Journal of Dental Rehabilitation and Applied Science
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v.25
no.1
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pp.61-71
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2009
Anchorage control is important in orthodontic treatment. Recently miniscrew is widly used as maximum anchorage in orthodontic treatment, and then it is important to install miniscrew safely without damaging adjacent anatomic structure. In a view of Miniscrew's stability, maxilla is unfavorable than mandible, and moreover maxillary soft buccal bone has disadvantage on stability. so palatal area comes into notice for installation area. We measured distance between palatal roots and bone thickness at midpalatal area using 3D computed tomography, and have found following results. 1. On the comparison of distance between palatal roots, the distance between 2nd premolar and 1st molar was significantly longest and the distance between premolars was significantly shortest. 2. Going toward lateral area from midpalatal suture and posterior area from zero point, bone thickness significantly became shorter and shorter. And 5.0mm palatal sagittal plane has more significance decrease of bone thickness than 2.5mm palatal sagittal plane. According to these results, we can conclude that the palatal installation of miniscrew between 2nd premolar and 1st molar is safest. And it is more safe that comes closer to midpalatal suture and to anterior area in regard to incisive canal.
Purpose: The purpose of this study is to compare the accuracy of the CT guided implant template that was produced by using an intraoral scanner according to the edentulous distance. Materials and methods: Five maxillary casts were fabricated using radiopaque acrylic resin with the second premolars, first molars, and second molars missing. Then a virtual cast was acquired by scanning each resin cast. Implant treatment was planned on the missing sites by superimposing the presurgical CT DICOM file and the virtual cast. Then the implants were placed using a surgical template followed by postsurgical CT scan. The distance and angle of the platform and apex between the presurgical implant and postsurgical implant were measured using the X, Y, and Z axis of the superimposed presurgical CT and postsurgical CT via software followed by statistical analysis using Kruskall-Wallis test and Mann-Whitney test. Results: The implant placement angle error increased towards the second molars but there was no statistically significant difference. The implant placement distance error at the platform and apex also increased towards the second molars and there was a statistically significant error at the second molars. Conclusion: Although the placement angle had no statistically significant difference between the presurgical implant and postsurgical implant, the placement distance at the platform and apex showed a larger error and a statistically significant difference at the second molar implant.
Statement of problems: Stress analysis on implant components of the combined screw- and cement-retained implant prosthesis has not investigated yet. Purpose: The purpose of this study was to assess the load distribution characteristics of implant prostheses with the different prosthodontic retention types, such as cement-type, screw-type and combined type by using 3-dimensional finite element analysis. Material and methods: A 3-dimensional finite element model was created in which two SS II implants (Osstem Co. Ltd.) were placed in the areas of the first premolar and the first molar in the mandible, and three-unit fixed partial dentures with four different retention types were fabricated on the two SS II implants. Model 1 was a cement-retained implant restoration made on two cement-retained type abutments (Comocta abutment; Osstem Co. Ltd.), and Model 2 was a screw-retained implant restoration made on the screw-retained type abutments (Octa abutment; Osstem Co. Ltd.). Model 3 was a combined type implant restoration made on the cement-retained type abutment (Comocta abutment) for the first molar and the screw-retained type abutment (Octa abutment) for the first premolar. Lastly, Model 4 was a combined type implant restoration made on the screw-retained type abutment (Octa abutment) for the first molar and the cement-retained type abutment (Comocta abutment) for the first premolar. Average masticatory force was applied on the central fossa in a vertical direction, and on the buccal cusp in a vertical and oblique direction for each model. Von-Mises stress patterns on alveolar bone, implant body, abutment, abutment screw, and prosthetic screw around implant prostheses were evaluated through 3-dimensional finite element analysis. Results: Model 2 showed the lowest von Mises stress. In all models, the von Mises stress distribution of cortical bone, cancellous bone and implant body showed the similar pattern. Regardless of loading conditions and type of abutment system, the stress of bone was concentrated on the cortical bone. The von-Mises stress on abutment, abutment screw, and prosthetic screw showed the lower values for the screw-retained type abutment than for the cement-retained type abutment regardless of the model type. There was little reciprocal effect of the abutment system between the molar and the premolar position. For all models, buccal cusp oblique loading caused the largest stress, followed by buccal cusp vertical loading and center vertical loading. Conclusion: Within the limitation of the FEA study, the combined type implant prosthesis did not demonstrate more stress around implant components than the cement type implant prosthesis. Under the assumption of ideal passive fit, the screw-type implant prosthesis showed the east stress around implant components.
Journal of the korean academy of Pediatric Dentistry
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v.28
no.3
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pp.488-495
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2001
Treatment of class II malocclusions require distalization of maxillary molars into class I relationship. Intraarch distal molar movement techniques have recently assumed an important role in young patients. In this study, the dental and skeletal effects of the pendulum appliance were evaluated by means of cephalometric radiographs. The samples were consisted of 19 patients: 11 females and 8 males, mean age $11.68{\pm}1.52$ years. Measurements were obtained from cephalometric prior to and the day of removal of the pendulum appliance. Treatment changes were analyzed. The following results were obtain. 1. The pendulum appliance produced $2.94{\pm}1.54mm$ distal molar movement with a mean intrusion of $1.17{\pm}0.97mm$, mean period $18.13{\pm}7.95$ weeks. 2. The anchor tooth was $1.34{\pm}1.40mm$ forward movement and $0.48{\pm}0.99mm$ extrusion, and labial tilting of incisors. 3. The angle between palatal plane and mandibular plane increased significantly. 4. There was no significant difference in according to 2nd molar position. 5. Total movement was consisted of 74% distal movement of 1st molar and 26% forward movement of the anchor tooth.
Objective: The purpose of this study was to evaluate the dentoskeletal and soft tissue profile changes after extraction of two lower first or second premolars in "borderline" adult skeletal Class III cases. Methods: Twenty-eight patients with "borderline" skeletal Class III malocclusion were studied. All of them were treated by extraction of two lower first or second premolars. Lateral cephalometric radiographs taken at the start and end of treatment were analysed. Twenty-five cephalometric variables were calculated and paired $t$-tests were performed. Results: After treatment, no significant changes were noted in the skeletal parameters ($p{\geq}0.05$). Regarding the dental parameters, the L1-MP angle decreased by $8.1^{\circ}$, the U1-L1 angle increased by $7.7^{\circ}$ ($p$ < 0.01), the overjet distance increased by 5.7 mm ($p$ < 0.01), the L1-NB angle decreased by $7.3^{\circ}$ and the L1-NB distance decreased by 4.8 mm ($p$ < 0.01). The soft tissue parameters of Li-E, Li-H and Li-RL2 distance decreased by 3.2 mm, 3.4 mm and 4.1 mm respectively ($p$ < 0.01). Conclusions: Orthodontic camouflage treatment by extraction of two lower first or second premolars provides a viable treatment alternative for "borderline" skeletal Class III cases to achieve a good occlusal relationship.
Journal of the korean academy of Pediatric Dentistry
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v.34
no.2
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pp.215-221
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2007
The aim of this study was to test whether metric measurements of crown length, root length and apex width during tooth development could be a better basis for correlation with age than the classical methods based on subjective estimations of various stages of tooth development. Panoramic radiographs of 120 children, aged 7 to 9 years, were collected from the department of the pediatric dentistry of Chonnam National University Hospital, Korea. The methods of Mornstad was used to estimate age. The structures measured were crown length root length and apex width in panoramic radiographic. The results were as follows : 1. In the boys, it showed higher correlation between lower 2nd molar crown length, lower 1st molar root length or lower 1st permolar apical width and age. In the girls, it showed higher correlation between lower 2nd premolar crown length, lower 2nd molar root length or lower 1st molar apical width and age. 2. With the aid of a multiple regression model, a linear relationship between some of these distances and age was shown. Boy(months) = 43.958 + lower 2nd molar crown length ${\times}$ 4.392 + lower 1st molar root length ${\times}$ 2.255 - lower 1st permolar apical width ${\times}$ 2.046, Girl(months) = 75.213 + lower 2nd premolar crown length ${\times}$ 3.910 lower 2nd molar root length ${\times}$ 2.280 - lower 1st molar apical width ${\times}$ 6.217 Age was estimated in boys and girls using the mathematic model ; the mean difference between chronological and estimated ages was $-2.1{\pm}6.8$ months for boys and $6.1{\pm}6.2$ months for girls. Therefore, it seems to be more accurate and easier than the earlier methods.
The purpose of this study was to determine the proliferative activity of the osteoblasts and fibroblasts in the midpalatal area and to investigate the adjacent periodontal tissues of individual tooth following rapid expansion of the palate. Ten young adult dogs, aged approximately ten months, were used in the experiment. The experimental design was consisted of 1 week expansion group(Group E1, 3 dogs), 2 week expansion group(Group E2, 3 dogs), 2 week expansion and 2 week retention group(Group E3, 3 dogs), and control group(Group C, 1 dog). For each group, expansion screw was activated one time per day(1/4 turn;$90^{\circ}$) following Hyrax-screw application. The experimental animals in each group were sacrificed at 1, 2 and 4 weeks following palatal expansion. Maxillary tissue blocks were obtained and prepared ior the histomorphologic and immunohistochemical studies. Light mcroscope, polarizing microscope, and soft X-ray apparatus were used in this study, and following results were obtained. 1. In polarizing microscopic study, the expansion groups(E1 & E2) showed blue color representing bone resorption and new bone formation in midpalatal suture area. E3 groups skewed less blue color compared to the E1 and E2 group. But yellow color increased by calcification in the E3 groups. 2. Immunohistochemical study revealed that positive responses of the osteoblasts to PCNA and undifferentiated fibroblasts to EGF in E1 group were somewhat increased. Positive response to PCNA and EGF were increased in fibroblasts and the osteoblasts forming new bone in E2 group. In E3 group, the positive response cell concentrated the periphery of edge of palatal process in both PCNA and EGF. 3. Throughout the expansion period(E1 & E2), light microscopic study showed the edges of the extensive resorption and new palatal processes, indicating bone remodeling within the suture. E3 group exhibited less remodeling of midpalatal suture area. E2 group and E3 group showed cementum formation and resorption at the apex of 3rd premolar and 1st molar E3 group exhibited extensive hyalinized zone on the cervical portion of buccal side of 1st molar. 4. Soft X-ray analysis of E1 group showed hypomineralized defect and microfractures in various parts of the suture areas when compared with control animals. There was no significant difference in the degree of mineralization in the midpalatal suture region between the C and E3 groups. Tooth axis showed tipping of 3rd premolar and 1st molar in the E2 group and E3 group. Based upon these experimental results, it is concluded that the undifferentiated mesenchymal cells always presented in midpalatal suture area following RPE. Differentiated osteoblasts and fibroblasts possess proliferating cellular activity until the 2 week retention period. The posterior teeth are tend to tip buccally as RPE force applied. Retention group exhibited irreversible response with severe hyalinized zone on the buccal surface of the first molar.
Purpose: Dentists suffer back, neck and shoulder pain during their careers due to bad operating posture. If dentists have a good operating posture ergonomically, there would be less pain and discomfort in the shoulder and back. Therefore, dentists should learn the Home position which enables dentists to approach a stable posture ergonomically. This study was to compare tooth preparation in the Home position and the Random position, and evaluate the clinical efficacy of the Home position. Materials and methods: Tooth preparation for fixed partial denture was performed on the maxillary left 2nd premolar and maxillary left 2nd molar at the two different operating positions were compared. The amount of occlusal reduction, marginal width, subgingival margin depth, and convergence angle were measured. A T-test was performed separately to compare the results of the Random position and the Home position. Results: 1. The amounts of average thickness of occlusal reduction on fossa were deficient to the ordered ones in the Random position and the Home position (P > .05). 2. The average subgingival margin depth of prepared margin on maxillary left 2nd premolar, maxillary left 2nd molar were excessive in the Random position than in the Home position. On the maxillary left 2nd premolar, there was no statistical difference in the Random position and the Home position except Distal midline, DL line angle, Lingual midline, ML line angle (P< .05). On the maxillary left 2nd molar, there was no statistical difference in the Random position and the Home position (P < .05). 3. Average convergence angle in the Random position and the Home position were excessive compared to the ordered angle. There was no statistical difference in the Random position and the Home position (P > .05). 4. Analysis of pearson correlation : In the Random position, the amounts of average thickness of occlusal reduction, the average subgingival margin depth of prepared margin, convergence angle were significantly associated with each other (P < .05). But in the Home position, they were not significantly associated with each other (P < .05). 5. The time needed for preparation in the Home position was faster or equal than that of the Random position as time went on. Conclusion: In conclusion, there were no significant differences between Home position and Random position in measures of occlusal reduction, marginal width, marginal depth, convergence angle. However, preparation time and incidence of damaging adjacent teeth were less in Home position than in Random position. Therefore, if trained properly, Home position which is more ergonomically stable can be adopted for clinical use.
Journal of the korean academy of Pediatric Dentistry
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v.28
no.3
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pp.421-429
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2001
Since Non-Extraction treatment in some orthodontic case shows unstable result and unfavorable profile, extraction is selected as inevitable treatment option for the harmonious profile, facial skeleton, and the stable dentition on both arches. For the achievement of proper goal, premolars, molars, sometimes incisors or canines are selected to be extracted. The first Premolar is usually extracted for relieving the crowded dentition with which the molar relations are class I to gain stable dentition and proper profile, but often results in the depression of profile or the loss of vortical dimension. On the contrary, the extracton of the second molar helps maintaining the fullness of profile and the vertical dimension, prevents additional space closural procedures which often make the procedures complicated, relieves both anterior and posterior crowding, and substitutes the extraction fossae for newly erupting 3rd molars. From the point of recurrence, the second molar extraction procedure, therefore, is more beneficial. This cases showed the good results of second molar extraction procedures in the patients with class I crowding.
Retrostpective study of two groups of patients was conducted to evaluate the physiologic drift of the mandibular teeth following the extraction of four first premolars. The concept of physiologic drift, commonly referred to as 'driftodontics', following first premolar extractions has been gaining acceptance in the orthodontic community, the exact nature and amount of drift has not been adequately documented. There were also no guide lines as to when drift should be allowed to now. The purpose of this study was to quantify physiologic drift of the untreated mandibular dentition following extraction of the four first premolars during the early permanent and late permanent dentition stages. The early permanent dentition extraction sample(Group 1) included 26 Patients and the mean age at pretreatment was approximately 13.5 years. The observation period following extraction was approximately 6.96 months. The late permanent dentition extraction sample(Group 2) included 31 patients. The mean age at pretreatment was 21.3 years, followed by a observation period of 7.26 months. During the observation period, except for the extractions, no other mandibular therapy was rendered. Pre-and post-treatment lateral cephalograms and dental casts were analyzed. The obtained results were as follows 1. Group 2 showed marked changes in movements of the mandibular incisors and canines but minimal changes in molars. 2. The amount of changes in movements of the mandibular incisors and canines were significantly greater in Group 1 than in Group 2. The results showed no differences in rates of molar movements between groups. 3. Physiologic drift of the dentition produced desirable changes such as decreased Incisor Irregularity.
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