Publications
2026
Tsai, Andrew; Suh, Heeyeon; Tai, Sandra Khong; Baird, Marta; Oh, Heesoo
Stability of transverse changes with clear aligners and hyrax expanders from the mixed to the permanent dentition Journal Article
In: American Journal of Orthodontics and Dentofacial Orthopedics, 2026, ISSN: 0889-5406.
Abstract | Links | BibTeX | Tags: clear aligners, Hyrax expander, permanent dentition, Transverse
@article{nokey,
title = {Stability of transverse changes with clear aligners and hyrax expanders from the mixed to the permanent dentition},
author = {Andrew Tsai and Heeyeon Suh and Sandra Khong Tai and Marta Baird and Heesoo Oh },
doi = {https://doi.org/10.1016/j.ajodo.2026.01.017},
issn = {0889-5406},
year = {2026},
date = {2026-03-04},
journal = {American Journal of Orthodontics and Dentofacial Orthopedics},
abstract = {This study evaluated the longitudinal stability of transverse changes in patients treated with the Invisalign First system (IFS; Align Technology Inc, Tempe, Ariz) and hyrax expanders during the mixed dentition, followed through the permanent dentition. The objective was to determine whether expansion achieved during the mixed dentition was maintained through the transition to the permanent dentition. This retrospective longitudinal study included 119 patients: 44 patients treated with IFS, 36 patients treated with hyrax, and 39 untreated controls. Arch width changes at the canines, premolars, and first molars were measured on digital study models at 3 time points: pre-phase 1 treatment (T1), post-phase 1 treatment (T2), and pre phase 2 evaluation (T3). Vertical skeletal changes were evaluated in a cephalogram subgroup. Statistical analyses included analysis of variance and linear mixed-effects models. Both IFS and hyrax groups showed greater maxillary arch width increases from T1 to T3 (IFS: 1.8-2.8 mm; hyrax: 2.2-3.7 mm) than controls (0.4-1.2 mm; P <0.0001). At T2, hyrax showed significantly greater interpremolar and intermolar expansion (4.1-4.8 mm) than IFS (1.9-2.8 mm), but more relapse from T2 to T3. The IFS group also showed increased mandibular arch width from T1 to T3 (1.9-2.9 mm) compared with controls (P<0.05). No significant vertical skeletal changes from T1 to T3 were observed. Both IFS and hyrax produced maxillary arch expansion that was maintained throughout the transition from mixed to permanent dentition. The IFS also showed stable mandibular arch expansion, supporting its use for mild crowding or transverse deficiencies without long-term vertical effects.},
keywords = {clear aligners, Hyrax expander, permanent dentition, Transverse},
pubstate = {published},
tppubtype = {article}
}
2025
Suh, Heeyeon; Garnett, Bella Shen; Mahood, Kimberly; Oh, Heesoo
Anterior open bite treatment with clear aligners in adults Journal Article
In: Seminars in Orthodontics, 2025, ISSN: 1073-8746.
Abstract | Links | BibTeX | Tags: anterior open bite, biomechanics, clear aligners, Retention
@article{nokey,
title = {Anterior open bite treatment with clear aligners in adults},
author = {Heeyeon Suh and Bella Shen Garnett and Kimberly Mahood and Heesoo Oh},
url = {https://www.sciencedirect.com/science/article/pii/S1073874625001227?pes=vor&utm_source=scopus&getft_integrator=scopus},
doi = {https://doi.org/10.1053/j.sodo.2025.10.006},
issn = {1073-8746},
year = {2025},
date = {2025-10-11},
journal = {Seminars in Orthodontics},
abstract = {Anterior open bites represent one of the most complex malocclusions to treat due to their multifactorial etiology and high risk of relapse. While traditionally managed with fixed appliances, extractions, temporary anchorage devices (TADs), or surgery, clear aligner therapy has emerged as an effective alternative for adult patients when biomechanics are properly applied. Anterior open bite correction with clear aligners occurs primarily through incisor extrusion, with limited and less predictable contributions from molar intrusion. This paper reviews current knowledge on anterior open bite correction with clear aligners, the predictability of relevant tooth movements, and clinical outcomes reported in the literature. It also presents a contemporary clinical protocol for managing anterior open bite with clear aligners, including setup strategies in the digital treatment plan, class-specific considerations, staging, and retention. },
keywords = {anterior open bite, biomechanics, clear aligners, Retention},
pubstate = {published},
tppubtype = {article}
}
Patel, Esha; Moon, Stacey H.; Suh, Heeyeon; Chen, James; Tai, Sandra Khong; Oh, Heesoo
Clear aligners for Class II correction in growing patients: elastics vs mandibular advancement Journal Article
In: Angle Orthodontist, vol. 95, 2025.
Abstract | Links | BibTeX | Tags: Class II, clear aligners, elastics, growing patients, Maxillomandibular advancement
@article{nokey,
title = {Clear aligners for Class II correction in growing patients: elastics vs mandibular advancement},
author = {Esha Patel and Stacey H. Moon and Heeyeon Suh and James Chen and Sandra Khong Tai and Heesoo Oh},
url = {https://angle-orthodontist.kglmeridian.com/view/journals/angl/aop/article-10.2319-032825-251.1/article-10.2319-032825-251.1.xml?isSearch=true&body=FullText},
doi = {10.2319/032825-251.1},
year = {2025},
date = {2025-09-25},
urldate = {2025-09-25},
journal = {Angle Orthodontist},
volume = {95},
abstract = {Objectives: To evaluate the skeletal and dental effects of Class II correction in growing patients using clear aligners, with either elastics or mandibular advancement (MA). Materials and Methods: The study included 66 growing Class II patients: 45 patients treated with clear aligners (20 using Class II elastics and 25 with MA) and 21 untreated controls observed over a comparable time period. Nine cephalometric and three study cast measurements were evaluated initially (T1) and the end of treatment (T2) to assess skeletal and dental changes. Results: The control group maintained a Class II molar relationship and overjet, whereas both treatment groups corrected to Class I. In the MA group, statistically significant skeletal changes from T1 to T2 were observed, including reduction in SNA (–1.09°) and ANB (–1.69°), in addition to dentialveolar Class II correction. The elastic group showed no statistically significant changes in SNA and ANB compared to the control group. Linear regression revealed 5.28° of lower incisor proclination with Class II elastics, whereas lower incisor inclination was maintained with MA treatment. Conclusions: Clear aligner treatment with Class II elastics and MA were effective for correcting Class II malocclusion in growing patients that would have otherwise been maintained without intervention. Although Class II correction was mainly due to dentoalveolar changes, a skeletal component was observed with MA treatment.},
keywords = {Class II, clear aligners, elastics, growing patients, Maxillomandibular advancement},
pubstate = {published},
tppubtype = {article}
}
2023
Suh, H; Garnett, B; Mahood, K; Boyd, R; Oh, H
Short-term stability of anterior open bite treatment with clear aligners in adults Journal Article
In: Am J Orthod Dentofacial Orthop, vol. 164, iss. 6, pp. 774-782, 2023.
Abstract | Links | BibTeX | Tags: anterior openbite, clear aligners, short-term stability
@article{Oh2023d,
title = {Short-term stability of anterior open bite treatment with clear aligners in adults},
author = {H Suh and B Garnett and K Mahood and R Boyd and H Oh },
url = {https://pubmed.ncbi.nlm.nih.gov/37552148/},
doi = {10.1016/j.ajodo.2023.05.026},
year = {2023},
date = {2023-08-07},
journal = {Am J Orthod Dentofacial Orthop},
volume = {164},
issue = {6},
pages = {774-782},
abstract = {Introduction: This study aimed to examine the stability of anterior open bite (AOB) treatment with clear aligners.
Methods: This retrospective cohort study included 52 adult AOB patients (aged >18 years; 15 males, 37 females) who underwent nonextraction clear aligner treatment and were at least 1 year posttreatment. Eleven cephalometric measurements were evaluated at pretreatment, end of active treatment, and at least 1-year posttreatment. Overbite change, the primary outcome variable, and other cephalometric changes during treatment and retention were calculated, and repeated measures analysis of variance were performed. Stepwise multiple regression was used to make a prediction equation for open bite relapse.
Results: The mean retention period was 2.1 ± 1.1 years. The mean change in overbite during treatment was 3.3 ± 1.5 mm; 6% of patients presented relapse at least 1 year after treatment completion. The mean change of overbite (0.2 ± 0.5 mm) during the retention period was not statistically significant (P = 0.59). None of the 11 cephalometric measurements showed significant change during the retention period. The prediction model showed that only the coefficient for a tongue posture issue at the initial examination was statistically significant.
Conclusions: AOB was successfully corrected in all 52 patients using only clear aligners with no additional adjunctive aids such as microimplants. When retained with maxillary and mandibular fixed retainers and maxillary and mandibular vacuum-formed retainers, there was no significant change in cephalometric measurements during the short-term retention period.},
keywords = {anterior openbite, clear aligners, short-term stability},
pubstate = {published},
tppubtype = {article}
}
Methods: This retrospective cohort study included 52 adult AOB patients (aged >18 years; 15 males, 37 females) who underwent nonextraction clear aligner treatment and were at least 1 year posttreatment. Eleven cephalometric measurements were evaluated at pretreatment, end of active treatment, and at least 1-year posttreatment. Overbite change, the primary outcome variable, and other cephalometric changes during treatment and retention were calculated, and repeated measures analysis of variance were performed. Stepwise multiple regression was used to make a prediction equation for open bite relapse.
Results: The mean retention period was 2.1 ± 1.1 years. The mean change in overbite during treatment was 3.3 ± 1.5 mm; 6% of patients presented relapse at least 1 year after treatment completion. The mean change of overbite (0.2 ± 0.5 mm) during the retention period was not statistically significant (P = 0.59). None of the 11 cephalometric measurements showed significant change during the retention period. The prediction model showed that only the coefficient for a tongue posture issue at the initial examination was statistically significant.
Conclusions: AOB was successfully corrected in all 52 patients using only clear aligners with no additional adjunctive aids such as microimplants. When retained with maxillary and mandibular fixed retainers and maxillary and mandibular vacuum-formed retainers, there was no significant change in cephalometric measurements during the short-term retention period.
ML, Gurgel; de Oliveria Ruellas A.C,; J, Bianchi; JA, McNamara; S, Tai; and, Franchi L
Clear aligner mandibular advancement in growing patients with Class II malocclusion. Journal Article
In: AJO DO Clin Companion, vol. 3, iss. 2, pp. 93-109, 2023.
Abstract | Links | BibTeX | Tags: Class II malocclusion, clear aligners, growing patients, three-dimensional
@article{Bianchi2023b,
title = {Clear aligner mandibular advancement in growing patients with Class II malocclusion.},
author = {Gurgel ML and de Oliveria Ruellas A.C and Bianchi J and McNamara JA and Tai S and Franchi L and et al.},
url = {https://pubmed.ncbi.nlm.nih.gov/37636594/},
doi = {10.1016/j.xaor.2023.01.003},
year = {2023},
date = {2023-04-03},
journal = {AJO DO Clin Companion},
volume = {3},
issue = {2},
pages = {93-109},
abstract = {Treatment effects occurring during Class II malocclusion treatment with the clear aligner mandibular advancement protocol were evaluated in two growing patients: one male (12 years, 3 months) and one female (11 years, 9 months). Both patients presented with full cusp Class II molar and canine relationships. Intraoral scans and cone-beam computed tomography were acquired before treatment and after mandibular advancement. Three-dimensional skeletal and dental long-axis changes were quantified, in which the dental long axis was determined by registering the dental crowns obtained from intraoral scans to the root canals in cone-beam computed tomography scans obtained at the same time points. Class II correction was achieved by a combination of mandibular skeletal and dental changes. A similar direction of skeletal and dental changes was observed in both patients, with downward and forward displacement of the mandible resulting from the growth of the mandibular condyle and ramus. Dental changes in both patients included mesialization of the mandibular posterior teeth with flaring of mandibular anterior teeth. In these two patients, clear aligner mandibular advancement was an effective treatment modality for Class II malocclusion correction with skeletal and dental effects and facial profile improvement.},
keywords = {Class II malocclusion, clear aligners, growing patients, three-dimensional},
pubstate = {published},
tppubtype = {article}
}
2022
A, Cong; de Oliveria Ruellas A.C,; S.K, Tai; C.T, Loh; M, Barkley; M, Yatabe; M, Caminiti; C, Massaro; J, Bianchi; R, Deleat-Besson
Presurgical orthodontic decompensation with clear aligners Journal Article
In: American Journal of Orthodontics & Dentofacial Orthopedics, vol. 162, iss. 4, pp. 538-553, 2022.
Abstract | Links | BibTeX | Tags: clear aligners, decomposition, ortho, orthodontic
@article{Bianchi2022c,
title = {Presurgical orthodontic decompensation with clear aligners},
author = {Cong A and de Oliveria Ruellas A.C and Tai S.K and Loh C.T and Barkley M and Yatabe M and Caminiti M and Massaro C and Bianchi J and Deleat-Besson R},
url = {https://pubmed.ncbi.nlm.nih.gov/36182208/},
doi = {10.1016/j.ajodo.2021.12.019},
year = {2022},
date = {2022-10-01},
journal = {American Journal of Orthodontics & Dentofacial Orthopedics},
volume = {162},
issue = {4},
pages = {538-553},
abstract = {Introduction: Orthodontists, surgeons, and patients have taken an interest in using clear aligners in combination with orthognathic surgery. This study aimed to evaluate the accuracy of tooth movements with clear aligners during presurgical orthodontics using novel 3-dimensional superimposition techniques.
Methods: The study sample consisted of 20 patients who have completed presurgical orthodontics using Invisalign clear aligners. Initial (pretreatment) digital dental models, presurgical digital dental models, and ClinCheck prediction models were obtained. Presurgical models were superimposed onto initial ones using stable anatomic landmarks; ClinCheck models were superimposed onto presurgical models using surface best-fit superimposition. Five hundred forty-five teeth were measured for 3 angular movements (buccolingual torque, mesiodistal tip, and rotation) and 4 linear movements (buccolingual, mesiodistal, vertical, and total scalar displacement). The predicted tooth movement was compared with the achieved amount for each movement and tooth, using both percentage accuracy and numerical difference.
Results: Average percentage accuracy (63.4% ± 11.5%) was higher than in previously reported literature. The most accurate tooth movements were buccal torque and mesial displacement compared with lingual torque and distal displacement, particularly for mandibular posterior teeth. Clinically significant inaccuracies were found for the buccal displacement of maxillary second molars, lingual displacement of all molars, intrusion of mandibular second molars, the distal tip of molars, second premolars, and mandibular first premolars, buccal torque of maxillary central and lateral incisors, and lingual torque of premolars and molars.
Conclusions: Superimposition techniques used in this study lay the groundwork for future studies to analyze advanced clear aligner patients. Invisalign is a treatment modality that can be considered for presurgical orthodontics-tooth movements involved in arch leveling and decompensation are highly accurate when comparing the simulated and the clinically achieved movements.},
keywords = {clear aligners, decomposition, ortho, orthodontic},
pubstate = {published},
tppubtype = {article}
}
Methods: The study sample consisted of 20 patients who have completed presurgical orthodontics using Invisalign clear aligners. Initial (pretreatment) digital dental models, presurgical digital dental models, and ClinCheck prediction models were obtained. Presurgical models were superimposed onto initial ones using stable anatomic landmarks; ClinCheck models were superimposed onto presurgical models using surface best-fit superimposition. Five hundred forty-five teeth were measured for 3 angular movements (buccolingual torque, mesiodistal tip, and rotation) and 4 linear movements (buccolingual, mesiodistal, vertical, and total scalar displacement). The predicted tooth movement was compared with the achieved amount for each movement and tooth, using both percentage accuracy and numerical difference.
Results: Average percentage accuracy (63.4% ± 11.5%) was higher than in previously reported literature. The most accurate tooth movements were buccal torque and mesial displacement compared with lingual torque and distal displacement, particularly for mandibular posterior teeth. Clinically significant inaccuracies were found for the buccal displacement of maxillary second molars, lingual displacement of all molars, intrusion of mandibular second molars, the distal tip of molars, second premolars, and mandibular first premolars, buccal torque of maxillary central and lateral incisors, and lingual torque of premolars and molars.
Conclusions: Superimposition techniques used in this study lay the groundwork for future studies to analyze advanced clear aligner patients. Invisalign is a treatment modality that can be considered for presurgical orthodontics-tooth movements involved in arch leveling and decompensation are highly accurate when comparing the simulated and the clinically achieved movements.
Suh, H; Garnett, B Shen; Mahood, K; Boyd, RL; Oh, H
Treatment of anterior open bites using non-extraction clear aligner therapy in adult patients Journal Article
In: Korean J Orthod, vol. 52, iss. 5, pp. 383-384, 2022.
Abstract | Links | BibTeX | Tags: aligner therapy, anterior openbite, clear aligners, non-extraction
@article{Oh2022e,
title = {Treatment of anterior open bites using non-extraction clear aligner therapy in adult patients},
author = {H Suh and B Shen Garnett and K Mahood and RL Boyd and H Oh},
url = {https://pubmed.ncbi.nlm.nih.gov/36148645/},
doi = {10.4041/kjod21.180.r},
year = {2022},
date = {2022-09-25},
urldate = {2022-09-25},
journal = {Korean J Orthod},
volume = {52},
issue = {5},
pages = {383-384},
abstract = {Objective: The purpose of this study was to examine the effectiveness and mechanism of clear aligner therapy for the correction of anterior open bite in adult nonextraction cases. Methods: Sixty-nine adult patients with anterior open bite were enrolled and classified into Angle's Class I, II, and III groups. Fifty patients presented with skeletal open bite (mandibular plane angle [MPA] ≥ 38°), whereas 19 presented with dental open bite. Fifteen cephalometric landmarks were identified before (T1) and after (T2) treatment. The magnitudes of planned and actual movements of the incisors and molars were calculated. Results: Positive overbite was achieved in 94% patients, with a mean final overbite of 1.1 ± 0.8 mm. The mean change in overbite was 3.3 ± 1.4 mm. With clear aligners alone, 0.36 ± 0.58 mm of maxillary molar intrusion was achieved. Compared with the Class I group, the Class II group showed greater maxillary molar intrusion and MPA reduction. The Class III group showed greater mandibular incisor extrusion with no significant vertical skeletal changes. Conclusions: Clear aligners can be effective in controlling the vertical dimension and correcting mild to moderate anterior open bite in adult nonextraction cases. The treatment mechanism for Class III patients significantly differed from that for Class I and Class II patients. Maxillary incisor extrusion in patients with dental open bite and MPA reduction with mandibular incisor extrusion in patients with skeletal open bite are the most significant contributing factors for open bite closure.},
keywords = {aligner therapy, anterior openbite, clear aligners, non-extraction},
pubstate = {published},
tppubtype = {article}
}
2021
Bianchi, J; Goncalves, J Roberto; Ruellas, A Carlos De Oliveira; Bianchi, J Vierira Pastana; Ashman, LM; et al,
Radiographic interpretation using high-resolution Cbct to diagnose degenerative temporomandibular joint disease Journal Article
In: PLOS ONE, vol. 16, no. 8, pp. e0255937, 2021.
Abstract | Links | BibTeX | Tags: AAOF, Adolescents, anterior openbite, clear aligners, clinical orthodontist, Cone-beam computed tomography, Cranial base, fixed appliances, Growth, hyperdivergent, Mandibular fixed retainer
@article{Bianchi2021b,
title = {Radiographic interpretation using high-resolution Cbct to diagnose degenerative temporomandibular joint disease},
author = {J Bianchi and J Roberto Goncalves and A Carlos De Oliveira Ruellas and J Vierira Pastana Bianchi and LM Ashman and et al },
url = {https://pubmed.ncbi.nlm.nih.gov/34375354/},
doi = {10.1371/journal.pone.0255937},
year = {2021},
date = {2021-08-10},
urldate = {2021-08-10},
journal = {PLOS ONE},
volume = {16},
number = {8},
pages = {e0255937},
abstract = {The objective of this study was to use high-resolution cone-beam computed images (hr- CBCT) to diagnose degenerative joint disease in asymptomatic and symptomatic subjects using the Diagnostic Criteria for Temporomandibular Disorders DC/TMD imaging criteria. This observational study comprised of 92 subjects age-sex matched and divided into two groups: clinical degenerative joint disease (c-DJD, n = 46) and asymptomatic control group (n = 46). Clinical assessment of the DJD and high-resolution CBCT images (isotropic voxel size of 0.08mm) of the temporomandibular joints were performed for each participant. An American Board of Oral and Maxillofacial Radiology certified radiologist and a maxillofacial radiologist used the DC/TMD imaging criteria to evaluate the radiographic findings, followed by a consensus of the radiographic evaluation. The two radiologists presented a high agreement (Cohen's Kappa ranging from 0.80 to 0.87) for all radiographic findings (osteophyte, erosion, cysts, flattening, and sclerosis). Five patients from the c- DJD group did not present radiographic findings, being then classified as arthralgia. In the asymptomatic control group, 82.6% of the patients presented radiographic findings determinant of DJD and were then classified as osteoarthrosis or overdiagnosis. In conclusion, our results showed a high number of radiographic findings in the asymptomatic control group, and for this reason, we suggest that there is a need for additional imaging criteria to classify DJD properly in hr-CBCT images.},
keywords = {AAOF, Adolescents, anterior openbite, clear aligners, clinical orthodontist, Cone-beam computed tomography, Cranial base, fixed appliances, Growth, hyperdivergent, Mandibular fixed retainer},
pubstate = {published},
tppubtype = {article}
}
Cong, A; Massaro, C; Bianchi, J; Ruellas, ACDO; et al,
Dental long axes using digital dental models compared to cone-beam computed tomography. Journal Article
In: Orthod Cranifac Res, 2021.
Abstract | Links | BibTeX | Tags: AAOF, adult, clear aligners, Cranial base, hyperdivergent, Mandibular fixed retainer, Posttreatment, retrospective, teaching
@article{Cong2021,
title = {Dental long axes using digital dental models compared to cone-beam computed tomography.},
author = {A Cong and C Massaro and J Bianchi and ACDO Ruellas and et al},
url = {https://onlinelibrary.wiley.com/doi/10.1111/ocr.12489},
doi = {10.1111/ocr.12489},
year = {2021},
date = {2021-05-09},
urldate = {2021-05-09},
journal = {Orthod Cranifac Res},
abstract = {Standard methods of evaluating tooth long axes are not comparable (digital dental models [DDMs], panoramic and cephalometric radiographs) or expose patients to more radiation (cone-beam computed tomography [CBCT]). This study aimed to compare angular changes in tooth long axes using DDMs vs using CBCTs. },
keywords = {AAOF, adult, clear aligners, Cranial base, hyperdivergent, Mandibular fixed retainer, Posttreatment, retrospective, teaching},
pubstate = {published},
tppubtype = {article}
}
Parizotto, JOL; Peixoto, AP; Borsato, KT; Bianchi, J; et al,
Craniofacial and airway morphology of individuals with oculoauriculovertebral spectrum. Journal Article
In: Orthodontics & Craniofacial Research, 2021.
Abstract | Links | BibTeX | Tags: AAOF, anterior openbite, clear aligners, clinical orthodontist, Mandibular fixed retainer, Posttreatment, research, technique, vertical control, x-ray
@article{Parizotto2021,
title = {Craniofacial and airway morphology of individuals with oculoauriculovertebral spectrum.},
author = {JOL Parizotto and AP Peixoto and KT Borsato and J Bianchi and et al},
url = {https://pubmed.ncbi.nlm.nih.gov/33713375/},
doi = {10.1111/ocr.12483},
year = {2021},
date = {2021-03-13},
urldate = {2021-03-13},
journal = {Orthodontics & Craniofacial Research},
abstract = {The objectives of this study were to characterize the craniofacial and airway morphology of oculo-auriculo-vertebral spectrum (OAVS) individuals using computed tomography (CT) examination.},
keywords = {AAOF, anterior openbite, clear aligners, clinical orthodontist, Mandibular fixed retainer, Posttreatment, research, technique, vertical control, x-ray},
pubstate = {published},
tppubtype = {article}
}
2020
Chen, G; Awadi, M Al; Chambers, D W; Lagravere-Vich, M O; Xu, Y; Oh, H
The three-dimensional stable mandibular landmarks in patients between the ages of 12.5 and 17.1 years. Journal Article
In: BMC Oral Health, vol. 20, no. 1, pp. 153, 2020.
Abstract | Links | BibTeX | Tags: AAOF, clear aligners, clinical orthodontist, Cone-beam computed tomography, Cranial base, technique
@article{Chen2020,
title = {The three-dimensional stable mandibular landmarks in patients between the ages of 12.5 and 17.1 years.},
author = {G Chen and M Al Awadi and D W Chambers and M O Lagravere-Vich and Y Xu and H Oh },
url = {https://pubmed.ncbi.nlm.nih.gov/32460733/},
doi = {10.1186/s12903-020-01142-2},
year = {2020},
date = {2020-05-27},
urldate = {2020-05-27},
journal = {BMC Oral Health},
volume = {20},
number = {1},
pages = {153},
abstract = {With the aid of implants, Björk identified two-dimensional mandibular stable structures in cephalograms during facial growth. However, we do not know what the three-dimensional stable structures are with certainty. The purpose of this study was to identify the most stable mandibular landmarks in growing patients using three-dimensional images.},
keywords = {AAOF, clear aligners, clinical orthodontist, Cone-beam computed tomography, Cranial base, technique},
pubstate = {published},
tppubtype = {article}
}
2019
C, Thereza-Bussolaro; HS, Oh; M, Lagravere; C, Flores-Mir
Pharyngeal dimensional changes in class II malocclusion treatment when using Forsus® or intermaxillary elastics - An exploratory study. Journal Article
In: Int Orthod, vol. 17, no. 4, pp. 667-677, 2019.
Abstract | Links | BibTeX | Tags: AAOF, adult, clear aligners, Cone-beam computed tomography, Cranial base, craniofacial, Mandibular fixed retainer, Mandibular remodeling, Peer Assessment Rating Index, pressure tension, research, teaching, technique, vertical control
@article{Bussolaro2019,
title = {Pharyngeal dimensional changes in class II malocclusion treatment when using Forsus® or intermaxillary elastics - An exploratory study.},
author = {Thereza-Bussolaro C and Oh HS and Lagravere M and Flores-Mir C },
url = {https://pubmed.ncbi.nlm.nih.gov/31492602/},
doi = {10.1016/j.ortho.2019.08.023},
year = {2019},
date = {2019-09-01},
journal = {Int Orthod},
volume = {17},
number = {4},
pages = {667-677},
abstract = {Pharyngeal airway obstruction can facilitate some forms of sleep disorder breathing (SDB) in susceptible children, especially in those having class II malocclusion. Changes in the anatomic areas surrounding the pharyngeal region during orthodontic treatment could hypothetically impact the pharyngeal airway dimensions. Management of a class II malocclusion on a growing individual with either intermaxillary elastics or different removable or fixed class II appliance designs have been proposed over the last century. The objective of this retrospective exploratory cohort study is to investigate to what extent the class II malocclusion treatment with either intermaxillary elastics (IME) or Forsus® fatigue resistance device (FFRD) leads to changes in oropharyngeal airway dimensions.},
keywords = {AAOF, adult, clear aligners, Cone-beam computed tomography, Cranial base, craniofacial, Mandibular fixed retainer, Mandibular remodeling, Peer Assessment Rating Index, pressure tension, research, teaching, technique, vertical control},
pubstate = {published},
tppubtype = {article}
}
2018
Garnett, Bella Shen; Mahood, Kimberly; Nguyen, Mai; Al-Khateeb, Aliaa; Liu, Siqi; Boyd, Robert; Oh, Heesoo
Cephalometric comparison of anterior openbite tx using clear aligners and fixed appliances Journal Article Forthcoming
In: Angle Orthodontist, Forthcoming.
Abstract | Links | BibTeX | Tags: adult, anterior openbite, clear aligners, fixed appliances, hyperdivergent, open bite, vertical control
@article{Garnett,
title = {Cephalometric comparison of anterior openbite tx using clear aligners and fixed appliances},
author = {Bella Shen Garnett and Kimberly Mahood and Mai Nguyen and Aliaa Al-Khateeb and Siqi Liu and Robert Boyd and Heesoo Oh},
doi = {10.2319/010418-4.1},
year = {2018},
date = {2018-10-03},
journal = {Angle Orthodontist},
abstract = {Objectives: To compare fixed appliances and clear aligner therapy in correcting anterior open biteand in controlling the vertical dimension in adult patients with hyperdivergent skeletal patterns.
Materials and Methods: In this retrospective study, two treatment groups of adult (_18 years old)hyperdivergent patients (mandibular plane angles of _388) with anterior open bites were included:17 fixed appliance patients and 36 clear aligner patients. Thirteen cephalometric measurementsrepresenting the vertical dimension were reported for each group. A two-sample t-test was used toassess differences in changes in mandibular plane angle and overbite between the two treatmentgroups.
Results: There were no statistical differences found in the magnitude of overbite correction and thechanges in any of the cephalometric measurements for vertical control. The clear aligner groupshowed a slightly greater amount of lower incisor extrusion (P . .009). The main mechanism ofopen bite correction was similar between the two treatment groups and was accomplished throughretroclination of the upper and lower incisors while maintaining the vertical position of the upper andlower molars.
Conclusions: Cephalometric comparison of anterior open bite correction and changes in themandibular plane angle associated with use of clear aligners and fixed appliances did notdemonstrate statistically significant differences in adult hyperdivergent patients. (Angle Orthod.0000;00:000–000.)},
keywords = {adult, anterior openbite, clear aligners, fixed appliances, hyperdivergent, open bite, vertical control},
pubstate = {forthcoming},
tppubtype = {article}
}
Materials and Methods: In this retrospective study, two treatment groups of adult (_18 years old)hyperdivergent patients (mandibular plane angles of _388) with anterior open bites were included:17 fixed appliance patients and 36 clear aligner patients. Thirteen cephalometric measurementsrepresenting the vertical dimension were reported for each group. A two-sample t-test was used toassess differences in changes in mandibular plane angle and overbite between the two treatmentgroups.
Results: There were no statistical differences found in the magnitude of overbite correction and thechanges in any of the cephalometric measurements for vertical control. The clear aligner groupshowed a slightly greater amount of lower incisor extrusion (P . .009). The main mechanism ofopen bite correction was similar between the two treatment groups and was accomplished throughretroclination of the upper and lower incisors while maintaining the vertical position of the upper andlower molars.
Conclusions: Cephalometric comparison of anterior open bite correction and changes in themandibular plane angle associated with use of clear aligners and fixed appliances did notdemonstrate statistically significant differences in adult hyperdivergent patients. (Angle Orthod.0000;00:000–000.)
Liu, S; Oh, H; Chambers, D; Baumrind, S; Xu, T
Interpreting Weightings of the Peer Assessment Rating Index and the Discrepancy Index across Contexts on Chinese Patients. Journal Article
In: European Journal of Orthodontics, vol. 40, no. 2, pp. 157-163, 2018.
Abstract | Links | BibTeX | Tags: clear aligners, clinical orthodontist, Cone-beam computed tomography, Cranial base, Growth, hyperdivergent, malocclusion severity, mandibular asymmetry, Peer Assessment Rating Index, teaching, vertical control
@article{Liu2017b,
title = {Interpreting Weightings of the Peer Assessment Rating Index and the Discrepancy Index across Contexts on Chinese Patients.},
author = {S Liu and H Oh and D Chambers and S Baumrind and T Xu},
url = {https://pubmed.ncbi.nlm.nih.gov/28575327/},
doi = {10.1093/ejo/cjx043},
year = {2018},
date = {2018-04-06},
urldate = {2018-04-06},
journal = {European Journal of Orthodontics},
volume = {40},
number = {2},
pages = {157-163},
abstract = {Determine optimal weightings of Peer Assessment Rating (PAR) index and Discrepancy Index (DI) for malocclusion severity assessment in Chinese orthodontic patients.},
keywords = {clear aligners, clinical orthodontist, Cone-beam computed tomography, Cranial base, Growth, hyperdivergent, malocclusion severity, mandibular asymmetry, Peer Assessment Rating Index, teaching, vertical control},
pubstate = {published},
tppubtype = {article}
}
2017
Afrand, M; Oh, H; Flores-Mir, C; Lagravere-Vich, M
Growth changes in the anterior and middle cranial bases as assessed through cone-beam computed tomography in adolescents. Journal Article
In: Am J Orthod Dentofacial Orthop, vol. 151, no. 2, pp. 342-350, 2017.
Abstract | Links | BibTeX | Tags: AAOF, anterior openbite, clear aligners, clinical orthodontist, Cone-beam computed tomography, Cranial base, hyperdivergent, Mandibular fixed retainer, orthodontic, Peer Assessment Rating Index, Posttreatment, retrospective, technique
@article{Afrand2017b,
title = {Growth changes in the anterior and middle cranial bases as assessed through cone-beam computed tomography in adolescents.},
author = {M Afrand and H Oh and C Flores-Mir and M Lagravere-Vich},
url = {https://www.sciencedirect.com/science/article/pii/S0889540616307405},
doi = {10.1016/j.ajodo.2016.02.032},
year = {2017},
date = {2017-02-00},
journal = {Am J Orthod Dentofacial Orthop},
volume = {151},
number = {2},
pages = {342-350},
abstract = {Initially, cone-beam computed tomography images from dry skulls were used to 3 dimensionallyevaluate intrarater and interrater reliabilities and accuracy of selected 3-dimensional landmarks located in theanterior and middle cranial bases. Thereafter, dimensional changes of the anterior and middle cranial baseswith growth were evaluated by using the previously selected landmarks.Methods:Cone-beam computed to-mography images of 10 dry skulls were used to identify useful landmarks from different areas of the anteriorand middle cranial bases based on their reliability and accuracy. These selected landmarks were identified inthe images of an already available sample of adolescents (n560) taken at 2 time points (19 months apart)to assess dimensional changes with growth.Results:The majority of the proposed 3-dimensional landmarkswith the exception of the lesser wing of the sphenoid showed acceptable intrarater and interrater reliabilities.The distances measured between foramina and canals in the transverse dimension showed evidence ofincreases in size. However, the mean amounts of increase in these transverse distances were equal to orless than 1.05 mm (from 1.1% to 4.1%). No change was observed between the right and left anterior andposterior clinoid processes. The vertical dimensions showed evidence of some changes, but these werewithin 2% of the original distances.Conclusions:In this adolescent sample, minor growth-related changeswere observed in the anterior and middle cranial bases. The midsagittal area of the anterior cranial base(foramen caecum to presphenoid) was stable. The right and left anterior and posterior clinoid processes canbe used for transverse superimposition. (Am J Orthod Dentofacial Orthop 2017;151:342-50)},
keywords = {AAOF, anterior openbite, clear aligners, clinical orthodontist, Cone-beam computed tomography, Cranial base, hyperdivergent, Mandibular fixed retainer, orthodontic, Peer Assessment Rating Index, Posttreatment, retrospective, technique},
pubstate = {published},
tppubtype = {article}
}
2009
Oh, HS; Korn, EL; Zhang, XY; Liu, Y; Xu, T-M; Boyd, R; Baumrind, S
In: American Journal of Orthodontics & Dentofacial Orthopedics, vol. 136, no. 6, pp. e1-14; discussion 762-3, 2009.
Abstract | Links | BibTeX | Tags: AAOF, Adolescents, anterior openbite, clear aligners, clinical orthodontist, Cone-beam computed tomography, Cranial base, Discrepency Index, hyperdivergent, Mandibular fixed retainer, Peer Assessment Rating Index, Posttreatment
@article{Oh2009,
title = {Correlation between cephalometric and photographic measurements of facial attractiveness in Chinese and U.S. patients at the end of orthodontic treatment.},
author = {HS Oh and EL Korn and XY Zhang and Y Liu and T-M Xu and R Boyd and S Baumrind},
url = {https://pubmed.ncbi.nlm.nih.gov/19962590/},
doi = {10.1016/j.ajodo.2009.04.020},
year = {2009},
date = {2009-12-00},
journal = {American Journal of Orthodontics & Dentofacial Orthopedics},
volume = {136},
number = {6},
pages = {e1-14; discussion 762-3},
abstract = {Orthodontists rely on esthetic judgments from facial photographs. Concordance between estimates of facial attractiveness made from lateral cephalograms and those made from clinical photographs has not been determined. We conducted a preliminary examination to correlate clinicians' rankings of facial attractiveness from standardized end-of-treatment facial photographs (Photo Attractiveness Rank) with cephalometric measurements of facial attractiveness made for the same subjects at the same time.},
keywords = {AAOF, Adolescents, anterior openbite, clear aligners, clinical orthodontist, Cone-beam computed tomography, Cranial base, Discrepency Index, hyperdivergent, Mandibular fixed retainer, Peer Assessment Rating Index, Posttreatment},
pubstate = {published},
tppubtype = {article}
}
2001
SK, Lee; YS, Kim; HS, Oh; KH, Yang; EC, Kim; JG, Chi
Prenatal development of the human mandible. Journal Article
In: The Anatomical Record, vol. 263, no. 3, pp. 314-25, 2001.
Abstract | Links | BibTeX | Tags: adult, anterior openbite, clear aligners, clinical orthodontist, Cone-beam computed tomography, craniofacial, Discrepency Index, hyperdivergent, Mandibular fixed retainer, Posttreatment, pressure tension
@article{Lee2001,
title = {Prenatal development of the human mandible. },
author = {Lee SK and Kim YS and Oh HS and Yang KH and Kim EC and Chi JG},
url = {https://pubmed.ncbi.nlm.nih.gov/11455541/},
doi = {10.1002/ar.1110},
year = {2001},
date = {2001-07-01},
journal = {The Anatomical Record},
volume = {263},
number = {3},
pages = {314-25},
abstract = {In an effort to better understand the interrelationship of the growth and development pattern of the mandible and condyle, a sequential growth pattern of human mandibles in 38 embryos and 111 fetuses were examined by serial histological sections and soft X-ray views. The basic growth pattern of the mandibular body and condyle appeared in week 7 of fertilization. Histologically, the embryonal mandible originated from primary intramembranous ossification in the fibrous mesenchymal tissue around the Meckel cartilage. From this initial ossification, the ramifying trabecular bones developed forward, backward and upward, to form the symphysis, mandibular body, and coronoid process, respectively. We named this initial ossification site of embryonal mandible as the mandibular primary growth center (MdPGC). During week 8 of fertilization, the trabecular bone of the mandibular body grew rapidly to form muscular attachments to the masseter, temporalis, and pterygoid muscles. The mandible was then rapidly separated from the Meckel cartilage and formed a condyle blastema at the posterior end of linear mandibular trabeculae. The condyle blastema, attached to the upper part of pterygoid muscle, grew backward and upward and concurrent endochondral ossification resulted in the formation of the condyle. From week 14 of fertilization, the growth of conical structure of condyle became apparent on histological and radiological examinations. The mandibular body showed a conspicuous radiating trabecular growth pattern centered at the MdPGC, located around the apical area of deciduous first molar. The condyle growth showed characteristic conical structure and abundant hematopoietic tissue in the marrow. The growth of the proximal end of condyle was also approximated to the MdPGC on radiograms. Taken together, we hypothesized that the MdPGC has an important morphogenetic affect for the development of the human mandible, providing a growth center for the trabecular bone of mandibular body and also indicating the initial growth of endochondral ossification of the condyle.},
keywords = {adult, anterior openbite, clear aligners, clinical orthodontist, Cone-beam computed tomography, craniofacial, Discrepency Index, hyperdivergent, Mandibular fixed retainer, Posttreatment, pressure tension},
pubstate = {published},
tppubtype = {article}
}
Tsai, Andrew; Suh, Heeyeon; Tai, Sandra Khong; Baird, Marta; Oh, Heesoo
Stability of transverse changes with clear aligners and hyrax expanders from the mixed to the permanent dentition Journal Article
In: American Journal of Orthodontics and Dentofacial Orthopedics, 2026, ISSN: 0889-5406.
@article{nokey,
title = {Stability of transverse changes with clear aligners and hyrax expanders from the mixed to the permanent dentition},
author = {Andrew Tsai and Heeyeon Suh and Sandra Khong Tai and Marta Baird and Heesoo Oh },
doi = {https://doi.org/10.1016/j.ajodo.2026.01.017},
issn = {0889-5406},
year = {2026},
date = {2026-03-04},
journal = {American Journal of Orthodontics and Dentofacial Orthopedics},
abstract = {This study evaluated the longitudinal stability of transverse changes in patients treated with the Invisalign First system (IFS; Align Technology Inc, Tempe, Ariz) and hyrax expanders during the mixed dentition, followed through the permanent dentition. The objective was to determine whether expansion achieved during the mixed dentition was maintained through the transition to the permanent dentition. This retrospective longitudinal study included 119 patients: 44 patients treated with IFS, 36 patients treated with hyrax, and 39 untreated controls. Arch width changes at the canines, premolars, and first molars were measured on digital study models at 3 time points: pre-phase 1 treatment (T1), post-phase 1 treatment (T2), and pre phase 2 evaluation (T3). Vertical skeletal changes were evaluated in a cephalogram subgroup. Statistical analyses included analysis of variance and linear mixed-effects models. Both IFS and hyrax groups showed greater maxillary arch width increases from T1 to T3 (IFS: 1.8-2.8 mm; hyrax: 2.2-3.7 mm) than controls (0.4-1.2 mm; P <0.0001). At T2, hyrax showed significantly greater interpremolar and intermolar expansion (4.1-4.8 mm) than IFS (1.9-2.8 mm), but more relapse from T2 to T3. The IFS group also showed increased mandibular arch width from T1 to T3 (1.9-2.9 mm) compared with controls (P<0.05). No significant vertical skeletal changes from T1 to T3 were observed. Both IFS and hyrax produced maxillary arch expansion that was maintained throughout the transition from mixed to permanent dentition. The IFS also showed stable mandibular arch expansion, supporting its use for mild crowding or transverse deficiencies without long-term vertical effects.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Suh, Heeyeon; Garnett, Bella Shen; Mahood, Kimberly; Oh, Heesoo
Anterior open bite treatment with clear aligners in adults Journal Article
In: Seminars in Orthodontics, 2025, ISSN: 1073-8746.
@article{nokey,
title = {Anterior open bite treatment with clear aligners in adults},
author = {Heeyeon Suh and Bella Shen Garnett and Kimberly Mahood and Heesoo Oh},
url = {https://www.sciencedirect.com/science/article/pii/S1073874625001227?pes=vor&utm_source=scopus&getft_integrator=scopus},
doi = {https://doi.org/10.1053/j.sodo.2025.10.006},
issn = {1073-8746},
year = {2025},
date = {2025-10-11},
journal = {Seminars in Orthodontics},
abstract = {Anterior open bites represent one of the most complex malocclusions to treat due to their multifactorial etiology and high risk of relapse. While traditionally managed with fixed appliances, extractions, temporary anchorage devices (TADs), or surgery, clear aligner therapy has emerged as an effective alternative for adult patients when biomechanics are properly applied. Anterior open bite correction with clear aligners occurs primarily through incisor extrusion, with limited and less predictable contributions from molar intrusion. This paper reviews current knowledge on anterior open bite correction with clear aligners, the predictability of relevant tooth movements, and clinical outcomes reported in the literature. It also presents a contemporary clinical protocol for managing anterior open bite with clear aligners, including setup strategies in the digital treatment plan, class-specific considerations, staging, and retention. },
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Patel, Esha; Moon, Stacey H.; Suh, Heeyeon; Chen, James; Tai, Sandra Khong; Oh, Heesoo
Clear aligners for Class II correction in growing patients: elastics vs mandibular advancement Journal Article
In: Angle Orthodontist, vol. 95, 2025.
@article{nokey,
title = {Clear aligners for Class II correction in growing patients: elastics vs mandibular advancement},
author = {Esha Patel and Stacey H. Moon and Heeyeon Suh and James Chen and Sandra Khong Tai and Heesoo Oh},
url = {https://angle-orthodontist.kglmeridian.com/view/journals/angl/aop/article-10.2319-032825-251.1/article-10.2319-032825-251.1.xml?isSearch=true&body=FullText},
doi = {10.2319/032825-251.1},
year = {2025},
date = {2025-09-25},
urldate = {2025-09-25},
journal = {Angle Orthodontist},
volume = {95},
abstract = {Objectives: To evaluate the skeletal and dental effects of Class II correction in growing patients using clear aligners, with either elastics or mandibular advancement (MA). Materials and Methods: The study included 66 growing Class II patients: 45 patients treated with clear aligners (20 using Class II elastics and 25 with MA) and 21 untreated controls observed over a comparable time period. Nine cephalometric and three study cast measurements were evaluated initially (T1) and the end of treatment (T2) to assess skeletal and dental changes. Results: The control group maintained a Class II molar relationship and overjet, whereas both treatment groups corrected to Class I. In the MA group, statistically significant skeletal changes from T1 to T2 were observed, including reduction in SNA (–1.09°) and ANB (–1.69°), in addition to dentialveolar Class II correction. The elastic group showed no statistically significant changes in SNA and ANB compared to the control group. Linear regression revealed 5.28° of lower incisor proclination with Class II elastics, whereas lower incisor inclination was maintained with MA treatment. Conclusions: Clear aligner treatment with Class II elastics and MA were effective for correcting Class II malocclusion in growing patients that would have otherwise been maintained without intervention. Although Class II correction was mainly due to dentoalveolar changes, a skeletal component was observed with MA treatment.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Suh, H; Garnett, B; Mahood, K; Boyd, R; Oh, H
Short-term stability of anterior open bite treatment with clear aligners in adults Journal Article
In: Am J Orthod Dentofacial Orthop, vol. 164, iss. 6, pp. 774-782, 2023.
@article{Oh2023d,
title = {Short-term stability of anterior open bite treatment with clear aligners in adults},
author = {H Suh and B Garnett and K Mahood and R Boyd and H Oh },
url = {https://pubmed.ncbi.nlm.nih.gov/37552148/},
doi = {10.1016/j.ajodo.2023.05.026},
year = {2023},
date = {2023-08-07},
journal = {Am J Orthod Dentofacial Orthop},
volume = {164},
issue = {6},
pages = {774-782},
abstract = {Introduction: This study aimed to examine the stability of anterior open bite (AOB) treatment with clear aligners.
Methods: This retrospective cohort study included 52 adult AOB patients (aged >18 years; 15 males, 37 females) who underwent nonextraction clear aligner treatment and were at least 1 year posttreatment. Eleven cephalometric measurements were evaluated at pretreatment, end of active treatment, and at least 1-year posttreatment. Overbite change, the primary outcome variable, and other cephalometric changes during treatment and retention were calculated, and repeated measures analysis of variance were performed. Stepwise multiple regression was used to make a prediction equation for open bite relapse.
Results: The mean retention period was 2.1 ± 1.1 years. The mean change in overbite during treatment was 3.3 ± 1.5 mm; 6% of patients presented relapse at least 1 year after treatment completion. The mean change of overbite (0.2 ± 0.5 mm) during the retention period was not statistically significant (P = 0.59). None of the 11 cephalometric measurements showed significant change during the retention period. The prediction model showed that only the coefficient for a tongue posture issue at the initial examination was statistically significant.
Conclusions: AOB was successfully corrected in all 52 patients using only clear aligners with no additional adjunctive aids such as microimplants. When retained with maxillary and mandibular fixed retainers and maxillary and mandibular vacuum-formed retainers, there was no significant change in cephalometric measurements during the short-term retention period.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Methods: This retrospective cohort study included 52 adult AOB patients (aged >18 years; 15 males, 37 females) who underwent nonextraction clear aligner treatment and were at least 1 year posttreatment. Eleven cephalometric measurements were evaluated at pretreatment, end of active treatment, and at least 1-year posttreatment. Overbite change, the primary outcome variable, and other cephalometric changes during treatment and retention were calculated, and repeated measures analysis of variance were performed. Stepwise multiple regression was used to make a prediction equation for open bite relapse.
Results: The mean retention period was 2.1 ± 1.1 years. The mean change in overbite during treatment was 3.3 ± 1.5 mm; 6% of patients presented relapse at least 1 year after treatment completion. The mean change of overbite (0.2 ± 0.5 mm) during the retention period was not statistically significant (P = 0.59). None of the 11 cephalometric measurements showed significant change during the retention period. The prediction model showed that only the coefficient for a tongue posture issue at the initial examination was statistically significant.
Conclusions: AOB was successfully corrected in all 52 patients using only clear aligners with no additional adjunctive aids such as microimplants. When retained with maxillary and mandibular fixed retainers and maxillary and mandibular vacuum-formed retainers, there was no significant change in cephalometric measurements during the short-term retention period.
ML, Gurgel; de Oliveria Ruellas A.C,; J, Bianchi; JA, McNamara; S, Tai; and, Franchi L
Clear aligner mandibular advancement in growing patients with Class II malocclusion. Journal Article
In: AJO DO Clin Companion, vol. 3, iss. 2, pp. 93-109, 2023.
@article{Bianchi2023b,
title = {Clear aligner mandibular advancement in growing patients with Class II malocclusion.},
author = {Gurgel ML and de Oliveria Ruellas A.C and Bianchi J and McNamara JA and Tai S and Franchi L and et al.},
url = {https://pubmed.ncbi.nlm.nih.gov/37636594/},
doi = {10.1016/j.xaor.2023.01.003},
year = {2023},
date = {2023-04-03},
journal = {AJO DO Clin Companion},
volume = {3},
issue = {2},
pages = {93-109},
abstract = {Treatment effects occurring during Class II malocclusion treatment with the clear aligner mandibular advancement protocol were evaluated in two growing patients: one male (12 years, 3 months) and one female (11 years, 9 months). Both patients presented with full cusp Class II molar and canine relationships. Intraoral scans and cone-beam computed tomography were acquired before treatment and after mandibular advancement. Three-dimensional skeletal and dental long-axis changes were quantified, in which the dental long axis was determined by registering the dental crowns obtained from intraoral scans to the root canals in cone-beam computed tomography scans obtained at the same time points. Class II correction was achieved by a combination of mandibular skeletal and dental changes. A similar direction of skeletal and dental changes was observed in both patients, with downward and forward displacement of the mandible resulting from the growth of the mandibular condyle and ramus. Dental changes in both patients included mesialization of the mandibular posterior teeth with flaring of mandibular anterior teeth. In these two patients, clear aligner mandibular advancement was an effective treatment modality for Class II malocclusion correction with skeletal and dental effects and facial profile improvement.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
A, Cong; de Oliveria Ruellas A.C,; S.K, Tai; C.T, Loh; M, Barkley; M, Yatabe; M, Caminiti; C, Massaro; J, Bianchi; R, Deleat-Besson
Presurgical orthodontic decompensation with clear aligners Journal Article
In: American Journal of Orthodontics & Dentofacial Orthopedics, vol. 162, iss. 4, pp. 538-553, 2022.
@article{Bianchi2022c,
title = {Presurgical orthodontic decompensation with clear aligners},
author = {Cong A and de Oliveria Ruellas A.C and Tai S.K and Loh C.T and Barkley M and Yatabe M and Caminiti M and Massaro C and Bianchi J and Deleat-Besson R},
url = {https://pubmed.ncbi.nlm.nih.gov/36182208/},
doi = {10.1016/j.ajodo.2021.12.019},
year = {2022},
date = {2022-10-01},
journal = {American Journal of Orthodontics & Dentofacial Orthopedics},
volume = {162},
issue = {4},
pages = {538-553},
abstract = {Introduction: Orthodontists, surgeons, and patients have taken an interest in using clear aligners in combination with orthognathic surgery. This study aimed to evaluate the accuracy of tooth movements with clear aligners during presurgical orthodontics using novel 3-dimensional superimposition techniques.
Methods: The study sample consisted of 20 patients who have completed presurgical orthodontics using Invisalign clear aligners. Initial (pretreatment) digital dental models, presurgical digital dental models, and ClinCheck prediction models were obtained. Presurgical models were superimposed onto initial ones using stable anatomic landmarks; ClinCheck models were superimposed onto presurgical models using surface best-fit superimposition. Five hundred forty-five teeth were measured for 3 angular movements (buccolingual torque, mesiodistal tip, and rotation) and 4 linear movements (buccolingual, mesiodistal, vertical, and total scalar displacement). The predicted tooth movement was compared with the achieved amount for each movement and tooth, using both percentage accuracy and numerical difference.
Results: Average percentage accuracy (63.4% ± 11.5%) was higher than in previously reported literature. The most accurate tooth movements were buccal torque and mesial displacement compared with lingual torque and distal displacement, particularly for mandibular posterior teeth. Clinically significant inaccuracies were found for the buccal displacement of maxillary second molars, lingual displacement of all molars, intrusion of mandibular second molars, the distal tip of molars, second premolars, and mandibular first premolars, buccal torque of maxillary central and lateral incisors, and lingual torque of premolars and molars.
Conclusions: Superimposition techniques used in this study lay the groundwork for future studies to analyze advanced clear aligner patients. Invisalign is a treatment modality that can be considered for presurgical orthodontics-tooth movements involved in arch leveling and decompensation are highly accurate when comparing the simulated and the clinically achieved movements.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Methods: The study sample consisted of 20 patients who have completed presurgical orthodontics using Invisalign clear aligners. Initial (pretreatment) digital dental models, presurgical digital dental models, and ClinCheck prediction models were obtained. Presurgical models were superimposed onto initial ones using stable anatomic landmarks; ClinCheck models were superimposed onto presurgical models using surface best-fit superimposition. Five hundred forty-five teeth were measured for 3 angular movements (buccolingual torque, mesiodistal tip, and rotation) and 4 linear movements (buccolingual, mesiodistal, vertical, and total scalar displacement). The predicted tooth movement was compared with the achieved amount for each movement and tooth, using both percentage accuracy and numerical difference.
Results: Average percentage accuracy (63.4% ± 11.5%) was higher than in previously reported literature. The most accurate tooth movements were buccal torque and mesial displacement compared with lingual torque and distal displacement, particularly for mandibular posterior teeth. Clinically significant inaccuracies were found for the buccal displacement of maxillary second molars, lingual displacement of all molars, intrusion of mandibular second molars, the distal tip of molars, second premolars, and mandibular first premolars, buccal torque of maxillary central and lateral incisors, and lingual torque of premolars and molars.
Conclusions: Superimposition techniques used in this study lay the groundwork for future studies to analyze advanced clear aligner patients. Invisalign is a treatment modality that can be considered for presurgical orthodontics-tooth movements involved in arch leveling and decompensation are highly accurate when comparing the simulated and the clinically achieved movements.
Suh, H; Garnett, B Shen; Mahood, K; Boyd, RL; Oh, H
Treatment of anterior open bites using non-extraction clear aligner therapy in adult patients Journal Article
In: Korean J Orthod, vol. 52, iss. 5, pp. 383-384, 2022.
@article{Oh2022e,
title = {Treatment of anterior open bites using non-extraction clear aligner therapy in adult patients},
author = {H Suh and B Shen Garnett and K Mahood and RL Boyd and H Oh},
url = {https://pubmed.ncbi.nlm.nih.gov/36148645/},
doi = {10.4041/kjod21.180.r},
year = {2022},
date = {2022-09-25},
urldate = {2022-09-25},
journal = {Korean J Orthod},
volume = {52},
issue = {5},
pages = {383-384},
abstract = {Objective: The purpose of this study was to examine the effectiveness and mechanism of clear aligner therapy for the correction of anterior open bite in adult nonextraction cases. Methods: Sixty-nine adult patients with anterior open bite were enrolled and classified into Angle's Class I, II, and III groups. Fifty patients presented with skeletal open bite (mandibular plane angle [MPA] ≥ 38°), whereas 19 presented with dental open bite. Fifteen cephalometric landmarks were identified before (T1) and after (T2) treatment. The magnitudes of planned and actual movements of the incisors and molars were calculated. Results: Positive overbite was achieved in 94% patients, with a mean final overbite of 1.1 ± 0.8 mm. The mean change in overbite was 3.3 ± 1.4 mm. With clear aligners alone, 0.36 ± 0.58 mm of maxillary molar intrusion was achieved. Compared with the Class I group, the Class II group showed greater maxillary molar intrusion and MPA reduction. The Class III group showed greater mandibular incisor extrusion with no significant vertical skeletal changes. Conclusions: Clear aligners can be effective in controlling the vertical dimension and correcting mild to moderate anterior open bite in adult nonextraction cases. The treatment mechanism for Class III patients significantly differed from that for Class I and Class II patients. Maxillary incisor extrusion in patients with dental open bite and MPA reduction with mandibular incisor extrusion in patients with skeletal open bite are the most significant contributing factors for open bite closure.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bianchi, J; Goncalves, J Roberto; Ruellas, A Carlos De Oliveira; Bianchi, J Vierira Pastana; Ashman, LM; et al,
Radiographic interpretation using high-resolution Cbct to diagnose degenerative temporomandibular joint disease Journal Article
In: PLOS ONE, vol. 16, no. 8, pp. e0255937, 2021.
@article{Bianchi2021b,
title = {Radiographic interpretation using high-resolution Cbct to diagnose degenerative temporomandibular joint disease},
author = {J Bianchi and J Roberto Goncalves and A Carlos De Oliveira Ruellas and J Vierira Pastana Bianchi and LM Ashman and et al },
url = {https://pubmed.ncbi.nlm.nih.gov/34375354/},
doi = {10.1371/journal.pone.0255937},
year = {2021},
date = {2021-08-10},
urldate = {2021-08-10},
journal = {PLOS ONE},
volume = {16},
number = {8},
pages = {e0255937},
abstract = {The objective of this study was to use high-resolution cone-beam computed images (hr- CBCT) to diagnose degenerative joint disease in asymptomatic and symptomatic subjects using the Diagnostic Criteria for Temporomandibular Disorders DC/TMD imaging criteria. This observational study comprised of 92 subjects age-sex matched and divided into two groups: clinical degenerative joint disease (c-DJD, n = 46) and asymptomatic control group (n = 46). Clinical assessment of the DJD and high-resolution CBCT images (isotropic voxel size of 0.08mm) of the temporomandibular joints were performed for each participant. An American Board of Oral and Maxillofacial Radiology certified radiologist and a maxillofacial radiologist used the DC/TMD imaging criteria to evaluate the radiographic findings, followed by a consensus of the radiographic evaluation. The two radiologists presented a high agreement (Cohen's Kappa ranging from 0.80 to 0.87) for all radiographic findings (osteophyte, erosion, cysts, flattening, and sclerosis). Five patients from the c- DJD group did not present radiographic findings, being then classified as arthralgia. In the asymptomatic control group, 82.6% of the patients presented radiographic findings determinant of DJD and were then classified as osteoarthrosis or overdiagnosis. In conclusion, our results showed a high number of radiographic findings in the asymptomatic control group, and for this reason, we suggest that there is a need for additional imaging criteria to classify DJD properly in hr-CBCT images.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cong, A; Massaro, C; Bianchi, J; Ruellas, ACDO; et al,
Dental long axes using digital dental models compared to cone-beam computed tomography. Journal Article
In: Orthod Cranifac Res, 2021.
@article{Cong2021,
title = {Dental long axes using digital dental models compared to cone-beam computed tomography.},
author = {A Cong and C Massaro and J Bianchi and ACDO Ruellas and et al},
url = {https://onlinelibrary.wiley.com/doi/10.1111/ocr.12489},
doi = {10.1111/ocr.12489},
year = {2021},
date = {2021-05-09},
urldate = {2021-05-09},
journal = {Orthod Cranifac Res},
abstract = {Standard methods of evaluating tooth long axes are not comparable (digital dental models [DDMs], panoramic and cephalometric radiographs) or expose patients to more radiation (cone-beam computed tomography [CBCT]). This study aimed to compare angular changes in tooth long axes using DDMs vs using CBCTs. },
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Parizotto, JOL; Peixoto, AP; Borsato, KT; Bianchi, J; et al,
Craniofacial and airway morphology of individuals with oculoauriculovertebral spectrum. Journal Article
In: Orthodontics & Craniofacial Research, 2021.
@article{Parizotto2021,
title = {Craniofacial and airway morphology of individuals with oculoauriculovertebral spectrum.},
author = {JOL Parizotto and AP Peixoto and KT Borsato and J Bianchi and et al},
url = {https://pubmed.ncbi.nlm.nih.gov/33713375/},
doi = {10.1111/ocr.12483},
year = {2021},
date = {2021-03-13},
urldate = {2021-03-13},
journal = {Orthodontics & Craniofacial Research},
abstract = {The objectives of this study were to characterize the craniofacial and airway morphology of oculo-auriculo-vertebral spectrum (OAVS) individuals using computed tomography (CT) examination.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Chen, G; Awadi, M Al; Chambers, D W; Lagravere-Vich, M O; Xu, Y; Oh, H
The three-dimensional stable mandibular landmarks in patients between the ages of 12.5 and 17.1 years. Journal Article
In: BMC Oral Health, vol. 20, no. 1, pp. 153, 2020.
@article{Chen2020,
title = {The three-dimensional stable mandibular landmarks in patients between the ages of 12.5 and 17.1 years.},
author = {G Chen and M Al Awadi and D W Chambers and M O Lagravere-Vich and Y Xu and H Oh },
url = {https://pubmed.ncbi.nlm.nih.gov/32460733/},
doi = {10.1186/s12903-020-01142-2},
year = {2020},
date = {2020-05-27},
urldate = {2020-05-27},
journal = {BMC Oral Health},
volume = {20},
number = {1},
pages = {153},
abstract = {With the aid of implants, Björk identified two-dimensional mandibular stable structures in cephalograms during facial growth. However, we do not know what the three-dimensional stable structures are with certainty. The purpose of this study was to identify the most stable mandibular landmarks in growing patients using three-dimensional images.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
C, Thereza-Bussolaro; HS, Oh; M, Lagravere; C, Flores-Mir
Pharyngeal dimensional changes in class II malocclusion treatment when using Forsus® or intermaxillary elastics - An exploratory study. Journal Article
In: Int Orthod, vol. 17, no. 4, pp. 667-677, 2019.
@article{Bussolaro2019,
title = {Pharyngeal dimensional changes in class II malocclusion treatment when using Forsus® or intermaxillary elastics - An exploratory study.},
author = {Thereza-Bussolaro C and Oh HS and Lagravere M and Flores-Mir C },
url = {https://pubmed.ncbi.nlm.nih.gov/31492602/},
doi = {10.1016/j.ortho.2019.08.023},
year = {2019},
date = {2019-09-01},
journal = {Int Orthod},
volume = {17},
number = {4},
pages = {667-677},
abstract = {Pharyngeal airway obstruction can facilitate some forms of sleep disorder breathing (SDB) in susceptible children, especially in those having class II malocclusion. Changes in the anatomic areas surrounding the pharyngeal region during orthodontic treatment could hypothetically impact the pharyngeal airway dimensions. Management of a class II malocclusion on a growing individual with either intermaxillary elastics or different removable or fixed class II appliance designs have been proposed over the last century. The objective of this retrospective exploratory cohort study is to investigate to what extent the class II malocclusion treatment with either intermaxillary elastics (IME) or Forsus® fatigue resistance device (FFRD) leads to changes in oropharyngeal airway dimensions.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Garnett, Bella Shen; Mahood, Kimberly; Nguyen, Mai; Al-Khateeb, Aliaa; Liu, Siqi; Boyd, Robert; Oh, Heesoo
Cephalometric comparison of anterior openbite tx using clear aligners and fixed appliances Journal Article Forthcoming
In: Angle Orthodontist, Forthcoming.
@article{Garnett,
title = {Cephalometric comparison of anterior openbite tx using clear aligners and fixed appliances},
author = {Bella Shen Garnett and Kimberly Mahood and Mai Nguyen and Aliaa Al-Khateeb and Siqi Liu and Robert Boyd and Heesoo Oh},
doi = {10.2319/010418-4.1},
year = {2018},
date = {2018-10-03},
journal = {Angle Orthodontist},
abstract = {Objectives: To compare fixed appliances and clear aligner therapy in correcting anterior open biteand in controlling the vertical dimension in adult patients with hyperdivergent skeletal patterns.
Materials and Methods: In this retrospective study, two treatment groups of adult (_18 years old)hyperdivergent patients (mandibular plane angles of _388) with anterior open bites were included:17 fixed appliance patients and 36 clear aligner patients. Thirteen cephalometric measurementsrepresenting the vertical dimension were reported for each group. A two-sample t-test was used toassess differences in changes in mandibular plane angle and overbite between the two treatmentgroups.
Results: There were no statistical differences found in the magnitude of overbite correction and thechanges in any of the cephalometric measurements for vertical control. The clear aligner groupshowed a slightly greater amount of lower incisor extrusion (P . .009). The main mechanism ofopen bite correction was similar between the two treatment groups and was accomplished throughretroclination of the upper and lower incisors while maintaining the vertical position of the upper andlower molars.
Conclusions: Cephalometric comparison of anterior open bite correction and changes in themandibular plane angle associated with use of clear aligners and fixed appliances did notdemonstrate statistically significant differences in adult hyperdivergent patients. (Angle Orthod.0000;00:000–000.)},
keywords = {},
pubstate = {forthcoming},
tppubtype = {article}
}
Materials and Methods: In this retrospective study, two treatment groups of adult (_18 years old)hyperdivergent patients (mandibular plane angles of _388) with anterior open bites were included:17 fixed appliance patients and 36 clear aligner patients. Thirteen cephalometric measurementsrepresenting the vertical dimension were reported for each group. A two-sample t-test was used toassess differences in changes in mandibular plane angle and overbite between the two treatmentgroups.
Results: There were no statistical differences found in the magnitude of overbite correction and thechanges in any of the cephalometric measurements for vertical control. The clear aligner groupshowed a slightly greater amount of lower incisor extrusion (P . .009). The main mechanism ofopen bite correction was similar between the two treatment groups and was accomplished throughretroclination of the upper and lower incisors while maintaining the vertical position of the upper andlower molars.
Conclusions: Cephalometric comparison of anterior open bite correction and changes in themandibular plane angle associated with use of clear aligners and fixed appliances did notdemonstrate statistically significant differences in adult hyperdivergent patients. (Angle Orthod.0000;00:000–000.)
Liu, S; Oh, H; Chambers, D; Baumrind, S; Xu, T
Interpreting Weightings of the Peer Assessment Rating Index and the Discrepancy Index across Contexts on Chinese Patients. Journal Article
In: European Journal of Orthodontics, vol. 40, no. 2, pp. 157-163, 2018.
@article{Liu2017b,
title = {Interpreting Weightings of the Peer Assessment Rating Index and the Discrepancy Index across Contexts on Chinese Patients.},
author = {S Liu and H Oh and D Chambers and S Baumrind and T Xu},
url = {https://pubmed.ncbi.nlm.nih.gov/28575327/},
doi = {10.1093/ejo/cjx043},
year = {2018},
date = {2018-04-06},
urldate = {2018-04-06},
journal = {European Journal of Orthodontics},
volume = {40},
number = {2},
pages = {157-163},
abstract = {Determine optimal weightings of Peer Assessment Rating (PAR) index and Discrepancy Index (DI) for malocclusion severity assessment in Chinese orthodontic patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Afrand, M; Oh, H; Flores-Mir, C; Lagravere-Vich, M
Growth changes in the anterior and middle cranial bases as assessed through cone-beam computed tomography in adolescents. Journal Article
In: Am J Orthod Dentofacial Orthop, vol. 151, no. 2, pp. 342-350, 2017.
@article{Afrand2017b,
title = {Growth changes in the anterior and middle cranial bases as assessed through cone-beam computed tomography in adolescents.},
author = {M Afrand and H Oh and C Flores-Mir and M Lagravere-Vich},
url = {https://www.sciencedirect.com/science/article/pii/S0889540616307405},
doi = {10.1016/j.ajodo.2016.02.032},
year = {2017},
date = {2017-02-00},
journal = {Am J Orthod Dentofacial Orthop},
volume = {151},
number = {2},
pages = {342-350},
abstract = {Initially, cone-beam computed tomography images from dry skulls were used to 3 dimensionallyevaluate intrarater and interrater reliabilities and accuracy of selected 3-dimensional landmarks located in theanterior and middle cranial bases. Thereafter, dimensional changes of the anterior and middle cranial baseswith growth were evaluated by using the previously selected landmarks.Methods:Cone-beam computed to-mography images of 10 dry skulls were used to identify useful landmarks from different areas of the anteriorand middle cranial bases based on their reliability and accuracy. These selected landmarks were identified inthe images of an already available sample of adolescents (n560) taken at 2 time points (19 months apart)to assess dimensional changes with growth.Results:The majority of the proposed 3-dimensional landmarkswith the exception of the lesser wing of the sphenoid showed acceptable intrarater and interrater reliabilities.The distances measured between foramina and canals in the transverse dimension showed evidence ofincreases in size. However, the mean amounts of increase in these transverse distances were equal to orless than 1.05 mm (from 1.1% to 4.1%). No change was observed between the right and left anterior andposterior clinoid processes. The vertical dimensions showed evidence of some changes, but these werewithin 2% of the original distances.Conclusions:In this adolescent sample, minor growth-related changeswere observed in the anterior and middle cranial bases. The midsagittal area of the anterior cranial base(foramen caecum to presphenoid) was stable. The right and left anterior and posterior clinoid processes canbe used for transverse superimposition. (Am J Orthod Dentofacial Orthop 2017;151:342-50)},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Oh, HS; Korn, EL; Zhang, XY; Liu, Y; Xu, T-M; Boyd, R; Baumrind, S
Correlation between cephalometric and photographic measurements of facial attractiveness in Chinese and U.S. patients at the end of orthodontic treatment. Journal Article
In: American Journal of Orthodontics & Dentofacial Orthopedics, vol. 136, no. 6, pp. e1-14; discussion 762-3, 2009.
@article{Oh2009,
title = {Correlation between cephalometric and photographic measurements of facial attractiveness in Chinese and U.S. patients at the end of orthodontic treatment.},
author = {HS Oh and EL Korn and XY Zhang and Y Liu and T-M Xu and R Boyd and S Baumrind},
url = {https://pubmed.ncbi.nlm.nih.gov/19962590/},
doi = {10.1016/j.ajodo.2009.04.020},
year = {2009},
date = {2009-12-00},
journal = {American Journal of Orthodontics & Dentofacial Orthopedics},
volume = {136},
number = {6},
pages = {e1-14; discussion 762-3},
abstract = {Orthodontists rely on esthetic judgments from facial photographs. Concordance between estimates of facial attractiveness made from lateral cephalograms and those made from clinical photographs has not been determined. We conducted a preliminary examination to correlate clinicians' rankings of facial attractiveness from standardized end-of-treatment facial photographs (Photo Attractiveness Rank) with cephalometric measurements of facial attractiveness made for the same subjects at the same time.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
SK, Lee; YS, Kim; HS, Oh; KH, Yang; EC, Kim; JG, Chi
Prenatal development of the human mandible. Journal Article
In: The Anatomical Record, vol. 263, no. 3, pp. 314-25, 2001.
@article{Lee2001,
title = {Prenatal development of the human mandible. },
author = {Lee SK and Kim YS and Oh HS and Yang KH and Kim EC and Chi JG},
url = {https://pubmed.ncbi.nlm.nih.gov/11455541/},
doi = {10.1002/ar.1110},
year = {2001},
date = {2001-07-01},
journal = {The Anatomical Record},
volume = {263},
number = {3},
pages = {314-25},
abstract = {In an effort to better understand the interrelationship of the growth and development pattern of the mandible and condyle, a sequential growth pattern of human mandibles in 38 embryos and 111 fetuses were examined by serial histological sections and soft X-ray views. The basic growth pattern of the mandibular body and condyle appeared in week 7 of fertilization. Histologically, the embryonal mandible originated from primary intramembranous ossification in the fibrous mesenchymal tissue around the Meckel cartilage. From this initial ossification, the ramifying trabecular bones developed forward, backward and upward, to form the symphysis, mandibular body, and coronoid process, respectively. We named this initial ossification site of embryonal mandible as the mandibular primary growth center (MdPGC). During week 8 of fertilization, the trabecular bone of the mandibular body grew rapidly to form muscular attachments to the masseter, temporalis, and pterygoid muscles. The mandible was then rapidly separated from the Meckel cartilage and formed a condyle blastema at the posterior end of linear mandibular trabeculae. The condyle blastema, attached to the upper part of pterygoid muscle, grew backward and upward and concurrent endochondral ossification resulted in the formation of the condyle. From week 14 of fertilization, the growth of conical structure of condyle became apparent on histological and radiological examinations. The mandibular body showed a conspicuous radiating trabecular growth pattern centered at the MdPGC, located around the apical area of deciduous first molar. The condyle growth showed characteristic conical structure and abundant hematopoietic tissue in the marrow. The growth of the proximal end of condyle was also approximated to the MdPGC on radiograms. Taken together, we hypothesized that the MdPGC has an important morphogenetic affect for the development of the human mandible, providing a growth center for the trabecular bone of mandibular body and also indicating the initial growth of endochondral ossification of the condyle.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2026 |
Tsai, Andrew; Suh, Heeyeon; Tai, Sandra Khong; Baird, Marta; Oh, Heesoo: Stability of transverse changes with clear aligners and hyrax expanders from the mixed to the permanent dentition. In: American Journal of Orthodontics and Dentofacial Orthopedics, 2026, ISSN: 0889-5406. (Type: Journal Article | Abstract | Links | BibTeX | Tags: clear aligners, Hyrax expander, permanent dentition, Transverse)@article{nokey,This study evaluated the longitudinal stability of transverse changes in patients treated with the Invisalign First system (IFS; Align Technology Inc, Tempe, Ariz) and hyrax expanders during the mixed dentition, followed through the permanent dentition. The objective was to determine whether expansion achieved during the mixed dentition was maintained through the transition to the permanent dentition. This retrospective longitudinal study included 119 patients: 44 patients treated with IFS, 36 patients treated with hyrax, and 39 untreated controls. Arch width changes at the canines, premolars, and first molars were measured on digital study models at 3 time points: pre-phase 1 treatment (T1), post-phase 1 treatment (T2), and pre phase 2 evaluation (T3). Vertical skeletal changes were evaluated in a cephalogram subgroup. Statistical analyses included analysis of variance and linear mixed-effects models. Both IFS and hyrax groups showed greater maxillary arch width increases from T1 to T3 (IFS: 1.8-2.8 mm; hyrax: 2.2-3.7 mm) than controls (0.4-1.2 mm; P <0.0001). At T2, hyrax showed significantly greater interpremolar and intermolar expansion (4.1-4.8 mm) than IFS (1.9-2.8 mm), but more relapse from T2 to T3. The IFS group also showed increased mandibular arch width from T1 to T3 (1.9-2.9 mm) compared with controls (P<0.05). No significant vertical skeletal changes from T1 to T3 were observed. Both IFS and hyrax produced maxillary arch expansion that was maintained throughout the transition from mixed to permanent dentition. The IFS also showed stable mandibular arch expansion, supporting its use for mild crowding or transverse deficiencies without long-term vertical effects. |
2025 |
Suh, Heeyeon; Garnett, Bella Shen; Mahood, Kimberly; Oh, Heesoo: Anterior open bite treatment with clear aligners in adults. In: Seminars in Orthodontics, 2025, ISSN: 1073-8746. (Type: Journal Article | Abstract | Links | BibTeX | Tags: anterior open bite, biomechanics, clear aligners, Retention)@article{nokey,Anterior open bites represent one of the most complex malocclusions to treat due to their multifactorial etiology and high risk of relapse. While traditionally managed with fixed appliances, extractions, temporary anchorage devices (TADs), or surgery, clear aligner therapy has emerged as an effective alternative for adult patients when biomechanics are properly applied. Anterior open bite correction with clear aligners occurs primarily through incisor extrusion, with limited and less predictable contributions from molar intrusion. This paper reviews current knowledge on anterior open bite correction with clear aligners, the predictability of relevant tooth movements, and clinical outcomes reported in the literature. It also presents a contemporary clinical protocol for managing anterior open bite with clear aligners, including setup strategies in the digital treatment plan, class-specific considerations, staging, and retention. |
Patel, Esha; Moon, Stacey H.; Suh, Heeyeon; Chen, James; Tai, Sandra Khong; Oh, Heesoo: Clear aligners for Class II correction in growing patients: elastics vs mandibular advancement. In: Angle Orthodontist, vol. 95, 2025. (Type: Journal Article | Abstract | Links | BibTeX | Tags: Class II, clear aligners, elastics, growing patients, Maxillomandibular advancement)@article{nokey,Objectives: To evaluate the skeletal and dental effects of Class II correction in growing patients using clear aligners, with either elastics or mandibular advancement (MA). Materials and Methods: The study included 66 growing Class II patients: 45 patients treated with clear aligners (20 using Class II elastics and 25 with MA) and 21 untreated controls observed over a comparable time period. Nine cephalometric and three study cast measurements were evaluated initially (T1) and the end of treatment (T2) to assess skeletal and dental changes. Results: The control group maintained a Class II molar relationship and overjet, whereas both treatment groups corrected to Class I. In the MA group, statistically significant skeletal changes from T1 to T2 were observed, including reduction in SNA (–1.09°) and ANB (–1.69°), in addition to dentialveolar Class II correction. The elastic group showed no statistically significant changes in SNA and ANB compared to the control group. Linear regression revealed 5.28° of lower incisor proclination with Class II elastics, whereas lower incisor inclination was maintained with MA treatment. Conclusions: Clear aligner treatment with Class II elastics and MA were effective for correcting Class II malocclusion in growing patients that would have otherwise been maintained without intervention. Although Class II correction was mainly due to dentoalveolar changes, a skeletal component was observed with MA treatment. |
2023 |
Suh, H; Garnett, B; Mahood, K; Boyd, R; Oh, H: Short-term stability of anterior open bite treatment with clear aligners in adults. In: Am J Orthod Dentofacial Orthop, vol. 164, iss. 6, pp. 774-782, 2023. (Type: Journal Article | Abstract | Links | BibTeX | Tags: anterior openbite, clear aligners, short-term stability)@article{Oh2023d,Introduction: This study aimed to examine the stability of anterior open bite (AOB) treatment with clear aligners. Methods: This retrospective cohort study included 52 adult AOB patients (aged >18 years; 15 males, 37 females) who underwent nonextraction clear aligner treatment and were at least 1 year posttreatment. Eleven cephalometric measurements were evaluated at pretreatment, end of active treatment, and at least 1-year posttreatment. Overbite change, the primary outcome variable, and other cephalometric changes during treatment and retention were calculated, and repeated measures analysis of variance were performed. Stepwise multiple regression was used to make a prediction equation for open bite relapse. Results: The mean retention period was 2.1 ± 1.1 years. The mean change in overbite during treatment was 3.3 ± 1.5 mm; 6% of patients presented relapse at least 1 year after treatment completion. The mean change of overbite (0.2 ± 0.5 mm) during the retention period was not statistically significant (P = 0.59). None of the 11 cephalometric measurements showed significant change during the retention period. The prediction model showed that only the coefficient for a tongue posture issue at the initial examination was statistically significant. Conclusions: AOB was successfully corrected in all 52 patients using only clear aligners with no additional adjunctive aids such as microimplants. When retained with maxillary and mandibular fixed retainers and maxillary and mandibular vacuum-formed retainers, there was no significant change in cephalometric measurements during the short-term retention period. |
ML, Gurgel; de Oliveria Ruellas A.C,; J, Bianchi; JA, McNamara; S, Tai; and, Franchi L: Clear aligner mandibular advancement in growing patients with Class II malocclusion.. In: AJO DO Clin Companion, vol. 3, iss. 2, pp. 93-109, 2023. (Type: Journal Article | Abstract | Links | BibTeX | Tags: Class II malocclusion, clear aligners, growing patients, three-dimensional)@article{Bianchi2023b,Treatment effects occurring during Class II malocclusion treatment with the clear aligner mandibular advancement protocol were evaluated in two growing patients: one male (12 years, 3 months) and one female (11 years, 9 months). Both patients presented with full cusp Class II molar and canine relationships. Intraoral scans and cone-beam computed tomography were acquired before treatment and after mandibular advancement. Three-dimensional skeletal and dental long-axis changes were quantified, in which the dental long axis was determined by registering the dental crowns obtained from intraoral scans to the root canals in cone-beam computed tomography scans obtained at the same time points. Class II correction was achieved by a combination of mandibular skeletal and dental changes. A similar direction of skeletal and dental changes was observed in both patients, with downward and forward displacement of the mandible resulting from the growth of the mandibular condyle and ramus. Dental changes in both patients included mesialization of the mandibular posterior teeth with flaring of mandibular anterior teeth. In these two patients, clear aligner mandibular advancement was an effective treatment modality for Class II malocclusion correction with skeletal and dental effects and facial profile improvement. |
2022 |
A, Cong; de Oliveria Ruellas A.C,; S.K, Tai; C.T, Loh; M, Barkley; M, Yatabe; M, Caminiti; C, Massaro; J, Bianchi; R, Deleat-Besson: Presurgical orthodontic decompensation with clear aligners. In: American Journal of Orthodontics & Dentofacial Orthopedics, vol. 162, iss. 4, pp. 538-553, 2022. (Type: Journal Article | Abstract | Links | BibTeX | Tags: clear aligners, decomposition, ortho, orthodontic)@article{Bianchi2022c,Introduction: Orthodontists, surgeons, and patients have taken an interest in using clear aligners in combination with orthognathic surgery. This study aimed to evaluate the accuracy of tooth movements with clear aligners during presurgical orthodontics using novel 3-dimensional superimposition techniques. Methods: The study sample consisted of 20 patients who have completed presurgical orthodontics using Invisalign clear aligners. Initial (pretreatment) digital dental models, presurgical digital dental models, and ClinCheck prediction models were obtained. Presurgical models were superimposed onto initial ones using stable anatomic landmarks; ClinCheck models were superimposed onto presurgical models using surface best-fit superimposition. Five hundred forty-five teeth were measured for 3 angular movements (buccolingual torque, mesiodistal tip, and rotation) and 4 linear movements (buccolingual, mesiodistal, vertical, and total scalar displacement). The predicted tooth movement was compared with the achieved amount for each movement and tooth, using both percentage accuracy and numerical difference. Results: Average percentage accuracy (63.4% ± 11.5%) was higher than in previously reported literature. The most accurate tooth movements were buccal torque and mesial displacement compared with lingual torque and distal displacement, particularly for mandibular posterior teeth. Clinically significant inaccuracies were found for the buccal displacement of maxillary second molars, lingual displacement of all molars, intrusion of mandibular second molars, the distal tip of molars, second premolars, and mandibular first premolars, buccal torque of maxillary central and lateral incisors, and lingual torque of premolars and molars. Conclusions: Superimposition techniques used in this study lay the groundwork for future studies to analyze advanced clear aligner patients. Invisalign is a treatment modality that can be considered for presurgical orthodontics-tooth movements involved in arch leveling and decompensation are highly accurate when comparing the simulated and the clinically achieved movements. |
Suh, H; Garnett, B Shen; Mahood, K; Boyd, RL; Oh, H: Treatment of anterior open bites using non-extraction clear aligner therapy in adult patients. In: Korean J Orthod, vol. 52, iss. 5, pp. 383-384, 2022. (Type: Journal Article | Abstract | Links | BibTeX | Tags: aligner therapy, anterior openbite, clear aligners, non-extraction)@article{Oh2022e,Objective: The purpose of this study was to examine the effectiveness and mechanism of clear aligner therapy for the correction of anterior open bite in adult nonextraction cases. Methods: Sixty-nine adult patients with anterior open bite were enrolled and classified into Angle's Class I, II, and III groups. Fifty patients presented with skeletal open bite (mandibular plane angle [MPA] ≥ 38°), whereas 19 presented with dental open bite. Fifteen cephalometric landmarks were identified before (T1) and after (T2) treatment. The magnitudes of planned and actual movements of the incisors and molars were calculated. Results: Positive overbite was achieved in 94% patients, with a mean final overbite of 1.1 ± 0.8 mm. The mean change in overbite was 3.3 ± 1.4 mm. With clear aligners alone, 0.36 ± 0.58 mm of maxillary molar intrusion was achieved. Compared with the Class I group, the Class II group showed greater maxillary molar intrusion and MPA reduction. The Class III group showed greater mandibular incisor extrusion with no significant vertical skeletal changes. Conclusions: Clear aligners can be effective in controlling the vertical dimension and correcting mild to moderate anterior open bite in adult nonextraction cases. The treatment mechanism for Class III patients significantly differed from that for Class I and Class II patients. Maxillary incisor extrusion in patients with dental open bite and MPA reduction with mandibular incisor extrusion in patients with skeletal open bite are the most significant contributing factors for open bite closure. |
2021 |
Bianchi, J; Goncalves, J Roberto; Ruellas, A Carlos De Oliveira; Bianchi, J Vierira Pastana; Ashman, LM; et al,: Radiographic interpretation using high-resolution Cbct to diagnose degenerative temporomandibular joint disease. In: PLOS ONE, vol. 16, no. 8, pp. e0255937, 2021. (Type: Journal Article | Abstract | Links | BibTeX | Tags: AAOF, Adolescents, anterior openbite, clear aligners, clinical orthodontist, Cone-beam computed tomography, Cranial base, fixed appliances, Growth, hyperdivergent, Mandibular fixed retainer)@article{Bianchi2021b,The objective of this study was to use high-resolution cone-beam computed images (hr- CBCT) to diagnose degenerative joint disease in asymptomatic and symptomatic subjects using the Diagnostic Criteria for Temporomandibular Disorders DC/TMD imaging criteria. This observational study comprised of 92 subjects age-sex matched and divided into two groups: clinical degenerative joint disease (c-DJD, n = 46) and asymptomatic control group (n = 46). Clinical assessment of the DJD and high-resolution CBCT images (isotropic voxel size of 0.08mm) of the temporomandibular joints were performed for each participant. An American Board of Oral and Maxillofacial Radiology certified radiologist and a maxillofacial radiologist used the DC/TMD imaging criteria to evaluate the radiographic findings, followed by a consensus of the radiographic evaluation. The two radiologists presented a high agreement (Cohen's Kappa ranging from 0.80 to 0.87) for all radiographic findings (osteophyte, erosion, cysts, flattening, and sclerosis). Five patients from the c- DJD group did not present radiographic findings, being then classified as arthralgia. In the asymptomatic control group, 82.6% of the patients presented radiographic findings determinant of DJD and were then classified as osteoarthrosis or overdiagnosis. In conclusion, our results showed a high number of radiographic findings in the asymptomatic control group, and for this reason, we suggest that there is a need for additional imaging criteria to classify DJD properly in hr-CBCT images. |
Cong, A; Massaro, C; Bianchi, J; Ruellas, ACDO; et al,: Dental long axes using digital dental models compared to cone-beam computed tomography.. In: Orthod Cranifac Res, 2021. (Type: Journal Article | Abstract | Links | BibTeX | Tags: AAOF, adult, clear aligners, Cranial base, hyperdivergent, Mandibular fixed retainer, Posttreatment, retrospective, teaching)@article{Cong2021,Standard methods of evaluating tooth long axes are not comparable (digital dental models [DDMs], panoramic and cephalometric radiographs) or expose patients to more radiation (cone-beam computed tomography [CBCT]). This study aimed to compare angular changes in tooth long axes using DDMs vs using CBCTs. |
Parizotto, JOL; Peixoto, AP; Borsato, KT; Bianchi, J; et al,: Craniofacial and airway morphology of individuals with oculoauriculovertebral spectrum.. In: Orthodontics & Craniofacial Research, 2021. (Type: Journal Article | Abstract | Links | BibTeX | Tags: AAOF, anterior openbite, clear aligners, clinical orthodontist, Mandibular fixed retainer, Posttreatment, research, technique, vertical control, x-ray)@article{Parizotto2021,The objectives of this study were to characterize the craniofacial and airway morphology of oculo-auriculo-vertebral spectrum (OAVS) individuals using computed tomography (CT) examination. |
2020 |
Chen, G; Awadi, M Al; Chambers, D W; Lagravere-Vich, M O; Xu, Y; Oh, H: The three-dimensional stable mandibular landmarks in patients between the ages of 12.5 and 17.1 years.. In: BMC Oral Health, vol. 20, no. 1, pp. 153, 2020. (Type: Journal Article | Abstract | Links | BibTeX | Tags: AAOF, clear aligners, clinical orthodontist, Cone-beam computed tomography, Cranial base, technique)@article{Chen2020,With the aid of implants, Björk identified two-dimensional mandibular stable structures in cephalograms during facial growth. However, we do not know what the three-dimensional stable structures are with certainty. The purpose of this study was to identify the most stable mandibular landmarks in growing patients using three-dimensional images. |
2019 |
C, Thereza-Bussolaro; HS, Oh; M, Lagravere; C, Flores-Mir: Pharyngeal dimensional changes in class II malocclusion treatment when using Forsus® or intermaxillary elastics - An exploratory study.. In: Int Orthod, vol. 17, no. 4, pp. 667-677, 2019. (Type: Journal Article | Abstract | Links | BibTeX | Tags: AAOF, adult, clear aligners, Cone-beam computed tomography, Cranial base, craniofacial, Mandibular fixed retainer, Mandibular remodeling, Peer Assessment Rating Index, pressure tension, research, teaching, technique, vertical control)@article{Bussolaro2019,Pharyngeal airway obstruction can facilitate some forms of sleep disorder breathing (SDB) in susceptible children, especially in those having class II malocclusion. Changes in the anatomic areas surrounding the pharyngeal region during orthodontic treatment could hypothetically impact the pharyngeal airway dimensions. Management of a class II malocclusion on a growing individual with either intermaxillary elastics or different removable or fixed class II appliance designs have been proposed over the last century. The objective of this retrospective exploratory cohort study is to investigate to what extent the class II malocclusion treatment with either intermaxillary elastics (IME) or Forsus® fatigue resistance device (FFRD) leads to changes in oropharyngeal airway dimensions. |
2018 |
Garnett, Bella Shen; Mahood, Kimberly; Nguyen, Mai; Al-Khateeb, Aliaa; Liu, Siqi; Boyd, Robert; Oh, Heesoo: Cephalometric comparison of anterior openbite tx using clear aligners and fixed appliances. In: Angle Orthodontist, Forthcoming. (Type: Journal Article | Abstract | Links | BibTeX | Tags: adult, anterior openbite, clear aligners, fixed appliances, hyperdivergent, open bite, vertical control)@article{Garnett,Objectives: To compare fixed appliances and clear aligner therapy in correcting anterior open biteand in controlling the vertical dimension in adult patients with hyperdivergent skeletal patterns. Materials and Methods: In this retrospective study, two treatment groups of adult (_18 years old)hyperdivergent patients (mandibular plane angles of _388) with anterior open bites were included:17 fixed appliance patients and 36 clear aligner patients. Thirteen cephalometric measurementsrepresenting the vertical dimension were reported for each group. A two-sample t-test was used toassess differences in changes in mandibular plane angle and overbite between the two treatmentgroups. Results: There were no statistical differences found in the magnitude of overbite correction and thechanges in any of the cephalometric measurements for vertical control. The clear aligner groupshowed a slightly greater amount of lower incisor extrusion (P . .009). The main mechanism ofopen bite correction was similar between the two treatment groups and was accomplished throughretroclination of the upper and lower incisors while maintaining the vertical position of the upper andlower molars. Conclusions: Cephalometric comparison of anterior open bite correction and changes in themandibular plane angle associated with use of clear aligners and fixed appliances did notdemonstrate statistically significant differences in adult hyperdivergent patients. (Angle Orthod.0000;00:000–000.) |
Liu, S; Oh, H; Chambers, D; Baumrind, S; Xu, T: Interpreting Weightings of the Peer Assessment Rating Index and the Discrepancy Index across Contexts on Chinese Patients.. In: European Journal of Orthodontics, vol. 40, no. 2, pp. 157-163, 2018. (Type: Journal Article | Abstract | Links | BibTeX | Tags: clear aligners, clinical orthodontist, Cone-beam computed tomography, Cranial base, Growth, hyperdivergent, malocclusion severity, mandibular asymmetry, Peer Assessment Rating Index, teaching, vertical control)@article{Liu2017b,Determine optimal weightings of Peer Assessment Rating (PAR) index and Discrepancy Index (DI) for malocclusion severity assessment in Chinese orthodontic patients. |
2017 |
Afrand, M; Oh, H; Flores-Mir, C; Lagravere-Vich, M: Growth changes in the anterior and middle cranial bases as assessed through cone-beam computed tomography in adolescents.. In: Am J Orthod Dentofacial Orthop, vol. 151, no. 2, pp. 342-350, 2017. (Type: Journal Article | Abstract | Links | BibTeX | Tags: AAOF, anterior openbite, clear aligners, clinical orthodontist, Cone-beam computed tomography, Cranial base, hyperdivergent, Mandibular fixed retainer, orthodontic, Peer Assessment Rating Index, Posttreatment, retrospective, technique)@article{Afrand2017b,Initially, cone-beam computed tomography images from dry skulls were used to 3 dimensionallyevaluate intrarater and interrater reliabilities and accuracy of selected 3-dimensional landmarks located in theanterior and middle cranial bases. Thereafter, dimensional changes of the anterior and middle cranial baseswith growth were evaluated by using the previously selected landmarks.Methods:Cone-beam computed to-mography images of 10 dry skulls were used to identify useful landmarks from different areas of the anteriorand middle cranial bases based on their reliability and accuracy. These selected landmarks were identified inthe images of an already available sample of adolescents (n560) taken at 2 time points (19 months apart)to assess dimensional changes with growth.Results:The majority of the proposed 3-dimensional landmarkswith the exception of the lesser wing of the sphenoid showed acceptable intrarater and interrater reliabilities.The distances measured between foramina and canals in the transverse dimension showed evidence ofincreases in size. However, the mean amounts of increase in these transverse distances were equal to orless than 1.05 mm (from 1.1% to 4.1%). No change was observed between the right and left anterior andposterior clinoid processes. The vertical dimensions showed evidence of some changes, but these werewithin 2% of the original distances.Conclusions:In this adolescent sample, minor growth-related changeswere observed in the anterior and middle cranial bases. The midsagittal area of the anterior cranial base(foramen caecum to presphenoid) was stable. The right and left anterior and posterior clinoid processes canbe used for transverse superimposition. (Am J Orthod Dentofacial Orthop 2017;151:342-50) |
2009 |
Oh, HS; Korn, EL; Zhang, XY; Liu, Y; Xu, T-M; Boyd, R; Baumrind, S: Correlation between cephalometric and photographic measurements of facial attractiveness in Chinese and U.S. patients at the end of orthodontic treatment.. In: American Journal of Orthodontics & Dentofacial Orthopedics, vol. 136, no. 6, pp. e1-14; discussion 762-3, 2009. (Type: Journal Article | Abstract | Links | BibTeX | Tags: AAOF, Adolescents, anterior openbite, clear aligners, clinical orthodontist, Cone-beam computed tomography, Cranial base, Discrepency Index, hyperdivergent, Mandibular fixed retainer, Peer Assessment Rating Index, Posttreatment)@article{Oh2009,Orthodontists rely on esthetic judgments from facial photographs. Concordance between estimates of facial attractiveness made from lateral cephalograms and those made from clinical photographs has not been determined. We conducted a preliminary examination to correlate clinicians' rankings of facial attractiveness from standardized end-of-treatment facial photographs (Photo Attractiveness Rank) with cephalometric measurements of facial attractiveness made for the same subjects at the same time. |
2001 |
SK, Lee; YS, Kim; HS, Oh; KH, Yang; EC, Kim; JG, Chi: Prenatal development of the human mandible. . In: The Anatomical Record, vol. 263, no. 3, pp. 314-25, 2001. (Type: Journal Article | Abstract | Links | BibTeX | Tags: adult, anterior openbite, clear aligners, clinical orthodontist, Cone-beam computed tomography, craniofacial, Discrepency Index, hyperdivergent, Mandibular fixed retainer, Posttreatment, pressure tension)@article{Lee2001,In an effort to better understand the interrelationship of the growth and development pattern of the mandible and condyle, a sequential growth pattern of human mandibles in 38 embryos and 111 fetuses were examined by serial histological sections and soft X-ray views. The basic growth pattern of the mandibular body and condyle appeared in week 7 of fertilization. Histologically, the embryonal mandible originated from primary intramembranous ossification in the fibrous mesenchymal tissue around the Meckel cartilage. From this initial ossification, the ramifying trabecular bones developed forward, backward and upward, to form the symphysis, mandibular body, and coronoid process, respectively. We named this initial ossification site of embryonal mandible as the mandibular primary growth center (MdPGC). During week 8 of fertilization, the trabecular bone of the mandibular body grew rapidly to form muscular attachments to the masseter, temporalis, and pterygoid muscles. The mandible was then rapidly separated from the Meckel cartilage and formed a condyle blastema at the posterior end of linear mandibular trabeculae. The condyle blastema, attached to the upper part of pterygoid muscle, grew backward and upward and concurrent endochondral ossification resulted in the formation of the condyle. From week 14 of fertilization, the growth of conical structure of condyle became apparent on histological and radiological examinations. The mandibular body showed a conspicuous radiating trabecular growth pattern centered at the MdPGC, located around the apical area of deciduous first molar. The condyle growth showed characteristic conical structure and abundant hematopoietic tissue in the marrow. The growth of the proximal end of condyle was also approximated to the MdPGC on radiograms. Taken together, we hypothesized that the MdPGC has an important morphogenetic affect for the development of the human mandible, providing a growth center for the trabecular bone of mandibular body and also indicating the initial growth of endochondral ossification of the condyle. |