Korean Journal of Orthodontics最新文献

Objective: To assess the effects of thermoforming on aligner thickness and gap width in six aligner systems with the same nominal thickness.

Methods: Six passive upper aligners of different brands were adapted to a single printed cast. Each sample was evaluated with high-resolution micro-computed tomography. To investigate aligner thickness and gap width, two-dimensional (2D) analysis was conducted assessing the effects of the following variables: tooth type (central incisor, canine, and first molar), 2D reference points, and aligner type. Data were analyzed and compared using analysis of variance and Tukey's post-hoc tests (p < 0.05).

Results: Tooth type, dental region, and aligner type affected both the gap width and aligner thickness. The aligner thickness remained moderately stable across the arch only in the F22.

Conclusions: All thermoformed samples displayed smaller aligner thickness and gap width at anterior teeth and both gingival and coronal centers than at posterior teeth and occlusal surfaces.

Objective: To evaluate the reasons influencing the preferences for a certain type of orthodontic appliance over another among prospective patients (PP) and orthodontists.

Methods: A total of 49 PP and 51 orthodontists were asked about their preferences for the following appliances: clear aligners (CA), lingual metallic brackets (LMB), polycrystalline and monocrystalline ceramic brackets, and buccal metallic brackets (BMB). The participants rated the importance of 17 potential reasons that would explain their choices. The reasons that contributed most to these preferences were identified. Non-parametric tests (Fisher's exact, χ² and Mann-Whitney tests) and multivariate analyses (regression and discriminant analysis) were used to assess the data (α = 0.05).

Results: CA and BMB were the most chosen appliances by PP and orthodontists, respectively. LMB was the most rejected option among both groups of participants (p < 0.001). Rates of the importance of pain/discomfort, smile esthetics, finishing details, and feeding/speech impairment showed the highest differences between PP and orthodontists (p < 0.0005). Discriminant analyses showed that individuals who considered treatment time and smile esthetics as more important were more likely to prefer CA, while those who prioritized finishing details and cost were more likely to choose BMB (p < 0.05).

Conclusions: Reasons related to comfort and quality of life during use were considered as more important by PP, while those related to the results and clinical performance of the appliances were considered as more relevant by orthodontists.

Objective: To evaluate the accuracy of a multi-stage convolutional neural network (CNN) model-based automated identification system for posteroanterior (PA) cephalometric landmarks.

Methods: The multi-stage CNN model was implemented with a personal computer. A total of 430 PA-cephalograms synthesized from cone-beam computed tomography scans (CBCT-PA) were selected as samples. Twenty-three landmarks used for Tweemac analysis were manually identified on all CBCT-PA images by a single examiner. Intra-examiner reproducibility was confirmed by repeating the identification on 85 randomly selected images, which were subsequently set as test data, with a two-week interval before training. For initial learning stage of the multi-stage CNN model, the data from 345 of 430 CBCT-PA images were used, after which the multi-stage CNN model was tested with previous 85 images. The first manual identification on these 85 images was set as a truth ground. The mean radial error (MRE) and successful detection rate (SDR) were calculated to evaluate the errors in manual identification and artificial intelligence (AI) prediction.

Results: The AI showed an average MRE of 2.23 ± 2.02 mm with an SDR of 60.88% for errors of 2 mm or lower. However, in a comparison of the repetitive task, the AI predicted landmarks at the same position, while the MRE for the repeated manual identification was 1.31 ± 0.94 mm.

Conclusions: Automated identification for CBCT-synthesized PA cephalometric landmarks did not sufficiently achieve the clinically favorable error range of less than 2 mm. However, AI landmark identification on PA cephalograms showed better consistency than manual identification.

Objective: To compare computer-aided design and computer-aided manufacturing (CAD/CAM) customized nitinol retainers with standard stainlesssteel fixed retainers over a 12-month study period.

Methods: This randomized controlled trial (RCT) was conducted on 62 patients randomly allocated to a control group that received stainless-steel retainers or a test group that received customized CAD/CAM nickel-titanium retainers. Four time points were defined: retainer placement (T0) and 1-month (T1), 6-month (T2), and 12-month (T3) follow-up appointments. At each time point, Little's irregularity index (LII) (primary endpoint) and dental stability measurements such as intercanine width were recorded in addition to assessment of periodontal parameters. Radiological measurements such as the incisor mandibular plane angle (IMPA) were recorded at T0 and T3. Failure events (wire integrity or debonding) were assessed at each time point.

Results: From T0 to T3, LII and other dental measurements showed no significant differences between the two groups. The data for periodontal parameters remained stable over the study period, except for the gingival index, which was slightly, but significantly, higher in the test group at T3 (p = 0.039). The IMPA angle showed no intergroup difference. The two groups showed no significant difference in debonding events.

Conclusions: This RCT conducted over a 12-month period demonstrated no significant difference between customized CAD/CAM nickel-titanium lingual retainers and standard stainlesssteel lingual retainers in terms of dental anterior stability and retainer survival. Both retainers eventually appeared to be equally effective in maintaining periodontal health.

Objective: To develop a standardized instrument to measure the level of cognition for orthodontic treatment in adults, and verify its reliability and validity for assessing perceptions of orthodontic treatment in adults.

Methods: A total of 406 adults aged 19-64 years were surveyed by an internet research system. A tool was developed through the instrument development and verification stages. The data were analyzed by correlation analysis, exploratory factor analysis, confirmatory factor analysis, and Cronbach's α test.

Results: The instrument consisted of 11 items covering four factors related to orthodontic treatment. Three items were related to general perception, four described the perception of the treatment for adults, two related to the treatment effects, and two related to the retention of orthodontic treatment. In the reliability test, Cronbach's α was 0.845 for the 11 items. In assessments for individual components, Cronbach's α was 0.764 for the general perception of orthodontic treatment, 0.705 for the perception of this treatment for adults, 0.707 for the effects of the treatment, and 0.701 for the retention of orthodontic treatment. Finally, a measurement instrument for the perception of orthodontic treatment in adults was designed to assess the 11 items on a four-point Likert scale.

Conclusions: This study developed a standard measurement instrument for assessing the perception of orthodontic treatment in adults. The proposed instrument will enable additional studies on the influence of an adult's perception of orthodontic treatment on the decision to undergo treatment.

Objective: Increased gingival elasticity has been implicated as the cause of relapse following orthodontic rotational tooth movement and approaches to reduce relapse are limited. This study aimed to investigate the effects of sulforaphane (SFN), an inhibitor of osteoclastogenesis, on gene expression in gingival fibroblasts and relapse after rotational tooth movement in beagle dogs.

Methods: The lower lateral incisors of five beagle dogs were rotated. SFN or dimethylsulfoxide (DMSO) were injected into the supra-alveolar gingiva of the experimental and control group, respectively, and the effect of SFN on relapse tendency was evaluated. Changes in mRNA expression of extracellular matrix components associated with gingival elasticity in beagles were investigated by real-time polymerase chain reaction. Morphology and arrangement of collagen fibers were observed on Masson's trichrome staining of buccal gingival tissues of experimental and control teeth.

Results: SFN reduced the amount and percentage of relapse of orthodontic rotation. It also decreased the gene expression of lysyl oxidase and increased the gene expression of matrix metalloproteinase (MMP) 1 and MMP 12, compared with DMSO control subjects. Histologically, collagen fiber bundles were arranged irregularly and were not well connected in the SFN-treated group, whereas the fibers extended in parallel and perpendicular directions toward the gingiva and alveolar bone in a more regular and well-ordered arrangement in the DMSO-treated group.

Conclusions: Our findings demonstrated that SFN treatment may be a promising pharmacologic approach to prevent orthodontic rotational relapse caused by increased gingival elasticity of rotated teeth in beagle dogs.

Objective: To investigate and compare the slot sizes and parallelism of metal injection molding (MIM) and computerized numerical control (CNC) brackets.

Methods: The following four MIM bracket series with 0.022-inch (in) slots were selected for investigation: Di MIM mini Twin (Ortho Organizers), Mini Diamond Roth (Ormco), Gemini MBT (3M Unitek), and Formula R Roth (Tomy). The following four CNC bracket series with 0.022-in slots were selected for investigation: Econoline MBT (Adenta), Legend mini MBT (GC Orthodontics), Crown mini MBT (Adenta), and Evolve MBT (DB Orthodontics). The slot dimensions were measured using an optical microscope (XTCam-D310M; Mitutoyo) with a resolution of 1 μm. The results were statistically analyzed using one-way analysis of variance and the Tukey post-hoc test with a significance level of 0.05.

Results: The results indicated that all the investigated slot sizes were oversized with respect to the manufacturers' specifications (0.022 in). Among the eight bracket series, the Di MIM bracket (MIM) was the most oversized by 10.4%, whereas the Evolve bracket (CNC) was the least oversized by 2.6%. The slots in seven of the bracket series had divergent walls instead of parallel ones. The Evolve bracket alone had parallel slot walls.

Conclusions: Regardless of the manufacturing method, all the slot sizes of the brackets investigated in this study were significantly oversized; most of the slot walls were nonparallel, except for those of the Evolve bracket. This study could not establish that the CNC method was more accurate than the MIM method in manufacturing bracket slots.