Objective: The purpose of this study was to compare the treatment duration and dentoskeletal changes between two different anchorage systems used to treat maxillary dentoalveolar protrusion and to examine the effectiveness of en-masse retraction using two miniscrews placed in the midpalatal suture. Methods: Fifty-seven patients (9 men, 48 women), who had undergone level anchorage system treatment at Aichi-Gakuin University Dental Hospital (Nagoya, Japan) were divided into two groups according to the method of maxillary posterior anchorage reinforcement: midpalatal miniscrews (25 patients, mean age 22 years) and conventional anchorage (32 patients, mean age 19 years). The en-masse retraction period, overall treatment duration, pre-treatment effective ANB angle, and change in the effective ANB angle were compared with an independent-samples t -test. Results: Compared to the headgear group, the duration of en-masse retraction was longer by approximately 4 months in the miniscrew group (p < 0.001). However, we found no significant difference in the total treatment duration between the groups. Moreover, a greater change in the effective ANB angle was observed in patients treated with miniscrews than in those treated with the conventional method (p < 0.05). Conclusions: The level anchorage system treatment using miniscrews placed in the midpalatal area will allow orthodontists more time to control the anterior teeth during en-masse retraction, without increasing the total treatment duration. Furthermore, it achieves better dentoskeletal control than does the conventional anchorage method, thereby improving the quality of the treatment results.
Background: Lower eyelid incisions are widely used for the orbital approach in periorbital trauma and aesthetic surgery. In general, the subciliary approach is known to cause disposition of the lower eyelid by scarring the anterior lamella in some cases. On the other hand, many surgeons believe that a transconjunctival approach usually does not result in such complications and is a reliable method. We measured positional changes in the lower eyelid in blowout fracture repair since entropion is one of the most serious complications of the transconjunctival orbital approach. Methods: To measure the positional changes in the lower eyelids, we analyzed preoperative and postoperative photographs over various time intervals. In the analysis of the photographs, marginal reflex distance 2 ($MRD_2$) and eyelash angle were used as an index of eyelid position. Statistical analyses were performed to identify the significance in the positional changes. All patients underwent orbital reconstruction through a transconjunctival incision by a single plastic surgeon. Results: In 42 blowout fracture patients, there was no statistical significant difference in the MRD2 and eyelash angle. Furthermore, there were no clinical complications, such as infection, hematoma, bleeding, or implant protrusion, during the follow-up periods. Conclusion: The advantages of the transconjunctival approach for orbital access include minimal scarring and a lower risk of eyelid displacement compared with other approaches. Based on these results, we recommend the transconjunctival approach for orbital exposure as a safe and reliable method.
Kim, Jae Woo;Shin, Ho Sung;Kim, Jun Hyuk;Park, Eun Soo;Tark, Min Sung
Archives of Plastic Surgery
/
v.34
no.1
/
pp.128-130
/
2007
Purpose: Pnumosinus dilatans is a rare disease that one or more of the paranasal sinuses are dilatated without functional alteration. The most frequently involved sites are frontal and sphenoid sinus. Facial asymmetric contour is the most common signs and nasal obstruction and pain may be combined. The purpose of reconstruction of pneumosinus dilatans is two-fold, to re-establish a permanent pressure equilibrium of sinus and to correct the possible facial deformities. Methods: We present a case of a 24-year-old female with a 7-year history of protrusion of right malar region. Plane radiography and computed tomography detailed an abnormal expansion of the right maxillary sinus without thinning of bony wall, leading to diagnosis of maxillary pneumosinus dilatans. Surgical decompression and maxilloplasty were achieved by ostectomy of anterior wall of maxillary sinus and repositioning of removed bony fragment with miniplate. Results: Post operative course was uneventful without complication and malar height became symmetric by physical and radiologic examination. Conclusion: We corrected successfully pneumosinus dilatans of maxillary sinus by surgical decompression and maxilloplasty. For this case, we reviewed literature related to this topic.
Ji-Young Park;Jong-Jin Kim;Jin Baik;Hyun-Suk Cha;Joo-Hee Lee
Journal of Dental Rehabilitation and Applied Science
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v.39
no.3
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pp.119-132
/
2023
The loss of posterior occlusal support due to tooth loss is likely to lead to compensatory protrusion and labial tilt of the anterior teeth, which may be accompanied by a deep bite and a decrease in vertical dimension. The patient may suffer from a decrease in masticatory efficiency, inaccurate pronunciation, facial appearance changes, and temporomandibular joint disorder, so stable occlusal formation with support of posterior occlusion and restoration of vertical dimension is necessary. We report the case of a patient with reduction of vertical dimension, and inaccurate pronunciation due to multiple tooth loss who underwent full mouth rehabilitation with increased vertical dimension accompanied by phonetic analysis and achieved satisfactory functional and aesthetic results.
Journal of the korean academy of Pediatric Dentistry
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v.48
no.2
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pp.140-150
/
2021
A total of 580 patients, who visited and received an orthodontic diagnosis in the Department of Pediatric Dentistry, Seoul National University Dental Hospital from 2017 to 2019, were investigated in this study. The aim of this study was to evaluate skeletal patterns of pediatric orthodontic patients determined with lateral cephalometric analysis and to analyze the relationship between skeletal pattern and probable associated clinical features. Also, the modality of orthodontic treatment for each skeletal classification was investigated to aid in therapeutic decisions. Patients aged 7 year accounted for the largest age group; 54.2% of patients showed a skeletal class I pattern, 22.2% showed a skeletal class II pattern, and 23.6% showed a skeletal class III pattern. Bi-maxillary retrusion for skeletal class I, retruded mandible with normal positioning of the maxilla for skeletal class II, and retrusion of the maxilla with protrusion of the mandible for skeletal class III were the largest subgroups by skeletal pattern. Brachyfacial type accounted for 55.0% of patients, followed by 31.9% of mesofacial type and 13.1% of dolichofacial type. The prevalence of anterior crossbite in the study was 43.3%, higher than that in previous studies.
Moon, So yeon;Lee, Dae woo;Kim, Jae gon;Yang, Yeon mi
The Journal of Korea Assosiation for Disability and Oral Health
/
v.15
no.1
/
pp.84-88
/
2019
Malocclusion occurs more frequently in Special Health Care Needed (SHCN) patients than those in general. As caregiver's needs for orthodontic treatment tend to increase, the dentist should know how to decide the extent of treatment. This case report is about orthodontic treatment for two SHCN patients; one patient with cerebral palsy, and another patient with autism. A 10-year-old patient with cerebral palsy showed protrusion and rotation of maxillary anterior teeth. To resolve his chief complaints and make better oral hygiene, he underwent orthodontic treatment using micro tube appliances for 6 months. Another 11-year-old patient with autism had anterior crossbite and showed space deficiency of #13 and chronic gingivitis because of poor oral hygiene. She underwent orthodontic treatment with maxillary skeletal expander, facemask and AP expansion appliance. After 18 months we found positive overjet and ended the treatment. When giving SHCNs orthodontic treatment, the extent of treatment can be chosen according to the patient's cooperative ability and the traits of disabilities. Before initiating orthodontic treatment, the caregivers should be aware of their limitations of the treatment. Since oral hygiene is crucial factor in every dental treatment, education of oral hygiene process for the caregivers and SHCN patient must be done before the orthodontic treatment.
The present study hypothesized that the double keyhole looped archwire plays a positive role for the sake of translatory movement and/or controlled tipping of upper 6 anteriors, and secures anchorage control as well. The purposes of the study were to evaluate the changes in lateral cephalograms during orthodontic treatment with DKHLs and to compare the skeletal & dental changes before- & after-treatment. The materials of this study were lateral cephalograms of 20 adult patients with upper dentoalveolar protrusion both in class I and in class II Division1 malocclusion. Lateral cephalograms were taken before and after orthodontic treatment with upper 1st bicuspid extraction and DKHLs. The results were obtained as follows : 1. There were no statistically significant differences in skeletal measurement except SNB and PTFH between before- & after-treatment. The major changes were in dentoalveolar region. 2. After treatment, there were statistically significant decrease in dental measurement except interincisal angle. 3. Both upper & lower lip protrusion was decreased. 4. There were statistically differences in upper anterior crown horizontal & root vertical dimension(7.08 ${\pm}$ 2.14 mm, 2.38 ${\pm}$ 1.15 mm, p<0.01). 5. There were statistically differences in upper posterior dental(both crown & root) horizontal dimension(2.48 ${\pm}$ 0.99 mm, 2.05 ${\pm}$ 0.91 mm, p<0.01).
Predicting the arch length discrepancy by simply comparing the available arch perimeter with tooth materials is merely a 2-dimensional analysis of the teeth movement. However, the real teeth movement takes place 3-dimensionally and is affected by various factors such as, the arch fen the curve of Spee and the axis of the incisors. The purpose of this study is to clarify the relationship between the decrease in the arch perimeter and the horizontal positional change of the incisors after extraction of the 1st bicuspids, for more analytic evaluation of the arch length discrepancy at pre-treatment model analysis stage. In addition to that to evaluate the effect of the curve of Spee, teeth axis to the basal plane, and the incisional crowding to the treatment outcome. All patients were treated at the department of orthodontics, dental hospital, Yonsei university. Inclusion criteria for patients selection were as follows. $\cdot$ Angle classification I malocclusion with bialveolar protrusion $\cdot$ Extraction of 4 1st bicuspids $\cdot$ No tooth anomaly or prosthesis $\cdot$ No abnormal attrition $\cdot$ No ectopically erupted teeth $\cdot$ Angle classification I canine and molar relationship $\cdot$ Less than 3mm of crowding Model analysis of the above patients was performed and the following conclusions were obtained. 1. When the intercanine distance was maintained, the available space for the distal movement of the mandibular incisors after the extraction of the 4 1st bicuspids was larger than the space provided by the extraction of the 4 1st bicuspids. However the difference was less than 1mm. The more tapered the anterior arch form, the larger the difference. 2. Compared to the situation in which the intercanine distance was maintained, when the intercanine distance was expanded to meet the width of the Posterior teeth, the incisors could move about 3mm more distally. 3. The positional difference of the incisal tip was insignificant whether the central incisors were moved by tipping or bodily movement. 4. When the anterior crowding was solved without changing the intercanine distance, the larger the anterior arch length was, the more the anterior movement of the incisors. 5. When the curve of Spee was levelled, the increase in the arch perimeter was less than half of the deepest curve of Spee.
Facial vertical dyscrepancies is decided on the relationship between the anterior vertical facial height and posterior vertical facial height. Thus this study was conducted to determine the factors that affect the FHI, and classify the Class II div.1, malocclusion, which success is dependent on the vertical control according to the FHI, which is the ratio of antero-inferior facial height, posterio-inferior facial height ratio, and to use this as a guideline for treatment. Angle between palatal plane and Mandibular plane were in the order of RH, ID. Thus showing that interrelated angle was more inportant than the independent angle of both, palatal plane and Mandibular plane. The tendency of Cl II div.1. Malocclusion according to FHI, showed the Low group to have Mx. protrusion, prominent development of Mn. ramus, and the Mn. body length and ant. post. position was normal. The Normo group showed slight protrusion of the Maxilla,. The development of the ramus was less than normal and the Mn. was in a slight retruded position. The High group showed the Mx. in a normal position, the development of the Mn. ramus and body was the lowest, and the Mn. was in a posterior position. In observation of the factors affecting the FHI between each groups of Cl II div.l, malocclusion; In the Low group the MP- PP angle was very small, the ID was smililar to the normal group, but the RH was very large thus the FHI was increased. In the Normo group, the PP-MP angle was normal, ID was slightly smaller than the normal group and the RH was slightly smaller than the normal group, thus maintaining a normal FHI ratio. In the High group the PP-MP angle was very large, the ID was similar to the normal group, but the RH was smaller than the normal group thus the FHI was small.
Purpose: Cleft lip and palate is one of the most frequent hereditary deformities of the maxillofacial region which can arise in facial and jaw abnormalities as well as malocclusion and speech problems. In particular, unilateral cleft lip and palate is characterized by midface deformity resulting in maxillary anterior nasal septal deviation and nasal deformity. The aim of this study is to analyze the facial deformity of untreated unilateral cleft lip patients for contribution to primary cheiloplasty. Methods: Thirty-three patients with unilateral cleft lip and palate were impressioned before operation and facial casts were made. The casts were classified into complete cleft lip and incomplete cleft lip groups and each group were classified into affected side and normal side. Anthropometric reference points and lines were setted up and analysis between points and lines were made. Results and Conclusion: The obtained results were as follows: 1. The intercanthal width had no significant difference between the incomplete and complete cleft lip groups. 2. Cleft width and alar base width were greater in the complete group, and nasal tip protrusion was greater in the incomplete group. 3. Involved alar width and nostril width were greater in the complete group and in both complete and incomplete groups, involved alar width and nostril width were greater than the non-involved side. 4. The lateral deviation of the subnasale was greater in the complete group in both involved and non-involved sides. 5. The nasal laterale was placed inferiorly in both cleft groups. 6. The subnasale was deviated to the non-involved side in both cleft groups. 7. The nose tip was deviated to the non-involved side in both cleft groups and had greater lateral deviation in the complete cleft group. 8. The midpoint of cupid's bow had no vertical difference between complete and incomplete groups, but had a greater lateral deviation in the complete group. 9. In the complete cleft group, correlation between differences in cleft width and nostril width and columella height difference were obtained.
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