• The Journal of the Korean dental association
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• v.33 no.8 s.315
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• pp.536-537
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• 1995

• The korean journal of orthodontics
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• v.48 no.3
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• pp.189-199
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• 2018

For patients with bimaxillary protrusion, significant retraction and intrusion of the anterior teeth are sometimes essential to improve the facial profile. However, severe root resorption of the maxillary incisors occasionally occurs after treatment because of various factors. For instance, it has been reported that approximation or invasion of the incisive canal by the anterior tooth roots during retraction may cause apical root damage. Thus, determination of the position of the maxillary incisors is key for orthodontic diagnosis and treatment planning in such cases. Cone-beam computed tomography (CBCT) may be useful for simulating the post-treatment position of the maxillary incisors and surrounding structures in order to ensure safe teeth movement. Here, we present a case of Class II malocclusion with bimaxillary protrusion, wherein apical root damage due to treatment was minimized by pretreatment evaluation of the anatomical structures and simulation of the maxillary central incisor movement using CBCT. Considerable retraction and intrusion of the maxillary incisors, which resulted in a significant improvement in the facial profile and smile, were achieved without severe root resorption. Our findings suggest that CBCT-based diagnosis and treatment simulation may facilitate safe and dynamic orthodontic tooth movement, particularly in patients requiring maximum anterior tooth retraction.

• The korean journal of orthodontics
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• v.51 no.3
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• pp.166-178
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• 2021

Objective: To investigate dimensional changes in regional pharyngeal airway spaces after premolar extraction in bimaxillary skeletal protrusion (BSP) patients according to vertical skeletal pattern, and to further identify dentoskeletal risk factors to predict posttreatment pharyngeal changes. Methods: Fifty-five adults showing BSP treated with microimplant anchorage after four premolar extractions were included in this retrospective study. The subjects were divided into two groups according to the mandibular plane steepness: hyperdivergent (Frankfort horizontal plane to mandibular plane [FH-MP] ≥ 30) and nonhyperdivergent groups (FH-MP < 30). The control group consisted of 20 untreated adults with skeletal Class I normodivergent pattern and favorable profile. Treatment changes in cephalometric variables were evaluated and compared. The association between posttreatment changes in the dentoskeletal and upper airway variables were analyzed using linear regression analysis. Results: The BSP patients showed no significant decrease in the pharyngeal dimensions to the lower level in comparison with controls, except for middle airway space (MAS, p < 0.01). The upper airway variable representing greater decrease in the hyperdivergent group than in the nonhyperdivergent group was the MAS (p < 0.01). Posttreatment changes in FH-MP had negative correlation with changes in MAS (β = -0.42, p < 0.01) and inferior airway space (β = -0.52, p < 0.01) as a result of multivariable regression analysis adjusted for sagittal skeletal relationship. Conclusions: Decreased pharyngeal dimensions after treatment in BSP patients showed no significant difference from the normal range of pharyngeal dimensions. However, the glossopharyngeal airway space may be susceptible to treatment when vertical dimension increased in hyperdivergent BSP patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.4
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• pp.365-371
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• 2005

In esthetic treatment of bimaxillary protrusion, it is important to move backward the anterior teeth segment. For the backward movement of the anterior teeth segment, orthodontic force and segmental osteotomy have been applied on the clinical treatment until recently. These methods caused long treatment time, anchorage loss, the possibility of root resorption and the complication followed by segmental osteotomy. Therefore, corticotomy has become a major concern lately. This research has been conducted to study the efficiency of corticotomy in the treatment of bimaxillary protrusion comparing the profile change, canine retraction velocity and space closing time. The research compared and analyzed space closing time, canine retraction velocity and profile change in two groups of patients. Both groups were formed out of patients over 18 years old who visited the department of dentistry in Hanyang University for treatments. The experimental group who was treated by corticotomy and Skeletal Anchorage System(SAS). The control group who received orthodontic treatment using SAS. The following results are produced after analyzing both groups. The significant statistic difference in space closing time has been observed in the experimental group as compared with the control group(p<0.05). In the experimental group, the significant statistic increase in canine retraction velocity was also observed(p<0.05). There was no significant difference in profile change between the control group and the experimental group(p<0.05). As a result, orthodontic treatment using corticotomy has a reasonable efficiency in space closing time as compared with the existing orthodontic treatment. Therefore, it is concluded that corticotomy with orthodontic treatment can be reasonably applied to dentofacial abnormality.

• Archives of Plastic Surgery
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• v.34 no.5
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• pp.635-640
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• 2007

Purpose: Mid and lower facial convexity is more common in Oriental people than in Caucasian. Bimaxillary dentoalveolar protrusion is characterized by procumbent teeth, protruding lips, acute nasolabial angle, gummy smile, receding chin, facial convexity. Especially, pure maxillary dentoalveolar protrusion is less frequent than bimaxillary dentoalveolar protrusion. Therefore, it is important to make an accurate decision for the operation throughout the history taking, cephalogram, dental cast to arrive at accurate diagnosis and surgical plan. Methods: From December 2002 to June 2004, ten patients with maxillary dentoalveolar protrusion and microgenia were corrected by maxillary anterior segmental osteotomy and advancement genioplasty. 10 patients were analyzed by preoperative and postoperative clinical photography, posteroanterior and lateral cephalograms. Results: No major complications were occurred throughout the follow-up period except one of the over-recessed, otherwise most of the patients were satisfied with the result. Conclusion: We could correct the occulusal relationship with teeth and improve lower facial profile, asthetically and functionally, by maxillary anterior segmental osteotomy and advancement genioplasty.

• The korean journal of orthodontics
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• v.24 no.1 s.44
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• pp.135-147
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• 1994

Facial esthetics is one of the most important goal of the orthodontic treatment and main concern of many patients. Facial esthetics should be considered in orthodontic diagnosis and treatment planning. Prediction of soft tissue profile changes after orthodontic tooth movement should be considered as well. The purpose of this study was to find out the effect of orthodontic treatment on lip profile in adult patient. The pre and post treatment cephalometric roentgenograms of 87 female adult with bimaxillary protrusion were used to analyze lip profile change. All subjects were treated with four bicuspids extraction. Obtained results were as follows . 1. Lip thickness changes after incisor retraction showed different patterns according to areas of the lip. The thickness of the red lip area showed 2.78 mm increase in average. In contrast the thickness of the cutaneous area showed 0.65 - 0.7 mm decrease according to the different cutaneous areas. 2. The length of the red lip area decreased(1.3mm) after incisor retraction. 3. The length of the cutaneous lip area increased(2.9mm) after incisor retraction.

• The Journal of the Korean dental association
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• v.47 no.3
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• pp.156-161
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• 2009

The purpose of this study was to survey a preference to the esthetic profile between Korean women and Korean American women. The interviewee were consisted of 30 Korean women and 30 Korean American women respectively. The survey has been done by using questionnaire. Altered facial profile of each normal male and female was got by moving maxilla, mandible to the front and back to survey the preference among the various profile. Then results were analyzed by SPSS program. The results were as follows, 1. In Korean women, in choosing the men's profile, 9 people out of 30, picked the standard profile as a most preferred profile, and bimaxillary retrusion and bimaxillary protrusion profile were followed by 6 people and 5people respectively. 2. In Korean American women, in choosing the men's profile, the 18 people out of 30, pick the bimaxillary retruded profile as a most preferred profile, and the standard profile were followed. 3. In Korean women, in choosing the women's profile, 18 people out of 30, picked the bimaxillary retruded profile as a most beautiful profile, and standard profile were followed by having 10people's voting. 4. In Korean American women, in choosing the women's profile, the 14 people out of 30, chose the bimaxillary retruded profile as a best one and the standard profile were followed by 12 people's voting. The preference of men's profile was significantly different between two groups (p<0.05) but the both group picked the bimaxillary retruded profile as a most beautiful when they choose the women's profile and then there was no statistical difference between the groups.

• The korean journal of orthodontics
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• v.33 no.6 s.101
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• pp.475-483
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• 2003

The purpose of this study is to evaluate hard and soft tissue changes following the subapical osteotomy in bimaxillary dentoalveolar protrusion patients requiring maximal retraction adult female patients was selected. Surgical procedures were performed by the same surgeon, anterior subapical osteotomy techniques were employed on the maxilla and cephalometric radiograms were traced and superimposed using the best-fit method and two reference The results were as follows 1. The bodily movement of the maxillary anterior segment was achieved in a posterior moved posteriorly with a slight correction of the lower incisors. 2. The horizontal soft tissue measurements changed significantly after treatment, but Nt and Sn vertical soft tissue measurements indicated that Ls moved inferiorly and Li superiorly. 3. The correlation between hard and soft tissue changes indicated that ${\Delta}HId/{\Delta}HLi,\;{\Delta}HId/{\Delta}LL-Eline,\;{\Delta}Hpt.B/{\Delta}HILS,\;and\;{\Delta}UI-FH/{\Delta}NL$ were significant. 4. More lower lip relative to upper lip retraction was demonstrated in relation to Rickett's E-line. The ratio between upper lip displacement was $50\%$, and between the lower incisor and lower lip displacement was $60\%$. We conclude from the results that the anterior subapical osteotomy is an efficient treatment severe dentoalveolar protrusion and desire rapid results.

• The korean journal of orthodontics
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• v.39 no.1
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• pp.54-65
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• 2009

This paper describes the case of a 50-year-old female with a Class II malocclusion who presented with severe bimaxillary protrusion and generalized alveolar bone loss due to adult periodontitis. The treatment plan consisted of extracting both upper and lower first premolars and periodontal treatment. Anterior segmental osteotomy(ASO) of the mandible and upper anterior segment retraction using compression osteogenesis after peri-segmental corticotomy(Speedy orthodontics) was performed. Correct overbite and overjet, facial balance, and improvement of lip protrusion were obtained. However, a slight root resorption tendency was observed on the lower anterior dentition. The active treatment period was 9 months and the results were stable for 27 months after debonding. This new type of treatment mechanics can be an effective alternative to orthognathic surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.4
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• pp.246-251
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• 2012

Purpose: The purpose of the study is to evaluate the effectiveness of anterior segmental osteotomy (ASO) in bimaxillary protrusion (BP) patients by comparison between the mandibular soft and hard tissue changes from orthodontic treatment and ASO. Methods: All 44 patients were diagnosed with BP in Kyung-Hee Medical Center. Orthodontic treatment with teeth extractions were underwent by 23 patients (Group A) and 21 patients underwent ASO (Group B). Mandibular soft and hard tissue changes were measured and evaluated, which were based on the vertical and horizontal reference line in lateral cephalometric radiographs. Statistical significance between the changes and correlation between each measurement were analyzed. Results: The amount of B point movement was lesser than that of the lower incisal tip (LIT) retraction, and LIT was tilted lingually in group A. The posterior movement discrepancy between LIT and B point was insignificant, and the inclination of lower incisor was not changed in group B. The soft tissues, including the lower lip, showed a posterior movement and reduction in the depth of mento-labial groove. According to the correlation analysis, the movement of the lower incisor was significantly related to the movement of the lower lip in group A, and the movement of the lower incisor was significantly related to that of the movement of lower lip, B point and Pog in group B. Conclusion: The orthodontic treatment in BP patients results in posterior tilting movement of the lower incisor, but ASO results in the bodily movement of the lower incisor. Consequently, ASO is more effective in BP cases because it ensures the controlled movement of the lower incisors.