• 대한치과교정학회지
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• 제51권1호
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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.

• 대한치과교정학회지
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• 제25권2호
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• pp.153-163
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• 1995

본 연구는 III급 부정 교합을 판별하는데 있어, 수평 부조화의 진단에 이용되는 여러 진단 항목들의 진단학적 효율과 타당성을 ROC analysis로 비교하는데 그 목적이 있다. ROC(Receiver Operating Characteristic) analysis는 연속적으로 변하는 cut-off value에서의 sensitivity와 1-specificity에 의해 그려지는 곡선으로서 진단 방법의 타당성을 결정하고, 여러 진단 방법들을 비교하는 분석법으로 알려져 있다. 부정교합자 496명을 대상으로 측모 두부 X-선 계측사진과 진단모형을 이용하여, 진단모형 계측을 통해 부정교합군을 분류하였으며, 이중 III급 부정 교합자는 245명이었다. 측모 두부 X-선계측사진에서 16개의 계측항목을 선정하였으며, 이 계측항목들과 III급 부정교합의 관계를 알아보고자 각도 계측항목에서는 $1^{\circ}$ 간격으로, 선계측항목에서는 1mm의 간격으로 sensitivity와 specificity를 구해 ROC curve를 그렸다. 그리고, 이 계측항목들의 직접적인 비교를 위해 ROC curve 아래의 면적을 계산해냈다. 결과는 다음과 같다. 1. III급 부정교합을 판별하는데 있어, "Wits" appraisal이 다른 계측 항목에 비해 더 나은 진단 효율을 보였다. 2. AB plane angle, ANB angle, App-Bpp distance, AF-BF distance, APDI, N perpendicular to A 와 Pog to N perpendicular의 차이, maxillomandibular differential도 높은 진단 가치를 보였다. 3. 하악골의 위치를 평가하는 계측항목은 중정도의 진단 효율을 보였다. 4. 상악골에 대한 계측항목은 III급 부정교합의 판별에 대한 진단 가치가 낮았다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권4호
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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.

• 대한치과교정학회지
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• 제32권2호통권91호
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• pp.79-89
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• 2002

본 연구의 목적은 일반두부방사선계측사진과 디지털두부방사선계측사진의 계측점 식별의 오차를 구하여 각각의 영상에서 오차의 특징을 살펴보고 재현성을 비교 평가하는 것이다. 연구 대상은 서울대학교병원 치과진료부 교정과에 내원한 교정 환자 중 18세에서 29세 사이의 성인 환자 중에서 일반두부방사선계측사진군과 디지털두부방사선계측사진군 각각 15명씩 30명을 무작위로 선택하여 연구 대상으로 하였으며 남녀의 구별이나 두개 안면 구조의 형태는 고려하지 않았다. 계측점은 동일인이 시간차를 두고 식별 하였다. 식별 후 각 계측점은 좌표 (x, y)로 표시하였으며, 처음 계측점을 식별한 두부방사선계측사진군을 T1으로, 1 주 후 동일 계측점을 재식별한 두부방사선계측사진군을 T2로, 1 달 후 동일계측점을 재식별한 두부방사선계측사진군을 T3로 분류하였다. 오차의 평균과 표준편차는 x좌표, y좌표로 구분하여 계산하였다. 초기 식별 1주 후 재식별시 오차는 T2-T1(x), T2-T1(y)로, 초기 측정 1달 후 재시별시 오차는 T3-T1(x), T3-T1(y)로 표시하였으며 일반두부방사선계측사진과 디지털두부방사선계측사진으로 각각 나누었다. 재현성의 평가를 위한 오차간의 통계학적인 검정은 independent t-test를 사용하였으며 다음과 같은 결론을 얻었다. 1. 디지털두부방사선계측사진이 일반두부방사선계측사진보다 일반적으로 오차의 평균 및 표준편차가 작았다. 2. 일반두부방사선계측사진의 오차와 디지털두부방사선계측사진의 오차가 통계학적으로 유의성 있는 차이를 보인 항목은 드물었다. 3.상의 향상을 통한 오차의 개선은 한계가 있었으며 상이 향상되더라도 각 계측점의 오차 의 경향은 크게 변하지 않았다.

• 대한소아치과학회지
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• 제49권1호
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• pp.85-94
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• 2022

이 후향적 연구의 목적은 7 - 15세 사이의 혼합치열기와 영구치열기의 소아 및 청소년 환자에서 기존 교정 분석 방법과 인공 지능을 활용한 교정 분석 방법을 이용한 변수의 차이를 비교하여 평가하는 것이다. 교정 진단을 위해 측면 두부계측 방사선 사진을 촬영한 소아 환자 60명(혼합 치열기 30명, 영구치열기 30명)을 무작위로 선정하였다. V-ceph을 사용한 기존 분석 방법과 WebCeph를 사용한 딥 러닝 기반 분석 방법으로 1명의 검사자가 17개의 두부 측정 계측점을 식별하고, 22개의 측정 항목을 평가했다. 기존 분석 방법의 반복 측정으로 인한 오차는 Pearson의 상관 분석을 사용하여 평가하었다. 혼합치열군과 영구치열군에 대한 각각 두 방법의 차이는 paired t-test를 사용하여 평가하였다. 혼합치열군에서 두 분석 방법의 차이는 8개의 계측항목에서 통계적으로 유의하였다: 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). 영구치열군에서는 두 분석 방법 간에 4개의 계측항목이 통계적으로 유의한 차이를 보였다: ODI (p = 0.020), Wits appraisal (p = 0.025), Facial ratio (p = 0.026), and U1 to A-Pg (p = 0.001). 많은 시간이 소요되는 기존의 교정 분석 방법과 비교하였을 때, 딥 러닝 기반 교정 분석 시스템은 측정의 신뢰성과 유효성 측면에서 임상적으로 허용될 수 있다. 하지만 소아 환자의 교정 분석을 위해 딥 러닝 기반 프로그램을 사용할 때에는 이러한 프로그램의 한계점을 인지하고 올바른 판단으로 사용하는 것이 중요하다.

• 대한구순구개열학회지
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• 제6권2호
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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.

• 치과방사선
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• 제24권2호
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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).

• 대한치과교정학회지
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• 제52권4호
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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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• 제35권1호
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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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• 제45권4호
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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.