• Title/Summary/Keyword: Cephalometric evaluation

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Skeletal stability following mandibular advancement: is it influenced by the magnitude of advancement or changes of the mandibular plane angle?

  • Tabrizi, Reza;Nili, Mahsa;Aliabadi, Ehsan;Pourdanesh, Fereydoun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.3
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    • pp.152-159
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    • 2017
  • Objectives: The aim of this study was to investigate the effects of advancement magnitude and changes in mandibular plane angle on the stability of mandibular advancement. Materials and Methods: This retrospective cohort study evaluated the postoperative stability of mandibular advancement in class II skeletal subjects who underwent bilateral sagittal split osteotomy. Radiographs taken preoperatively, immediately postoperatively and 1 year postoperatively were traced and analyzed using linear and angular measurements. To determine horizontal and vertical relapse, an X-Y coordinate system was established in which the X-axis was constructed by rotating S-N downward by $7^{\circ}$ (approximation of the Frankfort horizontal plane) and the Y-axis was defined as a line perpendicular to the X-axis and passing through the point Sella. For certain reference points including point A, point B, pogonion and menton, the perpendicular distance between each point and both axes was determined and cephalometric variables were recorded as X and Y coordinates. Results: Twenty-five subjects were studied. A significant correlation between the amount of mandibular advancement and relapse in the B point (vertical and horizontal) and the pogonion point was observed (vertical and horizontal, P<0.001). Evaluation of data demonstrated a positive correlation between the mandibular plane angle (SN/ML) change and vertical relapse in the B point (P<0.05). A simple regression model demonstrated that 74% of horizontal relapse and 42.3% of vertical relapse in the B point was related to the amount of mandibular advancement. The receiver operating characteristic test showed that 8.5 mm mandibular advancement is related to a relapse rate of 1 mm or more in the pogonion, vertically or horizontally. Conclusion: The magnitude of mandibular advancement is a stronger surgical predictor for horizontal rather than vertical relapse at the B point. Changes in mandibular plane angle (SN/ML) during surgery affect vertical, but not horizontal relapse at the B point.

THE CARE OF DELAYED MALUNION AFTER MAXILLARY FRACTURE BY DIFFERENT METHODS:REPORT OF THREE CASES (치료법을 달리한 상악골절후 부정유합 2예)

  • Yoo, Jae-Ha;Lee, Won-Yoo;Rew, Soo-Jang
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.117-127
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    • 1991
  • When open reduction of maxilla fractures is postponed due to concurrent life-threatening injuries, delayed union may result with malunion or nonunion. If delayed malunion is occurred, significant facial deformity may result, including a dished-out face, irregular retromaxillism with Angle's class III malocclusion, open anterior bite, nasal collapse, telecanthus and malar flattening. The treatment planning for this problem includes cephalometric evaluation anterior and lateral tomograms, dental casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue attachment at the fracture site. In this paper, one case presented a 58-year-old female patient with maxilla retrusion after comminuted fracture, who was treated with orthodontic methods of maxillary protraction headgear and Plaster headcap, whereas the other two cases were about male patients who were treated principally with surgically open reduction or Le Fort I-controlled transverse osteotomy with iliac bone graft.

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Survey of the Preferred Vertical Lip-Chin Ratio (상순과 턱의 수직 비율(vertical lip-chin ratio)에 대한 선호도 조사)

  • Kwon, Seong-Jun;Choi, Gab-Lim;Lim, Sung-Hoon;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.34 no.5 s.106
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    • pp.408-416
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    • 2004
  • The purpose of this study was to investigate the preference of Vertical Lip-Chin Ratio (=Sn-Stm/Stm-Me', hereafter VLCR) in Koreans. The assessors consisted of 44 dentists (male 22, female 22) and 430 lay persons (male 303, female 127). The survey was performed using a questionnaire asking the order of preference. The profiles presented in the questionnaire were based on the profiles of two males and two females, each morphed according to the VLCRs of 1/1.8, 1/1.9, 1/2.0. 1/2.1, 1/2.2. The results were as follows: The difference between males and females. and the difference betwwen dentists and lay persons in the preference of VLCR were not statistically apparent. The most Preferred VLCR was 1/1.9, and the least preferred VLCR was 1/2.2, These results Indicate that the preferred VLCR is smaller than the previously reported VLCR ratios based on the cephalometric evaluation of samples with favorable facial esthetics.

RELAPSE AND STABILITY : AN EVALUATION OF CLASS I MALOCCLUSION NONEXTRACTION THERAPY (비발치로 치료한 제1급 부정교합자의 재귀현상에 관한 연구)

  • Kim, Gu-Soon;Lee, Ki-Soo
    • The korean journal of orthodontics
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    • v.27 no.1
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    • pp.79-89
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    • 1997
  • One of the strenuous problems in orthodontic procedures is postretention stability and retention against relapse. Many investigative trial had been done to disclose the factors associated with relapse and effective prescription to stave off, however, the nature of these jeopardies remained obscure. The objective was to investigate the long-term stability and quantitative changes of dental arches subsequently after Class I nonextraction treatment. Study models,cephalometric headfilms of 26 samples which were taken before, after teatment and postretention were employed to measure the interdental width of corresponding buccal teeth,overbite,overjet and the inclination of incisors and molars. Statistical analysis was carried to compare each measurements across the time period, and followings were brought around. 1. The quantitative amount of relapse in overbite presented positive correlation with the amount of changes through the treatment. 2. Stability of intercanine width was so far secure in the case the expansion had been done through. 3. The amount of changes in intercanine width of the lower regardless of expansion or contraction manifested less than the upper, however, the relapse ratio got high. 4. The upper and lower incisors were likely to be labioversive, and remained stable after retention. 5. The first molars of the upper and lower were conceivably tipped back immediately after treatment and returned to the original angulation. The expansion of intermolar width stayed stable across the time scheme after treatment It was suggested that the maintenance of intercanine width of lower was pertinent to perform the postretention stabilityv and the expansion of dental arch shoed be confined within physiologic boundaries of the patients.

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Cephalometric Evaluation of the Midfacial Soft Tissue Changes on Smiling (두부규격 방사선 사진을 이용한 미소 시의 중안면부 연조직의 변화량 측정)

  • Cheon, Kang-Yong;Shin, Dong-Whan;Chun, Won-Bae;Kim, Soo-Ho;Kim, Eu-Gene;Park, Hyong-Wook;Cho, Jin-Yong;Yun, Jun-Yong;Seo, Mi-Hyun;Lee, Won-Deok;Suh, Je-Duck;Lee, Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.6
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    • pp.421-425
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    • 2012
  • Purpose: The aim of this study is to compare the soft tissue changes of the midfacial area at the repose position and the natural smiling position for the improvement of evaluation and planning in the orthognathic surgery. Methods: The total of 30 subjects, 15 male and 15 female, were included in this study. The metal point landmarks were placed at the cheek, orbital rim, subpupil, and nasal base. The movements of the landmarks were evaluated at the repose position and smiling position in the lateral and posteroanterior cephalograms. Paired t test and correlation analysis were used for the evaluation of the soft tissue changes statistically. Results: In the lateral cephalograms, the cheek point (4.49 mm in female, 4.87 mm in male) showed the most distant movement. All points presented significant movements, except the orbital rim and nasal base point in male. Cheek point presented significant positive correlation between the horizontal and vertical change in male. Subpupil point presented significant positive correlation between horizontal and vertical change in both male and female. In the posteroanterior cephalograms, the nasal base point (5.41 mm in female, 6.30 mm in male) showed the most distant movement. Subpupil point and nasal base point presented significant movements in both female and male. Nasal base point presented significant negative correlation between the horizontal and vertical change in both male and female. In the lateral and posteroanterior cephalograms, the positional changes of all points presented significant positive correlation with each other in both female and male. Conclusion: The cheek point in the sagittal view and the nasal base point in the frontal view showed the most distant movement on smile. In the sagittal view, the subpupil point and cheek point moved anteriorsuperiorly on smile. In the frontal view, the nasal base points moved laterosuperiorly on smile. In both the sagittal and frontal view, the positional changes of all point were highly correlated to each other. These results may be used in the soft tissue references for the treatment planning of the dentofacial deformity patients.

THE DENTAL MATURATION OF MAXILLA IN CHILDREN WITH ANTERIOR CROSSBITE OF MAXILLARY UNDERGROWTH TYPE (상악 열성장형 전치부 반대교합 아동에 있어서의 상악 치아 성숙도)

  • An, Ul-Jin;Noh, Hong-Seok;Jeong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.2
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    • pp.119-128
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    • 2011
  • In the process of assessing the children with anterior crossbite in early mixed dentition, it has frequently been detected that the stronger the skeletal pattern of the malocclusion is, the more markedly delayed the development and eruption of maxillary teeth are. If the anteroposterior characteristics of craniofacial skeleton has any relationship with dental maturation, the evaluation of dental development and eruption was thought to be able to contribute to early diagnosis of crossbite in children. This study was performed for the purpose of elucidating the relationship between dental maturation of maxillary teeth and some cephalometric values in children with anterior crossbite of maxillary undergrowth type in early mixed dentition. Among the children in Hellman dental age IIA and IIC who attended the Pediatric Dental Clinic of Pusan National University Hospital with orthodontic problems, cases with Class III malocclusion were classified and 50 cases of maxillary undergrowth type and type with normal maxilla respectively were randomly selected and studied as subjects. From their lateral cephalographs and panoramic radiographs, their anteroposterior skeletal features, the dental maturity and eruption rate were obtained of each group and data were analyzed to yield the results as follows: 1. Comparing the maturity of maxillary teeth of both groups, only the first molars of maxillary undergrowth group showed significantly slower development and eruption (p<0.05). 2. There was high correlation between maturation of maxillary 1st molar and chronological age(p<0.05). 3. Among the parameters of anteroposterior relationship of skeletal pattern in maxilla and mandible. Wits was revealed as a useful index to predict both the calcification and eruption rate of the 1st molars whereas SNA was to eruption rate(p<0.05).

A Posteroanterior Cephalometric Study on Craniofacial Proportions of Koreans with Normal Occlusion (한국인 정상 교합자의 정모 두부 방사선 사진을 이용한 안모비율에 관한 연구)

  • Baik, Hyoung-Seon;Yu, Hyung Seog;Lee, Kie-Joo
    • The korean journal of orthodontics
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    • v.27 no.4 s.63
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    • pp.643-659
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    • 1997
  • For the total treatment of skeletal malocclusions, 3-dimensional evaluation and diagnosis are essential. Although anteroposterior discrepancies can be evaluated through various methods, the satisfactory methods for evaluations of facial asymmetry and transverse discrepancies are yet to be found. The adequate diagnosis and treatment of transverse discrepancies may be more important in the maintenance of functional occlusion as well as for the stability of results obtained from orthognathic surgery than the anteroposterior or vertical discrepancies. Since the soft tissue effects from the transverse discrepancies may not be pronounced, especially when combined with anteroposterior or vertical discrepancies which have prominent characteristics, the differentiation of their effects may be difficult from visual inspection alone. Therefore it is essential that the normal facial proportions would be established from the posteroanterior cephalometry as a reference for the accurate diagnosis and treatment. The present study evaluates 76 subjects from Yonsei University freshmen with normal facial symmetry and occlusion. Posteroanterior cephalograms were taken from the subjects and the normal values and facial proportions are obtained. The results are as follows. 1. The transverse and vortical values from posteroanterior cephalometry and their ratio, with means and standard deviations are calculated. 2. The ratio of vertical values to transverse values is 0.837 (male 0.836, female 0.841). 3. The Proportion of maxillary and mandibular widths is 0.747 (male 0.745, female 0.752), with statistically significant correlation. 4. Various degree of significant correlations are observed in the following craniofacial widths; (Cranial width, Bizygomaticofrontal suture width, Facial width, Maxillary width, Upper & Lower Intermolar width, Mandibular width). 5. Although the facial height as well as other line measurements increase as the facial widths increase, angle measurement ($Bj\ddot{o}rk$ Sum, Mandibular Plane Angle, Gonial Angle), decreases and posterior to anterior facial height ratio increases, therefore indicating the tendency for a brachycephalic facial type. These results may be used as references for the treatment planning in orthognathic and orthodontic treatments for the dentofacial deformity patients.

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