• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권1호
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• pp.21-29
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• 2011

Introduction: To compare the change in frontal ramal inclination (FRI) in laterognathism after orthognathic surgery. Materials and Methods: Twenty four patients (10 men, 14 women; mean age, $22.8{\pm}5.2$ years) with minimal facial canting (${\leq}$ 2 mm) and apparent menton deviation ($5.9{\pm}2.4\;mm$) who had been operated on to correct facial asymmetry and skeletal CIII malocclusion, were selected. On a preoperative posteroanterior (PA) cephalogram, the FRI of the deviated side and non deviated side, L1 deviation amounts and menton deviation amounts were measured. The FRI differences between both sides were compared, and the correlations between the measured deviated elements and the FRI differences were analyzed. On a postoperative PA cephalogram, the shifting amount of L1, shifting amount of L7 and FRI of both sides were measured, and the correlations between the shifting elements and the change in FRI were analyzed. Results: On the preoperative PA cephalogram, the FRI of the non deviated side was significantly greater than those of the deviated side. The differences in FRI, with a menton deviation amount showed a significant correlation. On the postoperative PA cephalogram, the FRI differences between the deviated and non deviated side were decreased significantly and mandibular transverse movement toward central position was noted. The mean shifting amounts of L7 were associated with the amount of change in the deviated side of FRI. Conclusion: Transverse shifting of the mandible through orthognathic surgery decreases the FRI difference, which showed laterognathism, and improves the facial contour.

• 대한치과교정학회지
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• 제37권5호
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• pp.319-330
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• 2007

안면비대칭 환자의 진단 및 치료계획 수립 시 하악골 상행지 고경의 좌우 차이를 정확히 판정하는 것이 필요하다. 본 연구는 2차원 방사선사진에서 정면 상행지경사도 및 측면 상행지경사도를 이용하여 하악골 상행지 고경을 보정하는 방법이 비대칭 판정에 도움이 되는지 알아보고자 시행되었다. 이부 편위가 있는 안면비대칭자 40명을 대상으로 정모두부방사선규격사진을 촬영하고 좌우 각각의 하악골 상행지 고경을 측정하는 한편 정모 및 측모 방사선사진에서 계측된 정면 상행지 경사도 및 측면 상행지 경사도를 이용하여 상행지 고경을 3차원적 개념으로 보정한 후, 실제 3차원 영상에서의 비대칭 판정 결과와 비교 분석을 시행하였다. 측정결과, 정면 및 측면 상행지 경사도는 이부 편위측에 비하여 반대측에서 크게 나타났으며 보정 후 상행지 고경의 좌우 차이는 증가하는 양상을 나타내었다. 보정 전 그리고 보정 후 각각에서 상행지 고경의 좌우비대칭 여부를 판정한 후, 3차원 영상에서의 판정을 기준으로 하여 보정에 따른 sensitivity, specificity 그리고 accuracy 변화를 살펴본 결과, specificity는 44%에서 22%로 감소하였으나 sensitivity는 74%에서 94%로 증가하는 것으로 나타났다. 아울러 accuracy가 보정 전 68%에서 보정 후 78%로 증가하는 것으로 나타나 정면 및 측면 상행지 경사도를 이용하여 상행지 고경을 3차원적 개념으로 보정할 경우, 이는 보다 정확한 비대칭 판정에 유용함을 보여주었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권3호
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• pp.232-240
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• 2008

Purpose: This study was performed to evaluate transverse changes of proximal segment after bilateral sagittal split ramus osteotomy (BSSRO) using 3-D CT in mandibular prognathism. Patients and methods: Twenty-two patients who underwent BSSRO for mandibular set-back in class III malocclusion without facial asymmetry were examined. Miniplates were used for the fixation after BSSRO. Facial CT was taken before and after BSSRO within 3 months. Frontal-ramal inclination (FRI), inter-gonial width (IGW) and intercondylar width (ICW) were measured in 3-D CT images using V-works $4.0^{TM}$ program. Student t-test was used to compare the changes between pre- and post-operative measurements using SPSS 10.0 program. Results: 1. Mean peroperative FRI value ($12.87{\pm}3.43^{\circ}$) was slightly increased to postoperative value ($14.13{\pm}3.72^{\circ}$) (p < 0.05). The average FRI increased 10.42% and the range was from $-2.46^{\circ}$ to $3.34^{\circ}$. 2. Mean peroperative IGW ($99.01{\pm}5.36$) was slightly decreased to postoperative IGW ($96.51{\pm}5.88mm$) (p < 0.05). The average IGW decreased 2.52 % and the range was from $-6.61^{\circ}$ to 0.91 mm. 3. Mean preoperative ICW ($125.01{\pm}5.30mm$) was slightly decreased to postoperative ICW ($125.40{\pm}5.45mm$) (p < 0.05). There is no significant difference between pre- and post-operative ICW. 4. There was significant correlationship between FRI difference and IGW difference (p < 0.05). Conclusions: These results indicate that the lower ramus of the proximal segment is moved inward after BSSRO procedure for mandibular set-back.