• 대한치과의사협회지
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• 제47권10호
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• pp.669-676
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• 2009

Purpose : Anterior region is crucial area for esthetic implant restoration. However, the alveolar process undergoes atrophy after removal of teeth and creates unfavorable situation for implant installation. The knowledge of the thickness of alveolar bone is required to estimate and expect the bone resorption after extraction. The aim of this study is to measure facial, palatal and faciopalatal bone thickness on maxillary anterior teeth. Methods : Facial, palatal, and faciopalatal bone thickness were measured on the computed tomography (CT) images from 57 patients, using an image analyzer program (Ondemand$3D^{(R)}$, Cybermed, Seoul, Korea). Results : The thickness of facial bone in incisors, lateral incisors and canines were less than 1 mm. The thickness of facial bone increased from anterior to posterior region and the thickness of palatal bone increased from posterior to anterior region. Conclusion : The measurement can be used for planning implant surgery before extraction. CT has are clinically useful in the evaluation of thickness of alveolar bone.

• Journal of Periodontal and Implant Science
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• 제47권1호
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• pp.20-29
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• 2017

Purpose: The microstructural characteristics of trabecular bone were identified using micro-computed tomography (micro-CT), in order to develop a potential strategy for implant surface improvement to facilitate osseointegration. Methods: Alveolar bone specimens from the cadavers of 30 humans were scanned by high-resolution micro-CT and reconstructed. Volumes of interest chosen within the jaw were classified according to Hounsfield units into 4 bone quality categories. Several structural parameters were measured and statistically analyzed. Results: Alveolar bone specimens with D1 bone quality had significantly higher values for all structural parameters than the other bone quality categories, except for trabecular thickness (Tb.Th). The percentage of bone volume, trabecular separation (Tb.Sp), and trabecular number (Tb.N) varied significantly among bone quality categories. Tb.Sp varied markedly across the bone quality categories (D1: $0.59{\pm}0.22mm$, D4: $1.20{\pm}0.48mm$), whereas Tb.Th had similar values (D1: $0.30{\pm}0.08mm$, D4: $0.22{\pm}0.05mm$). Conclusions: Bone quality depended on Tb.Sp and number-that is, endosteal space architecture-rather than bone surface and Tb.Th. Regardless of bone quality, Tb.Th showed little variation. These factors should be taken into account when developing individualized implant surface topographies.

• 대한치과교정학회지
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• 제51권6호
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• pp.387-396
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• 2021

Objective: To identify optimal areas for the insertion of extra-alveolar miniscrews into the infrazygomatic crest (IZC) and mandibular buccal shelf (MBS), using cone beam computed tomography (CBCT) imaging in patients with different craniofacial patterns. Methods: CBCT reconstructions of untreated individuals were used to evaluate the IZC and MBS areas. The participants were divided into three groups, based on the craniofacial pattern, namely, brachyfacial (n = 15; mean age, 23.3 years), mesofacial (n = 15; mean age, 19.24 years), and dolichofacial (n = 15; mean age, 17.79 years). In the IZC, the evaluated areas were at 11, 13, and 15 mm above the buccal cusp tips of the right and left first molars. In the MBS, the evaluated areas were at the projections of the first molars' distal roots and second molars' mesial and distal roots, at a 4- and 8-mm distance from the cementoenamel junction. Intergroup comparisons were performed with analysis of variance and the Tukey test. Results: There was no statistically significant difference in the IZC bone thickness among the groups. For MBS bone availability, some comparisons revealed no difference; meanwhile, other comparisons revealed increased MBS bone thickness in the brachyfacial (first molars distal roots) and dolichofacial (second molars mesial and distal roots) patterns. Conclusions: There was no significant difference in the IZC bone thickness among the groups. The facial skeletal pattern may affect the availability of ideal bone thickness for the insertion of extra-alveolar miniscrews in the MBS region; however, this variability is unlikely to be clinically meaningful.

• 대한치과교정학회지
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• 제40권5호
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• pp.314-324
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• 2010

본 연구는 성인 환자를 대상으로 안면골의 수평적, 수직적 골격 형태에 따른 하악 전치부 치조골의 순설측 두께를 하악 전치 치축을 기준으로 계측하고, 하악 이부 치조골의 단면적을 비교해 형태학적 차이를 확인해 보기 위하여 시행되었다. 20세 이상 성인 환자들의 초진 시 측모두부 방사선 사진을 사용하여, 수평적, 수직적 분류 기준에 따라 9군으로 분류하여 무작위로 30명(남자 15명, 여자 15명)씩, 총 270명을 추출하였다. 수평적 골격 형태를 판단하는 기준으로 ANB 각도가 사용되었으며, 수직적 골격 형태를 판단하는 기준으로는 하악평면각(SN-MP 각도)을 사용하였다. 측모두부 방사선 사진에서 하악 전치부 치조골의 협설측 두께와 하악 이부 치조골의 단면적을 계측하여 형태학적 차이를 확인해 보았다. 연구 결과로 high angle group은 low angle group과 average group에 비해 CEJ 하방 2 mm 부위 아래의 협설측 치조골과 모든 부위의 설측 치조골에서 통계적으로 유의하게 얇은 두께를 보였으며 ($p$ < 0.05), low angle group과 average group 중에서 Class I, II group은 모든 부위에서 Class I average group에 비해 유사하거나 통계적으로 유의하게 두꺼운 치조골 두께를 보였다 ($p$ < 0.05). Average group 내에서 Class III group은 Class I, II group에 비해 치근 중간 부위의 협설측과 설측에서 통계적으로 유의하게 얇은 치조골 두께를 보였으며 ($p$ < 0.05), high angle group 중에서도 특히 Class III인 high angle group에서 더 얇은 평균 치조골 두께를 보였다. 수직적 안면 골격 형태에 따라 하악 이부 치조골의 단면적은 통계적으로 유의한 차이를 보이지 않았다 ($p$ > 0.05). 이상의 결과에서 성인의 교정 치료 시 Class III이면서도 high angle을 보이는 환자에서는 하악 전치부에서 얇은 치조골 두께를 가지게 되는 경우가 많으므로, 하악 전치의 위치를 결정할 때 주의를 기울여야 할 것으로 생각한다.

• 대한치과교정학회지
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• 제54권2호
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• pp.79-88
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• 2024

Objective: Alveolar bone loss is a common adverse effect of intrusion treatment. Mandibular incisors are prone to dehiscence and fenestrations as they suffer from thinner alveolar bone thickness. Methods: Thirty skeletal class II patients treated with mandibular intrusion arch therapy were included in this study. Lateral cephalograms and cone-beam computed tomography images were taken before treatment (T1) and immediately after intrusion arch removal (T2) to evaluate the tooth displacement and the alveolar bone changes. Pearson's and Spearman's correlation was used to identify risk factors of alveolar bone loss during the intrusion treatment. Results: Deep overbite was successfully corrected (P < 0.05), accompanied by mandibular incisor proclination (P < 0.05). There were no statistically significant change in the true incisor intrusion (P > 0.05). The labial and lingual vertical alveolar bone levels showed a significant decrease (P < 0.05). The alveolar bone is thinning in the labial crestal area and lingual apical area (P < 0.05); accompanied by thickening in the labial apical area (P < 0.05). Proclined incisors, non-extraction treatment, and increased A point-nasion-B point (ANB) degree were positively correlated with alveolar bone loss. Conclusions: While the mandibular intrusion arch effectively corrected the deep overbite, it did cause some unwanted incisor labial tipping/flaring. During the intrusion treatment, the alveolar bone underwent corresponding changes, which was thinning in the labial crestal area and thickening in the labial apical area vice versa. And increased axis change of incisors, non-extraction treatment, and increased ANB were identified as risk factors for alveolar bone loss in patients with mandibular intrusion therapy.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권2호
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• pp.107-114
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• 2001

Objectives : To compare jaw bone density of young adults (control group) and post-menopausal women(experimental group) in periapical and panoramic film. Materials and Methods : The bone mineral density values of lumbar and femur were measured by dual-energy X-ray absorptiometry(DEXA) and T scores of lumbar were obtained. T scores were classified into 3 group (T<-2.5, $-2.5{\leqq}T<-1$, $-1{\leqq}T$). Radiographic densities of alveolar bones were measured from interdental bones of premolar, molar areas in the maxilla and mandible and expressed into copper step wedge thickness by Scion $Image^{(R)}$ program. We considered these values of step wedge thickness as bone density of alveolar bone. Panorama mandibular index(PMI) was calculated by the method that the height of the inferior cortex of the mandible was divided by the height from the lower border of the mandible to the superior edge of the mental foramen. Bone density of alveolar bone and PMI were analysed statistically. Results : There were significant differences in bone mineral density of lumbar and femoral neck between control and experimental groups. There were also significant differences in bone density of premolar and molar area of jaw between control and experimental groups by MANOVA test. When considered lumbar T variables, there was only difference in interdental bone density of maxillary molar area between control and experimental group, but there was interaction. Interdental bone density of experimental group was appeared higher in $-1{\leqq}T$ group and lower in T<-2.5 group than control group. There was significant difference in PMI between control and experimental groups, but there was also inter action, thus, PMI of experimental group was appeared higher in $-1{\leqq}T$ group and lower in T<-2.5 group than control group. Conclusion : There were significant differences of alveolar density and cortical bone thickness between young men and post-menopausal women in periapical and panoramic film. These differences were dependent on lumbar T.

• Journal of Periodontal and Implant Science
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• 제31권3호
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• pp.581-595
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• 2001

In performing implant procedures in the anterior portion of the maxilla, many difficulties exist because of anatomical reasons, such as the proximity of the nasal floor, lateral extension of the incisive canal, and labial concavity. On the other hand, in the posterior region of the maxilla, there is often insufficient recipient bone between the maxillary sinus and alveolar ridge due to alveolar ridge resorption and pneumatization of the maxillary sinus. In order to perform implants in such regions, ridge augmentation procedures such as onlay bone graft, guided bone regeneration, and maxillary sinus grafting are performed. In studies of Caucasians, use of autograft from mandibular symphysis has been reported to be highly successful in maxillary sinus grafting. However, in a clinical study of Koreans, autograft of mandibular symphysis has been reported to have significantly low success rate. It has been hypothesized that this is because of insufficient cancellous bone due to thick cortical bone. In order to test this hypothesis, bone quality and morphology of Koreans can be compared with those of Caucasians. In this study, the bone density and morphology of the cortical bone and cancellous bone in the mandibular symphysis of 35 Korean cadavers were evaluated. The following results were obtained: 1. In terms of bone density, type I, type II, and type III consisted of 1.4%(3/213), 72.3%(154/213), and 26.3%(56/213) of the cross-sectioned specimens, respectively. In general, the bone density tended to change from type II to type III, as cross-sectioned specimens were evaluated from the midline to the canine. Type IV wasn't observed in this study. 2. The distance between the root apex and the lower border of the cancellous bone was 18.34mm-20.59mm. Considering that the bone has to be cut 5mm below the root apex during the procedure, autografts with about 15mm of vertical thickness can be obtained. 3. The thickness of cortical bone on the labial side increased from the root apex to the lower border of the mandible. The average values ranged from 1.43mm to 2.36mm. 4. The labio-lingual thickness of cancellous bone ranged from 3.43mm to 6.51mm. The thickness tended to increase from the apex to the lower border of the mandible and decrease around the lower border of cancellous bone. From the above results, the anatomic factors of the mandibular symphysis (bone density, thickness, quantity and length of the cortical bone and cancellous bone) didn't show any difference from Caucasians, and it cannot be viewed as the cause of failure in autografts in the maxillary sinus for implants.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권1호
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• pp.34-40
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• 2012

Purpose: The study was performed to compare patients with anatomical variations in facial asymmetry with patients in the normal range using cone-beam computed tomography (CBCT) and to take the preoperative condition into consideration in the case of a sagittal split ramus osteotomy (SSRO). Methods: The study was conducted on 46 adult patients composed of 2 subdivided groups, an asymmetry group (n=26) and a symmetry group (n=20). The asymmetry group was divided between patients with hemimandibular hyperplasia (HH, n=8) and hemimandibular elongation (HE, n=18). Using cross-sectional computed tomography images, the thickness of cancelleous bone in the buccal area of the mandible, thickness of buccal cortex in the buccal aspect of the mandible, thickness of cancellous bone in the inferior aspect of the mandible, thickness of buccal cortex in the inferior aspect of the mandible, and cross-sectional surface area of the mandible were measured. Results: In the asymmetry group, the cross-sectional area of the mandible including the inferior alveolar nerve positioned on the affected side was significantly different from the symmetry group. Thickness of cancelleous bone in the buccal aspect of the mandible, thickness of cancelleous bone in the inferior aspect of the mandible, and cross-sectional surface area of the mandible in the affected site of hemimandibular hyperplasia was significantly smaller than in the symmetry group. Conclusion: The inferior alveolar nerve runs lower and in a more buccal direction and shows a smaller cross-sectional surface of the mandible in the hemimandibular hyperplasia patients with asymmetry.

• 치과방사선
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• 제29권1호
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• pp.33-42
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• 1999

Geometrically standardized dental radiographs were taken. We prepared Digital Cu-Equivalent Image Analyzing System for quantitative assessment of mandible bone. Images of radiographs were digitized by means of Quick scanner and personal Mcquintosh computer. NIH image as software was used for analyzing images. A stepwedge composed of 10 steps of 0.1mm copper foil in thickness was used for reference material. This study evaluated the effects of step numbers of copper wedge adopted for calculating equation. kVp and exposure time on the coefficient of determination(r²)of the equation for conversion to Cu-equivalent image and the coefficient of variation and Cu-Eq value(mm) measured at each copper step and alveolar bone of the mandible. The results were as follows: 1. The coefficients of determination(r²) of 10 conversion equations ranged from 0.9996 to 0.9973(mean=0.9988) under 70kVp and 0.16 sec. exposure. The equation showed the highest r was Y=4.75614612-0.06300524x +0.00032367x² -0.00000060x³. 2. The value of r² became lower when the equation was calculated from the copper stepwedge including 1.0mm step. In case of including 0mm step for calculation. the value of r showed variability. 3. The coefficient of variation showed 0.11, 0.20 respectively at each copper step of 0.2, 0.1mm in thickness. Those of the other steps to 0.9 mm ranged from 0.06 to 0.09 in mean value. 4. The mean Cu-Eq value of alveolar bone was 0.14±0.02mm under optimal exposure. The values were lower than the mean under the exposures over 0.20sec. in 60kVp and over 0.16sec. in 70kVp. 5. Under the exposure condition of 60kVp 0.16sec.. the coefficient of variation showed 0.03. 0.05 respectively at each copper-step of 0.3, 0.2mm in thickness. The value of r² showed over 0.9991 from both 9 and 10 steps of copper. The Cu-Eq value and the coefficient of variation was 0.14±0.01mm and 0.07 at alveolar bone respectively. In summary. A clinical application of this system seemed to be useful for assessment of quantitative assessment of alveolar provided high coefficient of determination is obtained by the modified adoption of copper step numbers and the low coefficient of variation for the range of Cu-Equivalent value of alveolar bone from optimal kVp and exposure time for each x-ray machine.

• 대한치과교정학회지
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• 제6권1호
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• pp.17-24
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• 1976

The primary objective of this study was to define the differences that exist. between different sexes on the dentoskeletal framework and the soft tissue profile around the mouth. For the purpose of this study, cephalometric radiographs were obtained from the centric occlusion with closed lip position, through the research on each 42 males and females aged from 17 to 22 years with normal occlusion and acceptable facial appearence. The results were as follows: 1. Maxillary to mandibular relationships. Among the angles formed by the long axis of the maxillary and mandibular anterior teeth, the maxillary and mandibular anterior alveolar bone, and the lower and upper lips (Fig.2), only the angle formed by the lips was more acute in males than in females. The males have a more rounded profile, and the females have a flatter profile in the lower third of the face. The differences is statistically significant for the angle formed by the lips. The fact that the lips have a difference greater than that of teeth or the alveolar bone indicates that the lip position is not entirely due to tooth and bony support. Possibly the thickness of the lips has an influence. 2. Occlusal plane. The occlusal plane was related to the anterior tooth inclination, anterior alveolar bone profile, and the lip contour, both maxillary and mandibular (Fig.3). Only the angle related to lower lip was statistically significant. The females again had the more obtuse angle, indicating a flatter profile than that of the males. 3.Skeletal planes. The angles formed by the anterior maxillary lips, teeth, and alveolar bone with the Frankfort plane and the angles of the mandibular lips, teeth, and, alveolar bone and the mandibular plane were investigated (Fig.4). Results were similar to those from maxillary to mandibular relationships. The results were statistically significant for the upper lip and the lower lip, only. 4. Esthetics. The facial line and the mandibular plane were compared with the esthetic line. These angles were different for the different sexes, but only the latter was statistically significant. This difference may be due to the profile contour of the nose.