• The korean journal of orthodontics
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• v.30 no.3 s.80
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• pp.367-375
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• 2000

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 korean journal of orthodontics
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• v.33 no.1 s.96
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• pp.41-49
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• 2003

This study examined the relations between degree of posterior dental compensation and skeletal discrepancy in Class III malocclusion. The pretreatment lateral cephalogras and dental casts of 87 skeletal Class III adults were selected to provide a random sampling of skeletal Class III malocclusion. Skeletal discrepancy was described with ANB angle, Wits appraisal, SN-Mn plane angle, FMA and ratios of basal arch width. Degree of posterior dental compensation was described with maxillary intermolar angle, mandibular interolar angle and sum of intermoloar angle. The relationships between skeletal discrepancy and degree of posterior dental compensation were analyzed with simple correlation analysis, stepwise multiple regression analysis. The results were as follows 1. A strong association was found between the variation in the anteroposterior measure, ANB angle and the variation of posterior dental compensation measures, sum of intermolar angle and mandibular intermolar angle in skeletal Class III malocclusion. 2. There was no statistically significant relationship between the variation in the vertical measures and the variation of posterior dental compensation measures in skeletal Class III malocclusion. 3. There was no statistically significant relationship between the variation in the anteroposterior and vortical measures and degree of basal arch width discrepancy.

• The korean journal of orthodontics
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• v.29 no.3 s.74
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• pp.317-325
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• 1999

In proper diagnosis of skeletal Class III malocclusion, it was important to know the pattern of three dimensional skeletal & facial disharmony. The purpose of this study was to obtain P-A cephalometric characteristics in skeletal Class III malocclusion comparing with normal occlusion. The samples were consisted of 120 subjects, divided into four groups : Male normal occlusion, Female normal occlusion, Male skeletal Class III malocclusion, Female skeletal Class III malocclusion. Posteroanterior and lateral cephalogram were taken from the subjects with a x-ray apparatus (ASHAI CX90SP, Japan) and traced on acetate paper with routine manner. The transverse and vertical values from posteroanterior cephalometry, the sagittal values from lateral cephalometry and their ratio were obtained. The results were as follows: 1. The anteroposterior discrepancy in skeletal Class III group was not due to short maxillary length(Cd-A), but to longer mandibular length(Cd-Gn) than normal occlusion group. 2. The faces of skeletal Class III group were longer than normal occlusion group. It was not due to increase of upper face height(Cg-ANS) but to increase of the lower face height(ANS-Me) especially mandibular height(Cd-Me). 3. There was no difference in the facial width values between normal occlusion group and skeletal Class III group, except upper molar width(U6-U6), lower molar width(L6-L6) and mandibular width(Ag-Ag) of female skeletal Class III group which were larger than normal occlusion group. 4. The increase of mandibular length of skeletal Class III group was reflected in the increase of lower facial height but did not have an effect on the mandibular width.

• The korean journal of orthodontics
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• v.31 no.2 s.85
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• pp.159-172
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• 2001

Three dimensional analysis of malocclusion and craniofacial deformation is essential for the successful orthodontic treatment. But the orthodontists are not familiar with diagnosis and treatment plane based on lateral cephalometric analysis. Since orthodontists do not posses a sufficient knowledge in standard value of posteroanterior cephalometric anaysis and of clinical importance for transverse jaw growth. In this study male(n=130) and female(n=171) aged from 6 to 16 and diagnosed as Class I malocclusion were selected to analysis width of cranium, maxilla and mandible on the posteroanterior cephalogram. The changes as a function of chronologic age and cervical vertebrae maturity index(CVXI) were examined. The Proper regression model was selected by sex with polynominal regression models and method of variable selection. Mean of each measurements and 70% confidence interval of individual measurement according to age was assesed and a graphs were made. Results are as follows :1. All the measurements for the width are gradually incresed as increase in chronologic age and CVMI. From the total amount of change between age 6 and 16, there is a tendency that mandibular width is broader than maxillary width and the width of male is broader than female. 2. There is no statistically significant sexual difference in Mx-Mn difference, Mx-Mn width differential, Mx/Mn ratio according to age and CVMI. 3. Mean of each measurement and 70% confidence interval of individual measurement according to age and sex were assessed and graphs were made for maxillary width, mandibular width, Mx-Mn difference, Mx/Mn ratio. 4. The width of maxilla and mandible in Korean children are broader than Western children during growth period.

• The korean journal of orthodontics
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• v.37 no.3 s.122
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• pp.212-219
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• 2007

Objective: The purpose of this study was to provide an anatomical reference for cortical bone and soft tissue thickness, and the attached gingiva width in the mandible. Methods: Fifteen males and fifteen females participated in this study. An acrylic template was fabricated and the radiopaque markers were bonded on the estimated alveolar crest to take measurements of the hard and soft tissue thickness at the same locations. CT images were taken in samples wearing an acrylic template. Cortical bone and soft tissue thickness were measured at 2, 4, 6 and 8 mm from the alveolar crest in interradicular spaces from central incisor to first permanent molar. The attached gingival width was calibrated. Results: Cortical bone thickness was $1.33{\pm}0.38mm$ and soft tissue thickness was $1.49{\pm}0.54mm$. Cortical bone thickness was increased in the posterior area, while it was not the case for the soft tissue thickness. In addition, the total thickness was $2.82{\pm}0.70$. The attached gingival width was wider in the anterior area compared to that in posterior area. Conclusion: These results suggest that the attached gingiva width should be considered upon placement of mini-implants in the mandibular posterior area for orthodontic anchorage.

• The korean journal of orthodontics
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• v.30 no.1 s.78
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• pp.43-52
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• 2000

Hemifacial microsomia ( HFM ) is the second most common craniofacial abnormalies. HFM represnted a spectrum of clinical findings such as hypoplasia of the mandibular ramus and condyle, confinement of maxilla growth, external and/or middle ear defects, involvement of some cranial suture, buccal soft tissue, facial nerve, and muscles in the affected side. HFM often showed progressive facial asymmetry and occlusal plane slanting to the affected side with growth. There were several reports about asymmetry of tooth maturation, hypodontia, delayed eruption, enamel hypoplasia in HFM. Since teeth develope in close association with size and morphology of the maxillary and the mandible, it is highly likely that dental changes will be present in HFM. So the Purpose of this study was to investigate the differences of the primary and the permanent teeth dimensions in the maxillary and the mandibular dentition between the affected and the non-affected side of HFM.. The sample of this study consisted of 34 unilateral HFM Patients (18 males and 16 females, average age : 5 year 11 months old). The authors examined the mesiodistal and the faciolingual dimensions of the primary and the permanent teeth and performed statistical study by using paired t-test. The results were as follows 1. The mesiodistal dimensions of the mandibular second primary molar and the mandibular first permanent molar in the affected side of HFM were significantly smaller than those of non-affected side. But there were no significant differences in the anterior teeth and the mandibular first primary molar. It means that a gradient of severity from anterior teeth to posterior teeth was found in the mandibular dentition. 2. Although there were no significant differences in the faciolingual dimensions of the primary and the permanent teeth in the maxillary and the mandibular dentition between the affected and non-affected side of HFM, there were general trend of compensatory increase in faciolingual dimension of the mandibular primary and the permanent teeth in the affected side Therefore these results showed that HFM might affect on the abnormality of tooth dimension, especially the most posterior teeth, in the affected side of the mandible.

• The korean journal of orthodontics
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• v.19 no.2
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• pp.130-143
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• 1989

The purpose of this study was to assess the early effect of FR III on the growing patients with anterior cross-bite. The lateral cephalograms and models were obtained from 7 patients at the time of pretreatment and correction of anterior cross-bite. The results were as follows: 1. A slight tendency of rotation toward anterosuperior direction and the growth to anterior direction were shown in maxilla. 2. There were a little change of mandibular vertical position and increase in lower facial height although some variations existed. 3. The bodily or labial tipping movement was shown in maxillary incisors. 4. The lingual tipping of mandibular incisors was shown in all cases. 5. Maxillary arch width increased while mandibular arch width usually changed a little although some variations existed. But it was difficult to summary in a word because variable responses were noted according to a wide variety of skeletal type, growth, and malocclusion.

• The korean journal of orthodontics
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• v.35 no.4 s.111
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• pp.251-261
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• 2005

Enlargement is an inherent property of X-rays which occurs when straight hues diverse from small a focal spot. The purpose of the present study was to evaluate the validity of the correction of gonial angle width enlarged on frontal cephalogram, using frontal and lateral cephalograms taken orthogonally from each other. In 40 adult individuals, frontal and lateral cephalograms were taken at a $90^{\circ}$ angle using the Head Posture Aligner. The angle width was measured on the frontal cephalogram and subsequently. the corrected angle width was calculated using the magnification rate of two cephalograms. Measured and corrected angle widths were compared with the measurement from the 3D CT image. The measurement or the frontal cephalogram showed a 9.10mm of enlargement on average ranging from 7.92 to 11.31mm. Corrected angle width measurement showed a 0.14mm difference with the 3D CT image measurement, which was not statistically significant. The results of the study indicate that actual au91e width can be approached through calculation using frontal and lateral cephalograms taken orthogonally with the help of the Head Posture Aligner The study also showed that the magnitude of correction error did not show a significant correlation with the amount of menton deviation, and it suggests that the present correction method is valid even in individuals with severe facial asymmetry.

• The korean journal of orthodontics
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• v.27 no.4 s.63
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• pp.643-659
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• 1997

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 korean journal of orthodontics
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• v.32 no.2 s.91
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• pp.117-127
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• 2002

The purpose of this study was to compare the arch width of the hyperdivergent group with that of the neutral group in Class III malocclusion based on the vertical patterns and to compare the arch width of Class III neutral group With that of normal occlusion group based on sagittal patterns. The subjects consisted of 118 pairs of studty casts, divided into three groups , 37 Class III hyperdivergent group(18 males and 19 females, SN-Mn plane angle>39.5$^{\circ}$), 40 Class III neutral group(20 males and 20 females, SN-Mn plane angle : 32 ${\pm}$ 2.5$^{\circ}$) and 41 Class I normal occlusion group(20 males and 21 females). The intercanine, interpremolar, and intermolar width of the maxillary and mandibular study casts were measured, then the ratios of dental width to basal width and mandibular width to maxillary width were obtained. Basal arch width and dental arch width were measured to obtain the pure basal arch relation in transverse plane as ruled out the transverse dental compensation. The results were as follows 1. There were no significant differences in any ratios between Class III hyperdivergent group and Class III neutral group as different vertical pattern. 2. As the ratios of dental arch width to basal arch width between normal occlusion group and Class III neutral group were compared, the maxillary teeth flared buccally to the basal bone, and the mandibular teeth tilted lingually to the basal bone in Class III neutral group. 3. The ratios of mandibular arch width to maxillary arch width in basal arch level were significantly different in all regions. Maxillary basal arch width of Class III neutral group was narrower than that of normal occlusion group. 4. The ratios of mandibular arch width to maxillary arch width in teeth level were not significantly different between normal occlusion group and Class III neutral group. In spite of discrepancies of maxillary and mandibular basal arch width, the dental arch width of Class III malocclusion group compensated very well. At the presurgical orthodontic treatment in clinic, it would not be desirable to decompensate for compensated dental arch width too much, for obtaining an appropriate arch compatibility and good results for orthognathic surgery.