{\circ},\;7^{\circ},\;14^{\circ}$ torque and application of high polk J-hook headgear during retraction of four maxillary incisors using the photoelastic stress analysis. The photoelastic model was made with a PL-3 type epoxy resin which was substituted by alveolar bone portion. Each retraction archwire was fabricated from .020' X .025' stainless steel wire which had vertical loops in 7mm height and hooks for high pull J-hook headgear between central and lateral incisors. The high pull J-hook headgear was applied 35 degree backward and upward to occlusal plane with 200gm pet each side The findings of this study were as follows: 1. In case of $0^{\circ}$ torque, the stress was distributed from cervical 1/8 to apex of roots of central and lateral incisors which were the forms of arc mode. When the high pull J-hook headgear was applied, the stress distributed by arc mode was presented from cervical 1/2 to apex of roots of central and lateral incisors. And the stress distributed by following the root surface was presented from alveolar crest to cervical 1/2 of roots of central and lateral incisors. The stress between apecies of central and Lateral incisors was presented also. 2. In case of $7^{\circ}$ torque, the stress distributed by arc mode was presented from cervical 1/2 to apex of roots of central and lateral incisors. And the stress distributed by following the root surface was presented from alveolar crest to cervical 1/2 of roots of central and lateral incisors. When the high pull J-hook headgear was applied, the stress distributed by following the root surface was presented mote apically than without headgear. The stress between apecies of central and lateral incisors was presented also. 3. In case of $14^{\circ}$ torque, the stress distributed by following the root surface was Presented from alveolar crest to apex of roots of central and lateral incisors. When the high pull J-hook headgear was applied, the stress distributed by following the root surface was presented stronger than without headgear The stress between apecies of central and lateral incisors was presented also.
This study was designed to investigate the stress distribution of alveolar bone in case of on masse retraction with lingual K-loop archwire using the 3-dimensional photoelastic stress analysis followed by stress freezing process. Lingual K-loop archwire which had loop in 15mm height was used and activated by retraction force of 350gm per each side. The results were as follows 1. Central incisor : As the closer side to crown, the larger tensile stress was distributed at both mesial and labial surfaces and the larger compressive stress was distributed at distal surface. As the closer side to root apex, the larger compressive stress was distributed at lingual surface. The compressive stress was distributed at root apex. 2. Lateral incisor : The tensile stress was distributed at the coronal side of mesial surface. The compressive stress was distributed at distal surface. As the closer side to crown, the larger tensile stress was distributed at labial surface. The tensile stress was distributed at coronal side and the compressive stress was distributed at apical side of lingual surface. The compressive stress was distributed at root apex. 3. Canine The tensile stress was distributed at coronal side and the compressive stress was distributed at apical side of mesial surface. The tensile stress was distributed at distal surface. As the closer side to crown, the larger tensile stress was distributed at both mesial and distal surfaces. The compressive stress was distributed at root apex. 4. Second premolar : The tensile stress was distributed at mesial surface. The compressive stress was distributed at coronal side and the tensile stress was distributed at apical side of distal surface. The compressive stress was distributed at coronal side of buccal surface. As the closer side to crown, the larger tensile stress was distributed at lingual surface. The compressive stress was distributed at root apex. 5. First molar . As the closer side to crown, the larger tensile stress was distributed at both mesial and distal surfaces. No stress was distributed at buccal surface and palatal root apex. As the closer side to crown, the larger tensile stress was distributed at both lingual surfaces. The compressive stress was distributed a4 buccal root apexes. 6. Second molar The compressive stress was distributed at all root apexes. As the closer side to crown, the larger compressive stress was distributed at both mesial and lingual surfaces, and the larger tensile stress at both distal and buccal surfaces. Transverse bowing effect was observed in on-masse retraction with lingual K-loop archwire, however vertical towing effect was not. Rather, reverse vortical bowing effect was developed.
Kim, Seok-Pil;Hwang, In-Nam;Cho, Jin-Hyoung;Hwang, Hyeon-Shik
The korean journal of orthodontics
/
v.36
no.2
s.115
/
pp.114-124
/
2006
The purpose of this study was to evaluate the tooth color changes of resin bonding sites and their adjacent sites on orthodontic bracket bonding. Sixty extracted sound premolars were used and the tooth color was recorded according to the CIE $L^*a^*b^*$ color system using a spectrophotometer. The tooth colors of the twenty premolars were measured and compared before bracket bonding and after removal. On a further twenty premolars, the tooth color was measured before and after only primer application. In the change of $L^*$ values, according to the bracket bonding and primer application, the lightness was decreased, and in the change of $a^*\;and\;b^*$ values, the color was changed into a more yellowish color The color differences $({\Delta}E^*)$ were calculated from the $L^*a^*b^*$ values and compared with the standard value of clinical detection $({\Delta}E^*=3.7)$. The color differences between before the bracket bonding and after removal noted exceeded the standard value and those of between before and after the primer application were not larger than the standard value. Toothbrushing was performed after application of the primer to evaluate the color changes according to the primer abrasion. As a control, toothbrushing was performed on the last twenty premolars. The color differences noted were larger than the standard value after toothbrushing. Also, to evaluate the color changes of the tooth which is exposed to sun irradiation after bracket removal, additional photoaging was performed and the color was measured for all teeth. The additional color differences after photoaging were smaller than the standard value. The above results suggest that the tooth color changes after fixed orthodontic treatment.
One of the various mechanics used to treat unilateral Class II malocclusion is head gear with asymmetric face bow. We made the finite element models of unilateral Class II maxillary dental arch and power arm asymmetric face bow. We designed this experiment to observe stress distribution of periodontal ligament, reaction force, and displacement and to understand force system, so to predict the therapeutic effect. On the basis of computerized tomograph of maxillary dental arch of 25 years old male with normal occlusion without extraction and orthodontic treatment history, we made finite element models of maxillary dental arch and periodontal ligament. Then we modified that model to unilateral maxillary Class II malocclusion model of which maxillary left molar displaced mesially. Also, We made finite element model of asymmetric face bow of which right outer bow shorter than left by 25mm(RMO, Penta-FormTM/Medium size, 0.045 inch iner bow, 0.072 inch outer bow). After that, retraction force of 250g, 300b, 350g were applied to maxillary first molar. We concluded as follow. 1. The Net force that both maxillary first molars were received increased as the retraction force increased. Mesially positioned tooth received more force than normally positioned tooth. But, both tooth were received distal force, so distal movement occured. 2. Both tooth received buccal lateral force. In analysis of force element, as the retraction force were increased, force of X-axis at mesially positioned tooth decreased, and force of X-axis at normally positioned tooth increased. so lateral force component moved to the side received less force from more force. 3. There were rotation, tipping with distal movement in maxillary first molar. As retraction force were increased, rotation and tipping also increased. More tipping and rotation occured at the side received more force, that is, mesially positioned tooth. Though it Is small change, displacement of same pattern occur in normally positioned tooth
Objective: The purpose of this study was to determine the changes of mandibular anterior alveolar bone thickness with age. Methods: Cephalometric radiographs of 160 skeletal class I patients (male 80, female 80) with normal vertical growth pattern was investigated by measuring the buccolingual thickness of mandibular alveolar bone on the basis of root axis. Results: As the age increases, both male and female showed a significant decrease in buccolingual width of the mandibular anterior alveolar bone and in the width of mandibular anterior lingual alveolar bone except the CEJ area of females. However, there was no significant difference in the thickness of mandibular anterior buccal alveolar bone and in the width of maximum prominence of mandibular symphysis with age. Conclusion: From the above results, it is concluded that Korean children whose growth pattern is sagittally skeletal class l with a vertical normal growth pattern have a greater mandibular anterior lingual alveolar bone width than Korean adults; therefore, lingual movement of mandibular incisors, which is usually accompanied in extraction treatment, is considered to be more preferable in younger patients.
The purpose of this study was to evaluate the effects of a sealant resin on enamel demineralization In orthodontic bracket bonding. The forty eight extracted sound bovine teeth were subdivided into four groups and treated with Phase II (Reliance, itasca. III) on the surface Group 1 was not treated. Group 2 was acid etched with 37% phosphoric acid for 30 seconds. Group 3 was applied with sealant after acid etching. Group 4 was applied with resin paste after acid etching and sealant application. Each group was demineralized in artificial caries solution. Demineralized enamel depth was measured by confocal laser scanning microscopy. The results were as follows: the mean demineralized enamel depth was $47.4{\mu}m$. (Group 1), $61.8{\mu}m$ (Group 2), $13.9{\mu}m$ (Group 3). $8.2{\mu}m$ (Group 4) the demineralized enamel depth was increased in Group 2 than in Group 1 (p<0.05); the demineralized enamel depth was reduced in Group 3 than in Group 1 and Group 2 with statistically significant differences (p<0.05): and demineralization in Group 4 was very little. The results of the present study indicate that sealant application is useful for reducing enamel demineralization in orthodontic bracket bonding.
The purposes of present study were to evaluate changes in models and lateral cephalometric head films during orthodontic treatment and to compare the amount of incisal retraction and anterior movement of molars with the two approaches of the retraction method of canine(sectional canine retractions vs sliding canine retractions) and the anchorage management(head gears vs no head gears, transpalatal arches vs no transpalatal arches and lingual arches vs no lingual arches) and to evaluate changes during orthodontic treatment in models with relation to lateral cephalometric head films. 67 Korean women with Angle's Class I bialveolar protrusion were selected, whose initial chronologic age was above 16 yrs. Models and lateral cephalometric head films were taken before and after orthodontic treatment with four bicuspid extraction. the results were obtained as follows. 1. Significant decreases were observed in intermolar width, arch length and arch perimeter of maxilla and mandible but significant difference was not observed in intercanine width of maxilla and mandible during treatment period. 2. The linear change of the upper incisor to upper lip was 2.84:1 and the linear change of the lower incisor to lower lip was 1.45:1 3. There were no significant differences between the two groups(sectional canine retractions vs sliding canine retractions), the !we groups(transpalatal arches vs no transpalatal arches) and the two groups(lingual arches vs no lingual arches) in the amount of incisal retraction and anterior movement of molars. There were a greater amount of maxillary incisal retraction and a lesser amount of anterior movement of maxillary molars with the use of head gears than no use of head gears. 4. Changes during orthodontic treatment in models with relation to lateral cephalometric head films were obtained as follows : 1) Maxilla Central incisors were moved 3.79mm backward, canines were moved 0.22mm laterally and 3.70mm backward, and molars were moved 0.535mm medially and 2.29mm forward. 2) Mandible Central incisors were moved 3.04mm backward, canines were moved 0.145mm laterally and 3.92mm backward, and molars were moved 0.755mm medially and 1.77mm forward.
Kim, Ji-Woong;Lee, Ki-Soo;Nahm, Jong-Hyun;Kang, Yoon-Goo
The korean journal of orthodontics
/
v.39
no.4
/
pp.248-256
/
2009
Objective: The aim of this study was to determine if human PDL cells can produce osteoclastogenic mRNA and examine how compressive stress affects the expression of osteoclastogenic mRNA in human PDL cells. Methods: Human PDL cells were obtained from biscupids extracted for orthodontic treatment. The compressive force was adjusted by increasing the number of cover glasses. PDL cells were subjected to a compressive force of 0.5, 1.0, 2.0, 3.0 or $4.0\;g/cm^2$ for 0.5, 1.5, 6, 24 or 48 hours. Reverse transcription polymerase chain reaction (RT-PCR) analysis was performed to examine levels of M-CSF, IL-$1{\beta}$, RANKL, OPG mRNA expression. Results: Human PDL cells could produce M-CSF mRNA. Human PDL cells under compressive stress showed increased M-CSF, IL-$1{\beta}$ and RANKL mRNAs expression in a force (up to $2\;g/cm^2$) and time-dependent manner. However, OPG mRNA expression was constant regardless of the level and duration of stress. Conclusions: Continuous compressive stress induced the mRNA expression of osteoclastogenic cytokines including M-CSF, RANKL, IL-$1{\beta}$ in PDL cells. Together with an unchanged OPG mRNA level, these results suggest that compressive stress-induced osteoclastogenesis in vivo is partly controlled by M-CSF, RANKL and IL-$1{\beta}$ expression in PDL cells.
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