The purpose of this study was to compare the arch width of the hyperdivergent group with that of the neutral group in Class III malocclusion based on the vertical patterns and to compare the arch width of Class III neutral group With that of normal occlusion group based on sagittal patterns. The subjects consisted of 118 pairs of studty casts, divided into three groups , 37 Class III hyperdivergent group(18 males and 19 females, SN-Mn plane angle>39.5$^{\circ}$), 40 Class III neutral group(20 males and 20 females, SN-Mn plane angle : 32 ${\pm}$ 2.5$^{\circ}$) and 41 Class I normal occlusion group(20 males and 21 females). The intercanine, interpremolar, and intermolar width of the maxillary and mandibular study casts were measured, then the ratios of dental width to basal width and mandibular width to maxillary width were obtained. Basal arch width and dental arch width were measured to obtain the pure basal arch relation in transverse plane as ruled out the transverse dental compensation. The results were as follows 1. There were no significant differences in any ratios between Class III hyperdivergent group and Class III neutral group as different vertical pattern. 2. As the ratios of dental arch width to basal arch width between normal occlusion group and Class III neutral group were compared, the maxillary teeth flared buccally to the basal bone, and the mandibular teeth tilted lingually to the basal bone in Class III neutral group. 3. The ratios of mandibular arch width to maxillary arch width in basal arch level were significantly different in all regions. Maxillary basal arch width of Class III neutral group was narrower than that of normal occlusion group. 4. The ratios of mandibular arch width to maxillary arch width in teeth level were not significantly different between normal occlusion group and Class III neutral group. In spite of discrepancies of maxillary and mandibular basal arch width, the dental arch width of Class III malocclusion group compensated very well. At the presurgical orthodontic treatment in clinic, it would not be desirable to decompensate for compensated dental arch width too much, for obtaining an appropriate arch compatibility and good results for orthognathic surgery.
The purpose of this paper is to evaluate if there is a relationship between anterior disc displacement without reduction and development of anterior open bite, and a relation between occurrence of open bite and occlusal appliance therapy. In general, the statistically significant differences were found between the Group 1 and 2 and normal mean group. The variables that represent mandibular size and form, showed a statistical significance in all 3 groups. Also 3 groups patients had a smaller ANB, a larger FMA than normal mean group. When we compared the 3 groups with respect to all cephalometric measurements by One-way analysis of variance (ANOVA), group 1 and 2 patients had a larger FMA, a larger SN to mandibular plane angle, a larger maxillomandibular plane angle, a larger occlusal plane to mandibular plane angle, a smaller total posterior facial height/total anterior facial height(%), and a larger gonial angle than group 3. The statistically significant differences were not found between the Group 1 and 2, and skeletal patterns were similar. Thus, morphologic features of patients with vertical discrepancies may represent a risk factor for the development of anterior open bite with or without occlusal appliance treatment. In case of patients with vertical discrepancy, we may have to be more careful when inducing a change of the vertical dimension.
The purpose of this study was to investigate the changes in the craniofacial skeleton subsequent to chincap therapy in the juvenile skeletal Class III malocclusion with more appropriate control samples. The experimental group consisted of 29 Korean children(14 males, 15 females) who had skeletal Class III malocclusion with prognathic mandible and were undergone chincap thorny from the beginning of treatment. The control group was composed of 21 Korean children(10 males, 11 females) who had no orthodontic treatment, but with similar skeletal discrepancies to experimental group. Lateral cephalometric radiographs at the age of 7, and 2 years later were analyized and compared with student's t-test(p<0.05). The results of this study were as follows; 1. The control group without chincap therapy had not shown any improvement of the skeletal discrepancies, but had grown to be much severe. This means that the untreated Class III patient with prognathic mandible would not be corrected by growth. For the experimental group with chincap therapy, the anterior-posterior skeletal discrepancies and mandibular prognathism were both improved. 2. Neither significant restraint nor acceleration of growth was found in the cranial base and maxilla by chincap treatment. 3. The inhibition of mandibular growth could not be accepted, but the changes of the direction of growth and morphological changes were found. 4. Vertical growth tendency was increased with chincap therapy. 5. When Putting together the results of the analyses , it seems to be the rotation and displacement of the mandible that the major treatment effects of chincap we. The changes of the direction of growth and the morphological changes also seems to contibute to the treatment effect partly. In summary, the chincap doesn't restrain the mandibular growth. But, it is considered as a useful treatment modality for correction of skeletal discrepancies and reduction of mandibular prognathism in growing Class III patients with madibular prognathism.
The purpose of this study was to evaluate the dentofacial characteristics and the fost-treatment dentofacial changes of those treated by four premolar extractions and to investigate the factors affecting extraction decision. The sample consisted of 35 patients (27 females, and 8 males) with no more than 7.0mm crowding, diagnosed as Class I protrusion. Pre-treatment and post-treatment lateral cephalograms were evaluated. Computerized statistical analysis was carried out using SPSS/PC+ program. The results were as follows. 1. There was no significant change in skeletal pattern after treatment while there was significant change in dentoalveolar and soft tissue pattern. 2. In pre-treatment skeletal pattern, a tendency toward vertical discrepancy was found. 3. In pre-treatment dental pattern, interincisal angle was $113.11^{\circ}$, U1 to FH was $117.78^{\circ}$ and L1 to A-Pog was 7.94mm. Pre-treatment upper and lower lip position was 2.88mm and 5.43mm to E line. 4. After treatment, interincisal angle increased $14.46^{\circ}$ and upper and lower lip moved back 2.45mm and 3.2mm to E line.(p<0.001) 5. The EI was 138.71 before treatment and 148.2 after treatment.
This study has been performed to determine whether significant differences in the maxillary basal bone pattern exist between skeletal class II malocclusion and normal occlusion. Materials for the skeletal Class III sample consisted of lateral cephalometric roentgenograms and maxillary cast models of 29 adult individuals, 15 males and 14 females. The average age was 19.75 years with a range from 16.4 to 29.1 years. A normal control sample consisted of lateral cephalometric roentgenograms and maxillary cast models of 24 adult individuals, 13 males and 11 females. The average age was 24.25 years with a range from 20.8 to 29.4 years. The results of this study can be summarized and concluded as like follows. 1. In comparing sexual difference of maxillary basal bone morphology in skeletal Class III malocclusion, the following Parameters of males were found to be significally larger than those of females : inter first premolar width, inter molar width, oblique canine height, oblique molar height and maxillary basal bone perimeter. 2. In comparing sexual difference of maxillary basal bone morphology in normal occlusion, the following parameters of males were found to be significally larger than those of females : inter canine width, inter first and second premolar width, inter molar width, oblique canine height and oblique molar height. 3. In comparing maxillary basal bone morphologic difference between skeletal Class III malocclusion md normal occlusion in males, the following parameters were found to be significally larger in normal occlusion : inter canine width, inter canine height, inter molar height, oblique canine height and oblique molar height. 4. In comparing maxillary basal bone morphologic difference between skeletal Class III malocclusion and normal occlusion in females, the following parameters were found to be significally larger in normal occlusion : inter canine height, inter molar height, oblique canine height, oblique molar height and maxillary basal bone perimeter.
Enlow's counterpart analysis explains the complex with anatomic and developmental characteristics where craniofacial aspect of Individuals has been developed. Counterpart analysis does not compare individual measurement with the normal value from the average of majority but analyzes by comparison of values that each individual has. In this study we examined surgical changes in skeletal Class III malocclusion patients(male 40, female 40) and compared them with normal occlusion patients using counterpart analysis. The results indicated that : 1. Skeletal anterior-posterior discrepancy was relieved by shortening of the ramus width(B3). 2. The ramus alignment(R3, R4) was displaced posteriorly and the occlusal plane angle(R5) was rotated clockwise. 3. Skeletal Class III pattern was relieved in the post-operative group, but differences in the level of the cranium(R1, R2) was remaining compared to the normal occlusion patients. 4. In the comparison of surgery methods, the two-jaw surgery group presented changes In the maxillary length(A4), ramus alignment(R3, R4) and occlusal plane angle(R5) compared to the one-jaw surgery group, but the differences were not significant. In the past study about Korean skeletal Class m patients, the skeletal characteristics are upward backward rotation of the cranial base, posterior displacement of the maxilla, forward inclination of the ramus and lengthening of the mandibular body, but in this study, skeletal Class m pattern was relieved by shortening of the ramus width and maxillary advancement by orthognathic surgery, because orthognathic surgery is usually performed on limited areas in the maxilla and the mandible.
Radical paring of the cleft edge during primary cleft lip operation or repeated secondary surgeries can result in tightness of the upper lip. In case, the degree of the resulting side-to-side tension is very severe, the possibility of a lip switch flap must be considered. When the lip tightness accompanies a loss of more than two-thirds of the Cupid's bow, an Abbe flap is an alternative. The disadvantages of Abbe flap are scar formation on the lower lip, design of incision line on the upper lip, disharmony of colors, and the dysfunction of the orbicularis muscle. These problems have been recognized in the literature and extreme discretion has been advised in its application. We experienced four cases of Abbe flap operation which were designed differently to correct the secondary unilateral or bilateral cleft-lip nasal deformities. The Abbe flap operations resulted in removal of the scars and tightness of the upper lip, reconstruction of the Cupid's bow, lengthening of the columella, and therefore secondary cleft-lip nasal deformity could be corrected. It is thought that carefully applied Abbe flap is an appropriate method to relieve horizontal tightness or flattening of the upper lip which occured after primary operation of cleft lip.
For the total treatment of skeletal malocclusions, 3-dimensional evaluation and diagnosis are essential. Although anteroposterior discrepancies can be evaluated through various methods, the satisfactory methods for evaluations of facial asymmetry and transverse discrepancies are yet to be found. The adequate diagnosis and treatment of transverse discrepancies may be more important in the maintenance of functional occlusion as well as for the stability of results obtained from orthognathic surgery than the anteroposterior or vertical discrepancies. Since the soft tissue effects from the transverse discrepancies may not be pronounced, especially when combined with anteroposterior or vertical discrepancies which have prominent characteristics, the differentiation of their effects may be difficult from visual inspection alone. Therefore it is essential that the normal facial proportions would be established from the posteroanterior cephalometry as a reference for the accurate diagnosis and treatment. The present study evaluates 76 subjects from Yonsei University freshmen with normal facial symmetry and occlusion. Posteroanterior cephalograms were taken from the subjects and the normal values and facial proportions are obtained. The results are as follows. 1. The transverse and vortical values from posteroanterior cephalometry and their ratio, with means and standard deviations are calculated. 2. The ratio of vertical values to transverse values is 0.837 (male 0.836, female 0.841). 3. The Proportion of maxillary and mandibular widths is 0.747 (male 0.745, female 0.752), with statistically significant correlation. 4. Various degree of significant correlations are observed in the following craniofacial widths; (Cranial width, Bizygomaticofrontal suture width, Facial width, Maxillary width, Upper & Lower Intermolar width, Mandibular width). 5. Although the facial height as well as other line measurements increase as the facial widths increase, angle measurement ($Bj\ddot{o}rk$ Sum, Mandibular Plane Angle, Gonial Angle), decreases and posterior to anterior facial height ratio increases, therefore indicating the tendency for a brachycephalic facial type. These results may be used as references for the treatment planning in orthognathic and orthodontic treatments for the dentofacial deformity patients.
Park, Soyoung;Jeong, Taesung;Kim, Jiyeon;Kim, Shin
Journal of the korean academy of Pediatric Dentistry
/
v.46
no.2
/
pp.209-218
/
2019
This study was aimed to evaluate orofacial morphologies on the cases of developmental disorders of maxillary first molars. Panoramic radiographs, lateral cephalographs, and clinical photos of 2983 children who attended the Pediatric Dental Clinic of Pusan National University Dental Hospital from 2006 to August 2017 were assessed retrospectively. 34 patients were selected whose maxillary first molars were missed or developmentally delayed unilaterally or bilaterally. Demirjian's method was used for estimating dental age, then which was compared to chronologic age of children. Parameters expressing skeletal and dentoalveolar disharmony were checked and compared with control. Additionally, occlusion relationship was evaluated. Maxillary dental age was significantly delayed compared to chronologic age. Several parameters which show skeletal open-bite tendency and skeletal class III malocclusion with maxillary retrusion were statistically significant. Anterior crossbite and edge-bite were expected in most of these cases, but compensation by occlusion and soft tissue was also verified which might mask skeletal class III tendency. Congenital missed or developmentally delayed maxillary first molars might be related with declined growth of maxilla. If developmental disorders of maxillary first molars were verified during clinical examination, careful monitoring of orofacial growth was necessary during puberty and timed orthopedic and orthodontic intervention were considered.
Journal of the korean academy of Pediatric Dentistry
/
v.34
no.4
/
pp.599-612
/
2007
The present study was designed to compare the morphological and structural differences of craniofacial structures among 146 children with Class I and Class III malocclusions. The results below were obtained from the study. 1. Sphenoethmoidal synchondrosis continues to grow later in Class III. 2. Anteroposterior length of the nasomaxillary complex was significantly shorter in Class III, but the height of the nasomaxillary complex was similar. 3. Mandibular length and mandibular body length were longer in Class III, but had no statistical significance. Lower anterior facial height was shorter in Class III, but had no statistical significance. 4. Dentoalveolar height was similar between Class I and Class III. 5. In Class I, anterior cranial base took part in the anteroposterior length of the nasomaxillary complex and the mandible. 6. In Class III, anterior cranial base and middle cranial base had higher correlation with the mandible with aging. These results suggest that there exist a little differences between Class I and Class III malocclusions at age $7{\sim}11$, but growth patterns are mostly similar. Therefore it is necessary to correct Class III malocclusions at an early age before skeletal differences appear.
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