• The korean journal of orthodontics
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• v.37 no.4
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• pp.245-259
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• 2007

Improvements in jaw relationship through clockwise rotation of the mandible may be desirable in some Class III patients with short low facial height. The aim of this study was to examine the treatment effect of face mask for Class III malocclusion patients according to their low facial morphology. Methods: Class III patients in their pubertal growth period were divided into two groups (Group 1, high LFH; Group 2, low LFH) according to lower facial height (LFH) by Ricketts (norm, 47). treatment changes between groups after face mask treatment was compared not only for hard tissue but also for soft tissue. Results: There were no significant differences between the two groups for the skeletal and soft tissues of the maxilla. There were no significant differences between the two groups for the skeletal posterior movement of the mandible, but posterior movement of the mandibular soft tissues in group 2 was larger than group 1. There were no significant differences between the two groups for the vertical hard tissue proportion changes of the mandible, but the vertical soft tissue proportion changes of the mandible in group 2 was larger than group 1. There was a significant correlation between the sagittal hard tissue and soft tissue changes of the maxilla and mandible, but there was no significant difference in the vertical changes. Conclusion: The clockwise rotation of the mandible occurred from use of the face mask, and posterior movement of soft tissues of the mandible was higher in Cl III patients with low LFH than with high LFH.

• The korean journal of orthodontics
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• v.25 no.3 s.50
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• pp.355-373
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• 1995

Craniofacial region is a musculodentoskeletal system that consists of many anatomical structures ; cranioskeletal structures, dental arches, and formation and functions of masticatory muscles have close correlations. Growth and development of craniofacial region are influenced by not only hereditory factors, but also environmental factors such as craniofacial muscles and surrounding tissues. On the contrary, however, study on changes in functions or adaptations of craniofacial muscles following changes of craniofacial skeletal structures has been somewhat insufficient. The author's purpose was to observe correlations between masticatory muscular functions and change patterns according to cranial skeletal structures and occlusion patterns, for this, comparative study of muscle activity changes of preand post- orthognathic surgery states in skeletal Cl III malocclusion patients was peformed. The selected sample groups were 15 normal male patients, 15 skeletal Cl III pre-orthognatic surgery patients and 15 skeletal Cl III post-orthognatic surgery patients. For each sample groups, cephalometric x-ray taking, masticatory efficiency test and measurements of muscle activities in anterior temporal muscle, masseter and upper lip in rest, clenching, chewing and swallowing were carried out. The following results were obtained : 1. In resting state of mandible, pre-surgery malocclusion group showed higher m. activities in ant. temporalis, masseter and upper lip than post-surgery group. Post-surg. malocc. group showed significantly high m. activity only in upper lip compared to the normal group. 2. In clenching state, post-surg. malocc. group showed higher m. activities in ut. temporalis, masseter and upper lip than pre-surg. malocc. group. 3. In chewing state, post-surg. malocc. group showed higher m. activities in ant. temporalis and masseter than pre-surg. malocc. group, on the other hand, decreased upper lip activity was noticed. 4. In swallowing state, post-surg. malocc. group showed lower upper lip activity than pre-surg. malocc. group but higher than that of the normal group. No significant difference in m. activities of ant, temporalis and masseter was noticed among the three groups. 5. Masticatory efficiency was lower in pre-surg. malocc. group than normal group, masticatory efficiency showed an increase in post-surg. malocc. group compared to the pre-surg. malocc. group. However, both groups showed significant differences compared to the normal group.

• The korean journal of orthodontics
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• v.29 no.2 s.73
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• pp.147-156
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• 1999

Skeletal Cl III malocclusion is an orthopedic appliance mainly used for growing children with maxillary undergrowth, which largely entails skeletal Cl III malocclusion. It improves anterior crossbite and maxillary position and thus, enables patients to attain favorable Profile but often involves unfavorable profile with protrusive upper and lower lips. Therefore, if orthodontists have knowledge of which condition helps obtain favorable occlusion and profile, they are able to predict the prognosis and limitation of the treatment. This study was done in order to help obtain favorable Profile after treating growing skeletal Cl III children. In the study, we classified childern into two groups, the one with favorable profile(Group 1, n=12) and the other with unfavorable profile(Group 2, n=14) and, with retrospective study using pre- and post-treatment lateral cephalogram, drew the following conclusions. 1. As patients had more serious labioversion of upper incisors, they were more unlikely to have favorable profiles after the treatment. Protrusion of prosthion, which was related with maxillary incisors, also affected profiles. 2. As the NL-ML angle before the treatment was small, it was more likely to get favorable profile. 3. As the degree of lower lip protrusion was high, it was likely to have bialveolar protrusion after the treatment. 4. As the degree of downward and backward rotation of mandible was high, it was likely to get unfavorable profile.

• The korean journal of orthodontics
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• v.26 no.2 s.55
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• pp.205-218
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• 1996

A given facial type can be considered as a syndrome in which various features are aggregated, so a single parameter is not sufficient to accurately identify a given facial type. This study was designed to identify & characterize the skeletal types that blend under the headline-'Cl III,deepbite'. Cephalograms of thirty-four untreated mixed dentition patients, selected mainly on the basis of clinical impression of Cl III with reduced lower face heights were studied. The following conclusion can be drawn. 1. Cl III malocclusion with reduced lower face height could be classified into three types. 2. Subtype 1 was identified by the following features : strong ramus, more anteriorly positioned upper molars without alveolar hypoplasia, acutely reduced Mn. plane angle. 3. Subtype 2 was characterized by a short ramus, sharply reduced postrior alveolar height, and normal Mn. plane angle. In general, this type had hypoplasia tendency in the vertical dimension. 4. In subtype 3, the AUFH occupying more percentage than ALFH was a outstanding feature. Ramal height was in normal range, alveolar hypoplasia and slightly reduced Mn. plane angle was observed. 5. The features of the subtypes were reflected in certain indices, which can be regarded as discriminative index. LAFH: if reduced, regardless of subtypes, indicates reduced lower ant. face height consistently. FHR: when this ratio is increased, it indicates subtype 1. FHI: when this ratio is in normal range, it indicates subtype 2. FPI: if reduced greatly, it indicates subtype 3.

• The korean journal of orthodontics
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• v.15 no.2
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• pp.229-237
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• 1985

The Purpose of this study was to investigate the differences in soft tissue characteristics according to the dental or skeletal dysplasia. For this purpose, lateral cephalogram of 153 children (Hellman dental age IIIB: control group 32, Angle CIII. div. 1 malocclusion group 55, Angle Cl III group 66) were traced and measured. For these measurements, following conclusions were made. 1. FH A, FH Sn, FH UL, AA' of the Class III group were thicker than those of the normal and Class II group, but FH B, FH LL, BB' of the Class III group were not significantly different from those of the normal group. 2. FH B, FH LL, BB' of the Class II group were thicker than those of the normal and Class III group, but FH A, FH Sn, FH UL, AA' of the Class II group were not significantly different from those of the noraml group. 3. Ans-Sn, FH P were not significantly different in three groups, while PP' of the Class III group was thicker than those of the other groups. 4. The lower lips of the Class II group were more anterioly everted with respect to the lower incisor inclination than those of the other groups. 5. The severity of skeletal dysplasia was partly camouflaged by the soft tissue.

• The korean journal of orthodontics
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• v.27 no.3 s.62
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• pp.473-479
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• 1997

This author tried to find if the size of the frontal sinus can be used as a diagnostic aid to predict the manldibular growth pattern in growing Patients in lateral cephalogram utilizing the fact the the frontal sinus completes its growth in earlier stage but the mandible continues to grow until later. At this study, the 228 samples were divided into 3 groups as skeletal Class I, II, III malocclusions and three indicies(ANB, APDI, Wits) were measured which indicate the mandibular body length and the antero-posterior relationship of maxilla and mandible to evaluate their relations with frontal sinus. And results were obtained as followings 1. The size of frontal sinus is highly related to ANB, APDI, Wits and mandilar body length.(p<0.001) 2. the size of the frontal sinus of the Cl III malocclusion group was on the lateral cephalogram larger than Cl I and Cl II group.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.628-635
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• 2000

The purpose of this study was to evaluate the result after 2-phase surgical-orthodontic treatment without preoperative orthodontic treatment for the skeletal Cl III malocclusion patient and to obtain an adequate protocol on the bases of this result. This retrospective study of ten patients who underwent 2-phase treatment were done to evaluate 1) the surgical stability and relapse pattern 2) the facial esthetics 3) the TMJ problem 4) the total time of the treatment. Results were followed : 1) The horizontal relapse of the mandible was 26.8% and didn't show significant differences compared to the conventional 3-phase treatment. But, it was considered that this amount of relapse was the sum of true relapse and autoratation of mandible due to decreased vertical dimension during orthodontic treatment. 2) It was estimated that there's no difference on the ratio of anterior facial height between the subjects and the normal patients. On the horizontal analysis, the mandible of the subjects was located more anteriorly than that of the normal patients. This result showed that there was a need for the accurate preoperative esthetic evaluation and the additional methods for reducing the relapse due to the occlusal interference. 3) Wide variation was noted on the TMJ symptoms of the subjects, however, it was estimated that there's no significant differencees of symptoms compared to that of the conventional 3-phase treatment on literatures. 4) The average of the overall period of treatment was 20.8 months and we obtained reduction of the treatment time compaired to 3-phase treatment on many literatures. Most of the results of this study were similar to the findings of the 3-phase treatment(preoperative orthodontic-orthognathic surgery-postoperative orthodontic), but total time of the treatment was shorter in patients with 2-phase treatment than in those with the conventional 3-phase treatment. With 2-phase treatment, we experienced many advantages compared to the conventional method considering that it was favarable conditions for the teeth, it had the flexibility for the treatment, and it could be the adequate treatment approach for the stomatognathic system. Although this retrospective pilot study had some limitations, due to small samples, the authors would hope that it could serve as a guide for the future researches, and the clinical applications.

• The korean journal of orthodontics
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• v.15 no.1
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• pp.43-54
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• 1985

Recently, rapid palatal expansion technique is widely used for the correction of the skeletal imbalance in Cl III malocclusion patients. There were many studies about the cephalometric changes to rapid palatal expansion but quantitative analysis were small. The purpose of this study was to analysis the stresses and displacement of the maxilla in human dry skull to rapid palatal expansion. The results were as follows: 1. The anterior portion of palate show more lateral and inferior displacement than the posterior portion. But the posterior portion show more anterior displacement. 2. In transpalatal suture area, the medial portion show more anterior and inferior displacement than the lateral portion. But the lateral portion show more lateral displacement than the medial portion. 3. In mid-sagittal plane, the lower portion (palatal area) of maxilla show more anterior, lateral, inferior displacement than the upper portion (frontamaxillary stuture area). 4. In zygomatic arch, the adjacent area to maxilla show tonsil. stresses and the adjacent area to frontal bone show compressive stresses. 5. The sequence of stress bearing area to R.P.E. is upper retromolar area, upper 1st molar, 1st premolar, 2nd premolar, anterior segment of teeth.

• The korean journal of orthodontics
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• v.32 no.6 s.95
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• pp.413-424
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• 2002

Preadolescent children with deficient maxillae are suitable candidates for the maxillary protraction appliance(MPA). The theoretical effect of the MPA is protraction or anterior displacement of the maxilla. However, it is known that complex effects such as anterior displacement of the maxillary teeth, downward and backward rotation of the mandible, linguoversion of the mandibular anterior incisors, are known to play a role in improving the Cl III malocclusion. There have been much studies with regard to maxillary protraction, but the different effects of MPAs depending on the vertical facial pattern are not known precisely. This study was based on 67 patients (31 males, 36 females) aged from 6 years 6 months to 13 years 3months, who visited the Dept. of Orthodontics at Yonsei Univ., Dental Hospital and diagnosed as skeletal Class III with maxillary deficiency. They were divided into 3 groups (low, average, high angle groups) depending on genial angle and the SNMP (Go-Gn) angle, respectively. Pretreatment and post-treatment lateral cephalograms were used to compare the effects of MPA and the following conclusions were obtained: 1) A significantly large amount of backward movement of the B point was observed in patients with a low SNMP angle. Those with a high SNMP angle had significant forward movement at A point. 2) The patients with low genial angle had the least forward movement at the A point, and those with a high angle had more forward movement. 3) In comparing the arcTan of the A point, the high angle group showed more horizontal movement while the low angle group showed more vertical movement. 4) There was no significance between the treatment duration of the SNMP and the Genial angle groups.

• The korean journal of orthodontics
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• v.30 no.2 s.79
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• pp.235-243
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• 2000

Magnetic resonance imaging(MRI) of the temporomandibular joint(TMJ) is very useful method to diagnose internal derangement of the TMJ because of its high specificity foy identification of condyle-disc relationships. The purpose of this study was to evaluate the existence, incidence and severity o』 internal derangement o』 the TMJ by the MRI of Patients who are suspected to have TMJ disorder. MRI sample was composed of 50 subjects(10 males, 40 females) and the mean age was 22.9 years. 43 subjects of the sample were found to have positive findings. $56\%$ of the subjects with positive findings had ADD(anterior disc displacement) without reduction, and $65\%$ had internal derangement of bilateral joints. Distributions in the types of malocclusion in patients with positive findings, the Angle's classification had shown : the largest $41.9\%$ for Cl II ($39.6\%$ for Cl II div 1 and $2.3\%$ for Cl II div 2), $37.2\%$ for Cl I, $18.6\%$ for Cl III, and $2.3\%$ for the unidentified. $8.6\%$ of the subjects with positive findings had facial asymmetry and $55.8\%$ had openbite. We can conclude that the percentage of Cl II is the highest in patients with internal derangement of the TMJ. Openbite or facial asymmetry is considered to be uncompensated or compensated deformity which results from facial skeleton remodeling in the process of degenerative joint disease(DJD) due to TMJ degeneration. Therefore it is recommended to screen the patients with facial asymmetry or openbite by MRI before the beginning of orthodontic treatment. Differential diagnosis is essential because the tendency of relapse is high after the orthodontic treatment and continuous observation of TMJ is needed in patients with TMJ disorder.