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Shah ND, Goje SK. Skeletal Anchorage Augmentation in Extraction/Nonextraction Orthodontic Treatment: A Randomized Clinical Study. J Contemp Dent Pract 2023; 24:424-436. [PMID: 37622618 DOI: 10.5005/jp-journals-10024-3525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
AIM To evaluate and compare skeletal, dental, and soft tissue parameters by therapeutic extraction of first premolar and nonextraction distalization of maxillary and mandibular arches in bimaxillary proclination using the skeletal anchorage system. MATERIALS AND METHODS About 40 orthodontic patients undergoing extraction or nonextraction treatment are enrolled in a randomized clinical trial. Participants are randomly assigned to either the extraction or nonextraction group and receive treatment augmented with skeletal anchorage. Mini implants were placed in the extraction group for retraction and infra-zygomatic crest (IZC) and buccal shelf screws were placed in the nonextraction group for distalization. OBSERVATIONS AND RESULTS Comparison between the ages of the patients among both Groups showed no significant difference. A significant difference is observed in dental and soft tissue parameters before and after the treatment in group A, whereas skeletal parameters also showed significant changes along with dental and soft tissue parameters in group B. CONCLUSION There is a significant change in the position of incisors by retraction and facial profile improves gradually in group A while for group B, a marked change in lower facial height was even seen. On comparing both the groups, a highly significant difference can be seen with respect to the amount of incisor retraction and change in molar inclination. The time taken for retraction of incisors is less in comparison to distalization. CLINICAL SIGNIFICANCE With this, we can easily avoid premolar extraction, and in cases of impacted third molars distalization as when indicated can be helpful as a part of the nonextraction treatment plan.
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Affiliation(s)
- Niti Dharmendra Shah
- KM Shah Dental College & Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India, Phone: +91 9978601796, e-mail:
| | - Santosh Kumar Goje
- Department of Orthodontics and Dentofacial Orthopaedics, KM Shah Dental College & Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
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Kang DO, Yu HS, Choi SH, Kim ST, Jung HD, Lee KJ. Stability of vertical dimension following total arch intrusion. BMC Oral Health 2023; 23:164. [PMID: 36949457 PMCID: PMC10031991 DOI: 10.1186/s12903-023-02842-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/27/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND The purpose of this study is to evaluate stability of vertical dimension following total arch intrusion using miniscrews by measuring the change during treatment and relapse amount after more than one year of retention. METHODS Thirty patients (6 men, 24 women) were included in this study. Lateral cephalographs were taken with conventional radiography at the start of treatment (T0), after treatment (T1), and at least one year after treatment (T2). The evaluation was performed by measuring changes of selected parameters during treatment and the extent of relapse after more than one year. RESULTS During total arch intrusion treatment (T1-T0), anterior and posterior teeth intruded significantly. The mean vertical distance between the maxillary posterior teeth and palatal plane was reduced by 2.30 mm (P < 0.001). The mean vertical distance between the maxillary anterior teeth and palatal plane was reduced by 2.04 mm (P < 0.001). The anterior facial height was also reduced by 2.70 mm (P < 0.001). During retention period (T2-T1), the vertical distance between the maxillary anterior teeth and the palatal plane significantly increased by 0.92 mm (P < 0.001). The anterior facial height increased by 0.81 mm (P < 0.01). CONCLUSIONS Anterior facial height significantly decreases after treatment. During retention period, relapse of AFH and maxillary anterior teeth observed. There was no correlation between initial amount of AFH, mandibular plane angle, or SNPog and posttreatment AFH relapse. However, there was a significant correlation between the amount of intrusion of anterior and posterior teeth achieved by the treatment and the extent of relapse.
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Affiliation(s)
- Dong-Ok Kang
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50‑1 Yonsei‑ro, Seodaemun‑gu, Seoul, 03722, Korea
| | - Hyung-Seog Yu
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50‑1 Yonsei‑ro, Seodaemun‑gu, Seoul, 03722, Korea
| | - Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50‑1 Yonsei‑ro, Seodaemun‑gu, Seoul, 03722, Korea
| | - Seong-Taek Kim
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50‑1 Yonsei‑ro, Seodaemun‑gu, Seoul, 03722, Korea
| | - Hwi-Dong Jung
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50‑1 Yonsei‑ro, Seodaemun‑gu, Seoul, 03722, Korea
| | - Kee-Joon Lee
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50‑1 Yonsei‑ro, Seodaemun‑gu, Seoul, 03722, Korea.
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Mizuno M, Kawaguchi M, Tabuchi M, Miyazawa K, Goto S. A case of skeletal maxillary protrusion with high angle and gummy smile treated with anchor screws. J Oral Sci 2022; 64:315-318. [PMID: 36002268 DOI: 10.2334/josnusd.22-0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This report discusses a case of a 20 year and 7-month-old female patient with a skeletal maxillary protrusion with gummy smile, crowding, and high angle due to horizontal protrusion of the maxillary anterior teeth. The gummy smile in this case was improved by an upward movement of the occlusal plane associated with maxillary molar intrusion and sufficient lingual movement while performing maxillary anterior teeth intrusion. Following treatment, it was stable even after 8 years of retention. Thus, it is important to ascertain the cause of gummy smile, and establish whether it is due to the vertical maxillary excess in the maxillary anterior teeth, or the horizontal protrusion of the maxillary anterior teeth.
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Affiliation(s)
- Manami Mizuno
- Department of Orthodontics, School of Dentistry, Aichi-Gakuin University
| | - Misuzu Kawaguchi
- Department of Orthodontics, School of Dentistry, Aichi-Gakuin University
| | - Masako Tabuchi
- Department of Orthodontics, School of Dentistry, Aichi-Gakuin University
| | - Ken Miyazawa
- Department of Orthodontics, School of Dentistry, Aichi-Gakuin University
| | - Shigemi Goto
- Department of Orthodontics, School of Dentistry, Aichi-Gakuin University
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Choi SH, Jeon JY, Lee KJ, Hwang CJ. Clinical applications of miniscrews that broaden the scope of non-surgical orthodontic treatment. Orthod Craniofac Res 2020; 24 Suppl 1:48-58. [PMID: 33275826 DOI: 10.1111/ocr.12452] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 12/14/2022]
Abstract
Previously, in the case of malocclusion owing to skeletal discrepancy in adults, the amount of tooth movement was limited since there was no reliable skeletal anchorage device. The only way to treat this case was by repositioning the maxilla and mandible via orthognathic surgery, but most patients are reluctant to undergo surgery owing to the risk and expenses incurred. However, with the current introduction and use of miniscrews as temporary anchorage devices, the entire dental arch can be relocated to a target position without surgery, thus broadening the scope of non-surgical orthodontic treatment compared to the past. For a non-surgical approach to improve skeletal discrepancy, anteroposterior, vertical and transverse displacements of the dental arch are necessary. In this case, the localization of the centre of resistance of the whole arch must precede the appliance design with an appropriate biomechanical design. Especially, in the transverse dimension, the envelope of discrepancy is reportedly narrow, and the tooth movement must accompany the orthopaedic correction involving the midpalatal suture expansion. Recently, in adults with transverse maxillomandibular discrepancy, miniscrew-assisted rapid palatal expansion (MARPE) can be performed. Moreover, compared to surgically assisted rapid palatal expansion, MARPE reduces the cost to the patient and achieves clinically acceptable stable maxillary expansion. In this article, we will discuss the role of total arch movement and MARPE in widening the scope of non-surgical orthodontic treatment, despite the inherent limitations of miniscrews' mechanical aspects.
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Affiliation(s)
- Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea.,BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Ji Yoon Jeon
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - Kee-Joon Lee
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - Chung-Ju Hwang
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
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Liu Y, Yang ZJ, Zhou J, Xiong P, Wang Q, Yang Y, Hu Y, Hu JT. Comparison of Anchorage Efficiency of Orthodontic Mini-implant and Conventional Anchorage Reinforcement in Patients Requiring Maximum Orthodontic Anchorage: A Systematic Review and Meta-analysis. J Evid Based Dent Pract 2020; 20:101401. [PMID: 32473793 DOI: 10.1016/j.jebdp.2020.101401] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/17/2019] [Accepted: 01/17/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To compare the clinical effectiveness of mini-implants (MIs) and conventional anchorage appliances used for orthodontic anchorage reinforcement in patients with class I or II malocclusion with bimaxillary protrusion. MATERIALS AND METHODS Literature search was conducted through PubMed, Embase, and Cochrane from inception to July 2018. The following Medical Subject Heading terms were used for the search string: "skeletal anchorage", "temporary anchorage devices", "miniscrew implant", "mini-implant", "micro-implant". Standardized mean difference (SMD) and 95% confidence interval (CI) of horizontal and vertical movements of teeth from baseline were used for comparison. RESULTS A total of 12 studies were included in the final analysis. MI group significantly lowered mesial movement of molars compared to conventional anchorage group (SMD = -1.48, 95% CI = -2.25 to -0.72; P = .0002). There was significantly higher retraction of incisors in the MI group than in the conventional group (SMD = -0.47 mm, 95% CI = -0.87 to -0.07; P = .02). No significant difference was seen in vertical movement of molars (SMD = -0.21 mm, 95% CI = -0.87 to 0.45; P = .52) and incisors (SMD = -0.30, 95% CI = -1.18 to 0.58; P = .5). CONCLUSION MIs seem to be more effective than the conventional anchorage devices in terms of minimizing unintended mesial movement of molars with maximum retraction of anterior teeth.
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Affiliation(s)
- Yan Liu
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Zhen-Jin Yang
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Jing Zhou
- Department of Stomatology, Kunming Yanan Hospital, Kunming City, China.
| | - Ping Xiong
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Quan Wang
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Yan Yang
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Yu Hu
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Jiang-Tian Hu
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
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Liu Y, Yang ZJ, Zhou J, Xiong P, Wang Q, Yang Y, Hu Y, Hu JT. Soft Tissue Changes in Patients With Dentoalveolar Protrusion Treated With Maximum Anchorage: A Systematic Review and Meta-analysis. J Evid Based Dent Pract 2019; 19:101310. [PMID: 31843178 DOI: 10.1016/j.jebdp.2019.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 12/06/2018] [Accepted: 01/23/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This meta-analysis aimed at comparing the angular and linear changes of soft tissue profile using conventional anchorage techniques and mini-implant (MI)-based space closure in patients with dentoalveolar protrusion. MATERIALS AND METHODS Electronic databases, viz. PubMed, Embase, and Cochrane Central Register of Controlled Trials, were searched for relevant literature from their inception to December 2017 according to the specific inclusion and exclusion criteria. The following Medical Subject Heading terms were used for searching: "skeletal anchorage", "temporary anchorage devices", "miniscrew implant", "mini-implant", "micro-implant". Selected randomized control trials (RCTs) were assessed for their quality using Cochrane's Risk of Bias Tool, whereas the Newcastle-Ottawa scale was used for non-RCTs. Standardized mean difference (SMD) and 95% confidence interval (CI) were obtained with either fixed- or random-effects models based on the heterogeneity of the included studies. RESULTS A total of 5 articles (2 RCTs with moderate risk of bias and 3 high-quality non-RCT studies) were included in the final analysis. The nasolabial angle had significantly greater changes in the MI group than in the conventional anchorage group (SMD = 0.68, 95% CI = 0.39 to 0.97, P < .0001). Significantly higher retraction of the upper lip was seen in the MI group than in the conventional group (SMD = -0.51, 95% CI = -0.84 to -0.18; P = .002). No significant difference was seen in the facial convexity (SMD = -0.34, 95% CI = -0.76 to 0.07, P = .106) and lower lip retraction (SMD = 0.28, 95% CI = -1.72 to 2.28, P = .784) between the groups. CONCLUSION It was seen that MIs facilitated favorable soft tissue profile than the conventional anchorage devices. However, more high-quality studies are warranted to confirm the clinical effectiveness of MIs.
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Affiliation(s)
- Yan Liu
- Department of Orthodontics, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Zhen-Jin Yang
- Department of Orthodontics, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Jing Zhou
- Department of Stomatology, Yanan Hospital of Kunming City, Kunming, China.
| | - Ping Xiong
- Department of Orthodontics, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Quan Wang
- Department of Orthodontics, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Yan Yang
- Department of Orthodontics, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Yu Hu
- Department of Orthodontics, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Jiang-Tian Hu
- Department of Orthodontics, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
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Park CS, Yu HS, Cha JY, Mo SS, Lee KJ. Effect of archwire stiffness and friction on maxillary posterior segment displacement during anterior segment retraction: A three-dimensional finite element analysis. Korean J Orthod 2019; 49:393-403. [PMID: 31815107 PMCID: PMC6883216 DOI: 10.4041/kjod.2019.49.6.393] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/16/2019] [Accepted: 08/09/2019] [Indexed: 11/20/2022] Open
Abstract
Objective Sliding mechanics using orthodontic miniscrews is widely used to stabilize the anchorage during extraction space closure. However, previous studies have reported that both posterior segment displacement and anterior segment displacement are possible, depending on the mechanical properties of the archwire. The present study aimed to investigate the effect of archwire stiffness and friction change on the displacement pattern of the maxillary posterior segment during anterior segment retraction with orthodontic miniscrews in sliding mechanics. Methods A three-dimensional finite element model was constructed. The retraction point was set at the archwire level between the lateral incisor and canine, and the orthodontic miniscrew was located at a height of 8 mm from the archwire between the second premolar and first molar. Archwire stiffness was simulated with rectangular stainless steel wires and a rigid body was used as a control. Various friction levels were set for the surface contact model. Displacement patterns for the posterior and anterior segments were compared between the conditions. Results Both the anterior and posterior segments exhibited backward rotation, regardless of archwire stiffness or friction. Among the conditions tested in this study, the least undesirable rotation was found with low archwire stiffness and low friction. Conclusions Posterior segment displacement may be unavoidable but reducing the stiffness and friction of the main archwire may minimize unwanted rotations during extraction space closure.
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Affiliation(s)
- Choon-Soo Park
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyung-Seog Yu
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jung-Yul Cha
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea
| | - Sung-Seo Mo
- Division of Orthodontics, Department of Dentistry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kee-Joon Lee
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea.,Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
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Nonsurgical Orthodontic Intervention of a Severe Class II Case Accompanied by Posterior Crossbite Using a Miniscrew-Assisted Straight Wire Technique. Case Rep Dent 2019; 2019:5696370. [PMID: 31687219 PMCID: PMC6794968 DOI: 10.1155/2019/5696370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/14/2019] [Indexed: 11/25/2022] Open
Abstract
Class II malocclusion in nongrowing patients is a great challenge in treatment especially if the degree of malocclusion is severe. In such cases, the use of miniscrews for orthodontic camouflage can produce results comparable to that of orthognathic surgery. This case report presents an adult patient with severe Class II malocclusion combined with bilateral posterior crossbite, deep bite, a crowded lower arch, and a history of extraction of the lower right first molar. The treatment involved upper arch expansion by a quad helix appliance followed by the extraction of the right and left upper 1st premolars. A miniscrew-assisted straight wire technique was used to close the extraction space and reduce the overjet. Lower molar protraction was done to close the previous extraction space in the lower arch. At the end of treatment, overjet was reduced, lower arch crowding was relieved, lip competency was established, and the wide buccal corridor was reduced with a pleasing smile and normal facial proportions.
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Aly SA, Alyan D, Fayed MS, Alhammadi MS, Mostafa YA. Success rates and factors associated with failure of temporary anchorage devices: A prospective clinical trial. ACTA ACUST UNITED AC 2018; 9:e12331. [PMID: 29512336 DOI: 10.1111/jicd.12331] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 01/19/2018] [Indexed: 01/23/2023]
Abstract
AIM The objective of the present study was to investigate success rates and associated factors affecting temporary anchorage device (TAD) failure in different biomechanical applications. METHODS A total of 180 TADs were used as a part of 82 patients' treatment plan (24 males and 58 females); their mean age was 21.41 years. Three types of TADs were used: 50 (3M ESPE, Neuss, Germany), 56 (Bone screw; Jeil Medical, Seoul, Korea), and 74 (Morelli, Sorocaba, Brazil). Eight maxillary and four mandibular sites were selected for insertion. Three different lengths (6, 8, and 10 mm) and three different diameters (1.5, 1.6, and 1.8 mm) were used. The force levels were set at 50, 100, 150, 200, and 250 g. Patient-, implant-, and operator-dependent factors were evaluated throughout the 266 days of function. Qualitative variables were described by proportions and percentages and analyzed using χ2 test. RESULTS The overall success rate was 82.2%. The higher age group showed a significantly higher success rate. Oral hygiene showed a statistically-significant (P ˂ .05) difference between both success and failure groups. All other patient-related factors showed no significant differences. Regarding force levels used, the highest success rate was in 250 g and the lowest was in 100 g. There were no significant differences between both groups regarding other implant- and operator-related factors. CONCLUSIONS Temporary anchorage devices have a good success rate and are beneficial to be integrated in orthodontic treatment planning. Patient age, oral hygiene, and force level are the most significant factors affecting TAD success.
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Affiliation(s)
- Shehab A Aly
- Faculty of Dentistry, Future University, Cairo, Egypt
| | - Doha Alyan
- Faculty of Dentistry, Future University, Cairo, Egypt
| | - Mona S Fayed
- Department of Orthodontics and Dentofacial Orthopedics, Cairo University, Cairo, Egypt
| | - Maged S Alhammadi
- Department of Preventive Dental Science, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Yehya A Mostafa
- Department of Orthodontics and Dentofacial Orthopedics, Cairo University, Cairo, Egypt
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Lee KJ, Kim SJ. Advanced biomechanics for total arch movement and non-surgical treatment for hyperdivergent faces. Semin Orthod 2018. [DOI: 10.1053/j.sodo.2018.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Nanda R, Amat P. [Not Available]. Orthod Fr 2017; 88:297-317. [PMID: 29315064 DOI: 10.1051/orthodfr/2017029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Le Pr Ravindra Nanda a obtenu une licence et une maîtrise en dentisterie et en orthodontie du King George's Medical College, Lucknow University. En 1967, il a intégré l'Université Catholique de Nimègue, aux Pays-Bas, où il a obtenu un doctorat en philosophie en 1969. Il a rejoint la nouvelle école dentaire de Loyola à Chicago en 1970, après avoir occupé le poste de Professeur assistant en orthodontie dans le service dirigé par Frans van der Linden. En 1972, il fut promu au Département d'Orthodontie de l'Université du Connecticut à Farmington, CT, et y reçu son certificat en orthodontie sous la direction de Charles Burstone. Professeur adjoint, puis professeur titulaire à partir de 1979, il a assumé le poste de Chef du Département d'Orthodontie à partir de 1992 et a été promu pour diriger le Département des Sciences Craniofaciales en 2004, dont les divisions de chirurgie orale et maxillo-faciale, de dentisterie pédiatrique, de l'enseignement supérieur en dentisterie générale et en orthodontie.
Il est membre et ancien président de la composante Atlantique Nord de la Edward H. Angle Society of Orthodontists. Il occupe actuellement la fonction de rédacteur en chef de Progress in Orthodontics, de rédacteur associé du Journal of Clinical Orthodontics et est membre du comité éditorial de neuf revues d'orthodontie nationales et internationales. Il est membre de l'Association dentaire américaine, de l'Association dentaire de l'État du Connecticut, de la Hartford Dental Society, de l'Association américaine des orthodontistes, de la Société européenne d'orthodontie, de l'Association internationale de recherche dentaire et du College of Diplomates of American Board of Orthodontists.
Il a rédigé et publié sept manuels et plus de 200 articles dans des revues à comité de lecture. Il a donné des conférences magistrales dans plus de 40 pays et a reçu de nombreux prix et honneurs pour ses contributions en dentisterie et en orthodontie, aux États-Unis et de la part d'organisations internationales d'orthodontie. Il est membre d'honneur des Jordan Orthodontic Society, Czech Orthodontic Society, Taiwanese Orthodontic Society, Central American Orthodontics Society et membre d'honneur à vie de l'Indian Orthodontic Society.
Ravindra Nanda a été honoré du Life Time Achievement Award (University of Connecticut Foundation), et il est Senior Research Fellow (Japan Promotion for Science, Sendai, Japan − Tohoku University). Il a prononcé de nombreuses conférences d'honneur : la John Taylor Lecture, lors de la réunion annuelle de l'Australian Society of Orthodontics Foundation, la Sheldon Friel Memorial Lecture lors de la réunion annuelle de l'European Orthodontic Society, la Gordon Kirkness Memorial Lecture lors de la réunion annuelle de l'Australian Society of Orthodontics, la John Mershon Memorial Lecture, Boston, Massachusetts lors de la réunion annuelle de l'American Association of Orthodontics et la Wendell L. Wylie Memorial Lecture, à l'Université de San Francisco, Californie.
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Affiliation(s)
- Ravindra Nanda
- University of Connecticut, School of Dental Medicine Farmington, CT 06030-1725, États-Unis
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Wang XD, Lei FF, Liu DW, Zhang JN, Liu WT, Song Y, Zhou YH. Miniscrew-assisted customized lingual appliances for predictable treatment of skeletal Class II malocclusion with severe deep overbite and overjet. Am J Orthod Dentofacial Orthop 2017; 152:104-115. [PMID: 28651755 DOI: 10.1016/j.ajodo.2016.06.053] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 06/01/2016] [Accepted: 06/01/2016] [Indexed: 11/30/2022]
Abstract
This report describes the use of miniscrew-assisted customized lingual fixed appliances in a patient with severe skeletal Class II malocclusion. The patient was a 12-year-old Chinese girl with the chief complaint of protrusive lips and anterior teeth. Her diagnosis included a skeletal Class II relationship with maxillary protrusion, a backward-rotated mandible, a full Angle Class II molar relationship, and severe deep overjet and overbite. Four premolars were extracted, and miniscrew anchorage was placed in the maxillary posterior lingual segment to provide maximum anchorage and to achieve vertical control of the intruding molars. The customized lingual fixed appliance and temporary anchorage devices created a smooth and invisible treatment progress, resulting ultimately in a well-aligned dentition with ideal intercuspation and a dramatically improved profile. The 3-year follow-up examination indicated that the excellent treatment outcome was stable.
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Affiliation(s)
- Xue-Dong Wang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | | | - Da-Wei Liu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jie-Ni Zhang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | | | - Yang Song
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yan-Heng Zhou
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
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Wang XD, Zhang JN, Liu DW, Lei FF, Zhou YH. Nonsurgical correction of a severe anterior deep overbite accompanied by a gummy smile and posterior scissor bite using a miniscrew-assisted straight-wire technique in an adult high-angle case. Korean J Orthod 2016; 46:253-65. [PMID: 27478802 PMCID: PMC4965596 DOI: 10.4041/kjod.2016.46.4.253] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/26/2016] [Accepted: 04/11/2016] [Indexed: 02/07/2023] Open
Abstract
In the present report, we describe the successful use of miniscrews to achieve vertical control in combination with the conventional sliding MBT™ straight-wire technique for the treatment of a 26-year-old Chinese woman with a very high mandibular plane angle, deep overbite, retrognathic mandible with backward rotation, prognathic maxilla, and gummy smile. The patient exhibited skeletal Class II malocclusion. Orthodontic miniscrews were placed in the maxillary anterior and posterior segments to provide rigid anchorage and vertical control through intrusion of the incisors and molars. Intrusion and torque control of the maxillary incisors relieved the deep overbite and corrected the gummy smile, while intrusion of the maxillary molars aided in counterclockwise rotation of the mandibular plane, which consequently resulted in an improved facial profile. After 3.5 years of retention, we observed a stable, well-aligned dentition with ideal intercuspation and more harmonious facial contours. Thus, we were able to achieve a satisfactory occlusion, a significantly improved facial profile, and an attractive smile for this patient. The findings from this case suggest that nonsurgical correction using miniscrew anchorage is an effective approach for camouflage treatment of high-angle cases with skeletal Class II malocclusion.
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Affiliation(s)
- Xue-Dong Wang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jie-Ni Zhang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Da-Wei Liu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | | | - Yan-Heng Zhou
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
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Sivamurthy G, Sundari S. Stress distribution patterns at mini-implant site during retraction and intrusion--a three-dimensional finite element study. Prog Orthod 2016; 17:4. [PMID: 26780464 PMCID: PMC4716015 DOI: 10.1186/s40510-016-0117-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 01/08/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the stress patterns produced in mini-implant and alveolar bone, for various implant dimensions, under different directions of simulated orthodontic force, using a three-dimensional finite element method. METHODS Eight finite element (FE) models of mini-implant and bone were generated with insertion angles of 30° and 60°, diameters of 1 and 1.3 mm, and lengths of 6 and 8 mm. A simulated constant orthodontic force of 2 N was applied to each of these FE models in three directions simulating anterior retraction, anterior intrusion and retraction, and molar intrusion. RESULTS Comparison of the maximum von Mises stress in the mini-implant showed that the 1-mm diameter produced significantly high stress, and the amount of stress produced was more for a mini-implant inserted at an angle of 60°. The cortical bone showed that high stresses were generated for the 1-mm-diameter mini-implant and on increasing the insertion angulation from 30° to 60°, the stress produced increased as well. The comparison of von Mises stress in the cancellous bone was insignificant as the amount of stress transmitted was very low. CONCLUSIONS The 1-mm-diameter mini-implants are not safe to be used clinically for orthodontic anchorage. The 1.3 × 6 mm dimension mini-implants are recommended for use during anterior segment retraction and during simultaneous intrusion and retraction, and the 1.3 × 8 mm dimension mini-implant is recommended for use during molar intrusion. All mini-implants should be inserted at a 30° angle into the bone for reduced stress and improved stability.
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Affiliation(s)
| | - Shantha Sundari
- Department of Orthodontics, Saveetha Dental College and Hospital, Saveetha University, No. 162, Poonamallee High Road, Chennai, 600077, Tamil Nadu, India.
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Iwai H, Motoyoshi M, Uchida Y, Matsuoka M, Shimizu N. Effects of tooth root contact on the stability of orthodontic anchor screws in the maxilla: Comparison between self-drilling and self-tapping methods. Am J Orthod Dentofacial Orthop 2015; 147:483-91. [DOI: 10.1016/j.ajodo.2014.12.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 12/01/2014] [Accepted: 12/01/2014] [Indexed: 10/23/2022]
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Camouflage of Severe Skeletal Class II Gummy Smile Patient Treated Nonsurgically with Mini Implants. Case Rep Dent 2014; 2014:382367. [PMID: 25548686 PMCID: PMC4274844 DOI: 10.1155/2014/382367] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 10/28/2014] [Indexed: 11/17/2022] Open
Abstract
Skeletal class II has always been a challenge in orthodontics and often needs assistance of surgical orthodontics in nongrowing patients when it presents with severe discrepancy. Difficulty increases more when vertical dysplasia is also associated with sagittal discrepancy. The advent of mini implants in orthodontics has broadened the spectrum of camouflage treatment. This case report presents a 16-year-old nongrowing girl with severe class II because of retrognathic mandible, and anterior dentoalveolar protrusion sagittally and vertically resulted in severe overjet of 13 mm and excessive display of incisors and gums. Both maxillary central incisors were trimmed by general practitioner few years back to reduce visibility. Treatment involved use of micro implant for retraction and intrusion of anterior maxillary dentoalveolar segment while lower incisors were proclined to obtain normal overjet, and overbite and pleasing soft tissue profile. Smile esthetics was further improved with composite restoration of incisal edges of both central incisors.
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S C, Keluskar KM, Vasisht VN, Revankar S. En-masse Retraction of the Maxillary Anterior Teeth by Applying Force from Four Different Levels - A Finite Element Study. J Clin Diagn Res 2014; 8:ZC26-30. [PMID: 25386516 DOI: 10.7860/jcdr/2014/8408.4831] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 06/19/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To find out if it is possible to control maxillary anterior teeth in sagittal and vertical plane during retraction by altering the vertical levels of force application in the posterior region, i.e. identifying the type of movement of the maxillary anterior teeth which occurs when force would be applied from four different levels i.e. High, Medium, and Low pull Implants and from a conventional Molar hook and also to quantify the retraction and intrusion components of force thus setting a guideline for the implant height placement. MATERIALS AND METHODS A Finite Element Model of maxillary dentition along with alveolar bone, brackets and wire was developed with defined material properties. The model was analysed to calculate the displacement when force was applied from different levels. RESULTS From all points of force application, anterior teeth tipped lingually in the sagittal plane, whereas in the vertical plane extrusion was seen when retracted from molar hook and intrusion was seen when retracted from implants. For every mm of apical displacement of implant, the retraction component of force reduces approximately by around 1% and intrusion component of force increases approximately by around 0.3%. CONCLUSION Based on the results of this study we can reckon that by changing the position of implant in vertical plane one will have very little effect on the type of tooth movement. As the point of force application moves apically, type of tooth movement in the sagittal plane remained almost constant and in vertical plane intrusion is slightly increased.
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Affiliation(s)
- Chetan S
- Assistant Professor, Department of Orthodontics & Dentofacial Orthopedics, College of Dental Sciences , Davangere, India
| | - Kanhoba M Keluskar
- Professor and Head, Department of Orthodontics & Dentofacial Orthopedics, KLE Vishwanath Katti Institute of Dental Sciences , KLE University, Belgaum, India
| | - Vikram N Vasisht
- Private Practitioner, Townsville CBD 4810, Queensland, Australia
| | - Siddharth Revankar
- Assistant Professor, Department of Orthodontics & Dentofacial Orthopedics, Maratha Mandal Dental College , Belgaum, India
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Abstract
Mini-implants have been successfully incorporated into orthodontic practice all over the world. One of the most popular applications of mini-implant anchorage is to facilitate retraction of the anterior teeth. This article reviews the mechanics involved in anterior tooth retraction with mini-implant supported anchorage. An attempt has been made to synthesize information available in the literature and present it in a manner that is easily understandable from a clinical perspective. We discuss the fundamental differences mini-implant based incisor retraction has when compared to conventional techniques, mechanical factors affecting this process and provide a step-by-step analysis of incisor retraction. In addition, various models of space closure are discussed that have evolved through careful evaluation of in vitro and in vivo experiments.
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Affiliation(s)
- Madhur Upadhyay
- University of Connecticut, Health Center, Farmington, CT, USA
| | - Sumit Yadav
- University of Connecticut, Health Center, Farmington, CT, USA
| | - Ravindra Nanda
- University of Connecticut, Health Center, Farmington, CT, USA
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19
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On a definition of the appropriate timing for surgical intervention in orthognathic surgery. Int J Oral Maxillofac Surg 2014; 43:846-55. [DOI: 10.1016/j.ijom.2014.02.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 01/07/2014] [Accepted: 02/17/2014] [Indexed: 11/22/2022]
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Moresca R. Class I malocclusion with severe double protrusion treated with first premolars extraction. Dental Press J Orthod 2014; 19:127-38. [PMID: 25162577 PMCID: PMC4296619 DOI: 10.1590/2176-9451.19.3.127-138.bbo] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 04/15/2014] [Indexed: 11/23/2022] Open
Abstract
Angle Class I malocclusion with bymaxillary protrusion is characterized by severe buccal tipping of incisors, which causes upper and lower lip protrusion. First premolars extraction is recommended to reduce facial convexity as a result of anterior teeth retraction, which keeps canines and first molars in key to occlusion. In order to yield orthodontic results that are compatible with ideal esthetic and cephalometric outcomes, the space closure phase needs to be carried out with overbite and incisors torque control. The majority of cases also requires maximum anchorage of posterior teeth. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) as a requirement for the title of certified by the BBO.
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Affiliation(s)
- Ricardo Moresca
- PhD in Orthodontics, School of Dentistry - University of São Paulo.
MSc in Orthodontics, Methodist University of São Paulo (UMESP). Specialist in
Orthodontics, Federal University of Paraná (UFPR). Adjunct professor, Department of
Orthodontics, Federal University of Paraná (UFPR). Full Professor and Head of the
Postgraduate program in Orthodontics, Positivo University. Certified by the Brazilian
Board of Orthodontics and Facial Orthopedics (BBO)
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Moon W. An interview with Won Moon. By André Wilson Machado, Barry Briss, Greg J Huang, Richard Kulbersh and Sergei Godeiro Fernandes Rabelo Caldas. Dental Press J Orthod 2014; 18:12-28. [PMID: 24228299 DOI: 10.1590/s2176-94512013000300005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Baik UB, Bayome M, Han KH, Park JH, Jung MH, Kook YA. Evaluation of factors affecting the success rate of orthodontic mini-implants by survival analysis. World J Stomatol 2013; 2:56-61. [DOI: 10.5321/wjs.v2.i3.56] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 02/21/2013] [Accepted: 04/11/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the success rate of mini-implants and its characteristics and risk factors by survival analyses.
METHODS: Three hundred and ninety-four mini-implants of the same type were placed by a single clinician. Age, gender, treatment duration, time of failure, side and jaw of implantation and the soft tissue at placement site were recorded. Odds ratio, survival curves, and Cox proportional hazard model were applied to evaluate the factors influencing the mini-implants’ success rate.
RESULTS: The cumulative success rate was 88.1%. The maxilla had a significantly higher success rate than that of the mandible (91.7% vs 83.7%, respectively, P = 0.019). Placement of mini-implants in the attached gingiva (AG) showed a higher success rate than that of the mucogingival junction (MGJ) and mucous membrane (MM) (AG, 94.3%; MGJ, 85.8%; MM, 79.4%; P < 0.001). Significant association was found between the jaw and the gingival tissue type (P < 0.001). There were no significant differences between maxilla and mandible when compared within each placement site.
CONCLUSION: The gingival tissue type had the most significant effect on the success rate of the mini-implant with higher success rate in the attached gingiva.
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24
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Skeletal and dental considerations in orthodontic treatment mechanics: a contemporary view. Eur J Orthod 2012; 35:634-43. [DOI: 10.1093/ejo/cjs054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Upadhyay M, Yadav S, Nagaraj K, Uribe F, Nanda R. Mini-implants vs fixed functional appliances for treatment of young adult Class II female patients: a prospective clinical trial. Angle Orthod 2011; 82:294-303. [PMID: 21867432 DOI: 10.2319/042811-302.1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare the treatment effects of maxillary anterior teeth retraction with mini-implant anchorage in young adults with Class II division 1 malocclusion undergoing extraction of the maxillary first premolars with similar patients treated by a fixed functional appliance. MATERIALS AND METHODS Thirty-four young adult female patients (mean age 16.5 ± 3.2 years, overjet ≥ 6 mm) with a Class II division 1 malocclusion were divided into two groups: group 1 (G1), in which overjet correction was obtained with a fixed functional appliance (FFA), and group 2 (G2), in which upper first premolars were extracted, followed by space closure with MIs as anchor units. Dentoskeletal and soft tissue changes were analyzed on lateral cephalograms taken before (T1) and after (T2) correction of the overjet. RESULTS Both methods were useful in improving the overjet and interincisal relationships. Extrusion and mesial movement of the lower molar, together with lower incisor proclination, were noted in G1. G2 showed distalization and intrusion of the upper molar. The nasio-labial angle became more obtuse in G2, while lower lip protrusion was seen for G1. CONCLUSIONS The two treatment protocols provided adequate dental compensation for the Class II malocclusion, but did not correct the skeletal discrepancy. There were significant differences in the dental and soft tissue treatment effects between the two treatment protocols.
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Affiliation(s)
- Madhur Upadhyay
- Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut, Health Center, Farmington, CT 06030, USA.
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Wu JH, Lu PC, Lee KT, Du JK, Wang HC, Chen CM. Horizontal and vertical resistance strength of infrazygomatic mini-implants. Int J Oral Maxillofac Surg 2011; 40:521-5. [DOI: 10.1016/j.ijom.2011.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Revised: 12/09/2010] [Accepted: 01/12/2011] [Indexed: 11/25/2022]
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Morgon L. [Adult orthodontics. Anchorage in the adult]. Orthod Fr 2011; 82:95-106. [PMID: 21457697 DOI: 10.1051/orthodfr/2011100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Pernier C, Bridel N, Diemunsch C. [Adult orthodontics. Conventional orthodontics]. Orthod Fr 2011; 82:107-120. [PMID: 21457698 DOI: 10.1051/orthodfr/2011101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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