A cephalometric radiographic cross sectional comparative study was undertaken to investigate craniofacial growth in cleft lip and palate individuals. The material for this study consisted of 43 subjects with operated cleft lip and palate.(29 males, 14 females). The range of age was from 6 years to 12 years. The roentgenocephalometric values of cleft individuals were compared with values of normal individuals reported by Lee. The following conclusions were obtained; 1) The pattern of cranial base of the cleft subjects was almost the same as that previously reported for the normal individuals. 2) Anterio-posterior length of the mandible did not show any significant difference but in the cleft subjects, that of the males was larger than that of the females. 3) The maxilla of the cleft subjects was very retruded and showed very concave profile. 4) Gonial angle of the cleft subjects was very high, especially in the female clefts. 5) The height of ramus was very poor in the cleft subjects. 6) The facial length was almost the same, but the facial depth of the cleft subjects was smaller than that of the normal individuals. 7) Maxillary and mandibular incisors were severely retroclined. 8) The range of values in the cleft subjects was very variable and the female clefts showed more distured growth than the male clefts.
Background: We have devised a novel surgical method, termed as temporalis muscle tendonperiosteum (T-P) compound surgical method, by modifying pre-existing techniques. Our method is characterized by elevation of temporalis muscle tendon and the periosteum of the mandibular ramus as a single compound. Here, we describe the concept and clinical outcomes of our method. Methods: We conducted both a cadaveric study and a clinical study. First, we used four human cadavers (two males and two females) to confirm the anatomy of the temporalis muscle tendon and availability of sufficient length extension through the elevation of the T-P compound. Moreover, we obtained measurements of the mouth angle and the philtrum angle from a total of six patients (two males and four females) and compared them between preoperatively and postoperatively. Results: The mean length of the periosteal portion was measured as 2.43± 0.15 cm (range, 2.2-2.6 cm). There was an improvement in the mouth angle postoperatively as compared with preoperatively (7.2°± 3.0° vs. 14.5°± 4.7°, respectively). Moreover, there was also an improvement in the philtrum angle postoperatively as compared with preoperatively (7.2°± 3.4° vs. 17.2°± 6.5°, respectively). Conclusion: Our method is a simple, minimally-invasive modality that is effective in achieving good clinical outcomes. Its advantages include an ability to achieve a firm extension of the temporalis muscle tendon as well as a lack of requirement for a donor site that may cause complications.
In methods of finding causes for cleft palate, many cases have been studied by investigators using teratogenic agents. Among them, a synthetic agent known as triamcinolone acetonide (TA) was widely used. When this drug was injected into mice during palatogenesis, it induced lowered body weight and a deformed mandible. But many cases have been studied on growth changes, only of the developmental stages of the palate. Therefore, the objective of this study was to evaluate craniofacial growth in experimentally induced cleft palate mice after finishing palatogenesis namely just before birth. Normal, alcohol treated, and TA treated DDY mice were obtained at 18-days of gestation and heads were prepared for serial sectioning in the sagittal plane. The midsagittal sections were photographically enlarged (${\times}40$) and measurements made to asses the amount of growth. The obtained results were as follows. 1. The incidence of cleft palate was 41.2% when TA was injected. 2. The body weight of the cleft palate group was lower than the control group. 3. In the cleft palate group, mandibular length (H-M) was lighter than the control group. 4. In the cleft palate group, degree of staining was not distinct compared to the control group by the double staining method. 5. In the cleft palate group, anteroposterior posture of the tongue tip to facial plane (C-M) was more posterior than the control group. 6. The cause of posterior posture of the tongue tip to facial plane (C-M) in the cleft palate group, was not short and retracted tongue but the mandibular length was increased. 7. The anteroposterior relationship of hyoid cartilage to cranial base was the same in all groups.
Kim, Eun-Ja;Ki, Eun-Jung;Cheon, Hae-Myung;Choi, Eun-Joo;Kwon, Kyung-Hwan
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제39권4호
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pp.168-174
/
2013
Objectives: The aim of this study is to investigate the correlation between 2-dimensional (2D) cephalometric measurement and 3-dimensional (3D) cone beam computed tomography (CBCT) measurement, and to evaluate the availability of 3D analysis for asymmetry patients. Materials and Methods: A total of Twenty-seven patients were evaluated for facial asymmetry by photograph and cephalometric radiograph, and CBCT. The 14 measurements values were evaluated and those for 2D and 3D were compared. The patients were classified into two groups. Patients in group 1 were evaluated for symmetry in the middle 1/3 of the face and asymmetry in the lower 1/3 of the face, and those in group 2 for asymmetry of both the middle and lower 1/3 of the face. Results: In group 1, significant differences were observed in nine values out of 14 values. Values included three from anteroposterior cephalometric radiograph measurement values (cant and both body height) and six from lateral cephalometric radiographs (both ramus length, both lateral ramal inclination, and both gonial angles). In group 2, comparison between 2D and 3D showed significant difference in 10 factors. Values included four from anteroposterior cephalometric radiograph measurement values (both maxillary height, both body height) and six from lateral cephalometric radiographs (both ramus length, both lateral ramal inclination, and both gonial angles). Conclusion: Information from 2D analysis was inaccurate in several measurements. Therefore, in asymmetry patients, 3D analysis is useful in diagnosis of asymmetry.
Background: The objectives of the present study were to investigate the reliability and outcomes of computer-assisted techniques in mandibular reconstruction with a fibula flap and verify whether the surgical navigation system was feasible in mandible reconstructive surgery. Methods: Eight cases were enrolled in the computer assisted surgery (CAS) group and 14 cases in the traditional group. The shaping and fixation of the fibula grafts were guided by computer assisted techniques, which could be monitored with the BrainLAB surgical navigation system. The variation of mandible configuration was evaluated by CT measurement in the Mimics software, including the variation of length, width, height and gonial angle of the mandible. The 3D facial soft tissue alteration was also analyzed in 3D chromatogram by Geomagic software. Results: All 22 fibula flaps survived. The mandibular configurations and facial contours had a better clinic result in the CAS group. The length, width, height and gonial angle of the reconstructive mandible were more similar to the original one. The Wilcoxon rank sum test analysis suggested significant differences in the measurements. The chromatographic analysis also visually showed superiority over the traditional group. Conclusions: The computer assisted surgical navigation method used in mandibular reconstruction is feasible and precise for clinical application. The contour of the reconstructed mandible and facial symmetry are improved with computer techniques.
Objectives: This study was designed to define the Korean norm values for the Ricketts analysis. Methods: In this longitudinal study, lateral cephalograms of 31 subjects with normal occlusion were taken biennially from ages 9-19 years. Cephalometric measurements were performed. Parameters for which the 10-year change did not exceed one standard deviation were defined as unchanged. The means and standard deviations for the measured parameters were determined for each age group. Results: No significant changes in growth were observed in the molar relationship, incisor overjet, incisor overbite, mandibular incisor extrusion, interincisor angle, lower incisor tip (B1) to A point-Pogonion (A-PO) plane, upper incisor tip (A1) to A-PO plane, B1 inclination to A-PO, A1 inclination to A-PO, B1 inclination to Frankfurt plane (FH), convexity, lower facial height, facial axis, maxillary depth, maxillary height, palatal plane to FH, cranial deflection, ramus Xi position, or porion location. Continual changes over the 10 years of growth were observed in the maxillary first molar distal position to pterygoid true vertical plane, facial depth, mandibular plane to FH, anterior cranial length, mandibular arc, and corpus length. Conclusions: Clinicians can apply the Korean norms at age 9 as determined in this study when using the Ricketts analysis. The patient's age at the beginning of treatment and their sex should be taken into consideration when drawing visual treatment objectives.
The objective of this study was to understand the major changes of craniofacial dimensions and spatial growth pattern during the late embryonic and fetal period of human fetures. This study was performed with the selective materials of normal fetuses received from the Registry of Congenital Malformation of Seoul National University Hospital. The specimens consisted of nineteen embryos and sixty-six fetuses. The photomicrographs from mid-segittal sections of embryos were used for angular measurement, and the lateral cephalograms taken with soft X-ray were also measured in liners and angular aspects. All of the anatomical landmarks for the tracing of the photomicrographs and cephalograms were referred to the previous reports on literature. The sequential changes of prenatal craniofacial dimensions and agles were analysed statistically and discussed on the focus about the developmental growth directions of human ore-facial structure arised from heterogeneous origins. The results are as follows, 1) Cranial base angle was almost formed at about 6 weeks old embryos with the average angle of $127.4{\pm}6.33^{\circ}$ (n=3) and it was almost constant onwards. 2) The linear increase rates of anterior cranial base length and anterior facial height exceeded those of the posterior cranial base length and posterior facial height, and the maxilla grows more rapidly on the horizontal dimension than the vertical dmension during the fetal period. 3) The angular relationship between the anterior cranial base and palatal plane decreasedslightly during the fetal period, disclosing $11^{\circ}$ at 12th week gestation and $5^{\circ}$ at 41th weeks gestation. 4) Genial angle was maintained almost constantly at about $130^{\circ}$ during the fetal period from 12 weeks to 41 weeks of gestation.
Orthodontic treatment of cleft patients is difficult as the growth is different from that of normal ones. So it is very important to know the characteristic features of the craniofacial morphology and growth pattern in unilateral cleft lip and palate patients. The materials for this study consisted of 55 normal males and 50 unilateral cleft lip and palate ones who received cheiloplasty and palatoplasty previously. The cleft subjects were divided into 4 groups according to their ages kto find out the growth pattern of hard and soft tissue, and to compare the features with those of normal ones. Each cephalogram analysed by McNamara method and others. The obtained results were as follows 1. In the unilateral cleft lip and palate subjects, forward growth of the maxilla was smaller than that of normal ones from 9 years old. So the maxilla was retruded. The maxillary incisors were severely retruded in all age groups. 2. The mandibular overall length and its anteroposterior position did not show any significant differences between two groups. But the height of ramus was very short and the mandible had vertical growth tendency to compensate for undergrowth of the maxilla in cleft subjects after 12 years of age. 3. Horizontal growth of the soft tissue in middle face was smaller than that of any other facial region from 9 years old. The vertical growth rate of upper lip was decreased as growing old. 4. In cleft subjects, the upper and lower facial component angle and the facial convexity angle were large. So their facial profile changed to straight or concave as growing old.
Purpose: Herpes zoster is a common dermatologic disease characterized by unilateral pain and vesicular lesions over the unilateral sensory dermatomes being caused by the reactivation of Varicella zoster virus and its incidence seems to be increasing recently. In case of involving the ganglion of the fifth cranial nerve(trigeminal nerve), it can descend down the affected nerve into skin, then producing an eruption in the dermatome. Among the patients, about 40 - 50% had associated conditions such as diabetes mellitus, hypertension, pulmonary tuberculosis, liver diseases, peptic ulcer, hypothyroidism, pharyngitis but rare facial trauma. Methods: Retrospective study was done for 3 cases of Herpes zoster from May 2000 to May 2007, which had been treated with acyclovir and steroid. Results: The clinical course was uneventful. Follow-up length was about 3 months. After treatment, the patients became stable and there was no complications. Conclusion: Herpes zoster was commonly associated with systemic disorders and the treatment duration was prolonged in associated diseases. But herpes zoster occurring specifically at the site of previously traumatized facial skin has not yet been reported. We experienced the treatment of herpes zoster developing within recent operative facial scar and three cases are presented with the review of literatures. Finally, facial trauma might be a risk factor for herpes zoster in traumatized patients.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제26권6호
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pp.606-612
/
2000
This study was performed to investigate the average anthropometric value of normal Korean men and women and to compare the preceding literatures. Additionally, average Korean profilogram was made to serve as a template for diagnosis of facial form. Eighty five Korean subjects(41 men, 44 women) aged between 21 to 26 were selected by members of the author's department on the basis of intact dentition and Class I occlusion without facial asymmetry. Frontal and lateral photographs were taken under standardized condition with digital camera. The image was magnified and adjusted according to the FH plane of cephalometric radiographs and digitized using personal computer. To compare the Western beauty, 25 esthetically pleasing female was selected to measure various angle and distance of the face. 1. It was possible to calculate the mean coordinate value of Korean normal samples which enables the direct visualization and comparison with the use of template. The method in this study was easy to applicate under the Microsoft $Windows^{(R)}$ bases. 2. Maxillary vertical hypoplasia, upper and lower lip protrusion was characteristics of Korean norms and relatively narrow alar base distance, less conspicuous nasal projection was observed. As the vermilion exposure and upper lip length was more than western norm, chin looks shorter than western. To compare the Korean and Western esthetically pleasing profile, facial convexity and nose was less conspicuous in Korean women.
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