Purpose: The aim of this study is to assess the relationship between possible occlusal change after stabilization splint therapy and the research diagnostic criteria for temporomandibular disorders (RDC/TMD) Axis I diagnoses and lateral cephalometric variables. Methods: Clinical and radiographic records of 47 TMD patients wearing stablization splint were reviewed. The number of occluding teeth was recorded and lateral cephalogram was taken at pre-treatment and 6-month post-treatment. They were divided into two groups. The control group consists of patients with the unchanged number of occluding teeth throughout 6-month splint therapy (19 females and 4 males), and occlusal-loss group with the number of occluding teeth decreased (19 females and 5 males). The difference of RDC/TMD diagnoses and cephalometric variables were compared between two groups. Results: In the control group, RDC group I, muscle disorders, was 39.1% (9/23), group II, disc displacements, was 17.4% (4/23), group III OA, osteoarthritis/osteoarthrosis, was 73.9% (17/23), and group III pain, arthralgia, was 82.6% (19/23). In the occlusal-loss group, group I was 41.7% (10/24), group II was 41.7% (10/24), group III OA was 70.8% (17/24), and group III pain was 83.3% (20/24). The frequency of RDC groups was not different between two groups, analyzed by binomial logistic regression. Pre-treatment cephalometric variables were not different between two groups. However, articular angle, AB to mandibular plane and ODI decreased and gonial angle increased significantly in the occlusal-loss group, implying clockwise rotation of the mandible, between pre-treatment and 6-month post-treatment, while none of cephalometric variables showed any statistical difference in the control group. Conclusions: Change in the number of occluding teeth was not related to the RDC/TMD diagnoses. Cephalometric values changed only in the occlusal-loss group as a result of mandibular clockwise rotation. None of cephalometric variables before the stabilization splint therapy was statistically different between the control and occlusal loss group.
Objective: To investigate the phenotypes and predominant skeletodental pattern in pre-adolescent patients with Pierre-Robin sequence (PRS). Methods: The samples consisted of 26 Korean pre-adolescent PRS patients (11 boys and 15 girls; mean age at the investigation, 9.20 years) treated at the Department of Orthodontics, Seoul National University Dental Hospital between 1998 and 2019. Dental phenotypes, oral manifestation, cephalometric variables, and associated anomalies were investigated and statistically analyzed. Results: Congenitally missing teeth (CMT) were found in 34.6% of the patients (n = 9/26, 20 teeth, 2.22 teeth per patient) with 55.5% (n = 5/9) exhibiting bilaterally symmetric missing pattern. The mandibular incisors were the most common CMT (n = 11/20). Predominant skeletodental patterns included Class II relationship (57.7%), posteriorly positioned maxilla (76.9%) and mandible (92.3%), hyper-divergent pattern (92.3%), high gonial angle (65.4%), small mandibular body length to anterior cranial base ratio (65.4%), linguoversion of the maxillary incisors (76.9%), and linguoversion of the mandibular incisors (80.8%). Incomplete cleft palate (CP) of hard palate with complete CP of soft palate (61.5%) was the most frequently observed, followed by complete CP of hard and soft palate (19.2%) and CP of soft palate (19.2%) (p < 0.05). However, CP severity did not show a significant correlation with any cephalometric variables except incisor mandibular plane angle (p < 0.05). Five craniofacial and 15 extra-craniofacial anomalies were observed (53.8% patients); this implicated the need of routine screening. Conclusions: The results might provide primary data for individualized diagnosis and treatment planning for pre-adolescent PRS patients despite a single institution-based data.
Objective: The purpose of this study was to compare the longitudinal treatment effects of facemask with rapid maxillary expansion (FM/RME) and chincup (CC) therapy followed by fixed orthodontic treatment (FOT) in Class III malocclusion (CIII) patients. Methods: The samples consisted of twenty-one CIII patients who had similar skeletal and dental characteristics before FM/RME or CC therapy and good retention results (Class I molar/canine relationship and positive overbite/overjet) after FOT (Group 1, FM/RME, n = 11; Group 2, CC, n = 10). Lateral cephalograms were taken before (T0) and after FM/RME or CC therapy (T1), and after FOT and retention (T2). Skeletal and dental variables were measured. Mann-Whitney U-test and Wilcoxon signed-rank test were used for statistical analysis. Results: During T0-T1, FM/RME therapy induced forward movement of point A, and labioversion of the upper incisors. Both groups showed posterior repositioning of the mandible. FM/RME resulted in increase of the vertical dimension; however, CC caused an increase in articular angle and decrease in gonial angle. During T1-T2, both groups exhibited forward growth of point A. Group 1 showed forward growth and counterclockwise rotation of the mandible and increase of IMPA; however, Group 2, showed increase of ANS-Me/N-Me and decrease of overbite. Conclusions: The key factor for successful FM/RME and CC therapy and good retention results might be a harmonized forward growth of the maxilla that could keep pace with the growth and rotation of the mandible.
Lateral cephalometric X-ray films in maximal intercuspation and maximal opening of 68 children were taken and analyzed to examine the pattern of condylar movement and to study the relationship between opening movement and morphologic factors of craniofacial skeleton. The results were as follows : 1. The mean value of maximal opening capacity was 47.1mm, condylar moving distance was 18.1mm, horizontal condyle movement was 17.5mm, vertical condyle movement was 3.8mm and condylar moving angle was $13.1^{\circ}$. 2. The maximal opening capacity had positive relationship with the length of anterior cranial base, mandible and maxillary complex and with posterior facial height and had negative relationship with articular angle, sagittal jaw relationship. 3. Vertical condyle movement and condylar moving angle had positive relationship with articular angle and had negative relationship with gonial angle. 4. Horizontal condyle movement and condylar moving distance had positive relationship with the length of maxillary complex.
A study was made of a method of rational assessment on the roentgeno-cephalogram in orthodontic practice. Fifty eight measurements were analyzed on the roentgeno-cephalograms of 50 male and 50 female Korean adults with the acceptable profile and the normal occlusion. The means and standard deviations of measurements were studied in male and female groups by various analytic methods, and the sex difference was examined statistically. The obtained data were compared with those of the Japanese and American standards by useing a Japanese adults standard polygon chart reported by lizuka and Ishikawa. Amongs of 58 measurements, 14 have been selected as statistically significant and clinically useful, and used to make a Korean adult standard polygon chart. The results obtained were as follows: 1. Standards for cphalometric analysis in Korean adults were obtained, and the polygon chart and cephalometric profilogram were also made by using the standards in order to apply to a clinical diagnosis. 2. The sex difference was recognized in linear measurements, but not in angular measurments. 3. In comparison with the American standards from Downs and Graber, the Korean showed significant differences in angle of convexity, mandibular plane angle, Y-axis angle, interincisal angle and lower incisor to mandibular plane angle. Thus, the Korean showed a more retruded chin position, convex facial type, than white people. 4. In comparison with the Japanese standards from Iizuka and Ishikawa, the Korean showed a significant similarity with the Japanese, especially in females. 5. Upper incisor to Huxely line angle, established as a new measurement, proved to be paralell to X-Y axis angle.
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
Aims: The present study investigated the relationship between condylar resorption and craniofacial skeleton types(especially vertical relationships), the differences of craniofacial skeleton types between with open bite group and without open bite group, and the associations of anterior disc dislocation with or without reduction to condylar resorption with MRI. Patients selection and methods: Clinical examination, magnetic resonance imaging (MRI), panorama, lateral transcranial and lateral cephalometric radiographs in 34 patients with condylar resorption were used to investigate this relationship. Results and Conclusions: Patients with the following specific facial morphologic characteristics appear to be most susceptible to condylar resorption: (1) females were predominant, (2) patients' age ranged from 12 to 50 years old with a strong predominance for 2nd and 3rd decades, (3) patients had high mandibular plane angle and high gonial angle, (4) patients had decreased vertical height of the ramus, (5) patients had generally significant antegonial notch, (6) patients had predominance of Class I occlusal relationship with or without open bite but mandible was retruded as mean ANB 5.54 degrees, (7) condylar resorption rarely occurs in lower mandibular plane angle facial types, (8) although no statistically significant difference was found, the open bite group had a tendency more hyperdivergent skeletal pattern than the non open bite group, and (9) imaging demonstrates from small resorbing condyles to idiopathic condylar resorption and TMJ articular disc dislocations. Thus, morphologic features of patients with vertical discrepancies may represent a risk factor for the development of condylar resorption.
Objectives: This article reported three patients developed anterior open bite seemed to be related to TMJ anterior disc dislocation without reduction(ADD WO R), but no evidence of condylar destructive or collapse and analyzed the craniofacial skeletal structure by means of cephalometric analysis. Results: All patients suddenly developed a centric relation/centric occlusion discrepancy, an increased overjet and an anterior open bite following ADD WO R. All patients had Angle's Class I occlusion and shallow bite, but they had skeletally Class III and Class II pattern and all were vertically significant hyperdivergent type. Conclusions: These 3 patients had characteristics of common facial morphology including:(1)Angle classification Class I and shallow bite,(2)high mandibular plane angle,(3)high gonial angle. Developed anterior open bite resulted from clockwise rotation of the mandible related TMJ ADD WO R, rather than a result from the eruption of posterior teeth. We hypothesize rotation may relate to attached direction of masticatory muscle.
The purposes of this study were to evaluate the cephalometric characteristics of Korean female patients with Class II division 2 malocclusion and to compare Korean females with Caucasian females who had same type of malocclusion. All of the samples had Class II division 2 malocclusion with deep overbite (more than 4mm) and full permanent dentition. These samples were divided into two groups according to the races: Group 1(N=16; Korean females; average age=18Y 2M) and Group 2 (N:20; Caucasian females; average age=14Y 2M). The pretreatment lateral cephalograms were measured, analyzed and compared by using 38 variables and independent t-test. And the results were as follows: 1. Although there were no differences in Overbite, SN to mandibular plane angle, Palatomandibular plane angle, and FMA between Group 1 and 2, the other vertical relation variables of maxilla and mandible (SN to palatal plane angle, SN to occlusal plane angle, ODI) of Group 1 showed more clockwise rotation tendency of occlusal plane and less hypodivergency tendency than those of Group 2. 2. There were no differences in mandibular body length and ramus height between Group 1 and 2 except small upper genial angle of Group 1. There was less counterclockwise rotation tendency of mandible in Group 1. 3. There were no statistical significant differences in UAFH/LAFH and PFH/AFH between Group 1 and 2. 4. Although there were no differences of overjet and anteroposterior position of mandible between Group 1 and 2, the position of maxilla of Group 1 was more retropositioned than that of Group 2. 5. Except the more protrusion of lower incisor to A-Pog of Group 1, there were no differences of inclination and distance of upper and lower incisors to basal plane between Group 1 and 2. 6. The distance from upper- first molar to palatal plane showed no difference between Group 1 and 2. But the distance from lower first molar to mandibular plane of Group 1 was greater than that of Group 2. So it may be partially related to the clockwise rotation of occlusal plane and the less counterclockwise rotation tendency of mandible of Group 1. 7. Group 1 had more protrusive upper and lower lips than Group 2.
Objective: The purpose of this study was to assess new three-dimensional (3D) cephalometric variables, and to evaluate the relationships among skeletal and dentoalveolar variables through 3D cephalometric analysis. Methods: Cone-beam computed tomography (CBCT) scans were acquired from 38 young adults (18 men and 20 women; $22.6{\pm}3.2$ years) with normal occlusion. Thirty-five landmarks were digitized on the 3D-rendered views. Several measurements were obtained for selected landmarks. Correlations among different variables were calculated by means of Pearson's correlation coefficient values. Results: The body of the mandible had a longer curve length in men ($102.3{\pm}4.4$ mm) than in women ($94.5{\pm}4.7$ mm) (p < 0.001), but there was no significant difference in the maxillary basal curve length. Men had significantly larger facial dimensions, whereas women had a larger gonial angle ($117.0{\pm}4.0$ vs. $113.8{\pm}3.3$; p < 0.001). Strong-to-moderate correlation values were found among the vertical and transverse variables (r = 0.71 to 0.51). Conclusions: The normative values of new 3D cephalometric parameters, including the maxillary and mandibular curve length, were obtained. Strong-to-moderate correlation values were found among several vertical and transverse variables through 3D cephalometric analysis. This method of cephalometric analyses can be useful in diagnosis and treatment planning for patients with dentofacial deformities.
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