• Journal of Periodontal and Implant Science
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• v.38 no.2
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• pp.215-224
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• 2008

Purpose: These case reports show the orthodontic treatment of lower anterior incisors with gingival recession. Materials and Methods: Three cases were treated by an orthodontist and a periodontist. Each case had lingually tilted lower anterior incisors, anterior crossbite and skeletal Cl III pattern. Results: A variety of etiological factors were thought to cause gingival recession: aging, oral hygiene, tooth malpositioning, occlusal trauma. Conclusion: Due to the interaction among many possible contributing factors, it is difficult to predict whether further gingival recession may occur at a given site. The position and the movement of the lower anterior incisors with gingival recession are important factors in diagnosis and orthodontic treatment planning.

• The korean journal of orthodontics
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• v.51 no.3
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• pp.217-227
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• 2021

Maxillary transverse deficiency often manifests as a posterior crossbite or edge-to-edge bite and anterior crowding. However, arbitrary arch expansion in mature patients has been considered to be challenging due to the possible periodontal adverse effects such as alveolar bone dehiscence and gingival recession. To overcome these limitations, nonsurgical maxillary expansion of the basal bone has been demonstrated in young adults. However, the age range for successful orthopedic expansion has remained a topic of debate, possibly due to the underlying individual variations in suture maturity. This case report illustrates nonsurgical, miniscrew-assisted rapid palatal expansion (MARPE) in a 60-year-old patient with maxillary transverse deficiency accompanied by anterior and posterior crossbites, crowding, and gingival recession. The use of MARPE allowed relief of crowding and correction of the crossbite without causing significant periodontal adverse effects.

• The korean journal of orthodontics
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• v.31 no.6 s.89
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• pp.611-618
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• 2001

This is a case report of a 12.5-year-old girl who presented with moderate to severe anterior dental crowding and rotations. Treatment involved no extraction, but expansion of both the maxillary and the mandibular arches. Maxillary expansion was assisted by rapid palatal expansion despite the fact that this patient did not present with posterior crossbite. Crowding and rotations in both arches were corrected and good occlusal function and improved facial esthetic were achieved, with acceptable overbite and overjet. The application of rapid maxillary expansion in cases with no posterior crossbite, which has increased in recent years, calls for re-evaluation of the diagnostic basis and indications for the use of this technique.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.3
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• pp.667-673
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• 1996

The prevalence of class III malocclusion is approximately 5$\sim$9%, and about one fourth of this malocclusion is due to underdeveloped maxilla. Maxillary protraction appliance is an orthopedic device which promote the growth of a deficient maxilla by applying extraoral force to actively growing patients. The object of using maxillary protraction appliance is to guide a normal growth of maxilla and mandible and improve the occlusal relationship and also improve the facial profile. The author treated three patients whom were diagnosed as a class III malocclusion due to deficient maxilla using maxillary protraction appliance and the followings are the conclusions : 1. In these cases, anterior crossbite was corrected by anterior movement of maxilla and downward backward rotation of mandible and simultaneously, anterior facial height was increased. 2. The amount of dental change compare to skeletal change was greater as the patients got older. 3. When 500gm of force to each side was applied, the treatment period has been decreased. 4. As a result of applying the force between maxillary first primary molar and canine, there was a small degree of changes in palatal plane. So, it can be concluded that the maxillary protraction appliance is effective in treating growing patients with a deficient maxilla.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.4
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• pp.479-484
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• 2000

The conventional treatment of skeletal class III malocclusion has been focused on the application of orthopedic forrce primarily to the mandible. Thus moderate Class III malocclusions can be corrected by the anterior displacement of the maxilla and maxillary dentition, possibly by restricting the growth of the mandible or by changing its direction. The patients having skeletal Class III malocclusion were treated with removable appliance & fixed appliance for detailed tooth movement and the following results were observed: 1. The anterior crossbite was corrected. 2. The forward and downward growth of the maxillary complex was obtained. 3. The lingual tipping of the mandiblar incisors was performed and the mandible was rotated in the clockwise direction.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.2
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• pp.119-128
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• 2011

In the process of assessing the children with anterior crossbite in early mixed dentition, it has frequently been detected that the stronger the skeletal pattern of the malocclusion is, the more markedly delayed the development and eruption of maxillary teeth are. If the anteroposterior characteristics of craniofacial skeleton has any relationship with dental maturation, the evaluation of dental development and eruption was thought to be able to contribute to early diagnosis of crossbite in children. This study was performed for the purpose of elucidating the relationship between dental maturation of maxillary teeth and some cephalometric values in children with anterior crossbite of maxillary undergrowth type in early mixed dentition. Among the children in Hellman dental age IIA and IIC who attended the Pediatric Dental Clinic of Pusan National University Hospital with orthodontic problems, cases with Class III malocclusion were classified and 50 cases of maxillary undergrowth type and type with normal maxilla respectively were randomly selected and studied as subjects. From their lateral cephalographs and panoramic radiographs, their anteroposterior skeletal features, the dental maturity and eruption rate were obtained of each group and data were analyzed to yield the results as follows: 1. Comparing the maturity of maxillary teeth of both groups, only the first molars of maxillary undergrowth group showed significantly slower development and eruption (p<0.05). 2. There was high correlation between maturation of maxillary 1st molar and chronological age(p<0.05). 3. Among the parameters of anteroposterior relationship of skeletal pattern in maxilla and mandible. Wits was revealed as a useful index to predict both the calcification and eruption rate of the 1st molars whereas SNA was to eruption rate(p<0.05).

• The korean journal of orthodontics
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• v.31 no.6 s.89
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• pp.549-558
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• 2001

This study was undertaken to demonstrate the forces in the maxillary alveolar bone generated by the activation of the maxillary posterior crossbite appliance In the treatment of posterior buccal crossbite caused by buccal ectopic eruption of the maxillary second molar. A photoelastic model was fabricated using a Photoelastic material (PL-3) to simulate alveolar bone and ivory-colored resin teeth. The model was observed throughout the anterior and posterior view in a circular polariscope and recorded photographically before and after activation of the maxillary posterior crossbite appliance. The following conclusions were reached from this investigation : 1. When the traction force was applied on the palatal surface of the second molar, stresses were concentrated at the buccal and palatal root apices and alveolar crest area. The axis of rotation of palatal root was at the root apex and that of the buccal root was at the root li4 area. In this result, palatal tipping and rotating force were generated. 2. When the traction force was applied on the buccal surface of the second molar, more stresses than loading on the palatal surface were observed in the palatal and buccal root apices. Furthermore, the heavier stresses creating an intrusive force and controlled tipping force were recorded below the buccal and palatal root apices below the palatal root surface. In addition, the axis of rotation of palatal root disappeared whereas the rotation axis of the buccal root moved to the root apex from the apical 1/4 area. 3. When the traction force was simultaneously applied on the maxillary right and left second molars, the stress intensity around the maxillary first molar root area was greater than the stress generated by the only buccal traction of the maxillary right or left second molar. As in above mentioned results, we should realize that force application on the palatal surface of second molars with the maxillary posterior crossbite appliance Produced rotation of the second molar and palatal traction, which nay cause occlusal Interference. That is to say, we have to escape the rotation and uncontrolled tipping creating occlusal interference when correcting buccal posterior crossbite. For this purpose, we recommend buccal traction rather than palatal traction force on the second molar.

• The korean journal of orthodontics
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• v.31 no.6 s.89
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• pp.559-566
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• 2001

This study was undertaken to demonstrate the forces in the mandibular alveolar bone generated by activation of the mandibular posterior crossbite appliance in the treatment of buccal crossbite caused by lingual eruption of mandibular second molar. A three-dimensional photoelastic model was fabricated using a photoelastic material (PL-3) to simulate alveolar bone. We observed the model from the anterior to the posterior view in a circular polariscope and recorded photogtaphically before and after activation of the mandibular posterior crossbite appliance. The following results were obtained : 1. When the traction force was applied on the buccal surface of the mandibular second molar, stress was concentrated at the lingual alveolar crest and root apex area. The axis of rotation also was at the middle third of the buccal toot surface and the root apex, so that uncontrolled tipping and a buccal traction force for the mandibular second molar were developed. 2. When the traction force was applied on the lingual surface of the mandibular second molar more stress was observed as opposed to those situations in which the force application was on the buccal surface. In addition, stress intensity was increased below the loot areas and the axis of rotation of the mandibular second molar was lost. In result, controlled tipping and intrusive tooth movements were developed. 3. When the traction forte was applied on either buccal or lingual surface of the second molar, the color patterns of the anchorage unit were similar to the initial color pattern of that before the force application. So we can use the lingual arch for effective anchorage in correcting the posterior buccal crossbite. As in above mentioned results, we must avoid the rotation and uncontrolled tipping, creating occlusal interference of the malpositioned mandibular second molar when correcting posterior buccal crossbite. For this purpose, we recommend the lingual traction force on the second molar as opposed to the buccal traction.

• The korean journal of orthodontics
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• v.26 no.2 s.55
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• pp.125-139
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• 1996

The author obtained some useful information for the class III treatment from long term observation on the growing patients with class III malocclusion. 8 patients were selected for this study and presentation. From these observation so far my conclusions might be as follows: First in the early correction of the anterior crossbite, considerable forward growth changes were observed in the maxilla Second, as for the growth modification of jaws by orthopedic treatment only limited effects were recognized from the long-term observation Thrid, at early age of patients with anterior crossbite, any data couldn't make me predict the stability after treatment on the long-term basis. Fortunately, however, genial angle showed a marginal possibility of it prediction. Fourth, at an advanced age/ retraction orthopedic force on the mandible and the rapid change in the mandibular position may cause some trouble in the T.M.joint. Finally, the followings are recommendable. As for the anterior crossbite, correct it early as possible, and use orthopedic force under the age of ten. Do not enter the phase II treatment directly. Just wait and observe until the growth were almost completed, focusiong on some important factors such as airway problem, tongue position, and third molar development. Of course, these factors may have some effects on the mandibular growth. for the female, at the age of around 14 years old and the male, around 17 years old, make a final decision whether the patients will continue to be treated orthodontically or surgically Thereby, (I think) the relapse and retreatment problem after treatemnt we have observed so far might be minimized. Furthermore, the active treatment time may be also reduced.

• The korean journal of orthodontics
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• v.46 no.6
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• pp.395-408
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• 2016

We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR.