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ABSTRACT: The purpose of this study was to evaluate the effectiveness of the use of Reference Ear Plug (REP) during cone-beam computed tomography (CBCT) scan for the generation of lateral cephalograms from CBCT scan data.
Two CBCT scans were obtained from 33 adults. One CBCT scan was acquired using conventional methods, and the other scan was acquired with the use of REP. Virtual lateral cephalograms created from each CBCT image were traced and compared with tracings of the real cephalograms obtained from the same subject.
CBCT scan with REP resulted in a smaller discrepancy between real and virtual cephalograms. In comparing the real and virtual cephalograms, no measurements significantly differed from real cephalogram values in case of CBCT scan with REP, whereas many measurements significantly differed in the case of CBCT scan without REP.
Measurements from CBCT-generated cephalograms are more similar to those from real cephalograms when REP are used during CBCT scan. Thus, the use of REP is suggested during CBCT scan to generate accurate virtual cephalograms from CBCT scan data.
Korean Journal of Orthodontics 04/2013; 43(2):54-61. · 0.66 Impact Factor
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ABSTRACT: One hundred Korean adults (50 men, 50 women) were scanned in the upright position using a cone-beam CT (CBCT) scanner. The soft tissue (ST) thicknesses were measured at 31 landmarks, 10 midline and 21 bilateral landmark sites, and the means and standard deviations were obtained for male and female subjects. While 18 of 31 landmarks showed sex differences, the majority showed higher values for male subjects with the exception of a few landmark sites corresponding to the zygoma area, which showed smaller values in men than in women. The mandibular area showed greater differences between the right and left sides. Overall, the ST thickness measurements obtained in this study can be used as a database for the forensic craniofacial reconstruction of Korean adult faces.
Journal of Forensic Sciences 05/2012; · 1.23 Impact Factor
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03/2012; , ISBN: 978-953-51-0143-7
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ABSTRACT: The purpose of this study was to evaluate the reproducibility of the soft tissue (ST) thicknesses at 31 landmarks using the cone-beam computed tomography (CBCT) images obtained from 20 adult subjects. Four observers carried out ST thickness measurements using Skull Measure software, and the inter- and intra-observer error rates were evaluated. Only five of 31 landmarks showed significant differences in recorded ST thickness between the observers. When excluding inexperienced observers, only one landmark showed a significant difference between the observers. Regarding the intra-observer reproducibility, the ST thickness measurements at three landmarks showed low correlation coefficients. The results of this study indicate that CBCT images can be used to measure ST thickness with high reproducibility. However, some landmarks need to be redefined to reliably measure ST thickness on CBCT images.
Journal of Forensic Sciences 12/2011; 57(2):443-8. · 1.23 Impact Factor
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ABSTRACT: The utilization of 3D computerized systems has allowed more effective procedures for forensic facial reconstruction. Three 3D computerized facial reconstructions were produced using skull models from live adult Korean subjects to assess facial morphology prediction accuracy. The 3D skeletal and facial data were recorded from the subjects in an upright position using a cone-beam CT scanner. Shell-to-shell deviation maps were created using 3D surface comparison software, and the deviation errors between the reconstructed and target faces were measured. Results showed that 54%, 65%, and 77% of the three facial reconstruction surfaces had <2.5 mm of error when compared to the relevant target face. The average error for each reconstruction was -0.46 mm (SD = 2.81) for A, -0.31 mm (SD = 2.40) for B, and -0.49 mm (SD = 2.16) for C. The facial features of the reconstructions demonstrated good levels of accuracy compared to the target faces.
Journal of Forensic Sciences 11/2011; 57(2):318-27. · 1.23 Impact Factor
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ABSTRACT: A precision 3-dimensional (3D) head model can be fabricated by integrating a digital dental model into a maxillofacial 3D image. The integration requires accurate registration of 2 image modalities. The aims of this study were to determine the registration errors for implementation of laser-scanned dental images into cone-beam computed tomography (CBCT) scan data and to examine the influence of the registration area on the accuracy of registration.
The CBCT scans were obtained from 30 adults, and the maxillofacial 3D images were reconstructed. Maxillary and mandibular dental casts were taken from the same subjects and scanned with a 3D laser scanner. The laser-scanned maxillary and mandibular dentition images were incorporated into the CBCT images of each arch in 3 ways according to the registration area: only the buccal surfaces, only the lingual surfaces, and both the buccal and lingual surfaces. Surface-based registration was performed by using an iterative closest point algorithm, and its errors were evaluated by measuring the 3D Euclidean distances between the surface points on the 2 images.
The registration errors ranged from 0.27 to 0.33 mm. The mandibular arch did not show significant differences in registration errors according to the selected area for the registration. The maxillary arch, however, showed significant differences according to the registration area. When the lingual surfaces only were used for registration, the errors were greater than for the other 2 methods. The errors were least when both the buccal and lingual surfaces were used for registration.
The results of this study indicate that accuracy in the integration of laser-scanned dental images into the maxillofacial CBCT images increases when a broad area is used for registration.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 10/2011; 140(4):585-91. · 1.33 Impact Factor
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ABSTRACT: The purpose of this study was to compare asymmetric mandibular prognathism individuals with symmetric mandibular prognathism individuals using a new alternate spherical coordinate system.
This study consisted of 47 computed tomographic images of patients with mandibular prognathism. The patients were classified into symmetric and asymmetric groups. Mandibular and ramal lines were analyzed using an alternate spherical coordinate system. The length as well as midsagittal and coronal inclination angle of the lines was obtained. The bilateral differences of the spherical coordinates of the facial lines were statistically analyzed in the groups.
There were significant differences between the groups in bilateral difference of the length and midsagittal inclination angle of the lines (p<0.05). The bilateral difference of the length and midsagittal inclination angle of the lines has significant correlation with chin deviation (p<0.05).
The new alternate spherical coordinate system was able to effectively evaluate facial lines. The bilateral difference of lengths and midsagittal inclination of the facial lines might contribute to the facial asymmetry in mandibular prognathism individuals.
Imaging science in dentistry. 09/2011; 41(3):95-100.
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ABSTRACT: To develop a hard coating for stainless surfaces based on silver (Ag)-platinum (Pt) alloys.
Ag-Pt alloys, which have high degree of biocompatibility, excellent resistance to sterilization conditions, and antibacterial properties to different bacteria, are associated with long-term antibacterial efficiency. Approximately 1.03-µm to 2.34-µm-thick coatings, as determined by scanning electron microscopy, were deposited on stainless surfaces by the simultaneous vaporization of both metals (Ag and Pt) in an inert argon atmosphere. The coating was done by physical vapor deposition. Microorganisms and eukaryotic culture cells were grown on these surfaces.
The coatings released sufficient Ag ions when immersed in phosphate-buffered saline and showed significant antimicrobial potency against Streptococcus mutans and Aggregatibacter actinomycetemcomitans strains. At the same time, human gingival fibroblast cells were not adversely affected.
Ag-Pt coatings on load-bearing orthodontic bracket surfaces can provide suitable antimicrobial activity during active orthodontic treatment.
The Angle Orthodontist 08/2011; 82(1):151-7. · 1.21 Impact Factor
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ABSTRACT: To examine and compare the maxillofacial characteristics affecting chin deviation three-dimensionally in facial asymmetry patients with mandibular retrusion and mandibular prognathism.
Maxillofacial computed tomography (CT) scan data were obtained from 48 orthognathic surgery patients (24 cases of mandibular retrusion and 24 cases of mandibular prognathism) with facial asymmetry. Although chin deviation was assessed on the basis of the ANS-to-menton line on frontal cephalograms, its contributing factors were evaluated on three-dimensional CT images. Maxillary height, ramus length, frontal ramal inclination, lateral ramal inclination, mandibular body length, and body height were defined on each side, and right-left differences were calculated and analyzed.
In an assessment of chin deviation, subjects in this study showed predominantly left side deviation regardless of the group, and the degree of menton deviation did not reveal significant differences between groups. In a comparison of right-left differences in contributing factors, all values were noted to be greater in the retrusion group, except for body height, which showed no difference between chin-deviated and contralateral sides. In particular, ramus length presented a statistically significant difference between the two groups.
Based on the same degree of chin deviation in mandibular prognathism and retrusion in this study, results of right-left differences in contributing factors indicate that chin deviations are expressed easily in mandibular prognathism, whereas they occur only with significant right-left differences in relevant maxillofacial structures in individuals with mandibular retrusion.
The Angle Orthodontist 06/2011; 81(6):988-93. · 1.21 Impact Factor
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ABSTRACT: Root damage is a significant complication of orthodontic miniscrew implant placement. Although root damage is rare, its proper management should be clearly understood by practitioners. This article reports the iatrogenic root perforation of a mandibular lateral incisor caused by the placement of a miniscrew. Despite a large radiolucent area caused by chronic apical periodontitis, the perforation was successfully repaired by using a recently developed material, mineral trioxide aggregate. The treatment, clinical implications, and clinical guidelines for preventing root damage during miniscrew placement in orthodontic practice are discussed.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 03/2011; 139(3):407-11. · 1.33 Impact Factor
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ABSTRACT: The purpose of this retrospective study was to elucidate potential confounding factors affecting initial stability of miniscrews inserted to enhance orthodontic anchorage. Four hundred and seven miniscrews inserted in 168 patients treated by 17 orthodontic residents were analysed in a consecutive chart review. The outcome variable was the stability of the miniscrew, measured as a dichotomous variable, 0 if the miniscrew loosened during a 1 week period after insertion to the time of orthodontic force application and a value of 1 otherwise. Potential confounding variables examined were gender, age, jaw, insertion site, tissue type, length and diameter of the miniscrew, and number of previous insertions. Generalized estimating equations (GEE) methods were used to estimate the influence of each factor on stability for the correlated binary outcomes of each patient. A weighted analysis for the GEE approach was also performed for the convergence calculation of the estimation procedure due to a value of 0 in one of the cells. Crude odds ratio (cOR) and adjusted odds ratio (aOR) and their 95 per cent confidence intervals (CI) were calculated for this purpose. The overall success rate after 1 week was 93.1 per cent (379/407). The screws inserted by more experienced clinicians (more than 20 miniscrews) were found to have approximately a 3.6-fold higher success rate of initial stability compared with those inserted by less experienced clinicians after adjusting for the insertion site (aOR = 3.63, P = 0.015). The results of the present study suggest that the initial stability depends on insertion site and clinician experience.
The European Journal of Orthodontics 01/2011; 33(5):528-32. · 0.89 Impact Factor
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ABSTRACT: INTRODUCTION: The purposes of this study were to determine bone density at various orthodontic implant sites and compare them according to depth and area (anterior and posterior, buccal and lingual, and maxilla and mandible). METHODS: Maxillofacial computed tomography scan data were obtained from 30 adults with normal occlusion. Bone density was recorded in Hounsfield units with simulated placement of miniscrews with the V-Implant program (CyberMed, Seoul, Korea). Bone density was measured to a depth of 6 mm at 1-mm intervals in 60 interdental areas (30 in the maxilla, 30 in the mandible), and mean bone density was calculated at each site. RESULTS: Bone density tended to decrease with increasing depth, particularly in the posterior area. Mean bone density showed a progressive increase from posterior to anterior except for the mandibular buccal side, which had no significant differences. A comparison of the mean bone densities between the buccal and lingual sides in the mandible showed that the lingual side had higher values in the anterior area and vice versa in the posterior area. On the other hand, there were no distinct differences between the buccal and lingual sides in the maxilla. A comparison of the mean bone densities between the maxilla and the mandible showed higher values in the mandible, and these differences were more significant on the buccal side of the posterior. CONCLUSIONS: The differences in bone densities according to depth and area should be considered when selecting and placing miniscrew implants for orthodontic anchorage.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 12/2009; 136(6):766-7. · 1.33 Impact Factor
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ABSTRACT: The purposes of this study were to determine bone density at various orthodontic implant sites and compare them according to depth and area (anterior and posterior, buccal and lingual, and maxilla and mandible).
Maxillofacial computed tomography scan data were obtained from 30 adults with normal occlusion. Bone density was recorded in Hounsfield units with simulated placement of miniscrews with the V-Implant program (CyberMed, Seoul, Korea). Bone density was measured to a depth of 6 mm at 1-mm intervals in 60 interdental areas (30 in the maxilla, 30 in the mandible), and mean bone density was calculated at each site.
Bone density tended to decrease with increasing depth, particularly in the posterior area. Mean bone density showed a progressive increase from posterior to anterior except for the mandibular buccal side, which had no significant differences. A comparison of the mean bone densities between the buccal and lingual sides in the mandible showed that the lingual side had higher values in the anterior area and vice versa in the posterior area. On the other hand, there were no distinct differences between the buccal and lingual sides in the maxilla. A comparison of the mean bone densities between the maxilla and the mandible showed higher values in the mandible, and these differences were more significant on the buccal side of the posterior.
The differences in bone densities according to depth and area should be considered when selecting and placing miniscrew implants for orthodontic anchorage.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 12/2009; 136(6):766.e1-12; discussion 766-7. · 1.33 Impact Factor
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ABSTRACT: The purpose of this study was to investigate the change of lip-line cant (LLC) after 1-jaw orthognathic surgery in mandibular asymmetry patients.
Preoperative and postoperative data of 22 patients having 1-jaw orthognathic surgery, with menton deviation over 2 degrees before the surgery, were our subjects. LLC was measured in the preoperative and postoperative frontal photographs, and its change was correlated with various craniofacial measurements obtained from preoperative and postoperative frontal cephalograms and maxillofacial 3-dimensional computed tomography images.
Although these subjects had 2.4 degrees of LLC on average before surgery, LLC improved to 0.5 degrees after surgery, and the change (1.9 degrees ) was statistically significant. In the correlation analysis, preoperative LLC showed positive correlations with menton deviation and mandibular anterior occlusal plane cant. In the correlation analysis of LLC change, it had positive correlations with preoperative LLC and mandibular anterior occlusal plane cant and preoperative and postoperative change of menton deviation.
These results suggest that LLC is present with chin deviation, even without significant maxillary canting, and can be improved considerably by 1-jaw surgery alone.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 10/2009; 136(4):564-9. · 1.33 Impact Factor
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ABSTRACT: The purpose of this study was to investigate various factors associated with initial miniscrew stability for the prediction of the success rate.
A total of 378 miniscrews in 154 patients were examined by reviewing their charts. Potential confounding variables examined were age, sex, jaw (maxilla or mandible), placement site, tissue mobility (firm or movable tissue), type, length, and diameter of the miniscrew, and the number of previous operations. The outcome variable of this study was initial stability, defined as the stability of the miniscrew from placement to orthodontic force application. We used the generalized estimating equations method to estimate the influence of each factor on stability for the correlated outcomes of each patient.
The overall success rate was 83.6% for all miniscrews (316 of 378). After adjusting for the type of miniscrew, the relative success rate in the mandible was 0.48 times that in the maxilla but without statistical significance (crude odds ratio = 0.52, P = 0.13; adjusted odds ratio = 0.48, P = 0.09). There was no statistically significant association of any factors in this model with respect to initial stability.
These results suggest that initial stability cannot be guaranteed or predicted. For this reason, any treatment plan should consider the possibility of failure.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 09/2009; 136(2):236-42. · 1.33 Impact Factor
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ABSTRACT: The esthetic impact of the soft-tissue profile might play a major role in deciding on premolar extraction or nonextraction treatment, particularly in borderline patients. The purpose of this study was to compare the esthetic impact of extraction and nonextraction therapy on Korean patients.
Panels of 50 dentists and 50 laypersons evaluated randomly presented pretreatment and posttreatment soft-tissue profiles of 50 extraction and 50 nonextraction patients. As subjects in this study, borderline patients were selected based on their initial diagnostic records. Two panels were asked to compare the pretreatment and posttreatment profile tracings and to quantify their perceptions of the esthetic impact of treatment change using a visual analog scale.
Premolar extraction patients showed greater improvement in facial profile compared with nonextraction patients, regardless of the panel. Based on the results of regression analysis to determine the degree of lip protrusion at which the retraction that commonly follows premolar extraction would be needed, the intersection was about 3.0 mm behind the Ricketts' E-line; this is far behind the Korean norm.
The results indicate that premolar extraction is more beneficial than nonextraction treatment in terms of facial profile improvement in Korean borderline patients.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 05/2008; 133(4):524-31. · 1.33 Impact Factor
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ABSTRACT: The purpose of this study was to investigate factors affecting lip-line canting by using musculoskeletal analyses.
Fifty-six adults with lip-line canting were selected as subjects. They were divided into 3 groups according to the changes of lip line during smiling: increasing (group I), decreasing (group D), and minimal (group M). Lip-line canting at rest was correlated to craniofacial morphology and muscular activity: Regarding craniofacial morphology, various craniofacial measurements in lateral and frontal cephalograms were used, including inclination of the tongue blade placed across both first molars. The zygomaticus major was the focus of the measurement of muscular activity affecting lip-line canting, and its activity during smiling was evaluated by using a needle electrode.
In group I, lip-line canting at rest showed a significant correlation with the right-left (R/L) difference of muscular activity, but no significant correlation with the measurements of craniofacial morphology. In group D, lip-line canting showed a positive correlation with the measurements of craniofacial morphology, such as the inclination of the tongue blade, and a negative correlation with the R/L difference of muscular activity. In group M, lip-line canting showed no significant correlation with the R/L difference of muscular activity, but a significant correlation with inclination of the tongue blade.
The results indicate that lip-line canting is caused by craniofacial morphology when the change of lip-line canting during smiling is minimal, whereas lip-line canting is affected by the R/L difference of muscular activity in addition to craniofacial morphology when the cant of lip line markedly changes during smiling. The findings suggest that the cause of lip-line canting can be identified easily by the change of canting during smiling, without complicated musculoskeletal analyses.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 10/2007; 132(3):278.e7-14. · 1.33 Impact Factor
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ABSTRACT: The purposes of this study were to classify patients with facial asymmetry by using the cluster analysis and to evaluate the characteristics of the resultant groups.
One hundred consecutive orthodontic patients who had frontal cephalograms and photographs taken for the diagnosis of facial asymmetry were included in the sample. A cluster analysis was used to classify the subjects, with craniofacial measurements related to asymmetry obtained from the cephalograms and photographs.
The subjects were divided into 5 clusters based on only 3 variables from the frontal cephalograms: menton deviation, apical base midline discrepancy, and vertical difference of right and left antegonion. The results of the ANOVA test according to the variables showed statistically significant differences between the groups in all variables, indicating that each group can be easily identified with the variables.
The results suggest that patients with facial asymmetry can be classified simply based on some variables on frontal cephalograms, and this classification can be helpful in proper diagnosis and treatment planning for these patients.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 10/2007; 132(3):279.e1-6. · 1.33 Impact Factor
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ABSTRACT: In this study, we evaluated errors introduced into the interpretation of facial asymmetry on posteroanterior (PA) cephalograms due to malpositioning of the x-ray emitter focal spot. We tested the hypothesis that horizontal displacements of the emitter from its ideal position would produce systematic displacements of skull landmarks that could be fully accounted for by the rules of projective geometry alone.
A representative dry skull with 22 metal markers was used to generate a series of PA images from different emitter positions by using a fully calibrated stereo cephalometer. Empirical measurements of the resulting cephalograms were compared with mathematical predictions based solely on geometric rules. The empirical measurements matched the mathematical predictions within the limits of measurement error (x= 0.23 mm), thus supporting the hypothesis. Based upon this finding, we generated a completely symmetrical mathematical skull and calculated the expected errors for focal spots of several different magnitudes. Quantitative data were computed for focal spot displacements of different magnitudes.
Misalignment of the x-ray emitter focal spot introduces systematic errors into the interpretation of facial asymmetry on PA cephalograms. For misalignments of less than 20 mm, the effect is small in individual cases. However, misalignments as small as 10 mm can introduce spurious statistical findings of significant asymmetry when mean values for large groups of PA images are evaluated.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 08/2007; 132(1):15-27. · 1.33 Impact Factor
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Mi-Jin Chun,
Eunju Shim,
Eun-Hee Kho,
Keum-Joo Park,
Jarang Jung,
Jin-Man Kim,
Byunghoon Kim,
Ki-Heon Lee,
Dong-Lyun Cho,
Dong-Hoon Bai,
Syng-Ill Lee, Hyeon-Shik Hwang,
Seung-Ho Ohk
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ABSTRACT: To test the antiadherent and antibacterial properties of surface modification of orthodontic wires with photocatalytic titanium oxide (TiO(2)).
TiO(2) was coated on the surface of the orthodontic wires by a sol-gel thin film dip-coating method. Bacterial adhesion to the wires was evaluated by the weight change of the wires. The antibacterial activity of the surface-modified orthodontic wires was demonstrated by the dilution agar plate method for Streptococcus mutans and spectrophotometry for Porphyromonas gingivalis.
The orthodontic wires coated with the photocatalytic TiO(2) showed an antiadherent effect against S. mutans compared with the uncoated wires. The bacterial mass that bound to the TiO(2)-coated orthodontic wires remained unchanged, whereas that of the uncoated wires increased by 4.97%. Furthermore, the TiO(2)-coated orthodontic wires had a bactericidal effect on S. mutans and P. gingivalis, which cause dental caries and periodontitis, respectively. The antiadherent and antibacterial mechanisms of TiO(2) to break down the cell wall of those bacteria were revealed by scanning electron microscopy.
The surface modification of orthodontic wires with photocatalytic TiO(2) can be used to prevent the development of dental plaque during orthodontic treatment.
The Angle Orthodontist 06/2007; 77(3):483-8. · 1.21 Impact Factor