• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.11-21
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• 2012

Purpose: Mulliken's method allows for normal nasal and lip growth, which in turn forms a natural shape of the philtrum. Therefore, we used a modified Mulliken's method to correct unilateral and bilateral cleft lip nasal deformities and followed the patients for 10 years. Methods: Ninety-one patients, who had undergone repair of unilateral and bilateral cleft lip and nasal deformity simultaneously using Mulliken's method during the time period from June 1997 to June 2009, were enrolled into this study. To follow-up of the growth of the lips and nose after the operation, the following 5 anthropometric measurements were analyzed: nasal tip protrusion, columellar length, upper lip height, cutaneous lip height, and vermilion mucosa height. Results: Using this method, we obtained a result that there was no significant difference in the development of the lip compared to the normal control group, and that the bilateral cleft lip patients' nasal projection and columellar length was shorter than that in normal persons. Both measures were statistically significant. Conclusion: Mulliken's method is a superb surgical technique, which enables the normal development of the nose and lip, which further allows for the innate philtrum appearance. The author's result does not seem to be meaningful, because the normal rate of nasal growth is slow before adolescence; however, we recommend additional follow-up and accordant treatment, if needed, once the nasal growth is complete.

• The korean journal of orthodontics
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• v.54 no.1
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• pp.59-68
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• 2024

Objective: To investigate the long-term effects of maxillary skeletal expander (MSE) treatment on functional breathing. Methods: Objective measures of breathing, the peak nasal inspiratory flow (PNIF), and peak oral inspiratory flow (POIF), and subjective measures of breathing, the visual analog scale (VAS) and nasal obstruction symptom evaluation (NOSE) survey, were used to investigate the long-term effects of MSE in functional breathing. Seventeen patients, mean age 19.4 ± 3.9 years treated at the UCLA Orthodontics Clinic were assessed on their functional breathing at 3 timepoints: pre-expansion (T0), post-expansion (T1), and post-orthodontic treatment (T2). Results: Immediately after expansion (T1), all the objective functional breathing values were significantly increased in comparison to T0 (P < 0.05). The VAS total, VAS right and VAS left were significantly lower at T1 in comparison to T0 (P < 0.05). At 26.8 ± 3.9 months after MSE expansion (T2), PNIF total, PNIF right, PNIF left, and POIF were significantly higher when compared to T0 (P < 0.05). Also, VAS total, VAS right and VAS left were significantly lower at T2 when compared to T0 (P < 0.05). Additionally, there was a positive correlation between PNIF and the magnitude of expansion at anterior nasal spine and zygomaticomaxillary point (ZMA). There was a positive correlation between total VAS and the magnitude of expansion at the ZMA. There were no significant changes for the NOSE subjective breathing measurement at all time comparisons. Conclusions: Overall, MSE treatment produces an increased objective and subjective airway improvement that continues to remain stable in the long-term post expansion.

• 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 Journal of the Korean dental association
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• v.52 no.5
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• pp.281-290
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• 2014

Tooth eruption disturbance is seen commonly in mixed dentition or early permanent dentition. During this period of time, children experience the growth and development of craniofacial skeleton and dentition, so the impaction and eruption disturbance of permanent teeth make many problems in oral and maxillofacial areas. Eruption guidance of impacted tooth is not simple because many factors related to impaction are considered. Several factors such as etiology, tooth development stage, location of impacted teeth or eruption pathway, patient cooperation, etc. need to be taken into consideration in deciding the management of the impacted tooth. In the present study, it was assessed the etiology and impaction status of impacted tooth through various cases, and try to explain the treatment method to guide eruption by surgical exposure.

• The korean journal of orthodontics
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• v.27 no.6 s.65
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• pp.963-978
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• 1997

Orthodontic patients are individuals that grow and develop ;therefore selection of the proper time for orthodontic treatment Is considered to be one of the most difficult and yet difficult factor.Since the development of cephalometric X-ray, amount and pattern of craniofacial growth change with aging could be predicted and became useful in the process of orthodontic treatment. The relationship between the mean values of cephalometric measurements and body height and weight was studied among the groups(boys and girls) of Korean children from the ages of 3-years to 12-years. 126 boys and 90 girls with no abnormality in growth and development and no history of orthodontic treatment from the ages of 3 years to 12 years were chosen as subjects: Cephalometric X-ray were taken for 2 years and hard tissue analysis based on Burstone's COGS, which was divided into measurements of 6 parts (Cranial base, Maxillar and Mandible, Vertical measurements, Horizontal measurements, Basal bone relationship, Dental measurements). The relationship between craniofacial growth and body height & weight was studied. The following conclusions were obtained : 1. The maximum growth in the measurements of cranial base, N-Ar(FH), N-Ba(FH) corresponded with the age with the maximum increasein body height & weight in both boys and girls. 2. Genial angle gradually decreased with aging in both boys and girls. 3. N-ANS(L) showed greater amount of growth than ANS-Me(L), and this had greater influence on facial profile. 4. $N-A-Pog^{\circ}$ decreased with aging, and mandibular growth exceeded maxillary growth in amount and rate. 5. Length of Y-axis increased, but Y-axis to FH plane remained constant. This show that mandible grows at a constant angulation to cranial base. 6. As Permanent teeth erupt, interincisal angle deceased.

• The korean journal of orthodontics
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• v.26 no.5 s.58
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• pp.469-485
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• 1996

Orthodontic patients are individuals that grow and develop ; therefore selection of the proper time for orthodontic treatment is considered to be one of most difficult and yet difficult factor. Since the development of cephalometric X-ray, amount and Pattern of craniofacial growth change with aging could be predicted and be came useful in the process of orthodontic treatment. The relationship between the mean values of cephalometric measurements and body height and weight was studied among the groups(boys and girls) of Korean children from the ages 6-years to 17-years. 409 boys and 437 girls with no abnormality in growth and development and no history of orthodontic treatment from the ages of 6 years to 17 years were chosen as subjects Cephaloment X-ray were taken for 3 years and hard tissue analysis based on Burstone's COGS, which was devided into measurements of 6 parts(Cranial base, Maxillar and Mandible, Dental measurements). The relationship between craniofacial growth and height & weight was studied. The following conclusions were obtained : 1. The maximum growth in the measurements of cranial base, N-Ar(FH), N-Ba(FH) corresponded with the age with the maximum increase in body height & weight in both boys and girls. 2. Genial angle gradually decreased with aging in both boys and girls. 3. N-ANS(L) showed greater amount of growth than ANS-Ne(L), and this had greater influence on facial profile. 4. N-A-$Pog^{\circ}$ decreased with aging, and mandibular growth exceeded maxillary growth in amount and rate. 5. Length of Y-axis Increased, but Y-axis to FH plane remained constant. This show that mandible grows at a constant angulation to cranial base. 6. As permanent teeth erupt, interincisal angle deceased.

• Development and Reproduction
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• v.27 no.3
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• pp.137-147
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• 2023

Pharyngeal pouches are an important epithelial structure controlling facial skeletal development in vertebrates. A series of pouches arise sequentially in the pharyngeal endoderm through collective cell migration followed by rearrangement of pouch-forming cells. While crucial transcription factors and signaling molecules have been identified in pouch formation, a role for Neuropilins (Nrps) in pouch development has not yet been analyzed in any vertebrates. Nrps are cell surface receptors essential for angiogenesis and axon guidance. In all vertebrates, the two Nrp family members, Nrp1 and Nrp2, are conserved in the genome, with two paralogs for Nrp1 (Nrp1a and Nrp1b) and Nrp2 (Nrp2a and Nrp2b) being identified in zebrafish. Here, I report a potential requirement of Nrp signaling in pouch development in zebrafish. nrp1a and nrp2b were expressed in the developing pouches, with sema3d, a ligand for Nrps, being expressed in the pouches. Knocking down Nrps signaling in the pharyngeal endoderm led to severe defects in pouches and facial cartilages. In addition, blocking Mitogen-activated protein kinase (MAPK) activities, a downstream effector of Nrp signaling, in the pharyngeal endoderm caused similar defects in pouches and facial skeleton to those by knocking down Nrps signaling. My results suggest that Nrp signaling acts for pouch formation through MAPK.

• The korean journal of orthodontics
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• v.39 no.5
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• pp.330-336
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• 2009

Objective: To examine the differences in lateral cephalometric characteristics between patients with dental protrusion and crowding in order to determine what factors affect dental protrusion or crowding while both malocclusion types are caused by large tooth size. Methods: Twenty nine individuals with dental protrusion and 22 individuals with dental crowding were enrolled in this study. All subjects had larger teeth than average and Class I molar relationships. Craniofacial characteristics and hyoid bone positions were determined from lateral cephalograms and compared between the two groups. Results: In the comparisons of craniofacial characteristics, the measurements indicating maxillary length and facial convexity showed greater values in the protrusion group than in the crowding group. Comparisons of hyoid bone positions showed that the hyoid bone was positioned more anteriorly and superiorly in the protrusion group than in the crowding group. Conclusions: The results of the present study indicate that some craniofacial characteristics and tongue position may affect the development of dental protrusion or crowding; when an individual has large teeth, dental protrusion or crowding might be determined according to maxillary growth and tongue position.

• Archives of Craniofacial Surgery
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• v.10 no.2
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• pp.127-130
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• 2009

Purpose: In an amputated auricle, a microvascular anastomosis is the best treatment of choice. But, the neartotally amputated auricle which is connected by very narrow tissue pedicle to the head, can survive by simple attachment without a microvascular anastomosis owing to the rich vascular network through the superficial temporal artery and posterior auricular artery. In cases of venous congestion resulting from a lack of vein anastomosis, medical leeches (Hirudo medicinalis) can solve the problem. We are reporting the case of a 6-year-old boy who had a neartotally amputated auricle with successful results by simple closure and medical leech treatment without a microvascular anastomosis. Methods: A 6-year-old male patient had an left auricular injury by an escalator accident. The left auricle was neartotally amputated from the temporal head with connection only by very narrow skin and subcutaneous pedicle (about 1 cm in width) at the helical root of upper and anterior part of auricle. Marginal bleeding from the avulsed auricle was noted and the arterial blood was supplied from a branch of upper auricular branch of the superficial temporal artery. The auricle was repaired by simple closure including cartilage and skin without any vascular anastomosis. After simple closure, the auricle showed good circulation with pink color. But on the 2nd day after the operation, there was a venous congestion with severe swelling, which resulted in a purplish colored auricle. The venous congestion disappeared after using medical leeches by the 5th day after the operation. Results: The repaired auricle showed aesthetically and functionally satisfactory result with normal development at the 9 months follow-up check after the operation. Conclusion: In cases of neartotally amputated auricles of children or crushing injury in which microsurgery is difficult, we can try simple closure with the use of medical leeches in treating a of venous congestion for a successful result.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.4
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• pp.397-410
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• 2000

Skeletal class III had been classified by the position of the maxilla, the mandible, the maxillary alveolus, the mandibular alveolus and vertical development. This morphologic approach is simple and useful for clinical use, but it is insufficient to permit understanding of the pathophysiology of dysmorphoses. The author hypothesizes that there are different patterns of mutual relation of the skeletal components which have contributed pathologic equilibrium of skeletal class III. The purpose of this study are threefold: 1) to classify skeletal class III in subgroups, which can show the architectural characteristics of the deformity, 2) to analyse the craniofacial architecture of each subgroup on etio-pathogenic basis, and 3) to characterize and visualize the pattern as a prototype. Materials used in this study were lateral cephalograms of 106 skeletal class III adults, which were analysed with modified Delaire's architectural and structural analysis. Linear and angular measurements of the individual subject were obtained and cluster analysis was used for the subgrouping. Data were evaluated for verification of the statistical significances. The following results were obtained. 1. By the modified Delaire's architectural and structural analysis and cluster analysis, skeletal class III adults were classified into 7 clusters and presented as prototypes, which could show the pathophysiology of the skeletal architecture 2. There was significant relationship in measurement variables of each cluster, which could reflect characteristics of the skeletal pattern of growth. 3. The flexure of cranial base had a close relationship to the anterior rotational growth of the maxilla and contributes to understand the etio-pathology of skeletal class III. 4. The proportion of craniospinal area in cranial depth, craniocervical angle and vertical position of point Om had a close relationship to rotational growth of the mandible and direction of condylar growth. They contribute to understand the etio-pathology of skeletal class III. In summary, the cranium and the craniocervical area must be considered in diagnosis and treatment planning of dentofacial deformity. And the occlusal plane can be considered as a representative which shows the mutual relationships of the skeletal components.