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The aim of this retrospective study was to determine differences between the outcomes of treatment using implant anchorage compared with straight-pull headgear and intermaxillary elastics in bimaxillary protrusion patients. The lateral cephalograms of 28 adult orthodontic patients (3 males and 25 females; age, 24.9 ± 5.0 years) who had an Angle Class I malocclusion with bimaxillary protrusion were selected. Group 1 (14 patients; 1 male and 13 females; age, 25.0 ± 5.1 years) received sliding mechanics with implant anchorage and group 2 (14 patients; 2 males and 12 females; age, 24.8 ± 5.1 years) a straight-pull headgear and intermaxillary elastics. Lateral cephalometric radiographs obtained before and after treatment were traced, 13 landmarks identified, and differences in the skeletal and dental changes compared between the groups. Wilcoxon's signed-rank test was used to determine changes within the treatment groups and a Mann-Whitney U-test to evaluate significant differences. More anchorage loss occurred at the maxillary posterior teeth in group 2 (2.1 mm) than in group 1 (0.1 mm). Closing rotation of the mandible occurred in group 1, while opening rotation of the mandible was observed in group 2. These results suggest that sliding mechanics with implant anchorage may provide absolute anchorage and could control mandibular rotation more than the conventional technique.

Abstract:We performed an orthodontic treatment combined with corticotomy and the placement of titanium miniplates in an adult patient who desired a shortened treatment period. The patient had an Angle Class I malocclusion with flaring of the maxillary and mandibular incisors. First, titanium miniplates were placed into the buccal alveolar bone of the maxilla for absolute orthodontic anchorage. Second, an edgewise appliance was applied to the maxillary and mandibular teeth. Then, the maxillary first premolars and mandibular second premolars were extracted. At the same time, a corticotomy was performed on the cortical bone of the lingual and buccal sides in the maxillary anterior as well as the mandibular anterior and posterior regions. Leveling was initiated immediately after the corticotomy. The extraction spaces were closed with conventional orthodontic force (approximately 1 N per side). The edgewise appliance was adjusted once every 2 weeks. The total treatment time was 1 year. Cephalometric superimpositions showed no anchorage loss, and panoramic radiographs showed neither significant reduction in the crest bone height nor marked apical root resorption. A corticotomy-facilitated orthodontic treatment with titanium miniplates might shorten an orthodontic treatment period without any anchorage loss or adverse effects.

A 43-year-old man presented with gastrointestinal bleeding. A tumor with central ulceration was observed in the jejunum, with the use of a new enteroscopy system called "double-balloon enteroscopy". Bleeding after biopsy sampling of the tumor was controlled endoscopically by using electrocoagulation. Histological findings of the biopsy specimens were consistent with gastrointestinal stromal tumor, and this was surgically resected. Double-balloon enteroscopy was useful for the diagnosis as well as the control of bleeding in this patient.