Jiuxiang Lin

Comparison of intermaxillary tooth size discrepancies among different malocclusion groups.

The purpose of this study was to determine whether there is a prevalent tendency for intermaxillary tooth size discrepancies among different malocclusion groups. This study consisted of 60 subjects who served as the normal occlusion group and 300 patients divided into 5 malocclusion groups (ie, Class I with bimaxillary protrusion, Class II Division 1, Class II Division 2, Class III, and Class III surgery). Tooth size measurements were performed on the models of normal occlusion and pretreatment models of patients by the Three Dimension Measuring Machine. Moreover, tooth size ratios, analyzed as described by Bolton and the Student t test showed no sexual dimorphism for these ratios in each of 6 groups, so the sexes were combined for each group. Then these ratios were compared among different malocclusion groups. The results showed no significant difference between subcategories of malocclusion, so these groups were combined. There were now 120 cases in each of 3 categories: Class I, Class II, and Class III. A significant difference was found for all the ratios between the groups, the ratios showing that Class III > Class I > Class II. It demonstrated that intermaxillary tooth size discrepancy may be one of the important factors in the cause of malocclusions, especially in Class II and Class III malocclusions. Thus this study proved the fact that Bolton analysis should be taken into consideration during orthodontic diagnosis and therapy.

Torque control of the maxillary incisors in lingual and labial orthodontics: A 3-dimensional finite element analysis

INTRODUCTION Lingual orthodontics has developed rapidly in recent years; however, research on torque control variance of the maxillary incisors in both lingual and labial orthodontics is still limited, especially studies with 3-dimensional finite element methods. Thorough understanding of the biomechanical differences of incisor torque control during lingual and labial orthodontic treatment is critical for the best results. METHODS A 3-dimensional finite element model of the maxilla and the maxillary incisors was made with 98,106 nodes, 71,944 10-node solid elements, and 5236 triangle shell units. Horizontal retraction force, vertical intrusive force, and lingual root torque were applied to simulate labial and lingual orthodontic treatment. Then the distribution of the stress-strain (maximum and minimum principal stresses; maximum and minimum principal strains) in the periodontal ligament, the total displacement, and the vector graph of displacement of the nodes of the maxillary central incisor were analyzed and compared between labial and lingual orthodontics. RESULTS Loads of the same magnitude produced translation of the maxillary incisor in labial orthodontics but lingual crown tipping of the same tooth in lingual orthodontics. This suggests that loss of torque control of the maxillary incisors during retraction in extraction patients is more likely in lingual orthodontic treatment. CONCLUSIONS Lingual orthodontics should not simply follow the clinical experience of the labial techniques but should increase lingual root torque, increase vertical intrusive force, and decrease horizontal retraction force properly to achieve the best orthodontic results.

Quantitative cervical vertebral maturation assessment in adolescents with normal occlusion: a mixed longitudinal study.

INTRODUCTION The purpose of this study was to establish a quantitative cervical vertebral maturation (CVM) system for adolescents with normal occlusion. METHODS Mixed longitudinal data were used. The subjects included 87 children and adolescents from 8 to 18 years old with normal occlusion (32 boys, 55 girls) selected from 901 candidates. Sequential lateral cephalograms and hand-wrist films were taken once a year for 6 years. The lateral cephalograms of all subjects were divided into 11 maturation groups according to the Fishman skeletal maturity indicators. The morphologic characteristics of the second, third, and fourth cervical vertebrae at 11 developmental stages were measured and analyzed. RESULTS Three characteristic parameters (H4/W4, AH3/PH3, @2) were selected to determine the classification of CVM. With 3 morphologic variables, the quantitative CVM system including 4 maturational stages was established. An equation that can accurately estimate the maturation of the cervical vertebrae was established: CVM stage=-4.13+3.57xH4/W4+4.07xAH3/PH3+0.03x@2. CONCLUSIONS The quantitative CVM method is an efficient, objective, and relatively simple approach to assess the level of skeletal maturation during adolescence.

Local osteoprotegerin gene transfer inhibits relapse of orthodontic tooth movement

INTRODUCTION In orthodontic treatment, teeth can relapse after tooth movement without retention. The aim of this study was to evaluate the inhibition effects of local osteoprotegerin (OPG) gene transfer on orthodontic relapse. METHODS Eighteen male Wistar rats were divided into 3 groups. The maxillary right first molars of all animals were subjected to orthodontic force and moved mesially. Three weeks later, the force was removed, and the teeth relapsed. During the 2-week relapse period, the 3 groups of rats received local OPG gene transfer (experimental group), mock vector transfer (mock group), and no injections (control group). Tooth movement and relapse were measured by using palatal superimpositions of 3-dimensional digital models. Histomorphometric analysis was used to quantify osteoclasts, and microcomputed tomography analysis was done to quantify the alveolar bone and the tibia. RESULTS Relapse was significantly inhibited and the number of osteoclasts was reduced in the experimental group. On the other hand, bone mineral density and bone volume fraction of alveolar bone were significantly increased. Bone mineral density and bone volume fraction of the tibia showed no significant difference between the groups. CONCLUSIONS Local OPG gene transfer to periodontal tissues could inhibit relapse after orthodontic tooth movement, through the inhibition of osteoclastogenesis.

Quantitative skeletal evaluation based on cervical vertebral maturation: a longitudinal study of adolescents with normal occlusion

The study aims were to investigate the correlation between vertebral shape and hand-wrist maturation and to select characteristic parameters of C2-C5 (the second to fifth cervical vertebrae) for cervical vertebral maturation determination by mixed longitudinal data. 87 adolescents (32 males, 55 females) aged 8-18 years with normal occlusion were studied. Sequential lateral cephalograms and hand-wrist radiographs were taken annually for 6 consecutive years. Lateral cephalograms were divided into 11 maturation groups according to Fishman Skeletal Maturity Indicators (SMI). 62 morphological measurements of C2-C5 at 11 different developmental stages (SMI1-11) were measured and analysed. Locally weighted scatterplot smoothing, correlation coefficient analysis and variable cluster analysis were used for statistical analysis. Of the 62 cervical vertebral parameters, 44 were positively correlated with SMI, 6 were negatively correlated and 12 were not correlated. The correlation coefficients between cervical vertebral parameters and SMI were relatively high. Characteristic parameters for quantitative analysis of cervical vertebral maturation were selected. In summary, cervical vertebral maturation could be used reliably to evaluate the skeletal stage instead of the hand-wrist radiographic method. Selected characteristic parameters offered a simple and objective reference for the assessment of skeletal maturity and timing of orthognathic surgery.

Longitudinal changes in mandibular arch posterior space in adolescents with normal occlusion

INTRODUCTION The purpose of this study was to investigate the changes of available mandibular space in the posterior dental arch of teenagers from 13 to 18 years old. METHODS Longitudinal cephalograms of 28 adolescents (13 boys, 15 girls) with normal occlusion, selected from among 901 candidates, were taken annually from 13 to 18 years of age inclusively. Modified analyses with occlusal plane and occlusal plane perpendicular as reference planes were used to evaluate the changes of available space of the posterior mandibular arch. RESULTS From 13 to 18 years of age, significant differences of mandibular posterior space were found among ages and sexes. The total increases of available space were 5.12 mm in the girls and 5.79 mm in the boys. For girls before age 16 and boys before age 17, the increased available space was contributed mainly by resorption of bone on the anterior border of the ramus. Mesial drift of the dental arch did not occur until the eruption of the third molars. The average available spaces increased 1.22 mm in girls less than age 16 and 1.45 mm in boys less than age 17 per side per year. CONCLUSIONS The prediction of available space in the posterior mandibular arch should be based on age and sex.

Effects of local osteoprotegerin gene transfection on orthodontic root resorption during retention: an in vivo micro-CT analysis.

OBJECTIVES External root resorption (ERR) is a serious complication of orthodontic treatment. Aim of this study was to evaluate the effects of local osteoprotegerin (OPG) gene transfection on ERR during retention. MATERIAL AND METHODS Eighteen 6-week-old male Wistar rats were divided into three groups. All the rats were subjected to 2 weeks of orthodontic tooth movement followed by a 2-week retention period. During retention, the three groups of rats received local OPG gene transfection (OPG transfection group, n=6), mock vector transfection (mock group, n=6), or no injections (control group, n=6). ERR of all three groups was evaluated with in vivo micro-CT analysis at three different time points: baseline, the last day of orthodontic tooth movement, and the last day of retention. RESULTS In the OPG transfection group, there was no significant difference between ERR at the baseline and ERR on the last day of retention. By the last day of retention, the repair ratio of ERR in the OPG transfection group was statistically higher in relation to the repair ratio of the other groups (p<0.001). CONCLUSION The results indicated that local OPG gene transfection significantly enhanced the repair of ERR during retention. Local OPG gene transfection might therefore be a useful tool for ERR repair during retention.

Longitudinal study of relative growth rates of the maxilla and the mandible according to quantitative cervical vertebral maturation

INTRODUCTION The purpose of this study was to investigate the relative growth rates (RGR) of the maxilla and the mandible according to quantitative cervical vertebral maturation (QCVM) of adolescents with normal occlusion. METHODS Mixed longitudinal data were used. The sample included 87 adolescents (32 boys, 55 girls) from 8 to 18 years of age with normal occlusion, selected from 901 candidates. Sequential lateral cephalograms and hand-wrist films were taken once a year for 6 consecutive years. The growth magnitude (GM) and RGR of the maxilla and the mandible were measured and analyzed. RESULTS GM and RGR were not always consistent, because subjects had different periods of time between the QCVM stages. GM was not as reliable as RGR. RGR had no significant sex differences in the maxilla and the mandible, in spite of different decelerating curves. However, statistically significant sex differences were found in the GM of mandibular measurements. The greatest growth potentials were not synchronized between the maxilla and the mandible. For both sexes, the greatest RGR of maxillary length and height was in QCVM stage I; then, deceleration occurred. The greatest RGR of mandibular length and height was in QCVM stage II, and the next largest was in QCVM stage I. CONCLUSIONS Understanding the RGR can provide references for orthodontic treatment and orthognathic surgery.

Clinical study of frontal chewing patterns in various crossbite malocclusions.

INTRODUCTION The purpose of this study was to clarify the frontal chewing patterns of various crossbite malocclusions. METHODS A mandibular kinesiograph was used to record the masticatory movements of 106 subjects (ages, 12-35 years) with crossbite malocclusion and 22 subjects (ages, 16-30 years) with normal occlusion. The chewing patterns were classified into 8 chewing types according to the cycle shape of the frontal incisor point movement. The crossbite subjects were divided into 5 groups by the anteroposterior position of the crossbite, and then the subjects with posterior crossbite were divided into 3 groups by the transverse position of the crossbite. The Mann-Whitney U test was used to compare the frequency of each chewing type between any crossbite group and the control group; and between the various crossbite groups. RESULTS In the crossbite groups, normal chewing occurred much less often than in subjects with normal occlusion. In the posterior crossbite group, reverse chewing was greater (P = 0.002), and normal chewing was less frequent (P = 0.001) compared with the anterior crossbite group. When accompanied by mandibular shift, mandibular prognathism, arch crossbite, in the crossbite or shift side, reverse type, and reverse-crossing type occurred more often than in contralateral side. CONCLUSIONS In the frontal plane, patients with posterior crossbite might have more abnormal chewing types than those with anterior crossbite, and posterior crossbite could contribute to the high frequency of reverse and reverse-crossing chewing types, especially when accompanied by mandibular shift, mandibular prognathism, or arch crossbite.

The longitudinal sagittal growth changes of maxilla and mandible according to quantitative cervical vertebral maturation

To investigate the longitudinal sagittal growth changes of maxilla and mandible according to the quantitative cervical vertebral maturation (QCVM) for adolescents with normal occlusion, mixed longitudinal data were used. The samples included 87 adolescents aged from 8 to 18 y old with normal occlusion (32 males, 55 females) selected from 901 candidates. Sequential lateral cephalograms and hand-wrist films were taken once a year, lasting for 6 y. The longitudinal sagittal growth changes of maxilla and mandible according to QCVM were measured. There were some significant differences between maxilla and mandible according to QCVM. The sagittal growth change of maxilla showed a trend towards high velocity→decelerating velocity→completing velocity from QCVM stage I to stage IV. The sagittal growth change of mandible showed a trend towards accelerating velocity→high velocity→decelerating velocity→completing velocity from QCVM stage I to stage IV. With sagittal relationship, growth magnitude was almost the same between maxilla and mandible at QCVM stage I. At stage II the growth of mandible exceeded that of maxilla and growth in mandible continued at stages III and IV, while the maxilla ceased to grow. Growth magnitude was greater and the growth duration was longer with male mandible. It is concluded that the longitudinal sagittal growth changes of maxilla and mandible on the basis of QCVM is of value in the orthodontic practice.SummaryTo investigate the longitudinal sagittal growth changes of maxilla and mandible according to the quantitative cervical vertebral maturation (QCVM) for adolescents with normal occlusion, mixed longitudinal data were used. The samples included 87 adolescents aged from 8 to 18 y old with normal occlusion (32 males, 55 females) selected from 901 candidates. Sequential lateral cephalograms and hand-wrist films were taken once a year, lasting for 6 y. The longitudinal sagittal growth changes of maxilla and mandible according to QCVM were measured. There were some significant differences between maxilla and mandible according to QCVM. The sagittal growth change of maxilla showed a trend towards high velocity→decelerating velocity→completing velocity from QCVM stage I to stage IV. The sagittal growth change of mandible showed a trend towards accelerating velocity→high velocity→decelerating velocity→completing velocity from QCVM stage I to stage IV. With sagittal relationship, growth magnitude was almost the same between maxilla and mandible at QCVM stage I. At stage II the growth of mandible exceeded that of maxilla and growth in mandible continued at stages III and IV, while the maxilla ceased to grow. Growth magnitude was greater and the growth duration was longer with male mandible. It is concluded that the longitudinal sagittal growth changes of maxilla and mandible on the basis of QCVM is of value in the orthodontic practice.