{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T15:06:09Z","timestamp":1780067169187,"version":"3.54.0"},"reference-count":72,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess three-dimensional (3D) changes in tooth position, arch dimensions, and gingival levels after mandibular total arch distalization in skeletal Class III malocclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Skeletal Class III patients treated with mandibular total arch distalization using interradicular temporary anchorage devices were analyzed using stepwise 3D superimposition and reorientation of serial cone beam computed tomography (CBCT) and digital casts (N = 19). After mandibular regional superimposition of pre- (T0) and post-treatment (T1) CBCTs, the mandibles were segmented and merged with the corresponding digital casts, generating reoriented, superimposed T0 and T1 digital casts. Changes in individual tooth position, arch dimensions, occlusal plane, and clinical crown height (CCH) were measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mandibular teeth exhibited posterior movement ranging from 1.74 to 2.50 mm with significant lateral movement of the premolars and increase of inter-premolar width by 2.15\u20132.66 mm (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05). Extrusive movement of the entire dentition excluding the second molar was noted (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05), inducing changes of the occlusal plane. The overall changes in CCH were limited to \u22120.23 to 0.16 mm. CCH significantly increased in the premolars and decreased in the first molar (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Based on a stepwise digital superimposition, mandibular total arch distalization induced complex 3D changes in the mandibular arch, including distalization, extrusion, and increase of interpremolar width. Gingival margins generally were maintained, though mild-to-moderate recession was suggested in around 20% of the premolars, which may require attention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/010125-2.1","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:30:15Z","timestamp":1753662615000},"page":"611-618","source":"Crossref","is-referenced-by-count":1,"title":["Three-dimensional changes of the mandibular arch after total arch distalization in skeletal Class III malocclusion"],"prefix":"10.2319","volume":"95","author":[{"given":"Youi","family":"Sreng","sequence":"first","affiliation":[{"name":"Graduate Student, Department of Orthodontics, Gangnam Severance Hospital, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Hyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Professor, Department of Orthodontics, Gangnam Severance Hospital, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tung","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Professor, Department of Orthodontics, University of North Carolina School of Dentistry, Chapel Hill, NC, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kee-Joon","family":"Lee","sequence":"additional","affiliation":[{"name":"Professor, Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung-Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"Professor, Department of Orthodontics, Gangnam Severance Hospital, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chooryung J.","family":"Chung","sequence":"additional","affiliation":[{"name":"Professor and Chair, Department of Orthodontics, Gangnam Severance Hospital, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i1945-7103-95-6-611-b01","series-title":"Contemporary Orthodontics","author":"Proffit","year":"2018","unstructured":"Proffit WR,\nFields H,\nLarson B,\nSarver DM. Contemporary Orthodontics. St Louis: Mosby; 2018."},{"key":"i1945-7103-95-6-611-b02","series-title":"Angle Orthod","first-page":"266","article-title":"Distalization pattern of the maxillary arch depending on the number of orthodontic miniscrews","volume":"83","author":"Bechtold","year":"2013","unstructured":"Bechtold TE,\nKim JW,\nChoi TH,\nPark YC,\nLee KJ. Distalization pattern of the maxillary arch depending on the number of orthodontic miniscrews. Angle Orthod. 2013;83:266\u2013273."},{"key":"i1945-7103-95-6-611-b03","series-title":"Am J Orthod Dentofacial Orthop","first-page":"1116","article-title":"Comparative evaluation of treatment outcomes between temporary anchorage devices and Class III elastics in Class III malocclusions","volume":"151","author":"Nakamura","year":"2017","unstructured":"Nakamura M,\nKawanabe N,\nKataoka T,\nMurakami T,\nYamashiro T,\nKamioka H. Comparative evaluation of treatment outcomes between temporary anchorage devices and Class III elastics in Class III malocclusions. Am J Orthod Dentofacial Orthop. 2017;151:1116\u20131124."},{"key":"i1945-7103-95-6-611-b04","series-title":"Semin Orthod","first-page":"83","article-title":"Advanced biomechanics for total arch movement and non-surgical treatment for hyperdivergent faces","volume":"24","author":"Lee","year":"2018","unstructured":"Lee KJ,\nKim SJ. Advanced biomechanics for total arch movement and non-surgical treatment for hyperdivergent faces. Semin Orthod. 2018;24:83\u201394."},{"key":"i1945-7103-95-6-611-b05","series-title":"Angle Orthod","first-page":"505","article-title":"Nonsurgical and nonprosthetic camouflage treatment of skeletal Class II open bite with bilaterally missing lower first molars","volume":"89","author":"Nguyen","year":"2019","unstructured":"Nguyen T,\nBaek ES,\nHwang S,\nKim KH,\nChung CJ. 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Quantitative and perceived visual changes of the nasolabial fold following orthodontic retraction of lip protrusion. Angle Orthod. 2018;88:465\u2013473."},{"key":"i1945-7103-95-6-611-b08","series-title":"J Dent Res","first-page":"1372","article-title":"Deep learning-based prediction of the 3D postorthodontic facial changes","volume":"101","author":"Park","year":"2022","unstructured":"Park YS,\nChoi JH,\nKim Y, et al. Deep learning-based prediction of the 3D postorthodontic facial changes. J Dent Res. 2022;101:1372\u20131379."},{"key":"i1945-7103-95-6-611-b09","series-title":"Angle Orthod","first-page":"362","article-title":"Long-term stability of miniscrew anchored maxillary molar distalization in Class II treatment","volume":"90","author":"Bechtold","year":"2020","unstructured":"Bechtold TE,\nPark YC,\nKim KH,\nJung H,\nKang JY,\nChoi YJ. Long-term stability of miniscrew anchored maxillary molar distalization in Class II treatment. Angle Orthod. 2020;90:362\u2013368."},{"key":"i1945-7103-95-6-611-b10","series-title":"Appl Sci-Basel","article-title":"Stability of the maxillary and mandibular total arch distalization using temporary anchorage devices (TADs) in adults","volume":"12","author":"Song","year":"2022","unstructured":"Song BJ,\nLee KJ,\nCha JY,\nLee JS,\nMo SS,\nYu HS. Stability of the maxillary and mandibular total arch distalization using temporary anchorage devices (TADs) in adults. Appl Sci-Basel. 2022;12."},{"key":"i1945-7103-95-6-611-b11","series-title":"Am J Orthod Dentofacial Orthop","first-page":"470","article-title":"Treatment effects of microimplant-aided sliding mechanics on distal retraction of posterior teeth","volume":"139","author":"Oh","year":"2011","unstructured":"Oh YH,\nPark HS,\nKwon TG. Treatment effects of microimplant-aided sliding mechanics on distal retraction of posterior teeth. Am J Orthod Dentofacial Orthop. 2011;139:470\u2013481."},{"key":"i1945-7103-95-6-611-b12","series-title":"Am J Orthod Dentofacial Orthop","first-page":"529","article-title":"Comparison of treatment effects after total mandibular arch distalization with miniscrews vs ramal plates in patients with Class III malocclusion","volume":"161","author":"Yeon","year":"2022","unstructured":"Yeon BM,\nLee NK,\nPark JH,\nKim JM,\nKim SH,\nKook YA. Comparison of treatment effects after total mandibular arch distalization with miniscrews vs ramal plates in patients with Class III malocclusion. Am J Orthod Dentofacial Orthop. 2022;161:529\u2013536."},{"key":"i1945-7103-95-6-611-b13","series-title":"Am J Orthod Dentofacial Orthop","first-page":"130","article-title":"Distal movement of mandibular molars in adult patients with the skeletal anchorage system","volume":"125","author":"Sugawara","year":"2004","unstructured":"Sugawara J,\nDaimaruya T,\nUmemori M, et al. Distal movement of mandibular molars in adult patients with the skeletal anchorage system. Am J Orthod Dentofacial Orthop. 2004;125:130\u2013138."},{"key":"i1945-7103-95-6-611-b14","series-title":"Sci Rep","first-page":"5838","article-title":"Assessment of different techniques for 3D superimposition of serial digital maxillary dental casts on palatal structures","volume":"7","author":"Vasilakos","year":"2017","unstructured":"Vasilakos G,\nSchilling R,\nHalazonetis D,\nGkantidis N. Assessment of different techniques for 3D superimposition of serial digital maxillary dental casts on palatal structures. Sci Rep. 2017;7:5838."},{"key":"i1945-7103-95-6-611-b15","series-title":"Am J Orthod Dentofacial Orthop","first-page":"347","article-title":"Anchorage loss assessment of the indirect anchor tooth during adjunctive orthodontic treatment","volume":"155","author":"Jang","year":"2019","unstructured":"Jang W,\nChoi YJ,\nHwang S,\nChung CJ,\nKim KH. 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Am J Orthod Dentofacial Orthop. 2014;145:655\u2013666."},{"key":"i1945-7103-95-6-611-b31","series-title":"Am J Orthod Dentofacial Orthop","first-page":"36","article-title":"Gingival reactions after experimentally induced extrusion of the upper incisors in monkeys","volume":"104","author":"Kajiyama","year":"1993","unstructured":"Kajiyama K,\nMurakami T,\nYokota S. Gingival reactions after experimentally induced extrusion of the upper incisors in monkeys. Am J Orthod Dentofacial Orthop. 1993;104:36\u201347."},{"key":"i1945-7103-95-6-611-b32","series-title":"J Am Dent Assoc","first-page":"220","article-title":"The etiology and prevalence of gingival recession","volume":"134","author":"Kassab","year":"2003","unstructured":"Kassab MM,\nCohen RE. The etiology and prevalence of gingival recession. J Am Dent Assoc. 2003;134:220\u2013225."},{"key":"i1945-7103-95-6-611-b33","series-title":"Am J Orthod Dentofacial Orthop","first-page":"365","article-title":"The 3-dimensional zone of the center of resistance of the mandibular posterior teeth segment","volume":"156","author":"Oh","year":"2019","unstructured":"Oh MB,\nMo SS,\nHwang CJ,\nChung C,\nKang JM,\nLee KJ. The 3-dimensional zone of the center of resistance of the mandibular posterior teeth segment. Am J Orthod Dentofacial Orthop. 2019;156:365\u2013374."},{"key":"i1945-7103-95-6-611-b34","series-title":"Am J Orthod Dentofacial Orthop","first-page":"148","article-title":"Transverse dental compensation in relation to sagittal and transverse skeletal discrepancies in skeletal Class III patients","volume":"151","author":"Ahn","year":"2017","unstructured":"Ahn J,\nKim SJ,\nLee JY,\nChung CJ,\nKim KH. Transverse dental compensation in relation to sagittal and transverse skeletal discrepancies in skeletal Class III patients. Am J Orthod Dentofacial Orthop. 2017;151:148\u2013156."},{"key":"i1945-7103-95-6-611-b35","series-title":"J Clin Orthod","first-page":"305","article-title":"Anatomical limits for distalization of lower posterior molars with micro-implant anchorage","volume":"53","author":"Kim","year":"2019","unstructured":"Kim HJ,\nJang WS,\nPark HS. Anatomical limits for distalization of lower posterior molars with micro-implant anchorage. J Clin Orthod. 2019;53:305\u2013313."},{"key":"i1945-7103-95-6-611-b36","series-title":"Angle Orthod","first-page":"159","article-title":"Comparison of posttreatment stability after total mandibular arch distalization with mini-implants and mandibular setback surgery","volume":"94","author":"Kook","year":"2024","unstructured":"Kook YA,\nChoi TH,\nPark JH,\nKim SH,\nLee NK. Comparison of posttreatment stability after total mandibular arch distalization with mini-implants and mandibular setback surgery. Angle Orthod. 2024;94:159\u2013167."},{"key":"i1945-7103-95-6-611-b01","series-title":"Contemporary Orthodontics","author":"Proffit","year":"2018","unstructured":"Proffit WR,\nFields H,\nLarson B,\nSarver DM. Contemporary Orthodontics. St Louis: Mosby; 2018."},{"key":"i1945-7103-95-6-611-b02","series-title":"Angle Orthod","first-page":"266","article-title":"Distalization pattern of the maxillary arch depending on the number of orthodontic miniscrews","volume":"83","author":"Bechtold","year":"2013","unstructured":"Bechtold TE,\nKim JW,\nChoi TH,\nPark YC,\nLee KJ. Distalization pattern of the maxillary arch depending on the number of orthodontic miniscrews. Angle Orthod. 2013;83:266\u2013273."},{"key":"i1945-7103-95-6-611-b03","series-title":"Am J Orthod Dentofacial Orthop","first-page":"1116","article-title":"Comparative evaluation of treatment outcomes between temporary anchorage devices and Class III elastics in Class III malocclusions","volume":"151","author":"Nakamura","year":"2017","unstructured":"Nakamura M,\nKawanabe N,\nKataoka T,\nMurakami T,\nYamashiro T,\nKamioka H. Comparative evaluation of treatment outcomes between temporary anchorage devices and Class III elastics in Class III malocclusions. Am J Orthod Dentofacial Orthop. 2017;151:1116\u20131124."},{"key":"i1945-7103-95-6-611-b04","series-title":"Semin Orthod","first-page":"83","article-title":"Advanced biomechanics for total arch movement and non-surgical treatment for hyperdivergent faces","volume":"24","author":"Lee","year":"2018","unstructured":"Lee KJ,\nKim SJ. Advanced biomechanics for total arch movement and non-surgical treatment for hyperdivergent faces. Semin Orthod. 2018;24:83\u201394."},{"key":"i1945-7103-95-6-611-b05","series-title":"Angle Orthod","first-page":"505","article-title":"Nonsurgical and nonprosthetic camouflage treatment of skeletal Class II open bite with bilaterally missing lower first molars","volume":"89","author":"Nguyen","year":"2019","unstructured":"Nguyen T,\nBaek ES,\nHwang S,\nKim KH,\nChung CJ. Nonsurgical and nonprosthetic camouflage treatment of skeletal Class II open bite with bilaterally missing lower first molars. Angle Orthod. 2019;89:505\u2013517."},{"key":"i1945-7103-95-6-611-b06","series-title":"Korean J Orthod","first-page":"59","article-title":"Total intrusion and distalization of the maxillary arch to improve smile esthetics","volume":"47","author":"Baek","year":"2017","unstructured":"Baek ES,\nHwang S,\nKim KH,\nChung CJ. Total intrusion and distalization of the maxillary arch to improve smile esthetics. Korean J Orthod. 2017;47:59\u201373."},{"key":"i1945-7103-95-6-611-b07","series-title":"Angle Orthod","first-page":"465","article-title":"Quantitative and perceived visual changes of the nasolabial fold following orthodontic retraction of lip protrusion","volume":"88","author":"Baek","year":"2018","unstructured":"Baek ES,\nHwang S,\nChoi YJ, et al. Quantitative and perceived visual changes of the nasolabial fold following orthodontic retraction of lip protrusion. Angle Orthod. 2018;88:465\u2013473."},{"key":"i1945-7103-95-6-611-b08","series-title":"J Dent Res","first-page":"1372","article-title":"Deep learning-based prediction of the 3D postorthodontic facial changes","volume":"101","author":"Park","year":"2022","unstructured":"Park YS,\nChoi JH,\nKim Y, et al. Deep learning-based prediction of the 3D postorthodontic facial changes. J Dent Res. 2022;101:1372\u20131379."},{"key":"i1945-7103-95-6-611-b09","series-title":"Angle Orthod","first-page":"362","article-title":"Long-term stability of miniscrew anchored maxillary molar distalization in Class II treatment","volume":"90","author":"Bechtold","year":"2020","unstructured":"Bechtold TE,\nPark YC,\nKim KH,\nJung H,\nKang JY,\nChoi YJ. Long-term stability of miniscrew anchored maxillary molar distalization in Class II treatment. Angle Orthod. 2020;90:362\u2013368."},{"key":"i1945-7103-95-6-611-b10","series-title":"Appl Sci-Basel","article-title":"Stability of the maxillary and mandibular total arch distalization using temporary anchorage devices (TADs) in adults","volume":"12","author":"Song","year":"2022","unstructured":"Song BJ,\nLee KJ,\nCha JY,\nLee JS,\nMo SS,\nYu HS. Stability of the maxillary and mandibular total arch distalization using temporary anchorage devices (TADs) in adults. Appl Sci-Basel. 2022;12."},{"key":"i1945-7103-95-6-611-b11","series-title":"Am J Orthod Dentofacial Orthop","first-page":"470","article-title":"Treatment effects of microimplant-aided sliding mechanics on distal retraction of posterior teeth","volume":"139","author":"Oh","year":"2011","unstructured":"Oh YH,\nPark HS,\nKwon TG. Treatment effects of microimplant-aided sliding mechanics on distal retraction of posterior teeth. Am J Orthod Dentofacial Orthop. 2011;139:470\u2013481."},{"key":"i1945-7103-95-6-611-b12","series-title":"Am J Orthod Dentofacial Orthop","first-page":"529","article-title":"Comparison of treatment effects after total mandibular arch distalization with miniscrews vs ramal plates in patients with Class III malocclusion","volume":"161","author":"Yeon","year":"2022","unstructured":"Yeon BM,\nLee NK,\nPark JH,\nKim JM,\nKim SH,\nKook YA. Comparison of treatment effects after total mandibular arch distalization with miniscrews vs ramal plates in patients with Class III malocclusion. Am J Orthod Dentofacial Orthop. 2022;161:529\u2013536."},{"key":"i1945-7103-95-6-611-b13","series-title":"Am J Orthod Dentofacial Orthop","first-page":"130","article-title":"Distal movement of mandibular molars in adult patients with the skeletal anchorage system","volume":"125","author":"Sugawara","year":"2004","unstructured":"Sugawara J,\nDaimaruya T,\nUmemori M, et al. Distal movement of mandibular molars in adult patients with the skeletal anchorage system. 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