• Title/Summary/Keyword: Hyperdivergent skeletal pattern

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Effect of extraction treatment on upper airway dimensions in patients with bimaxillary skeletal protrusion relative to their vertical skeletal pattern

  • Cho, Ha-Nul;Yoon, Hyun Joo;Park, Jae Hyun;Park, Young-Guk;Kim, Su-Jung
    • The korean journal of orthodontics
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    • v.51 no.3
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    • pp.166-178
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    • 2021
  • Objective: To investigate dimensional changes in regional pharyngeal airway spaces after premolar extraction in bimaxillary skeletal protrusion (BSP) patients according to vertical skeletal pattern, and to further identify dentoskeletal risk factors to predict posttreatment pharyngeal changes. Methods: Fifty-five adults showing BSP treated with microimplant anchorage after four premolar extractions were included in this retrospective study. The subjects were divided into two groups according to the mandibular plane steepness: hyperdivergent (Frankfort horizontal plane to mandibular plane [FH-MP] ≥ 30) and nonhyperdivergent groups (FH-MP < 30). The control group consisted of 20 untreated adults with skeletal Class I normodivergent pattern and favorable profile. Treatment changes in cephalometric variables were evaluated and compared. The association between posttreatment changes in the dentoskeletal and upper airway variables were analyzed using linear regression analysis. Results: The BSP patients showed no significant decrease in the pharyngeal dimensions to the lower level in comparison with controls, except for middle airway space (MAS, p < 0.01). The upper airway variable representing greater decrease in the hyperdivergent group than in the nonhyperdivergent group was the MAS (p < 0.01). Posttreatment changes in FH-MP had negative correlation with changes in MAS (β = -0.42, p < 0.01) and inferior airway space (β = -0.52, p < 0.01) as a result of multivariable regression analysis adjusted for sagittal skeletal relationship. Conclusions: Decreased pharyngeal dimensions after treatment in BSP patients showed no significant difference from the normal range of pharyngeal dimensions. However, the glossopharyngeal airway space may be susceptible to treatment when vertical dimension increased in hyperdivergent BSP patients.

Clustering of craniofacial patterns in Korean children with snoring

  • Anderson, Stephanie Maritza;Lim, Hoi-Jeong;Kim, Ki-Beom;Kim, Sung-Wan;Kim, Su-Jung
    • The korean journal of orthodontics
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    • v.47 no.4
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    • pp.248-255
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    • 2017
  • Objective: The purpose of this study was to investigate whether the craniofacial patterns of Korean children with snoring and adenotonsillar hypertrophy (ATH) could be categorized into characteristic clusters according to age. Methods: We enrolled 236 children with snoring and ATH (age range, 5-12 years) in this study. They were subdivided into four age groups: 5-6, 7-8, 9-10, and 11-12 years. Based on cephalometric analysis, the sagittal and vertical skeletal patterns of each individual were divided into Class I, II, and III, as well as the normodivergent, hypodivergent, and hyperdivergent patterns, respectively. Cluster analysis was performed using cephalometric principal components in addition to the age factor. Results: Three heterogeneous clusters of craniofacial patterns were obtained in relation to age: cluster 1 (41.9%) included patients aged 5-8 years with a skeletal Class I or mild Class II and hyperdivergent pattern; cluster 2 (45.3%) included patients aged 9-12 years with a Class II and hyperdivergent pattern; and cluster 3 (12.8%) included patients aged 7-8 years with a Class III and hyperdivergent pattern. Conclusions: This study found that the craniofacial patterns of Korean children with snoring and ATH could be categorized into three characteristic clusters according to age groups. Although no significantly dominant sagittal skeletal discrepancy was observed, hyperdivergent vertical discrepancy was consistently evident in all clusters.

Dentoalveolar Compensation of Hyperdivergent Skeletal Pattern in Children and Adults (개방교합성 골격 형태를 가진 아동과 성인의 치성보상 양상)

  • Jeon, Young-Mi;Park, Dong-Cheol;Kim, Jong-Ghee
    • The korean journal of orthodontics
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    • v.29 no.2 s.73
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    • pp.197-207
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    • 1999
  • Although there is a severe underlying skeletal deformity, the dentition has often maintained some occlusal contact and interdigitation by the teeth compensating in their positions for the skeletal problem, and these dental compensations are manifested in all three planes of space. The purposes of present investigation were 1) to study the pattern of dentoalveolar compensation of hyperdivergent skeletal pattern , and 2) to compare the dentoalveolar compensations of hyperdivergent skeletal pattern in children with adults. The samples selected for this study were consisted of 60 subjects in normal group, 60 subjects in hyperdivergent group. Each was divided into two subgroups by age ; child groups($8\~12yr$ old) and adult groups(17yr old over). The findings of this study were as follows; 1. In child, hyperdivergent subjects had smaller posterior lower facial height(p<0.01) and slightly longer anterior lower facial height than normal ones. In adults, they still expressed smaller posterior lower facial height and much longer anterior lower facial height than normal ones(p<0.01). 2. Hyperdivergent subjects had larger amount of upper and lower incisor relative eruption to their basal bone length than normal ones(p<0.05). In adult, relative eruption of upper incisor was increasing(p<0.05), although relative eruption of lower incisor remained the same as the child. 3. In child, there was no difference between hyperdivergent group and nomal one in the upper and lower molar relative eruption to their basal bone length. In adult, hyperdivergent group had target amount of upper molar relative eruption than normal ones(p<0.01), but relative eruption of lower molar was similar to normal ones. 4. Hyperdivergent group had larger angle between lower occlusal plane and mandibular plane than normal group(p<0.01). Upper occlusal plane of adult groups rotated more antero-superiorly than child groups, and adult hyperdivergent group had sleeper upper occlusal plane than normal group(p<0.05).

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A study on correlations between tongue with skeletal pattern and intermaxillary space in Class II malocclusion adult patients (골격성 II급 성인 부정교합자에서 혀와 두개안면골격 및 악간공간과의 상관관계에 관한 연구)

  • Kang, Hyun-Hee;Park, Soo-Byung
    • The korean journal of orthodontics
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    • v.29 no.5 s.76
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    • pp.575-587
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    • 1999
  • This study was designed to evaluate the correlations between tongue with skeletal pattern and intermaxillary space in Class II malocclusion adult patients. Craniofacial skeletal pattern was analyzed on the lateral cephalometric radiograph and the subjects were devided two groups by facial ratio, the 30 subjects of hyperdivergent group and the 30 subjects of hypodivergent group. The size and posture of tongue and intermaxillary space were measured on the lateral cephalometric radiograph. These data were statistically analyzed to examine significant differences between both groups and compared the correlation between tongue with skeletal measurements and intermaxillary space in each group. The results of this study were as follows. 1. In comparison of the tongue and intermaxillary space, the measurement of TS/IS showed significantly larger in hyperdivergent group and PIH and IS showed significantly larger in hypodivergent group. There were no statistically significant differences in the measurements of the height and posture of tongue. 2. In correlation between tongue with craniofacial skeletal measurements, the length and height of tongue showed the highest correlation with AFH(anterior facial height) in both groups(p<0.01). And that measurements showed high correlation with PFH(posterior facial height) in hypodivergent group. 3. In both groups, most measurements of tongue showed high correlation with intermaxillary space and the height and space of tongue showed high correlation with AIH and PIH(p<0.01).

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Three-dimensional cone-beam computed tomography based comparison of condylar position and morphology according to the vertical skeletal pattern

  • Park, In-Young;Kim, Ji-Hyun;Park, Yang-Ho
    • The korean journal of orthodontics
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    • v.45 no.2
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    • pp.66-73
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    • 2015
  • Objective: To compare condylar position and morphology among different vertical skeletal patterns. Methods: Diagnostic cone-beam computed tomography images of 60 adult patients (120 temporomandibular joints) who visited the orthodontic clinic of Hallym University Sacred Heart Hospital were reviewed. The subjects were divided into three equal groups according to the mandibular plane angle: hypodivergent, normodivergent, and hyperdivergent groups. Morphology of the condyle and mandibular fossa and condylar position were compared among the groups. Results: The hypodivergent and hyperdivergent groups showed significant differences in superior joint spaces, antero-posterior condyle width, medio-lateral condyle width, condyle head angle, and condylar shapes. Conclusions: Condylar position and morphology vary according to vertical facial morphology. This relationship should be considered for predicting and establishing a proper treatment plan for temporomandibular diseases during orthodontic treatment.

Airway size in malocclusions with hyperdivergent skeletal pattern (개방교합성 골격헝태를 갖는 부정교합자의 기도크기)

  • Kwak, So-Yeong;Kim, Hyo-Young;Jeon, Young-MI;Kim, Jong-Ghee
    • The korean journal of orthodontics
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    • v.33 no.4 s.99
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    • pp.293-305
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    • 2003
  • The pharynx have significant locations and functions because it forms a part of the unit in which respiration and deglutition are carried out. Because of the closed relationship between the pharynx and the dentofacial and craniofacial structure, many studies are carried out on this subjects. The purpose of this study were to compare the airway size including pharynx, soft palate, tongue and hyoid bone between normal and hyperdivergent skeletal pattern and to evaluate the change of those size in different age. The sample of this study were consisted of 51 subjects in normal group, 52 subjects in hyperdivergent group. Each was divided into two subgroups by age , child group(9-l2yr old) and adult group(18yr old over). The lateral cephalometric radiographs were taken and the distance, angle and ratio of the facial skeleton, pharynx, soft palate, tongue and hyoid bone were measured and evaluated statistically. The result obtained were summarized as follows : 1 SN-Mn angle, FMA, and Pal-Mn angle were significantly larger in child group than adult group, but the lower anterior facial height(LAFH) and facial height ratio(FHR) were significantly smaller in child group than adult group. Occlu-Mn angle was significantly steep in hyperdivergent group than normal, but not significantly different between child group and adult group. 2. Hyperdivergent group and child group had the stronger correlation between SN-Mn angle, FMA, Pal-Mn angle, LAFH and FHR and airway size than normal group and adult group. Hyperdivevgent child group had significant negative correlation between SN-Mn angle, FMA, Pal-Mn angle and sagittal skeletal dimension of nasopharynx and sagittal depth of nasopharyngeal lumen. Significant positive correlation were seen between LAFH and vertical measurement of airway. 3. There was no difference of the linear measurement of airway size between hyperdivergent group and normal group. 4. Adult group had smaller posterior pharyngeal wall, target nasopharyngeal depth longer nasopharyngeal height and longer pharyngeal length than child group. 5. The sagittal measurement of hyoid bone had no difference between child group and adult group. But adult group had larger vertical measurement of hyoid bone than child group.

Cone-beam computed tomography based evaluation of rotational patterns of dentofacial structures in skeletal Class III deformity with mandibular asymmetry

  • Ryu, Hyeong-Seok;An, Ki-Yong;Kang, Kyung-Hwa
    • The korean journal of orthodontics
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    • v.45 no.4
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    • pp.153-163
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    • 2015
  • Objective: The purpose of this study was to assess rotational patterns of dentofacial structures according to different vertical skeletal patterns by cone-beam computed tomography (CBCT) and analyze their influence on menton deviation in skeletal Class III deformity with mandibular asymmetry. Methods: The control group consisted of 30 young adults (15 men, 15 women) without any severe skeletal deformity. The asymmetry group included 55 adults (28 men, 27 women) with skeletal Class III deformity and at least 3-mm menton deviation from the midsagittal plane; it was divided into the hyperdivergent and hypodivergent subgroups using a mandibular plane angle cutoff of $35^{\circ}$. Fourteen rotational variables of the dental arches and mandible were measured and compared among the groups. Correlations between menton deviation and the other variables were evaluated. Results: The asymmetry group showed significantly larger measurements of roll and yaw in the mandible than the control group. The hypodivergent subgroup showed significant differences in maxillary posterior measurements of yaw (p < 0.01) and maxillary anterior shift (p < 0.05) compared with the hyperdivergent subgroup. All the mandibular measurements had significant correlations with menton deviation (p < 0.01). Most measurements of roll were positively correlated with one another (p < 0.01). Measurements of yaw and roll in the posterior regions were also positively correlated (p < 0.05). Conclusions: Menton deviation in skeletal Class III deformity with mandibular asymmetry is influenced by rotation of mandibular posterior dentofacial structures. The rotational patterns vary slightly according to the vertical skeletal pattern.

Effects of activator treatment on different skeletal patterns in growing class II malocclusion patients (성장기 II급 부정교합자에서 골격 형태에 따른 액티베이터 사용 효과에 관한 연구)

  • Ki, Jun-Hun;Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.37 no.1 s.120
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    • pp.29-43
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    • 2007
  • Objective: To establish proper diagnosis and treatment plan for skeletal Class II malocclusions, some important factors to consider are the patient's skeletal morphology, prognosis as well as the treatment effects. Therefore, the present study analyzed the effects of activator treatment on different skeletal patterns in growing Class II malocclusion patients. Methods: A total of 116 patients (53 boys & 63 girls) in the experimental group were treated with the activator appliance. The experimental group was classified into either hyperdivergent or hypodivergent groups according to articular and genial angles. Results: Patients with hypodivergent growth patterns showed good effects of activator treatment. Conclusion: It seems conceivable that through classifying adolescent Class II malocclusion patients into different skeletal patterns, activator treatment effects may be predicted during the diagnosis and treatment planning stage.

Analysis of effects from usage of skeletal anchorage-assisted Pendulum appliance on vertical component of craniofacial structure (골격고정원을 이용한 Pendulum 장치가 두개 안면의 수직적 요소에 미치는 효과 분석)

  • Lee, Jin-Woo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.1
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    • pp.10-16
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    • 2018
  • Purpose: The purpose of this study was to evaluate distalizing effects from the Pendulum appliance on vertical component of craniofacial structures. Materials and Methods: 20 Patients who visited for orthodontic treatments are assigned to two groups. Group I, SN-MP > 37 degrees are showing hyperdivergent pattern. Group II, 29 < SN-MP < 37 degrees are showing mesocephalic pattern. Each group are consisted of 10 people. Results and Conclusions: Differences between skeletal classifications result in significant differences at labioversion of lower incisors and distalized amount, which is larger at Group I (P <.05). Group II has only shown significant distalized molars (P < .05). Labioversion of lower incisors has not shown significant change. Skeletal anchorage-assisted Pendulum appliance doesn't deteriorate vertical component nor significantly improve.

A study on the position of tongue and hyoid bone in relation to vertical facial patterns in skeletal Class III malocclusion (골격성 III급 부정교합에서 수직적 안모형태에 따른 혀와 설골의 위치 비교)

  • Woo, Kwang-Su;Yoon, Jeong-Hyun;Kim, Sang-Cheol;Moon, Seong-cheol
    • The korean journal of orthodontics
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    • v.30 no.5 s.82
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    • pp.579-589
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    • 2000
  • The purpose of this study was to evaluate the position of tongue and hyoid bone in relation to vortical facial patterns in the adult and child. Lateral cephalograms taken in adults(63 cases, 11.7 years in average age) and children(69 cases, 22.6 years in average age) were traced and measured about position and posture of tongue and hyoid bone using the horizontal and vertical reference lines. The angle of mandibular plane to SN Plane was employed to classify the samples into groups of hypodivergent and hyperdivergent. The comparison of the tongue/hyoid bone measurements between hypodivergent group and hyperdivergent group in the adult and child were statistically executed with Student's f-test. The results were as follows, 1. The tongue height was lower in the hyperdivergent group than in hypodivergent group, and higher in children than in adults. 2. The vertical height of hyoid bone was higher in hypodivergent group than in hyperdivergent group and also higher in children than in adults. 3. The anteroposterior position was of no significant difference in relation to age or vortical facial pattern. 4. The inclination of hyoid bone in relation to cranial base was steeper in children than in adults.

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