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.
The purpose of this study was to investigate the preference of Vertical Lip-Chin Ratio (=Sn-Stm/Stm-Me', hereafter VLCR) in Koreans. The assessors consisted of 44 dentists (male 22, female 22) and 430 lay persons (male 303, female 127). The survey was performed using a questionnaire asking the order of preference. The profiles presented in the questionnaire were based on the profiles of two males and two females, each morphed according to the VLCRs of 1/1.8, 1/1.9, 1/2.0. 1/2.1, 1/2.2. The results were as follows: The difference between males and females. and the difference betwwen dentists and lay persons in the preference of VLCR were not statistically apparent. The most Preferred VLCR was 1/1.9, and the least preferred VLCR was 1/2.2, These results Indicate that the preferred VLCR is smaller than the previously reported VLCR ratios based on the cephalometric evaluation of samples with favorable facial esthetics.
Because many of patients seeking orthodontic treatment worry about the facial appearance and their chief motivation for orthodontic treatment is facial esthetics, it is critical to understand the influence of gender or culture on the evaluation of profile esthetics. The purpose of this study was to find out any influence of gender or culture on judging good facial profile. 4 different groups were asked to evaluate 133 facial profiles to test the influence of gender or culture on judging good facial profiles. Those 4 groups consisted of 10 Korean males, 10 Korean females, 10 Korean American males, and 10 Korean American females. 2 evaluation systems were introduced, absolute and relative. Soft tissues of selected good profile group were analyzed and statistic analysis was performed. Conclusions were as follows 1. Inter-evaluator difference for judging good facial profile was statistically significant, even if there was general agreement for the best profile among 40 raters. 2. Gender difference under the same cultural environment was not significant statistically. 3. The same ethnic groups with different cultural background showed statistically different preference on judging good Profile. 4. Good facial profile group had their own characteristics compared to remaining group in several soft tissue measurements which were vertical facial ratio, soft tissue facial convexity, and antero-posterior relative lip position.
Kim, Yi-Dong;Chung, Dong-Hwa;Cha, Kyung-Suk;Lee, Jin-Woo;Lee, Sang-Min
Journal of Dental Rehabilitation and Applied Science
/
v.29
no.4
/
pp.347-358
/
2013
When analyzing soft tissue of the profile, Subnasale is often used as an important reference point. But there are few studies on the ideal position of the Subnasale. Therefore, the purpose of this study is to present an objective reference of the esthetic face relating to the change of Subnasale position in Koreans' profile, and also to determine whether there is concordance between professionals and laypersons in their perception of facial attractiveness. The one determined as appropriate profile portion by experts of pictures taken in women in 20s was selected. The photograph was modified changing the Subnasale anteroposteriorly on the plane perpendicular to the true vertical line, while maintaining the nasolabial angle. The photographs were presented to a group of professionals (9 orthodontists) and 126 laypersons, who were asked to assess the facial attractiveness of the photographs on a VAS independently. The conclusion was obtained. 1. The ideal position of the Subnasale is when the ratio of the distance Lateral canthus~Subnasale : Subnasale~Pronasale is 1.769 : 1. 2. The ideal degrees between the true vertical line passing through Nasion and Subnasale is $5.5^{\circ}$ 3. The professionals recognized every change in the ratio, but the laypersons couldn't differentiate between the change from 1.571 : 1 to 1.769 : 1.
If a mandibular prognathic patient has an extremely unnatural anteroposterior and vertical maxilla or keen esthetical perception for facial profile, orthognathic surgery must be performed along with orthodontic treatment, which alone cannot provide satisfactory results in this case. Esthetical improvement becomes an important factor in the satisfaction level of the patient's treatment result, but an attempt to objectively measure beauty holds many problems. Therefore, in the end, the patient submits the final esthetical evaluation based on his/her subjective viewpoint. Because Korean people have a tendency to prefer the facial appeareance of westerners, they favor an oval shaped face over the traditional round face. This research was conducted in response to the complaints raised by patients who claim that their face had become more round from widening of facial width after the orthognathic surgery for manidibular prognathism than before the surgery. The following results were obtained on the changes in facial appearance and patient satisfaction level by analyzing the skull P-A analysis of total of 14 patients (8 male and 6 female) who underwent orthognathic surgery primarily chief complaint for manidibular prognathism and from their responses on questionnaires. These results are to be used in the research on the pre- and post- operative changes in facial height and width from orthognatic surgery. 1. Three ($21.4\%$) of 14 patients said that their face had widened. 2. The A group showed no change in mandibular width but B group showed a 0.7mm reduction. The facial width increased by 0.45mm and 0.66mm in groups A and B, respectively, after the orthognathic surgery 3. After the surgery the facial length changed by an 0.52mm increase in upper facial height , 1.19mm reduction in lower facial height, and 0.7mm reduction in mandibular height in group A. In group B group, there was a 0.67mm reduction in upper facial height, 3.66mm reduction in lower facial height, and 5mm reduction in mandibular height. 4. In reference to facial width, the facial height showed $1.5\%$ reduction in group A and $3.6\%$ reduction in group B after the surgery. 5. In reference mandibular height-to-facial width ratio, there was a $1.3\%$ reduction in group A, and $4.4\%$ reduction in group B after the surgery. 6. In reference to the mandibular height-to-width ratio, there was a $1.3\%$ reduction in group A and $4.3\%$ reduction in group B after the surgery. 7. Although the change in the facial width due to surgery can be ignored, sufficient explanation should be Provided to the patient before surgery on the fact that the face can appear to be relatively wide because of the reduced facial length as result of the surgery.
The purpose of this study was to evaluate the amount and interrelationship of hard and soft tissue changes after mandibular setback osteotomy and reduction genioplasty in mandibular prognathism with long anterior facial height. The control group (Group A) consisted of 20 patients who had severe horizontal discrepancy. They experienced Presurgical orthodontic treatment and orthognathic surgery via mandibular setback. The experimental group (Group B) consisted of 20 patients who had severe horizontal and vertical discrepancy. They experienced presurgical orthodontic treatment and orthognathic surgery via mandibular setback and reduction genioplasty. The presurgical and postsurgical lateral cephalograms were evaluated. The computerized statistical analysis was tarried on with EXCEL 97 program. The results were as follows : 1. The correlation of hard and soft tissue horizontal changes in lower 2/3 of lower anterior facial height were high for both groups. The correlation coefficients of hard tissue changes and Ls, Stm, Li changes in Group B were moderately higher than Group A. 2. The correlation of hard and soft tissue vortical changes in Group B were lower than Group A. (except for pointB-Ils, Me-Me') 3. The ratio for soft tissue to Pog in Group B was lower than Group A. The ratios of hard and soft tissue vertical changes were 32% at Ils, 54% at Pog', and 60% at Me'. 4. The ratio of lower anterior facial height to total anterior facial height was reduced for both groups. But ratio of upper 1/3 of lower anterior facial height to total anterior facial height did not changed significantly in Group B. 5. Reduction genioplasty combined with mandibular setback procedure showed no change in upper one third(Sn-Stm) and significant decrease(Stm-Me') in the lower two thirds of the soft-tissue anterior lower facial height
Kim, Nam-Woo;Lee, Gung-Chol;Moon, Cheol-Hyun;Bae, Jung-Yoon;Kim, Ji-Yeon
The Journal of Korean Academy of Prosthodontics
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v.54
no.1
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pp.1-7
/
2016
Purpose: The aim of this study was to evaluate the effect of increased vertical dimension of occlusion on lower facial changes by facial type. Materials and methods: Lateral cephalograms from 261 patients were obtained and classified by sagittal (Class I, II, and III) and vertical (hypodivergent, normodivergent, and hyperdivergent) facial patterns. Retrusive displacement of soft tissue Pogonion and downward displacement of soft tissue Menton were measured in each group after 2 mm of vertical dimension of occlusion was increased at the lower central incisor using a virtual simulation program. The ratio of both displacements was calculated in all groups. The statistical analysis was done by 2-way ANOVA and Post hoc was done by Tukey test (5% level of significance). Results: Retrusive displacement of soft tissue Pogonion in Class III group was statistically different compared to Class I and II, and in vertical facial groups all 3 groups were significantly different (P<.05). Downward displacement of soft tissue Menton showed statistically significant difference between all sagittal groups and vertical groups (P<.05). The ratio of both displacements showed statistically significant difference in all sagittal groups and vertical groups (P<.05), and Class II hyperdivergent group had the highest value. Conclusion: Lower facial change was statically significant according to the facial type when vertical dimension of occlusion increased. Class II hyperdivergent facial type showed the highest ratio after increase in vertical dimension of occlusion.
This study was intended to perform cephalometric analysis of the facial soft tissue profile after surgical correction of skeletal Class III malocclusion after SSRO in 29 patients (Males 12, females 17). Lateral cephalograms were taken in centric occlusion before and immediate, long term after surgeries. 1. Counter-clockwise rotation of mandible was observed after the surgery, average relapses of mandibular set back were 1.23-1.28mm. The net effects of the mandibular set-back after surgeries were 81.7-82.2%. Because these relapse tendencies may reduce the effects of the surgical outcomes, surgeon must consider these net before the surgical treatment planning. 2. The ratio of horizontal changes of hard tissue to soft tissue at lower lip, mentolabial sulcus, pogonion were 72.7-93.7%, 100.3%, 99.1-102.1% respectively. There were little changes at upper lip position anteroposteriorly. 3. The relationship of upper and lower lips were improved after surgery. Lower lip was posteriorly repostioned and upper lip was flattend and elongated in conjunction with deepening of inferior lobial sulcus. But profile of chin was still prominent after surgery. 4. Hard tissue horizontal changes and tissue vertical changes were significantly correlated with each other and there were reverse correlations with hard tissue vertical changes and soft tissue horizontal changes.
Kim, Hyun-Hwi;Lee, Jong-Hyuk;Ha, Seung-Ryong;Choi, Yu-Sung
The Journal of Korean Academy of Prosthodontics
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v.60
no.4
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pp.404-411
/
2022
The patient in this case was an 80-year-old female who had lost #16, 13, 26, 37, 36, 35, 44, 45, 46, 47 teeth. The patient showed loss of posterior support, loss of vertical dimension of occlusion, and deep anterior overbite. Her chief complaint was esthetic and functional discomfort. She wanted to restore normal facial aesthetic shape and masticatory function through prosthetic treatment. Clinical evaluation, radiographic examinations, and facial and oral analysis were performed. Interocclusal rest space was excessive than the average. Distance between labial vestibules and zenith of central incisors, and lower facial ratio were below the average. Taken together, occlusal rehabilitation was determined through increasing 4 mm of vertical dimension on premolars. In this case, a patient who lacked restoration space with deep bite in the anterior region due to loss of the posterior teeth support restored a stable occlusal relationship and harmonious anterior and lateral guidance through fixed and removable prosthesis with increased vertical dimension.
Distributions and trends were examined in 2155 malocclusion patients who had been examined and diagnosed at Deparment of Orthodontics in Youngdong Severance Hospital over a 10 year-period from 1984 to 1993. The results were as follows ; 1. The number of patients per you had nearly quadrupled during the 10 year-period, with females($58.3\%$) outnumbering males ($41.7\%$). 2. Age distribution had shown 7-12 year-old group being the largest($53.3\%$), but percentages of 7-12 year-old and 13-18 year-old groups had been decreasing while that of above-19 patients had gradually incresed. 3. Distributions in the types of malocclusion according to the Angle's Classification had shown $27.8\%$ for Class I, $22.6\%$ for Class II division 1, $7.9\%$ for Class II division 2, and $41.6\%$ for Class III. Percentages of Class I patients had decreased while percentages of Class II and III patients had increased. 4. Non-extraction cases ($75.4\%$) had outnumbered extraction cases ($24.6\%$), with a general trend toward fewer extraction cases over the 10 year period. 5. Patients who had orthognathic surgery had been increasing, with Class I, II, and III cases comprising $8.8\%,\;16.9\%\;and\;74.3\%$, respectively. There had been three times as newly 2-jaw operations as 1-jaw operations. 6. Nearly $4\%$ of the subjects had facial asymmetries, with Class III cases being the most frequent. 7. Patients with TMD symptoms comprised $4.6\%$, with an increasing trend. The symptoms had occurred more frequently in older patients and in females. 8. Geograpic distributions showed majority (3/4) of patients from the nearby areas, namely Gangnam-gu, Seocho-gu and Songpa-gu.
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