• Journal of Dental Rehabilitation and Applied Science
• /
• v.25 no.2
• /
• pp.109-123
• /
• 2009

The aim of the study was to assess the influence of insertion torque of bone quality and to compare axial force, moment and von Mises stress using finite element analysis of plastoelastic property for bone stress and strain by dividing bone quality to its thickness of cortical bone, density of trabecular bone and existence of lower cortical bone when implant inserted to mandibular premolar region. The $Br{\aa}nemark$ MKIII. RP implant and cylindrical bone finite model were designed as cortical bone at upper border and trabecular bone below the cortical bone. 7 models were made according to thickness of cortical bone, density of trabecular bone and bicortical anchorage and von Mises stress, axial force and moment were compared by running time. Dividing the insertion time, it seemed 300msec that inferior border of implant flange impinged the upper border of bone, 550msec that implant flange placed in middle of upper border and 800msec that superior border of implant flange was at the same level as bone surface. The maximum axial force peak was at about 500msec, and maximum moment peak was at about 800msec. The correlation of von Mises stress distribution was seen at both peak level. The following findings were appeared by the study which compared the axial force by its each area. The axial force was measured highest when $Br{\aa}nemark$ MKIII implant flange inserts the cortical bone. And maximal moment was measured highest after axial force suddenly decreased when the flange impinged at upper border and the concentration of von Mises stress distribution was at the same site. When implant was placed, the axial force and moment was measured high as the cortical bone got thicker and the force concentrated at the cortical bone site. The influence of density in trabecular bone to axial force was less when cortical bone was 1.5 mm thick but it might be more affected when the thickness was 0.5 mm. The total axial force with bicortical anchorage, was similar when upper border thickness was the same. But at the lower border the axial force of bicortical model was higher than that of monocortical model. Within the limitation of this FEA study, the insertion torque was most affected by the thickness of cortical bone when it was placed the $Br{\aa}nemark$ MKIII implant in premolar region of mandible.

• Imaging Science in Dentistry
• /
• v.48 no.1
• /
• pp.51-57
• /
• 2018

Purpose: To perform a comparative analysis of the palatal bone thickness in Thai patients exhibiting class I malocclusion according to whether they exhibited a normal or open vertical skeletal configuration using cone-beam computed tomography (CBCT). Materials and Methods: Thirty CBCT images of Thai orthodontic patients (15-30 years of age) exhibiting class I malocclusion with a normal or open vertical skeletal configuration were selected. Palatal bone thickness was measured in a 3.0-mm grid pattern on both the right and left sides. The palatal bone thickness of the normal-bite and open-bite groups was compared using the independent t-test. The level of significance was established at P<.05. Results: The palatal bone thickness in the normal-bite group ranged from $2.2{\pm}1.0mm$ to $12.6{\pm}4.1mm$. The palatal bone thickness in the open-bite group ranged from $1.9{\pm}1.1mm$ to $13.2{\pm}2.3mm$. The palatal bone thickness was lower at almost all sites in patients with open bite than in those with normal bite. Significant differences were found at almost all anteroposterior sites along the 3 most medial sections (3.0, 6.0, and 9.0 mm lateral to the midsagittal plane)(P<.05). Conclusion: Class I malocclusion with open vertical skeletal configuration may affect palatal bone thickness, so the placement of temporary anchorage devices or miniscrew implants in the palatal area in such patients should be performed with caution.

• The korean journal of orthodontics
• /
• v.28 no.3 s.68
• /
• pp.453-459
• /
• 1998

The dental implants for edentulous Patients have been used for more than 20 years. After the introduction of osseointegration by $Br{\aa}nemark$, the commercially pure titanium implants were accepted by most practitioners. Recently dental implants are used for orthodontic anchorages as well as prosthetic abutment. Many researchers have reported implants as a good orthodontic anchorage through basic research and clinical evaluation. But previous researches were done after the healing time for osseointegration of inserted implants. If dental implants are to be used for prosthetic abutment the healing time for osseointegration is necessary, but orthodontic forces to implants are different from bite force regarding its amount of force, duration and direction. The authors evaluated the effect of orthopedic force to implants on bone tissue before osseointegration. 48 implants were placed at 12 rabbits. 2 implants into left side and 2 implants into right side were inserted along the long axis of femur respectively 2 weeks (2 weeks group), 4 weeks (4 weeks group) and 6 weeks (6 weeks group) after implants placement, 300g force had been applied to the implants at left side femur by Ni-Ti close coil spring for 4 weeks (experimental group) and no force applied to implants at right side femur (control group). After the force application for 4weeks, rabbits were sacrificed and microscopic evaluation was done by hematoxylin-eosin stain and Masson trichrome stain. The result3 were followed. 1. All implants in experimental group remained rigid after the force application for 4 weeks. 2. More fibrous tissue between bone and implants were noticed at 2 weeks experimental group than 2 weeks control group 3. More bone remodeling was noticed at 4weeks group than 2 weeks group and it was difficult to find out fibrous tissue between bone and implants at both experimental and control group of 4 weeks group. 4. It was hard to distinguish experimental group from control group at 6 weeks group. Therefore if initial stability can be obtained on implant insertion, it can be possible to use implants as a orthodontic anchorage before the healing time for osseointegration.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.36 no.4
• /
• pp.272-281
• /
• 2020

Agenesis of permanent tooth in adolescent patients can be treated either by orthodontic treatment for space closure or by maintaining the space until implant restoration can be carried out in adult. However, gradual atrophy of alveolar bone width makes it difficult to restore the prosthesis in the future or may cause unaesthetic results. Therefore, maintaining of not only the missing space but also the alveolar bone width should be considered. This case is a treatment whereby a temporary replacement of missing 2 mandibular incisors in adolescent patient was carried out using 2 temporary anchorage devices (TADs). Two TADs were placed horizontally 2 - 3 mm below the top of alveolar ridge, and fixed with artificial teeth by stainless steel wires extended. During the 2 year follow-up, neither gingival inflammation nor loss of the TADs have occurred. In the radiographic evaluation, the growth of the adjacent alveolar bone was not inhibited, and the width of the alveolar bone was maintained.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.41 no.2
• /
• pp.157-165
• /
• 2014

Skeletal anchorage is recommended as an orthodontic treatment for an impacted immature permanent tooth. Among these methods, C-tube is relatively safe because it is fixed to the cortical bone of interdental and the lower part of the root with several short miniscrews, which causes less damage to the root in patients of early permanent dentition. As it can be easily bent, the traction direction can be adjusted to favorable bone density sites. However, patient cooperation is important and traction based on physiological force in order to gain root and dentoalveolar tissue development in immature permanent teeth is required. Periodic follow-ups should be mandatory.

• Journal of Periodontal and Implant Science
• /
• v.35 no.3
• /
• pp.789-798
• /
• 2005

Primary stability is a fundamental criteria of implant success. There has been various trials to increase initial stability and bone to implant contact. The objective of osteotome technique is to preserve all the existing bone by minimizing or even eliminating the drilling sequence of the surgical protocol. The bone layer adjacent to the osteotomy site is progressively compacted with various bone condensers(osteotomes) this will result in a denser bone to implant contact. This improved bone density helps to optimize primary implant stability in low density bone. The use of wide implant is one of methods to increse primary stability. They can be used in special situations in which they can increase the surface area available for implant anchorage and improve their primary stability The aim of this study was to evaluate the influence of the osteotome technique and implant width on primary stability. Osteotome technique was compared with conventional drilling method by resonance frequency measurments according to the implant fixtures diameter. The results were as follows: 1. The average of ISQ value was sightly higher in osteotome technique, but there was not statistically significant in regular and narrow implant(p <0.05). 2. Either osteotome technique or conventional technique. ISQ value was significantly higer as increasing of implant diameter(p <0.05). 3. ISQ value of drilling technique was higer than those of osteotome technique in wide implant. It was assumed to be caused by difference in final preparation diameter.

• The korean journal of orthodontics
• /
• v.51 no.1
• /
• pp.23-31
• /
• 2021

Objective: To evaluate the mandibular buccal shelf (MBS) in terms of the angulation and bone depth and thickness according to sex, age, and sagittal and vertical skeletal patterns in a Colombian population using cone-beam computed tomography (CBCT). Accordingly, the optimal site for miniscrew insertion in this area was determined. Methods: This descriptive, retrospective study included 64 hemi-arches of 34 patients. On CBCT images, the angulation, buccal bone depth (4 and 6 mm from the cementoenamel junction [CEJ] of MBS), and buccal bone thickness (6 and 11 mm from the CEJ of MBS) were measured at the mesial and distal roots of the mandibular first and second molars. Results: There were no statistically significant differences in the angulation, depth, and thickness of MBS between male and female patients. The values for the bone around the distal root of the mandibular second molar were significantly greater than the other values. The osseous characteristics were significantly better in participants aged 16-24 years. Class III patients exhibited the best osseous characteristics, with the bone depth at 6 mm being significantly different from that in Class I and Class II patients. Although values tended to be greater in patients with low angles, the difference was not statistically significant. Conclusions: MBS provides an optimal bone surface for miniscrew insertion, with better osseous characteristics at the distal root of the mandibular second molar, 4 mm from CEJ. Adolescent patients, Class III patients, and patients with a low angle exhibit the most favorable osseous characteristics in the MBS area.

• Imaging Science in Dentistry
• /
• v.40 no.4
• /
• pp.179-185
• /
• 2010

Purpose : Cortical bone thickness is one of the important factor in mini-implant stability. This study was performed to investigate the buccal cortical bone thickness at every interdental area as an aid in planning mini-implant placement. Materials and Methods : Two-dimensional slices at every interdental area were selected from the cone-beam computed tomography scans of 20 patients in third decade. Buccal cortical bone thickness was measured at 2, 4, and 6 mm levels from the alveolar crest in the interdental bones of posterior regions of both jaws using the plot profile function of $Ez3D2009^{TM}$ (Vatech, Yongin, Korea). The results were analyzed using by Mann-Whitney test. Results : Buccal cortical bone was thicker in the mandible than in the maxilla. The thickness increased with further distance from the alveolar crest in the maxilla and with coming from the posterior to anterior region in the mandible (p<0.01). The maximum CT value showed an increasing tendency with further distance from the alveolar crest and with coming from posterior to anterior region in both jaws. Conclusion : Interdental buccal cortical bone thickness varied in both jaws, however our study showed a distinct tendency. We expect that these results could be helpful for the selection and preparation of mini-implant sites.

• The korean journal of orthodontics
• /
• v.52 no.5
• /
• pp.313-323
• /
• 2022

Objective: This study aimed to estimate the clinical effects of different types of bone-anchored maxillary protraction devices by using a network meta-analysis. Methods: We searched seven databases for randomized and controlled clinical trials that compared bone-anchored maxillary protraction with tooth-anchored maxillary protraction interventions or untreated groups up to May 2021. After literature selection, data extraction, and quality assessment, we calculated the mean differences, 95% confidence intervals, and surface under the cumulative ranking scores of eleven indicators. Statistical analysis was performed using R statistical software with the GeMTC package based on the Bayesian framework. Results: Six interventions and 667 patients were involved in 18 studies. In comparison with the tooth-anchored groups, the bone-anchored groups showed significantly more increases in Sella-Nasion-Subspinale (°), Subspinale-Nasion-Supramentale(°) and significantly fewer increases in mandibular plane angle and the labial proclination angle of upper incisors. In comparison with the control group, Sella-Nasion-Supramentale(°) decreased without any statistical significance in all treated groups. IMPA (angle of lower incisors and mandibular plane) decreased in groups with facemasks and increased in other groups. Conclusions: Bone-anchored maxillary protraction can promote greater maxillary forward movement and correct the Class III intermaxillary relationship better, in addition to showing less clockwise rotation of mandible and labial proclination of upper incisors. However, strengthening anchorage could not inhibit mandibular growth better and the lingual inclination of lower incisors caused by the treatment is related to the use of a facemask.

• The korean journal of orthodontics
• /
• v.39 no.6
• /
• pp.354-361
• /
• 2009

Objective: Miniscrews are widely used in orthodontic treatment for the purpose of anchorage control. Maximum anchorage can be acquired by the use of miniscrews. Maxillary miniscrew has many clinical advantage for orthodontic treatment. Maxillary sinus, tooth root can be an obstacle for maxillary miniscrew installation. The purpose of this study was to find the safest area and direction of miniscrew insertion in consideration of the maxillary sinus. Methods: The maxillary sinus area of 40 patients (20 male, 20 female) was measured using 3D computed tomography and 3D reconstruction program. Results: The maxillary sinus floor was located most inferiorly between the 1st molar and 2nd molar and located most superiorly between the 1st premolar and 2nd premolar. Buccal bone thickness from the maxillary sinus is significantly thicker between the 1st molar and 2nd molar and significantly thinner between the 1st premolar and 2nd premolar. The area between the 1st premolar and 2nd premolar has a significantly longer vertical distance from CEJ to sinus in consideration of buccal bone thickness. Conclusions: Considering maxillary bone thickness, the posterior area has advantages over the anterior area for installing miniscrews safely and preventing perforation.