• The korean journal of orthodontics
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• v.54 no.2
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• pp.117-127
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• 2024

Objective: To evaluate the effect of clear aligner treatment and differential sequence distalization of maxillary posterior teeth on anchorage loss in the upper incisors (U1s). Methods: This study used lateral cephalometries and digital models of 12 patients treated with 33% sequential distalization (group 1, mean age: 22.9 ± 0.7 years, five males, seven females) and 12 treated with 50% sequential distalization (group 2, mean age: 25.83 ± 0.5 years, three males, nine females) acquired before and after distalization of upper second premolars (U5) and upper first molars (U6) and upper second molars (U7). The amount of distalization was determined as 2.5 mm in both the groups. Independent Samples t test was used to compare normally distributed parameters. Mann-Whitney U and Wilcoxon tests were used to compare parameters that were not normally distributed. Results: In both groups, the posterior teeth significantly moved by tipping distally and the U1s were displaced anteriorly. Increase in maxillary posterior transverse width (P < 0.001) and distopalatal rotation were observed in U5, U6, and U7 after distalization. It was also observed that U1 was significantly more proclined (1.82°; P < 0.001) and protruded (0.62 mm; P < 0.001), and the overjet (0.45 mm; P < 0.001) increased more in group 1 than in group 2. Conclusions: After sequential distalization of maxillary posterior teeth, more anchorage loss was observed in the anterior region in group 1 than in group 2.

• The korean journal of orthodontics
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• v.47 no.5
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• pp.289-297
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• 2017

Objective: The objective of this study was to analyze the patterns of tooth movements when distalization of mandibular molars using a mini-plate took place. A finite element analysis was applied to analyze patterns of tooth movements. Methods: The model of the mandible and teeth were used to build a finite element analysis model, and a mini-plate was inserted in the mandibular ramus. Two different orthodontic forces were established for displacement of mandibular molars. Orthodontic forces were applied at the level of the bracket and at the level of the cemento-enamel junction in the mandibular canine respectively. Results: Applying orthodontic forces at the level of the cemento-enamel junction resulted in a greater biomechanical bodily movement in distalization of the mandibular molars compared to when the orthodontic forces were applied at the level of the bracket. Applying orthodontic forces to the cemento-enamel junction also resulted in unwanted greater extrusive movements in distalization of the mandibular molars compared to the bracket level. Conclusions: With considering the mode of orthodontic teeth movement, applying different vertical orthodontic forces for distalization of mandibular molars can lead to more effective distalization of teeth.

• The korean journal of orthodontics
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• v.47 no.2
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• pp.142-147
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• 2017

The purpose of this study was to investigate immediate changes in the mandibular dentition after maxillary molar distalization using headgear in non-growing patients. Sixteen patients (mean age, $18.9{\pm}2.0$ years) with Class II molar relationship and crowding were included in the present study. To correct the molar relationship, headgear was used for maxillary molar distalization. Cone-beam computed tomography-generated half-cephalograms (CG Cephs) and dental casts were used to evaluate dental changes for each subject before and immediately after molar distalization using headgear. The mean duration that subjects wore the headgear was 6.3 months. CG Cephs showed that the first maxillary molars were distalized $4.2{\pm}1.6\;mm$ with $9.7^{\circ}{\pm}6.1^{\circ}$ of distal angulation. The intercanine, interpremolar, and intermolar widths of the mandible increased after maxillary molar distalization. The present study's results suggest that maxillary molar distalization using headgear induces a spontaneous response in the untreated mandibular dentition of non-growing patients.

• The korean journal of orthodontics
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• v.46 no.4
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• pp.212-219
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• 2016

Objective: The purpose of this study was to evaluate treatment effects after distalization of the mandibular dentition using ramal plates through lateral cephalograms. Methods: Pre- and post-treatment lateral cephalograms and dental casts of 22 adult patients (11 males and 11 females; mean age, $23.9{\pm}5.52years$) who received ramal plates for mandibular molar distalization were analyzed. The treatment effects and amount of distalization of the mandibular molars were calculated and tested for statistical significance. The significance level was set at p < 0.001. Results: The mandibular first molar distalization at the crown and root were 2.10 mm (p < 0.001) and 0.81 mm (p = 0.011), respectively. In the evaluation of skeletal variables, there was a significant increase in the Wits appraisal (p < 0.001). In the evaluation of the soft tissue, there was no significant effect on upper lip position, but the lower lips showed a significant retraction of 2.2 mm (p < 0.001). Conclusions: The mandibular molars showed a significant amount of distalization accompanied by limited extrusion and mesiobuccal rotation of the crowns. A ramal plate may be a viable device for mandibular total arch distalization in Class III patients who are reluctant to undergo orthognathic surgery.

• The korean journal of orthodontics
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• v.40 no.3
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• pp.195-206
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• 2010

The aim of this report is to present an intraoral upper molar distalization system supported with zygomatic anchorage plates (Zygoma-gear Appliance, ZGA). This system was used for a 16-year-old female patient with a Class II molar relationship requiring molar distalization. The system consisted of bilateral zygomatic anchorage plates, an inner-bow and heavy intraoral elastics. Distalization of the upper molars was achieved in 3 months and the treatment results were evaluated from lateral cephalometric radiographs. According to the results of the cephalometric analysis, the maxillary first molars showed a distalization of 4 mm, associated with a distal axial inclination of $4.5^{\circ}$. The results of this study show that an effective upper molar distalization without anchorage loss can be achieved in a short time using the ZGA. We suggest that this new system may be used in cases requiring molar distalization in place of extraoral appliances.

• The korean journal of orthodontics
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• v.53 no.6
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• pp.420-430
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• 2023

Objective: The purpose of this finite element method (FEM) study was to analyze the biomechanical differences and tooth displacement patterns according to the traction direction, methods, and sites for total distalization of the mandibular dentition using clear aligner treatment (CAT). Methods: A finite element analysis was performed on four FEM models using different traction methods (via a precision cut hook or button) and traction sites (mandibular canine or first premolar). A distalization force of 1.5 N was applied to the traction site by changing the direction from -30 to +30° to the occlusal plane. The initial tooth displacement and von Mises stress on the clear aligners were analyzed. Results: All CAT-based total distalization groups showed an overall trend of clockwise or counterclockwise rotation of the occlusal plane as the force direction varied. Mesiodistal tipping of individual teeth was more prominent than that of bodily movements. The initial displacement pattern of the mandibular teeth was more predominant based on the traction site than on the traction method. The elastic deformation of clear aligners is attributed to unintentional lingual tipping or extrusion of the mandibular anterior teeth. Conclusions: The initial tooth displacement can vary according to different distalization strategies for CAT-based total distalization. Discreet application and biomechanical understanding of traction sites and directions are necessary for appropriate mandibular total distalization.

• The korean journal of orthodontics
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• v.43 no.2
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• pp.101-109
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• 2013

Objective: To evaluate the efficiency of the Frog appliance (FA) alone or in combination with headgear for distalizing the maxillary molars. Methods: Fifty patients (25 males and 25 females) aged 12.6 - 16.7 years who received treatment for Class II malocclusion at the Orthodontic Clinic of Al-Baath University were selected for this study and randomly divided into 2 equal groups. Maxillary molar distalization was achieved using the FA alone (group 1) or a combination of the FA with high-pull headgear worn at night (group 2). Lateral cephalograms were obtained before and after treatment. Results: The maxillary molars moved distally by 5.51 and 5.93 mm in groups 1 and 2, respectively. Distal movements were associated with axial tipping by $4.96^{\circ}$ and $1.25^{\circ}$, and with loss of anchorage by mesial movement of the second maxillary premolars by 2.70 and 0.90 mm in groups 1 and 2, respectively. The combined use of the FA and nighttime high-pull headgear decreased the distalization time and improved the ratio of maxillary molar distalization movement relative to the overall opening space between the first maxillary molars and second premolars. Conclusions: The FA can effectively distalize the maxillary molars, this distalization associates with some unfavorable changes. Nighttime use of high-pull headgear combined with the FA can reduce these unfavorable changes and improve treatment outcomes.

• The korean journal of orthodontics
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• v.45 no.2
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• pp.82-88
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• 2015

Objective: The aim of this study was to evaluate the reliability of measurements obtained after the superimposition of three-dimensional (3D) digital models by comparing them with those obtained from lateral cephalometric radiographs and photocopies of plaster models for the evaluation of upper molar distalization. Methods: Data were collected from plaster models and lateral cephalometric radiographs of 20 Class II patients whose maxillary first molars were distalized with an intraoral distalizer. The posterior movements of the maxillary first molars were evaluated using lateral cephalometric radiographs (group CP), photocopies of plaster models (group PH), and digitized 3D models (group TD). Additionally, distalization and expansion of the other teeth and the degrees of molar rotation were measured in group PH and group TD and compared between the two groups. Results: No significant difference was observed regarding the amount of molar distalization among the three groups. A comparison of the aforementioned parameters between group PH and group TD did not reveal any significant difference. Conclusions: 3D digital models are reliable to assess the results of upper molar distalization and can be considered a valid alternative to conventional measurement methods.

• The korean journal of orthodontics
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• v.40 no.1
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• pp.50-60
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• 2010

The purpose of this article was to evaluate the effects of a new upper molar distalization system, the Frog Appliance, on dentofacial structures in a Class II, division 1 patient. An 11-year-old girl was referred to our clinic for orthodontic treatment. She had a mild skeletal Class II malocclusion with Class II molar and canine relationship on both sides. The treatment plan included distalization of the upper first molars bilaterally followed by full fixed appliance therapy. For the upper molar distalization, a new system, the Frog Appliance, was constructed and applied. Lateral cephalometric radiographs were used to evaluate the treatment results. Distalization of the upper first molars was achieved in four months successfully, and Class I molar relationship was obtained. Total treatment time was 16 months. According to the results of the cephalometric evaluation, a nearly bodily distal molar movement with a slight anchorage loss was attained. In conclusion, the Frog Appliance was found to be a simple, ef ective, non-invasive, and compliance-free intraoral distalization appliance for achieving bilateral molar distalization.

• The korean journal of orthodontics
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• v.49 no.3
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• pp.194-201
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• 2019

When a patient shows severe crowding, premolar extraction should be considered to provide required available space for alignment. If the third molars have already erupted and demonstrate a poor prognosis, third molar extraction and distalization of the posterior dentition can be used instead of premolar extraction to obtain space. Interproximal stripping (IPS) may also be used to gain space in cases of crowding. This case report describes the treatment of a 25-year-old man with severe crowding and mild lip protrusion. Although the crowding in the lower arch was severe enough to require first premolar extraction, distalization of the entire lower dentition with orthodontic mini-implants, extraction of the lower third molars, and IPS could successfully resolve the crowding and lip protrusion.