• The korean journal of orthodontics
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• v.52 no.1
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• pp.29-41
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• 2022

Objective: Condylar resorption (CR) is one of the major post-surgical complications of orthognathic surgery. This systematic review (SR) aimed to evaluate epidemiological data, risk factors, and therapeutical management of CR. Methods: Six databases were screened by two investigators until September 2020 to obtain all SRs. After reading the titles and abstracts, eligible SRs were determined and data extraction was performed. Using the latest version of A Measurement Tool to Assess Systematic Reviews, the methodological quality of the included SRs was determined. Results: Ten SRs with low or critically-low methodological quality were included in this review. Mandibular hypoplasia on the sagittal plane and hyperdivergent growth pattern on the vertical plane were the most common skeletal alterations in which CR could occur after orthognathic surgery. Post-operative condylar changes were analyzed both on two-dimensional and three-dimensional (3D) radiographic examinations. The incidence of CR was not related to the fixation method. Based on the severity of the pathological conditions, management of CR can include conservative or surgical therapy. Conclusions: Despite the limited evidence in literature, CR is considered a consequence of orthognathic surgery. However, an accurate diagnosis of CR and a better orthognathic surgical planning must include 3D radiographic examinations to improve pre- and post-surgical comparison. Well-designed studies with long-term follow-up and 3D data are needed to clarify the findings of this analysis..

• Journal of Korean Neurosurgical Society
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• v.59 no.3
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• pp.219-226
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• 2016

The purpose of this article is to review imaging findings and to discuss the optimal imaging methods for craniosynostosis. The discussion of imaging findings are focused on ultrasonography, plain radiography, magnetic resonance imaging and computed tomography with 3-dimensional reconstruction. We suggest a strategy for imaging work-up for the diagnosis, treatment planning and follow-up to minimize or avoid ionized radiation exposure to children by reviewing the current literature.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.55-59
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• 2017

Digital dentistry has influenced many dental procedures, such as three-dimensional (3D) diagnosis and treatment planning, surgical splints, and prosthetic treatments. Patient-specific protective appliances (PSPAs) prevent dental injury during endotracheal intubation. However, the required laboratory work takes time, and there is the possibility of tooth extraction while obtaining the dental impression. In this technical report, we utilized new digital technology for creating PSPAs, using direct intraoral scanners and 3D printers for dental cast fabrication.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.4
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• pp.262-269
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• 2010

Introduction: Accurate diagnosis and treatment planning are very important for orthognathic surgery. A small error in diagnosis can cause postoperative functional and esthetic problems. Pre-existing 2-dimensional (D) chephalogram analysis has a high likelihood of error due to its intrinsic and extrinsic problems. A cephalogram can also be inaccurate due to the limited anatomic points, superimposition of the image, and the considerable time and effort required. Recently, an improvement in technology and popularization of computed tomography (CT) provides patients with 3-D computer based cephalometric analysis, which complements traditional analysis in many ways. However, the results are affected by the experience and the subject of the investigator. Materials and Methods: The effects of the sources human error in 2-D cephalogram analysis and 3-D computerized tomography cephalometric analysis were compared using Simplant CMF program. From 2008 Jan to 2009 June, patients who had undergone CT, cephalo AP, lat were investigated. Results: 1. In the 3 D and 2 D images, 10 out of 93 variables (10.4%) and 11 out 44 variables (25%), respectively, showed a significant difference. 2. Landmarks that showed a significant difference in the 2 D image were the points frequently superimposed anatomically. 3. Go Po Orb landmarks, which showed a significant difference in the 3 D images, were found to be the artificial points for analysis in the 2 D image, and in the current definition, these points cannot be used for reproducibility in the 3 D image. Conclusion: Generally, 3-D CT images provide more precise identification of the traditional cephalometric landmark. Greater variability of certain landmarks in the mediolateral direction is probably related to the inadequate definition of the landmarks in the third dimension.

• The korean journal of orthodontics
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• v.44 no.5
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• pp.229-235
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• 2014

Objective: The aim of this study was to assess artifacts induced by metallic restorations in three-dimensional (3D) dental surface models derived by cone-beam computed tomography (CBCT). Methods: Fifteen specimens, each with four extracted human premolars and molars embedded in a plaster block, were scanned by CBCT before and after the cavitated second premolars were restored with dental amalgam. Five consecutive surface models of each specimen were created according to increasing restoration size: no restoration (control) and small occlusal, large occlusal, disto-occlusal, and mesio-occluso-distal restorations. After registering each restored model with the control model, maximum linear discrepancy, area, and intensity of the artifacts were measured and compared. Results: Artifacts developed mostly on the buccal and lingual surfaces. They occurred not only on the second premolar but also on the first premolar and first molar. The parametric values increased significantly with increasing restoration size. Conclusions: Metallic restorations induce considerable artifacts in 3D dental surface models. Artifact reduction should be taken into consideration for a proper diagnosis and treatment planning when using 3D surface model derived by CBCT in dentofacial deformity patients.

• The korean journal of orthodontics
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• v.43 no.1
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• pp.42-52
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• 2013

The aim of this paper was to propose a new method of bimaxillary orthognathic surgery planning and model surgery based on the concept of 6 degrees of freedom (DOF). A 22-year-old man with Class III malocclusion was referred to our clinic with complaints of facial deformity and chewing difficulty. To correct a prognathic mandible, facial asymmetry, flat occlusal plane angle, labioversion of the maxillary central incisors, and concavity of the facial profile, bimaxillary orthognathic surgery was planned. After preoperative orthodontic treatment, surgical planning based on the concept of 6 DOF was performed on a surgical treatment objective drawing, and a Jeon's model surgery chart (JMSC) was prepared. Model surgery was performed with Jeon's orthognathic surgery simulator (JOSS) using the JMSC, and an interim wafer was fabricated. Le Fort I osteotomy, bilateral sagittal split ramus osteotomy, and malar augmentation were performed. The patient received lateral cephalometric and posteroanterior cephalometric analysis in postretention for 1 year. The follow-up results were determined to be satisfactory, and skeletal relapse did not occur after 1.5 years of surgery. When maxillary and mandibular models are considered as rigid bodies, and their state of motion is described in a quantitative manner based on 6 DOF, sharing of exact information on locational movement in 3-dimensional space is possible. The use of JMSC and JOSS will actualize accurate communication and performance of model surgery among clinicians based on objective measurements.

• The korean journal of orthodontics
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• v.45 no.3
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• pp.105-112
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• 2015

Objective: A recently developed facial scanning method uses three-dimensional (3D) surface imaging with a light-emitting diode. Such scanning enables surface data to be captured in high-resolution color and at relatively fast speeds. The purpose of this study was to evaluate the accuracy and precision of 3D images obtained using the Morpheus 3D$^{(R)}$ scanner (Morpheus Co., Seoul, Korea). Methods: The sample comprised 30 subjects aged 24.34 years (mean $29.0{\pm}2.5$ years). To test the correlation between direct and 3D image measurements, 21 landmarks were labeled on the face of each subject. Sixteen direct measurements were obtained twice using digital calipers; the same measurements were then made on two sets of 3D facial images. The mean values of measurements obtained from both methods were compared. To investigate the precision, a comparison was made between two sets of measurements taken with each method. Results: When comparing the variables from both methods, five of the 16 possible anthropometric variables were found to be significantly different. However, in 12 of the 16 cases, the mean difference was under 1 mm. The average value of the differences for all variables was 0.75 mm. Precision was high in both methods, with error magnitudes under 0.5 mm. Conclusions: 3D scanning images have high levels of precision and fairly good congruence with traditional anthropometry methods, with mean differences of less than 1 mm. 3D surface imaging using the Morpheus 3D$^{(R)}$ scanner is therefore a clinically acceptable method of recording facial integumental data.

• The korean journal of orthodontics
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• v.46 no.1
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• pp.3-12
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• 2016

Objective: The purpose of this study was to compare the precision of three-dimensional (3D) images acquired using iTero$^{(R)}$(Align Technology Inc., San Jose, CA, USA) and Trios$^{(R)}$(3Shape Dental Systems, Copenhagen, Denmark) digital intraoral scanners, and to evaluate the effects of the severity of tooth irregularities and scanning sequence on precision. Methods: Dental arch models were fabricated with differing degrees of tooth irregularity and divided into 2 groups based on scanning sequence. To assess their precision, images were superimposed and an optimized superimposition algorithm was employed to measure any 3D deviation. The t-test, paired t-test, and one-way ANOVA were performed (p < 0.05) for statistical analysis. Results: The iTero$^{(R)}$ and Trios$^{(R)}$ systems showed no statistically significant difference in precision among models with differing degrees of tooth irregularity. However, there were statistically significant differences in the precision of the 2 scanners when the starting points of scanning were different. The iTero$^{(R)}$ scanner (mean deviation, $29.84{\pm}12.08{\mu}m$) proved to be less precise than the Trios$^{(R)}$ scanner ($22.17{\pm}4.47{\mu}m$). Conclusions: The precision of 3D images differed according to the degree of tooth irregularity, scanning sequence, and scanner type. However, from a clinical standpoint, both scanners were highly accurate regardless of the degree of tooth irregularity.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.295-303
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• 1999

Presented in this paper are the experimental results that measure rapid prototyping (RP) errors in 3D medical models. We identified various factors that can cause dimensional errors when producing RP models, specifically in maxillofacial areas. For the experiment, we used a human dry skull. A number of linear measurements based on landmarks were first obtained on the skull. This was followed by CT scanning, 3D model reconstruction, and RP model fabrication. The landmarks were measured again on both the reconstructed models and the physical RP models, and these were compared with those on dry skull. We focused on major sources of errors, such as CT scanning, conversion from CT data to STL models, and RP model fabrication. The results show that the overall error from skull to RP is $0.64{\times}0.36mm(0.71{\times}0.66%)$ in absolute value. This indicates that the RP technology can be acceptable in the real clinical applications. A clinical case that has applied RP models successfully for treatment planning and surgical rehearsal is presented. Although the use of RP models is rare in the medical area yet, we believe RP is promising in that it has a great potential in developing new tools which can aid diagnosis, treatment planning, surgical rehearsal, education, and so on.

• The korean journal of orthodontics
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• v.50 no.1
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• pp.3-12
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• 2020

Objective: This study compared three prominent midsagittal planes (MSPs) to identify the MSP that best approximates the true symmetrical MSP. Methods: Forty-three patients (mean age, 23.0 ± 8.20 years) were grouped as follows: group 1 consisted of 10 patients with skeletal Class I and a menton (Me) deviation of < 2 mm; group 2, 11 patients with skeletal Class III and a Me deviation < 2 mm; group 3, nine patients with skeletal Class III and a Me deviation of 2 to less than 4 mm; and group 4, 13 patients with skeletal Class III and an Me deviation ≥ 4 mm. The candidate MSPs were established by three-dimensional (3D) cone beam computed tomography (CBCT) reorientation methods (RMs): (1) the MSP perpendicular to the Frankfort horizontal (FH) plane while passing through the crista galli and basion; (2) the MSP including the nasion, incisive foramen, and basion; (3) the MSP including the nasion, anterior nasal spine, and posterior nasal spine. The mean absolute distances (MADs) to the MSPs were calculated from the coordinates of 1,548 points on 129 CBCT images. The differences in the values of the 3D coordinates among RMs were compared. Results: The MADs of the three RMs showed significant differences (p < 0.05). Most of the differences in values of the coordinates were not significant among RMs. Conclusions: Although the differences in distance among the three MSPs were minor, the MSP perpendicular to the FH plane while passing through the crista galli and basion best approximated the true symmetrical MSP.