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Biomedical subjects

Shingo Kuroda

Publications and source records attributed to Shingo Kuroda.

7 recordsLinked to original sources

Clinical use of miniscrew implants as orthodontic anchorage: success rates and postoperative discomfort.

INTRODUCTION: In this study, we evaluated the clinical usefulness of miniscrews as orthodontic anchorage. We examined their success rates, analyzed factors associated with their stability, and evaluated patients' postoperative pain and discomfort with a retrospective questionnaire. METHODS: Seventy-five patients, 116 titanium screws of 2 types, and 38 miniplates were retrospectively examined. Each patient was given a questionnaire that included a visual analog scale to indicate discomfort after implantation. RESULTS: The success rate for each type of implant was greater than 80%. The analysis of 79 miniscrews with a 1.3-mm diameter showed no significant correlations between success rate and these variables: age, sex, mandibular plane angle, anteroposterior jaw-base relationship, control of periodontitis, temporomandibular disorder symptoms, loading, and screw length. Most patients receiving titanium screws or miniplates with mucoperiosteal-flap surgery reported pain, but half of the patients receiving miniscrews without flap surgery did not report feeling pain at any time after placement. In addition, patients with miniscrews reported minimal discomfort due to swelling, speech difficulty, and difficulty in chewing. CONCLUSIONS: Miniscrews placed without flap surgery have high success rates with less pain and discomfort after surgery than miniscrews placed with flap surgery or miniplates placed with either procedure.

Adult↗

Skeletal anchorage for orthodontic correction of maxillary protrusion with adult periodontitis.

Because the number of adult patients seeking orthodontic treatment is increasing, orthodontists are becoming more likely to encounter patients with adult periodontitis. However, it is sometimes difficult to establish anchorage because of poor periodontal tissues in patients with adult periodontitis. This article reports the successful use of skeletal anchorage to treat a maxillary protrusion case complicated by severe adult periodontitis. A female patient aged 50 years seven months showed a skeletal Class II jaw base relationship. A spacing of five mm in the upper anterior teeth with an overjet of 7.5 mm and overbite of four mm was observed. She had generalized horizontal bone loss in both arches, with vertical bone loss in the posterior segment. After periodontal treatment, miniplates were placed in the zygomatic process, and retraction and intrusion of the maxillary incisors were performed. After active treatment for 21 months, the upper incisors had been inclined 9.5 degrees lingually, intruded two mm at the apex, and good anterior occlusion was achieved. Acceptable occlusion and periodontal tissue were maintained after a retention period of two years. Our results suggest that skeletal anchorage is useful for retraction and intrusion of upper incisors in cases of maxillary protrusion with severe adult periodontitis.

Female↗

Skeletal Class III oligodontia patient treated with titanium screw anchorage and orthognathic surgery.

This article reports the successful treatment of a patient, aged 15 years 8 months, with a Class III malocclusion and oligodontia; a titanium screw was used for absolute anchorage during treatment. The patient had a concave profile because of mandibular excess and asymmetric spaces in both arches. Titanium screws were implanted in the retromolar area during intraoral vertical ramus osteotomy combined with LeFort I osteotomy. Absolute anchorage was provided with anchorage wires extending from the screws to the left canine and the right lateral incisor. After orthodontic space closure, the mandibular molars were moved mesially without lingual tipping of the mandibular incisors. A good interincisal relationship was achieved. Our results suggest that titanium screws and anchorage wires in the retromolar area are useful for the mesial movement of mandibular molars.

Adolescent↗

Maxillary distraction osteogenesis to treat maxillary hypoplasia: comparison of an internal and an external system.

BACKGROUND: Distraction osteogenesis (DO) has become a mainstream surgical technique for patients with jaw deformities. In cases of maxillary hypoplasia, DO with a rigid external distraction (RED) system has been used for maxillary advancement; however, DO with internal devices is currently popular. MATERIALS: This article describes DO with an internal device and a RED system in 2 patients with maxillary hypoplasia with oligodontia. The first patient, a young girl, had a concave profile due to maxillary hypoplasia and 9 congenitally missing permanent teeth. At age 11 years 11 months, she received DO with an internal device. The second patient, a boy aged 11 years 7 months, was treated with DO with a RED system. RESULTS: In the girl, the maxilla was advanced 5.0 mm without any dentoalveolar compensation. In the boy, the maxilla was advanced 7.0 mm, but undesirable mesial movement of posterior teeth was observed. CONCLUSIONS: DO with internal devices is simpler and more useful than the RED system for maxillary hypoplasia with oligodontia.

Anodontia↗

Nonextraction treatment of upper canine-premolar transposition in an adult patient.

This article reports the successful treatment of a unilateral maxillary canine and first premolar transposition without the extraction of the premolar in an adult patient. A female patient, 21 years and three months of age, had moderate crowding in the upper arch with complete transposition of the canine and first premolar. After distal movement of the upper molars with a lingual arch and headgear appliance, the upper left first premolar and canine were transposed. Thirty-eight months after the placement of preadjusted appliances, the transposed canine and premolar were reordered in the proper positions. The total active treatment period was 49 months. After two years of retention, the occlusion is generally stable.

Adult↗

Severe anterior open-bite case treated using titanium screw anchorage.

Anterior open bite is often caused by a downward rotation of the mandible and/or by excessive eruption of the posterior teeth. In such cases, it is difficult to establish absolute anchorage for molar intrusion by traditional orthodontic mechanics. This article reports the successful treatment of a severe skeletal anterior open-bite case using titanium screw anchorage. A female patient 33 years eight months of age had open bite of -7.0 mm and increased facial height. The titanium screws were implanted in both the maxilla and the mandible, and an intrusion force was provided with elastic chains for 13 months. After active treatment of 19 months, her upper and lower first molars were intruded about 3.0 mm each, and good occlusion was achieved. Her retrognathic chin and convex profiles were improved by an upward rotation of the mandible. Our results suggest that titanium screws are useful for intrusion of molars in anterior open-bite cases.

Adult↗