Korean J Orthod.  2016 Sep;46(5):280-289. 10.4041/kjod.2016.46.5.280.

Three-dimensional evaluation of tooth movement in Class II malocclusions treated without extraction by orthodontic mini-implant anchorage

• Ali D
• Mohammed H
• Koo SH
• Kang KH
• Kim SC

• KMID: 2352290
• DOI: http://doi.org/10.4041/kjod.2016.46.5.280

Abstract

OBJECTIVE
The aim of this study was to analyze tooth movement and arch width changes in maxillary dentition following nonextraction treatment with orthodontic mini-implant (OMI) anchorage in Class II division 1 malocclusions.
METHODS
Seventeen adult patients diagnosed with Angle's Class II division 1 malocclusion were treated by nonextraction with OMIs as anchorage for distalization of whole maxillary dentition. Three-dimensional virtual maxillary models were superimposed with the best-fit method at the pretreatment and post-treatment stages. Linear, angular, and arch width variables were measured using Rapidform 2006 software, and analyzed by the paired t-test.
RESULTS
All maxillary teeth showed statistically significant movement posteriorly (p < 0.05). There were no significant changes in the vertical position of the maxillary teeth, except that the second molars were extruded (0.86 mm, p < 0.01). The maxillary first and second molars were rotated distal-in (4.5°, p < 0.001; 3.0°, p < 0.05, respectively). The intersecond molar width increased slightly (0.1 mm, p > 0.05) and the intercanine, interfirst premolar, intersecond premolar, and interfirst molar widths increased significantly (2.2 mm, p < 0.01; 2.2 mm, p < 0.05; 1.9 mm, p < 0.01; 2.0 mm, p < 0.01; respectively).
CONCLUSIONS
Nonextraction treatment with OMI anchorage for Class II division 1 malocclusions could retract the whole maxillary dentition to achieve a Class I canine and molar relationship without a change in the vertical position of the teeth; however, the second molars were significantly extruded. Simultaneously, the maxillary arch was shown to be expanded with distal-in rotation of the molars.

Keyword

Tooth movement; Class II division 1 malocclusion; Nonextraction treatment; Mini-implant anchorage

MeSH Terms

Adult
Bicuspid
Dentition
Humans
Malocclusion*
Methods
Molar
Tooth Movement*
Tooth*

Figure

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  Figure 1 Superimposition of three-dimensional pretreatment and post-treatment virtual maxillary models.

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  Figure 2 Confirmation of the accuracy of superimposition of the three-dimensional (3D) virtual maxillary models. The angle between the Frankfort horizontal (FH) plane and the maxillary occlusal plane in the lateral cephalogram was measured pretreatment (T0) and post-treatment (T1) to verify a change in the occlusal plane of the 3D virtual maxillary models between T0 and T1. If the angular difference between the 3D virtual models and lateral cephalograms was greater than 5o, superimposition of the 3D models was repeated to correct the error.

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  Figure 3 A, Facial axis (FA) points. B, Definition of the coordinate system established at the FA point; the X-axis is the horizontal one, the Y-axis is the vertical one, and the Z-axis is a sagittal axis perpendicular to the X-axis and Y-axis.

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  Figure 4 Definition of reference planes. A, The horizontal plane was set to the uppermost region in the midpalatal area, and was parallel to the occlusal plane. B, The coronal plane was set to be perpendicular to the horizontal plane connecting the facial axis points of the upper right and left second molars at the pretreatment (T0) stage. C, The midsagittal plane was set to be perpendicular to the horizontal and coronal planes passing through a midpoint between the maxillary right and left central incisor edges. D, The point of origin was set at the intersection of the horizontal, coronal, and mid-sagittal planes.

• 

  Figure 5 Definitions of linear and angular variables. A, Anteroposterior displacement (mm): distance between the facial axis (FA) point and the coronal plane. For the difference between pretreatment (T0) and post-treatment (T1), i.e., T0–T1, positive means posterior movement and negative means anterior movement. B, Vertical displacement (mm): distance between the FA point and the horizontal plane. For T0–T1, positive means intrusion and negative means extrusion. C, Molar rotation (°): the angle made with the x-axis of an individual molar tooth and the midsagittal plane on the occlusal plane. For T0–T1, positive means mesial-in rotation and negative means distal-in rotation.

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  Figure 6 Definitions of arch width variables. Intercanine width (ICW), distance between the cusp tip of right and left maxillary canines; interfirst premolar width (IP1W), distance between the cusp tip of right and left maxillary first premolars; intersecond premolar width (IP2W), distance between the cusp tip of right and left maxillary second premolars; interfirst molar width (IM1W), distance between the mesiobuccal cusp tip of right and left maxillary first molars; intersecond molar width (IM2W), distance between the mesiobuccal cusp tip of right and left maxillary second molars.

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