Korean J Orthod.  2022 Sep;52(5):354-361. 10.4041/kjod22.140.

A cone-beam computed tomography study on strategic uprighting of mandibular molars using a biocreative reverse curve system

• Kim JW
• Choi JY
• Kim MJ
• Bin X
• Kim SH

• KMID: 2533260
• DOI: http://doi.org/10.4041/kjod22.140

Abstract

Objective
To analyze the overall treatment effects in terms of the amount of uprighting with changes in the three-dimensional positions of the mandibular posterior teeth after applying the biocreative reverse curve (BRC) system.
Methods
Thirty-four patients (mean age, 20.5 ± 8.56 years) were treated using the BRC system (mean period, 8.17 ± 2.19 months). Cone-beam computed tomography was performed before treatment and after treatment with the BRC system. The three-dimensional movement of each tooth was analyzed in the coordinate system at points on the crown and root apex. A paired t-test was used to analyze the treatment effects of the BRC system.
Results
The application of the BRC system spanning from the first premolar to the second molar resulted not only in buccal and distal uprighting, but also in increased buccal and distal tipping of the teeth. The premolars and the first molar were extruded, and the second molar was intruded.
Conclusions
When the BRC system is applied, simultaneous distal and buccal uprighting of the premolars and molars can be achieved bilaterally using a temporary skeletal anchorage device without unnecessary movement of the anterior teeth.

Keyword

Molar uprighting; Biocreative reverse curve; Miniplate; Computed tomography

Figure

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  Figure 1 Clinical application of the biocreative reverse curve (BRC) system. A, Initial. B, Application of BRC. C, 8 months after BRC. D, Superimposition.

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  Figure 2 Orientation. A, Reference points in frontal view. B, Reference points in lateral view. C, Coordinate axes. Rt., right; Lt., left; MF, mental foramen; Go, gonion; Me, menton.

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  Figure 3 Landmark determination process. A, Landmark determination in the ON3D program (3D ONS Inc., Seoul, Korea) (pre-BRC). B, Landmark determination in the ON3D program (post-BRC). C, Reference point of landmarks. BRC, biocreative reverse curve.

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  Figure 4 Inclination change. A, Pre-BRC inclination of the mandibular first molar. B, Post-BRC inclination of the mandibular first molar with apparent change in angulation. C, Pre-BRC inclination of the mandibular first molar. D, Post-BRC inclination of the mandibular first molar. BRC, biocreative reverse curve.

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  Figure 5 Changes in angulation and inclination before and after biocreative reverse curve system application. A, Angulation change. B, Inclination change. L4, the mandibular first premolar; L5, the mandibular second premolar; L6, the mandibular first molar; L7, the mandibular second molar; T1, pre-biocreative reverse curve (BRC); T2, post-BRC.

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  Figure 6 Application of the twisting technique in the biocreative reverse curve (BRC) system. A, Placement of metal stop accessories. B, Archwire twisting and fixation with flowable resin composite. C, Intrusive force by twisting technique. D, Cross-sectional illustration of the twisting BRC technique. E, The biomechanics of the twisting BRC system.

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