• The korean journal of orthodontics
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• v.32 no.5 s.94
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• pp.301-312
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• 2002

Treatment timing is a very important factor to consider in treating skeletal Class III patients by means of maxillary protraction. According to the literature maxillary Protraction should be carried out at an early age before puberty. However, no scientific data were presented to support this statement and recent studies supported by statistical data showed disagreement concerning the optimum treatment time of maxillary protraction. Therefore, there is no agreement about the optimum treatment time of maxillary protraction. In this study hand-wrist X-rays were taken from 119 patients and subjects were grouped into prepubertal and pubertal group according to their skeletal maturity. Pretreatment and posttreatment lateral cephalometric X-rays were taken and treatment effects were compared. The average treatment time was 6.5 months for the prepubertal group and 6.1 months for the pubertal group. The obtained results were as follows ; 1. The amount of maxillary forward movement was the same for Pretreatment and pubertal group. 2. The amount of maxillary downward movement was the same for prepubertal and pubertal group. 3. The amount of mandibular downward and backward rotational movement was the same for prepubertal and pubertal group. 4. Dental effects were the same for prepubertal and pubertal group.

• 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.28 no.4 s.69
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• pp.533-546
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• 1998

A Skeletal Class III malocclusion may be the result of a large mandible, a small maxilla or combination of the two. Protraction devices for the maxilla are used to promote the growth of a deficient maxilla by applying extraoral force to actively growing patients. This study has been performed to determine whether there are significant differences in skeletal and dental changes between FH/Pal 1 and FH/Pal 2 group, SNA 1 and SNA 2 group, SNB 1 and SNB 2 group, and LFH 1 and LFH 2 group after RME and facial mask therapy. The results of this study can be summarized and concluded as follows ; 1. In all patients after maxillary protraction, the maxilla and maxillary dentitions moved forward, and the mandible rotated backward and downward. In most of them, palatal plane is tends to have an upward inclination. 2. The FH/Pal group 1, having an upward inclination of the palatal plane as a result of Facial mast showed statistically significant maxillary forward movement compared to the FH/Pal group 2. 3. The SNA group 1 showed significantly less mandibular backward movement and there was a tendency for the palatal plane to upward inclination compared to SNA group 2. 4. The SNB group 1 showed significantly less maxillary forward movement, but the vertical dimension, especially the lower facial height increased by mandibular downward rotation compared to SNB group 2. 5. LFH group 1, which had large saddle angle and posterior positioned mandible in the pre-treatment stage, showed maxillary protraction effect without significant increase in lower facial height compared to LFH group 2.

• 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.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.36 no.2 s.115
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• pp.161-169
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• 2006

The purpose of this study was to investigate cephalometrically the short term static velopharyngeal changes in 25 patients (10 boys and 15 girls, aged from 5 years 9 months to 12 years 10 months in the beginning of treatment) with skeletal Class III malocclusions who underwent nonsurgical maxillary protraction therapy with a facemask. The linear, angular and ratio measurements were made on lateral cephalograms. Only the change in hard palatal plane angle was negatively correlated with the change in maxillary depth or N-perp to A (p<0.01). The change in velar angle showed a statistically significant increase (p<0.001). This change was influenced more by the soft palatal plane angle than by the hard palatal plane angle (p<0.001). The changes in soft tissue nasopharyngeal depth and hard tissue nasopharyngeal depth showed statistically significant increases (p<0.001). Correlations between the changes in soft tissue (or hard tissue) nasopharyngeal depth and the change in soft palatal plane angle were significant (p<0.05). The increase in hard palate length was statistically significant (p<0.001). The change in hard palate length was negatively correlated with the change in soft tissue nasopharyngeal depth (p<0.05). The change in need ratio S (C) showed a statistically significant increase (p<0.001). But this difference was within the normal range reported by previous studies. These findings indicate that the velopharyngeal competence was maintained even if the anatomical condition of the static velopharyngeal area were changed after maxillary protraction.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.2
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• pp.171-181
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• 2009

The objective of this study was to analyse stress distribution of maxillary complex by use of face mask. The construction of the three-dimensional FEM model was based on the computed tomography(CT) scans of 13.5 years-old male subject. The CT image were digitized and converted to the finite element model by using the mimics program, with PATRAN. An anteriorly directed force of 500g was applied at the first premolar 45 degrees downwards to the FH plane and at the first molar 20 degrees downwards to the FH plane. When 45 degrees force was applied at maxillary first premolar, there were observed expansion at molar part and constriction at premolar part. The largest displacement was 0.00011mm in the x-axis. In the y-axis, anterior displacement observed generally 0.00030mm at maximum. In the z-axis, maxillary complex was displaced 0.00036 mm forward and downward. When 20 degrees force was applied at maxilla first molar, there were observed expansion at lateral nasal wall and constriction at molar part. The largest displacement was 0.001mm in the X-axis. In the Y-axis, anterior displacement observed generally 0.004mm at maximum. In the Z-axis, ANS was displaced upward and pterygoid complex was displaced downward. The largest displacement was 0.002mm.

• 대한치과교정학회:학술대회논문집
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• 1999.11a
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• pp.38.2-38.2
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• 1999

• 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.

• Journal of The Korean Dental Society of Anesthesiology
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• v.10 no.2
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• pp.178-182
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• 2010

배경: 임상적으로 굴곡성 기관지 내시경을 이용 삽관 시행시 후두경으로 성문부위가 잘 드러나지 않는 환자의 경우 삽관 시행이 어려운 경우를 경험한다. 하지만 이에 대한 연구는 거의 없는 실정이다. 본 연구에서는 어려운 기도환자에서 굴곡성 기관지경 시행시 후두시야를 확보시 차이가 있는지 확인하고자 하였다. 방법: 전신마취 유도 후 Cormack - Lehane classification을 이용하여 기관 삽관의 어려움을 먼저 평가하였다. 기관지 내시경을 이용하여 내시경하 후두시야의 정도를 평가하였다. 후두경으로 기도 확보가 용이한 그룹(Cormack - Lehane grades 1, 2)과 어려운 그룹(Cormack - Lehane grades 3, 4) 간의 내시경하 후두 시야의 정도가 차이가 나는 지를 확인하였다. 결과: 후두경으로 기도확보가 용이하지 않을 경우에 기관지 내시경으로 후두 시야를 용이하게 (fiberoptic laryngeal view 1, 2) 확보하기가 어려웠다. 반면 하악을 전방으로 견인시 후두시야의 정도가 통계적으로 유의하게 개선되었다. 결론: 전방하악견인법 (jaw-thrust maneuver)은 기도확보가 어려운 환자에서 기관지 내시경을 이용한 기관내 삽관 시행시 시야를 개선시켜서 삽관을 용이하게 할 수 있을 것으로 생각된다.