Search

Objectives: This study examined the effects of palate depth, modifications of the arm shape, and anchor screw placement in the mid-palatal area on rapid maxillary expansion (RME) using finite element (FE) analysis., Materials and Methods: Three-dimensional FE models were constructed that included the maxilla (cortical and cancellous bone), maxillary sinus, maxillary first molar and first premolar, periodontal membrane, and an RME appliance with arms, bands, and anchor screws. The expansion screws were activated 0.2mm transversely., Results: The deepest palate model had the smallest lateral displacement of the tooth and expansion of the mid-palatal suture and the greatest strain of the arm among the models with different palate heights. The model with a larger diameter arm had the smallest arm strain among the models with various arm shapes. The model with an anchor screw had the greatest lateral displacement of the tooth and expansion of the mid-palatal suture among all models., Conclusions: For a deeper palate, the arm strain increased and the effect of RME decreased. Modified arm shapes such as a larger diameter arm, arms connected by a diagonal wire, a straight arm, and a shorter arm efficiently expanded the maxillary dental arch. Anchor screws increased the effect of RME, generated more and closer bodily movement of the tooth, and parallel expansion of the mid-palatal suture. The model with an anchor screw without arms decreased the displacement of the teeth compared to the models with arms, so the arms are necessary for effective RME., (© The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Orthodontic miniscrews placed in growing subjects often loosen during orthodontic treatment. The ability to place miniscrews, regardless of age, would be clinically beneficial., Objectives: To assess the effects of low-intensity pulsed ultrasound (LIPUS) on the stability of orthodontic miniscrews in growing rats., Materials/methods: The mobility of miniscrews after placement was recorded and the miniscrew-bone interface was examined histomorphometrically using tibiae of seven male Sprague-Dawley rats (aged 6 weeks). Field-emission scanning electron microscopic images were used to evaluate the bone-miniscrew interface, and a mobility test device was used to assess the stiffness of miniscrew placement. Fourteen custom-made miniscrews with 1.4mm diameters and 4.0mm lengths were placed in the right and left tibiae. LIPUS was used to stimulate right tibiae at the sites of miniscrew placement, and left tibiae were left untreated as controls., Results: Significantly lower mobility was observed in the LIPUS-treated group compared with the control group (P < 0.05). Histomorphometric evaluation indicated that bone-miniscrew adhesion was significantly better in the LIPUS-treated group than in the control group (P < 0.05)., Limitations: This in vivo study used tibiae rather than jaw bones because the jaw bones of 6-week-old rats were too small to allow miniscrew placement., Conclusions: LIPUS was able to increase the bone-miniscrew contact and reduce the mobility of miniscrews in growing subjects., Implications: LIPUS may accelerate the bone healing process after miniscrew placement in growing subjects and can reduce the latent period., (© The Author 2013. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

The purpose of this study was to analyse distal movements of molars in a force system using a trans-palatal arch (TPA), fixed to the maxillary first molar, and mini-implants placed at the palatal midline, considering the diagnostic standard for placement site in association with variation in upper molar locations, using finite element (FE) analysis. Three-dimensional FE models, divided by the differing direction of traction force, mesiodistal locations of the left and right molars, and the lateral location of the mini-implant were constructed. (1) When a traction force was fixed from the height of alveolar crest to the mini-implant placed at the middle of palate, the molars underwent bodily movement. (2) When the location of the mini-implant was moved to the left of the midline, the amount of distal movement of the left molar increased. When the mesiodistal locations of the left and right molars differed, the amount of distal movement of the molar located mesially was larger than that of the contralateral molar, even when the mini-implant was located on the midline.

This study used an experimental dental arch model to examine the orthodontic forces generated by a quadhelix appliance in terms of parallel expansion, fan expansion, or a combination of the two. Strain gauges were attached to experimental brass rods that represented the teeth arranged in the shape of an average dental arch to detect forces in the buccal, lingual, mesial, and distal directions. Orthodontic forces generated by different types of activation were compared by Scheffe's multiple test. The largest orthodontic force generated during parallel expansion was observed at the first molar in the buccal direction. When fan expansion was applied, significant orthodontic force was observed at the canine in the mesial and labial directions, whereas force in the mesial and lingual directions was noted at the first molar. When a combination of 3 mm parallel and 5 mm fan expansion was used, the forces generated at the canine and first and second premolar, and first molar were nearly equivalent. Depending on the type of malocclusion, the most appropriate expansion technique may be parallel or fan expansion or a combination of the two. When expanding the entire dental arch simultaneously, a combination of 3 mm parallel and 5 mm fan expansion may be the most suitable.

One notable complication of mini-implants that are used to provide anchorage in orthodontic treatment is loosening. The aim of this study was to evaluate the relationship between mini-implant mobility during the healing phase and the prognosis for implant stability. Twenty male Wistar rats (aged 20 weeks) were used. Drills with diameters of 0.8, 0.9, 1.0, and 1.1 mm were used to make pilot holes in the rat tibiae. The inserted mini-implants (diameter 1.4 mm; spearhead 1.2 mm; halfway between maximum and minimum 1.3 mm; length 4.0 mm) were subjected to an experimental traction of force for 3 weeks. Bone-to-implant contact (BIC) was observed histologically. Another 20 male rats (aged 20 weeks) underwent an identical procedure, and the stability of the mini-implants was measured using the Periotest before and after traction. The data were statistically analysed using Scheffé's test. The BIC ratios of the 0.9 and 1.0 mm groups were significantly greater than those of the other groups. The Periotest values measured 3 weeks after implant insertion were significantly lower (P < 0.05) than those measured at insertion, except in the 1.1 mm group. To obtain mini-implant stability, the hole diameter should be between 69 and 77 per cent of the diameter of the mini-implant. A significant decrease in the mobility of the mini-implants 3 weeks post-insertion implies a good prognosis for the subsequent mini-implant stability.

The aim of this study was to investigate the relationship between masseter muscle size and craniofacial morphology, focusing on the maxilla. Twenty-four patients (11 males and 13 females; mean age 27.6 ± 5.6 years) underwent cephalometric analyses. Ultrasonography was used to measure the cross-sectional area (CSA) of the masseter muscle and bite force was measured using pressure sensitive film. The results showed that CSA-relaxed was positively correlated with upper anterior face height (UAFH)/total anterior face height (TAFH) and negatively with lower anterior face height (LAFH)/TAFH and LAFH (P < 0.05). CSA-clenched was correlated positively with SN-palatal, FH-palatal, UAFH/TAFH, and lower posterior face height (LPFH)/total posterior face height (TPFH) and negatively with LAFH/TAFH, LAFH, upper posterior face height (UPFH)/TPFH, and UPFH (P < 0.05). Bite force was positively correlated with LPFH/TPFH and negatively with UPFH/TPFH (P < 0.05). As the masseter became larger, the anterior maxillary region tended to shift downwards relative to the cranial base, whereas the posterior region tended to shift upwards. The decrease in LAFH/TAFH and increase in LPFH/TPFH as the size of the masseter muscle increases may be influenced not only by the inclination of the mandibular plane but also by the clockwise rotation of the maxilla.

It is thought that the stress concentration at the root apex caused by orthodontic force induces root resorption. The purpose of this study was to investigate stress distribution at the root in cases of deviated root shapes using finite element models (FEMs). To clarify this, five three-dimensional FEMs divided by deviated root shape (normal, short, blunt, bent root apex, pipette shape) were constructed and, experimental orthodontic forces, applied in a vertical (intrusive) and horizontal (lingual) direction to the tooth axis. In the short-root model, significant stress was concentrated at the middle of the root. The blunt-shaped root model showed no significant stress concentration at the root. In the models with a bent or pipette-shaped root, significant stress was concentrated at the root apex. During orthodontic force application, stress concentration was observed in the root of the models with short, bent, and pipette-shaped roots, indicating that attention must be paid to root shape during orthodontic treatment.

Using lateral cephalograms and a jaw movement-recording system, the relationship between the masticatory movement path and dentofacial morphology was investigated in 17 subjects (9 males and 8 females, mean age 23.5 years) without a history of orthodontic treatment. The masticatory movement path was measured at the right and left lower first molar while the subjects chewed gum. The angle between the Frankfort horizontal plane and the masticatory axis (FH-masticatory angle), defined as the axis passing the opening and closing turning point on the sagittal masticatory path, was also measured. The correlation between the angular measurements derived from the lateral cephalogram and the FH-masticatory angle was then investigated. A positive correlation was observed in the FH-masticatory, occlusal plane (P < 0.05), and mandibular plane (P < 0.01) angles. Furthermore, it was found that the angle between the masticatory axis and the occlusal plane (69.1 +/- 4.2 degrees) remained constant even as the masticatory axis showed a tendency to incline forward as the mandibular plane angle became steeper; the rates of change of the FH-masticatory and the occlusal plane angles were approximately 1:1. This finding suggests that the masticatory movement path is closely associated with the occlusal plane.

The aim of this study was to investigate the initial stability of tapered orthodontic miniscrews (T-type screws) after placement, the necessity of a healing period, and the propriety of immediate loading. Twenty male Wistar rats with a mean age of 20 weeks were divided into two groups. In the immediate-loading groups, straight orthodontic miniscrews (S-type screws) and T-type screws (five rats each) underwent experimental traction force for 2 weeks (W) immediately after placement. In the healing groups (S- and T-type, five rats each), force was applied for 2 W after a 6-W healing period. The right tibia in each rat was identified as the test limb, while the left tibia in each rat was used as the control group, and underwent no experimental force during the experimental period. The screw-to-bone contact was observed histologically and the bone-screw contact ratio was calculated. Scheffe's test was performed to compare the bone-screw contact ratio in each group using statistical software package (SPSS 8.0 for Windows). In the control group, the bone-screw contact ratio improved from 34.8 +/- 16.0 to 74.8 +/- 12.0 per cent with S-type screws in proportion to the experimental period (2 to 8 W, respectively). With the T-type screws in the test group, there was no significant difference between the immediate-loading and healing groups. In the immediate-loading group, the bone-screw contact ratio with T-type screws was significantly greater (82.3 +/- 15.0 per cent) than with the S-type screws (33.3 +/- 11.8 per cent; P < 0.05), suggesting that T-type screws can be used for orthodontic anchorage immediately after placement.

In recent years, mandibular expansion has been increasingly performed in conjunction with orthodontic treatment. Lateral tipping of the molars associated with mandibular expansion should, however, be considered, because excessive expansion may result in excessive buccal tooth inclination, which may disturb the occlusal relationship. This study was conducted to quantitatively clarify molar movement during mandibular expansion using the Schwarz appliance to determine the permissible limit of mandibular expansion as a clinical index for inclination movement. Inclinations in the masticatory surface of the first molar and intermolar width were measured before expansion (T1), after expansion (T2), and before edgewise treatment (T3). Lower plaster models from 29 subjects treated with expansion plates were used and compared with models from 11 control subjects with normal occlusion. The average treatment change (T1-T2) in intermolar width was 5.42 mm (standard deviation 1.98), and the average angle of buccal tooth inclination was 10.16 degrees (standard deviation 3.83). No significant correlation was found between age prior to treatment and the treatment period when they were compared with the intermolar width increments and inclination angles. There was a significant positive correlation between retention duration and the amount of expansion. The regression coefficient of the angle of buccal tooth inclination during expansion to the increment of the intermolar width was approximately 0.2. This means that 1 mm of expansion is accompanied by 5 degrees of molar lateral tipping. This coefficient is clinically useful for estimating the permissible limit for mandibular expansion.

The characteristics of mandibular lateral displacement include lateral inclination of the occlusal plane and the differences between the right and left masticatory muscles. The aims of this investigation were to compare the mandibular stress distribution and displacement of the cervical spine using three-dimensional finite element models (3D FEM) to simulate masticatory movements and to clarify the association between morphological and functional characteristics and head posture. A symmetrical standard model was produced (model-A). Model-B had higher masticatory muscle strength on the left side, model-C had symmetrical masticatory muscle strength but the occlusal plane was inclined upwards towards the right and model-D had the occlusal plane inclined upwards towards the right with higher masticatory muscle strength on the left side. Model-A showed a completely symmetrical stress distribution pattern, while in model-B there was an uneven distribution in the mandible with higher stress on the left side. In addition, the stress distribution in the cervical spine was asymmetrical, showing displacement to the right. Model-C showed a similar mandibular tendency to model-B but the opposite tendency in the cervical spine. In model-D, the mandibular stress distribution was markedly asymmetrical, but almost symmetrical in the cervical spine with markedly decreased lateral displacement. These results suggest that lateral inclination of the occlusal plane and imbalance between the right and left masticatory muscles antagonistically act on displacement of the cervical spine, i.e. the morphological and functional characteristics in patients with mandibular lateral displacement may play a compensatory role in posture control.

The biomechanical effects on cervical vertebral columns (C1-C7) during mastication were calculated using a three-dimensional (3D) finite element method. To verify the biomechanical influences of vertical occlusal alteration to the cervical column, three finite element models (FEM) showing a normal (model A), a steep (model B), and a flat occlusal plane (model C) were constructed. The occlusal stress distribution showed various patterns for the three models; the stress extended to the anterior area as the occlusal plane became steeper. The plots of the stresses on the mid sagittal section of the cervical columns showed different patterns for the three models; the stress converged at the odontoid process in models A and B, whereas the stresses at C7 in model B tended to decrease compared with model A. Concentrated stress was observed at C5 in model C, supporting the hypothesis that vertical occlusal alteration could influence stress distribution in the cervical columns.

The biomechanical influences of head posture on the cervical column and craniofacial complex during masticatory simulation were quantified using three-dimensional (3D) finite element analysis (FEA). Three types of finite element model (FEM) were designed to examine relationships between the position of the head and malocclusion. Model A was constructed to have a standardized cervical column curve, model B a forward inclined posture, and model C a backward inclined posture. The results of the spinal displacements revealed that model B moved in a forward direction and model C in a backward direction during masticatory simulation. The stress distributions on the cervical column (C1-C7) for models A, B, and C showed differences; stress converged at the atlas in model A, high-level stresses were observed at the spinous processes of C6 and C7 in model C, and the stress converged at the anterior edge in the vertebral body of C4 of model B. Stress distribution on the occlusal plane and maxillofacial structure did not show absolute differences among the three models. Alteration of head posture was directly related to stress distribution on the cervical column, but may not always directly influence the occlusal state.

The purpose of this study was to estimate the increase in arch perimeter associated with mandibular lateral expansion. The mandibular expansion was simulated using a three-dimensional (3D) finite element method (FEM) and a computer graphics technique (3D simulation). The centre of rotation of molars during movement accompanied by lateral expansion was calculated using 3D FEM. The geometry of the model was determined using the mandibular bone of an East Indian skeletal specimen and 1 mm computer tomogram (CT) slices. The 3D set-up simulation was then conducted using 3D computer graphics instead of performing a manual set-up. Rotational movement was induced in the buccal segment, from the first premolar to second molar, in the 3D set-up model around the location of the centre of rotation (4.5 mm below the root apex of the first molar) derived from the FEM. According to 3D simulation, the model showed an opening space of 1.43 mm between the canine and first premolar, and thus a change in arch perimeter of 2.86 mm. The tip of the mesio-lingual cusp of the first molar moved 3.88 mm laterally, resulting in a change in inter-molar width of 7.76 mm. These values mean that a 1 mm increase in arch width resulted in an increase in arch perimeter of 0.37 mm. This result would be of value clinically for prediction of the effects of mandibular expansion.