Defining right and left side differences in mandibular ramus height is one of the key elements in the diagnosis of facial asymmetry. The purpose of the present study was to evaluate the effect of correction of ramus height with frontal and lateral ramal inclinations (FRI and LRI) in 2-dimensional cephalograms and observe how this affects the diagnostic accuracy of asymmetry. Methods: Frontal and lateral cephalograms were obtained in 40 individuals with chin deviation. FRI and LRI were measured on each side and ramus height measurement was corrected with these inclinations using Pythagorean's theorem. The results of diagnosis before and after correction on cephalograms were compared with the results in 3D CT images. Results: Both FRI and LRI showed greater values in the contralateral side than in the chin-deviated side and these contributed to an increase in the right and left side ramus height differences. After comparison of diagnostic results before and after correction on cephalograms with the results on 3D CT images, the sensitivity increased significantly (from 74 to 94 %) whereas the specificity decreased (from 44 to 22 %). Overall accuracy increased from 68 to 78 % with the correction using FRI and LRI. Conclusions: The results of the present study indicate that correction of ramus height with FRI and LRI is useful for an accurate diagnosis of facial asymmetry on frontal cephalograms.
Journal of Dental Rehabilitation and Applied Science
/
v.26
no.1
/
pp.77-87
/
2010
Skeletodental asymmetries are common and asymmetric orthodontic treatments are very difficult to correct successfully. The cause of asymmetries can be the skeletal asymmetry, dental, or functional, or combinations of these causes. Skeletodental asymmetries can be the result of congenital factors, such as hemifacial microsomia and environmental factors, such as trauma. Optimal treatment outcome of the severe facial asymmetry requires the orthognathic surgery. Mild asymmetry problem can be treated by only orthodontic treatment. The orthodontic treatment of asymmetry is usually difficult. Facial asymmetry orthodontic treatment are primarily based on proper diagnosis and careful treatment planning. Side effects of asymmetric elastic to treat midline discrepancies are canted occlusal plane, tipped incisors and unesthetic results. In the management of dental arch asymmetries, the clinician should select the appropriate force system and the appliance design necessary to address the asymmetry while minimizing undesirable side effects. This report presents treatment strategies for the treatment of skeletodental asymmetry. In this case report, the clinical case with midline discrepancies treated by optimal mechanics is described. Through diagnosis and strategic treatment mechanics can obtain proper midline correction with minimal side effects.
Journal of the Korean Society of Fisheries and Ocean Technology
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v.20
no.2
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pp.105-111
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1984
Recently, Hybrid Navigation Systems combining Omega, NNSS, Loran C and Dead reckoning etc. served to give us highly accurate ship's position, and a number of ships are equipped with these navigation systems. In order to evaluate for the accuracy of this navigation system observations of Loran C, 5970 and 9970 chains and Radar at the same time were made on board m.s Jeonbuk 401 and 403 training ships of Gunsan Fisheries Collage at nine stations in the yellow sea from July, 1982 to June, 1983, and then were done by the Hybrid Navigation System combining Dead reckoning and Loran C at the same areas. The authors investigated the accuracy of the Hybrid Navigation System based on measurements of the relative positional error which is defined as the difference between the position fixed by this system or the Loran C system, and the one by the Radar. The obtained results are as follows; 1. The mean standard deviation of the time difference of Loran C were about 0.21$\mu$s in 9970 chain and about 0.06$\mu$s in 5970 chain, and the fluctuation of the time difference of Loran C in 5970 chain was smaller than that in 9970 chain. 2. The positional error between two positions by Radar and the Hybrid Navigation System in 9970 chain was about 0.4 miles, and between two positions by Radar and Loran C was about 0.51 miles. The Hybrid Navigation System was therefore more accurate than Loran C System. 3. The positional error between two positions by Radar and Hybrid Navigation System in 5970 chain was about 0.4 miles, and between two positions by Radar and computer simulation of Loran C was about 0.98 miles. Consequently, Hybrid Navigation System was more accurate than computer simulation of Loran C system.
Although pantograph has been used to investigate whether the determinents of the mandibular movement were possible contributing factors of TMJ click, there was the problems to understand the role of tooth morphology upon the occurrence of click because of using appliance without tooth contacts. There Were advantages to evaluate the effects of tooth morphology upon the mandibular movements, because intraoral tracing device(Functiograph$^{(R)}$) had been obtained maintaining occlusal contact between the upper and lower natural teeth during mandibular movement. The purpose of this study was to record the mandibular eccentric movement quantitatively performed in 20 adult control subjects and 20 adult subjects with TMJ click and to investigate the effects of occlusion upon the occurrence of TMJ click. The obtained results were as follows : 1. The average ICP-P distance was $3.07{\pm}0.73mm$ in subjects with TMJ click, $2.14{\pm}0.85mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.001). 2. The average ICP-P distance was $3.07{\pm}1.14mm$ in subjects with TMJ click, $2.61{\pm}0.96mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.05). 3. The average distance of right and left lateral movement was not statistically significant between subjects with TMJ click and control subjects. 4. The average lateral displacement from midline during RCP was $0.75{\pm}0.54mm$ subjects with TMJ click, $0.16{\pm}0.17mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.001). 5. The average lateral displacement from midline during protrusive movement was $0.88{\pm}0.54mm$ in subjects with TMJ click, $0.20{\pm}0.23mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.001). 6. The average angle of right and left lateral movement was $144.2{\pm}20.20^{\circ}$ in subjects with TMJ click, $138.15{\pm}20.09^{\circ}$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.05).
Application of the left lateral tilt position has been recommended during cardiopulmonary resuscitation (CPR) of pregnant patients. However, the left lateral tilt could displace the left ventricle (LV) besides the gravid uterus and may compromise the cardiac pump mechanism of CPR. Thus, we investigated the effect of left lateral tilt on the spatial relationship between the anterior-posterior axis (AP axis), which represents the direction of sternal displacement during CPR, and the LV. We retrospectively reviewed the medical records and multidetector computed tomography (MDCT) scans of 90 patients who underwent virtual gastroscopy using MDCT. Virtual gastroscopy was performed with the patient both in the left lateral tilt position and in the supine position. On an axial image showing the maximal area of the LV, the angle between the AP axis and the LV axis ($Angle_{AP-LV}$), the shortest distance between the AP axis and the mid-point of LV cavity ($D_{AP-MidLV}$) and the shortest distance between the AP axis and the LV apex ($D_{AP-Apex}$) were measured. In the supine scans, the LV was situated on the left side of the AP axis in 87 patients (96.7%). On the left lateral tilt scans, the mean tilt angle was $43.4{\pm}11.0^{\circ}$. $D_{AP-MidLV}$ and $D_{AP-Apex}$ were significantly longer in the left lateral tilt position (p<0.001), but $Angle_{AP-LV}$ was comparable between the positions. This study indicates that the left lateral tilt position may compromise the cardiac pump mechanism of chest compression in pregnant cardiac arrest patients.
This study was performed to investigate the effect of mandibular midline shift and difference of mandibular height between both sides on the electromyo- graphic(EMG) activity of the masticatory muscles on clenching or gum chewing movement. For this study, 105 patients with temporomandibular disorders(TMD) were selected and panoramic radiograph were taken. Amount and side of the midline shift and height of the mandible from antegonial notch to the top of the condylar head were measured on panoramic view. $BioEMG^{(R)}$ (Bioresearch Inc., Milwaukee, USA) was used for recording of EMG activity(${\mu}V$) of the anterior temporalis and the superficial masseter on clenching or gum chewing movement. EMG activity on clenching during 533msec period were measured for activity of the starting point and the one second-after activity as the early EMG and the maximum EMG, respectively. EMG activity on gum chewing movement were measured for activity of the first and the second chewing stroke. The data collected were analysed by SPSS windows program, and the results of this study were as follows : 1. Height of the mandible was 8.06cm on right side and 8.03cm on left side, and showed no difference by age, but significantly differed by sex with higher in male subjects. 2. Mean value of the midline shift was 0.1mm with range of 0~5mm on both sides. The amount and side of the midline shift did not related with height difference of the mandible and/or the EMG activity of the masticatory muscles on clenching. 3. Prevalence of higher right side and higher left side of the mandible were almost same, and the EMG activity of higher side was not higher than that of the other side. 4. In the subjects with height difference of more than 5mm between both sides of the mandible, the early EMG activity on clenching were differed for the anterior temporalis, but the maximum activity were differed for the superficial masseter. 5. In the subjects with height difference of more than 5mm between both sides of the mandible, EMG activity of the anterior temporalis of the gum chewing side was not higher than that of the other side when chewing on the side of lower height, but in the subjects with height difference of less than 5mm, the EMG activity was higher than that of the other side.
Journal of the korean academy of Pediatric Dentistry
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v.28
no.4
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pp.649-653
/
2001
The Chiari malformation is a deformation within the central nervous system which the lower brain stem and the cerebellum migrate into the foramen magnum causing herniation. In 1891, Arnold Chiari classified such symptoms into 3 categories. This case report is of a 8-year-old female with the complaint of a slight facial swelling and pain on the upper right molar during tooth brushing since 10 days before. Clinical examination showed gingival pocket formation on distal of the upper right first molar with pain and mobility of the tooth. Radiographic examination showed generalized low bone density in the upper molar area, and especially no bone support above the upper right and left first molars were noted. With a temporary diagnosis of Early-onset periodontitis, consultations with medical doctors for the possibility of an underlying systemic disease were made during periodontal treatment. 3D CT was taken with after a final diagnosis of Chiari malformation. Generalized thinning and defect of the cranial bone was noted and the foramen magnum was slightly enlarged. The occipital and maxillary bone was low in density, and the alveolar bone of maxillary posterior teeth was especially almost non-existing causing the upper right and left first molar to be floating. For this, the patient went under consultation with the department of neurosurgery and is still under observation. Periodontitis in childreren is very rare. When symptoms of periodontitis appear in a child, due to the possibility of an underlying systemic disease such as leukemia, histiocytosis X, and hypophosphatasia, proper examinations should be carried out so that the primary factor the symptoms can be treated.
This study was performed to investigate the relationship between mandibular midline shift and anteroposterior first molar occlusal relation, and their effects on the mandibular height and the occlusal plane angle. For this study, 49 patients with temporomandibular disorders were selected. They did not show facial asymmetry and their facial midline coincide with maxillary dental midline. Upper and lower mandibular impression were taken and the casts were fabricated. Amount and direction of the mandibular midline shift and the anteroposterior shift between the two occluding first molars were measured on the casts. Several items related to height such as mandibular height from top of the articular surface of the condyle to curve changing point between antegonial notch and mandibular angle, condylar height which was the vertical distance from the articular surface to retroepicondyle of the condyle, and sigmoid height from the deepest point of sigmoid notch to the curve changing point and the occlusal plane angle were also measured on the panoramic and on the transcranial radiographs. Correlation between midline shift and anteroposterior first molar relation and comparison between right and left mandibular height by the midline shift and the first molar relation were analysed by SPSS windows program. The results of this study were as follows : 1. Mean amount of midline shift in the subjects with midline shift were 2.0mm for both side, respectively. The first molar relation of the ipsilateral side of midline shift showed Angle class II tendency and the contralateral side showed Angle class III tendency, which meant drift of the dentition to the side of the midline shift. 2. The occlusal plane angle on the panoramic radiograph were $13.0^{\circ}$ in right, and $12.5^{\circ}$ in left side, and their were no correlation between occlusal plane angle and mandibular midline shift and the first molar occlusal relation. 3. Angle's classification for both sides of the first molar relation were same in about half of all the subjects. Amount of deviation from class I first molar relation, however, were decreased in the contralateral side of observed side. 4. Mandibular height of the ipsilateral side to which mandibular midline shift showed tendency of lower than that of the contralateral side, and there was a tendency that the height was higher in class III subjects, then class II subjects, and lower in class I subjects. However, condylar height did not show any difference in the subjects with midline shift and also show no difference by the first molar occlusal relation.
Clinical estimation of bladder and rectal doses from high dose rate intracavitary irradiation in carcinoma of the cervix uteri has been initiated on a routine basis in an effort to obtain the optimum radiotherapeutic dose. Simulation films with contrast media are used to image the bladder and rectum, and dose rates are estimated at various interesting points with the aid of treatment planning computer, NEC Therac-2300. Fifty-three patients have been reviewed in order to ascertain the correlation between radiation dose at interesting points in the bladder and rectum and the dose at Point A and B. The dose ratio between doses at Point A 'and interesting points is an important clinical factor in evaluating the treatment planning. This also serves as documentation of the dose to normal structures within the treatment volume. Authors conclude that obtained data are within acceptable ranges and routine simulation films of the bladder and rectum after administration of contrast media with dose calculations at interesting points provide important information for optimizing radiotherapy planning in the treatment of cervical carcinoma without increased time and effort or patient's discomfort.
In this paper, Han Yong-un's view point of Buddhism was examined in the traditional Zen Buddhism. He emphasized the essence of calm and awakened Zen in Wonhyo's theory of Jigwanssangun and Jinul's theory of Jeonghyessangsu. He criticized the behaviors of Zen priests at that time who turned their back on common people, secluded themselves in mountains and tried to stay calm in their places, and ideologically stressed that calm and awakened Zen should be realized in disciplinants' daily lives while enlightening the public. On the other hand, he had consistently stuck to Imjeseonpung(臨濟禪風) based on the spirit of saving the world, rather than depending on Jodongowi(曹洞 五位), when glossing "Sip-hyun-dam" with the traditional $S{\bar{o}}t{\bar{o}}$ Zen(曹洞宗) after Kim Si-seup Compared with Jodongowi, Siphyeondamjuhae(十玄談註解) emphasized Pyeonjungjeong (偏中正) where the right position(正位) of a true man(眞人) is founded in the middle of common people's partiality(偏位). In Siphyeondamjuhae, he intended to rebuke Japanese $S{\bar{o}}t{\bar{o}}$ Zen priests' brutality of trying to annihilate even the spirit of Zen Buddhism through Treaty of Alliance of Korea-Japan Buddhism(朝日佛敎同盟條約). Considering Han Yong-un's view point of Buddhism, it has the characteristic of patriotism and love of the people in the traditional Zen Buddhism.
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