• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.4
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• pp.709-716
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• 2005

Patients with cleft tip and palate present severe maxillary hypoplasia due to scar of lip and palate, often accompanied by compromised mastication, speech abnormalities. Sometimes maxillary hypoplasia persist even though active orthodontic treatment was done. In theses cases, patients born with cleft lip and palate will be potential candidates for maxillary advancement with bone grafting after growth to correct the functional deformities and improve aesthetic facial proportions. But, maxillary advancement using standard surgical approaches has several limitations : increased relapse tendency after maxillary advancement, necessity of additional bone graft and mandibular setback surgery. Distraction osteogenesis is current treatment modality to overcome these limitations, thus has become popular for treatment of maxillary hypoplasia associated cleft lip and palate, craniosyntosis. Especially, rigid external distraction, contrary to internal device, has advantages : better vector control of osteotomized segment, effective traction of the bony segments, the ease of the application and removal the distraction device. This study showed that relatively successful result could be generated by using rigid external distraction osteogenesis(RED) in the case of cleft lip and palate with severe maxillary hypoplasia, 6 years 7 months old.

• The korean journal of orthodontics
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• v.28 no.3 s.68
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• pp.479-486
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• 1998

Bimaxillary Protrusion can be treated effectively in growing patients and in adults with conventional orthodontic therapy. However, In the adult patient, combined surgical and orthodontic treatment modalities may offer distinct advantages over such conventional therapy. In those cases complicate by vertical jaw dysplasia, sagittal dysplasia, or transverse skeletal discrepancy in addition to bimaxillary protrusion, the possibilities of obtaining successful results through orthodontic treatment alone greatly diminish. Surgical retraction of both maxillary and mandibular anterior segments with subapical osteotomies and ostectomies in the extraction site may be a good treatment alternative. Treatment time and possible adverse effects of lengthy orthodontic therapy may be reduced and optimum esthetic improvement may be facilitated. On the following cases, patient who had bimaxillary protrusion with Angle class III malocclusion was treated with combined orthodontic - surgical therapy by anterior subapical segmental osteotomies.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.4
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• pp.675-681
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• 2005

The Horseshoe appliance was introduced by Dr. Schwarz, and it is used to correct sagittal relationships by elastic force in class III malocclusion. It minimizes the increment of lower anterior facial height and allows the mandible to be repositioned harmoniously with the soft tissue and muscle matrix of the jaw It has the advantages of better patient cooperation, easier construction, and more effective modification. In the patients who were treated with Horseshoe appliance, forward growth of maxilla and counterclockwise rotation of occlusal plane with labioversion of maxillary incisors and linguoversion of mandibular incisors were obtained. Minimum downward and backward rotation of mandible was accepted, so increasing of lower anterior facial height was minimized.

• The korean journal of orthodontics
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• v.40 no.3
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• pp.195-206
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• 2010

The aim of this report is to present an intraoral upper molar distalization system supported with zygomatic anchorage plates (Zygoma-gear Appliance, ZGA). This system was used for a 16-year-old female patient with a Class II molar relationship requiring molar distalization. The system consisted of bilateral zygomatic anchorage plates, an inner-bow and heavy intraoral elastics. Distalization of the upper molars was achieved in 3 months and the treatment results were evaluated from lateral cephalometric radiographs. According to the results of the cephalometric analysis, the maxillary first molars showed a distalization of 4 mm, associated with a distal axial inclination of $4.5^{\circ}$. The results of this study show that an effective upper molar distalization without anchorage loss can be achieved in a short time using the ZGA. We suggest that this new system may be used in cases requiring molar distalization in place of extraoral appliances.

• The korean journal of orthodontics
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• v.40 no.6
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• pp.432-443
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• 2010

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.