The purpose of this study was to investigate the degree of relapse following orthognathic surgery and the relationship between preoperative state and the methods of orthognathic surgery in skeletal Class III patients. Thirty-one patients were selected(17 men, and 14 women) for this study, who had received orthognathic surgery(20 one jaw surgery, and 11 two jaw surgery). The mean age was 22.5 years. Their lateral cephalograms, that were taken preoperatively, immediate postoperatively and follow-up over one year, were traced and analysed. The results were as follows : 1. In two jaw surgery, mandibular length, lower facial height and lower lip length were 4.24mm, 4.64mm and 4.13mm longer than in one jaw surgery, respectively But in two jaw surgery, overjet was 3.13mm shorter than in one jaw surgery. 2. In one jaw surgery, mandible was moved back $8.95\pm4.45mm$ at B point. In two jaw surgery, maxilla was moved forward $5.15\pm3.46mm$ and mandible was moved back $7.24\pm9.11mm$ at B point. 3. Between postoperation and follow-up over one year, A point, A' point, Pn and Sn were moved backward 1.02 $\pm$ 2.14mm, $1.73\pm1.63mm,\;1.05\pm1.48mm\;and\;1.55\pm1.37mm$ in two jaw surgery, respectively. 4. Between postoperation and follow-up over one year, in one jaw surgery, B point was moved forward $2.58\pm4.22mm$ and B' point was moved forward $1.95\pm4.39mm$. In two jaw surgery, B point was moved forward $0.65\pm2.88mm$ and B' point was moved forward $0.19\pm3.32mm$. In one jaw surgery, relapse rate was $28\%$ at B point and $24\%$ at B' point, whereas in two jaw surgery, relapse rate was $8\%$ at B point and $3\%$ at B' point.
Mandibular incisor crowding is one of the most common features of malocclusion and is interesting characteristic in view of relapse and stability after orthodontic treatment. There are many potential factors in the etiology of lower anterior crowding. The tooth size variation is one of them, but biologic significance for the faciolingual width of the teeth has been overlooked. Peck and Peck reported that persons with ideal mandibular incisor alignment were shown to have incisor with smaller mesiodistal and larger faciolingual dimensions than persons with incisor crowding. On the basis of these findings they suggested MD/FL index as a clinical guideline for the assessment for lower incisor crowding. The present study was undertaken to examine the relationship between mandibular incisor crowding and mandibular incisor dimension, and determine their correlation with arch length discrepancy. 154 dental casts of people from 11 to 17 years of age were made, and were divided into normal group with irregularity index less than of 1, and crowding group with irregularity index greater than 1.The casts were measured and analyzed statistically. The results were as follows. 1. The mean mesiodistal width for mandibular incisor was larger in crowding group, and has significant difference in central inciosr measurement. There are no significant differences in the faciolingul width and MD/FL index. 2. Irregularity index has significant correlation coefficients with mesiodistal width and MD/FL index for mandibular incisor in crowding group, but no correlation with faciolingual width. It also has correlation with maxillary and mandibular arch length discrepancy, total tooth material, mandibular intercanine width, and mandibular inter first premolar width. 3. Upper and lower arch length discrepancy have significant correlation with mesiodistal width of mandibular incisor and overbite, but have no correlation with faciolingual width. Lower arch lenth discrepancy has significant correlation with MD/FL index for mandibular incisor and upper arch length discrepancy has correlation with MD/FL index for mandibular lateral incisor. 4. Significant differences were observed between normal and crowding group for the mandibular arch length discrepancy and overbite.
Kim, Bo-Kyung;Park, Kuk-Pil;Kyung, Hee-Moon;Kwon, Oh-Won;Sung, Jae-Hyun
The korean journal of orthodontics
/
v.29
no.1
s.72
/
pp.73-81
/
1999
Midpalatal suture expansion is often used for patients haying narrow maxillary arch, cleft palate, respiratory handicap with narrow nasal cavity. CGRP has been known as a modulator of pain transmission in central nervous system and a local effector to peripheral tissue causing vasodilation, increase of blood flow, modulation of immune system, regulation of macrophagic function and stimulation of bone formation. To investigate changes of CGRP-immunoreactive nerve fibers in midpalatal suture during the expansion, immunohistochemical study was performed by using rats. Experimental rats (10 weeks, 250 gm) were divided into five groups (control, 1, 4, 7, 14 days group (each n=4) and applied orthodontic force (approximately 200gm) to upper anterior incisors. Frozen sections of midpalatal suture area were immunostained by using rabbit antisera. The results were as follows. ${\cdot}$ The CGRP-immunoreactive nerve fibers were hardly observed in control group. ${\cdot}$ In 1 day group, the CGRP-immunoreactive nerve fibers were more increased around the vessels than control group. ${\cdot}$ In 4 days group, the CGRP-immunoreactive nerve fibers were more increased than control group, but not more increased than 1 day group. Vascular diameter was more enlarged. ${\cdot}$ In 7 days group, especially, hematoxilin affinity of cells was remarkable and cells were arranged along the bone margin. The CGRP-immunoreactive nerve fibers were more reduced than 4 days group and vascular diameter was also reduced. ${\cdot}$ In 14 days group, the CGRP-immunoreactive nerve fibers were similar to those of 7 days group and the irregularity of bone margin was almost recoverd. In Conclusion, the CGRP-immunoreactive nerve fibers nay be related to initial neurogenic inflammatory reaction in expanding mid-palatal suture.
This study was performed to examine the effect of bisphosphonate, an inhibitor of bone resorption, on the formation of osteoclast and bone resorption during experimental tooth movement. Whether bisphosphonate has a cytotoxicity in high dose was also examined. Eighty-seven male Sprague-Dawley rats, weighing 260-350g, were classified into normal (no appliance + $0.9\%$ NaCl), control (appliance + $0.9\%$ NaCl) and four bisphosphonate-treated (appliance + 0.8, 4, 20 or 100mg/kg) groups. The maxillary left first molar was moved mesially with the tipping movement using 50-70g of force. Bisphosphonate(etidronate disodium) was injected intraperitoneally with a dose of 0.8, 4, 20, or 100 mg/kg simultaneously with the application or the orthodontic force. They were killed at day 1, 3, or 7 after the application or the orthodontic force. The activities of serum acid phosphatase and lactate dehydrogenase (LDH) were assayed, and osteoclasts and the degree of bone resorption were examined histologically. The results obtained were as follows: 1. Acid phosphatase activities were significantly higher in the appliance groups, both control and bisphosphonate-treated (4, 20, and 100 mg/kg) groups, at days 1 and 3 than these in normal. At day 1, bisphosphonate-treated(4, 20mg/kg) groups showed even higher acid phosphatase than control. However, at day 7, no significant difference was noted between the control and bisphosphonate-treated groups. 2. LDH activities in the 4, 20mg/kg bisphosphonate-treated groups were increased during the experimental Periods examined, but there were no significant differences in the 0.8, 100mg/kg bisphosphonate-treated groups. 3. There was no bone resolution at day 1, but severe bone resorption was observed at days 3 and 7 in the control. Bone resorption was reduced by bisphosphonate-treatment at day 3. Bone resolution observed at day 7 was similar between the control and bisphosphonate-treated groups. 4. Few osteoclasts were observed at the alveolar bone in the control and bisphosphonate-treated groups at day 1. At day 3, numerous osteoclasts were shown in the control, the degree of which was reduced in bisphosphonate-treated groups. These results suggest that the inhibition of the osteoclast formation was not the mechanism of bone resorption by the bisphosphonate-treatment during experimenal tooth movement. There was no distinct cytotoxicity with a high dose of bisphosphonate. And the drug should be administrated repeatedly to maintain the inhibitory effect of bone resolution.
Enlow's counterpart analysis reflects the characteristics of each individual sample to find out the cause of the malocclusion and further applying them to the clinic. Enlow's counterpart analysis was performed on 100 Korean samples (50 male, 50 female) with normal occlusion and 100 skeletal class III patients (50 male, 50 female) scheduled for orthognathic surgery. The following conclusions were obtained. 1. The cause of malocclusion in skeletal class III patients were complex and interrelated : backward upward rotation of the cranial base, forward inclination of the ramus, increase in the mandibular body length, and posteriorly located maxilla. 2. Seen on R2 (male-1.68mm, female-2.33mm), in skeletal class III, the maxilla Is mote posteriorly located than the normal group. 3. The cause of malocclusion In skeletal class III patients, consists of retrognathic maxilla(A1) male $22\%$, female $26\%$, prognathic mandible(B1) male $44\%$, female $34\%$, and combination of an retrognathic maxilla and prognathic mandible were male $28\%$, female $38\%$. 4. There was no significant difference in the anterior-posterior length of the maxilla(A4) between skeletal class III males with the normal group, while in the female subjects, the skeletal class m group showed a smaller maxilla(A4) compared to the normal group. 5. In skeletal class III patients the proganthic mandible was primarily caused by the Inclination of the ramus(R3, R4) and mandibular body length(B4, B6) rather than ramus width(B3).
This study was designed to analysis the displacement and stress distribution of individual tooth by orthodontic force during distal on masse movement of the maxillary dentition. In this study, three dimensional finite element analysis was used. Author made the finite element model of maxillary teeth, periodontal ligament, alveolar bone and bracket with anatomic and physiologic characteristics on computer. Author analysed and evaluated the displacement and stress distribution of individual tooth when extraoral force, Class II intermaxillary elastics, ideal arch wire, MEAW and tip back bend were used for distal on masse movement of the maxillary dentition. These analyses were also applied in the case of the maxillary second molar were not extracted. Author compared the results of the cases which maxillary second molar were extracted or not. The results were expressed quantitatively and visually. Author obtained following results, 1. When anterior headgear was applied, the posterior translation, posterior tipping, and vertical displacement of teeth were produced more in the anterior segment of the dentition. 2. When Class II intermaxillary elastics were applied in the ideal arch wire, the teeth displacement were usually produced in the anterior segment. But when tip back bend were added in the ideal arch wire, the orthodontic force produced by elastics were transmitted to the posterior segment. As increasing the tip back bend, posterior translation and lingual tipping of anterior teeth were decreased, posterior translation and tipping displacement of posterior teeth were increased, and extrusion of anterior teeth by Class II elastics were decreased 3. When MDAW and Class II elastics were applied, the teeth movement were sir flu with the case of ideal arch wire and Class II elastics, but more small and uniform teeth displacement were produced Compared with the ideal arch wire, posterior tipping of the posterior segment were more produced than lingual tipping displacement of the anterior segment. 4. When the maxillary second molar without orthodontic appliance existed, the displacement of maxillary first molar were decreased.
The purpose of this study was to investigate the alveolar bone turnover in diabetic rat, and to compare the alveolar bone turnover during tooth movement in diabetes with that in normal control Eighty Male Sprague-Dawley strain rats(8th week) were divided into normal control(N), normal-tooth movement (N-tm), diabetes(D), and diabetes-tooth movement(D-tm) groups. Eighteen days before the start of the experiment, diabetes was induced with a single injection of streptozotocin 50 mg/kg of body weight in citrate buffer as vehicle via the tail vein. Maxillary first molars of rats were moved mesially by 40 grams of the closed coil spring. Experimental animals were sacrificed after 1d, 3d, 7d, and 14d experimental period, and the alveolar bone around the maxillary first molars were assayed biochemically for acid phsophatase(ACP) and tartrate-resistant acid phosphatase (TRAP) as bone resorption markers, and alkaline phosphatase(ALP) and osteocalcin(OC) as bone formation markers. TRAP and OC concentration in serum and alveolar bone of D group were lower than those in N group, and especially OC concentration decreased mote following diabetes prolonged, which showed the decreased skeletal and alveolar bone resorption and formation potential in diabetic rats. In N-tm group compared with N group, alveolar bone ACP and TRAP concentrations were highest at 1d and 3d(p<0.01), decreased after then, and showed lowest at 14d, and alveolar bone OC concentration was higher at 3d, 7d, and 14d(p<0.001) and showed a tendency of peak level at 7d. which showed the peak of concentration of bone resorption markets at 1d-3d and those of bone formation markers at 7d. In D-tm group compared with N group, alveolar bone ACP and TRAP concentrations were higher at 3d, 7d and 14d(p<0.001), and tended to reach peak value at 7d and persisted through 14d, and alveolar bone ALP and OC concentration increased but not different from that of N group. The amount of tooth movement in D group were greater than that of N group at all experimental period. Those results were suggested that during diabetes, the alveolar and skeletal bone undergo low bone turnover and the mote amount of tooth movement, hut because the peak time of alveolar bone resorption activity was delayed and sustained in longer period of tooth movement and alveolar bone formation activity is lower than that of normal tooth movement, the periodontal space is supposed to be larger doting tooth movement.
The purpose of this study is to define the characteristics of the skeleton and soft tissues of severe adult class III malocclusion. The materials selected for this study were lateral cephalograms of 112 adult class III malocclusion patients with ANB difference below -2 degrees. and the mean age was 22.9 years old. The normal control sampler consisted of lateral cephalograms of 50 adults in normal occlusion and the mean age was 22.1 years old. The Horizontal reference line was FH line and the vertical reference line was nasion perpendicular to FH line. The skeletal and soft tissue characteristics of Class III malocclusion are as follows : 1. In the skeletal profile evaluated by vertical reference line (Nasion perpendicular to FH), the forehead and maxilla was similar to normal, but the mandible was protruded significantly. 2. The soft tissue profile is concave. The thickness of soft tissue covering forehead area and nose is within normal range. but the upper lip is thicker and the nasolabial angle is smaller than normal. The lower lip and inferior labial sulcus is thinner than normal. The degree of eversion of lower lip is lesser than normal. 3. The cranial base of class III malocclusion is shorter and saddle angle is smaller than normal. 4. The location of midface evaluated in relations to cranial base is within normal range but, the length of midface is shorter than normal when compared from the deep portion of the facial skeleton. 5. The location of maxilla in reference to cranial base is within normal range but the length of maxilla was shorter in class III malocclusion. 6. The mandible was protruded, ramus height and body length, gonial angle were greater than normal, and the chin angle was smaller. 7. Upper incisor was proclined, lower incisor was retroclined.
Surgical-orthodontic treatment is performed for the skeletal Class III patients with no remaining growth and too big a skeletal discrepancy (or camouflage treatment, and two jaw surgery is needed in order to have maximum effect in such patients. In two jaw surgery cases, surgical alteration of the occlusal plane is necessary to establish optimal function, esthetics and postoperative sability, therefore the establishment of the occlusal plane is essential in diagnosis and treatment. The object of this study is to evaluate the stability of the indiviual ideal occlusal plane bsaed on the architectural and structural craniofacial analysis of Delaires. Thus, the subjects of this study were 48 patients who underwent two jaw surgery, and divided in two groups. Each group were composed of 24patients, A group were operated with ideal occlusal plane and B group were not. Two groups were compared at the preoperative, immediate postoperative (average 4.3days), and long-term postoperative (average 1.3years) lateral cephalometric radiographs. The following results were obtained: 1. There was no significance in occlusal plane angulation between $T_2\;and\;T_3$. Average long term follow-up changes of occlusal Plane angle were $0.24^{\circ}{\pm}2.43$, with FH plane and $0.15{\circ}{\pm}2.16{\circ}$ with SN plane in all 48 patients. These results demonstrated that the occlusal plane after two jaw surgery in skeletal Class III malocclusion was stable. 2. There was no significance in postoperative stability of occlusal plane between A and B group. 3. There was no significance in postoperative stability of occlusal plane depending on surgeon and operative method within each group. 4. The postoperative changes of occlusal plane were correlated to the postoperative changes of jaw rather than tooth position. 5. There was no correlation between the postoperative changes of occlusal plane and maxillary impaction and mandibular setback with surgery.
The purpose of this study was to evaluate the effects of caffeine and calcium on the activities of the osteoblastic cell from mouse calvaria. The author cultured osteoblastic cells obtained from the mouse calvaria and were divided into three groups : the caffeine-treated, the calcium-treated and the combine-treated group. In caffeine-treated group, the cell toxicity was measured by MTT assay at 1, 2 and 4 days after treatment of caffeine. In all groups, the densities of the mineralized bone nodules were measured by imaging analyzer after Von Kossa staining. The alkaline phosphotase (ALP) activities were measured at 2, 7, 14, 21 and 28 days and the interleukin-1 ${\beta}$ activities at 48 hours after treatment of caffeine and calcium. The measurements were statistically executed with ANOVA test and the results were as follows. 1. The cellular toxicity of the caffeine increased with the concentration of caffeine during the incubation period. 2. The maximum densities of mineralization were observed at 0.2 mM caffeine-treated group, 1.2 mM calcium-treated group, 0.1 mM caffeine and 1.8 mM calcium-treated group. 3. The activities of ALP were peaked at 14 days at calcium-treated group as no-treated. But, the activities of ALP increased with concentrations of caffeine at caffeine-treated group. At combine-treated group, the act of ALP were peaked at 24 days at 1.2 mM, 1.8 mM calcium-treated group, But decreased at 2.5 mM calcium-treated group. 4. The activites of the IL-1 ${\beta}$ were increased significantly at 0.2 mM caffeine-treated group, 1.8 mM calcium-treated group and 0.1 mM caffeine and 1.8 mM calcium-treated group. But, they were decreased at all groups of high concentration.
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