• 대한치과교정학회지
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• 제28권1호
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• pp.113-122
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• 1998

본 연구는 조선대학교 부속 치과병원 교정과에 내원하여 교정치료를 시행하고 있는 환자중 Panadent 교합기 및 condylar position indicator(CPI)를 이용하여 중심위-중심교합 편위양을 측정한 결과, 전후방 및 수직적 편위양이 1.00mm이내, 측방편위양이 0.30mm 이내인 정상범주를 넘는 부정교합 환자 47명을 대상으로 하여 3개월간 교합안정장치를 24시간 장착하고, CPI 및 transcranial projection을 이용하여 교합안정장치 장착전과 장착후의 하악과두의 위치변화를 관찰한 결과 다음과 같은 결론을 얻었다. 1. CPI상의 모든 군에서 중심교합-중심위 사이에 통계적인 유의성이 있었다(p<0.001). 2. transcranial projection상의 superior joint space의 Rt와 Lt+Rt/2에서 중심교합-중심위 사이에 통계적인 유의성이 있었다(p<0.05). 3. CPI상의 모든 superior-inferior components군에서 교합안정장치 사용 전, 후의 중심교합-중심위 사이에 통계적인 유의성이 있었다(p<0.01). 4. transcranial projection상의 superior joint space의 Rt를 제외한 모든 군에서 교합안정장치 사용 전, 후의 중심교합-중심위 사이에 통계적인 유의성이 없었다. 이상의 결론을 종합해 볼 때 중심교합-중심위 사이의 변화를 평가하는데는 transcranial projection보다 CPI가 보다 유용하며, 교합안정장치는 하악과두의 전, 후방적 위치변화보다는 수직적 위치변화에 미치는 영향이 보다 큰 것으로 보인다.

• Journal of Oral Medicine and Pain
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• 제14권1호
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• pp.57-66
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• 1989

66 patients with temporomandibular disorders were selected for experimental group, and 45 normal subjects who were Dental students were selected for control group. Average age of experimental group was 30.5 years, Male to Female ratio was 2 : 3, and their age distribution were teen-ages to seventh decades. Transcranial radiography (TR) with Denar Accurad 100 was used for each group to get the values of width in joint spaces and to investigate the bony changes of articular surfaces and relative condylar position to articular fossa. In addition to TR, clinical interview and routine charting about amount of mandibular movements and occlusal variations were carried out in experimental group. The obtained results were as follows : 1. The mean values of joint space with in control group were 2.15mm to anterior, 2.98mm to superior and 2.29mm to posterior and the value of relative condylar position to the deepest portion of articular fossa was 0.21mm to anterior. In experimental group, those values were 2.01mm, 2.14mm 2.22mm and 0.12mm to posterior in sequence, respectively. Joint spaces in experimental group, therefore, were inclined to decreased, and relative condylar position was inclined to retrude. Joint space in control group showed symmetric condylar position, but in experimental group showed asymmetry. 2. Non-affected joints with no bony changes in experimental group showed the narrowest joint spaces which were thought to manifest the abnormal stress to non-affected side to dysfunctional state of contralateral affected joints. 3. Amount of mandibular movements in experimental group were within normal values in lateral movements and in protrusive movement but in opening movement with or without passive stretch, those were lower than normal values. Frequency of occlusal variation, for example, protrusive posterior contacts, open bite, median line shift to lateral side were inclined to increase with bony changes and with crepitus.

• The Journal of Advanced Prosthodontics
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• 제10권6호
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• pp.401-407
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• 2018

PURPOSE. When performing an occlusal procedure, it is recommended that the patient should be sitting straight with the head in a natural position. An inappropriate mandibular position caused by an incorrect occlusal record registration or occlusal adjustment can result in damaged teeth and cause functional disorders in muscles and temporomandibular joints. The purpose of this study was to clarify the influence of horizontal cephalic rotation on mandibular position by investigating the three-dimensional positions of condylar and incisal points. MATERIALS AND METHODS. A three-dimensional jaw movement measurement device with six degrees of freedom (the WinJaw System) was used to measure condylar and incisal points. The subjects were asked to sit straight with the head in a natural position. The subjects were then instructed to rotate their head horizontally $0^{\circ}$, $10^{\circ}$, $20^{\circ}$, $30^{\circ}$, $40^{\circ}$, $50^{\circ}$and $60^{\circ}$ in the right or left direction. RESULTS. The results indicated that horizontal cephalic rotation made the condyle on the rotating side shift forward, downward, and toward the inside, and the condyle on the counter rotating side shift backward, upward, and toward the outside. Significant differences in deviations were found for angles of rotation higher than $20^{\circ}$. The incisal point shifted in the forward and counterrotating directions, and significant differences were found for angles of rotation higher than $20^{\circ}$. CONCLUSION. The mandibular position was altered by horizontal cephalic rotations of more than $20^{\circ}$. It is essential to consider the possibility of deviation of the mandibular position during occlusal procedures.

• 대한치과보철학회지
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• 제29권2호
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• pp.295-317
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• 1991

The discrepancy between centric relation and centric occlusion have a great role on the successful prosthodontic and occlusal treatment. This study was performed to investigate the effect of the discrepancy between centric relation and centric occlusion on condylar guidance inclination and Bennett shift (immediate and progressive side shift). Sixteen adults who have physiologically normal occlusion and are free of TMJ dysfunction were selected. The amount of the sagittal CR-CO discrepancy in lower anterior incisor was obtained by Saphon Visi-Trainer. The amount of the CR-CO discrepancy in condylar level was measured on the individualized corrected tomography. Pantronic survey was performed by using a arbitrary hinge axis according to manufacturer's direction. All subjects were divided into two groups, group I (small) and group II (large), according to the amount of CR-CO discrepancy. At first the amount of the CR-CO discrepancy in condylar level between two groups was compared and then the condylar guidance inclination and Bennett shift between two groups were compared and analyzed. The results were as follows; 1. The average CR-CO discrepancy in lower anterior incisors was 0.7mm superoinferiorly, 0.49mm anteroposteriorly, and 0.88 mm in total. The average CR-CO discrepancy in condylar level was 0.43mm. 2. The CR-CO discrepancy measured on teeth level and condylar level were highly correlated (p<0.01). 3. The correlation of the condylar position in the glenoid fossa between two groups was not statistically significant. 4. The large CR-CO discrepancy group showed greater amount of Bennett shift and condylar guidance inclination, but there is no statistical significancy. 5. It seems that the CR-CO discrepancy have greater effect on progressive side shift than other elements of mandibular movements.

• Archives of Plastic Surgery
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• 제44권1호
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• pp.19-25
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• 2017

Background Numerous condylar repositioning methods have been reported. However, most of them are 2-dimensional or are complex procedures that require a longer operation time and a highly trained surgeon. This study aims to introduce a new technique using a condylar repositioning plate and a centric relation splint to achieve a centric relationship. Methods We evaluated 387 patients who had undergone surgery for skeletal jaw deformities. During the operation, a centric relation splint, intermediate splint, final centric occlusion splint, and condylar repositioning plate along with an L-type mini-plate for LeFort I osteotomy or a bicortical screw for bilateral sagittal split ramus osteotomy were utilized for rigid fixation. The evaluation included: a physical examination to detect preoperative and postoperative temporomandibular joint dysfunction, 3-dimensional computed tomography and oblique transcranial temporomandibular joint radiography to measure 3-dimensional condylar head movement, and posteroanterior and lateral cephalometric radiography to measure the preoperative and postoperative movement of the bony segment and relapse rate. Results A 0.3% relapse rate was observed in the coronal plane, and a 2.8% relapse rate in the sagittal plane, which is indistinguishable from the dental relapse rate in orthodontic treatment. The condylar repositioning plate could not fully prevent movement of the condylar head, but the relapse rate was minimal, implying that the movement of the condylar head was within tolerable limits. Conclusions Our condylar repositioning method using a centric relation splint and miniplate in orthognathic surgery was found to be simple and effective for patients suffering from skeletal jaw deformities.

• Imaging Science in Dentistry
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• 제37권1호
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• pp.19-26
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• 2007

Purpose : To examine whether the maxillofacial skeletal morphology correlates with the condylar position and the anatomic characteristics of articular eminence using measurements of lateral cephalometric radiographs and individualized sagittal temporomandibular joint (TMJ) tomographs. Materials and Methods : I compared measurements of 202 TMJs of 101 orthodontic patients of Kangnung National University Dental Hospital. 1 used Pearson's correlation for comparison of the measuring values in lateral cephalometric radiographs and individualized sagittal TMJ tomographs. Results : Large occlusal plane angle tendency showed decreased width of posterior eminence slope, decreased depth of articular fossa and decreased posterior slope angle of eminence. Large mandibular plane angle tendency showed decreased superior joint space, decreased depth of articular fossa and decreased posterior slope angle of eminence. Large genial angle tendency showed decreased depth of articular fossa, decreased posterior slope angle of eminence and anterior position of condylar head. Large anterior facial height and large posterior facial height tendency showed increased width of posterior slope of eminence, increased depth of articular fossa, increased posterior slope angle of eminence and posterior position of condylar head. Conclusion : Maxillofacial skeletal morphology has correlation with the anatomic characteristics of TMJ. Individualized sagittal TMJ tomographs can provide useful information for anatomical analysis of TMJ.

• The Journal of Advanced Prosthodontics
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• 제3권1호
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• pp.51-55
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• 2011

BACKGROUND. Mandibular displacement is a common complication of condylar fracture. In the mandibular displacement due to condylar fracture, it is difficult to restore both esthetics and function without using orthognathic surgery. CASE DESCRIPTION. This clinical report described a full mouth rehabilitation in the patient with bilateral condylar fractures and displaced mandible using bilateral sagittal split ramus osteotomy (BSSRO) and simultaneous dental implant surgery. Mandibular position was determined by model surgery through the diagnostic wax up and restoration of fractured teeth. The precise amount of the mandibular shift can be obtained from the ideal intercuspation of remaining teeth. CLINICAL IMPLICATION. Mandibular displacement by both condylar fractures can be successfully treated by orthognathic surgery. Determination of occlusal plane and visualization from diagnostic wax up are mandatory for mandibular repositioning of model surgery. Stable occlusion and regular recall check up are needed for long-term outcome.

• 치과방사선
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• 제22권2호
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• pp.351-364
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• 1992

Internal derangement of the temporomandibular joint can be defined an abnormal relationships of the meniscus relative to the mandibular condyle, articuar fossa and eminence. This may cause variable mandibular dysfunctions and pain. For diagnosis, arthrography, computed tomography and magnetic resonance imaging are used. In this study, the author reviewed 98 TMJs of 88 patients who were diagnosed as internal derangement througth inferior joint space arthrography at the department of Oral & Maxillofacial Radiology, Dental Hospita, Dankook university through 1986 to 1992. 98 TMJs consisting of 30 disc displcement with reduction, 48 disc displcement without reduction and 20 perforation were studied about clinical and radiological findings. The results were as follows: 1. Internal derangement was found most frequently in the 2nd 3rd decades and the average age of perforation was higher than that of disc displcement with higher than that of disc displcement with reduction. The sexual predilection was 2 times hiher in females. 2. The most frequent chief complaints were TMJ sound in disc displcement with reduction, pain and limitation of mouth opening in disc displcement without reduction and pain in perforation. The duration of the chief complaints was longer in disc displcement with reduction with than in preforation and disc displcement without reduction. 3. Reciprocal click was the most frequently TMJ sound in disc displcement with reduction. History of joint sound in disc displcement without reduction an crepitus in perforation was the most frequent one. 4. The average maximum opening was 45.4㎜ in disc displcement with reduction, 31.4㎜ in disc displcement without reduction and 33.8㎜ in perforation. 5. In the centric occlusion, posterior condylar position was the most frequent in disc displcement with reduction. posterior and concentric condylar position was frequent in disc displcement without reduction, concentric and anterior condylar position in perforation. At 1 inch opening, the same position to articular eminence was most frequently found in disc displcement with reduction, posterior position in disc disp1cement without reduction, posterior and nterior position in perforation was frequently found. 6. Bony changes, especially sclerosis and flattening, was most frequently found in perforation.

• 대한치과교정학회지
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• 제47권5호
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• pp.277-288
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• 2017

Objective: Treating Class II subdivision malocclusion with asymmetry has been a challenge for orthodontists because of the complicated characteristics of asymmetry. This study aimed to explore the characteristics of dental and skeletal asymmetry in Class II subdivision malocclusion, and to assess the relationship between the condyle-glenoid fossa and first molar. Methods: Cone-beam computed tomographic images of 32 patients with Class II subdivision malocclusion were three-dimensionally reconstructed using the Mimics software. Forty-five anatomic landmarks on the reconstructed structures were selected and 27 linear and angular measurements were performed. Paired-samples t-tests were used to compare the average differences between the Class I and Class II sides; Pearson correlation coefficient (r) was used for analyzing the linear association. Results: The faciolingual crown angulation of the mandibular first molar (p < 0.05), sagittal position of the maxillary and mandibular first molars (p < 0.01), condylar head height (p < 0.01), condylar process height (p < 0.05), and angle of the posterior wall of the articular tubercle and coronal position of the glenoid fossa (p < 0.01) were significantly different between the two sides. The morphology and position of the condyle-glenoid fossa significantly correlated with the three-dimensional changes in the first molar. Conclusions: Asymmetry in the sagittal position of the maxillary and mandibular first molars between the two sides and significant lingual inclination of the mandibular first molar on the Class II side were the dental characteristics of Class II subdivision malocclusion. Condylar morphology and glenoid fossa position asymmetries were the major components of skeletal asymmetry and were well correlated with the three-dimensional position of the first molar.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권1호
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• pp.29-34
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• 1999

Special attention should be directed toward the preservation of preoperative condylar position during orthognathic surgery because their positional change may leads to postoperative skeletal relapse as well as TM joint problem. Various condylar positioning devices, therefore, have been introduced and utilized in orthognathic surgery. Even though most of them provided us with improvement of surgical results, we also found some problems including limited indication, etc. For more accurately repositioning the maxilla and the mandible and its wide versatility, a newly designed maxilla and condylar positioning device based on the fixed part of cranium is introduced.