Kim, Seung Hyun;Choi, Jun Ho;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
Archives of Craniofacial Surgery
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v.21
no.5
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pp.276-282
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2020
Background: Orbital fractures are the most common pediatric facial fractures. Treatment is conservative due to the anatomical differences that make children more resilient to severe displacement or orbital volume change than adults. Although rarely, extensive fractures may result in enophthalmos, causing cosmetic problems. We aimed to establish criteria for extensive fractures that may result in enophthalmos. Methods: We retrospectively reviewed the charts of patients aged 0-15 years diagnosed with orbital fractures in our hospital from January 2010 to February 2019. Computed tomography images were used to classify the fractures into linear, trapdoor, and open-door types, and to estimate the defect size. Data on enophthalmos severity (Hertel exophthalmometry results) and fracture pattern and size at the time of injury were obtained from patients who did not undergo surgery during the follow-up and were used to identify the surgical indications for pediatric orbital fractures. Results: A total of 305 pediatric patients with pure orbital fractures were included-257 males (84.3%), 48 females (15.7%); mean age, 12.01±2.99 years. The defect size (p=0.002) and fracture type (p=0.017) were identified as the variables affecting the enophthalmometric difference between the eyes of non-operated patients. In the linear regression analysis, the variable affecting the fracture size was open-door type fracture (p<0.001). Pearson's correlation analysis demonstrated a positive correlation between the enophthalmometric difference and the bony defect size (p=0.003). Using receiver operating characteristic curve analysis, a cutoff value of 1.81 ㎠ was obtained (sensitivity, 0.543; specificity, 0.724; p=0.002). Conclusion: The incidence of enophthalmos in pediatric pure orbital fractures was found to increase with fracture size, with an even higher incidence when open-door type fracture was a cofactor. In clinical settings, pediatric orbital fractures larger than 1.81 ㎠ may be considered as extensive fractures that can result in enophthalmos and consequent cosmetic problems.
Background: Craniofacial anatomic abnormalities related to structural narrowing of the upper airway have been reported in patients with obstructive sleep apnea syndrome. In this study, we evaluated the craniofacial anatomic characteristics of Korean patients with obstructive sleep apnea syndrome, and the role of cephalometric analysis in the prediction of abnormal breathing during sleep. Methods: Thirty-nine patients with obstructive sleep apnea syndrome(OSAS), 39 simple snorers(simple snorers) and 20 controls(control) had cephalometric analysis using the technique of Riley et al, and underwent standardized polysomnographic recordings. Different variables, including sex, body mass index, cephalometric and polysomnographic data, were statistically analyzed. Results: Pm-UPW and V-LPW distances were significantly shorter in OSAS when compared with simple snorers or control. PAS in simple snorers was shorter than in control. ANS-Gn distance in OSAS was significantly longer than in control. PNS-P distance in OSAS or simple snorers was significantly longer than in control. MP-H distance in OSAS was significantly longer than in simple snorers or control and MP-H distance in simple snorers was also longer than in control. NL/Pm-P angle in OSAS was lesser than in control. MP-H distance in OSAS or in the combined groups of OSAS and simple snorers was significantly correlated with apneahypopnea index(AHI). PNS-P distance in the combined groups of OSAS and simple snorers was correlated with AHI. In male of all subjects, body mass index was significantly correlated with PNS-P or MP-H distance. Conclusion: Cephalometric analysis can be useful tool in determining the craniofacial anatomic abnormalities in patients with obstructive sleep apnea syndrome. Cephalometric parameters, especially MP-H distance, can be useful for predicting frequency of narrowing or obstruction of upper airway during sleep.
Studies for diagnostic analysis using three-dimensional (3D) CT images are recently in progress and needs for 3D craniofacial analysis are increasing in the fields of orthodontics. It is especially essential to analyze the facial soft tissue after orthodontic treatment and orthognathic surgery. In this study 3D CT images of adults with normal occlusion were taken to analyze the facial soft tissue. Norms were obtained from CT images of adults with normal occlusion (12 males, 11 females) using a computer program named V works 4.0 program. 3D coordinate planes were established using soft tissue Nasion as the reference point and a total of 20 reproducible landmarks of facial soft tissue were obtained using the multiple reconstructive sectional images (axial, sagittal and coronal images) of the V works 4.0 program: soft tissue Nasion, Pronasale, Subnasale, Upper lip center, Lower lip center, soft tissue B, soft tissue Pogonion, soft tissue Menton, Endocanthion (Rt/Lt), Alare lateralis (Rt/Lt), Cheilion (Rt/Lt), soft tissue Gonion (Rt/Lt), Tragus (Rt/Lt), and Zygomatic point (Rt/Lt). According to the established landmarks and measuring method, the 3D CT images of adults with normal occlusion were measured and the normal positional measurements and their Net (${\delta}=\sqrt{{X^2}+{Y^2}+{Z^2}}$) values were obtained using V surgery program, In the linear measurement between landmarks, there was a significant difference between males and females except Na' -Sn and En(Rt)-En(Lt). The normal ranges of Na'-Zy, Na'-Ch and Na'-Go' (facial depth) were obtained, which was difficult to measure by two-dimensional (2D) cephalometric analysis and facial photographs. These data may be used as references for 3D diagnosis and treatment planning for patients with malocclusion and dentofacial deformity.
Background: Position of the facial foramina is important for regional block and for various maxillofacial surgical procedures. In this study, we report on anthropometry and morphology of these foramina using three-dimensional computed tomography (3D-CT) data. Methods: A retrospective review was performed for all patients who have undergone 3D-CT scan of the facial skeleton for reasons other than fracture or deformity of the facial skeleton. Anthropometry of the supraorbital, infraorbital, and mental foramina (SOF, IOF, MF) were described in relation to facial midline, inferior orbital margin, and inferior mandibular margin (FM, IOM, IMM). This data was analyzed according to sex and age. Additionally, infraorbital and mental foramen were classified into 5 positions based on the anatomic relationships to the nearest perpendicular dentition. Results: The review identified 137 patients meeting study criteria. Supraorbital foramina was more often in the shape of a foramen (62%) than that of a notch (38%). The supraorbital, infraorbital, and mental foramina were located 33.7 mm, 37.1 mm, and 33.7 mm away from the midline. The mean vertical distance between IOF and IOM was 13.4 mm. The mean distance between MF and IMM was 21.0 mm. The IOF and MF most commonly coincided with upper and lower second premolar dentition, respectively. Between the sex, the distance between MF and IMM was significantly higher for males than for female. In a correlation analysis, SOF-FM, IOF-FM and MF-FM values were significantly increased with age, but IOF-IOM values were significantly decreased with age. Conclusion: In the current study, we have reported anthropometric data concerning facial foramina in the Korean population, using a large-scale data analysis of three-dimensional computed tomography of facial skeletons. The correlations made respect to patient sex and age will provide help to operating surgeons when considering nerve blocks and periosteal dissections around the facial foramina.
Kim, Yo-Sook;Jung, Ae-Jin;Kang, Kyung-Wha;Kim, Sang-Cheol
The korean journal of orthodontics
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v.33
no.4
s.99
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pp.223-233
/
2003
The Purpose of this study was to Investigate the relationship between the space discrepancy of the mandibular dentition and craiofacial morphology in adults with good Angle class I occlusion. Dental casts of normal group, crowded group and spaced group were selected on the basis of dental crowding and spacing. Subjects with excessive space to accomodate the lower teeth were classified as spaced group(39). Subjects with a space discrepancy of more than 4mm were classified as crowded group(45). Normal subjects had little or no dental crowding and spacing(40). Various skeletodental measurements in lateral cephalograms were evaluated and compared by ANOVA, Pearson correlation analysis and multiple stepwise regression analysis. The results were as follows; 1. ANB angle was larger in crowded group than in spaced group. 2. Maxilla and mandible in crowded group were inclined more downward and forward than in spaced group, so crowded group was found to have vortical tendency. 3. Anterior cranial base length and mandibular body length were longer in spaced group than in crowded group. 4. According to the multiple stepwise regression analysis with space discrepancy as dependent variable, 40% of variance of space discrepancy could be explained by ANB angle, anterior facial height and ramus height. Multiple regression equation was as follows Space discrepancy=46.51-2.51ANB-0.58AFH+0.65RH
Nowrin, Shifat A;Jaafar, Saidi;Rahman, Norma Ab;Basri, Rehana;Alam, Mohammad Khursheed;Shahid, Fazal
The korean journal of orthodontics
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v.48
no.6
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pp.395-404
/
2018
Objective: To date, only a few studies have investigated the relationships between genetic polymorphisms and external apical root resorption (EARR). Hence, the aim of this systematic review was to explore the relationship between different gene polymorphisms and their association with EARR. Methods: A complete literature search was conducted by two independent reviewers. The PubMed, Science Direct, and Scopus databases were searched. In addition, the bibliographies of all textbooks and relevant articles were searched manually. A meta-analysis was performed using data entered into the electronic databases until February 28, 2017. Results: On the basis of the search, we identified 17 and 7 publications for the systematic review and meta-analysis, respectively. Odds ratio (OR) was used to evaluate the association of the interleukin 1B (+3954) polymorphism and the risk of EARR. The overall OR from the studies was used to estimate the risk of EARR. However, no association was found and no publication bias was apparent for the risk of EARR in patients receiving orthodontic treatment. Conclusions: More research on the relationship between gene polymorphism and EARR is necessary to determine better specificity of possible interactions.
This study was investigated to evaluate the morphologic characteristics of deepbite tendency as multiple factors. The subjects consisted of 60 control subjects(male 25, female 35) and 137 deephite patients(68 male, 69 female). The deepbite group was composed of 4 subgroups(Class I 44, Class II div. 1 40, Class II div. 2 13, Class III 40). The mean age was 21.57 year for the control group 21 year for deepbite group lateral cephalograph in centric occlusion were taken, traced, and digitized for each subject. The statistically computerized analysis was carried out with SAS program. The results were as follows ; 1. In deepbite group, saddle angle is lesser than that of normal group. 2. The vertical dysplasia is prominent on anterior lower face and is closely related with mandibular form and inclination. 3. Without consideration of sagittal relationship, the dental factors such as curve of Spee, interincisal angle, U1 to upper lip length were prominent in the deepbite group. 4. Although there were individual variances in the perioral soft tissue profile, the lip presented more protruded pattern. 5. There was no significant difference in hyoid bone position and inclination between normal and deepbite group. 6. The multivariate discriminant analysis between normal and Class I deepbite group showed that curve of Spee, AB-MP angle, interincisal angle, articular agnle were critical in the determination of deepbite as multiple factors.
Ossifying fibroma is a slow-growing benign neoplasm that occurs most often in the jaws, especially the mandible. The tumor is composed of bone that develops within fibrous connective tissue. Some ossifying fibromas consist of cementum-like calcifications, while others contain only bony material; however, a mixture of these calcification types is commonly seen in a single lesion. Of the craniofacial bones, the mandible is the most commonly involved site, with the lesion typically inferior to the premolars and molars. Ossifying fibroma of the jaw shows a female predominance. Some reports of ossifying fibroma have been published in the literature; however, this report continues the research on this topic by detailing 3 types of ossifying fibroma findings on panoramic radiographs and cone-beam computed tomographic images of 4 patients. The radiographs of the presented cases could help clinicians understand the variations in the radiographic appearance of this lesion.
Cephalogram is one of the most important tool in researching growth and development of craniofacial area, orthodontic diagnosis and treatment planning. But its inherent distortion of actual length and angles during projecting three dimensional object to two dimensional plane might cause errors in quantitative analysis of shape and size. three dimensional high quality images can be obtained using computerized tomogram and have reported in literatures. Considering its expenses and amount of exposure to radiation, limitations still remain to be solved in its application to routine practice. construction of three dimensional image using principle of orientator can be obtained by biplanar stereoradiography. Theoretically two images, lateral and P-A can be used to construct three dimensional image provided that those are taken at same time by two different focal spots. As two images(lateral and P-A) obtained by conventional cephalogram have different head posture, those need compensation to construct three dimensional images. This study introduced principle of computerized head posture compensation and showed that conventional cephalogram could be used to construct three dimensional image and could be applied to routine orthodontic practice.
The purpose of this study was observing the annual growth increment in cephalogram. The cephalograms of 29 boys & 23 girls were analized by method of Downs & Steiner, range from 7 to 8 years in Korean children. the results were as follows; 1. The craniofacial complex of Korean children grew downward and fordward. 2. The pronounced linear and angular growth changes were in the upper central incisors and lower central incisors. 3. The SN Plane to Mandibular plane angle was reduced. 4. The SNA and SNB was almost constant in male.
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