• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.4
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• pp.331-336
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• 2011

Purpose: McNamara and Delaire analyses are two commonly used analytic methods, yet, they differ in their theoretic concepts and different reference lines are used for ideal surgical prediction. Therefore, the use of different analytic methods may result in different surgical plans. The purpose of this study was to compare the anterior and posterior relationship of the maxilla and mandible by using McNamara and Delaire analysis. Methods: 30 Korean patients (15 male and 15 female) who had visited the Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, for dentofacial evaluation were studied by using McNamara's and Delaire's analyses. Results: On the maxillary analysis, 26 out of 30 patients (86.7%) were in accordance. On the mandibular analysis, 20 out of 30 patients (66.7%) were in accordance. On the maxillary analysis, McNamara's analysis showed an average of 0.36 mm greater amount of prognathism compared to Delaire's analysis, and this was not statistically significant. On the mandibular analysis, McNamara's analysis showed an average of 6.03 mm greater amount of prognathism compared to Delaire's analysis, and this was statistically significant. On the mandibular analysis, 26 out of 30 patients (86.7%) showed a greater amount of prognathism on McNamara's analysis compared to that of Delaire's analysis. The remaining 4 patients (13.3%) showed the same amount of prognathism on both analyses. Conclusion: These results may serve as a reference for surgeons when determining which analytic method is to be used for optimal surgical results.

• Korean Journal of Cleft Lip And Palate
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• v.12 no.2
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• pp.73-84
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• 2009

The treatment of cleft lip and palate must be based on a complete knowledge of the anatomy, physiology and growth of the involved deformity, because of not only the appearance but also impaired functions such as phonation, mastication, respiration and lingual posture of the maxillomandibular complex. Delaire has long studied all these aspects, and has published many numbers of articles and constructed a philosophy concerning the significance and interrelationship of the various structures. The results obtained from its application seem to be particularly valid from a clinical point of view, although it has not all been scientifically supported by experimental data. For these reasons, Delaire's primary unilateral and bilateral cheilorhinoplasty procedures are particulary good, as is his secondary gingivoalveoloplsty procedure during the course of the surgical repair of the hard palate. In order to understand Delaire's philosophy, it is necessary to consider the normal and pathologic anatomy of the structures involved in the deformity, the role of some structures, such as nasal septum, musculature, and tongue, and some functions, such as dental occlusion or nasal respiration, which play important roles in maxillary and particularly premaxillary growth. Despite of important concept and meanings, Delaire's philosophy has not been introduced widely to our Korean cleft surgeons yet. So authors will summarize the basic concepts of Delaire's philosophy according to already published literatures and lectures based on our previous treatment outcomes.

• Korean Journal of Cleft Lip And Palate
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• v.13 no.2
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• pp.63-76
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• 2010

After introduction of Delaire's basic philosophy, to consider the normal and pathologic anatomy, the role of some structures, such as nasal septum, musculature, and tongue, and some functions, such as dental occlusion or nasal respiration, which play important roles in maxillary and particularly premaxillary growth, on the Korean Journal of cleft lip and palate in 2009, Delaire's primary functional cheilorhinoplasty (FCR) in the unilateral and bilateral cleft lip patients was summarized and introduced according to already published literatures and lectures. This paper will be the second publishment of Delaire philosophy with Korean language.

• Archives of Craniofacial Surgery
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• v.12 no.2
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• pp.75-80
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• 2011

Deformities related with cleft lip are not only limited to the cleft site but also extended to all around the nasolabial region. Facial development is composed of several complex processes as the formation, migration, coalescence and interaction of separate fields. When there is a cleft event, it means there are general problems of those processes. As a result facial elements should have displacement, deformation and functional hypotrophy. These also affect the mucocutaneous structures, which result in the typical deformities of cleft lip. Traditional surgical methods are not sufficient of the correction of functional impairments in the cleft lip. Accordingly, there are relatively high possibilities of occurring secondary deformities. The Delaire's method focuses on repair of functional impairment of the cleft. Consequently, it can maintain the initial good surgical result and avoid the unnecessary incision scar. And this method can minimize secondary nasal deformities which can reduce the risk of additional nasal correction. Therefore authors introduce this advantageous the Delaire technique cheliolplasty which it can be widely used for the cleft lip correction in Korea.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.3
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• pp.229-237
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• 2000

According to the functional matrix theory, Delaire proposes that individual occlusal plane was determined by variable effects of teeth, maxilla, mandible, cranium, cranial base and soft tissue matrix including the orofacial musculature. and that there is the ideal occlusal plane determined by the most proper spatial position of maxilla and mandible, functionally and esthetically. This study was designed to find out the relation between Delaire's ideal occlusal plane and muscle activity of masticatory muscles in individuals who have normal maxillo-mandibular relationships. Lateral cephalometric radiographs were taken and his/her individual occlusal plane and ideal occlusal plane were analyzed with Delaire's architectural and structural craniofacial analytic method. For evaluation of muscle activities of masticatory muscles, electromyography of anterior temporal muscle, superficial masseter muscle, and anterior belly of digastric muscle was recorded in fifty Korean normal Angle class I occlusion individuals. According to the average value of ideal occlusal plane, fifty normal Angle class I occlusion individuals were classified into three groups: Ideal occlusal plane group(I group), hyperrotation group(I+ group) and hyporotation group(I- group). The result of this study was as follows: 1. The results of Delaire's architectural and structural craniofacial analysis of lateral cephalography of the fifty Korean normal Angle class I occlusion individuals are that twelve persons(24%) have consistent or parallel with ideal occlusal plane and the average of angular difference was $1.22^{\circ}{\pm}3.69^{\circ}$. 2. There is no significant difference in muscle activities of masticatory muscles during resting(p<0.05), but significant increases of muscle activity of ipsilateral anterior temporal and masseter muscle, contralateral anterior belly of digastric muscle during unilateral chewing and of anterior temporal and masseter muscle during bilateral clenching(p<0.05). 3. To find out the effect of the angular difference between Delaire's ideal occlusal plane and real occlusal plane to muscle activity, muscle activities of masticatory muscles were compared with three groups in each other; I group, I+ group and I- group. The results were no significant differences during resting, unilateral chewing and bilateral clenching.(p>0.05) 4. Although there is no significant differences of masticatory muscle activities among the three groups, the fact that increasing tendency of masseter muscle activity of ideal occlusal plane group(I+) than those of any other groups(I+ and I-) during bilateral clenching was noted. There is only the implication that occlusal plane makes some effects on masticatory muscle activities, espacially that of masseter muscle during bilateral clenching. In conclusion, the hypothesis that occlusal plane is one of the factors which affect the muscle activities of masticatory muscles and that anyone whose occlusal plane consistent with Delaire's ideal occlusal plane has an extraordinary functional advantage in masticatory muscle function cannot be proven with electromyography methods.

• Korean Journal of Cleft Lip And Palate
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• v.11 no.2
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• pp.71-75
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• 2008

The outcome of primary surgery for cleft lip is judged by its effects on the quality of oro-facial function and development. Many surgical techniques have been tried to obtain better results, however, Delaire introduced a technique of functional closure of the lip and nose, based on the findings of no true hypoplasia in the tissues either side of the cleft. In a seven-month-old Asian male patient with unilateral incomplete cleft lip, we carried out the primary closure by modified Delaire's technique. With no alveolar bone graft, the vertical incision on the nasal base was omitted in this patient because of his acceptable symmetry of nose. Also, a small Z plasty was added on the non-cleft side. The V-shaped incisions, whose notch was located on each side of the red vermilion, were designed and beveled incisions were performed for the rehabilitation of lip length and thickness, considering the postoperative wound contracture. We assured that this modification of Delaire's technique could be applied for various cases of primary closure of incomplete cleft lip.

• Korean Journal of Cleft Lip And Palate
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• v.9 no.2
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• pp.93-100
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• 2006

Although the delayed type of rhinoplasty is currently acceptable in the correction of cleft lip and nasal deformity, Delaire tried to achieve the simultaneous nasolabial reconstruction and muscular rearrangement that affect the subsequent skeletal growth of the face. the anatomic muscular reconstruction can be achieved by making the anchorage of the nasolabial muscles of the cleft side to the nasal septum and muscles on the non-cleft side. Two cleft lip patients of 6 and 7 year-old without any previous operation history were treated with the functional cheilorhinoplasty. One patient with incomplete cleft lip underwent a cheiloplasty along with the rearrangement of orbicularis oris muscle. The other patient had a complete cleft lip and palate with accompanying nasal deformity, who underwent the functional cheilorhinoplasty with the reconstruction of anterior nasal base. All the operation was done under the general anesthesia and patients healed without any significant complications. In the incomplete case, the shapes of Cupid's bow was restored, and the length of columella was regained comparable to the non-affected side. In the complete cleft lip and palate case, the depressed nostril was reconstructed with acceptable symmetry by complete releasing of deformed alar cartilage undermined with a dissecting scissors. In summary, the functional repair of cleft lip and nose could be possible at the same time by using Delaire method. This method is effective to correct the primary nasolabial deformity, which results in the restoring favorable anatomy and its function.

• The korean journal of orthodontics
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• v.30 no.5 s.82
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• pp.643-655
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• 2000

In Patients with severe skeletal discrepancy, surgical orthodontic treatment must be accompanied, and recently two jaw surgery has become a common procedure, resulting in improved esthetics and function. Choosing the position of the occlusal plane in this two jaw surgery is an important factor in postoperative stability Therefore this must be taken into consideration during the diagnosis and treatment plan. In this study, among patients with skeletal Class III occlusion, 25 patients(8 male, 17 female, average age $23.2{\pm}3.17$) who have undergone two jaw surgery, setting the ideal occlusal plane according to Delaire's architectural and structural cranial analysis. In comparing preoperative($T_1$). postoperative($T_2$, average of 15.4 days), and long-term postoperative($T_3$, average of 32.6 months) lateral cephalometric radiography, the following conclusions have been made. 1. There were no significant changes of the occlusal plane angle after the two jaw surgery, and there were no significant differences between the surgical technique(SSRO and IVRO). 2. The postoperative changes of the occlusal Plane had no relationship with the amount of jaw movement, amount of posterior impaction, nor the time relapse after surgery. 3. After two jaw surgery, in the SSRO group there was significant forward movement of the mandible, and in the IVRO group the lower incisors extruded as the mandible moved backward and downward which makes the genial angle and the mandibular plane angle significantly increased

• 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.

• The korean journal of orthodontics
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• v.22 no.3 s.38
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• pp.509-529
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• 1992

Skeletal Class III malocclusion is one of the most difficult type to treat and stabilize. For a child with developing skeletal Class III malocclusion, the treatment objective would be to stimulate maxillary growth, particulary one who has markedly deficient maxilla, and to restrain excessive mandibular growth. In order to stimulate the maxillary growth, maxillary protraction appliance is the one of the effective orthopedic appliances in skeletal Class III. The purposes of this study were as follows ; evaluation of the skeletal and dental changes of the maxillary protraction in children with Class III Maxillary deficiency , comparison of the clinical effects between the group with RPE and labiolingual intraoral appliances , comparison of the clinical effects and stability related to the ages of the patients : stability of the maxillary protraction about 1 year after retention. The subjects consisted of 60 children between the ages of 8 and 13.4 who were diagnosed as Class III with maxillary deficiency and were treated with Face Mask (Delaire Type) from the Dept. of Orthodontics Yong Dong Severance Hospital, Yonsei University. 48 children wore the RPE and 12 children wore Labiolingual Appliance. Lateral Cephalograms were taken for each patient at before and after correction of anterior cross-bite in 60 children, and after an observation period of 10 to 14 months in 19 children. X and Y coordinate of 10 landmarks were analyzed using a horizontal line through sella and rotated $6^{\circ}$ down anteriorly as the horizontal reference axis, and a perpendicular verticual line through sella as the vertical reference axis. Each of the 31 measurents (10 verticals, 10 horizontals, 2 angles and 9 others) was statistically analyzed using SPSS/PC statistics. The results are as follows; 1. After maxillary protraction the maxilla and maxillary teeth moved downward and forward, while the mandible and mandibular incisor rotated downward and backward. 2. Maxillary protraction with rapid palatal expansion appliance was more effective than with labiolingual appliance. 3. More downward movement of the posterior palatal plane obserbed with maxillary protraction doing the midpalatal suture opening than with protraction after finishing the palatal expansion 4. The clinical effects of protraction and changes of the retention periods were not statistically significant among the age groups. 5. During the retention period, maxilla and maxillary teeth, and mandible and mandibular teeth moved downward and forward, however the mandibular changes were larger than the maxillary changes.