• 대한치과교정학회지
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• 제52권3호
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• pp.236-245
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• 2022

New digital technologies, many involving three-dimensional printing, bring benefits for clinical applications. This article reports on the clinical procedure and fabrication of a skeletally anchored mesialization appliance (Mesialslider) using computer-aided design/computer-aided manufacturing (CAD/CAM) for space closure of a congenitally missing lateral incisor in a 12-year-old female patient. The insertion of the mini-implants and appliance was performed in a single appointment. Bodily movement of the molars was achieved using the Mesialslider. Anchorage loss, such as deviation of the anterior midline or palatal tilting of the anterior teeth, was completely avoided. CAD/CAM facilitates safe and precise insertion of mini-implants. Further, mini-implants can improve patient comfort by reducing the number of office visits and eliminating the need for orthodontic bands and physical impressions.

• 대한치과교정학회지
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• 제54권3호
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• pp.160-170
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• 2024

Objective: Owing to the availability of 3D software, scanners, and printers, clinicians are encouraged to produce in-office aligners. Recently, a new direct-printing resin (Tera Harz TC-85DAC) has been introduced. Studies on its mechanical characteristics and biological effects have been published; however, evidence on its efficacy in orthodontic treatment remains scarce. This pilot study aimed to investigate the accuracy of teeth movement achieved with direct-printed aligners. Methods: Seventeen patients (eight males and nine females) with a mean age of 27.67 ± 8.95 years, presenting with dental rotations < 30° and spaces/crowding < 5 mm, were recruited for this study. The teeth movement was planned starting from a T0 digital dental cast. The 3D direct-printed aligners were produced using Tera Harz TC-85DAC resin. Once the orthodontic treatment was completed, a final digital cast was obtained (T1). The planned teeth positions were then superimposed onto the T0 and T1 digital models. The differences between the programmed movements and the achieved overall torque, tip, rotation, and transverse dimensions were assessed using the paired t test or Wilcoxon's signed rank test. Results: The overall accuracies for torque, tip, and rotation were 67.6%, 64.2%, and 72.0%, respectively. The accuracy of the change in transverse diameter was 99.6%. Conclusions: Within the limits of the present pilot study (difficulties with abnormally shaped teeth and use of attachments), it can be concluded that 3D printed aligners can be successfully printed in-house and utilized for mildly crowded cases, with a comparable accuracy of tooth movement to that of other aligners.

• 대한치과의사협회지
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• 제56권11호
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• pp.622-630
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• 2018

For successful surgery-first approach, accurate prediction of skeletal and dental changes following orthognathic surgery is essential. With recent development of digital technology using computer-aided design/computer-aided manufacturing (CAD/CAM) technology, attempts to provide more predictable orthodontic/orthognathic treatment have been made through 3D virtual surgery and digital tooth setup. A clinical protocol for the surgery-first orthognathic approach using virtual surgery is proposed. A case of skeletal Class III patient with facial asymmetry treated by the surgery-first approach using digital setup and virtual surgery is presented. Advantages and limitations of applying CAD/CAM technology to orthognathic surgery are discussed.

• 대한치과의사협회지
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• 제47권5호
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• pp.282-290
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• 2009

The purpose of this study was to evaluate the measurement error between conventional films, digital cephalographs and hardcopy. The material consisted of 29 cephalographs which used image modality of Asahi CX-90SP in the Kyung Hee University Dental Hospital. One observer measured fiducial measurements at an interval of four weeks. Measurement error was tested by Dahlberg's formula. A paired t-test was used to detect it between each modality. The results are as follows; 1. The monitor-displayed digital image showed enlargement compared with the conventional image. The cephalometric measurements of the monitor-displayed digital image and conventional image were no statistically significant difference except SNB. 2. In conventional image, measurement errors of linear and angular measurements were 0.23mm, $0.36^{\circ}$, respective. In monitor-displayed digital image, measurement errors of linear and angular measurements were 0.63mm, $0.48^{\circ}$ respective. 3. The reduction ratio of hardcopy was 1.01% compared to the monitor-displayed digital image. Based on the results, it indicates that the digital cephalographs and hardcopy using storage phosphor digital radiography showed the same accuracy as the conventional films in clinical use.

• 대한치과교정학회지
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• 제42권4호
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• pp.169-181
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• 2012

Objective: The purpose of this study was to develop superimposition method on the lower arch using 3-dimensional (3D) cone beam computed tomography (CBCT) images and orthodontic 3D digital modeling. Methods: Integrated 3D CBCT images were acquired by substituting the dental portion of 3D CBCT images with precise dental images of an orthodontic 3D digital model. Images were acquired before and after treatment. For the superimposition, 2 superimposition methods were designed. Surface superimposition was based on the basal bone structure of the mandible by surface-to-surface matching (best-fit method). Plane superimposition was based on anatomical structures (mental and lingual foramen). For the evaluation, 10 landmarks including teeth and anatomic structures were assigned, and 30 times of superimpositions and measurements were performed to determine the more reproducible and reliable method. Results: All landmarks demonstrated that the surface superimposition method produced relatively more consistent coordinate values. The mean distances of measured landmarks values from the means were statistically significantly lower with the surface superimpositions method. Conclusions: Between the 2 superimposition methods designed for the evaluation of 3D changes in the lower arch, surface superimposition was the simpler, more reproducible, reliable method.

• Imaging Science in Dentistry
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• 제53권3호
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• pp.269-269
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• 2023

• 대한치과교정학회지
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• 제51권6호
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• pp.375-386
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• 2021

Objective: To evaluate the accuracy of a one-piece bracket jig system fabricated using computer-aided design and manufacturing (CAD/CAM) by employing three-dimensional (3D) digital superimposition. Methods: This in vitro study included 226 anterior teeth selected from 20 patients undergoing orthodontic treatment. Bracket position errors from each of the 40 arches were analyzed quantitatively via 3D digital superimposition (best-fit algorithm) of the virtual bracket and actual bracket after indirect bonding, after accounting for possible variables that may affect accuracy, such as crowding and presence of the resin base. Results: The device could transfer the bracket accurately to the desired position of the patient's dentition within a clinically acceptable range of ± 0.05 mm and 2.0° for linear and angular measurements, respectively. The average linear measurements ranged from 0.029 to 0.101 mm. Among the angular measurements, rotation values showed the least deviation and ranged from 0.396° to 0.623°. Directional bias was pronounced in the vertical direction, and many brackets were bonded toward the occlusal surface. However, no statistical difference was found for the three angular measurement values (torque, angulation, and rotation) in any of the groups classified according to crowding. When the teeth were moderately crowded, the mesio-distal, bucco-lingual, and rotation measurement values were affected by the presence of the resin base. Conclusions: The characteristics of the CAD/CAM one-piece jig system were demonstrated according to the influencing factors, and the transfer accuracy was verified to be within a clinically acceptable level for the indirect bracket bonding of anterior teeth.

• 대한치과교정학회지
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• 제54권3호
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• pp.171-184
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• 2024

Objective: This study aimed to determine the maxillary and mandibular basal bone regions and explore the three-dimensional positional relationship between the dentition and basal bone regions in patients with skeletal Class I and Class II malocclusions with mandibular retrusion. Methods: Eighty patients (40 each with Class I and Class II malocclusion) were enrolled. Maxillary and mandibular basal bone regions were determined using cone-beam computed tomography images. To measure the relationship between the dentition and basal bone region, the root position and root inclination were calculated using the coordinates of specific fixed points by a computer program written in Python. Results: In the Class II group, the mandibular anterior teeth inclined more labially (P < 0.05), with their apices positioned closer to the external boundary. The apex of the maxillary anterior root was positioned closer to the external boundary in both groups. Considering the molar region, the maxillary first molars tended to be more lingually inclined in females (P = 0.037), whereas the mandibular first molars were significantly more labially inclined in the Class II group (P < 0.05). Conclusions: Mandibular anterior teeth in Class II malocclusion exhibit a compensatory labial inclination trend with the crown and apex relative to the basal bone region when mandibular retrusion occurs. Moreover, as the root apices of the maxillary anterior teeth are much closer to the labial side in Class I and Class II malocclusion, the range of movement at the root apex should be limited to avoid extensive labial movement.

• Imaging Science in Dentistry
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• 제49권4호
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• pp.257-263
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• 2019

Purpose: This study was performed to evaluate the dimensional accuracy of digital dental models constructed from cone-beam computed tomographic (CBCT) scans of polyvinyl siloxane (PVS) impressions and cast scan models. Materials and Methods: A pair of PVS impressions was obtained from 20 subjects and scanned using CBCT (resolution, 0.1 mm). A cast scan model was constructed by scanning the gypsum model using a model scanner. After reconstruction of the digital models, the mesio-distal width of each tooth, inter-canine width, and inter-molar width were measured, and the Bolton ratios were calculated and compared. The 2 models were superimposed and the difference between the models was measured using 3-dimensional analysis. Results: The range of mean error between the cast scan model and the CBCT scan model was -0.15 mm to 0.13 mm in the mesio-distal width of the teeth and 0.03 mm to 0.42 mm in the width analysis. The differences in the Bolton ratios between the cast scan models and CBCT scan models were 0.87 (anterior ratio) and 0.72 (overall ratio), with no significant difference (P>0.05). The mean maxillary and mandibular difference when the cast scan model and the CBCT scan model were superimposed was 53 ㎛. Conclusion: There was no statistically significant difference in most of the measurements. The maximum tooth size difference was 0.15mm, and the average difference in model overlap was 53 ㎛. Digital models produced by scanning impressions at a high resolution using CBCT can be used in clinical practice.

• 대한치과교정학회지
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• 제53권1호
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• pp.26-34
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• 2023

Objective: The purpose of the present study was to compare the root positions in virtual tooth setups using only crowns in a simulated treatment with those achieved in the actual treatment. Methods: Pre- and post-treatment intraoral and corresponding cone beam computed tomography (CBCT) scans were obtained from 15 patients who underwent orthodontic treatment with premolar extraction. A conventional virtual tooth setup was used for the treatment simulation. Pre- and post-treatment three-dimensional digital tooth models were fabricated by integrating the patients' intraoral and CBCT scans. The simulated root positions in the virtual setup were obtained by merging the crown in the virtual setup and root in the pre-treatment tooth model. The root positions of the simulated and actual post-treatment tooth models were compared. Results: Differences in root positions between the simulated and actual models were > 1 mm in all teeth, and statistically significant differences were observed (p < 0.05), except for the maxillary lateral incisors. The differences in the inter-root angulation were > 1° in all teeth, and statistically significant differences were observed in the maxillary and mandibular canines. Conclusions: The virtual tooth setup using only crown data showed errors over the clinical limits. The clinical application of a virtual setup using crowns and roots is necessary for accurate and precise treatment simulation, particularly in extraction treatment.