Purpose: To investigate the healing pattern of the mucous membrane after tooth extraction necessitated by periodontal disease in the maxillary sinus. Methods: One hundred and three patients with 119 maxillary sinuses were investigated. Before implant placement, cone-beam computed tomography (CT) scanning was performed. The causes of extraction, the time elapsed since extraction, smoking, periodontal disease in adjacent teeth, and gender were recorded. In addition, the thickness of the mucous membrane of the maxillary sinus and the height of residual alveolar bone at the extracted area were calculated from CT images. Results: The thickness of the mucous membrane in the periodontal disease group ($3.05{\pm}2.71\;mm$) was greater than that of the pulp disease group ($1.92{\pm}1.78\;mm$) and the tooth fracture group ($1.35{\pm}0.55\;mm$; P<0.05). The causes of extraction, the time elapsed since extraction, and gender had relationships with a thickening of the mucous membrane of the maxillary sinus (P<0.05). In contrast, the height of the residual alveolar bone at the extracted area, periodontal disease in adjacent teeth, and smoking did not show any relation to the thickening of the mucous membrane of the maxillary sinus. Conclusions: The present study revealed distinct differences in healing patterns according to the causes of extraction in the maxillary sinus, especially periodontal disease, which resulted in more severe thickening of the mucous membrane.
Objectives : This study aims to prepare the basic data of the teeth color by measuring tooth mode using the color of the maxillary central incisor of the college students in their twenties as the dental colorimeter, and oral health and eating habit characteristics were examined. Methods : The maxillary central incisor(1 teeth) of the subjects of study as 467 students(male 89, female 378) was measured during the period from November 14, December 2 2011, so the color of total 467 teeth were examined, and oral health and eating habit characteristics were researched. Results : 1. As the results of measurement of the shade, value, hue of maxillary central incisor by the general characteristics of the subject, the major(shipbuilding information, special rehabilitation for young children) was higher at 3.3 of the shade, and the grade(1), age($$\geq_-20$$), major(beauty culture & cosmetic, occupational therapy) showed higher at +2 of the value, and the grade(1) and all major showed higher at R3 of the hue. 2. As the results of measurement of the shade, value, hue of maxillary central incisor by the oral health characteristics, the subjective teeth color(yellow) and the education of oral health(no) showed higher at 2.5 of the shade. 3. As the results of measurement of the shade, value, hue of maxillary central incisor by the eating habit characteristics of the subjects, the chocolate showed higher at 3.0 and 2.0 of the shade, and the red pepper paste showed higher at +2 and STD of the value, and the green tea showed higher at $R_3$ of the hue. Conclusions : This study demonstrates that the color of the maxillary central incisor showed differences various tendency according to the oral health and eating habit characteristics.
Objective: The purpose of this study was to evaluate the validity of the 3-dimensional (3D) superimposition method of digital models in patients who received treatment with rapid maxillary expansion (RME) and maxillary protraction headgear. Methods: The material consisted of pre- and post-treatment maxillary dental casts and lateral cephalograms of 30 patients, who underwent RME and maxillary protraction headgear treatment. Digital models were superimposed using the palate as a reference area. The movement of the maxillary central incisor and the first molar was measured on superimposed cephalograms and 3D digital models. To determine whether any difference existed between the 2 measuring techniques, intra-class correlation (ICC) and Bland-Altman plots were analyzed. Results: The measurements on the 3D digital models and cephalograms showed a very high correlation in the antero-posterior direction (ICC, 0.956 for central incisor and 0.941 for first molar) and a moderate correlation in the vertical direction (ICC, 0.748 for central incisor and 0.717 for first molar). Conclusions: The 3D model superimposition method using the palate as a reference area is as clinically reliable for assessing antero-posterior tooth movement as cephalometric superimposition, even in cases treated with orthopedic appliances, such as RME and maxillary protraction headgear.
Objective: To identify the available evidence on the effects of rapid maxillary expansion (RME) with three-dimensional imaging and provide meta-analytic data from studies assessing the outcomes using computed tomography. Methods: Eleven electronic databases were searched, and prospective case series were selected. Two authors screened all titles and abstracts and assessed full texts of the remaining articles. Seventeen case series were included in the quantitative synthesis. Seven outcomes were investigated: nasal cavity width, maxillary basal bone width, alveolar buccal crest width, alveolar palatal crest width, inter-molar crown width, inter-molar root apex width, and buccopalatal molar inclination. The outcomes were investigated at two-time points: post-expansion (2-6 weeks) and post-retention (4-8 months). Mean differences and 95% confidence intervals were used to summarize and combine the data. Results: All the investigated outcomes showed significant differences post-expansion (maxillary basal bone width, +2.46 mm; nasal cavity width, +1.95 mm; alveolar buccal crest width, +3.90 mm; alveolar palatal crest width, +3.09 mm; intermolar crown width, +5.69 mm; inter-molar root apex width, +2.85 mm; and dental tipping, +3.75°) and post-retention (maxillary basal bone width, +2.21 mm; nasal cavity width, +1.55 mm; alveolar buccal crest width, +3.57 mm; alveolar palatal crest width, +3.32 mm; inter-molar crown width, +5.43 mm; inter-molar root apex width, +4.75 mm; and dental tipping, 2.22°) compared to pre-expansion. Conclusions: After RME, skeletal expansion of the nasomaxillary complex was greater in most caudal structures. Maxillary basal bone showed 10% post-retention relapse. During retention period, uprighting of maxillary molars occurred.
Lee, Jang Won;Yoo, Ji Yong;Paek, Seung Jae;Park, Won-Jong;Choi, Eun Joo;Choi, Moon-Gi;Kwon, Kyung-Hwan
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.42
no.5
/
pp.278-283
/
2016
Objectives: The maxillary sinus mucosa is reported to recover to preoperative sterility after sinus floor elevation. However, when drainage of maxillary sinus is impaired, recovery can be delayed and maxillary sinusitis can occur. Therefore, in this study, we investigated the correlations between anatomic variants that can interrupt the ostium of the maxillary sinus and incidence of complication after sinus lifting. Materials and Methods: The subjects are 81 patients who underwent sinus lifting in Wonkwang University Dental Hospital (Iksan, Korea). Computed tomography (CT) images of the subjects were reviewed for presence of nasal septum deviation, anatomic variants of the middle turbinate, and Haller cells. Correlations between anatomic variations and occurrence of maxillary sinusitis were statistically analyzed. Results: Patients with anatomic variants of ostio-meatal units, such as deviated nasal septum, concha bullosa or paradoxical curvature of the middle turbinate, or Haller cells, showed a higher rate of complication. However, only presence of Haller cell showed statistically significant. Conclusion: Before sinus lifting, CT images are recommended to detect anatomic variants of the ostio-meatal complex. If disadvantageous anatomic variants are detected, the use of nasal decongestants should be considered to reduce the risk of postoperative sinusitis.
The purpose of this study was to analyse the center of resistance of the maxillary first molar using the 3-dimension finite element method. An extracted maxillary first molar of normal shape and average root length was selected and sectioned every 1.5mm parallel to the cementoenamel junction. Each section was traced and digitized to construct 3-D finite element model of the maxillary first molar. After a certain magnitude of counterbalancing moment(M) was applied to the tooth, a varying single force(F) of distomesial direction was applied to a certain point of th tooth until the tooth was translated. The force producing translation(Ft) was substituted to the equation ${\Delta}d=M/Ft$ to calculate the center of resistance of the maxillary first molar. And reducing the alveolar bone level 1.68mm, and 3.36mm below to the cementoenamel junction, the tooth movement was analysed to see the effect of reducing the alveolar bone level to the location of the center of resistance. The results were as follows ; 1. The center of resistance of the maxillary first molar was 3.72mm apical, 1.10mm buccal, and 0.71mm mesial to the geometric center of the horizontally sectioned surface at the cementoenamel junction. This point was 0.36mm apical, 1.20mm buccal, and 0.71mm mesial to the trifurcation point, indicating that it was not on the tooth root. 2. As the alveolar bone level was reduced, the center of resistance of the maxillary first molar was moved to the apical direction.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.43
no.6
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pp.407-414
/
2017
Objectives: The study was designed to evaluate the efficacy of performing a second, repeat anterior maxillary distraction (AMD) to treat residual cleft maxillary hypoplasia. Materials and Methods: Five patients between the ages of 12 to 15 years with a history of AMD and with residual cleft maxillary hypoplasia were included in the study. Inclusion was irrespective of gender, type of cleft lip and palate, and the amount of advancement needed. Repeat AMD was executed in these patients 4 to 5 years after the primary AMD procedure to correct the cleft maxillary hypoplasia that had developed since the initial procedure. Orthopantomogram (OPG) and lateral cephalograms were taken for evaluation preoperatively, immediately after distraction, after consolidation, and one year postoperatively. The data obtained was tabulated and a Mann Whitney U-test was used for statistical comparisons. Results: At the time of presentation, a residual maxillary hypoplasia was observed with a well maintained distraction gap on the OPG which ruled out the occurrence of a relapse. Favorable movement of the segments without any resistance was seen in all patients. Mean maxillary advancement of 10.56 mm was achieved at repeat AMD. Statistically significant increases in midfacial length, SNA angle, and nasion perpendicular to point A distance was achieved (P=0.012, P=0.011, and P=0.012, respectively). Good profile was achieved for all patients. Minimal transient complications, for example anterior open bite and bleeding episodes, were managed. Conclusion: Addressing the problem of cleft maxillary hypoplasia at an early age (12-15 years) is beneficial for the child. Residual hypoplasia may develop in some patients, which may require additional corrective procedures. The results of our study show that AMD can be repeated when residual deformity develops with the previous procedure having no negative impact on the results of the repeat procedure.
Journal of Dental Rehabilitation and Applied Science
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v.23
no.4
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pp.313-326
/
2007
With rising prevalency of mouth breathing children caused by developing civilization and increasing pollution, there are many maxillary transverse discrepancy patients with undergrowth of maxilla. For improving this, maxillary mid-palatal suture splitting was often performed. The purpose of this study was to analyse the stress distribution on the craniofacial suture and cranium after rapid maxillary expansion by finite element model. The boy(13Y6M) was chosen for taking computed-tomography for finite element model. Three-dimensional model of maxilla, first premolar, first molar, buccal and lingual part of rapid maxillary expansion were constructed. 1. The alveolar bone adjacent to the first molar and the first premolar that was affected directly by rapid maxillary expansion was displaced laterally approximately 4.04mm at maximum. The force decreased toward anterior region and frontal alveolar bone displaced laterally about 3.18mm. 2. A forward maximum displacement was exhibited at zygomatic process middle region. 3. At maximum, maxillary median part experienced 0.973mm downward repositioning and 0.65mm upward repositioning at lateral alveolar bone. 4. Von mises stress was observed the largest stress distribution around teeth and zygomatic buttress. 5. The largest tensile force was observed around alveolar bone of teeth, while compression force was observed at zygomatic buttress.
Generally, an adult cleft lip or/and palate patient shows some amount of maxillary deficiency due to limitation of bony growth caused by heavy scars resulted from previous operations such as a cheiloplasty and/or a palatoplasty at an early child age. To solve the problem, advancement of the maxilla is usually required during orthognathic surgery. However, severe tensional force resulted from heavy scars on the palate and/or the lip, as well as the bony defect at the cleft area limited sufficient advancement of the maxillary segment and finally caused relapse of the reposed maxilla. Therefore, distraction osteogenesis of the maxilla was introduced for the successful maxillary advancement inthose kinds of patients. As both hard and soft tissues can be simultaneously and gradually extended with this technique, tensional force caused by heavy scars opposed to forward movement of the maxilla can be reduced to an extent not to develop severe relapse of the advanced maxilla. Since distraction osteogenesis of the maxilla was applied as one of standard protocols for the treatment of the patients with severe maxillary hypoplasia dueto cleft lip and/or palate, the devices for the distraction was improved to control the vectors of distraction with better and more stable. We have treated a 23-year-old male cleft patient with a severe maxillary hypoplasia using a newly developed a maxillary distraction device and a RP model for a pre-operative simulation surgery. As a result, we could successfully move the maxilla as we designed pre-operatively and also reduce much of operation time. Therefore, we report of the case to share our experience with colleagues.
Objective: The aim of this study was to analyze tooth movement and arch width changes in maxillary dentition following nonextraction treatment with orthodontic mini-implant (OMI) anchorage in Class II division 1 malocclusions. Methods: Seventeen adult patients diagnosed with Angle's Class II division 1 malocclusion were treated by nonextraction with OMIs as anchorage for distalization of whole maxillary dentition. Three-dimensional virtual maxillary models were superimposed with the best-fit method at the pretreatment and post-treatment stages. Linear, angular, and arch width variables were measured using Rapidform 2006 software, and analyzed by the paired t -test. Results: All maxillary teeth showed statistically significant movement posteriorly (p < 0.05). There were no significant changes in the vertical position of the maxillary teeth, except that the second molars were extruded (0.86 mm, p < 0.01). The maxillary first and second molars were rotated distal-in ($4.5^{\circ}$, p < 0.001; $3.0^{\circ}$, p < 0.05, respectively). The intersecond molar width increased slightly (0.1 mm, p > 0.05) and the intercanine, interfirst premolar, intersecond premolar, and interfirst molar widths increased significantly (2.2 mm, p < 0.01; 2.2 mm, p < 0.05; 1.9 mm, p < 0.01; 2.0 mm, p < 0.01; respectively). Conclusions: Nonextraction treatment with OMI anchorage for Class II division 1 malocclusions could retract the whole maxillary dentition to achieve a Class I canine and molar relationship without a change in the vertical position of the teeth; however, the second molars were significantly extruded. Simultaneously, the maxillary arch was shown to be expanded with distal-in rotation of the molars.
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