• The korean journal of orthodontics
• /
• v.40 no.2
• /
• pp.66-76
• /
• 2010

Objective: Obstructive sleep apnea (OSA) is a common disorder which is characterized by a recurrence of entire or partial collapse of the pharyngeal airway during sleep. A given tidal volume must traverse the soft tissue tube structure of the upper airway, so the tendency for airway obstruction is influenced by the geometries of the duct and characteristics of the airflow in respect to fluid dynamics. Methods: Individualized 3D FEA models were reconstructed from pretreatment computerized tomogram images of three patients with obstructive sleep apnea. 3D computational fluid dynamics analysis was used to observe the effect of airway geometry on the flow velocity, negative pressure and pressure drop in the upper airway at an inspiration flow rate of 170, 200, and 230 ml/s per nostril. Results: In all 3 models, large airflow velocity and negative pressure were observed around the section of minimum area (SMA), the region which narrows around the velopharynx and oropharynx. The bigger the Out-A (outlet area)/ SMA-A (SMA area) ratio, the greater was the change in airflow velocity and negative pressure. Conclusions: Pressure drop meaning the difference between highest pressure at nostril and lowest pressure at SMA, is a good indicator for upper airway resistance which increased more as the airflow volume was increased.

• Korean Journal of Cleft Lip And Palate
• /
• v.2 no.1_2
• /
• pp.29-41
• /
• 1999

Cleft lip and palate is the most frequent congenital facial deformity of the orofacial area. Successful management of patients with cleft lip / palate requires a multidiciplinary approach from birth to adult stage. Coordinated treatment by the cleft palate team is an essential requirement to obtain optimum treatment results. One of the negative effect of the early surgical interventions of lip and palate is a significant incidence of maxillary growth restriction that produces secondary deformities of the jaws and malocclusion that includes congenital missing of lateral incisor, malformed teeth, rotation or ectopic position of upper anterior teeth, and it has been thought due to the resistance of palatal scar tissue. In Orthodontic treatment for cleft lip / palate patients, expansion of upper dental arch or palatal suture is often needed to correct posterior and/or anterior cross bite and align upper teeth. Various appliances such as hyrax, quad-helix, fan-type expansion screw and jointed-fan type expander can be used for palatal expansion. In the orthodontic treatment of the cleft lip / palate patient, we must consider patient age and severity of palatal constriction for proper appliance selection, and must pay special attention to maintain the treatment results.

• Radiation Oncology Journal
• /
• v.9 no.1
• /
• pp.111-116
• /
• 1991

From 1979 to 1987, 33 patients with polymorphic reticulosis (PMR) limited in the upper airway were treated with primary radiation therapy and the analysis of treatment results was undertaken. Systemic symptoms such as fever, night sweats, and weight ioss were noted in $48\%$. The nasal cavity was most frequently involved $(85\%)$, although involvement of PNS $(33\%)$ and palate $(30\%)$ was not uncommon. The 5 and 10 year actuarial survival rates were $47\%\;and\;40\%$, respectively. The difference in NSD between patients with in-field failure and those without it was significant statistically. Also, field size was significantly smaller in patients with marginal failure than those without it. During the follow-up period, systemic failure was found in S patients (diffuse histiocytic Iymphoma in 4, histiocytic medullary reticulosis in 1). In this study, we can suggest that total radiation dose of at least 4500 cGy with generous treatment volume should be delivered to achieve better local control and that the developement of an effective systemic chemotherapeutic regimen is required to improve the survival after systemic relapse.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.30 no.3
• /
• pp.483-488
• /
• 2003

Nasopalatine duct cyst(NPDC) is the most common non-odontogenic cyst in the oral area and is thought to be originated from the epithelial remnants of the nasopalatine duct. Many etiologic factors have been proposed for the NPDC; trauma to the region during mastication or from ill fitting dentures, bacterial infection, and spontaneous proliferation of tissue. The majority of cases are seen between the ages of 40th and 60th and it is rare in children. Surgical enucleation is the recommended treatment for NPDC, usually under general anaesthesia. A 9-year-old boy was refered to the chosun university pedodontics clinic that this child who has anterior palatal swelling is in routine check. In this case, swelling was presented at the bottom of the anterior nasal cavity as well as in the labial aspect of the upper alveolar ridge. It was so large that we treated it by marsupialization and obturator was put. This patient is on the continuous observation. We treated the child who had NPDC by marsupialization, and got the successful results such as rapid bone regeneration and the consistency of incisor vitality.

• The korean journal of orthodontics
• /
• v.38 no.3
• /
• pp.159-174
• /
• 2008

Objective: The purpose of this study was to investigate whether cortical punching could stimulate the expression of OPG, RANK, and RANKL during tooth movement by immunohistochemistry. Methods: 34 sprague-dawley rats (15 weeks old) were allocated into 3 groups: TMC group (experimental group; Tooth Movement with Corticotomy, n = 16), TM group (control group; Tooth Movement only group, n = 16), and non-treatment group (n = 2). 20 gm of orthodontic force was applied to rat incisors by inserting elastic bands. The duration of force application was 1, 4, 7 and 14 days. A microscrew (diameter 1.2 mm) was used for cortical punching of the palatal side of the upper incisors in the TMC group. Results: Distributions of OPG, RANK, and RANKL were evaluated by immunohistochemistry. OPG, RANK and RANKL were observed on experimental and control groups. On the compression side, the degree of the expression of OPG decreased in both groups. The expression of RANK was most prominent in the experimental group of day 4. The expression of RANKL was most intensive and extensive in the experimental group of day 7. However, the expression of OPG was decreased in the experimental and control groups compared to the non treatment group. The expression of OPG, RANK and RANKL after force application were decreased at day 14. Conclusions: These findings suggested that cortical punching might stimulate remodeling of alveolar bone during a 2 week period of tooth movement without any pathologic change.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.6
• /
• pp.460-465
• /
• 2010

Introduction: A cleft palate is a common birth defect in humans with an incidence of 1/500 to 1/1,000 births. It appears to be caused by multiple genetic and environmental factors during palatogenesis. Many molecules are involved in palate formation but the biological mechanisms underlying the normal palate formation and cleft palate are unclear. Accumulating evidence suggests that transforming growth factor $\beta$/bone morphogenetic proteins (TGF-$\beta$/BMP) family members mediate the epithelial-mesenchymal interactions during palate formation. However, their roles in palatal morphogenesis are not completely understood. Materials and Methods: To understand the roles of TGF-$\beta$/BMP signaling in vivo during palatogenesis, mice with a palatal mesenchyme- specific deletion of Smad4, a key intracellular mediator of TGF-$\beta$/BMP signaling, were generated and analyzed using the Osr2Ires-Cre mice. Results: The mutant mice were alive at the time of birth with open eyelids and complete cleft palate but died within 24 hours after birth. In skeletal preparation, the horizontal processes of the palatine bones in mutants were not formed and resulted in a complete cleft palate. At E13.5, the palatal shelves of the mutants were growing as normally as those of theirwild type littermates. However, the palatal shelves of the mutants were not elevated at E14.5 in contrast to the elevated palatal shelves of the wild type mice. At E15.5, the palatal shelves of the mutants were elevated over the tongue but did not come in contact with each other, resulting in a cleft palate. Conclusion: These results suggest that mesenchymal Smad4 mediated signaling is essential for the growth of palatal processes and suggests that TGF-$\beta$/BMP family members are essential regulators during palate development.

• The korean journal of orthodontics
• /
• v.34 no.4 s.105
• /
• pp.289-301
• /
• 2004

It is the purpose of this study to characterize oral symptoms and to comprehend the cause and the relapse possibility of patients with open bite. This case study examines the orthodontic treatment of a group of female patients with open bite and Angle's Class I malocclusion. A cephalograph of the patient was taken and tracing of the radiograph was completed. In addition to Bjork and Ricketts analysis, additional measurements of specific areas were taken. The occlusal plane was determined by drawing a line connecting the mesiobuccal cusp tip of the maxillary first molar and the incisal edge of the maxillary central incisors. Patients were divided into two groups depending on the relationship between the marginal ridge of the maxillayy first premolar and the drawn line. Those patients with marginal ridges above the occlusal plane were placed into Group 1, while Group 2 subjects exhibited marginal ridges lower than the occlusal plane. The common characteristics within each group and the characteristic differences between each group both prior to and after orthodontic treatment were examined, and finally, the functional oral volume of each patient was analyzed. The results of the case study were as follows: 1. An examination of the skeletal relationship and anatomical form for both Group 1 and 2 showed that all subjects exhibited hyperdivergent skeletal forms, but Group 2 subjects generally demonstrated underdevelopment of the mandible and a smaller articular angle, resulting in an anterior positioning tendency of the mandible. 2. An analysis of the maxillary arches of Group 1 subjects prior to and after orthodontic treatment showed that the antero-inferior direction had changed to an antero-superior directional tendency, while the maxillary arches of the Group 2 patients showed a trend from an antero-superior direction to an antero-inferior relationship. The mandibular arches in both groups showed a change to an antero-superior direction. 3. Functional space analysis showed that Group 2 patients exhibited a greater tendency of haying palatal planes that drop in a postero-inferior direction, resulting in a more severe open bite than their Group 1 counterparts. The results of this case study show that although patients belonging to either Group 1 or 2 exhibited few external differences in the appearance of open bite, an examination of the dental and skeletal relationships by analyzing patient cephalographs showed that patients presenting with flat maxillary occlusal planes exhibited more severe open bite relationships than patients with curved occlusal planes.

• The korean journal of orthodontics
• /
• v.31 no.6 s.89
• /
• pp.579-587
• /
• 2001

Cleft palate has been studied with epidemiologic and molecular methods, and many etiologic factors have been examined closely Among the research methods, biologic molecule research has been the most important method for cleft palate formation study The $TGF-\beta$ played an important role in cell migration, epithelial-mesenchymal transdifferentiation, extracellular matrix synthesis and deposition. But there was not much research on the correlation cleft palate induced by beta-aminonitroproprionitrile(BAPN) and $TGF-\beta$ expression. The purpose of the present study was to examine how $TGF-\beta$ is expressed in cleft palate rats. 4 Timed-pregnant Sprague-Dawley rats were obtained on the 10th gestation day. On the 13th day of gestation, BAPN-monofumarate salts (${(C_3H_6N_2)}_2{\cdot}C_4H_4O_4$) were individually, ovally administered to 3 pregnant rats at a ratio of 1g/kg body weight. And 4 pregnant rats were sacrificed on day 20 post coitus (p.c.). The $TGF-\beta$ expression in the cleft formed rats fetuses showed the following patterns : 1. Osteoblast and mesenchymal cells of the cleft pa)ate rats were of low expression compared with those of the control rats. 2. The cleft palate rats didn't show uy difference in the $TGF-\beta$ expression of osteocyte item the control rats. 3. In western blot analysis, the thickness of band of $TGF-\beta$ in the cleft palate rats was thinner and more diluted than that of the control rats.

• The korean journal of orthodontics
• /
• v.40 no.4
• /
• pp.276-287
• /
• 2010

This case report describes the treatment of a 23-year, 8-month-old female patient with a Class II malocclusion who showed severe bidentoalveolar protrusion and anterior crowding. The treatment plan consisted of extracting all the first premolars, decrowding and en masse retraction of the upper six anterior teeth and lower anteriors. The upper C-plate placed in the midpalatal area combined with lingual sheath fixtures were used as substitutes for posterior anchorage teeth during upper anterior retraction. Preadjusted brackets (0.022-inch) were used for upper anterior decrowding. A 0.9 mm diameter stainless steel lever-arm soldered to the main arch wire facilitated controlled retraction of upper anteriors. The upper and lower dentition was detailed using a tooth positioner during the finishing stage. Correct overbite and overjet were obtained by decrowding and retraction of the upper six anterior teeth into their proper positions. Use of the C-plate and lingual appliances provided ideal anchorage to enhance the improvement in facial balance. The active treatment period was 19 months. The treatment result was stable 13 months after debonding.

• Journal of Yeungnam Medical Science
• /
• v.9 no.1
• /
• pp.189-196
• /
• 1992

Pre-surgical and post-surgical change in adult cleft lip and palate patient following Le Fort I advancement osteotomy combined with bone graft was evaluated clinically and cephalometically. We obtained a successful function and esthetic improvement. The bone graft of alveolo-palatal clefts provides a stable bone support to the adjacent teeth of the cleft area, and well union of adjacent bone tissue, the closure of oronasal fistula and improvement of speech problem. Le Fort I osteotomy following the ostectomy of nasal septum for advancement of the maxilla was obtained relative improvement of esthetics and functional occlusion. 1. The orthodontic correction was required before and after surgery. 2. In this case, there was a limited range of anterior advancement of the Premaxillary-segment due to the scar tissue. 3. After 8 months of operation, we could show the new bone deposition on the cleft site in dental radiograph and then the prosthetic treatement to the missing teeth was done.