• The korean journal of orthodontics
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• v.53 no.4
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• pp.254-263
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• 2023

Objective: The evidence on the accuracy of bite registration using intraoral scanners is sparse. This study aimed to develop a new method for evaluating bite registration accuracy using intraoral scanners. Methods: Two different types of models were used; 10 stone models and 10 with acrylic resin teeth. A triangular frame with cylindrical posts at each apex (one anterior and two posteriors) was digitally designed and manufactured using three-dimensional (3D) printing. Such a structure was fitted in the lingual space of each maxillary and mandibular model so that, in occlusion, the posts would contact their opposing counterparts, enforcing a small interocclusal gap between the two arches. This ensured no tooth interference and full contact between opposing posts. Bite registration accuracy was evaluated by measuring the distance between opposing posts, with small values indicating high-accuracy. Three intraoral scanners were used: Medit i500, Primescan, and Trios 4. Viewbox software was used to measure the distance between opposing posts and compute roll and pitch. Results: The average maximum error in interocclusal registration exceeded 50 ㎛. Roll and pitch orientation errors ranged above 0.1 degrees, implying an additional interocclusal error of around 40 ㎛ or more. The models with acrylic teeth exhibited higher errors. Conclusions: A method that avoids the need for reference hardware and the imprecision of locating reference points on tooth surfaces, and offers simplicity in the assessment of bite registration with an intraoral scanner, was developed. These results suggest that intraoral scanners may exhibit clinically significant errors in reproducing the interocclusal relationships.

• Archives of Craniofacial Surgery
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• v.25 no.3
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• pp.123-132
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• 2024

Background: The introduction of presurgical nasoalveolar molding represented a significant departure from traditional molding methods. Developed by Grayson and colleagues in 1993, this technique combines an intraoral molding device with a nasal molding stent. This study aimed to compare the Grayson nasoalveolar molding appliance versus DynaCleft appliance as two methods of presurgical nasoalveolar molding. Methods: A single-blinded, randomized, parallel-arm clinical trial was conducted. Sixteen infants with complete unilateral cleft lip and palate were enrolled and divided into two groups of eight. Group 1 was treated with a modified Grayson nasoalveolar molding appliance that included a nasal stent, while group 2 was treated with DynaCleft elastic adhesive tape and an external nasal elevator. Standardized digital photographs of each infant were taken at baseline and post-treatment using a professional camera. Nine extraoral anthropometric measurements were obtained from each image using image measurement software. Results: The modified Grayson nasoalveolar appliance demonstrated a more significant improvement compared to DynaCleft in terms of alar length projection (on both sides), columella angle, and nasal tip projection. Symmetry ratios also showed enhancement, with significant improvements observed in nasal width, nasal basal width, and alar length projection (p< 0.05). Conclusion: Both the modified Grayson nasoalveolar appliance and DynaCleft appear to be effective presurgical infant orthopedics treatment options, demonstrating improvements in nasolabial aesthetics. The modified Grayson appliance, equipped with a nasal stent, improved nasal symmetry more effectively than DynaCleft, resulting in a straighter columella and a more medially positioned nasal tip.

• The korean journal of orthodontics
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• v.53 no.4
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• pp.264-275
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• 2023

Objective: To investigate the effects of maxillary orthodontic expansion on the alveolar bone tissue in adult patients treated with aligners by using cone-beam computed tomography. Methods: Thirty patients (22 females and 8 males; mean age: 36.3 years) were treated with Invisalign^® aligners. Cone-beam computed tomography and digital models were obtained before (T0) and after (T1) upper arch expansion. The bone thicknesses in the cervical, middle, and apical areas of the incisors, canines, premolar, and first molars were buccally and palatally measured, totaling 96 areas and 2,880 measurements. The buccolingual inclinations and transverse measurements of the teeth were obtained from digital models to correlate them with the bone changes. The statistical tests used were Student's t-test, analysis of variance, and Pearson's correlation tests (p < 0.05). Results: From the 96 areas evaluated, 84 revealed an increase or stability in the alveolar bone thickness and twelve displayed significant bone loss. Bone changes did not correlate with the tooth inclination and transverse measurements. Conclusions: Within the limitation of the present study, mild levels of upper arch expansion obtained with Invisalign^® aligners in adult patients did not result in any clinically significant loss of alveolar bone thickness.

• The korean journal of orthodontics
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• v.49 no.6
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• pp.372-380
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• 2019

Objective: To determine the effects of a local injection of leukocyte-platelet-rich plasma (L-PRP) on orthodontic tooth movement in rabbits. Methods: Twenty-three male New Zealand white rabbits were included in a split-mouth design. Tooth movement with a 100-g nickel-titanium closed-coil spring was performed on the maxillary first premolars. L-PRP was injected submucosally at the buccal and lingual areas of the first premolar in one random side of the maxilla and the other side served as the control and received normal saline. The amount of tooth movement was assessed on three-dimensional digital models on days 0, 3, 7, 14, 21, and 28. Histological findings and osteoclast numbers were examined on day 0 as the baseline and on days 7, 14, and 28. Results: The L-PRP group showed significantly greater cumulative tooth movement at all observed periods. However, a significantly higher rate of tooth movement was observed only on days 0-7 and 7-14. The osteoclast numbers were significantly increased in the L-PRP group on days 7 and 14. Conclusions: Local injection of L-PRP resulted in a transient increase in the rate of tooth movement and higher osteoclast numbers.

• The Journal of the Korean dental association
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• v.54 no.7
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• pp.551-562
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• 2016

There are interferences between the teeth to be moved and the clear aligner made from setup. These interferences generate forces which move teeth to the desired position. However, these can cause incomplete tooth capture of clear aligner. When these interferences exceed the acceptable deformation of aligner, unwanted intrusion of teeth to be moved occurs. When correction of rotation or tipping of teeth is attempted, intrusion prevails before rotation or tipping. However, clear aligner can induce labiolingual tipping or intrusion easily. To achieve preliminary alignment including control of rotation and tipping, NiTi archwires with fixed appliance can be used first, and then clear aligner can be used for finishing in mild Class I maloccusion cases. For this purpose, clear aligner can be made using a digital setup and 3D printing. To move teeth using a clear aligner, tooth capture is critical. To improve tooth capture of clear aligners, slingshot or vertical elastics can be used. These were discussed with illustrations.

• The korean journal of orthodontics
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• v.48 no.3
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• pp.172-181
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• 2018

Objective: This study was performed to investigate buccal facial depth (BFD) changes after extraction and nonextraction orthodontic treatments in post-adolescent and adult female patients, and to explore possible influencing factors. Methods: Twelve and nine female patients were enrolled in the extraction and nonextraction groups, respectively. Changes in BFD in the defined buccal region and six transverse and two coronal measuring planes were measured after registering pretreatment and posttreatment three-dimensional facial scans. Changes in posterior dentoalveolar arch widths were also measured. Treatment duration, changes in body mass index (BMI), and cephalometric variables were compared between the groups. Results: BFD in the buccal region decreased by approximately 1.45 mm in the extraction group, but no significant change was observed in the nonextraction group. In the extraction group, the decrease in BFD was identical between the two coronal measuring planes, whereas this differed among the six transverse measuring planes. Posterior dentoalveolar arch widths decreased in the extraction group, whereas these increased at the second premolar level in the nonextraction group. The treatment duration of the extraction group was twice that of the nonextraction group. No differences were found in BMI and Frankfort horizontal-mandibular plane angle changes between the groups. BFD changes in the buccal region moderately correlated with treatment duration and dental arch width change. Conclusions: BFD decreased in adult female patients undergoing extraction, and this may be influenced by the long treatment duration and constriction of dentoalveolar arch width. However, nonextraction treatment did not significantly alter BFD.

• The korean journal of orthodontics
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• v.29 no.6 s.77
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• pp.649-661
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• 1999

The goals of this study were 1) to present pre-surgical naso-alveolar molding (PNAM) appliance for bilateral cleft lip and palate treatment and 2) to evaluate the effects of the PNAM appliance on the alveolar molding of the premaxilla and the lateral segments. Subjects consisted of 8 bilateral cleft lip and palate infants (7 males and 1 female, mean age at first visit = 61.6 days after birth) who were treated with PNAM appliances in Department of Orthodontics, Seoul National University Dental Hospital. Average alveolar cleft gap between the premaxilla and the lateral segment was $8.09{\pm}5.03mm$ and average duration of alveolar molding treatment was $8.8{\pm}3.1$ weeks. These patients' models were obtained at initial visit (T0) and after alveolar molding (T1). 20 linear and 14 angular variables were measured by using photometry and digital caliper, All statistical analyses were performed by Microsoft Excel 97 program. Paired t-test was used to discriminate the effect of alveolar molding by PNAM appliance. 1. Closure of the alveolar cleft gap in bilateral cleft cases by molding therapy was completed successfully, 2. Alveolar molding inhibited outward growth of lateral segments and produced inward bending of lateral segments. 3. By bending the anterior part of the vomer, the premaxilla could be rotated and moved. posteriorly via alveolar molding. Conclusion This appliance can be applied to bilateral cleft lip and palate infants with satisfactory results before cheiloplasty.

• The korean journal of orthodontics
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• v.37 no.6
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• pp.391-399
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• 2007

Three-dimensional approaches for the diagnosis and analysis of the dentofacial area are becoming more popular in accordance with the development of cone-beam CT (CBCT). The purposes of this study were to evaluate the reliability of cephalometric measurements of lateral cephalograms generated from a CBCT image by making comparisons with the traditional digital lateral cephalogram, and to evaluate the possibility of the clinical application of CBCT generated cephalogram images. Methods: Twenty patients whose external auditory meatus could be identified in the CBCT image were selected, and both CBCT and digital cephalograms were taken. Differences between the measurements of both cephalograms were tested by paired t-test. Results: Among the 22 measurements used, only U1-FH, Mx6 to PTV, and maxillomandibular difference showed statistically significant differences between the CBCT generated cephalogram and the digital cephalogram. Conclusions: The results suggest that the CBCT generated cephalogram can be used for some cephalometric measurements not requiring porion, PTV, condylion as a landmark (SNA, SNB, U1 to SN, IMPA, interincisal angle, etc.).

• The korean journal of orthodontics
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• v.46 no.3
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• pp.171-179
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• 2016

Objective: The primary aim of the study was to generate new prediction equations for the estimation of maxillary and mandibular canine and premolar widths based on mandibular incisors and first permanent molar widths. Methods: A total of 2,340 calculations (768 based on the sum of mandibular incisor and first permanent molar widths, and 1,572 based on the maxillary and mandibular canine and premolar widths) were performed, and a digital stereomicroscope was used to derive the the digital models and measurements. Mesiodistal widths of maxillary and mandibular teeth were measured via scanned digital models. Results: There was a strong positive correlation between the estimation of maxillary (r = 0.85994, $r^2=0.7395$) and mandibular (r = 0.8708, $r^2=0.7582$) canine and premolar widths. The intraclass correlation coefficients were statistically significant, and the coefficients were in the strong correlation range, with an average of 0.9. Linear regression analysis was used to establish prediction equations. Prediction equations were developed to estimate maxillary arches based on $Y=15.746+0.602{\times}sum$ of mandibular incisors and mandibular first permanent molar widths (sum of mandibular incisors [SMI] + molars), $Y=18.224+0.540{\times}(SMI+molars)$, and $Y=16.186+0.586{\times}(SMI+molars)$ for both genders, and to estimate mandibular arches the parameters used were $Y=16.391+0.564{\times}(SMI+molars)$, $Y=14.444+0.609{\times}(SMI+molars)$, and $Y=19.915+0.481{\times}(SMI+molars)$. Conclusions: These formulas will be helpful for orthodontic diagnosis and clinical treatment planning during the mixed dentition stage.

• Imaging Science in Dentistry
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• v.42 no.2
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• pp.89-93
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• 2012

Purpose : Clinicians commonly encounter cases in which it is difficult to determine whether adjacent radiopacities are normal or pathologic. The ideal radiopacity of composite resin is equal to or higher than that of the same thickness of aluminum. We aimed to investigate the possible effects of different curing times on the post-24-hour radiopacity of composite resins on digital radiographs. Materials and Methods : One mm thick samples of Filtek P60 and Clearfil resin composites were prepared and cured with three regimens of continuous 400 mW/$cm^2$ irradiance for 10, 20 and 30 seconds. Along with a 12-step aluminum step wedge, digital radiographs were captured and the radiopacities were transformed to the equivalent aluminum thicknesses. Data were compared by a general linear model and repeated-measures of ANOVA. Results : Overall, the calculated equivalent aluminum thicknesses of composite resins were increased significantly by doubling and tripling the curing times (F(2,8)=8.94, p=0.002). Notably, Bonferroni post-hoc tests confirmed that the radiopacity of the cured Filtek P60 was significantly higher at 30 seconds compared with 10 seconds (p=0.04). Although the higher radiopacity was observed by increasing the time, other comparisons showed no statistical significance (p>0.05). Conclusion : These results supported the hypothesis that the radiopacity of resin composites might be related to the duration of light curing. In addition to the current standards for radiopacity of digital images, defining a standard protocol for curing of dental materials should be considered, and it is suggested that they should be added to the current requirements for dental material.