Various types of horizontal reference planes are used for diagnosis, treatment planning and evaluation of treatment results. But these reference Planes lack accuracy and repro-ducibility, and are mainly for Caucasian. Unlike the adult patients who have completed growth, the horizontal reference planes for growing children may change continuously during growth. Therefore this must be considered in selecting the horizontal reference plane. The purpose of this study was to Investigate the angle formed by the Sella-Nasion(SN) plane and Frankfort-Horizontal(FH) plane and evaluate the angle formed by FH plane and other horizontal reference planes in relation to different skeletal maturity and malocclusion types. 540 subjects with no orthodontic treatment history were chosen, and hand -wrist X-rays and lateral cephalometric X-rays were taken. According to SMA(Skeletal Maturity Assessment) of hand-wrist X-rays, the subjects were classified into 3 skeletal maturity groups : SMI 1-4 for group A, SMI 5-7 for group B and SMI 8-11 for group C. A second classification was made according to cephalometric analysis of lateral cephalograms. The subjects were classified into 3 malocclusion groups : Skeletal Class I, II and III malocclusion group. 10 measurements were evaluated. The results were as follows. 1. The angle formed by the SN plane and FH plane showed no difference among skeletal maturity groups, malocclusion groups, and between .sexes. 2. The angles formed by the SN plane and FH plane were $8.27^{\circ}{\pm}2.31^{\circ}$ for males and $8.59^{\circ}{\pm}2.24^{\circ}$ for females. The average value for females and males was $8.42^{\circ}{\pm}2.28^{\circ}$. 3. The angle formed by the FH plane and palatal plane was almost constant showing no difference among skeletal maturity groups, malocclusion groups, and between sexes($1.09^{\circ}{\pm}3.21^{\circ}$).
The extraction lot orthodontic treatment can be adopted for aligning crowded dentition, improving facial esthetics and solving a skeletal discrepancy as alternative for a surgical option. Mandibular second premolar extraction was often selected as treatment plan when there we very little or no space shortage in lower arch or limited retraction of the lower incisors was required. The primary object of this study was evaluate a pretreatment condition and examine the amount of tooth movement ior a mandibular second premolar extraction in growing patients. Pretreatment and posttreatment lateral cephalograms of 14 cases that had their four first premolar extracted (4/4 group), 15 cases with upper first and lower second premolar extraction (4/5 group) were selected. Structural method superimposition was conducted to evaluate a difference of dental change between 4/4 and 4/5 group. The results were as follows, 1. Pretreatment factor for 4/4 extraction or 4/5 extraction choice included maxillary incisor axis to occlusal plane, Class II molar relationship, IMPA and interincisal angle. 2. The amount of molar anterior movement in 4/5 group was greater than that of 4/4 group(p<0.05). 3. There was no significant difference between 4/4 group and 4/5 group in aspects of maxillary tooth movement(p<0.05).
The purpose of this study was to evaluate the morphological changes of olveolar bone and mandibular symphysis of lower incisor by presurgical orthodontic treatment and orthognathic surgery in skeletal class III malocclusion. The sample consisted of 30 adult class III malocclusion patients who have received bilateral sagittal split mandibular osteotomy. Lateral cephalograms were taken before treatment, after presurgical orthodontic treatment and 3 months after orthognathic surgery. Skeletal and symphyseal measurements were compared and the relationships between them were analysed. The results were as follow : 1. The labial and lingual alveolar bone height in presurgical and postsurgical group were decreased than that of pretreatment group. 2. The vertical measurements of the craniofacial skeleton showed reverse correlationship with anteroposterior width of basal alveolar bone, but IMPA showed correlatiionship (p<0.01) 3. The craniofacial skeleton and the change of symphyseal measurements(symphyseal length, symphyseal width) showed no correlationship. 4. The labial alveolar bone height showed correlationship with lingual alveolar bone height(p<0.001), and negative correlationship with lingual alveolar crestal width(p<0.01). Labial and lingual alveolar crestal width has negative correlationship (p<0.05). Mandibular symphyseal length and width has positive correlationship(p<0.01). 5. IMPA, LISA showed negative correlationship with labiolingual alveolar bone height and lingual alveolar width and positive correlationship with labial alveolar base bone width.
Numbers of postulations lie on the difference of integumental changes with two major surgical remedies of one jaw vs. two jaw surgery in skeletal Class III malocclusion. Accordingly it was the aim of the study to elucidate the skeletal profile changes with an accompanying disposition of soft tissues, consequently to yield the correlation and ratio of soft tissue changes with two types of surgical procedures, which in turn make it possible to predict the soft tissue outcomes by means of assembled regression equations. Cephalometric headfilms of fifty two adult skeletal Class III comprised of 26 maxillary advancement by Le Fort I osteotomy and mandibular setback by sagittal split ramus osteotomy simultaneously (double jaw surgery, group A), 26 mandibular setback alone (one jaw surgery, group B) were statistically analyzed. Group A manifested 72.4% soft tissue advancement to skeletal changes in the upper lip area, while group B appeared to have no statistically significant changes. The nasolabial angle showed more increment in group A than in group B, whereas the mentolabial angle illustrated more reduction in group B. The backward movement of soft tissue pogonion to skeletal change revealed 98% in group A, and 109% in group B. The double jaw surgery group characteristically revealed remarkable integ umental change in the upper lip area, while the one jaw surgery had major effects in the lower lip and soft tissue pogonion areas.
In order to investigate the possibility of using a cervical vertebral maturation indicator as a mandibular growth indicator, the relationship of cervical vertebral maturation and mandibular & body height growth changes was assessed in biennial serial lateral cephalometric radiographs of eighteen korean male and fourteen korean female while they were 8.5 to 18.5 years old. The following results were obtained. 1. It was a reliable method to evaluate skeletal maturation by using cervical vertebrae. 2. In general, cervical vertebral maturation stages of females were higher than those of males at the same age and there were significant differences in statistics at the age of 10.5, 14.5. 3. The age of a female at the same cervical vertebral maturation stage were earlier than that of a male. 4. In the case of males, significant Ar-Gn increases were found between stage 3 and 4,5; Ar-Go increases between stage 4 and 5. 5. In the case of females, significant S-Gn and Ar-Gn increases were (end between stage 3 and 4. 6. Significant body height increases were found between stage 3 and 4 in both sexes. 7. The peak velocity of body height and mandibular length was observed between cervical vertebral maturation stage 3 and 4 in both sexes. 8. The relationship between mandibular & body height changes and specific maturation stage of cervical vertebra was found, therfore using a cervical vertebral maturation indicator as mandibular growth indicator is quite within realms of possibility.
This study was undertaken to investigate the growth change of genial angle and interrelationship between the growth change of gonial angle and IMPA in the longitudinal data from 7 years to 15 years. By analyzing the serial lateral cephalograms or 15 males and 19 females of 7 years old to 15 yens old who had no abnomality in growth and development and no history of orthodontic treatment, the following conclusion were obtained. 1. Genial angle gradually decreased with aging in 25 children and in 9 children increased or maintained. 2. There was a tendency that children who decreased genial angle with aging showed gradual increase of IMPA and children who increased or maintained gonial angle with aging showed decrease of IMPA. 3. There was a tendency that regardless of the change of gonial angle, interincisal angle decreased with aging.
The purpose of this study was to investigate the factors affecting the postsurgical mandibular stability for both one- and two jaw surgery. 18 for one-jaw surgerys and 24 for two-jaw surgerys among skeletal class III malocclusion patients who experienced orthodontic treatment and orthognathic surgery at Pusan National University Hospital were selected. Lateral cephalograms taken at the first visit, after presurgical orthodontic treatment, immediately after surgery and follow-up over 6 months, were traced. Based ANOVA, multiple linear regression analysis was completed for one-jaw surgery with postsurgical stability as the criterion and the magnitude of mandibular setback, the change of mandibular incisor height during surgery, the changes of mandibular plane angle and mandibular incisor angle during presurgical orthodontic treatment as affecting factors. Same analysis was completed for two-jaw surgery with postsurgical stability as the criterion and the magnitude of mandibular setback as affecting factor. The results were as follows : 1. In the one-jaw surgery cases, the magnitude of mandibular setback, the change of mandibular incisor height during surgery, the changes of mandibular plane angle and mandibular incisor angle during presurgical orthodontic treatment explained the variability in postsurgical stability with a significant $R^2$ value of 0.84. 2. In the two-jaw surgery cases, the magnitude of mandibular setback explained the variability in postsurgical stability with a significant $R^2$ value of 0,28.
To investigate the association between the hypertrophy of adenoid and jaw morphology during growth, this paper was based on children patients with experimental adenoids (male-15 subjects at each bone age group, female-15 subjects at each bone group) and comparing them to data taken from a control group (male-15 subjects at each bone age group, female-15 subjects at each bone group) with normal respiratory function. The comparisons between the groups were done at each growth stage using cervical vertebrae maturation index(CVMI) of Hassel. The obtained results were as follows : 1. The differences in craniofacial morphology between experimental group and control group were appeared from CVMI 3 and CVMI 4 (aroud adolescent period) in males, and from CVMI 1 in females. 2. The mandibular position of experimental group was more inferior than control group. The difference appeared at adolescent period(male : at CVMI 4, female : at CVMI 5). 3. Experimental group had greater anterior facial height than control group. This difference seemed a relation with lower anterior facial height. The difference appears at CVMI 3(11.94 ${\pm}$ 1.38 years old, at adolescent period) in male and at CVMI 1 in female. 4. The adenoid size of control male group was increased until CVMI 2(10.58 ${\pm}$ 1.07 years old, just before adolescent growth peak) and then decreased, but in female the adenoid size was decreased from CVMI 1(6.92 ${\pm}$ 0.53 years old).
Severe skeletal anteroposterior and vertical discrepancy is difficult to obtain satisfactory result by only orthodontic treatment, and much anteroposterior movement and treatment stability require orthodontic treatment with orthognathic surgery. The treatment goal of mandibular prognathic patients is to promote the function of stomatognathic system including mastication and phonetics, to improve the esthetics of facial profile and to maintain stability. Positional changes of hyoid bone, pharynx and tongue were seen with mandibular movement after orthognathic surgery. This study was performed to observe the changes of perimandibular tissues of orthodontic patients with skeletal mandibular prognathism who treated with orthodontic treatment, and the changes of hyoid bone, pharyx and tongue by relapse or recurrance after before and after orthognathic surgery and retention. The 22 patients who had mandibular prognathism were selected. They treated with orthodontic treatment with sagittal split ramus osteotomy as orthognathic surgery. And lateral cephalometric radiographs were taken 3 times : pre-surgery (T1), immediate post-surgery (T2) and 2 years alter retention (T3). The results were as follows : 1. The hyoid bone returned back after clockwise rotation to maxilla and occlusal plane during retention (P<0.01). 2. The hyoid bone moved posterior-inferiorly by mandibular surgery and returned back anterior-superior after retention. (P<0.01) 3. The changes of pharyngeal depth showed a little decrease at upper area in post- surgery, but it was not a significant difference generally through before, after and retention. 4. In relating to tongue base, the angle of tongue base was decreased and the dorsal area of tongue base moved to inferior-posterior direction and to superior direction again after retention (P<0.01). 5. Related to the thickness of upper and lower lip, the thickness of upper lip decreased after surgery, and the soft tissues below lower lip increased after surgery and decreased after retention.
The purposes of this study were to compare the soft tissue changes following hard tissue change after surgery between the one jaw and two-jaw surgery in skeletal class III patients and to get the reference of the incisal inclination at presurgical orthodontics. For this study 24 patients for the two-jaw surgery group and 18 patients for one jaw surgery group were selected. Lateral cephalograms were taken at pretreatment, after presurgical orthodontic treatment, immediately after surgical treatment and at least 6 months after surgery. They were traced and analyzed on skeletodental structure and soft tissue. The results were as follows: 1. After surgery, maxilla, maxillary incisors and upper lip were moved anteriorly and superiorly in two-jaw surgery group. Mandible and mandibular incisors were moved posteriorly and superiorly, and thickness of lower lip was increased in both group but there were no statistically significant difference. Anterior facial height was more decreased in two-jaw surgery group (p<0.05). At least 6 months after surgery, by the postorthodontic treatment, maxillary incisors were moved labially 1.44mm, mandible and mandiibular incisors were moved lingually 1.43mrn, 1.26mm respectively in one jaw surgery group. But there was no statistically significant changes of hard tissue in two :jaw surgery group. 2. The correlation coefficients of maxillary hard and soft tissue horizontal changes were high in two jaw surgery group and the ratios for soft tissue to A point were 19% at Sri, 80% at SLS, 82% at LS. The ratios for soft tissue to B point were 92% at LI, 104% at ILS in one jaw surgery group, 89% at LI, 101% at ILS in two-jaw surgery group. 3. The correlation coefficients and change ratios of mandibular incisors and LL HS on lower lip horizontal changes were 0 0.89 and 75%, 85% in one jaw surgery group, 0.93, 0.90 and 76%, 87% in two-jaw surgery group. The correlation coefficients of maxillary incisors and Sn, SLS and LS on upper lip horizontal changes were 072, 0.76 and 0.75 in two jaw surgery group and ratios of changes were 57%, 58% and 59%. 4. The regression equations between skeletal horizontal discrepancy and incisal inclinaton were taken in one jaw surgery group. Those were FMIA=57.48-2.17ANB, U1-SN=-75.02+2.17SNB and $R^2$ were 0.63, 063 respectively. So if there is skeletal horizontal discrepancy by mandibular prognathism in one jaw surgery case, we consider attaining more labial inclination of maxillary incisors than normal and more lingual inclination of mandibular incisors than normal. But correlation coefficient of the regression equations in two jaw surgery group was low, so, that equation was not reliable.
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