• The korean journal of orthodontics
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• v.28 no.5 s.70
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• pp.763-774
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• 1998

The purpose of this study was to evaluate the morphology of mandibular symphysis and location of lower incisor under the influence of the craniofacial skeleton in skeletal Class III malocclusion. The sample consisted of 132 adults who have severe Class III malocclusion(prognathism group, 33 males and 33 females), and who have normal occlusion(normal group, 33 males and 33 females). They had not received any orthodontic treatment or orthognathic surgery. The lateral cephalograms were evaluated. The results were as follows : 1. Prognathism group were larger than normal group in comparison of facial skeleton (p<0.05) with the exception of ${\angle}FH-Pal$, ${\angle}SNA$. 2. In the morphology of symphysis, measurements of anteroposterior width(LaABBW, LiABBW, SW) of prognathism group were significantly less than that of normal group(p<0.001). 3. In the correlative analysis between the craniofacial skeleton and symphysis measurements of prognathism group, vertical measurements in relation with cranial base and mandibular plane showed reverse correlationship with anteroposterior width of symphysis(LiACBW, LaACBW, LiABBW, SW)(p<0.05). But, there was not distinct difference between horizontal skeletal measurements and symphysis measurements(p>0.05). 4. The probability by regression test between vertical measurements(${\angle}SN-Mn,\;{\angle}FMA,\;{\angle}Pal-Mn,\;{\angle}LFH$) and symphysis measurements(LiACBW, LiABBW, SW, ${\angle}LISA$) were very high(p<0.001).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.1
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• pp.24-30
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• 2002

The facial patterns were expressed by the interrelation of variable factors such as heredity, function and environment. Such variable factors have an effect on the growth and development of maxillofacial bones. The malocclusions with skeletal discrepancies are caused by abnormal forms, sizes and positions of cranial base, maxilla and mandible. For the proper diagnosis and treatment planning, the analysis of such structures is necessary. Lateral cephalograms of 54 adults with class III malocclusion patients (test group) and 61 adults with normal occlusion (control group) were analyzed. Anteroposterior relations and sizes of cranial base, maxilla, mandible were estimated to compare with those of normal ones. In test group, the anterior cranial base length was within normal range, but posterior cranial base, maxilla and mandibular body were longer than those in control group, significantly. Based on the cranial base, the location of maxilla in test group was normal, but the location of mandible was more anterior than that in control. Based on the maxilla, the location of mandible was more anterior in test group than that in control. Both mandibular body and ramus anteroposterior lengths in test group were larger than those in control. Both mandibular plane angle and upper gonial angle were within normal range, but lower gonial angle was significantly high in test group.

• The korean journal of orthodontics
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• v.51 no.5
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• pp.337-345
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• 2021

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.

• The korean journal of orthodontics
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• v.26 no.4
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• pp.401-413
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• 1996

Facial vertical dyscrepancies is decided on the relationship between the anterior vertical facial height and posterior vertical facial height. Thus this study was conducted to determine the factors that affect the FHI, and classify the Class II div.1, malocclusion, which success is dependent on the vertical control according to the FHI, which is the ratio of antero-inferior facial height, posterio-inferior facial height ratio, and to use this as a guideline for treatment. Angle between palatal plane and Mandibular plane were in the order of RH, ID. Thus showing that interrelated angle was more inportant than the independent angle of both, palatal plane and Mandibular plane. The tendency of Cl II div.1. Malocclusion according to FHI, showed the Low group to have Mx. protrusion, prominent development of Mn. ramus, and the Mn. body length and ant. post. position was normal. The Normo group showed slight protrusion of the Maxilla,. The development of the ramus was less than normal and the Mn. was in a slight retruded position. The High group showed the Mx. in a normal position, the development of the Mn. ramus and body was the lowest, and the Mn. was in a posterior position. In observation of the factors affecting the FHI between each groups of Cl II div.l, malocclusion; In the Low group the MP- PP angle was very small, the ID was smililar to the normal group, but the RH was very large thus the FHI was increased. In the Normo group, the PP-MP angle was normal, ID was slightly smaller than the normal group and the RH was slightly smaller than the normal group, thus maintaining a normal FHI ratio. In the High group the PP-MP angle was very large, the ID was similar to the normal group, but the RH was smaller than the normal group thus the FHI was small.

• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.337-346
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• 2006

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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.49.1-49.9
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• 2016

Background: The aim of this report is to present a new reference for aesthetic mandible surgery using three-dimensional cone-beam computed tomography-based treatment planning for orthognathic surgery which can be implemented in surgical planning and perioperative procedure. Methods: To make an objective standard for evaluating aesthetic mandibular outline, we make an aesthetic scoring criteria with consideration of asymmetry, broad mandibular border line, and prominent mandibular angle. Two maxillofacial surgeons and two orthodontists rated their aesthetical evaluation from 1 to 5. Experimental group consisting of 47 female and 38 male patients who had rotational orthognathic two-jaw surgery from 2010 to 2011 were chosen according to aesthetic scoring done by two maxillofacial surgeons and two orthodontists. A high aesthetic score (${\geq}16$) means the facial contour is symmetric, with no broad and narrow aesthetic mandible frontal profiles. Control A group consisted of ten female and ten male patients who had no orthognathic surgery experience and low aesthetic score (${\geq}10$). Control B group consisted of ten female and ten male patients who had no orthognathic surgery experience and had anaesthetic mandibular frontal profile and a high aesthetic score (${\geq}16$). The three-dimensional image of the patient was taken from dental cone-beam CT (DCT) scanning (experimental group and control A group: 6 months DCT after surgery, control B group: 1st visit DCT). Each DCT was reformatted to reorient the 3D image using 3D analyzing program (OnDemand3D, cybermed Inc, CA, USA). After selection of 12 landmarks and the construction of reoriented horizontal, vertical, and coronal reference lines, 15 measurements were taken in 3D analysis of frontal mandibular morphology. Afterwards, horizontal and vertical linear measurements and angular measurements, linear ratio were obtained. Results: Mean $Go^{\prime}_{Rt}-Me^{\prime}-Go^{\prime}_{Lt}$ angular measurement was $100.74{\pm}2.14$ in female patients and $105.37{\pm}3.62$ in male patients. These showed significant difference with control A group in both genders. Ratio of $Go^{\prime}_{Rt}-Go^{\prime}_{Lt}-Me^{\prime}$ length to some linear measurements (ratio of $Me^{\prime}-Cd^{\prime}_{Rt}Cd^{\prime}_{Lt}$ to $Me^{\prime}-Go^{\prime}_{Rt}Go^{\prime}_{Lt}$, ratio of $Me^{\prime}-Go^{\prime}$ to $Me^{\prime}-Go^{\prime}_{Rt}Go^{\prime}_{Lt}$, ratio of $Go^{\prime}_{Rt}-Go^{\prime}_{Lt}$ to $Me^{\prime}-Go^{\prime}_{Rt}Go^{\prime}_{Lt}$) showed significant difference with control A group in both genders. Conclusion: This study was intended to find some standard measurement of mandible frontal view in 3D analysis of aesthetic patient. So, these potential measurement value may be helpful for orthognathic treatment planning to have more aesthetic and perspective outcomes.

• The korean journal of orthodontics
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• v.49 no.5
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• pp.326-337
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• 2019

Objective: The objective of this study was to develop new parameters based on the foramina of the trigeminal nerve and to compare them with the conventional cephalometric parameters in different facial skeletal types. Methods: Cone-beam computed tomography (CBCT) scans and cephalograms from 147 adult patients (57 males and 90 females; mean age, 26.1 years) were categorized as Class I ($1^{\circ}$ < ANB < $3^{\circ}$), Class II (ANB > $5^{\circ}$), and Class III (ANB < $-1^{\circ}$). Seven foramina in the craniofacial area-foramen rotundum (Rot), foramen ovale (Ov), infraorbital foramen, greater palatine foramen, incisive foramen (IF), mandibular foramen (MDF), and mental foramen (MTF)-were identified in the CBCT images. Various linear, angular, and ratio parameters were compared between the groups by using the foramina, and the relationship between the new parameters and the conventional cephalometric parameters was assessed. Results: The distances between the foramina in the cranial base did not differ among the three groups. However, the Rot-IF length was shorter in female Class III patients, while the Ov-MTF length, MDF-MTF length, and Ov-MDF length were shorter in Class II patients than in Class III patients of both sexes. The MDF-MTF/FH plane angle was larger in Class II patients than in Class III patients of both sexes. Most parameters showed moderate to high correlations, but the Ov-MDF-MTF angle showed a relatively low correlation with the gonial angle. Conclusions: The foramina of the trigeminal nerve can be used to supplement assessments based on the conventional skeletal landmarks on CBCT images.

• The korean journal of orthodontics
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• v.53 no.2
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• pp.125-136
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• 2023

Before progress was recently made in the application of temporary anchorage devices (TADs) in bio-mechanical design, orthodontists were rarely able to intrude molars to reduce upper posterior dental height (UPDH). However, TADs are now widely used to intrude molars to flatten the occlusal plane or induce counterclockwise rotation of the mandible. Previous studies involving clinical or animal histological evaluation on changes in periodontal conditions after molar intrusion have been reported, however, studies involving human histology are scarce. This case was a Class I malocclusion with a high mandibular plane angle. Upper molar intrusion with TADs was performed to reduce UPDH, which led to counterclockwise rotation of the mandible. After 5 months of upper molar intrusion, shortened clinical crowns were noticed, which caused difficulties in oral hygiene and hindered orthodontic tooth movement. The mid-treatment cone-beam computed tomography revealed redundant bone physically interfering with buccal attachment and osseous resective surgeries were followed. During the surgeries, bilateral mini screws were removed and bulging alveolar bone and gingiva were harvested for biopsy. Histological examination revealed bacterial colonies at the bottom of the sulcus. Infiltration of chronic inflammatory cells underneath the non-keratinized sulcular epithelium was noted, with abundant capillaries being filled with red blood cells. Proximal alveolar bone facing the bottom of the gingival sulcus exhibited active bone remodeling and woven bone formation with plump osteocytes in the lacunae. On the other hand, buccal alveolar bone exhibited lamination, indicating slow bone turnover in the lateral region.

• Journal of Oral Medicine and Pain
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• v.31 no.3
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• pp.255-263
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• 2006

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 Journal of Korean Academy of Prosthodontics
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• v.33 no.4
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• pp.780-806
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• 1995

The purpose of this study was to describe the application of 3D finite element analysis to determine resultant stresses on the bone anchored fixed prosthesis, implants and supporting bone of the mandible according to fixture numbers and load conditions. 4 or 6 fixtures and the bone anchored fixed prosthesis were placed in 3D finite element mandibular arch model which represents an actual mandibular skull. A $45^{\circ}$ diagonal load of 10㎏ was labiolingually applied in the center of the prosthesis(P1). A $45^{\circ}$ diagonal load of 20㎏ was buccolingually applied at the location of the 10mm or 20mm cantilever posterior to the most distal implant(P2 or P3). The vertical distribution loads were applied to the superior surfaces of both the right and the left 20mm cantilevers(P4). In order that the boundary conditions of the structure were located to the mandibular ramus and angle, the distal bone plane was to totally fixed to prevent rigid body motion of the entire model. 3D finite element analysis was perfomed for stress distribution and deflection on implants and supporting bone using commercial software(ABAQUS program. for Sun-SPARC Workstation. The results were as follows : 1. In all conditions of load, the hightest tensile stresses were observed at the metal lates of prostheses. 2. The higher tensile stresses were observed at the diagonal loads rather than the vertical loads 3. 6-implants cases were more stable than 4-implants cases for decreasing bending and torque under diagonal load on the anterior of prosthesis. 4. From a biomechanical perspective, high stress developed at the metal plate of cantilever-to-the most distal implant junctions as a consequence of loads applied to the cantilever extension. 5. Under diagonal load on cantilever extension, the 6-implants cases had a tendency to reduce displacement and to increase the reaction force of supporting point due to increasing the bendign stiffness of the prosthesis than 4-implants cases. 6. Under diagonal load on cantilever extension, the case of 10mm long cantilever was more stable than that of 20mm long cnatilever in respect of stress distribution and displacement. 7. When the ends of 10mm or 20mm long cantilever were loaded, the higher tensile stress was observed at the second most distal implant rather than the first most distal implant. 8. The 6-implants cases were more favorable about prevention of screw loosening under repeated loadings because 6-implants cases had smaller deformation and 4-implants cases had larger deformation.