The placement of orthodontic appliances affects the subgingival microbial composition even during the early period of orthodontic treatment, increasing the prevalence of periodontopathogens, especially in the molar region.

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Objective: To evaluate the accuracy of the superimposition of three-dimensional (3D) digital models using the palatal surface as a reference for measuring tooth movements. Materials and Methods: Maxillary plaster models were selected from 20 patients. The right and left canines, premolars, and molars were individually cut underneath the gingival margins and set up in wax (plaster model 1 5 PM1). The PM1s were scanned to create 3D digital models (digital model 1 5 DM1). Teeth on the PM1s were randomly moved (plaster model 2 5 PM2) and subsequently scanned to produce another set of 3D digital models (digital model 2 5 DM2). DM1s and DM2s were superimposed using the palatal area as reference via surface-to-surface matching software, and the changes in tooth movement were calculated. In the plaster models, the tooth movements were directly measured using the Reference Measurement Instrument. A paired t-test and a correlation analysis were performed to determine whether the two measurement methods differed significantly. Results: The means of the anteroposterior (x-axis), transverse (y-axis), and vertical (z-axis) tooth movements of the plaster models and the digital models did not differ significantly, and very high correlations were found between the plaster models and the digital models. Conclusion: From a technical point of view, the superimposition of 3D digital models using the palatal surface provides accurate and reliable measurements, but it remains to be investigated how stable the palatal surface is longitudinally after growth and/or orthopedic treatment take place. (Angle Orthod. 2010;80:685-691.)

ObjectiveThe purpose of this study was to evaluate the validity of the 3-dimensional (3D) superimposition method of digital models in patients who received treatment with rapid maxillary expansion (RME) and maxillary protraction headgear.MethodsThe material consisted of pre- and post-treatment maxillary dental casts and lateral cephalograms of 30 patients, who underwent RME and maxillary protraction headgear treatment. Digital models were superimposed using the palate as a reference area. The movement of the maxillary central incisor and the first molar was measured on superimposed cephalograms and 3D digital models. To determine whether any difference existed between the 2 measuring techniques, intra-class correlation (ICC) and Bland-Altman plots were analyzed.ResultsThe measurements on the 3D digital models and cephalograms showed a very high correlation in the antero-posterior direction (ICC, 0.956 for central incisor and 0.941 for first molar) and a moderate correlation in the vertical direction (ICC, 0.748 for central incisor and 0.717 for first molar).ConclusionsThe 3D model superimposition method using the palate as a reference area is as clinically reliable for assessing antero-posterior tooth movement as cephalometric superimposition, even in cases treated with orthopedic appliances, such as RME and maxillary protraction headgear.

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Objectives: To evaluate area-and gender-related differences in the soft tissue thickness of potential areas for installing miniscrews in the buccal-attached gingiva and the palatal masticatory mucosa. Materials and Methods:The sample consisted of 61 Korean young adults. An ultrasonic gingivalthickness meter was used to measure the soft-tissue thickness in the buccal-attached gingiva just adjacent to the mucogingival junction of the upper and lower arches and 4 mm and 8 mm below the gingival crest in the palatal masticatory mucosa. Independent t-test, paired t-test, and oneway analysis of variance were used for statistical analysis. Results: Buccal-attached gingiva thickness in the upper arch was significantly greater in men than in women, but buccal-attached gingiva thickness in the lower arch and palatal masticatory mucosa thickness 4 and 8 mm below the gingival crest did not show gender differences. Significantly thicker soft tissue occurred in the anterior areas in the upper arch and in the posterior areas in the lower arch. In the palatal masticatory mucosa, significantly thicker soft tissue was found 4 mm below the gingival crest in the anterior areas and 8 mm below the gingival crest in the posterior areas. The areas between the canines and the premolars showed higher values than other areas 4 mm below the gingival crest. However, the soft-tissue thickness 8 mm below the gingival crest showed a progressive increase from the anterior to the posterior areas. Conclusion: Measurements of the soft-tissue thickness using an ultrasonic device could help practitioners select the proper orthodontic miniscrew in daily clinical practice.

The buccal and lingual alveolar surface near the dentition seems to be inappropriate as a reference area for superimposing 3D mandibular digital models of patients without a mandibular torus. Mandibular tori in adult patients are stable structures which can be used as reference areas for the superimposition of 3D mandibular digital models.

Periodontopathogens during orthodontic treatment were significantly reduced within 3 months of appliance removal. However, how long it takes to return to the preorthodontic composition of the subgingival microbiota and whether it happens at all remain to be seen.