Objective: The aim of this study was to illustrate the circumferential comfortable retainer (CCR) as a removable maxillary retainer with good potential patient compliance and to evaluate the discomfort of the retainers including distorted speech, gagging sensation and appliance discomfort. Methods: Sixty-six orthodontic patients (male, 23; female, 43; mean age, $23.42{\pm}10.19$ years) who received orthodontic treatment with fixed orthodontic appliances were randomly assigned to two groups after debonding, a conventional wraparound retainer (CWR) group that fully covers the palate with an acrylic plate and a highly polished surface, and a circumferential comfortable retainer (CCR) group which has a horseshoe shaped base plate with three folds on the anterior region. A questionnaire that had a visual analog scale (VAS) which consists of a 100-mm horizontal line with 2 end-points labeled "no discomfort" on the left and "worst discomfort" on the right, with regard to distorted speech, gagging sensation and discomfort, was administered to patients after 4 weeks of retainer wear. The Mann-Whitney test was used to test the hypothesis that there was no difference between the two retainers. Results: Comparing distorted speech and discomfort, the CCR group significantly had lower values than the CWR group ($p$ < 0.05). Comparing gagging sensation, the CCR group had lower values than the CWR group but there were no statistically significant differences between groups ($p$ = 0.146). Conclusions: In conclusion, the results suggest that the circumferential comfortable retainer (CCR) might facilitate patient compliance and thereby improve the maintenance of the fixed orthodontic treatment outcome.
Objective: The purposes of this study were to provide an epidemiologic data base related to the orthodontic treatment need and to know the changing trends about treatment modality of private orthodontic clinics. Methods: Distribution, trends and orthodontic treatment plan of malocclusion patients were investigated in 1,620 consecutive patients who had been visited and examined in 4 private orthodontic clinics located in Seoul from 2003-2006. Results: Percentage of male and female patients was 26.9% and 73.1% respectively Age distribution had shown that percentage of the patients above 13 years was 78.9%, and above 19 years was 59.0%. Average age of whole patients was 20.5 years. With regard to Angle classification, each percentage of Class I, Class II division 1, Class II division 2 and Class III malocclusion was 38.9%, 34.8%, 2.3% and 24.0%. The percentage of extraction cases(00.9%) outnumbered nonextraction cases(39.1%) and 46% of extraction cases were upper and lower 1st premolar extraction cases. Patients who had chose treatment with fixed appliance and orthognathic surgery was 10.2%. Conclusions: Because the high percentage of adult, Class II malocclusion and orthognathic surgery cases in patients of private orthodontic clinics were shown in this study, orthodontic education program and national health policy in Korea need reformation.
Objective: This study was performed to evaluate functional changes of occlusion after orthodontic treatment by measuring the occlusal force (OcFr) and occlusal contact area (OcAr), and to compare OcFr and OcAr change according to premolar extractions. Methods: Data were obtained from 74 patients who had finished orthodontic treatment using fixed appliance aged between 18 and 40 years. Subjects were divided into groups who had four premolars extractions or non-extraction (Male extraction-16, Male nonextraction-18, Female extraction-19, Female nonextraction-21). All subjects were asked to bite pressure-sensitive sheets into maximum intercuspation with maximum bite force, and OcFr and OcAr were evaluated by measuring the sheet with a CCD camera. Records were taken right after debonding, 1 week, 1 month, 3 months, 6 months and 1 year after debonding. Results: OcFr and OcAr increased gradually in all groups during the 1 year retention period (p < 0.05). Male groups showed higher OcFr and OcAr than female groups throughout the retention periods (p < 0.05). There were no statistically significant differences of OcFr and OcAr between extraction and non-extraction groups in both males and females (p > 0.05). Conclusions: Occlusion was improved functionally throughout the 1 year retention, and premolar extraction did not induce a decline in the functional aspect of occlusion.
Journal of the korean academy of Pediatric Dentistry
/
v.33
no.1
/
pp.122-130
/
2006
Congenital Missing Teeth(hypodontia, oligodontia) is the developmental absence of one or more teeth. It has been reported as being the most common anomaly of dental development in human, relatively common in the permanent dentition. In a recent review, Vastardis has quoted incidence ranges of $1.6%{\sim}9.6%$ in the permanent dentition. Brook has quoted a prevalence of $3.5%{\sim}6.5%$ in most populations, with severe hypodontia, defined as the absence of six or more teeth, having a prevalence of $0.3{\sim}0.4%$. The most commonly affected teeth are third molars, followed by maxillary lateral incisor, and second premolars. The etiology is unknown, several hypotheses include trauma, nutritional deficiency, infection, metabolic abnormalities, systemic disease and genetic influence. The multiple congenital missing is commonly associated with specific syndrome or severe systemic abnormalities such as cleft lip & palate and Down's syndrome. These cases present that children have multiple congenital missing teeth in the permanent dentition, without any systemic disease. Management of this condition must be considered orthodontic and prosthodontic treatment comprehensively. In these cases, children were treated by space maintainer or orthodontic appliance and follow-up checked.
Journal of Dental Rehabilitation and Applied Science
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v.16
no.2
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pp.149-159
/
2000
Occlusal disease is comparable to periodontitis in that it is generally not reversible. Occlusal disease, however, like periodontitis, often maintainable. It does itself to treatment and when restorative dentistry is utilized it becomes, in that sense, reversible. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. An integrated treatment plan is first developed on one set of diagnostic casts, properly mounted on a semiadjustable articulator using jaw relationship records. This is accomplished by using wax to make reconstructive modifications to the casts. These modified casts become the blueprint for planned occlusal changes and the fabrication of provisional restorations. The treatment goals are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. This report shows the treatment procedures for a patient whose mandibular position has been altered due to posterior bite collapse. Migration of the maxillary anterior teeth had occurred, and the posterior occlusal contacts showed pathologic interference. Precise diagnosis using mounted casts was executed and prosthodontic reconstruction by the aid of an unconventional orthodontic correction on maxillary flaring was planned. An unconventional orthodontic correction can be accomplished by using preexisting natural teeth, which can be modified for use in active tooth movement or splinted together for orthodontic anchorage. This technique has an advantage over conventional fixed appliance orthodontic therapy because it can accomplish tooth movement concurrently with restorative and periodontal therapy. On occasion, minor tooth movement can be necessary to achieve the optimum occlusal scheme, crown form, and tooth position for the forces of occlusion to be displaced down the long axis of the periodontally compromised teeth. Once the occlusion, periodontal health, and crown contours for the provisional splinted restoration are acceptable, the final splinted restoration can be similarly fabricated, and it becomes an excellent orthodontic retainer.
Journal of Dental Rehabilitation and Applied Science
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v.16
no.2
/
pp.133-147
/
2000
A well-planned, precise occlusal adjustment of natural teeth has some distinct advantages over other forms of occlusal therapy. It should be emphasized, however, that an occlusal adjustment is an irreversible procedure and has definite contraindications in some mouths. Generally, the treatment methods for the patients that has open-bite will be following as below. : (1) Use of removable orthopedic repositioning appliance, (2) Orthodontics, (3) Full or partial reconstruction of the dentition, (4) Orthognathic surgical procedure, (5) Occlusal adjustment of the existing natural teeth, (6) Any combination of the above. Above all, the advantages of occlusal adjustment of natural teeth are : (1) the patient is more able to adapt to the changes in jaw position and posture; (2) the phonetic or speaking ability of the patient is not significantly changed and usually is improved; (3) the esthetics of the natural teeth is not altered and often is better; (4) the hygiene of the individual teeth is easily maintained; and (5) the functional usage of the teeth as cutting and chewing devices is markedly improved. The objective of an occlusal adjustment, as with any form of occlusal therapy, is to correct or remove the occlusal interferences, or premature contacts, on the occluding parts of the teeth which prevent a centric relation closure of the mandible. A systematic, disciplined approach can be followed in treatment, the objectives should be listed. They are : (1) Centric relation occlusion of the posterior teeth. (2) Proper "coupling" of the anterior teeth. (3) An acceptable disclusive angle of the anterior teeth in harmony with the condylar movement patterns. (4) Stability of the corrected occlusion. (5) Resolution of the related symptoms. For the patient with open-bite on anterior and posterior teeth, this case report shows the treatment methods in combination the fixed prosthesis with the selective cutting of the natural teeth. Occlusal adjustment is no longer an elective procedure but a mandatory one for patients requiring restorations and those in treatment for TMD dysfunctions or those whose dentitions show signs of occlusal trauma. Occlusal adjustment is essential for all who do not display the above lists.
Background: This study was done to better understand patterns, trends and local distribution patterns of malocclusion so that we can provide adequate information to patients, to help make the appropriate diagnosis and therapeutic plans, and to assess the future directions of malocclusion treatment. Materials and Methods: Malocclusion patterns, distribution and trends of visiting patients were examined in 993 malocclusion patients who had been evaluated and diagnosed at the Department of Dentistry, Yeungnam University Hospital over a 10-year period from 1995 to 2004. Results: The number of visiting patients per year showed an increasing trend and the visit rate was 1.28 time-higher in females(56.1%) than in males(43.9%). 1) Age distribution showed that the 7-12 year-old group was the largest (36.7%). Geographic distribution showed the majority of patients were from the Dalseo district(28.2%). Angle's malocclusion classification revealed that class III was the largest(38.4%). Crowding was the chief complaint in the highest percentage of patients(33.9%). The therapeutic method used was the fixed appliance in 61% of cases and a combination with extraction in 30.8%. Conclusions: The availability of dental services can accommodate orthodontic needs adequately as well as obtain reliable quantitative information regarding the characteristics of orthodontic patients.
Moon, So yeon;Lee, Dae woo;Kim, Jae gon;Yang, Yeon mi
The Journal of Korea Assosiation for Disability and Oral Health
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v.15
no.1
/
pp.84-88
/
2019
Malocclusion occurs more frequently in Special Health Care Needed (SHCN) patients than those in general. As caregiver's needs for orthodontic treatment tend to increase, the dentist should know how to decide the extent of treatment. This case report is about orthodontic treatment for two SHCN patients; one patient with cerebral palsy, and another patient with autism. A 10-year-old patient with cerebral palsy showed protrusion and rotation of maxillary anterior teeth. To resolve his chief complaints and make better oral hygiene, he underwent orthodontic treatment using micro tube appliances for 6 months. Another 11-year-old patient with autism had anterior crossbite and showed space deficiency of #13 and chronic gingivitis because of poor oral hygiene. She underwent orthodontic treatment with maxillary skeletal expander, facemask and AP expansion appliance. After 18 months we found positive overjet and ended the treatment. When giving SHCNs orthodontic treatment, the extent of treatment can be chosen according to the patient's cooperative ability and the traits of disabilities. Before initiating orthodontic treatment, the caregivers should be aware of their limitations of the treatment. Since oral hygiene is crucial factor in every dental treatment, education of oral hygiene process for the caregivers and SHCN patient must be done before the orthodontic treatment.
Over the Past decades, the number of Patients seeking orthodontic treatment has increased markedly with socioeconomic development and change of recognition on appearance. The purpose of this study was to provide an epidemiologic data base related to the orthodontic treatment need. We could take an adequate information regarding the characteristics of orthodontic patients, and the changing trends about treatment mordality. Distrubution and treands were Investigated in 676 patients who had been examined and diagnosed at Department of orthodontics, Dental Hospital, Seoul National University from January to June in 1992 and 2002. 1. Sex distribution of patients changed from 1:2.1 to 1:1.5 (male female). 2. In 2002, are distribution had shown $7\~12$ year-old group being the largest$(32.0\%)$ and percentage of $19\~24,\;13\~18,\;over\;25,\;4\~6,\;0\~3$ year-old group were $24.0\%,\;21.6\%,\;14.2\%,\;5.8\%,\;2.4\%$ respctively. Compared with data in 1992, the number of adult patients highly increased. 3. With regard to Angle classification, each percentage of Class I, Class II div 1, Class II div 2, and Class III malocclusion were $25.0\%,\;20.9\%,\;3.4\%,\;and\;48.1\%$ respectively in 2002. 4. Geographic distribution showed that most of the patients visited $(37.0\%)$ lived in northeast of Seoul in 2002. 5. Mandibular prognathism showed the highest percentage in chief complaints. The percentages of crowding and facial asymmetry were $14.2\%\;and\;11.8\%$ in 2002. Patients with facial asymmetry increased significantly. 6. Percentages of patients treated with fixed appliance and orthognathic surgery were $38.0\%\;and\;25.0\%$ in 2002. Patients needed to observe the growth pattern comprised $13.0\%$ with increasing trends. The use of chin cap reduced and the percentage of ortognathic surgery and growth observation increased significantly.
The purpose of this study was to evaluate the efficacy of an electric toothbrush, with a specially designed orthodontic brush head, compared to a manual toothbrush on the periodontal health of patients with fixed orthodontic appliances Forty patients were randomly divided into two groups. the electric and the manual toothbrush groups, 1 month after attachment of fixed orthodontic appliances. Periodontal status was measured using a plaque index, a gingival index. a bleeding index, a pocket depth and a relative attachment loss, at baseline and after 3 months. 6 months, 9 mouths. and 12 mouths. The Braun Oral-B Plak Control with Ortho OD 15-1 brush head was used as the electric toothbrush while the Butler G.U.M 124 was given as the manual toothbrush. In the manual toothbrush group, the giugival and bleeding indices showed no statistically significant differences, but the plaque index was significantly decreased (P<0.001) and pocket depth as well as relative attachment loss were significantly increased (p<0.01). In the electric toothbrush group. the bleeding index, pocket depth and relative attachment loss showed no statistically significant differences. but the plaque and gingival indices were significantly decreased (p<0.001). In the case of the plaque. giugival and bleeding indices, there were no statistically significant differences between the electric and the manual toothbrush groups. On the contrary, in the case of pocket depth and relative attachment loss, there were statistically significant differences between the electric and the manual toothbrush groups: an increase in the manual toothbrush groups unlike the electric toothbrush group which kept the same state (P<0.05) These findings suggest that an electric toothbrush is useful for orthodontic patients with fixed appliances.
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