Orthodontists often treat cases which are difficult to treat with conventional orthodontics. In such cases, it could be treated with surgical procedures with the help of an oral surgeon. Especially, transverse deficiency of the mandible can be corrected by widening the transverse width of mandibular symphysis, using distraction osteogenesis. Transverse widening of mandibular sympysis is known as a safe treatment but still complications could occur during the treatment. We are reporting some complications of cases that mandibular symphysis transverse widening were applied. Some cases showed complications because of the inappropriate osteotomy line. Since straight vertical osteotomy line was inclined to the left, only the left bony segment was likely to expand. According to bio-mechanical considerations, it will be better to perform a step osteotomy, cutting the eccentric area of the alveolar crest and the centric area of the basal symphyseal area. Complications could also occur by the failure of the distraction device. The tooth borne distraction device was attached on the lingual side of the tooth with composite resin. During the distraction period, it was impossible to obtain appropriate distraction speed and rhythm because of frequent fall off of the distraction device. Therefore, distraction device should be attached firmly with orthodontic band or bone screw, etc. Tooth mobility increasement could also occur as a complication. 'Walking teeth phenomenon' was observed during the distraction period, showing severe teeth mobility and pain during mastication. These symptoms fade out during the consolidation period. Since the patient could feel insecure and uncomfortable, it should be notified to the patient before the procedure. Finally, alveolar crestal bone loss could occur. Alveolar crestal bone loss occurred because of lack of distraction device firmness and teeth trauma caused by lower lip biting habit. Therefore, adequate firmness of the distraction device and habit control will be needed.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.43
no.2
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pp.100-105
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2017
Objectives: Localization of the mandibular canal (MC) and measurement of the height and width of the available alveolar bone at the proposed implant site in the posterior segment of the mandible using cone-beam computed tomography (CBCT) in patients with a single missing tooth. Materials and Methods: A cross-sectional study was performed where CBCT scans of the patients with a single missing tooth in the posterior segment of the mandible-premolar, I (1st) molar, and II (2nd) molar were used. The scans were assessed using OnDemand3D software (version 1.0; CyberMed Inc., Seoul, Korea) for localization of the MC asnd remaining alveolar bone both vertically (from the superior position of the MC to the crest of the alveolar ridge) and horizontally (buccolingual, 3 mm below the crest of the alveolar ridge). The findings were statistically analyzed using independent t-test. Results: A total of 120 mandibular sites (40 sites for each of the three missing premolar, I molar, and II molar) from 91 CBCT scans were analyzed. The average heights (from the alveolar crest to the superior margin of the MC) at the premolar, I molar, and II molar areas were $15.19{\pm}2.12mm$, $14.53{\pm}2.34mm$, and $14.21{\pm}2.23mm$, respectively. The average widths, measured 3 mm below the crest of the alveolar ridge, at the premolar, I molar, and II molar areas were $6.22{\pm}1.96mm$, $6.51{\pm}1.75mm$, and $7.60{\pm}2.08mm$, respectively. There was no statistically significant difference between males and females regarding the vertical and horizontal measurements of the alveolar ridges. Conclusion: In the study, the measurements were averaged separately for each of the single missing teeth (premolar, I molar, or II molar), giving more accurate information for dental implant placement.
Purpose: Following tooth extraction, alveolar ridge preservation (ARP) can maintain the dimensions of ridge height and width. Although previous studies have demonstrated the effects of ARP, few if any studies have investigated the compressive force applied during grafting. The aim of this study was to determine the effects of different compressive forces on the graft materials during ARP. Methods: After tooth extraction, sockets were filled with deproteinized bovine bone mineral with 10% porcine collagen and covered by a resorbable collagen membrane in a double-layered fashion. The graft materials were compressed using a force of 5 N in the test group (n=12) and a force of 30 N in the control group (n=12). A hidden X suture was performed to secure the graft without primary closure. Cone-beam computed tomography (CBCT) was performed immediately after grafting and 4 months later, just before implant surgery. Tissue samples were retrieved using a trephine bur from the grafted sites during implant surgery for histologic and histomorphometric evaluations. Periotest values (PTVs) were measured to assess the initial stability of the dental implants. Results: Four patients dropped out from the control group and 20 patients finished the study. Both groups healed without any complications. The CBCT measurements showed that the ridge volume was comparably preserved vertically and horizontally in both groups (P>0.05). Histomorphometric analysis demonstrated that the ratio of new bone formation was significantly greater in the test group (P<0.05). The PTVs showed no significant differences between the 2 groups (P>0.05). Conclusions: The application of a greater compressive force on biomaterials during ARP significantly enhanced new bone formation while preserving the horizontal and vertical dimensions of the alveolar ridge. Further studies are required to identity the optimal compressive force for ARP.
Kim, Do-Yoon;Ha, Sang-Woon;Cho, Il-Sik;Yang, Il-Hyung;Baek, Seung-Hak
The korean journal of orthodontics
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v.49
no.2
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pp.73-80
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2019
Objective: The purpose of this study was to compare the static (SFF) and kinetic frictional forces (KFF) of a computer-aided design and computer-aided manufacturing lingual bracket (CAD/CAM-LB) with those of conventional LB (Con-LB) and Con-LB with narrow bracket width (Con-LB-NBW) under 3 tooth displacement conditions. Methods: The samples were divided into 9 groups according to combinations of 3 LB types (CAD/CAM-LB [Incognito], Con-LB [7th Generation, 7G], and Con-LB-NBW [STb]) with 3 displacement conditions (no displacement [control], maxillary right lateral incisor with 1-mm palatal displacement [MXLI-PD], and maxillary right canine with 1-mm gingival displacement [MXC-GD]; n = 6/group). While drawing a 0.016-inch copper or super-elastic nickel-titanium archwire with 0.5 mm/min for 5 minutes in a chamber maintained at $36.5^{\circ}C$, SFF and KFF were measured. The Kruskal-Wallis method with Bonferroni correction was performed. Results: The Incognito group demonstrated the highest SFF, followed by the 7G and STb groups ([STb-control, STb-MXLI-PD, Stb-MXC-GD] < [7G-MXC-GD, 7G-MXLI-PD, 7G-control] < [Incognito-MXLI-PD, Incognito-control, Incognito-MXC-GD]; p < 0.001). However, there were no significant differences in SFF among the 3 displacement conditions within each bracket group. Within each displacement condition, the Incognito group demonstrated the highest KFF, followed by the 7G and STb groups ([STb-control, STb-MXLI-PD] < Stb-MXC-GD < 7G-MXLI-PD < [7G-control, 7G-MXC-GD] < [7G-MXC-GD, Incognito-MXLI-PD, Incognito-control] < [Incognito-control, Incognito-MXC-GD]; p < 0.001). MXC-GD exhibited higher KFFs than MXLI-PD in the same bracket group. Conclusions: The slot design and ligation method of the CAD/CAM-LB system should be modified to reduce SFF and KFF during the leveling/alignment stage.
Journal of the korean academy of Pediatric Dentistry
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v.50
no.2
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pp.142-154
/
2023
The canine tooth is important both functionally and aesthetically, being positioned between the anterior and posterior teeth. The upper canine has the longest eruption path, forming in the deepest part of the maxillary bone and often experiencing eruption disorders, leading to significant aesthetic and functional issues. Early detection and management of canine impaction are crucial in pediatric dentistry, which focuses on tooth growth and eruption. The prevalence of maxillary canine impaction ranges from 1.1% to 3.0%. In Western populations, palatal impaction is twice as common as labial impaction, while some Korean studies report more labial impaction. Maxillary canine impaction occurs more frequently in women and is associated with various factors such as structural obstacles, pathological conditions in surrounding tissues, developmental abnormalities, and genetic factors. Labial displaced canines are linked to narrow maxillary intercanine width, total dental crowding, and skeletal Class III malocclusion. Maxillary palatal displaced canine impaction is more prevalent in patients with familial agenesis of lateral incisors or conical supernumerary lateral incisors. Understanding these factors aids in early diagnosis and appropriate intervention for canine tooth impaction, ensuring optimal oral health and aesthetics.
The purpose of this study was to examine the clear concept of the designs for cavity preparations. Among the several parameters in cavity designs, profound understanding of isthmus width factor would facilitate selection of the appropriate cavity preparation for a specific clinical situation. In this study, the cavities were prepared on maxillary first premolar and filled with gold inaly. A two - dimensional model was composed of 1037 - node triangle elements. In this model, isthmus was varied in width at 1/4, 1/3 and 1/2 of intercuspal width and material properties were given for four element groups, i.e., enamel, dentin, pulp and gold. The 500N occlusal load varied in direction and it was examined using three types of load : concentrated load, divided load and distributed load. The models were also examined with empty cavities using the devided load and distributed load. These models were analyzed the displacement and strees distribution by the two - dimensional Finite Element Method. The results were as follows : 1. All experimental models which filled with gold inlay after cavity preparation were similar direction of displacement with control model under same load type. But in the models with empty cavities, as isthmus width was wider, the degree of displacement was increased at same load type. 2. Among the experimental models which were filled with gold inaly after cavity preparation, the model II showed the least stress concentration under concentrated load and divided load. But in the models with empty cavities, the model III showed the largest stress concentration and tooth fracture is expected regardless isthmus width. 3. All experimental models showed similar displacement pattern beneath restorative material under a concentrated load. In the models with empty cavities, a divided load resulted in a lingual displacement of the lingual cusp, but a distributed load resulted in a buccal displacement of the lingual cusp. In regard to the above results, the restored models were stronger than empty models in respect to the bending moment and tensile stress. The empty models are expected to fracture regardless isthmus width. The safest isthmus width was 1/3 of intercuspal distance, which showed the least stress concentration in respect to the effect of stress distribution.
This study was carried out in order to study early histologic changes and repair reaction appling to extrusive force for 3rd premolar of adult dogs. After 1 week of extrusive force with elastic chain, one of dogs was sacrified and after 3 weeks retention period, another dog was sacrified. The paraffin sections of samples were stained with Hematoxylin - Eosin and Masson's Trichrome and were examed by light microscopy . The obtained results as follows 1. In Hematoxylin - Eosin and Masson Trichrome stain of control group , the periodontal ligament width was constant from apical third to cervical third of the root and periodontal fiber arrangement was horizontal or oblique in cervical third. oblique in middle third, oblique in apical third of root. in alveolar bone, smooth appearance was shown 2. In Group 1, all periodontal fiber arrangement was oblique toward tooth, and the periodontal ligament width increased Partially PDL was ruptured in apex. In MT stain, immature bone formation was seen at alveolar crest area. Active bone formation was observed along the one side of alveolus, and apical portion of pulp was involved with blood vessel rupture , vacuolization of pulp tissue and hyperemia 3. In Group 2, most periodontal ligament arrangement and PDL width was repaired and fiber density increased. In MT stain, mineralization of immature bone on the alveolar crest was progressed. In pulp, vacuole and hyperemia was diminished and fibrotic change was diminished 4. After 3 week periodontal ligament has more repair ability than pulp tissue. pulp was involved with vacuolization and fibrosis, so it takes more time for repair.
Journal of Dental Rehabilitation and Applied Science
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v.36
no.4
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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.
Multilevel inverters have been widely used for high-voltage and high-power applications. Their performance is greatly superior to that of conventional two-level inverters due to their reduced total harmonic distortion (THD), lower switch ratings, lower electromagnetic interference, and higher dc link voltages. However, they have some disadvantages such as an increased number of components, a complex pulse width modulation control method, and a voltage-balancing problem. In this paper, a novel nine-level reduced switch cascaded multilevel inverter based on a multilevel DC link (MLDCL) inverter topology with reduced switching components is proposed to improve the multilevel inverter performance by compensating the above mentioned disadvantages. This topology requires fewer components when compared to diode clamped, flying capacitor and cascaded inverters and it requires fewer carrier signals and gate drives. Therefore, the overall cost and circuit complexity are greatly reduced. This paper presents modulation methods by a novel reference and multicarrier based PWM schemes for reduced switch cascaded multilevel inverters (RSCMLI). It also compares the performance of the proposed scheme with that of conventional cascaded multilevel inverters (CCMLI). Simulation results from MATLAB/SIMULINK are presented to verify the performance of the nine-level RSCMLI. Finally, a prototype of the nine-level RSCMLI topology is built and tested to show the performance of the inverter through experimental results.
The purpose of this study was to obtain the lingual morphology (size, angulation, contour, eminence) of adults with normal occlusion in order to provide the basic data for lingual bracket and lingual arch form in Korean. The subjects (Male: 50, Female: 50) were selected who have normal occlusion and dental casts were prepared. Tooth size, angulation, arch width, horizontal contour, lingual eminence were measured for all 28 teeth both upper and lower arch. The results were as follows: 1. Measuring items of all individual teeth for adults with normal occlusion were obtained. 2. In comparison tests, there was a statistically difference between intermolar widths $(\underline{6}\;to\;\underline{6})$ before occlusal reduction and intermolar width $(\underline{6}\;to\;\underline{6},\underline{7}\;to\;\underline{7})$ after occlusal reduction only all the other measuring items showed no statistically differences. 3. There was small variation in horizontal contour of lingual surface on lower incisors and upper and lower bicuspids. The other teeth showed somewhat greater variations. 4. There was offset between canine and bicuspid in upper arch while there was no prominent offset in lower arch.
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