Korean J Orthod.  2017 May;47(3):167-175. 10.4041/kjod.2017.47.3.167.

Maxillomandibular arch width differences at estimated centers of resistance: Comparison between normal occlusion and skeletal Class III malocclusion

• Koo YJ
• Choi SH
• Keum BT
• Yu HS
• Hwang CJ
• Melsen B
• Lee KJ

• KMID: 2379650
• DOI: http://doi.org/10.4041/kjod.2017.47.3.167

Abstract

OBJECTIVE
To evaluate the differences in maxillomandibular transverse measurements at either the crown or the estimated center of resistance (CR), and to compare values between normal occlusion and Class III malocclusion groups.
METHODS
Dental casts and computed tomography (CT) data from 30 individuals with normal occlusion and 30 with skeletal Class III malocclusions were evaluated. Using the casts, dental arch widths (DAWs) were measured from the cusp tips, and basal arch widths (BAWs-cast) were measured as the distance between the points at the mucogingival junction adjacent to the respective cusp tips. The BAWs determined from CT (BAWs-CT) images were measured from the estimated CRs of the teeth.
RESULTS
None of the DAW measurements or maxillomandibular DAW differences showed statistically significant intergroup differences. In contrast, the maxillary BAWs-CT and BAWs-cast were lesser in the Class III malocclusion group than in the normal occlusion group. The mandibular BAWs-CT were significantly greater in the Class III malocclusion group than in the normal occlusion group. Moreover, the maxillomandibular BAW differences on both CT and cast showed significant intergroup differences in all transverse measurements.
CONCLUSIONS
The maxillomandibular DAW differences showed no significant intergroup differences. In contrast, the maxillomandibular BAW differences on both CT and cast showed significant intergroup differences in all transverse measurements. The maxillomandibular BAW differences at the estimated CRs, measured using CT or casts, can reveal underlying transverse maxillary basal arch deficiencies in patients with skeletal Class III malocclusions.

Keyword

Centers of resistance; Maxillomandibular basal arch width differences; Class III malocclusion; Computed tomography

MeSH Terms

Crowns
Dental Arch
Humans
Malocclusion*
Tooth

Figure

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  Figure 1 Dental arch width on cast (DAW). A, Maxilla: 1, canine; 2, premolar; 3, 1st molar; 4, 2nd molar. B, Mandible: 5, canine; 6, premolar; 7, 1st molar; 8, 2nd molar. Basal arch width on cast (BAW-cast). A, Maxilla: a, canine; b, premolar; c, first molar; d, second molar. B, Mandible: e, canine; f, premolar; g, first molar; h, second molar.

• 

  Figure 2 Basal arch width on three-dimensional computed tomography (BAW-CT). The digitization of centers of resistance: a single-rooted tooth, at the level of the coronal one-third; a multirooted tooth, at the level of the furcation. A, Maxilla: 1, canine; 2, premolar; 3, 1st molar; 4, 2nd molar. B, Mandible: 5, canine; 6, premolar; 7, 1st molar; 8, 2nd molar.

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  Figure 3 Dental compensation of the maxillary and mandibular posterior teeth. A, A patient exhibiting a constricted mandibular arch with several lingually tilted posterior teeth at initial treatment. B, An end-to-end relationship on the left second molar side is shown after alignment. Red circle indicates estimated center of resistance. C, The superimposition via three-dimensional (3D) rendering shows the changes in the transverse molar relationship before (white) and after (yellow) alignment. Unknown moment on the maxillary and mandibular first molars resulted in uncontrolled rotation, leading to iatrogenic transverse dental decompensation. No differences were observed in the BAW-CT of both the arches at the first molar before and after alignment using a rectangular wire. Purple circle, the estimated center of resistance of the maxillary and mandibular first molar.BAW-CT, Basal arch width on the computed tomography image.

• 

  Figure 4 Correction of the maxillary basal arch width (BAW) by using a miniscrew-assisted rapid palatal expansion appliance (MARPE). A, A patient exhibiting a constricted maxillary arch and initial transverse dental compensation of the maxillary posterior teeth. B, MARPE is used to expand the maxillary BAW. C, The posttreatment dental cast shows that ideal occlusion was established with the proper long axis of the maxillary posterior teeth. D, The superimposition via three dimensional rendering shows that the maxillary (BAW-CT) at the first molar was corrected from 46.2 to 51.0 mm before (white) and after treatment (yellow), respectively. The estimated center of resistance of the maxillary first molar displaced before (purple circle) and after treatment (gray circle) using MARPE.

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  Figure 5 A schematic diagram for the Yonsei Transverse Index (YTI).Mx., Maxilla; Mn., mandible; CR, center of resistance; NS, not significant.

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