• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.1
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• pp.91-96
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• 2007

Amelogenesis imperfecta (AI) is a hereditary disease that affects enamel formation. The patients with AI have esthetic and functional problems due to damage of multiple teeth. So most AI patients resolve these problem through the conservative and prosthodontic treatments. In our case, It was difficult to obtain good results in means of conservative and prosthodontic treatments, because the AI patient had skeletal Class III malocclusion. Moreover, because of vertical dimension loss due to severe dental caries and maxillofacial skeletal disharmony, the ordinary prosthodontic treatment was troublesome. So we planned orthognathic surgery to resolve these problems. After the endodontic treatment, temporary restoration was delivered for stable post-operative occlusion. Then orthognathic surgery was done, and final restoration was delivered in stable period. We obtained satisfactory results in esthetic and functional aspects through multidisciplinary management(conservative treatment, prosthodontics and orthognathic surgery).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.6
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• pp.483-489
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• 2011

Purpose: Craniofacial structure form results from the adaptation to morphologic and functional changes in their neighboring structures for a mutual balance. The purpose of this study is classification of maxillomandibular complex growth pattern follow by cranial base growth pattern. And this study is identifying the correlation between maxilla-mandibular complex growth pattern and orthodontic criteria. Methods: 142 Class III malocclusion patients had orthognathic surgery at Wonkwang University Dental Hospital during April 2004 to October 2010. Patients were divided into 4 groups and the correlation between cranial base and maxillomandibular growth patterns were evaluated. Results: There was a correlation between cranial base and maxillomandibular growth patterns. Positive relationships were found between the occlusal plane, Incisor mandibular plane angle, mandibular plane, positioning of pogonion and the saddle angle, indicating maxillary growth patterns. Negative relationships were found between SNA, SNB, maxillary incisor angle and saddle angle. Positive relationships were found between the ratio of the anterior and posterior cranium, positioning of pogonion and the percentage of cranial depth indicating mandibular growth patterns. Negative relationships were found between the occlusal plane, maxillary incisor angle, mandibular plane, mandibular angle and cranial depth. Conclusion: Cranial base and maxillofacial growth patterns were correlated and the classification should be adjusted before orthognathic surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.1
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• pp.69-76
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• 1991

A 9-year old boy suffering from cleidocranial dysplasia associated with impacted 4 supernumerary teeth and unerupted all permanent teeth is presented with his mother. The pedigree showed autosomal dominant pattern of inheritance, and the raiographic features of them were very similar in clavicle, skull, vertebrae, peivis and extremities. Although almost of the skeleton was involved with this syndrome, they did not recognize any other problem but except dental problem. In mother, who was wearing removable partial dentures leaving 24 impacted teeth in her jaws, the radiographic abnormalities like cystic lesion were not detected. And in the son, who showed impacted 4 supernumerary and all permanent teeth, we have attempted surgical extraction of the supernumerary teeth and periodic surgical opening of the alveolar bone covering the permanent dentition to induce the eruption of permanent teeth at the proper position, Orthodontic treatment has also been combined to correct class III malocclusion state.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.16 no.1
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• pp.69-79
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• 1986

The purpose of this investigation was to know correlation of mean values between centric occlusion and centric relation by the cephalogram in Angle's Class Ⅰ and Ⅲ malocclusion subjects. 22 adults with Angle's Class Ⅰ malocclusion (17 men and 5 women, 21 to 27 years of age) and 14 adults with Angle's Class Ⅲ malocclusion (10 men and 4 women, 21 to 27 years of age) were selected from the dental students in Yonsei University. Each subject was given two lateral cephalometric radiographies and cephalometric analysis was performed. All data from these analyses was recorded and statistically processed with CYBER computer system. 1. The results were obtained as follows: There was a strong positive correlation between centric occlusion and centric relation in all subjects with Angle's Class Ⅰ and Ⅲ malocclusion. 2. In Angle's Class Ⅰ malocclusion, measurements in lower facial height revealed significant difference between centric occlusion and centric relation (P<0.05). In Angle's Class Ⅲmalocclusion, measurements in facial axis angle, mandibular plane angle, convexity of A point, lower incisor protrusion, lower facial height revealed significant difference between centric occlusion and centric relation (P<0.05). 3. When the mandible was moved from centric occlusion to centric relation, the mean distance of mandibular movement was 1.27㎜ (0.2-2.8㎜) in Angle's Class Ⅰ malocclusion, 1.70㎜ (0.55-4.15㎜) in Angle's Class Ⅲ malocclusion, and 1.44㎜ (0.2-4.15㎜) in all subjects.

• Journal of Yeungnam Medical Science
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• v.6 no.2
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• pp.183-194
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• 1989

This is a report of 2-cases of mandibular prognathism corrected by Intraoral oblique splitting osteotomy of mandibular ramus. The Intraoral oblique splitting osteotomy is a modification of sagittal split osteotomy of ramus and it is documented by Yoshida, on 1985. By this method. authors obtained the following results. 1. The patients' esthetic, psychological and functional problems were dissolved by setback of mandibular prognathism. 2. The postoperative infection, splitted bone segments fracture, paresthesia of the face and T.M.J. dysfunction were not appeared. 3. Postoperative intermaxillary fixation was maintained for 8 weeks. The patients could open their mouths in normal range after a week of intermaxillary fixation removal. 4. The soft tissue changes of lower lip and chin were about 1:1 to the hard tissue changes. 5. During intermaxillary fixation period and postoperative orthodontic treatment, slight relapse was observed. Now, the patients are under postoperative orthodontic treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.3
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• pp.343-350
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• 2000

The goal of this study is the comparison of upper airway size and change of skeletal Class I group and skeletal Class III group (before operation, within 2 weeks after operation, 6 months after operation) respectively. At first, we measured the lines between selected upper air way landmarks on lateral cephalometric x-ray film of skeletal Class I 40 persons whoes age were 23-26 years old, ,and did the same lines of landmarks of skeletal Class III 44 persons who had not been operated yet, were within 2 weeks after operation, were 6 months after operation. And we compared it respectively and analyzed it with paired t-test. We studied the relationship of those on produced data. 1. Skeletal Class III group was narrower in nasopharyngeal air way space than that of skeletal Class I group, and increased in thickness of oropharyngeal, hypopharyngeal wall within 2 weeks after operation, and reduced in nasopharyngeal, oropharyngeal air way space, and did in thickness of nasopharngeal, hypopharyngeal wall 6 months after operation. 2. Skeletal Class III group reduced in nasopharyngeal, oropharyngeal air way space, and increased in thickness of nasopharyngeal, oropharyngeal, hypopharyngeal wall within 2 weeks after operation, restored the thickness of nasopharyngeal, oropharyngeal wall, but did not restored nasopharyngeal, oropharyngeal, hypopharyngeal air way space. 3. Vertical length from hyoid bone to mandibular plane did not have signifacant difference from Class I group but after operation, it increased more than Class I group significantly. 4. The size of airway reduced after operation. Among this, oropharyngeal airway most reduced.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.2
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• pp.148-156
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• 2007

Purpose: The aim of this study is the changes of upper respiratory airway space in patients with mandibular prognathism after 2-jaw orthognathic surgery in patients with skeletal classs III malocclusion. Method: We measured the lines between selected upper airway landmarks on lateral cephalometric x-ray films of skeletal class III 64 persons who had not been operated yet, were 6 months after operation. The test subjects were divided into 3 groups according to maxillary movement, as follows; maxillary advancement (MA) group, maxillary posterior impaction (MPI) group, maxillary posterior impaction and superior repositioning (MPI+MSR) group. Result: In this study, nasopharyngeal airway space in MPI+MSR group was significantly increased after operation (p<0.05). Oropharygeal and hypopharyngeal airway space in MA group and MPI group were significantly decreased after operation (p<0.05). From hyoid bone to anterior mandible point distance in MA group and MPI group were significantly decreased after operation (p<0.05). Conclusion: Oropharygeal and hypopharyngeal airway space were influenced more by mandibular set-back than maxillary movement. Maxillary movement surgery as well as mandibular setback surgery should be taken into consideration in order to minimize symptoms related to obstructive sleep apnea syndrome after operation.

• The korean journal of orthodontics
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• v.19 no.3
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• pp.67-78
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• 1989

This study was designed to investigate the difference of teeth and craniofacial complex between normal occlusion and Angle's Class II, div. 1 malocclusion in Korean children. The sample was divided into 2 groups, the 66 subjects with normal occlusion and 96 subjects with Angle's Class II, div. 1 malocclusion in both sexes. The results obtained were as follows: 1. No significant differences were observed in ant. cranial base length & cranial flexure (saddle) angle) between normal occlusion & Angle's Class II, div. 1 malocclusion group, but posterior cranial base length of Class II, div. 1 malocclusion group was larger than that of normal occlusion group. 2. No significant difference was observed in the anteroposterior position of Maxilla to cranial base between two groups, but mandibular position in Class II, Div. 1 malocclusion was posterior and interior to that of normal occlusion. 3. The length of maxilla (ANS-PSN) was larger in Class II, div. 1 malocclusion than normal occlusion. The length of mandibular body (Go-Me) was nor different between Class II, div. 1 malocclusion and normal occlusion. 4. Maxillary incisor position of Class II, div. 1 malocclusion to cranial base was more protrusive than that of normal occlusion, but there was no difference in mandibular incisor position between two groups.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.5
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• pp.316-323
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• 2009

Purpose: This study was performed to evaluate three-dimensional positional change of the condyle using 3D CT after bilateral sagittal split ramus osteotomy (BSSRO) in skeletal class III patients. Patients and methods: Nine patients who underwent BSSRO for mandibular set-back in skeletal class III malocclusion without facial asymmetry were examined. Miniplates were used for the fixation after BSSRO. 3-D CT was taken before, immediately after, and 6 months after undergoing BSSRO. After creating 3D-CT images using V-works $4.0^{TM}$ program, axial plane, coronal plane, & sagittal plane were configured. Three dimensional positional change, from each plane to the condyle, of the nine patients was measured before, immediately after, and 6 months after undergoing BSSRO. Results: 1. The mean value of mandibular set-back for nine mandibular prognathism patients was 7.36 mm (${\pm}\;2.42\;mm$). 2. In the axial view, condyle is rotated inward immediately after BSSRO (p < 0.05), comparing with preoperative but outward 6 months after BSSRO comparing with postoperative (p < 0.05). 3. In the axial view, condyle is moved laterally immediately after BSSRO (p < 0.05), comparing with preoperative but regressed 6 months after BSSRO comparing with preoperative (p > 0.05). 4. In the frontal & coronal view, there is changed immediately after and 6 months after BSSRO, comparing with preoperative but no statistical difference. Conclusion: These results indicate that three-dimensional positional change of the condyle in skeletal class III patients is observed lateral displacement & inward rotation immediate after BSSRO, but the condyle in 6 months after BSSRO tends to regress to preoperative position.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.1
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• pp.27-34
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• 2006

After orthognathic surgery in skeletal class III patients, the hyoid bone position and the upper airway dimension could be changed due to mandibular setback. There has been many studies about airway dimension of the patients with skeletal class II malocclusion or obstructive sleep apnea. but not with skeletal class III. The purpose of this study was to examine the change of position of the hyoid bone and the consequent change of airway space as the result of retrusion of mandible after orthognathic surgery in skeletal Cl III malocclusion patients. It is also to apply this results in predicting, diagnosing and treating the subsequent obstructive sleep apnea. Forty patients who were diagnosed as skeletal Cl III maloccusion, received orthoganthic surgery of both jaws including mandibular setback, and were followed up post-operatively for more than 6 months were selected. There were 10 male patients 30 female patients. The preoperative and postoperative lateral cephalograms were traced and the distances and angles were measured. The nasopharyngeal space increased postoperatively while the oropharyngeal space decreased. Except for the change of oroparyngeal space, the changes in male patients were greater than female patients. The hyoid bone moved in the posterior-inferior direction, and the change was greater in males than in females. If the postoperative mandibular setback is great, then a significant decrease of airway space and posterior and inferior movement of the hyoid bone were observed. This can result in symptoms related to obstructive sleep apnea. This result should be considered in the diagnosis and treatment planning of orthognathic surgery patients.