• The korean journal of orthodontics
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• v.51 no.1
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• pp.43-54
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• 2021

Objective: To investigate the cephalometric predictors of the future need for orthognathic surgery in Korean patients with unilateral cleft lip and palate (UCLP) despite long-term use of facemask with miniplate (FMMP). Methods: The sample consisted of 53 UCLP patients treated by a single orthodontist using an identical protocol. Lateral cephalograms were taken before commencement of FMMP therapy (T0; mean age, 10.45 years), after FMMP therapy (T1; mean age, 14.72 years), and at follow-up (T2; mean age, 18.68 years). Twenty-eight cephalometric variables were measured. At T2 stage, the subjects were divided into FMMP-Nonsurgery (n = 33, 62.3%) and FMMP-Surgery (n = 20, 37.7%) groups according to cephalometric criteria (point A-nasion-point B [ANB] < -3°; Wits-appraisal < -5 mm; and Harvold unit difference [HUD] > 34 mm for FMMP-Surgery group). Statistical analyses including discrimination analysis were performed. Results: In FMMP-Surgery group, the forward position of the mandible at T0 stage was maintained throughout the whole stages and Class III relationship worsened with significant growth of the mandibular body and ramus and counterclockwise rotation of the maxilla and mandible at the T1 and T2 stages. Six cephalometric variables at T0 stage including ANB, anteroposterior dysplasia indicator, Wits-appraisal, mandibular body length, HUD, and overjet were selected as effective predictors of the future need for surgical intervention to correct sagittal skeletal discrepancies. Conclusions: Despite long-term use of FMMP therapy, 37.7% of UCLP patients became candidates for orthognathic surgery. Therefore, differential diagnosis is necessary to predict the future need for orthognathic surgery at early age.

• The korean journal of orthodontics
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• v.25 no.2 s.49
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• pp.153-163
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• 1995

In this study, Receiver Operating Characteristic(ROC) analysis was used to evaluate the ability of cephalometric measurements to identify patients with Class III malocclusions. ROC analysis is the method for determining the validity of a diagnostic measure and for evaluating the relative value of diagnostic tests. The sample consisted of 496 patients with malocclusion. Class III malocclusion is defined as the dental relationship for which The mesiobuccal groove of the lower first molar is deviated mesially from the mesiobuccal cusp of the upper first molar. Of the total sample of 496 patients, 245 had Class III malocclusions. 16 cephalometric measurements were selected, each of which was treated as a diagnostic test. The ROC curves were generated for each cephalometric measurement with intervals of $1.0^{\circ}$ for angular measurements, 1.0mm for linear measurements. The area under the ROC curves was measured for direct comparison among different diagnostic tests. The results were as follows; 1. The 'Wits' appraisal was found to be a better diagnostic criterion for the presence of Class III malocclusion than any other commonly'used cephalometric measurement. 2. AB plane angle, ANB angle, App-Bpp distance, AF-BF distance, APDI, Distance of point A and Pog to N perpendicular, maxillomandibular differential had high diagnostic value. 3. Cephalometric measurements which evaluate the position of the mandible had moderate diagnostic value. 4. Cephalometric measurements related to the maxilla discriminated least between patients with and without Class III malocclusion.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.353-359
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• 1999

Purpose : A new method of lateral cephalometric analysis for midface, focusing on zygomatic bone, was created in this study, and measured in Korean adults. The purposes of this study are understanding about new approach for midfacial depression, especially zygomatic bone, and using to make adequate diagnosis and treatment plan. Materials and methods : In this study, esthetic Korean adults, 25 males and 25 females who were between $0^{\circ}$ and $4^{\circ}$ in ${\angle}ANB$, and between 62% and 70% in P/A facial height ratio, and had normal overbite and overjet, were used. Orbitale(Or) and Soft tissue orbitale(Or') were used for indicators of anteroposterior position of zygomatic area. And, mean value and standard deviation of linear and angular measurements, and ratio about each linear measurements, were obtained. then, standard deviation diagram - wiggle diagram - was made for visualization of results. Results : Mean values, standard deviations and ranges of 19 measurements were obtained, and among them, 5 linear measurements that had large standard deviation were excluded and the others were used for making standard deviation diagram. In standard deviation diagram, the following results were obtained. 1. If the measurements are located on more left side of mean-value-vertical -line, the potential of midfacial hypoplasia are stronger, especially zygomatic area. 2. If the measurements are located on more right side of mean-value-vertical-line, the potential of midfacial hypoplasia are decreased. Conclusion : This study presented a new method of lateral cephalometric analysis focusing on zygomatic bone in Korean adults. We expect that the results of this study can be used as parameter when clinicians make decisions about diagnosis and treatment plan for rehabilitation of esthetics and function. But, it is necessary to prove its usefulness, and to further evaluate the results.

• The korean journal of orthodontics
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• v.32 no.2 s.91
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• pp.79-89
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• 2002

The purpose of this study is to evaluate the reproducibility and errors in landmark identification of conventional lateral cephalometric radiography and digital lateral cephalometric radiography. Fifteen conventional lateral cephalometric radiographs and fifteen digital lateral cephalometric radiographs were selected in adults with no considerations on sex and craniofacial forms. Each landmark was identified and expressed as the coordinate (x, y). The landmarks were classified into 3 groups. The landmarks of the first identification was T1, identification after one week was T2, and identification after one month was T3. The mean and standard deviation of identification errors between replicates were calculated according to the x and y coordinates. The errors between first identification and second identification were expressed as T2-T1(x), T2-T1(y) and those between first identification and third identification were expressed as T3-T1(x), T2-T1(y). Each was divided into conventional lateral cephalometric radiography and digital lateral cephalometric radiography. The independent t- test was used for statistical analysis of identification errors for the evaluation of reproducibility. The results of this study were as follows ; 1. Generally, the mean and standard deviation of landmark identification errors in digital lateral cephalometric radiography was smaller than those of conventional lateral cephalometric radiography. 2. Only a few landmarks showed statistically significant difference in identification error between conventional lateral cephalometric radiography and digital lateral cephalometric radiography. 3. The enhancement of image quality didn't guarantee decrease in landmark identification error and didn't affect tendency of landmark identification error.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.1
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• pp.85-94
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• 2022

This retrospective study aimed to evaluate the difference in measurement between conventional orthodontic analysis and artificial intelligence orthodontic analysis in pediatric and adolescent patients aged 7 - 15 with the mixed and permanent dentition. A total of 60 pediatric and adolescent patients (30 mixed dentition, 30 permanent dentition) who underwent lateral cephalometric radiograph for orthodontic diagnosis were randomly selected. Seventeen cephalometric landmarks were identified, and 22 measurements were calculated by 1 examiner, using both conventional analysis method and deep learning-based analysis method. Errors due to repeated measurements were assessed by Pearson's correlation coefficient. For the mixed dentition group and the permanent dentition group, respectively, a paired t-test was used to evaluate the difference between the 2 methods. The difference between the 2 methods for 8 measurements were statistically significant in mixed dentition group: APDI, SNA, SNB, Mandibular plane angle, LAFH (p < 0.001), Facial ratio (p = 0.001), U1 to SN (p = 0.012), and U1 to A-Pg (p = 0.021). In the permanent dentition group, 4 measurements showed a statistically significant difference between the 2 methods: ODI (p = 0.020), Wits appraisal (p = 0.025), Facial ratio (p = 0.026), and U1 to A-Pg (p = 0.001). Compared with the time-consuming conventional orthodontic analysis, the deep learning-based cephalometric system can be clinically acceptable in terms of reliability and validity. However, it is essential to understand the limitations of the deep learning-based programs for orthodontic analysis of pediatric and adolescent patients and use these programs with the proper assessment.

• Korean Journal of Cleft Lip And Palate
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• v.6 no.2
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• pp.59-67
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• 2003

A cephalometric study was performed to reveal differences between skeletal Class III malocclusion patients and cleft lip and palate patients, The material for this study consisted of 16 males (mean age 19.8, range 17-29) and 9 females(mean age 19.4, range 16-27) with cleft lip and palate, and 222 Skeletal Class III malocclusion patients(males 106, females 116), Cephalometric tracing and measurements were done by one investigator. Results were followed: 1. Cleft lip and palate group had more retrusive maxilla than the skeletal Class III malocclusion group. 2, Cleft lip and palate group had smaller effective maxillary and mandibular length than skeletal Class III malocclusion group, and the difference was more prominent in the mandible than in the maxilla. 3. Dental compensation was not observed in the upper incisors of cleft lip and palate group and in the lower incisors it was smaller than skeletal Class III group. 4, In the Gonial angle and lower anterior facial height values, there was no significant difference between cleft lip and palate and skeletal Class III malocclusion group. These results can be used in orthodontic treatment planning and orthognathic surgery for the cleft lip and palate patients.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.24 no.2
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• pp.427-437
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• 1994

Clinical examination, photometric evaluation, & radiographic analysis have been used to evaluate the asymmetry of the face. Commonly used skull radiographs to assess skeletal asymmetry include poatero-anterior cephalometries, submentovertex view, & panoramic view. The purpose of this study is the comparison of the reliance of the postero-anterior cephalometric view, submentovertex view, & panoramic view in the asymmetry evaluation. All measurements were performed on the each radiographs of 31 control group & 30 asymmetric group. The measurements are MSL(midsagittal plane)-Co, MSL-Go, MSL-Me, MSL-Al, MSL-Bl, Mn. Ramus Height(Co-Go), Mn. Body Length(Go-Me), and Total Mn. Length(Co-Me). The results were as follows: 1. The lack of either a right-sided or left-sided asymmetric dominant was found. 2. The postero-anterior cephalometric view & submentovertex view relatively agreed with each other in the result. The postero-anterior cephalometric view & submentovertex view had the clinical reliability & effectiveness in the diagnosis of the skeletal asymmetry(p<0.05). 3. The panoramic view showed more magnification compared to the other radiographs. In the vertical measurements the panoramic view had clinical reliability relatively(p<0.05). But we cannot rely on the horizontal measurements in the panoramic view(p>0.05).

• The korean journal of orthodontics
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• v.52 no.4
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• pp.258-267
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• 2022

Objective: This study aimed to evaluate the superimposition accuracy of digital modes for measuring tooth movement in patients requiring anterior retraction after premolar extraction based on the proposed reference regions. Methods: Forty patients treated with bilateral maxillary first premolar extraction were divided into two groups: moderate retraction (< 7.0 mm) and maximum retraction (≥ 7.0 mm). Central incisor displacement was measured using cephalometric superimpositions and three-dimensional (3D) digital superimpositions with the 3rd or 4th ruga as the reference point. The Wilcoxon signed-rank test and linear regression analyses were performed to test the significance of the differences and relationships between the two measurement techniques. Results: In the moderate retraction group, the central incisor anteroposterior displacement values did not differ significantly between 3D digital and cephalometric superimpositions. However, in the maximum-retraction group, significant differences were observed between the anteroposterior displacement evaluated by the 3rd ruga superimposition and cephalometric methods (p < 0.05). Conclusions: This study demonstrated that 3D digital superimpositions were clinically as reliable as cephalometric superimpositions in assessing tooth movements in patients requiring moderate retraction. However, the reference point should be carefully examined in patients who require maximum retraction.

• Imaging Science in Dentistry
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• v.35 no.1
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• pp.15-23
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• 2005

Purpose : To compare cephalometric measurement between measuring methods in digital and conventional lateral cephalometric radiograph. Materials and Methods : Twenty digital and conventional lateral cephalometric radiographs were selected. In digital group, cephalometric measurements were performed manually using hardcopies and automatically using $V-Ceph^{TM}$ program on the monitor. In conventional group, the same measurements were performed manually on conventional films, and for automatic measurement conventional films were digitized by scanner. All measurements were performed twice by 4 observers, and 24 cephalometric variables were calculated and the time spent for each measurement was recorded. The differences in measurements data and the time spent for each measurement were compared within each group. Intra-observer and inter-observer comparisons were performed. Results : In both groups, no statistically significant difference between manual and automatic measurements was observed and most of the variables didn't show statistically significant differences between methods. The observer with less experience tended to show statistically significant differences of measurements between methods, and differences from other observers. The differences of measurements between methods in digital group were lesser than those of conventional group with statistical significance in 8 variables out of 24. With automatic method and in digital group, the spent time was shorter. Conclusion : With direct digital radiograph, automatic method using manually idenitified landmarks can be preferable in cephalometric analysis. (Korean J Oral Maxillofac Radiol 2005; 35 : 15-23)

• Imaging Science in Dentistry
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• v.45 no.4
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• pp.213-220
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• 2015

Purpose: The aim this study was to compare the accuracy of orthodontists and dentomaxillofacial radiologists in identifying 17 commonly used cephalometric landmarks, and to determine the extent of variability associated with each of those landmarks. Materials and Methods: Twenty digital lateral cephalometric radiographs were evaluated by two groups of dental specialists, and 17 cephalometric landmarks were identified. The x and y coordinates of each landmark were recorded. The mean value for each landmark was considered the best estimate and used as the standard. Variation in measurements of the distance between landmarks and measurements of the angles associated with certain landmarks was also assessed by a subset of two observers, and intraobserver and interobserver agreement were evaluated. Results: Intraclass correlation coefficients were excellent for intraobserver agreement, but only good for interobserver agreement. The least reliable landmark for orthodontists was the gnathion (Gn) point (standard deviation [SD], 5.92 mm), while the orbitale (Or) was the least reliable landmark (SD, 4.41 mm) for dentomaxillofacial radiologists. Furthermore, the condylion (Co)-Gn plane was the least consistent (SD, 4.43 mm). Conclusion: We established that some landmarks were not as reproducible as others, both horizontally and vertically. The most consistently identified landmark in both groups was the lower incisor border, while the least reliable points were Co, Gn, Or, and the anterior nasal spine. Overall, a lower level of reproducibility in the identification of cephalometric landmarks was observed among orthodontists.