The purpose of this study was to investigate the variations of the soft tissue profile contour in relation to the skeletal patterns and to confirm the correlation of soft tissue angles to the sagittal or vertical skeletal elements. Lateral cephalograms of 79 cases which were older than 17 years in age, were traced and statistically analyzed. The obtained results were as follows : 1. Nasolabial, interlabial, lower lip, mentolabial, and symphyseal angles showed the significant differences between skeletal Class II and skeletal. Class III group, but nasofrontal, upper lip, mentolabial, and symphyseal angles showed the significant differences between high angle and low angle group. 2. ANB value showed the significant positive correlation to nasolabial, symphyseal, and interlabial angles and the significant negative relation to lower lip angle. 3. SN-GoMe value showed the significant positive correlation to mentolabial, symphyseal, nasofrontal, and upper lip angles. 4. Soft tissue profile contour in SK. Class II group showed greater accordance to SN-GoMe value than those in SK. Class III group.
The purpose of this study was to investigate the degree of relapse following orthognathic surgery and the relationship between preoperative state and the methods of orthognathic surgery in skeletal Class III patients. Thirty-one patients were selected(17 men, and 14 women) for this study, who had received orthognathic surgery(20 one jaw surgery, and 11 two jaw surgery). The mean age was 22.5 years. Their lateral cephalograms, that were taken preoperatively, immediate postoperatively and follow-up over one year, were traced and analysed. The results were as follows : 1. In two jaw surgery, mandibular length, lower facial height and lower lip length were 4.24mm, 4.64mm and 4.13mm longer than in one jaw surgery, respectively But in two jaw surgery, overjet was 3.13mm shorter than in one jaw surgery. 2. In one jaw surgery, mandible was moved back $8.95\pm4.45mm$ at B point. In two jaw surgery, maxilla was moved forward $5.15\pm3.46mm$ and mandible was moved back $7.24\pm9.11mm$ at B point. 3. Between postoperation and follow-up over one year, A point, A' point, Pn and Sn were moved backward 1.02 $\pm$ 2.14mm, $1.73\pm1.63mm,\;1.05\pm1.48mm\;and\;1.55\pm1.37mm$ in two jaw surgery, respectively. 4. Between postoperation and follow-up over one year, in one jaw surgery, B point was moved forward $2.58\pm4.22mm$ and B' point was moved forward $1.95\pm4.39mm$. In two jaw surgery, B point was moved forward $0.65\pm2.88mm$ and B' point was moved forward $0.19\pm3.32mm$. In one jaw surgery, relapse rate was $28\%$ at B point and $24\%$ at B' point, whereas in two jaw surgery, relapse rate was $8\%$ at B point and $3\%$ at B' point.
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.
In the orthopedic therapy, the biomechanical analysis of the appliance is necessary to get a desirable orthopedic effect. The purpose of this study was to investigate the desirable direction and application position of the protraction force. The protraction force of 500g was applied to the first premolar or to the first molar. The direction of force application was paralell or $20^{\circ}$ downward to the occlusal plane respectively. The stress distribution and the displacement within the maxilla was analyzed by a 3-dimensional finite element method. The findings obtained were as follows 1. Protraction forces caused a counterclockwise rotation of the maxilla. 2. The degree of maxillary rotation was less when the force was applied $20^{\circ}$ downward direction to the occlusal plane than when applied to the parallel direction. 3. The degree of rotation of maxilla was greater when the parallel force was applied to the 1st premolar than when applied to the first molar, whereas it was greater when force is applied $20^{\circ}$ downward than at the first premolar. In conclusion, the $20^{\circ}$ downward protraction from the first premolar induced the least counterclockwise rotation of the maxilla and was thought as the desirable direction and application position of the protraction force.
Kim, Na-Ri;Kim, Yong-Il;Park, Soo-Byung;Hwang, Dae-Seok
The korean journal of orthodontics
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v.40
no.3
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pp.145-155
/
2010
Objective: Lateral cephalometric radiographs have been the main form of resource for assessing two dimensional anteroposterior airway changes. The purpose of this study was to evaluate the three dimensional volumetric change in the upper airway space in Class III malocclusion patients who underwent mandibular setback surgery. Methods: Three dimensional cone-beam computed tomographs (CBCT) and their three dimensional reconstruction images were analyzed. The samples consisted of 20 adult patients (12 males and 8 females) who were diagnosed as skeletal Class III and underwent mandibular setback surgery. CBCTs were taken at 3 stages - Baseline (1.8 weeks before surgery), T1 (2.3 months after surgery), and T2 (1 year after surgery). Pharyngeal airway was separated according to the reference planes and reconstructed into the nasopharynx, the oropharynx and the hypopharynx. Measurements at Baseline, T1, and T2 were compared between groups. Results: The result showed the volume of the pharyngeal airway decreased significantly 2.3 months after surgery (p < 0.001) and the diminished airway did not recover after 1 year post-surgery. The oropharynx was the most decreased area. Conclusions: These findings suggest that mandibular setback surgery causes both short-term and long-term decrease in the upper airway space.
Journal of the korean academy of Pediatric Dentistry
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v.37
no.3
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pp.359-366
/
2010
It was easy to find that children of a skeletal anterior crossbite in the early mixed dentition period showed a stark difference in the dental maturity between their maxillary and mandibular teeth, if they have stronger physical characteristics. If the difference of dental age between maxillary and mandibular teeth which can be identified via panoramic radiographs may serve as an early sign of class III malocclusion, this is considered valuable as a tool of early detection diagnosis. We obtained lateral cephalometric radiographs, panoramic radiographs, working model and clinical images of patients of Hellman dental age IIA and IIC who visited the department of pediatric dentistry, Pusan National University Dental Hospital and examined them to select 50 patents for normal occlusion group and skeletal anterior crossbite group, respectively. Their panoramic radiographs were used for the Demirjian's method to figure out dental ages of maxillary and mandibular teeth of each group and the eruption rate of the first molars. Their differences are as follows: 1. In both groups, the dental ages from Demirjian's method were advanced than the chronological ages. No sexual dimorphism was detected for the chronological or dental age in either group (p>0.05). 2. The difference of dental age of maxillary and mandibular teeth between the normal occlusion group and crossbite group was 0.22 and 0.69 years, respectively, with a higher difference in crossbite group(p<0.05). 3. Compared to the normal occlusion group, the crossbite group showed a higher difference in the eruption rate between maxillary and mandibular first molar(p<0.05).
Objective: The purpose of this prospective study was to evaluate the dentofacial effects of conventional and modified facemask therapies with rapid maxillary expansion, in a group of Class III patients; and compared with an untreated control group. Methods: The conventional facemask group (Group 1) comprised of 24 patients, 13 girls and 11 boys (mean age, $9.2{\pm}1.4$ years); the modified facemask treatment group (Group 2) comprised of 24 patients, 12 girls and 12 boys (mean age, $9.3{\pm}1.6$ years); and the control group (Group 3) comprised of 21 subjects, 11 girls and 10 boys (mean age, $9.8{\pm}1.9$ years). Treatment and control changes within the groups and the differences between the groups were analyzed statistically. Intra-group comparisons were evaluated using the non-parametric Wilcoxon's test and intergroup changes were analyzed using the Kruskal-Wallis test. The statistical significance of intergroup differences was further assessed with the Mann-Whitney test for independent samples and applying Bonferroni's correction (p < 0.016). Results: In group 1, SNB changes were less than the control. There were increases in SNA, ANB, SN-MP, A to N perp and Upper lip to E plane. In group 2, SNB, U1-NA (mm) U1-NA (${\circ}$) and Pog to N perp (mm) changes were less than the control. There were increases in SNA, ANB, SN-MP, A to N perp and Upper lip to E plane. Conclusions: Modified facemask appliance can be used effectively in Class III patients with a retrognathic maxilla. Facemask therapies with expansion resulted in an anterior advancement and translation of maxilla without rotation; and the mandible moved downward and backward ward in both treatment groups.
Various types of horizontal reference planes are used for diagnosis, treatment planning and evaluation of treatment results. But these reference Planes lack accuracy and repro-ducibility, and are mainly for Caucasian. Unlike the adult patients who have completed growth, the horizontal reference planes for growing children may change continuously during growth. Therefore this must be considered in selecting the horizontal reference plane. The purpose of this study was to Investigate the angle formed by the Sella-Nasion(SN) plane and Frankfort-Horizontal(FH) plane and evaluate the angle formed by FH plane and other horizontal reference planes in relation to different skeletal maturity and malocclusion types. 540 subjects with no orthodontic treatment history were chosen, and hand -wrist X-rays and lateral cephalometric X-rays were taken. According to SMA(Skeletal Maturity Assessment) of hand-wrist X-rays, the subjects were classified into 3 skeletal maturity groups : SMI 1-4 for group A, SMI 5-7 for group B and SMI 8-11 for group C. A second classification was made according to cephalometric analysis of lateral cephalograms. The subjects were classified into 3 malocclusion groups : Skeletal Class I, II and III malocclusion group. 10 measurements were evaluated. The results were as follows. 1. The angle formed by the SN plane and FH plane showed no difference among skeletal maturity groups, malocclusion groups, and between .sexes. 2. The angles formed by the SN plane and FH plane were $8.27^{\circ}{\pm}2.31^{\circ}$ for males and $8.59^{\circ}{\pm}2.24^{\circ}$ for females. The average value for females and males was $8.42^{\circ}{\pm}2.28^{\circ}$. 3. The angle formed by the FH plane and palatal plane was almost constant showing no difference among skeletal maturity groups, malocclusion groups, and between sexes($1.09^{\circ}{\pm}3.21^{\circ}$).
Journal of Dental Rehabilitation and Applied Science
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v.32
no.1
/
pp.70-79
/
2016
Patients who lost posterior teeth due to periodontitis or dental caries have collapsed vertical dimension, unstable occlusion and change of the mandibular position. In particular, patients in orthognathic surgery, clinician should re-establish the pre-operative stable position of mandibular condyle in articular fossa and favorable vertical dimension for high post-operative stability of mandible. Therefore, interdisciplinary approach and co-operation, including prosthetics, orthodontics, oral and maxillofacial surgeon, from diagnosis and treatment plan is important to get a good outcome. This case report was patients who had collapsed occlusal plane due to severe dental caries on maxillary molars with skeletal Class III malocclusion. Before orthognathic surgery, resetting of maxillary occlusal plane with temporary removable denture was performed. Then successful multidisciplinary approach was done and lead to acceptable clinical outcome.
Kim, Keun-Ryoung;Kim, Seong-Sik;Son, Woo-Sung;Park, Soo-Byung
The korean journal of orthodontics
/
v.38
no.2
/
pp.104-120
/
2008
Purpose: The purpose of this study was to assess the hard and soft tissue changes associated with mandibular bilateral sagittal split osteotomy and genioplasty. Methods: This is a retrospective study of 40 patients who underwent either bilateral sagittal split osteotomy for mandibular setback (BSSO group, n = 20) or in combination with advancement genioplasty (Genio group, n = 20). Lateral radiographs, were taken before and immediately after surgery, and at least 6 months after surgery. Results: Comparing hard and soft tissue changes between the BSSO group and Genio group, there were significant differences in the lower incisor, soft tissue B point (B'), and soft tissue Pogonion (Pg') (p < 0.5). The mean ratio of hard and soft tissue changes for B/B', Pg/Pg', and Menton/soft tissue Menton after surgery in the BSSO group was 0.997, 0.965, and 1.022 respectively, and 0.824, 0.602, and 0.887 respectively in the genio group. Significant differences were found between the two groups. There were significant differences in lip thickness (B-B', Pg-Pg') in the Genioplasty group between pre and postsurgery, but not in the BSSO group. Pogonion to Labrale inferior and B' had a correlation coefficient of 0.833, 0.922, respectively for the BSSO group, and 0.775, 0.799 for the Genio group. Conclusions: The results indicate that there is a significant difference between bilateral sagittal split osteotomy with or without genioplasty in the lower facial esthetics values. The combination of mandibular setback and genioplasty had a smaller change in soft tissue thickness of the symphysis area after surgery than that of mandibular setback only.
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