• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.5
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• pp.254-259
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• 2019

Objectives: Crown-root fracture and cervical caries in maxillary premolars constitute a challenge in cases of subgingival placement of restoration margins. Surgical extrusion has been practiced successfully in permanent anterior teeth. The aim of the present retrospective study was to assess the clinical outcome of surgical extrusion after orthodontic extrusion in maxillary premolars. Materials and Methods: Twenty-one single, tapered root maxillary premolars with subgingival crown-root fracture or caries were included. Presurgical orthodontic extrusion was performed on all teeth to prevent root resorption. Extent of extrusion and rotation was determined based on crown/root ratio. The postoperative splinting period was 7 to 14 days. Clinical and radiographic examination was performed at an interval of 1, 2, and 3 months. Results: After the mean follow-up of $41.9{\pm}15.2months$, failure was observed as increased mobility in 3 of 21 cases. No significant difference was observed in the outcome of surgical extrusion based on tooth type, age, sex, $180^{\circ}$ rotation, or time for extraction. Furthermore, marginal bone loss was not observed. Conclusion: Surgical extrusion of maxillary premolars can be a possible therapeutic option in cases of subgingival crown-root fracture.

• The korean journal of orthodontics
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• v.51 no.4
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• pp.241-249
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• 2021

Objective: This study aimed to evaluate the volume, amount, and localization of root resorption in the maxillary first premolars using micro-computed tomography (micro-CT) after expansion with four different rapid maxillary expansion (RME) appliances. Methods: In total, 20 patients who required RME and extraction of the maxillary first premolars were recruited for this study. The patients were divided into four groups according to the appliance used: mini-implant-supported hybrid RME appliance, hyrax RME appliance, acrylic-bonded RME appliance, and full-coverage RME appliance. The same activation protocol (one activation daily) was implemented in all groups. For each group, the left and right maxillary first premolars were scanned using micro-CT, and each root were divided into six regions. Resorption craters in the six regions were analyzed using special CTAn software for direct volumetric measurements. Data were statistically analyzed using Kruskal-Wallis one-way analysis of variance and Mann-Whitney U test with Bonferroni adjustment. Results: The hybrid expansion appliance resulted in the lowest volume of root resorption and the smallest number of craters (p < 0.001). In terms of overall root resorption, no significant difference was found among the other groups (p > 0.05). Resorption was greater on the buccal surface than on the lingual surface in all groups except the hybrid appliance group (p < 0.05). Conclusions: The findings of this study suggest that all expansion appliances cause root resorption, with resorption craters generally concentrated on the buccal surface. However, the mini-implant-supported hybrid RME appliance causes lesser root resorption than do other conventional appliances.

• Imaging Science in Dentistry
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• v.52 no.3
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• pp.327-332
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• 2022

Mucocele of the paranasal sinuses is a benign, slow-growing, expansile lesion. Maxillary sinus mucoceles are usually associated with painless bulging of the cheek; however, orbital expansion is rarely observed. Maxillary sinus mucoceles can be classified as primary or secondary according to their etiology. An impediment to sinus ostium ventilation is thought to be the cause of primary mucocele, while sequestering of residual mucosa after surgery in the wound and long-term retention of tissue fluid have been suggested to lead to the formation of secondary mucocele. This report presents 2 cases of primary and secondary mucoceles, with a focus on radiographic features. As primary and superiorly positioned secondary maxillary sinus mucoceles are uncommon and their close proximity to the orbit predisposes the patient to significant morbidity, the authors expect that this report will contribute to a better understanding and diagnosis of maxillary sinus mucocele involving the orbit.

• The korean journal of orthodontics
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• v.52 no.6
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• pp.432-438
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• 2022

Objective: To compare crown-root angulations of the permanent maxillary anterior teeth in skeletal Class I, Class II, and Class III Korean malocclusion patients using cone-bean computed tomography (CBCT) images. Methods: Sixty CBCT images were collected from orthodontic patients archive based on skeletal Class I (0˚< A point-nasion-B point angle [ANB] < 4˚), Class II (ANB ≥ 4˚), and Class III (ANB ≤ 0˚) to have 20 samples in each group. Mesiodistal crown-root angulation (MDCRA) and labiolingual crown-root angulation (LLCRA) were evaluated after orientation of images. Crown-root angulations were compared among Class I, Class II, and Class III groups and among the maxillary anterior teeth in each group. Results: LLCRAs of the maxillary central incisor and the lateral incisor were significantly lower in Class III group than those in Class I group. However, those of the canine showed no significant differences among groups. MDCRAs of the maxillary anterior teeth did not significantly differ among groups either. Conclusions: Our results suggest that skeletal Class III malocclusion might affect LLCRA of the maxillary incisors, especially the central incisor.

• The korean journal of orthodontics
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• v.54 no.4
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• pp.239-246
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• 2024

Objective: To examine the areas of the maxillary tuberosity (MT) (coronal, apical, width, and height) with respect to the presence or absence of the third molar to establish possible anatomical limitations for molar distalization. Methods: A total of 277 tuberosities were evaluated through sagittal computed tomography (CT) images, divided for measurement into coronal (free of bone), apical (area of influence of the maxillary sinus), and tuberosity (bony area) zones, and stratified by the presence or absence of the third molar, sex, and two age subgroups. Mann-Whitney U test was used to compare the groups considering the third molar. Results: The medians of the width and height of the tuberosity decreased significantly in the absence of the third molar (P < 0.001). The apical area also showed differences, with negative values in the absence of the third molar and positive values in the presence of the third molar (P < 0.001). However, no differences were observed for the coronal area (P > 0.05). Conclusions: In the absence of the third molar, the size of the MT, represented by its width and height, was smaller and negative values (decrease) were observed for the maxillary sinus. The sagittal CT provides useful information regarding the amount of bone tissue available for distalization and relationship of the second molar with respect to the maxillary sinus, which allows individualizing each case in relation to the amount and type of movement expected.

• The korean journal of orthodontics
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• v.35 no.1 s.108
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• pp.23-34
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• 2005

Collective changes caused by orthodontic tooth movement evaluated in a specific treatment modality could give suggestive information on the specific treatment strategy. The aim of this study was to investigate retrospectively the characteristics of the orthodontic tooth movement during surgical-orthodontic treatment in order to provide an effective presurgical orthodontic treatment planning for the maxillary premolar extraction modality In the skeletal Class III malocclusion patient. Pre- and post-treatment dental casts of skeletal Class III malocclusion patients with nonextraction (N=:24) and the maxillary premolar extraction (N=31) were collected. The angulation and inclination measuring gauge(Invisitech Co. Seoul, Korea) was used to evaluate the orthodontic tooth movement. The changes in the maxillary and mandibular dental arch widths were also measured from the canines to the second molars. As a result, more palatal inclination change in the maxillary dentition was found with the premolar extraction modality than with the nonextraction modality. Linear regression analysis showed that the inter-arch width coordination was mainly due to the inclination changes of maxillary posterior teeth We conclude that the indications and proper treatment planning for surgical-orthodontic treatment in skeletal Class III malocclusion with maxillary premolar extraction could depend partly on the magnitude of the transverse inter-arch coordination especially in the maxillary dentition.

• The korean journal of orthodontics
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• v.39 no.2
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• pp.83-94
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• 2009

Objective: The aim of this study was to investigate the 3-dimensional position of the center of resistance of the 4 maxillary anterior teeth, 6 maxillary anterior teeth, and the full maxillary dentition using 3-dimensional finite element analysis. Methods: Finite element models included the whole upper dentition, periodontal ligament, and alveolar bone. The crowns of the teeth in each group were fixed with buccal and lingual arch wires and lingual splint wires to minimize individual tooth movement and to evenly disperse the forces to the teeth. A force of 100 g or 200 g was applied to the wire beam extended from the incisal edge of the upper central incisor, and displacement of teeth was evaluated. The center of resistance was defined as the point where the applied force induced parallel movement. Results: The results of study showed that the center of resistance of the 4 maxillary anterior teeth group, the 6 maxillary anterior teeth group, and the full maxillary dentition group were at 13.5 mm apical and 12.0 mm posterior, 13.5 mm apical and 14.0 mm posterior, and 11.0 mm apical and 26.5 mm posterior to the incisal edge of the upper central incisor, respectively. Conclusions: It is thought that the results from this finite element models will improve the efficiency of orthodontic treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.4
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• pp.301-307
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• 2004

The flap considered at first for the reconstruction of large maxillary defect, especially mid-face defect, is scapular free flap, because it provides ample composite tissue which can be designed 3-dimensionally for orbital, facial and oral reconstruction. In case of maxillary defect involving hard palate, however, this flap has some limitations. First, its bulk prevents oral function and physio-anatomic reconstruction of nasal and oral cavity. Second, mobility and thickness of cutaneous paddle covering the alveolar area reduce retention of tissue-supported denture and give rise to peri-implantitis when implant is installed. Third, lateral border of scapula that is to reconstruct maxillary arch and hold implants is straight, not U-shaped maxillary arch form. To overcome these problems, new concept of step prefabrication technique was provided to a 27-year-old male patient who had been suffering from a complete hard palate and maxillary alveolar ridge defect. In the first stage, scapular osteomuscular flap was elevated, tailored to fit the maxillary defect, particulated autologous bone was placed subperiosteally to simulate U-shaped alveolar process, and then wrapped up with split thickness skin graft(STSG, 0.3mm thickness). Two months later, thus prefabricated new flap was elevated and microtransferred to the palato-maxillary defect. After 6 months, 10 implant fixtures were installed along the reconstructed maxillary alveolus, with following final prosthetic rehabilitation. The procedure was very successful and patient is enjoying normal rigid diet and speech.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.5
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• pp.326-331
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• 2012

Purpose: Length measurement from maxillary anterior teeth root tip to nasal floor is incorrect in panoramic radiography. Comparison of cone beam computed tomography (CBCT) and panoramic radiography should be helpful in determining the vertical length. Methods: Sixty nine patients were taken CBCT and panoramic radiography of the maxillary anterior. First measurement is length of parallel lines from the central incisor and lateral incisor root tip to nasal floor on CBCT. Second measurement is length of perpendicular lines from the central incisor and lateral incisor root tip to nasal floor on CBCT. Third measurement is length from the central incisor and lateral incisor root tip to nasal floor on panoramic radiographys. Results: In the first measurement of the maxillary central incisors, an average of $11.36{\pm}2.49$ mm in males and $10.49{\pm}2.17$ mm in females. In the second measurement of the maxillary central incisors, $10.41{\pm}2.42$ mm in males and $9.18{\pm}2.08$ mm in females. In the third measurement of the maxillary central incisors, $10.71{\pm}2.20$ mm in males and $9.27{\pm}2.10$ mm in females. In the first measurement of the maxillary lateral incisors, an average of $13.40{\pm}2.04$ mm in males and $11.96{\pm}2.20$ mm in females. In the second measurement of the maxillary lateral incisors, $11.25{\pm}1.82$ mm in males and $10.06{\pm}1.68$ mm in females. In the third measurement of the maxillary lateral incisors, $11.47{\pm}2.01$ mm in males and $10.13{\pm}1.70$ mm in females. Conclusion: The vertical length from root tip to nasal floor was longer in male than female (P>0.05). First measurement was longer than third measurement (P<0.05). This is the actual placement of the implant site measured on the vertical length than the length of the panorama means that there are a few more free. The first measurement was longer than 114% over the third measurement.

• The korean journal of orthodontics
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• v.39 no.6
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• pp.354-361
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• 2009

Objective: Miniscrews are widely used in orthodontic treatment for the purpose of anchorage control. Maximum anchorage can be acquired by the use of miniscrews. Maxillary miniscrew has many clinical advantage for orthodontic treatment. Maxillary sinus, tooth root can be an obstacle for maxillary miniscrew installation. The purpose of this study was to find the safest area and direction of miniscrew insertion in consideration of the maxillary sinus. Methods: The maxillary sinus area of 40 patients (20 male, 20 female) was measured using 3D computed tomography and 3D reconstruction program. Results: The maxillary sinus floor was located most inferiorly between the 1st molar and 2nd molar and located most superiorly between the 1st premolar and 2nd premolar. Buccal bone thickness from the maxillary sinus is significantly thicker between the 1st molar and 2nd molar and significantly thinner between the 1st premolar and 2nd premolar. The area between the 1st premolar and 2nd premolar has a significantly longer vertical distance from CEJ to sinus in consideration of buccal bone thickness. Conclusions: Considering maxillary bone thickness, the posterior area has advantages over the anterior area for installing miniscrews safely and preventing perforation.