• The korean journal of orthodontics
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• 제23권1호
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• pp.89-100
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• 1993

The purpose of this study was to evaluate the effect of orthodontic force on periodontal cellular activity by immunoperoxidase stain of epidermal growth factor, one of the tissue hormone. And supplementarily, to investigate of the changes of periodontal structures, periodontium was stained by H-E, Masson's Trichrome, P. A. S. stain after orthodontic force application. The experimental animals were four young adult dogs of average 8 month old. The fixed orthodontic appliance was cemented on mandibular right 4th premolar and 1st molar of each animal as experimental site. Mandibular left 4th premolar area of the same animal was used as control. The appliance consist of two silver crown soldered with 0.030' tube, $0.018\times0.022'$ S.S. sectional arch wire, and 0.009' open coil spring for manifestating of orthodontic force for bodily tooth movement of mandibular 4th premolar toward mesial direction. Experimental group was sacrificed at 1, 2, 3, 5 weeks from beginning of the experiment, and was investigated immunohistochemically and bistochemically by several staining methods. Findings were as follows: 1. The degree of EGF staining in control group was highest in epithelium of periodontium, and osteoclasts, osteoblasts and fibroblasts around the capillary were stained at higher level in periodontium. Generally, control group shows positive distribution of EGF all around the periodontal area. 2. The degree of EGF staining in control and 5 week group were similar, and did not show the significant different level between tension and pressure side. 3. All of 1, 2, 3 week group showed the same staining degree and distribution of EGF, and the tension side was more positive reaction of EGF stain than the pressure side. 4. The features of collagen fiber and periodontal fiber arrangement observed by H-E, Masson's Trichrome and P. A. S. stain revealed that oblique periodontal fibers were strectched in tension side, compressed in pressure side of all experimental group. Some fiber group in pressure side of 5 week group recovered the regular arrangement along the capillaries.

• The Journal of Korea Assosiation for Disability and Oral Health
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• 제7권1호
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• pp.38-43
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• 2011

Treatment of the mandibular fracture consists of reduction and fixation. Primary wire & Arch bar are perhaps the ideal method for intermaxillary fixation. But, daily feeding, swallowing, speech, and in some instances, respiration is difficult to maintain during the period of intermaxillary fixation, owing to muscle weakness, emotional disorder and poor oral hygiene in a position of the long-term bed disabled patient with multiple injuries. Therefore, Intermaxillary fixation is not applied in the disabled bed patient, the alternative methods must be obtained. In the case of the mandibular fracture, because of the absence of weight bearing, osseous union may eventually occur even without immobilization if the patient is maintained without wound infection on a controlled soft diet. For the purpose of the prevention of the wound infection, the establishment of an drainage on the oral lacerated wound is necessary for the removal of the hematoma & seroma in the fracture site. This is the report of a case that was managed conservatively without the intermaxillary fixation in the long-term disabled bed patient with a mandibular compound fracture.

• Journal of Periodontal and Implant Science
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• 제28권1호
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• pp.177-185
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• 1998

Periodontal disease and/or loss of teeth brings pathologic tooth migration that can result in esthetic and occlusal problems. Diastema and general spacing of the teeth, particularly in the anterior segments of the dentition are frequently developed in individuals with advanced periodontal disease. Thus, the overall treatment plan for a patent with advanced periodontal disease often involves periodontal orthodontic combined therapy. Orthodontic treatment in adults with periodontal disease is restricted to tooth alignment with special caution. Indirect bonding can achieve accurate bracket placement. A 38 year old woman with adult periodontitis was treated by periodontal therapy. Subsequently, her diastema was orthodontically corrected by indirect bonding technique. It must be an appropriate case report of periodontal-orthodontic combined therapy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권4호
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• pp.255-263
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• 2011

Introduction: Maxillomandibular fixation (MMF) is essential before surgery under general anesthesia in maxillofacial trauma patients. MMF is used basically to reconstruct the occlusion and occlusal stability to recover the facial shape and oral functions. The arch bar and wire is a traditional method for MMF, but it can not only bring pressure to the periodontal ligaments and teeth but also cause a penetrating injury to the surgeons. Materials and Methods: In this study, 198 patients with an open reduction using a manual reduction without MMF from September 2005 to May 2010 in Dankook University Dental Hospital were subjected to a follow-up evaluation during the postoperative 4 months periods. This study evaluated the incidence of complications according to the condition of the patient (gender, age), the state of bony union of the fracture sites and a numeric rating scale evaluation for postoperative pain scoring. Results: 1. The complications were classified into major and minor according to the seriousness, and the major complication rate was as low as 2.02%. Only 2 cases of re-operations (1.01%) were encountered. In the classification according to the fracture line, plate fracture was observed in both cases of mandibular symphysis fracture, and angle fractures and loosening of two screws were noted in the case of mandibular angle fracture. 2. The complication rate was similar regardless of gender and age. 3. The degree of bony union was satisfactory, and the complication rate was reduced as the bony union improved. 4. More patients complained of pain as the operation time was increased. Conclusion: The use of MMF is not always necessary if a skilled assistant is provided to help manually reduce the fracture site. Compared to other studies of mandibular fracture surgery using MMF, the complication rate was similar using only manual reduction and the patients' discomfort was reduced without MMF.

• Archives of Craniofacial Surgery
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• 제15권2호
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• pp.53-58
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• 2014

Background: Maxillomandibular fixation (MMF) is usually used to treat double mandibular fractures. However, advancements in reduction and fixation techniques may allow recovery of the premorbid dental arch and occlusion without the use of MMF. We investigated whether anatomical reduction and microplate fixation without MMF could provide secure immobilization and correct occlusion in double mandibular fractures. Methods: Thirty-four patients with double mandibular fractures were treated with open reduction and internal fixation without MMF. Both fracture sites were surgically treated. For bony fixations, we used microplates with or without wire. After reduction, each fracture site was fixed at two or three points to maintain anatomical alignment of the mandible. Interdental wiring was used to reduce the fracture at the superior border and to enhance stability for 6 weeks. Mouth opening was permitted immediately. Results: No major complications were observed, including infection, plate exposure, non-union, or significant malocclusion. Five patients experienced minor complications, among whom the only one patient experienced a persistant but mild malocclusion with no need for additional management. Conclusion: This study showed that double mandibular fractures correction with two-or three-point fixation without MMF simplified the surgical procedure, increased patient comfort, and reduced complications, due to good stability and excellent adaptation.

• The korean journal of orthodontics
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• 제37권2호
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• pp.114-124
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• 2007

Objective: The purpose of this study was to examine how the mesio-distal angulation and the length of each tooth changes on panoramic radiograph at different bucco-lingual inclinations. Methods: After constructing an acrylic model based on the mean arch of 30 adults with normal occlusion, the wire was placed in the center of the teeth on the acrylic model. First, the wire was implanted in normal angulation and inclination and a panoramic radiograph taken. After changing the inclination from $I-5^{\circ}\;to\;I+15^{\circ}\;by\;5^{\circ}$, a panoramic radiograph was taken again and the mesio-distal angle and wire length on the panoramic radiograph were assessed. Results: When the wire was implanted at the normal angulation and inclination, the length measured in the panoramic radiograph was magnified $111{\sim}117%$ from the original length in the anterior region and $121{\sim}125%$ in the posterior region. Only the central and lateral incisors showed significant length differences when the inclination was changed from $l-15^{\circ}\;to\;I+15^{\circ}$ at fixed angulation. When the inclination was changed from $l-15^{\circ}\;to\;I+15^{\circ}$, the angulation of most teeth on panoramic radiograph appeared to be more disto-angulated than in reality, and the lateral incisor and canine showed the largest difference. Only $l-15^{\circ}\;to\;I+15^{\circ}$ groups of premolars and $I+15^{\circ}$ group of molars showed more mesio-angulation than in reality. As the labio(bucco)lingual inclination of all teeth were decreased, tooth angulation in the panoramic radiograph appeared to be more disto-angulated. Conclusion: The labio-liugual inclination of teeth should be considered because it affects panoramic image of teeth, such as length of incisors and angulation of other teeth.

• Journal of the korean academy of Pediatric Dentistry
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• 제35권1호
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• pp.175-180
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• 2008

Traumatic injuries to the primary dentition are commonly encountered problems in dental practice. It is found that 30% of the children had injuries to the primary dentition and 22% to the permanent dentition. The greatest incidence of trauma to the primary dentition occurs at the ages of 2 and 3 as children start to learn motor coordination. Because teeth and alveolar bone are traumatized simultaneously, alveolar bone fractures are likely to occur when multiple teeth are involved in injuries. Dental splints are indicated for the management of maxillofacial fractures. They enable anatomic reduction of fractured segments and help immobilization and maintenance of the fragments after reduction. They also act as a stabilizer during rehabilitation. Various types of dental splints are available. In this case, routine resin-wire splint technique could not be applied because of the child's uncooperative behavior. Oral sedation was not indicated because N.P.O. had not been preceded. Therefore, we decided to use open-cap acrylic splint instead. Stabilization using open cap acrylic splint requires minimum chair time with reduced discomfort to both patient and dentist. It is an effective means of splint for uncooperative children and especially useful when other means of fixation have been failed. Because trauma on the primary dentition can affect the underlying permanent tooth germ, it is important to monitor eruption process of the permanent dentition.

• Journal of the korean academy of Pediatric Dentistry
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• 제37권1호
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• pp.117-123
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• 2010

Tooth eruption is the movement of the tooth from the developing place in the alveolar bone to the functional position in the oral cavity. The permanent incisors originate from the dental lamina on the lingual side of preceding deciduous tooth and erupt to the level of the occlusion through the well developed gubernacular cord. Ectopic eruption is a developmental disturbance in the eruption pattern of the permanent dentition. Most of the ectopically erupted lower incisor has been found in lingual side. The ectopically erupted tooth could be repositioned by orthodontic force in the early mixed dentition, which could help preventing the problems of loss of space and the lingual tilting of the lower anterior teeth. An eight-year-old girl visited the department of pediatric dentistry, Yonsei Dental University Hospital, for the evaluation and the treatment of the lower right lateral incisor, which was horizontally erupted in the lingual side, parallel to the mouth floor. Her tongue was placed on the labial side of that tooth. There was no previous dental history of dental caries or trauma on the pre-occupied primary incisor. Clinical and radiographic examinations including the computed tomography(CT), showed no evidence of dilacerations on root. Therefore, we decided to start active orthodontic traction of the lower right lateral incisor. We designed the fixed type of buccal arch wire and the lip bumper with hook for the traction. Button was attached to the lingual side of the ectopically positioned tooth. Elastic was used between the appliance and the button on that tooth. After the tooth become upright over the tongue level, appliance was change to the removable type and periodic check-up with occlusal guidance was followed to monitor the position of the tooth. In this case using the fixed appliance with modified form of lip bumper and hook embedded in acrylic part instead of extraction was very efficient up-righting the ectopically erupted tooth toward the occlusal plane.

• The korean journal of orthodontics
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• 제36권2호
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• pp.125-135
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• 2006

The purpose of this study was to measure and compare the level of frictional resistance generated from three currently used ceramic brackets; 1, Crystaline $V^{(R)}$, Tomy International Inc., Tokyo, Japan; 2, $Clarity^{(R)}$, 3M Unitek, Monrovia, CA, USA; 3, $Inspire^{(R)}$, Ormco, Orange, CA, USA; with composite resin brackets, Spirit, Ormco, Orange, CA, USA; and conventional stainless steel brackets, Kosaka, Tomy International Inc., Tokyo, Japan used as controls. In this experiment, the resistance to sliding was studied as a function of four angulations $(0^{\circ},\;5^{\circ},\;10^{\circ}\;and\;15^{\circ})$ using 2 different orthodontic wire alloys: stainless steel (stainless steel, SDS Ormco, Orange, CA, USA), and beta-titanium (TMA, SDS Ormco, Orange, CA, USA). After mounting the 22 mil brackets to the fixture and $.019{\times}.025$ wires ligated with elastic ligatures, the arch wires were slid through the brackets at 5mm/min in the dry state at $34^{\circ}C$. Silica-insert ceramic brackets generated a significantly lower frictional force than did other ceramic brackets, similar to that of stainless steel brackets. Beta-titanium archwires had higher frictional resistance than did stainless steel, and all the brackets showed higher static and kinetic frictional force as the angulation increased. When the angulation exceeded $5^{\circ}$, the active configuration emerged and frictional force quickly increased by 2.5 to 4.5-fold. The order of frictional force of the different wire-bracket couples transposed as the angle increased. The silica-insert ceramic bracket is a valuable alternative to conventional stainless steel brackets for patients with esthetic demands.

• The korean journal of orthodontics
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• 제40권4호
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• pp.276-287
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• 2010

This case report describes the treatment of a 23-year, 8-month-old female patient with a Class II malocclusion who showed severe bidentoalveolar protrusion and anterior crowding. The treatment plan consisted of extracting all the first premolars, decrowding and en masse retraction of the upper six anterior teeth and lower anteriors. The upper C-plate placed in the midpalatal area combined with lingual sheath fixtures were used as substitutes for posterior anchorage teeth during upper anterior retraction. Preadjusted brackets (0.022-inch) were used for upper anterior decrowding. A 0.9 mm diameter stainless steel lever-arm soldered to the main arch wire facilitated controlled retraction of upper anteriors. The upper and lower dentition was detailed using a tooth positioner during the finishing stage. Correct overbite and overjet were obtained by decrowding and retraction of the upper six anterior teeth into their proper positions. Use of the C-plate and lingual appliances provided ideal anchorage to enhance the improvement in facial balance. The active treatment period was 19 months. The treatment result was stable 13 months after debonding.