Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.35
no.5
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pp.329-334
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2009
Objective: To evaluate the ratio between bone-contact length and inter-segmental length of the rigid fixation screw used in bilateral sagittal split ramus osteotomy (BSSRO) for mandibular setback. Material and Methods: Records of 40 patients with Class III malocclusion were selected. 20 of them had BSSRO, while the other 20 had BSSRO with maxillary LeFort I osteotomy. All of the patients had three noncompressive bicortical screws inserted at the gonial angle through transcutaneous approach. Two screws were inserted antero-posteriorly above inferior alveolar nerve and one screw was inserted below. The lengths of bone-contact and that of inter-segmental part were measured using cone-beam computed tomography. Ratio between these two measured lengths was calculated. Results: Both bone-contact and inter-segmental lengths were longer in BSSRO group than in BSSRO with maxillary LeFort I osteotomy group. Ratio of bone-contact to inter-segmental length was lower in BSSRO group than in BSSRO with Lefort I group. Both bone-contact and inter-segmental lengths were longer at the antero-superior position than at the inferior position. However, their ratio showed little difference. Conclusion: This study suggest that stability of screws in BSSRO group was greater than in BSSRO with Lefort I group. Stability of screws at the antero-superior position was greater than at the inferior position. Ratio of bone-contact to inter-segmental lengths was 0.2 in average.
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.14
no.1
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pp.99-107
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1984
The auther studied clinically and. radiologically 48 cases which had been diagnosed as TMJ ankylosis in SNUDH (1974-1984). The purpose of this study is to analyse clinical features of TMJ ankylosis and to evaluate the effect of TMJ ankylosis on the growth of the mandible. The obtained results were as follows: 1. Total 48 cases of TMJ ankylosis patients consist of 23 males and 25 females. 65 percent of all cases of TMJ ankylosis occurred in patients between 1 and 10 years of age. The awerage age at the onset of ankylosis was 11.7 and average duration at the time of examination was 11.7 years. 2. Unilateral akylosis (81.3%) was more frequent than bilateral ankylosis (18.7%). 3. Traum a (57.9%) and infection (21.2%) were main etiology. 4. Inability to open the mouth (78.3%) and facial asymmetry (17.4%) were main chief complaints. 5. Mandibular morphology through radiographic features. (a) In TMJ ankylosis patients the ramus length of the ankylosed side was shorter than that of the non-ankylosed side. Comparing with the centrol group, ramus length of the each side was shorter than normal value. (b) The partial body length of the ankylosed side was longer than that of the non-ankylosed side. Comparing with the control group, partial body length of the each side was longer than normal value. Partial body length was related with antegonial notch depth. (c) Ratio of upper and lower ramus length at the level of mandibular foramen was smaller in ankylosed side than in non-ankylosed side. (d) Antegonial notch depth and ramus posterior contour depth were deeper in ankylosed side than in non-ankylosed side and those of both sides were deeper than normal value. (e) Gonial angle in ankylosed side was larger than in non-ankylosed side and that in both sides was smaller than normal value.
Purpose: The purpose of this study was to investigate the effects of a mouthguard on stress distribution under mandibular impact. Materials and methods: The FEM model of head consisted of skull, maxilla, mandible, articular disc, teeth, and mouthguard. The impact locations on mandible were gnathion, the center of inferior border, and the anterior edge of gonial angle. And the impact directions were vertical, oblique ($45^{\circ}$), and horizontal. The impact load was 800 N for 0.1 sec. Results: When vertical impact was applied, the similar stress and the distribution pattern was occurred without the relation of the mouthguard use (P>.05). The model with mouthguard was dispersed the stress to the teeth, the facial bone and the skull when the oblique ($45^{\circ}$) impacts were happened. However, the stress was centralized on the teeth in the model without mouthguard(P<.05). The model with mouthguard was dispersed the stress to the teeth, the facial bone and the skull when the horizontal impacts was occurred. However, the stress was centralized on the teeth without mouthguard (P<.05). For all impact loads, stress concentrated on maxillary anterior teeth in model without mouthguard, on the contrary, the stress was low in the model with mouthguard and distributed broadly on maxillary anterior teeth, facial bone, and skull. Conclusion: The mouthguard was less effective at shock absorbing when vertical impact was added. However, it was approved that mouthguard absorbed the shock regarded to the oblique ($45^{\circ}$) and horizontal impact by dispersing the shock to the broader areas and decreasing the stress.
The author obtained some useful information for the class III treatment from long term observation on the growing patients with class III malocclusion. 8 patients were selected for this study and presentation. From these observation so far my conclusions might be as follows: First in the early correction of the anterior crossbite, considerable forward growth changes were observed in the maxilla Second, as for the growth modification of jaws by orthopedic treatment only limited effects were recognized from the long-term observation Thrid, at early age of patients with anterior crossbite, any data couldn't make me predict the stability after treatment on the long-term basis. Fortunately, however, genial angle showed a marginal possibility of it prediction. Fourth, at an advanced age/ retraction orthopedic force on the mandible and the rapid change in the mandibular position may cause some trouble in the T.M.joint. Finally, the followings are recommendable. As for the anterior crossbite, correct it early as possible, and use orthopedic force under the age of ten. Do not enter the phase II treatment directly. Just wait and observe until the growth were almost completed, focusiong on some important factors such as airway problem, tongue position, and third molar development. Of course, these factors may have some effects on the mandibular growth. for the female, at the age of around 14 years old and the male, around 17 years old, make a final decision whether the patients will continue to be treated orthodontically or surgically Thereby, (I think) the relapse and retreatment problem after treatemnt we have observed so far might be minimized. Furthermore, the active treatment time may be also reduced.
Objective: The aim of this study was to evaluate the occlusal force and contact area and to find its associating factors in Koreans. Methods: Occlusal force and contact area in maximum intercuspation were measured using the Dental $Prescale^{(R)}$ system in 651 subjects (15 with normal occlusion, 636 with various malocclusions divided into subgroups according to the skeletal pattern, Angle's molar relationship, age and gender). Results: Occlusal force of the normal occlusion group ($744.5{\pm}262.6N$) was significantly higher than those of the malocclusion group ($439.0{\pm}229.9N$, $p$ < 0.05). Occlusal force was similar regardless of differences in ANB angle or Angle's molar classification, however the increase in vertical dimension significantly reduced occlusal force ($p$ < 0.05). Conclusions: Occlusal force was significantly lower in the malocclusion group compared to the normal occlusion group, and in females compared to males, but it was not affected by age, antero-posterior skeletal pattern or molar classification. Although a hyperdivergent facial pattern indicated lower occlusal force compared to a hypodivergent facial pattern, the differences in skeletal pattern were not the primary cause of its decrease, but a secondary result induced by the differences in occlusal contact area according to the facial pattern.
The purpose of this study is to define the characteristics of the skeleton and soft tissues of severe adult class III malocclusion. The materials selected for this study were lateral cephalograms of 112 adult class III malocclusion patients with ANB difference below -2 degrees. and the mean age was 22.9 years old. The normal control sampler consisted of lateral cephalograms of 50 adults in normal occlusion and the mean age was 22.1 years old. The Horizontal reference line was FH line and the vertical reference line was nasion perpendicular to FH line. The skeletal and soft tissue characteristics of Class III malocclusion are as follows : 1. In the skeletal profile evaluated by vertical reference line (Nasion perpendicular to FH), the forehead and maxilla was similar to normal, but the mandible was protruded significantly. 2. The soft tissue profile is concave. The thickness of soft tissue covering forehead area and nose is within normal range. but the upper lip is thicker and the nasolabial angle is smaller than normal. The lower lip and inferior labial sulcus is thinner than normal. The degree of eversion of lower lip is lesser than normal. 3. The cranial base of class III malocclusion is shorter and saddle angle is smaller than normal. 4. The location of midface evaluated in relations to cranial base is within normal range but, the length of midface is shorter than normal when compared from the deep portion of the facial skeleton. 5. The location of maxilla in reference to cranial base is within normal range but the length of maxilla was shorter in class III malocclusion. 6. The mandible was protruded, ramus height and body length, gonial angle were greater than normal, and the chin angle was smaller. 7. Upper incisor was proclined, lower incisor was retroclined.
The purpose of this paper is to evaluate if there is a relationship between anterior disc displacement without reduction and development of anterior open bite, and a relation between occurrence of open bite and occlusal appliance therapy. In general, the statistically significant differences were found between the Group 1 and 2 and normal mean group. The variables that represent mandibular size and form, showed a statistical significance in all 3 groups. Also 3 groups patients had a smaller ANB, a larger FMA than normal mean group. When we compared the 3 groups with respect to all cephalometric measurements by One-way analysis of variance (ANOVA), group 1 and 2 patients had a larger FMA, a larger SN to mandibular plane angle, a larger maxillomandibular plane angle, a larger occlusal plane to mandibular plane angle, a smaller total posterior facial height/total anterior facial height(%), and a larger gonial angle than group 3. The statistically significant differences were not found between the Group 1 and 2, and skeletal patterns were similar. Thus, morphologic features of patients with vertical discrepancies may represent a risk factor for the development of anterior open bite with or without occlusal appliance treatment. In case of patients with vertical discrepancy, we may have to be more careful when inducing a change of the vertical dimension.
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.
The purpose of this study was to investigate the characteristics of craniofacial morphology in adult with crowded dentition. The craniofacial morphology associated with normal and crowded of mandibular dentition was studied in lateral cephalometric radiograph obtained from 145 subjects grouped 44 males and 40 females in normal group, 33 males and 28 females in crowded group. The conclusions were as follows: Means, standard deviations and facial polygons from measurements were obtained from normal and crowded groups. Palatal plane to SN, occlusal plans to SN, mandibular plane to SN, mandibular plane to palatal plane and gonial angle measurements of crowded group were significantly different from normal group and were larger than normal group. SNA, SNB measurements of crowded group were significantly different from normal group and were smaller than normal group. Significant differences were observed between normal group and crowded groups on the basis of $SN/{\underline{1}}$, PP/1, $MP/{\bar{1}}$, and compared with normal group, upper incisors of crowded group were inclined more labially, whereas lower incisors of crowded group were inclined more lingually. Posterior facial height and ramal height were shorter in males of crowded group than those of normal group. Posterior facial height, mandibular length and posterior cranial base length were shorter in females of crowded group than those of normal group. Anterior facial height was longer in females of crowded group than those of normal group.
Sella turcica contains pituitary gland that has influence on craniofacial growth. So, if the volume of sella turcica correlate to the function of Pituitary gland, we can assume that the volume of sella turcica in skeletal Class III patients has some difference to that of normal occlusion group. The purpose of this study was to evaluate the difference of shape and volume of sella turcica between normal occlusion group and Class III patients. The shape of sella turcica was Classified by Inaba method and the volume of sella turcica was measured in lateral and P-A cephalograms by Di Chiro method. To find out the possibility of the volume of sella turcica as diagnostic aid to predict Class III growth pattern, the correlation coefficients between the volume of sella and cephalometric variables were calculated. The results were as follows. 1. The volume of sella turcica in Class III patients is larger than that of normal occlusion groups 2. The volume of sella turcica in female was larger than that of male in Class III patients 3. The volume of sella turcica has close correlation with APDI, ANB, SNA, SNB, ODI, gonial angle, post. cranial base length 4. Sella Index (volume of sella / ant. cranial base length) can be a more accurate indicator that represent Class III growth pattern than volume of sella itself. 5. The morphologic pattern of sella turcica had no significant difference between two groups.
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