• Title/Summary/Keyword: Class III treatment

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Prosthetic rehabilitation in a Class III malocclusion patient with increasing occlusal vertical dimension (3급 부정교합 환자의 교합수직고경 증가를 동반한 보철 수복)

  • Ha-Eun Choi;Han-Sol Song;Kyung-Ho Ko;Yoon-Hyuk Huh;Chan-Jin Park;Lee-Ra Cho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.3
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    • pp.133-145
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    • 2023
  • Class III malocclusion with mandibular protrusion can be divided into skeletal and pseudo malocclusion due to tooth displacement. For skeletal malocclusion, favorable treatment results can be obtained by establishing an appropriate vertical and horizontal intermaxillary relationship in order to secure a restoration space and obtain aesthetic and functional results. In this case, complete mouth rehabilitation was performed using an implant and a fixed prosthesis in a patient with mandibular protrusion and anterior teeth wear and reduced occlusal vertical dimension. After cast analysis and digital diagnosis, a provisional restoration with increased vertical dimension was fabricated to secure posterior support and evaluate stable centric occlusion. With the definitive prosthesis reflecting the provisional restoration, favorable function and aesthetics were obtained.

Clinical Results alter Pulmonary Endarterectomy as a Curative Surgical Method in Chronic Thromboembolic Pulmonary Hypertension: an Approach to Operative Classification of Thromboembolic Disease (만성 폐동맥 색전증의 치료로서 내막제거술의 임상적 결과: 색전증 분류에 따른 접근)

  • Lim, Ju-Yong;Lee, Jae-Won;Kim, Jeong-Won;Jung, Sung-Ho;Je, Hyoung-Gon;Song, Hyun;Chung, Cheol-Hyun;Choo, Suk-Jung
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.591-597
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    • 2008
  • Background: Pulmonary endarterectomy is widely accepted as a treatment for chronic thromboembolic pulmonary hypertension. Based on our experiences, we sought to find ways to reduce perioperative complications and to improve surgical outcomes in patients undergoing pulmonary endarterectomy. Material and Method: This study was designed as a retrospective analysis of 20 patients with pulmonary hypertension who underwent pulmonary endarterectomy between January 1998 and March 2008. All patients presented with chronic dyspnea. Deep vein thrombosis (DVT) was the major cause of chronic pulmonary thromboembolism (55%). Seventeen patients (85%) underwent inferior vena cava (IVC) filter placement. Thirteen patients underwent surgery under total circulatory arrest, while the others underwent surgery while on low flow cardiopulmonary bypass. Concomitant tricuspid annuloplasty was done in 6 patients (66%) whose tricuspid regurgitation was as severe as grade IV/IV. The mean follow-up duration was $45{\pm}32$ months. Result: Using of University of California, San Diego (UCSD), thromboembolism classification, 4 patients (20%) were type 1, 8 patients (40%) were type II, and 8 patients (40%) were type III. Right ventricular systolic pressure was reduced significantly from $77{\pm}29$ mmHg to $37{\pm}19$ mmHg after pulmonary endarterectomy (p<0.001). The degree of tricuspid regurgitation and the NYHA functional class were all improved postoperatively. Reperfusion edema occurred in 7 cases (35%). The incidence of reperfusion edema was higher in the UCSD type III group than in the other group (25% vs 50%, p=0.25) and the length of postoperative intensive care unit stay was longer in type III group ($5{\pm}2$ days vs $9{\pm}7$ days, p=0.07). The early mortality rate was 10%, and the late mortality rate was 15% (n=3); one death was due to progression of underlying non-Hodgkin's lymphoma, and the other deaths were related to recurrent thromboembolism and persistent pulmonary hypertension, respectively. Conclusion: Pulmonary endarterectomy, as a curative surgical method for treating chronic thromboernbolic pulmonary hypertension, should be performed aggressively in patients diagnosed with chronic thromboembolic pulmonary hypertension, and an effort should be made to reduce the frequency of perioperative complications and to improve surgical outcomes.

The effect of treatment timing on maxillary protraction treatment response - A comparison of prepubertal and pubertal patients (치료시기에 따른 상악골 전방견인효과 - 사춘기전과 사춘기의 비교)

  • Kim, Kyung-Ho;Choy, Kwang-Chul;Baik, Hyoung-Seon;Lee, Ji-Hyun
    • The korean journal of orthodontics
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    • v.32 no.5 s.94
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    • pp.301-312
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    • 2002
  • Treatment timing is a very important factor to consider in treating skeletal Class III patients by means of maxillary protraction. According to the literature maxillary Protraction should be carried out at an early age before puberty. However, no scientific data were presented to support this statement and recent studies supported by statistical data showed disagreement concerning the optimum treatment time of maxillary protraction. Therefore, there is no agreement about the optimum treatment time of maxillary protraction. In this study hand-wrist X-rays were taken from 119 patients and subjects were grouped into prepubertal and pubertal group according to their skeletal maturity. Pretreatment and posttreatment lateral cephalometric X-rays were taken and treatment effects were compared. The average treatment time was 6.5 months for the prepubertal group and 6.1 months for the pubertal group. The obtained results were as follows ; 1. The amount of maxillary forward movement was the same for Pretreatment and pubertal group. 2. The amount of maxillary downward movement was the same for prepubertal and pubertal group. 3. The amount of mandibular downward and backward rotational movement was the same for prepubertal and pubertal group. 4. Dental effects were the same for prepubertal and pubertal group.

Using 3-dimensional digital smile design in esthetic restoration of anterior teeth: A case report (3차원 Digital Smile Design을 활용한 전치부 심미수복 증례)

  • Hong, Sungman;Lee, Younghoo;Hong, Seoung-Jin;Paek, Janghyun;Noh, Kwantae;Pae, Ahran;Kim, Hyeong-Seob;Kwon, Kung-Rock
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.451-458
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    • 2021
  • Currently, digital technology is being used in various fields of dental treatment. In particular, in the case of anterior esthetic restoration, the traditional restoration method cannot contain facial information and it is difficult for the patient to predict the treatment result. However, in the case of esthetic restoration through digital design, the visualization of the prosthesis design and the ease of reflecting patient feedback, and expecting the treatment result is available. In this case, the patient confirmed the results of restoration treatment using a digital method before treatment and obtained consent for treatment in an anterior tooth trauma patient. In addition, since the conventional digital smile design method uses only the patient's facial and smile information, the design was made on a two-dimensional plane, and its application was somewhat limited. However, in this case, a three-dimensional virtual patient was created and thus the designed restoration was viewed from various angles. Through this case, it was possible to obtain a high degree of satisfaction with the ease of communication with the patient and the technician during the esthetic restoration using the digital method, the simplicity of the procedure, and the treatment result.

Current trends in orthodontic patients in Seoul National University Dental Hospital (서울대학교 치과병원 교정과에 내원한 부정교합 환자의 최근 경향)

  • Im, Dong-Hyuk;Kim, Tae-Woo;Nahm, Dong-Seok;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.33 no.1 s.96
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    • pp.63-72
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    • 2003
  • Over the Past decades, the number of Patients seeking orthodontic treatment has increased markedly with socioeconomic development and change of recognition on appearance. The purpose of this study was to provide an epidemiologic data base related to the orthodontic treatment need. We could take an adequate information regarding the characteristics of orthodontic patients, and the changing trends about treatment mordality. Distrubution and treands were Investigated in 676 patients who had been examined and diagnosed at Department of orthodontics, Dental Hospital, Seoul National University from January to June in 1992 and 2002. 1. Sex distribution of patients changed from 1:2.1 to 1:1.5 (male female). 2. In 2002, are distribution had shown $7\~12$ year-old group being the largest$(32.0\%)$ and percentage of $19\~24,\;13\~18,\;over\;25,\;4\~6,\;0\~3$ year-old group were $24.0\%,\;21.6\%,\;14.2\%,\;5.8\%,\;2.4\%$ respctively. Compared with data in 1992, the number of adult patients highly increased. 3. With regard to Angle classification, each percentage of Class I, Class II div 1, Class II div 2, and Class III malocclusion were $25.0\%,\;20.9\%,\;3.4\%,\;and\;48.1\%$ respectively in 2002. 4. Geographic distribution showed that most of the patients visited $(37.0\%)$ lived in northeast of Seoul in 2002. 5. Mandibular prognathism showed the highest percentage in chief complaints. The percentages of crowding and facial asymmetry were $14.2\%\;and\;11.8\%$ in 2002. Patients with facial asymmetry increased significantly. 6. Percentages of patients treated with fixed appliance and orthognathic surgery were $38.0\%\;and\;25.0\%$ in 2002. Patients needed to observe the growth pattern comprised $13.0\%$ with increasing trends. The use of chin cap reduced and the percentage of ortognathic surgery and growth observation increased significantly.

The Effects of the Group Reward and Cooperative Skill Training on the Science Achievement and Learning Motivation of Elementary Students (집단보상과 협동기술 훈련이 초등학생의 과학성취도와 학습동기에 미치는 효과)

  • Park, Soo-Kyong
    • Journal of the Korean earth science society
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    • v.27 no.2
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    • pp.121-129
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    • 2006
  • The purpose of this study was to investigate the effects of the group reward and cooperative skill training on science achievement and learning motivation of elementary students. 3 classes of the 6th grade students were selected from an elementary school in Busan. Group I took traditional cooperative learning (TCL), group II took cooperative learning with competitive group reward (GR), and group III was trained in cooperative skill (CS) before cooperative learning. Students were taught about 'weather forecast' for thirteen periods and problem-based learning steps were applied in each class. The results from this study were as follows: First, there was an interactive effect between the treatment and achievement level in the science achievement test scores. In the case of high-level students the group reward was more effective than cooperative skill training on the science achievement; on the other hand, in the case of low-level students the cooperative skill training was more effective than the group reward on the science achievement. Second, there was no interactive effect between the treatment and achievement level in the motivation scores.

The Retrospective Study of Closed Reduction of Nasal Bone Fracture

  • Park, Han-Kyul;Lee, Jae-Yeol;Song, Jae-Min;Kim, Tae-Seup;Shin, Sang-Hun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.6
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    • pp.266-272
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    • 2014
  • Purpose: This study was conducted in order to investigate the therapeutic effect of closed reduction according to a classification in patients with nasal bone fracture. Methods: The study was conducted retrospectively on 186 patients with a mean age of 38 years (range: 7 to 80 years). All patients were diagnosed by clinical and radiologic examination, and then classified according to Hwang's classification by computed tomography. The patients were further classified by their age, gender, causes of fracture, operation timing after fracture, concurrent facial bone fracture, and complications. All patients underwent the same reduction and treatment protocol and were then followed up regularly for at least three months. Results: The cause of the fracture was slip down, and the highest prevalence was shown in the 20s. The mean operation timing after fracture was 4.1 days (range: 1 to 14 days), and it tended to be longer in the case of defected septal bone or more severe fracture. The most common concurrent facial bone fracture was orbital blow-out fracture, and zygomaticomaxillary complex and maxillary fracture occured frequently. The largest number of complications occurred in class III and IIBs patients, and the main complication was postoperative pain. Conclusion: Results of nasal bone closed reduction on the 186 patients showed that serious complications rarely occurred. Closed reduction is generally an effective treatment for nasal bone fracture. However, in the case of severe concurrent septal bone fracture or comminuted fracture with depression, open reduction should be considered. Further study with a larger number of patients and further classification is required.

Surgical and Orthognathic Treatment of Skeletal Class III Featuring Severe Transversal and Sagittal Discrepancy: A Case Report (심한 상하악 치열궁 부조화 환자의 수술적 해결: 증례보고)

  • Ryu, Kyung-Sun;Lee, Baek-Soo;Kim, Yeo-Gab;Kwon, Yong-Dae;Choi, Byung-Joon;Ohe, Joo-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.2
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    • pp.124-129
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    • 2013
  • Multiple segment osteotomy orthognathic surgery serves to combine the total or segmental maxillary and mandibular correction of the dentofacial deformities with concurrent procedures to provide immediate repositioning to the dento-osseous elements. In addition, splitting the palate may often be necessary to correct a functionally poor relationship of the maxilla to the mandible or the facial skeleton by realigning the maxillary arch. In this case, the discrepancy in a bimaxillary horizontal relationship and the space between the 2nd premolar and 2nd molar was retained after lengthy preoperative orthodontic treatment. However, we could correct these dento-osseous discrepancies immediately by performing midpalatal expansion, anterior segmental osteotomy and symphyseal osteotomy with bimaxillary osteotomies. If the blood supply to each segment segments was maintained and primary closure of the operation site was feasible, multiple segment osteotomy was considered as a very effective technique for treating dentofacial deformities in vertical, transverse, and sagittal dimensions with differential repositioning of all segments.

CHANGES IN GONIAL ANGLE AND MANDIBULAR WIDTH AFTER ORTHOGNATHIC SURGERY IN MANDIBULAR PROGNATHIC PATIENTS (하악전돌증 환자에서 악교정수술 후 하악각 및 하악폭경의 변화)

  • Kim, In-Ho;Han, Chang-Hun;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.2
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    • pp.129-137
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    • 2006
  • The treatment plan for orthognathic surgery must be based on accurate predictions, and this can be produced the most esthetic, functional and stable results. The purpose of this study was aimed to evaluate the amount and interrelationship of the gonial angle and the mandibular width change after the mandibular setback surgery in the mandibular prognathic patients. Twenty patients were selected who received orthognathic surgery after presurgical orthodontic treatment. The patients with skeletal and dental Class III malocclusion were operated upon with bilateral sagittal split ramus osteotomy and mandibular setback. The lateral and posteroanterior cephalometric radiographs were taken preoperatively, postoperative 1 day and 12 months later after the orthognathic surgery, and then the gonial angle and mandibular width were measured. The computerized statistical analysis was carried out with SPSS/PC program. The gonial angle at postoperative 1 day was decreased about $5.3^{\circ}$ than preoperative value and the gonial angle at postoperative 12 months was increased about $1.4^{\circ}$ than postoperative 1 day. So the gonial angle at postoperative 12 months was decreased about $3.9^{\circ}$ than preoperative value. The mean preoperative gonial angle was $125.35^{\circ}{\pm}7.36$, showing significantly high value than normal and mean gonial angle at postoperative 12 months was $121.45^{\circ}{\pm}6.81$, showing value near to normal. The mandibular width at postoperative 1 day was decreased about 1.1 mm than preoperative value and the mandibular width at postoperative 12 months was more decreased about 1.7 mm than postoperative 1 day. So the mandibular width at postoperative 12 months was decreased about 2.8 mm than preoperative value. These results indicate that sagittal split ramus osteotomy in mandibular prognathic patients with high gonial angle is effective to improvement of gonial angle. It is considered to be helpful for maintenance of postoperative stable gonial angle area that detailed postoperative care and follow-up.

Root proximity of the anchoring miniscrews of orthodontic miniplates in the mandibular incisal area: Cone-beam computed tomographic analysis

  • Jeong, Do-Min;Oh, Song Hee;Choo, HyeRan;Choi, Yong-Suk;Kim, Seong-Hun;Lee, Jin-Suk;Hwang, Eui-Hwan
    • The korean journal of orthodontics
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    • v.51 no.4
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    • pp.231-240
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    • 2021
  • Objective: This outcome analysis study evaluated the actual positions of the orthodontic miniplate and miniplate anchoring screws (MPASs) and the risk factors affecting adjacent anatomic structures after miniplate placement in the mandibular incisal area. Methods: Cone-beam computed tomographic images of 97 orthodontic miniplates and their 194 MPASs (diameter, 1.5 mm; length, 4 mm) in patients whose miniplates provided sufficient clinical stability for orthodontic treatment were retrospectively reviewed. For evaluating the actual positions of the miniplates and analyzing the risk factors, including the effects on adjacent roots, MPAS placement height (PH), placement depth (PD), plate angle (PA), mental fossa angle (MA), and root proximity were assessed using the paired t-test, analysis of variance, and generalized linear model and regression analyses. Results: The mean PDs of MPASs at positions 1 (P1) and 2 (P2) were 2.01 mm and 2.23 mm, respectively. PA was significantly higher in the Class III malocclusion group than in the other groups. PH was positively correlated with MA and PD at P1. Of the 97 MPASs at P1, 49 were in the no-root area and 48 in the dentulous area; moreover, 19 showed a degree of root contact (19.6%) without root perforation. All MPASs at P2 were in the no-root area. Conclusions: Positioning the miniplate head approximately 1 mm lower than the mucogingival junction is highly likely to provide sufficient PH for the P1-MPASs to be placed in the no-root area.