• Korean Journal of Cleft Lip And Palate
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• v.16 no.1
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• pp.19-23
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• 2013

Maxilla protraction, orthopedic correction of deficient maxilla is necessary for treatment of most Class III growing patients. Protraction method has evolved from tooth-born appliance to miniplates on the maxilla, and from face mask to miniplates on the chin. By placing miniplates on the maxilla and the mandible and running elastics between them, we can minimize dentoalveolar relapse and maximize orthopedic change.

• The korean journal of orthodontics
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• v.32 no.6 s.95
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• pp.425-434
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• 2002

The purpose of this investigation was to study the spatial changes of the maxillofacial complex following maxillary protraction transmitted to the center of resistance of a dry juvenile human skull by a modified maxillary protraction appliance. Four dry juvenile human skulls (without mandible) with well aligned upper deciduous dentition and early mixed dentition were used as experimental samples. A modified protraction headgear was fabricated from a Delare's facemask, and following an alginate impression, an orthodontic resin maxillary splint was made for each dry skull. Protraction force level was maintained at approximately 1000gm per side for 6 hours. Cephalometric radiographs were taken pre- and post- protraction, and nine reference markers with 1.5 mm length of $.017\times.025$ TMA wire were placed on the right side of the skull for an accurate superimposition of serial cephalometric radiographs. The present investigation demonstrated that vertical changes associated with an anterior displacement of the maxillary complex was observed, and the most prominent effect of protraction headgear was a counterclockwise rotation of the maxilla, that is, a forward and downward tipping around the palatomaxillary region.

• The korean journal of orthodontics
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• v.29 no.2 s.73
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• pp.147-156
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• 1999

Skeletal Cl III malocclusion is an orthopedic appliance mainly used for growing children with maxillary undergrowth, which largely entails skeletal Cl III malocclusion. It improves anterior crossbite and maxillary position and thus, enables patients to attain favorable Profile but often involves unfavorable profile with protrusive upper and lower lips. Therefore, if orthodontists have knowledge of which condition helps obtain favorable occlusion and profile, they are able to predict the prognosis and limitation of the treatment. This study was done in order to help obtain favorable Profile after treating growing skeletal Cl III children. In the study, we classified childern into two groups, the one with favorable profile(Group 1, n=12) and the other with unfavorable profile(Group 2, n=14) and, with retrospective study using pre- and post-treatment lateral cephalogram, drew the following conclusions. 1. As patients had more serious labioversion of upper incisors, they were more unlikely to have favorable profiles after the treatment. Protrusion of prosthion, which was related with maxillary incisors, also affected profiles. 2. As the NL-ML angle before the treatment was small, it was more likely to get favorable profile. 3. As the degree of lower lip protrusion was high, it was likely to have bialveolar protrusion after the treatment. 4. As the degree of downward and backward rotation of mandible was high, it was likely to get unfavorable profile.

• The korean journal of orthodontics
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• v.37 no.4
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• pp.245-259
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• 2007

Improvements in jaw relationship through clockwise rotation of the mandible may be desirable in some Class III patients with short low facial height. The aim of this study was to examine the treatment effect of face mask for Class III malocclusion patients according to their low facial morphology. Methods: Class III patients in their pubertal growth period were divided into two groups (Group 1, high LFH; Group 2, low LFH) according to lower facial height (LFH) by Ricketts (norm, 47). treatment changes between groups after face mask treatment was compared not only for hard tissue but also for soft tissue. Results: There were no significant differences between the two groups for the skeletal and soft tissues of the maxilla. There were no significant differences between the two groups for the skeletal posterior movement of the mandible, but posterior movement of the mandibular soft tissues in group 2 was larger than group 1. There were no significant differences between the two groups for the vertical hard tissue proportion changes of the mandible, but the vertical soft tissue proportion changes of the mandible in group 2 was larger than group 1. There was a significant correlation between the sagittal hard tissue and soft tissue changes of the maxilla and mandible, but there was no significant difference in the vertical changes. Conclusion: The clockwise rotation of the mandible occurred from use of the face mask, and posterior movement of soft tissues of the mandible was higher in Cl III patients with low LFH than with high LFH.

• The Journal of the Korean dental association
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• v.29 no.1 s.260
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• pp.22-30
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• 1991

• The korean journal of orthodontics
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• v.39 no.6
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• pp.362-371
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• 2009

Objective: The purpose of this study was to compare the longitudinal treatment effects of facemask with rapid maxillary expansion (FM/RME) and chincup (CC) therapy followed by fixed orthodontic treatment (FOT) in Class III malocclusion (CIII) patients. Methods: The samples consisted of twenty-one CIII patients who had similar skeletal and dental characteristics before FM/RME or CC therapy and good retention results (Class I molar/canine relationship and positive overbite/overjet) after FOT (Group 1, FM/RME, n = 11; Group 2, CC, n = 10). Lateral cephalograms were taken before (T0) and after FM/RME or CC therapy (T1), and after FOT and retention (T2). Skeletal and dental variables were measured. Mann-Whitney U-test and Wilcoxon signed-rank test were used for statistical analysis. Results: During T0-T1, FM/RME therapy induced forward movement of point A, and labioversion of the upper incisors. Both groups showed posterior repositioning of the mandible. FM/RME resulted in increase of the vertical dimension; however, CC caused an increase in articular angle and decrease in gonial angle. During T1-T2, both groups exhibited forward growth of point A. Group 1 showed forward growth and counterclockwise rotation of the mandible and increase of IMPA; however, Group 2, showed increase of ANS-Me/N-Me and decrease of overbite. Conclusions: The key factor for successful FM/RME and CC therapy and good retention results might be a harmonized forward growth of the maxilla that could keep pace with the growth and rotation of the mandible.

• The korean journal of orthodontics
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• v.26 no.5 s.58
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• pp.547-556
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• 1996

The purpose of this study was to evaluate the skeletal, dental and soft tissue profile changes following the face mask therapy in growing skeletal class III malocclusion patients. The fifteen patients with the good results were selected among the patients who visited the Department of Orthodontics in Seoul National University Hospital. The mean age was 10.63(range 7.25-13.25) years and the mean treatment duration was 9.84(range 2.00-27.00) months. Lateral cephalograms were taken just before and after face mask application. After tracing the cephalograms, thirty five items(twety angular and fifteen linear) were measured. The differences before and after the face mask therapy were compared statistically by the paired t-test(p<0.05). The results were as follows : SNA and Co-A(effective maxillary length) increased significantly after using the face mask(p<0.001), which reflects the orthopedic changes of maxilla. SNB and Co-Gn(effective mandibular length) also showed an increase(p<0.01), which may be a result of the strong growth trends of the samples. FMA, SN-GoGn and Y-axis angle increased significantly(p<0.01), which means the backward and downward rotation of the mandible. This positional change seemed to have compensated an increase of effective mandibular length. There was no statistically significant difference in angulation of upper and lower incisors between pre-treatment and post-treatment(p>0.05). In soft tissue profile, the upper lip was positioned anteriorly(p<0.01) after treatment and approximated to the normal standards.

• The korean journal of orthodontics
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• v.36 no.6
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• pp.412-421
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• 2006

Objective: The result of finite element analysis depends on material properties, structural expression, density of element, and boundar or loading conditions. To represent proper elastic behavior, a finite element model was made using Hounsfield unit (HU) values in CT images. Methods: A 13 year 6 month old male was used as the subject. A 3 dimensional visualizing program, Mimics, was used to build a 3D object from the DICOM file which was acquired from the CT images. Model 1 was established by giving 24 material properties according to HU. Model 2 was constructed by the conventional method which provides 2 material properties. Protraction force of 500g was applied at a 45 degree downward angle from Frankfort horizontal (FH) plane. Results: Model 1 showed a more flexible response on the first premolar region which had more forward and downward movement of the maxillary anterior segment. Maxilla was bent on the sagittal plane and frontal plane. Model 2 revealed less movement in all directions. It moved downward on the anterior part and upward on the posterior part, which is clockwise rotation of the maxilla. Conclusion: These results signify that different outcomes of finite element analysis can occur according to the given material properties and it is recommended to use HU values for more accurate results.

• 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.37 no.3 s.122
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• pp.231-240
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• 2007

Objective: The purpose of this study was to investigate the maxillary protraction effects of the Tandem Traction Bow Appliance (TTBA), a new appliance devised several years ago for the treatment of growing skeletal Class III patients. Methods: Participants were 88 Korean children (42 boys, 46 girls) with skeletal Class III malocclusion treated with TTBA at the orthodontic clinic of Ewha Womans University Mokdong Hospital. Mean age at the start of treatment was 7.5 years${\pm}$1.5 years. Mean treatment periods were $13{\pm}3$ months. Pretreatment and posttreatment lateral cephalograms were traced and superimposed by the same investigator and analyzed by modified McNamara analysis and pitchfork analysis. Changes were evaluated with paired t-tests at a significance level of p<0.05. Results: The maxilla and maxillary dentition moved forward. The mandible moved backward, although not significantly; and the mandibular dentition moved forward. The net dental changes combined with the apical base change resulted in a favorable total molar relationship correction. Net dental movement was 26% and the apical base change 74% of the total molar relationship correction. Conclusion: These results suggest that TTBA has a maxillary protraction effect that can be useful in the treatment of growing skeletal Class III malocclusion with maxillary deficiency.