Search

Maxillary transverse deficiency is a frequent finding in growing patients with Class III malocclusion, where the relative position of the mandible to the maxilla contributes to a transverse skeletal discrepancy, often accompanied by dental compensations in both the sagittal and transverse planes. This case series examines the impact of midfacial protraction using a temporary anchorage device (TAD)-anchored Class III palatal plate in patients with relative maxillary transverse deficiency. The series highlights the occurrence of transverse autocorrection, particularly the spontaneous improvement of maxillary molar inclination, following protraction without the need for concurrent maxillary expansion. Key diagnostic considerations for maxillary transverse deficiency and the severity-based differential diagnosis are explored to guide the appropriate therapeutic approach. The potential mechanisms underlying the autocorrection of maxillary transverse discrepancies are discussed, alongside the biomechanical advantages of TAD-anchored maxillary protraction. Notably, this case series illustrates that the inclination of the maxillary molars corrected automatically after midfacial protraction, offering an alternative to conventional expansion techniques. The findings from this case series suggest that maxillary protraction without expansion may be a viable treatment option for growing Class III patients with relative maxillary transverse deficiency. However, while these preliminary observations are promising, further controlled clinical trials are necessary to validate the efficacy and long-term stability of this approach. Future studies will be crucial in confirming these outcomes and optimizing protocols for the management of transverse discrepancies in Class III malocclusions. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the available retromolar space for ramal plates in patients with Class I and III malocclusions and compare that space with and without third molars using cone-beam computed tomography. Cone-beam computed tomography images of 30 patients (17 males, 13 females; mean age, 22.2 ± 4.5 years) with Class III malocclusion and 29 subjects (18 males, 11 females; mean age, 24.3 ± 3.7 years) with Class I malocclusion were analyzed. Available retromolar space at 4 axial levels of the second molar root and the volume of the retromolar bone were evaluated. Two-way repeated measures analysis of covariance (repeated measures analysis of covariance) was applied to compare the variables between Class I and III malocclusions and the presence of third molars. Patients with Class I and III relationships showed up to 12.7 mm of available retromolar space at 2 mm apical from the cementoenamel junction (CEJ). At 8 mm apical from CEJ, patients with Class III malocclusion had 11.1 mm of space, whereas those with a Class I relationship showed 9.8 mm of available space. When patients had third molars, the amount of available retromolar space was significantly greater in patients with a Class I and III relationship. However, patients with Class III malocclusion exhibited greater available retromolar space than those with a Class I relationship (P = 0.028). In addition, the bone volume was significantly greater in patients with Class III malocclusion than in patients with a Class I relationship and those with third molars than in those without them (P <0.001). Class I and III groups showed the availability of at least 10.0 mm of retromolar space 2 mm apical to the CEJ for molar distalization. Based on this information, it is suggested that clinicians consider available retromolar space for molar distalization in diagnosing and planning treatment for patients with Class I and III malocclusion. • Class I and III patients showed at least 10.0 mm of retromolar space 2 mm apical to the CEJ. • The retromolar space was significantly greater in patients with third molars. • The bone volume was greater Class III patients than Class I subjects and those with third molars. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to evaluate the dentoskeletal and soft-tissue changes after molar distalization using modified C-palatal plates in patients with severe maxillomandibular arch length discrepancies.Methods: Twenty-four patients with Class I and II malocclusion (19.0 ± 7.3 years; 17 females and 8 males), who had severe maxillary crowding of >10 mm, and moderate mandibular crowding of >6 mm, underwent molar distalization using modified C-palatal plates and buccal miniscrews with approximately 300 g of force per side. Models were made, and cephalograms were taken before and after treatment. Cephalometric variables and arch dimensions were measured. Paired t test and Wilcoxon rank sum test were used for statistical analysis.Results: In the maxillary dentition, an average of 12.4 mm of crowding was resolved by molar distalization of 4.4 mm, interproximal stripping of 0.7 mm, and arch expansion. In the mandibular dentition, crowding of 6.7 mm was alleviated by molar distalization of 2.4 mm, an interproximal of 1.5 mm, and additional arch expansion. The incisor positions were maintained (SN-U1, 101.3°; IMPA, 88.8°), and soft-tissue profiles were improved (LL/E-line -1.1 mm; P < 0.001) after treatment.Conclusions: Maxillary and mandibular tooth-size arch length discrepancy of 12.4 mm and 6.7 mm, respectively, were resolved by molar distalization, interproximal reduction, and arch expansion, whereas incisor positions were maintained, and soft-tissue profiles were improved. This could be a viable treatment option in patients with moderate-to-severe crowding. [ABSTRACT FROM AUTHOR]

Introduction: Evaluate the treatment effects of maxillary protraction using palatal plates and compare them to those with conventional tooth-borne anchorage in growing patients with Class III malocclusion.Methods: Forty patients were divided into 2 groups according to the type of anchorage used: group 1 (n = 20; mean age, 10.5 ± 1.6 years; palatal plates) and group 2 (n = 20; mean age, 10.0 ± 1.2 years; tooth-borne appliances). Lateral cephalograms were taken before and after maxillary protraction. Skeletal, dental, and soft-tissue variables were measured. For statistical analysis, paired and independent t tests were performed.Results: Group 1 showed maxilla advancement by 2.3 ± 1.0 mm compared with group 2 by 0.9 ± 0.6 mm, and group 2 indicated clockwise rotation of the mandible, but there was no such clockwise rotation in group 1 (P <0.001). Group 1 had a less lingual inclination of the mandibular incisors than group 2 (IMPA, -1.0 ± 3.8° vs -3.8 ± 2.8°; P <0.05). There was no difference in soft-tissue changes between the 2 groups.Conclusions: A facemask with palatal plate induced maxillary advancement with less mandibular clockwise rotation and dental movement than conventional tooth-borne anchorage. This modality can be used efficiently for maxillary protraction in growing patients with Class III malocclusion. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to evaluate the treatment effects after molar distalization using modified C-palatal plates in patients with Class II malocclusion with maxillary sinus pneumatization.Methods: This study consisted of 70 lateral cephalograms derived from cone-beam computerized tomography images of 35 patients with Class II malocclusion (mean age 22.3 ± 7.4 years) who had undergone bilateral total arch distalization of the maxillary dentition using modified C-palatal plates. The samples were divided into 2 groups according to sinus pneumatization; group 1 (n = 40), cephalograms with sinus pneumatization and group 2 (n = 30) cephalograms without sinus pneumatization. Paired t tests and independent-sample t tests were used to compare the changes in each group and between groups.Results: The distal movement of the maxillary first molars was 4.3 mm for group 1 and 3.5 mm for group 2, with the intrusion of 1.4 mm and 2.5 mm, respectively. There was no statistically significant difference between the 2 groups. Group 1 showed 3.5° of distal tipping of the maxillary second molars, which was significantly greater than the 0.2° in group 2 (P <0.05). The total treatment period, including distalization, was 2.2 years for group 1 and 1.9 years for group 2, but the difference was not significant.Conclusions: There was no significant difference in the amount of distal movement and intrusion of the maxillary first molars between groups 1 and 2. Therefore, these results suggest that regardless of sinus pneumatization, molar distalization using temporary skeletal anchorage devices in Class II patients can be performed as a nonextraction treatment. [ABSTRACT FROM AUTHOR]

Extraction has traditionally been necessary to correct bimaxillary and lip protrusion with proclined maxillary and mandibular incisors. However, non-extraction treatment using temporary skeletal anchorage devices (TSADs) is now an option for severe overjet or full-step Class II malocclusions. It is possible to treat bimaxillary protrusion with non-extraction, but for successful non-extraction treatment in bimaxillary patients, the amount of total arch distalization of the mandibular dentition is crucial. For maximum total mandibular arch distalization in protrusion patients, it is recommended to extrude and distalize the molars simultaneously, which results in more posterior movement of the mandibular dentition without gingival impingement. Therefore, this paper presents efficient biomechanics, a strategy, and the anatomy of the retromolar area for total arch distalization using TSADs to improve facial profile without extracting premolars in Class II maxillary and bimaxillary protrusion patients. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to compare treatment effects after total mandibular arch distalization with buccal interradicular miniscrews vs ramal plates in patients with Class III malocclusion.Methods: The sample consisted of 40 patients with Class III malocclusion; 20 were treated with distalization via buccal miniscrews (age, 25.8 ± 7.9 years), whereas 20 were treated with ramal plates (age, 26.4 ± 6.1 years). Twenty-three linear and angular measurements were analyzed on pretreatment and posttreatment lateral cephalograms. The changes in each group and differences in treatment effects between the 2 groups were evaluated.Results: The mean amount of distalization at the crown and root levels of the mandibular first molars and the amount of distal tipping was 1.8 mm, 0.6 mm, and 5.4° in the buccal miniscrew group vs 3.6 mm, 2.0 mm, and 6.8° in the ramal plate group, respectively. In addition, 2.2° of counterclockwise rotation of the occlusal plane was observed in the buccal miniscrew group after 1.3 mm of molar intrusion (P <0.001). The distal movement of the lower lip was 0.6 mm in the buccal miniscrew group vs 2.3 mm in the ramal plate group.Conclusions: The buccal miniscrew group showed more molar intrusion and counterclockwise rotation of the occlusal plane than in the ramal plate group. The ramal plate produced more distalization of the mandibular dentition with clockwise rotation of the mandible. Therefore, these results can be useful when selecting the type of temporary skeletal anchorage devices to treat patients with Class III malocclusion, depending on their vertical pattern. [ABSTRACT FROM AUTHOR]

Introduction: Controlling transverse discrepancies is necessary to ensure stable and functional occlusion. Altered molar inclinations can camouflage the transverse relationship. The purpose of this research was to evaluate the maxillomandibular relationship of the center of resistance (CR) of the arch form created by the CR of teeth and compare these CR arch forms by their skeletal patterns.Methods: Sixty patients with minor crowding and normal posterior overjet were divided into 3 groups according to ANB angle: skeletal Class I group had ANB angle between 0° and 4° (n = 20), skeletal Class II group had ANB angle >4° (n = 20), and skeletal Class III group had ANB angle <0° (n = 20). The 3-dimensional coordinates of the CR were estimated using cone-beam computed tomography images and projected on the CR occlusal plane to obtain the 2-dimensional coordinates. The CR arch forms were constructed and evaluated using Matlab (MathWorks, Natick, Mass).Results: On comparing maxillomandibular CR arch form widths, the maxilla was significantly larger than the mandible of the canine and first premolar. The mandible was larger in the first molar of the skeletal Class III group. The maxillomandibular CR arch form width ratios were between 0.97 and 1.35. On comparing maxillomandibular CR arch form areas, the maxilla was significantly larger than the mandible in the anterior segment, and the mandible was larger in the posterior segment. The ratios were between 0.86 and 2.25. In between-group comparison, the skeletal Class III group showed significantly greater arch forms in the mandible.Conclusions: CR arch forms had significant maxillomandibular differences throughout the arch. The maxillomandibular ratios could be a reference for site-specific transverse discrepancy analysis. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to analyze the treatment effects after molar distalization using modified C-palatal plates with and without second molar eruption and to evaluate the three-dimensional position of the molars during long-term retention using cone-beam computed tomography.Methods: The study sample comprised 74 third molars in 42 patients. Twenty-seven adolescent patients (mean age, 12.6 years) having 48 maxillary third molars were divided into 2 groups according to the eruption of their second molars: 15 patients with second molar eruption (group 1) and 12 patients without second molar eruption (group 2). Pretreatment, posttreatment, and long-term data (mean, 5.2 years) from cone-beam computed tomography were scanned and compared with control groups.Results: There was less tipping movement of the first and second molars (0.94° and 3.22°) and distal tipping movement of the third molars (8.91°) in group 1 than in group 2 (4.36°, 7.39°, and 3.08°, respectively), but the treatment time was shorter and the positional change of the third molars was insignificant in group 2. In the long-term, the second molars fully erupted after distalization in group 2, and there was no difference in the third molar position between group 1, group 2, and the control group, except for the vertical position of the third molars in group 1.Conclusions: In the long-term, the second molars fully erupted after distalization, and the third molars were in a favorable position. Therefore, these findings suggest that clinicians do not need to extract developing third molars before distalization in adolescents. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to identify the tooth movement patterns relative to various force angulations (FAs) when distalizing the total maxillary dentition.Methods: Long-term orthodontic movement of the maxillary dentition was simulated by accumulating the initial displacement of teeth produced by elastic deflection of the periodontal ligament using a finite element analysis. Distalization forces of 3 N were applied to the archwire between the maxillary canine and first premolar at 5 different FAs (-30°, -15°, 0°, 15°, and 30°) to the occlusal plane.Results: Maxillary incisors and molars showed lingual and distal tipping at all FAs, respectively. At a force angulation of 30°, almost bodily distalization of the total maxillary dentition occurred, but incisors showed considerable lingual tipping because of the effect of clearance gap (0.003-in, 0.022 × 0.025-in bracket slot, 0.019 × 0.025-in archwire) and elastic deflection of the archwire. Medial displacement of the maxillary anterior teeth occurred because of lingual tipping during distalization. The occlusal plane rotated clockwise at all FAs because of extrusion of the maxillary incisors and intrusion of the maxillary second molars, and the amounts decreased as FA increased.Conclusions: Tooth movement patterns during distalization of the total maxillary dentition were recognized. With an understanding of the mechanics, a proper treatment plan can be established. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to analyze and clarify tooth movement during mesialization of the whole maxillary dentition with various force angulations (FAs).Methods: A finite element method was used to simulate the long-term orthodontic movement of the maxillary dentition by accumulating the initial displacement of teeth produced by elastic deformation of the periodontal ligament. A mesial force of 3 N was applied to the maxillary second molar at 5 different FAs (-30°, -15°, 0°, 15°, and 30°) to the occlusal plane.Results: At an FA of 28°, the line of action of the force passed through the center of resistance of the maxillary whole dentition. With all FAs, the central incisors and molars tipped labially and mesially, respectively. The tipping angles gradually decreased as the FAs shifted from -30° to 30°. The molars tipped lingually with FAs of -30° and -15°, whereas they tipped buccally with FAs of 0°, 15°, and 30°. The molars tended to rotate mesiolingually more as the angle of force increased toward an FA of 30°. The occlusal plane rotated counterclockwise with FAs of -30°, -15°, and 0°, whereas it rotated clockwise with FAs of 15° and 30°. With an FA of 30°, buccal tipping and mesiolingual rotation of the molars, and the change in the occlusal plane angle decreased when the transpalatal arch (TPA) was fixed to the first molars and decreased, even more when the TPA was fixed to the second molars rather than the first molars, when a thicker TPA was used, and when the TPA was fixed to both molars rather than a single molar.Conclusions: There was a correlation between tooth movement during mesialization of the whole maxillary dentition and the angle at which the force was applied. [ABSTRACT FROM AUTHOR]

Maxillary molar distalization is a standard option for nonextraction treatment of Class II malocclusions. The purpose of this study was to develop an automated, artificial intelligence (AI) system to predict the dental, skeletal, and soft tissue changes after nonextraction treatment. Retrospective data and images were obtained for 284 patients who had had nonextraction treatment using modified C-palatal plates. Pre and posttreatment cephalograms were superimposed using the sella and the nasion as reference points. Cephalometric changes as a result of treatment were used for learning using convolutional neural networks (CNN). From the results, heatmaps were generated in the form of lateral cephalograms, representing the predicted amount of change for each landmark as a result of treatment. Six landmarks had a prediction error of < 1.0 mm: the A point, anterior nasal spine, subnasale, soft tissue A, pronasale, and columella. Ten landmarks, including the upper lip, labrale superius, and stomion superius, showed errors of 1.0–2.0 mm. Eleven landmarks, including the lower lip, soft tissue B, and stomion inferius, had errors of 2.0–3.0 mm. Only the soft tissue pogonion and menton landmarks had errors > 3.0 mm. Our AI model based on CNN architecture shows that it is possible to predict the cephalometric changes resulting from nonextraction treatment. The predicted changes expressed in the form of lateral cephalometric images may be useful visual guides for clinicians as well as patients when considering nonextraction treatment. [ABSTRACT FROM AUTHOR]

Introduction: The aims of this study were to evaluate the long-term skeletodental effects, the volume of maxillary tuberosity, and airway space changes after maxillary molar distalization using modified C-palatal plate (MCPP) in adolescents with Class II malocclusion.Methods: The sample consisted of 20 adolescent patients (MCPP group; mean age, 12.9 ± 1.0 year) who underwent bilateral distalization of their maxillary dentition and 20 subjects as a control group. In the MCPP group, cone-beam computed tomography images were taken before distalization, at the end of the treatment, and during retention with a minimum of a 3-year posttreatment follow up period. Repeated measures ANOVA followed by post-hoc analysis with the Bonferroni test were used to identify significant differences between time points.Results: After the long-term observation period, sagittal skeletal and dental relationships were maintained (there were no significant changes in ANB, occlusal plane angle, and overjet postretention). The vertical skeletal dimension did not change during treatment and was stable at the long-term follow-up (the mandibular plane angle and ANS-Me were relatively well maintained). The volume of the maxillary tuberosity showed no significant change during long-term retention. However, the volume was significantly smaller in the treatment group than in the control group (P <0.0001). There were no significant airway space changes after distalization and the postretention period. In addition, there was no significant difference between the MCPP and control groups.Conclusions: Improved sagittal skeletal and dental relationships because of treatment were maintained in the long-term evaluation. There was no negative long-term effect on airway space associated with the maxillary arch distalization. Therefore, these findings might be beneficial for clinicians in diagnosis and treatment planning for Class II malocclusion in adolescents. [ABSTRACT FROM AUTHOR]

To ensure that orthognathic surgery is successful, functional aspects such as mastication, pronunciation, swallowing and aesthetic factors must be considered. For successful orthognathic surgery, the orthodontist and the surgeon must constantly study and discuss accurate facial analysis, presurgical orthodontics, choice of appropriate surgical methods, and postsurgical orthodontics. In this article, we will discuss the team approach for successful orthodontic treatment and orthognathic surgery, establishing close cooperation between the orthodontist and surgeon. [ABSTRACT FROM AUTHOR]

Autotransplantation of a mature premolar in adults can be a treatment of choice for tooth replacement when combined with well-planned orthodontic treatment. This case report describes the successful treatment of a 39-year-old patient with severe crowding and a hopelessly fractured tooth on the maxillary left side. Maxillary dental crowding was relieved by extraction of a premolar on the right side, and this extracted tooth was autotransplanted to replace the fractured tooth. A mandibular incisor was extracted to correct anterior crossbite. The total treatment period was 20 months. The treatment results showed a good long-term prognosis after transplantation of a mature premolar with normal surrounding alveolar bone level for over 6 years of follow-up. Occlusion and periodontal health were excellent in the long term. [ABSTRACT FROM AUTHOR]

Class III malocclusions with mild to moderate skeletal discrepancies can be camouflaged by orthodontic tooth movement. Conventional methods using Class III elastics can correct Class III into Class I molar relationships. These mechanics show side-effects such as labioversion and intrusion of the maxillary incisors, extrusion of the maxillary molars, linguoversion and extrusion of the mandibular incisors, and intrusion of the mandibular molars along with flattening of the occlusal plane. Conventional mechanics can improve occlusal relationships and some profile esthetics but may produce detrimental smile esthetics by reducing the amount of maxillary incisor exposure. Recently, with the advent of temporary skeletal anchorage devices (TSADs), clinicians are able to achieve total distalization of the mandibular dentition and therefore improve the occlusal relationship without worsening smile esthetics. With the use of TSADs, the en masse movement of an entire dentition can be easily accomplished using a statically determinate force system, which makes treatment plans easier and treatment results more predictable. Finite element studies have identified the location of the center of resistance of the entire dentition and simulated displacement of the dentition depending on the force angulations (FAs) and have thus provided the theoretical basis for 3-dimensional tooth movement patterns. This article provides the biomechanical considerations and clinical applications of total distalization of the mandibular dentition depending on various FAs to the mandibular occlusal plane for camouflage treatment of various types of skeletal Class III malocclusions. [ABSTRACT FROM AUTHOR]

Class II malocclusions have traditionally been treated as nonextraction, extraction, or orthognathic surgery depending on the severity of the dental and skeletal discrepancies. To enhance function and improve esthetics with nonextraction treatment, functional appliances, tooth-borne molar distalization, and Class II elastics have been used, but they require patient cooperation and have drawbacks such as mesial movement of the anchor teeth, molar extrusion, and flaring of the incisors. Recently, with the application of temporary skeletal anchorage devices (TSADs) in patients with Class II malocclusions, clinicians have been able to achieve total distalization of the maxillary dentition without patient compliance and with less unwanted tooth movement. Before a clinician uses a TSAD, they must consider where to place it and what type to use for efficient, total arch distalization of the maxilla. TSADs such as miniscrews and miniplates can be inserted on the buccal and palatal sides for total arch distalization. When using them, the center of resistance of the entire maxillary dentition should be determined to obtain en masse movement of the maxillary dentition by a statically determinate force system. The treatment effects and the difference in biomechanics between buccal miniscrews and modified C-palatal plates (MCPPs) for total arch distalization of the maxilla are presented in this paper based on finite element and clinical studies. Additionally, a strategy for efficient total arch distalization with MCPPs is discussed along with considerations for the position of the second and third molars after total arch distalization. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the facial esthetic standards between Paraguayan and Korean beauty pageant contestants as well as to evaluate the deviation in Farkas proportion indexes (PI) from the golden ratio for each group using three-dimensional (3D) stereophotogrammetric analysis. 3D soft tissue images of 34 Miss Paraguay (MP) and 54 Miss Korea (MK) pageant contestants were obtained. The 3D images were digitized and 52 measurements and ratios were calculated. One-way multivariate analysis of variance was applied to compare the two groups. One-sample t -test was applied to assess the differences between the PI of each group and the golden ratio. The MP group showed greater mouth width, total vermilion perimeter, and lower lip protrusion (P < 0.001) than the MK group. Meanwhile, the MK group showed longer forehead height and total facial height (P = 0.002 and P < 0.001, respectively). All Farkas PIs in each group showed significant differences from the golden ratio except for PI19 (upper/lower vermilion heights). Paraguayans favor rectangular faces with wide mouths and large lips, especially the lower lips, whereas Koreans prefer long tapered faces with small mouths and lips. All proportion indexes were significantly different from the golden ratio except for PI19. Therefore, it would be beneficial for clinicians to consider the differences in ethnic preferences in facial esthetics during diagnosis and treatment planning. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate skeletal, dentoalveolar, and soft tissue changes at 3 years posttreatment in patients with Class II Division 1 malocclusion treated with modified C-palatal plates (MCPPs). The sample consisted of 69 lateral cephalograms of 23 patients Class II Division 1 malocclusion (9 men, 14 women; average age, 20.1 years) who underwent bilateral distalization of their maxillary dentition. The lateral cephalograms were taken immediately before the placement of the MCPPs (T1); at the end of orthodontic fixed appliance therapy (T2); and at the posttreatment observation period (3 years posttreatment; T3). Twenty-three variables were measured. Repeated measures ANOVA followed by post hoc analysis using Bonferroni test was used to identify significant differences between time points. Maxillary first molars showed a distal movement of 3.44 ± 1.08 mm (P <0.001) distal crown tipping of 2.35° ± 6.74°, and intrusion of 1.42 ± 1.12 mm from T1 to T2. However, from T2 to T3, there was an average of 0.41 ± 0.25 mm of mesial movement, 0.50 ± 0.46 mm of extrusion, and insignificant mesial crown tipping (0.92° ± 2.46°; P = 0.06). The nasolabial angle increased 9.36° ± 6.04° from T1 to T2 (P <0.001) but then decreased 1.55° ± 1.54° from T2 to T3. MCPPs are a viable treatment option for maxillary total arch distalization with minimal changes in treatment effects 3 years posttreatment. • Cephalometric changes in patients with Class II Division 1 malocclusion were evaluated following modified C-palatal plate (MCPP) treatment. • No significant changes were found in skeletal or soft-tissue measurements. • Relapse in the maxillary first molars was 12% of the achieved distalization and 35% of the intrusion. • MCPPs are a viable treatment for maxillary total arch distalization with minimal loss. [ABSTRACT FROM AUTHOR]

There has been an increased public interest in orthognathic surgery that has led to many additional surgeries being performed in response to patients' aesthetic needs. Often procedures such as genioplasty, mandibuloplasty, malarplasty, paranasal augmentation could be done to enhance the aesthetic effects of orthognathic surgery. With these procedures, it is very important to establish clear communication between the patient and surgeon to reduce misunderstandings and to increase patient's satisfaction after surgery. In this article, we will discuss cases where additional aesthetic surgeries were performed in connection with orthognathic surgery to demonstrate ways that patient facial beauty can be improved. [ABSTRACT FROM AUTHOR]

To ensure that orthognathic surgery is successful, functional aspects such as mastication, pronunciation, swallowing and aesthetic factors must be considered. For successful orthognathic surgery, the orthodontist and the surgeon must constantly study and discuss accurate facial analysis, presurgical orthodontics, choice of appropriate surgical methods, and postsurgical orthodontics. In this article, we will discuss the team approach for successful orthodontic treatment and orthognathic surgery, establishing close cooperation between the orthodontist and surgeon. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this finite element study was to analyze and clarify the mechanics of tooth movement patterns for total distalization of the mandibular dentition based on force angulation.Methods: Long-term orthodontic movement of the mandibular dentition was simulated by accumulating the initial displacement of teeth produced by elastic deformation of the periodontal ligament.Results: Displacement of each tooth was caused by movement of the whole dentition, elastic deflection of the archwire, and clearance gap between the archwire and bracket slot. The whole dentition was rotated clockwise or counterclockwise when the line of action of the force passed below or above the center of resistance. Elastic deflection of the archwire induced a lingual tipping of the anterior teeth. It became larger when increasing the magnitude of angulation. The archwire could be rotated within the clearance gap between the archwire and the bracket slot, and thereby the teeth tipped.Conclusions: Mechanics of total mandibular distalization was clarified. Selective use of force angulation with a careful biomechanical understanding can achieve proper distalization of the whole mandibular dentition. [ABSTRACT FROM AUTHOR]

Introduction: Our objectives were to evaluate changes in the position of maxillary third molars with cone-beam computed tomography images in adolescents after total arch distalization using a modified C-palatal plate (MCPP) and to compare them with the changes in a matched control group.Methods: We included 68 maxillary third molars of 40 adolescent patients (mean age, 12.6 years). They were divided into MCPP and control groups. Cone-beam computed tomography images were taken before and after molar distalization (mean duration, 14.4 months) in the MCPP group and also in the control group (mean duration, 12.9 months). The changes in the position, angulation, and rotation of the third molars were assessed, and the volumes of maxillary tuberosity were measured.Results: After distalization, the third molars moved backward (1.2 mm) and upward (0.5 mm) in the MCPP group with a significant difference (P <0.003), and they moved downward and forward in the control group. The changes in rotation and angulation were insignificant. The volumes of maxillary tuberosity increased in both groups.Conclusions: Maxillary total arch distalization caused unerupted third molars to move backward and upward, with an insignificant difference in the posttreatment volume of maxillary tuberosity. Therefore, it may be possible to perform maxillary total arch distalization in adolescents with unerupted third molars without a germectomy, at least in the short term. [ABSTRACT FROM AUTHOR]

The modified C-palatal plate (MCPP) successfully distalizes maxillary teeth while limiting unwanted effects associated with other maxillary distalization appliances. The MCPP appliance is a safe, simple and effective non-extraction approach to maxillary distalization. Compared to other maxillary distalization appliances, the MCPP appliance provides statistically significant improved tooth movement. The MCPP appliance is our appliance of choice for chin retrusion and moderate skeletal discrepancies requiring more than 3 mm of distalization, in both adults and adolescents. [ABSTRACT FROM AUTHOR]

A modified C-palatal plate (MCPP) is introduced as a treatment option for adolescent patients with Class I malocclusion and severe overjet. A boy, 10 years 11 months old, was successfully treated without extractions in 22 months. Indications for clinical application of the MCPP as well as procedures and biomechanical analysis of the treatment effects are described in detail. The MCPP was used to distalize the maxillary dentition. The results were stable 1 year after retention. Clinicians should consider the application of MCPP as a nonextraction treatment option for adolescents with Class I malocclusion and severe overjet when the patient or parent refuses extractions. [ABSTRACT FROM AUTHOR]

A 22-year-old woman came with a unilateral missing mandibular first molar and buccal crossbite. The open space was closed by protraction of the mandibular left second molar and uprighting and protraction of the horizontally impacted third molar using temporary skeletal anchorage devices, and her buccal crossbite was corrected with modified palatal and lingual appliances. The total active treatment time was 36 months. Posttreatment records after 9 months showed excellent results with a stable occlusion. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to analyze displacement and stress distribution in the maxilla during maxillary expansion followed by protraction using bone-borne and conventional tooth-borne palatal expanders and a facemask via 3-dimensional finite element analysis.Methods: A finite element model of an adolescent skull was created, and 4 different types of appliances were integrated into it: facemask (type A); facemask with paramedian bone-borne expander (type B), facemask with palatal-slope bone-borne expander (type C), and facemask with conventional expander (type D). Expansion of 0.25 mm followed by 500 g of force per side was applied.Results: Type A showed anterior displacement of the dentition combined with downward displacement of posterior teeth and upward displacement of anterior teeth. The combination of protraction and expansion in type D showed the greatest anterior displacement. In types B and C, the expansion forces resulted in posterior displacement decreasing the net displacement of the combination. Stresses concentrated around the miniscrews in types B and C. In types A and D, stresses concentrated at the first premolar and first molar. Type B had the highest stresses followed by type C and then D.Conclusions: The conventional tooth-borne expander (type D) enhanced the effect of maxillary protraction. Facemask alone (type A) resulted in more anterior displacement of the maxilla than the combination of facemask and bone-borne expanders (types B and C). The clinician should be aware of the initial stresses and movements from different expanders with facemask found in this study and confirm the movements in future clinical Class III studies. [ABSTRACT FROM AUTHOR]

The retromolar fossa is an anatomically suitable skeletal anchorage site. The aim of this report was to introduce a novel appliance for the correction of skeletal Class III malocclusions with mandibular dentition distalization. The placement site and the procedure of the ramal plate are described. The resulting force vectors are parallel to the functional occlusal plane leading to efficient molar distalization. This approach is demonstrated with 2 adult patients who refused a surgical treatment option. This ramal plate may be indicated for total arch distalization for nonextraction and nonsurgical cases. [ABSTRACT FROM AUTHOR]

There is a marked increase in the importance of facial esthetics. This means that interdisciplinary treatment plans are an important strategy for achieving pleasing facial appearance with dental treatment. Over the decades, missing anterior teeth have been a challenge for clinicians and replacing them with an implant in children and adolescents was questionable. One concern was that an implant might influence the growth of the alveolar ridge, which could compromise facial esthetics in the long run since the positioning of the implant within the alveolar ridge plays a key role in the esthetic outcome. Another concern was the long-term effects of immediate loading of orthodontic force on implants. The short-term effects have been evaluated but not the long-term implications. This article summarizes a discussion about the effects of implants to restore missing anterior teeth in growing patients and the effect of the immediate application of orthodontic forces on newly placed implants. [ABSTRACT FROM AUTHOR]

Cone-beam computed tomography (CBCT) images is an essential element in diagnosing and treatment planning patients in need of orthodontic and/or orthognathic surgery. An accurate evaluation of the dental, skeletal, and soft-tissue relationships through the normative values of three-dimensional (3D) cephalometric parameters, specifically palatal and alveolar bone thickness, mandibular body and maxillary basal curve length, and basal arch form have been demanded. The normative values of innovative 3D cephalometric parameters for palatal bone thickness in adolescents versus adults may be helpful for clinicians to enhance the success in application and use of temporary skeletal anchorage devices. Characteristics of alveolar bone thickness, basal arch form, and facial asymmetry of both normal occlusion and Class III malocclusion are also discussed with 3D CBCT images. In this article, the various 3D analyses and clinical applications including bone thickness, facial asymmetry, basal curve length, and basal arch form are addressed. [ABSTRACT FROM AUTHOR]

The palate has been reported to be a suitable skeletal anchorage site in adolescents and adults. This article introduces new treatment modalities for correction of sagittal discrepancies by molar protraction and distalization with a modified palatal anchorage plate appliance. The effectiveness and versatility of this method are demonstrated in 2 adolescent patients. [ABSTRACT FROM AUTHOR]

Correction of a severe protrusive soft tissue profile without orthognathic surgery can be challenging. This case report describes the treatment of a young woman with a severe bimaxillary protrusion. Orthodontic treatment included extraction of her 4 first premolars and total arch distalization of both arches using a palatal plate appliance. The total treatment time was 24 months. Her occlusion and facial appearance were significantly improved. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to evaluate the treatment effects of maxillary posterior tooth distalization performed by a modified palatal anchorage plate appliance with cephalograms derived from cone-beam computed tomography. Methods: The sample consisted of 40 lateral cephalograms obtained from the conebeam computed tomography images of 20 Class II patients (7 men, 13 women; average age, 22.9 years) who underwent bilateral distalization of their maxillary dentition. The lateral cephalograms were derived from the cone-beam computed tomography images taken immediately before placement of a modified palatal anchorage plate appliance and at the end of distalization. Paired t tests were used for comparisons of the changes. Results: The distal movement of the maxillary first molar was 3.3 ± 1.8 mm, with distal tipping of 3.4° ± 5.8° and intrusion of 1.8 ± 1.4 mm. Moreover, the maxillary incisors moved 3.0 ± 2.7 mm lingually, with lingual tipping of 6.2° ± 7.6° and insignificant extrusion (1.1 mm; P = 0.06). The occlusal plane angle was Increased significantly (P = 0.0001). Conclusions: The maxillary first molar was distalized by 3.3 mm at the crown and 2.2 mm at root levels, with distal tipping of 3.4°. It is recommended that clinicians should consider using the modified palatal anchorage plate appliance in treatment planning for patients who require maxillary total arch distalization. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to analyze stress distribution and displacement of the craniofacial structures resulting from bone-borne rapid maxillary expanders with and without surgical assistance using finite element analysis. Methods: Five designs of rapid maxillary expanders were made: a tooth-borne hyrax expander (type A); a bone-borne expander (type B); and 3 bone-borne surgically assisted modalities: separation of the midpalatal suture (type C), added separation of the pterygomaxillary sutures (type D), and added LeFort I corticotomy (type E). The geometric nonlinear theory was applied to evaluate the Von Mises stress distribution and displacement. Results: The surgical types C, D, and E demonstrated more transverse movement than did the nonsurgical types A and B. The amounts of expansion were greater in the posterior teeth in types A and B, but in types C, D, and E, the amounts of expansion were greater in the anterior teeth. At the midpalatal suture, the nonsurgical types showed more anterior expansion than did the posterior region, and higher stresses than with the surgical types. Type B showed the highest stresses at the infraorbital margin, anterior and posterior nasal spines, maxillary tuberosity, and pterygoid plate and hamulus. Conclusions: The 3 surgical models showed similar amounts of stress and displacement along the teeth, midpalatal sutures, and craniofacial sutures. Therefore, when using a bone-borne rapid maxillary expander in an adult, it is recommended to assist it with midpalatal suture separation, which requires minimal surgical intervention. [Copyright &y& Elsevier]

Purpose: To investigate the difference between the self-perception of the facial profile and analogous measurements of profile photographs in 2 age groups, adolescents and young adults, and adults. Patients and Methods: A prototypical Caucasian profile was constructed for each gender by averaging the profiles of 28 subjects with normal occlusion. Each prototypical profile was manipulated by protruding and retruding the lips in 1-mm increments to construct a series of 13 silhouettes. Next, 85 laypeople were divided into 2 groups: adolescents and young adults (age, 15 to 25 years) and adults (age, 26 to 55 years). They were asked to complete a questionnaire that included choosing the facial profile in the constructed series they thought most resembled their own profile photograph. For each group, the difference between the chosen and actual profile was compared using a 1-sample t test. The differences between the 2 groups in identifying their own profile were compared using a 2-sample t test. Results: The 2 groups were different in their ability to recognize their own profile (P = .040 for the upper lip and P = .006 for the lower lip). The adolescent and young adult group was most accurate, showing no significant difference from 0 for the chosen and actual profiles. However, the adult group was significantly different for both the upper (P = .040) and lower (P = .003) lips. Conclusions: From our study results, most laypeople aged 15 to 25 years could accurately evaluate the fullness of their own facial profile, although adults aged 26 to 55 years had more difficulty in this evaluation and tended to overestimate the protrusion of their lips. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare changes in hard and soft tissues and the treatment efficacy of 2-jaw surgery combined with nonextraction treatment for skeletal Class III malocclusion in patients who received minimal presurgical orthodontics (MPO) versus those who received conventional presurgical orthodontics (CPO). Materials and Methods: Thirty-two patients (16 in each group) with skeletal Class III malocclusion who underwent 2-jaw surgery were included in the study. Serial lateral cephalometric films were traced at 4 stages: before treatment (T0), before surgery (T1), 1 month after surgery (T2), and at debonding (T3). Cephalometric measurements and treatment duration were compared using independent t test and Mann-Whitney U test. Results: After the presurgical treatment phase, the angle between the lower incisor axis and mandibular plane, overjet, and soft tissue pogonion to the vertical reference line showed larger changes (P < 0.01) in the CPO group, whereas the pogonion to the horizontal reference line showed larger changes (P < .05) in the MPO group. In the postsurgical phase (T2 to T3), there were no significant differences between the 2 groups. Total treatment duration was significantly shorter in the MPO group. Conclusions: There were no significant differences between the MPO and CPO groups in the hard and soft tissue cephalometric variables. The MPO group had a shorter total treatment time. It is therefore recommended that clinicians consider these results when selecting MPO as a treatment option for accurate diagnosis and treatment planning of Class III surgical patients. [Copyright &y& Elsevier]

Introduction: The purpose of this study was to compare the bone thickness of the palatal areas in early and late mixed and early permanent dentitions according to dental age. Methods: Cone-beam computed tomography scans of 118 subjects were selected and divided into 38 early mixed (8.03 ± 0.93 years), 40 late mixed (11.51 ± 0.92 years), and 40 permanent (20.92 ± 1.17 years) dentition subjects. The measurements of palatal bone thickness were made at 49 sites by using InVivoDental5.0 software (Anatomage, San Jose, Calif). Repeated measures analysis of variance was used to analyze intragroup and intergroup differences as well as sex dimorphism. Results: There was significantly lower bone thickness in the early mixed dentition group than in the 2 other groups (P <0.001). Bone thickness was higher in the anterior region than in the middle and posterior regions (P <0.001). Also, significant differences were found among the midline, medial, and lateral areas of the palate. Conclusions: Palatal bone thicknesses were significantly lower in the early mixed dentition group than in both the late mixed and permanent dentition groups. These findings might be helpful for clinicians to enhance the successful use of temporary anchorage devices in the palate. [Copyright &y& Elsevier]

Introduction: The purpose of this study was to use cone-beam computed tomography to compare mandibular dimensions in subjects with asymmetric skeletal Class III malocclusion and those with normal occlusion. Methods: Cone-beam computed tomography scans of 38 subjects with normal occlusion and 28 patients with facial asymmetry were evaluated and digitized with Invivo software (Anatomage, San Jose, Calif). Three midsagittal and 13 right and left measurements were taken. The paired t test was used to compare the right and left sides in each group. The Mann-Whitney U test was used to compare the midsagittal variables and the differences between the 2 sides of the group with normal occlusion with those of asymmetry patients. Results: The posterior part of the mandibular body showed significant differences between the deviated and nondeviated sides in asymmetric Class III patients. The difference of the asymmetry group was significantly greater than that of the normal occlusion group for the mediolateral ramal and the anteroposterior condylar inclinations (P = 0.007 and P = 0.019, respectively). Conclusions: The asymmetric skeletal Class III group showed significant differences in condylar height, ramus height, and posterior part of the mandibular body compared with the subjects with normal occlusion. These results might be useful for diagnosis and treatment planning of asymmetric Class III patients. [Copyright &y& Elsevier]

Introduction: Our objective was to evaluate the factors that affect effective torque control during en-masse incisor and canine retraction when using partially osseointegrated C-implants (Cimplant, Seoul, Korea) as the exclusive source of anchorage without posterior bonded or banded appliances. Methods: Base models were constructed from a dental study model. No brackets or bands were placed on the maxillary posterior dentition during retraction. The working archwire was modeled by using a 3-dimensional beam element (ANSYS beam 4, Swanson Analysis System, Canonsburg, Pa) with a cross section of 0.016 × 0.022-in stainless steel. Different heights of anterior retraction hooks and different degrees of gable bends were applied to the working utility archwire that was placed into the 0.8-mm diameter hole of the C-implant to generate anterior torque on the anterior segment of the teeth. The amount of tooth displacement after finite element analysis was exaggerated 70 times and compared with tooth-axis graphs of the central and lateral incisors and the canine. Results: The height of the anterior retraction hook and the degree of the gable bend had a combined effect on the labial crown torque applied to the incisors during en-masse retraction. By using 30° gable bends and the longest hook, lingual root movement of the 6 anterior teeth occurred. By using 20° gable bends, the 6 anterior teeth showed a translation tendency during retraction. Conclusions: Three-dimensional en-masse retraction of the 6 anterior teeth can be accomplished by using partially osseointegrated C-implants as the only source of anchorage, gable bends, and a long retraction hook (biocreative therapy type I technique). [ABSTRACT FROM AUTHOR]

Introduction: The purposes of this study were to determine factors favoring successful mini-implant placement and to evaluate root proximity as a possible risk factor for failure of osseointegration-based mini-implants during orthodontic treatment. Methods: Three-dimensional cone-beam computed tomography images were used to examine 50 sandblasted, large-grit, and acid-etched surface-treated mini-implants (C-implant, Seoul, Korea) placed in 25 patients. The images were analyzed for 3-dimensional position of the mini-implant (placement angle and depth) and any contact with root surfaces or maxillary sinuses. Results: There were no remarkable differences in horizontal placement angles in the axial plane and placement depths of the mini-implants, but the vertical placement angle was significantly higher on the left side (24.5° ± 11.0°) compared with the right side (11.8° ± 11.6°). The horizontal mini-implant placement angle had a greater inclination tendency toward the maxillary first molar, and 11 mini-implants with root proximity showed mesiobuccal contact with the maxillary first molar root. Only 1 failure in 15 mini-implants with root proximity and 1 failure in 35 without root proximity were observed on the images. Conclusions: Root proximity alone was not considered a major risk factor for osseointegration-based mini-implant failure. [Copyright &y& Elsevier]

This article describes the orthodontic treatment for a young woman, aged 23 years 5 months, with a Class III malocclusion and a deviated midline. Two orthodontic mini-implants (C-implants, CIMPLANT Company, Seoul, Korea) were placed in the interdental spaces between the mandibular second premolars and first molars. The treatment plan consisted of distalizing the mandibular dentition asymmetrically and creating space for en-masse retraction of the mandibular anterior teeth. C-implants were placed to provide anchorage for Class I intra-arch elastics. The head design of the C-implant minimizes gingival irritation during orthodontic treatment. Sliding jigs were applied buccally for distalization of the mandibular posterior teeth. The active treatment period was 18 months. Normal overbite and overjet were obtained, and facial balance was improved. [Copyright &y& Elsevier]

Introduction: This article illustrates a new treatment system combining accelerated osteogenic orthodontics and osseointegrated mini-implants for minor tooth movement in severely compromised conditions. The procedures, advantages, efficacy, and indications of this method are discussed. Methods: Three patients who needed minor tooth movement and orthodontic mini-implant treatment were recruited to use this combined technique; 1 required molar intrusion, and 2 required molar uprighting. C-Implant (diameter, 1.8 mm; length, 8.5 mm) were placed, and, after 5 weeks of healing, decortication of bone was performed near the malpositioned teeth by using a low-speed round bur. Bleeding was controlled, and the bone graft material was placed into the decorticated area. After the flap was secured, an immediate strong orthodontic force from the C-implant was applied to the teeth to start rapid tooth movement. Results: Only a few orthodontic attachments were necessary, and the teeth moved rapidly to a good occlusal relationship without root resorption. Conclusions: The combination of accelerated osteogenic orthodontics and a partially osteointegrated mini-implant (C-Implant) was a safe and effective treatment choice. The C-implant''s surface allows partial osseointegration, so it can resist a force moment without loosening and withstand the heavy forces associated with the accelerated osteogenic orthodontics protocol. [Copyright &y& Elsevier]

Introduction: Our objectives in this study were to measure in a group of patients the interradicular spaces between the maxillary second premolar and first molar, which is often used as placement sites for mini-implants, and to suggest simple guidelines for safe placement. Methods: Cone-beam computed tomography was used in 35 patients to measure interdental spaces and distances between the surface of the cortical bone and the closest interradicular area apically in 1-mm intervals in 9 axial images from the cementoenamel junction (CEJ). The cone-beam computed tomography data were analyzed by using anlaysis of variance (ANOVA) to evaluate the differences in interradicular distances, cortical bone surfaces, and narrowest interradicular spaces. A t test was also performed to evaluate sex and placement side differences. Results: Interradicular space became wider toward the apical area; several axial planes showed statistically nonsignificant differences from the CEJ to the root, and the average distance from the surface of the cortical bone to the area of the closest interradicular space was over 5 mm in the most sections. Conclusions: Guidelines for safe placement are as follows: the initial point for mini-implant placement is near the mucogingival line (2-4 mm from the CEJ) and less than a 45° apical angulation to the long axis of tooth, with a mini-implant diameter of 1.4 to 1.8 mm and length of about 6 mm (bone contact). A larger placement angle would increase the cortical bone contact; however, it is difficult to apply various traction materials and might increase the danger of maxillary sinus perforation. [Copyright &y& Elsevier]

A new type of orthodontic mini-implant called the C-implant can be an effective alternative to conventional 1-component screws in orthognathic patients because of its particular design. Its small size and 2-component structure make it easily applicable for various types of difficult intermaxillary fixation cases such as 2-jaw orthognathic surgery, 1-jaw surgery with genioplasty, and orthognathic surgery without presurgical orthodontic treatment. The 2-part design highly resists fracture or deformation during placement and removal, and the long-span head allows the patient to easily attach intermaxillary elastics for traction. This mini-implant can be used not only as an intermaxillary fixation screw but also as anchorage during presurgical and postsurgical orthodontic treatment. Better osseointegration potential of the surface-treated screw part allows it to endure heavy and dynamic forces. In this article, we attempted to show that this mini-implant is a good tool for effective anchorage in presurgical treatment, intermaxillary fixation during surgery, and postsurgical treatment of orthognathic patients. [Copyright &y& Elsevier]

Introduction: Although the sand-blasted, large-grit, and acid-etched surface-treated mini-implant (C-implant, CImplant Co, Seoul, South Korea) is designed to endure heavy and dynamic loads and offers high stability during orthodontic treatment, implications of its removal are still unknown. The purpose of this study was to evaluate the removal torque values (RTVs) of early-loaded mini-implants. Methods: Sixty-four mini-implants (1.8 mm in diameter and 8.5 mm in length) were placed in 37 patients for orthodontic anchorage and were subjected to early loading (4 weeks healing period). RTVs were recorded after orthodontic treatment by using a digital torque driver that was calibrated on a torque sensor. Torque values were subjected to a paired t test and analysis of variance (P <0.05). Results: All mini-implants remained intact, for a 100% success rate. There was no fracture or distortion during removal, and the mean RTV was 16.4 N per centimeter (range, 3.94-35.41 N per centimeter). Age, malocclusion, and loading period were not significantly related to the RTVs. The longer nonloading period from debonding to removal had a higher RTV. The RTV measured over 6 months of the nonloading period showed a significantly higher RTV than the group measured less than 6 months of the nonloading period. Conclusions: Surface-treated mini-implants can be safely removed after treatment. A nonloading period of less than 6 months before removal is recommended to prevent complications. [Copyright &y& Elsevier]

In this article, we describe the treatment of a woman, aged 25 years 8 months, with a Class II malocclusion, severe anterior protrusion, and a high mandibular plane angle. The treatment plan consisted of extracting both maxillary first premolars and mandibular second premolars. En-masse retraction of the 6 maxillary anterior teeth was performed with a lingual approach combining a C-lingual retractor and a C-palatal plate (C-plate). However, the mandibular dentition was treated with conventional labial fixed appliances. After the maxillary anterior retraction, labial fixed appliances were placed on the maxillary dentition only during the finishing stage. Correct overbite and overjet, facial balance, and improved lip protrusion were obtained. The active treatment period was 17 months, and the results were stable for 13 months after debonding. This C-lingual retractor and C-plate combined retraction method can be effective for intrusive retraction of the anterior teeth. [Copyright &y& Elsevier]

This article describes the orthodontic treatment of a 14.5-year-old girl with severe bidentoalveolar protrusion. Specially designed sandblasted, large-grit, acid-etched (SLA) orthodontic microimplants (C-implants, Cimplant Co, Seoul, Korea) were placed in the alveolar bone in all 4 quadrants to provide anchorage for en-masse retraction without the help of banded or bonded molars. Successful retraction was achieved. The mandibular dentition was detailed by using conventional orthodontic appliances during the finishing stage. The osseointegration potential of these microimplants allows them to resist rotational force moments and control 3-dimensional movements of the anterior teeth during retraction. Facial esthetics improved for the patient, fullness of the upper and lower lips was reduced, and the interdental relationship was corrected. Biomechanical considerations, efficacy, and potential complications of the treatment technique are discussed. [Copyright &y& Elsevier]

Purpose: The purposes of the present study were to evaluate the effects of frequent applications of low-level laser therapy (LLLT) on corticotomy-assisted tooth movement in a beagle dog model and to compare the effects in the mandible and maxilla. Materials and Methods: In 4 male beagles, the maxillary and mandibular second premolars were extracted. The third premolars were corticotomized and then protracted from the canines with a continuous force of 200 g. Daily LLLT (using an aluminum gallium indium phosphide [AlGaInP] diode) was applied at the buccal mucosa of the corticotomized premolars on 1 side only. The tooth movement was measured for 8 weeks. Fluorochromes were injected intravenously at the start of the experiment (T0) and after 2 (T2), 4 (T4), and 8 (T8) weeks to evaluate new bone formation on the tension sides. Histomorphometric and immunohistologic evaluations were performed. Results: In the mandible, the movement of the corticotomized premolars in the LLLT plus corticotomy group was less than that in the corticotomy-only group, although the difference was not statistically significant. In the maxilla, no significant differences between the 2 groups were found. Osteoclastic and proliferating cell activities and the amount of new bone formation were greater in the mandibular LLLT plus corticotomy group than in the corticotomy-only group. Conclusions: The frequent application of LLLT showed no significant effect on the corticotomized tooth movement. [Copyright &y& Elsevier]