This study aimed at investigating the skeletal, dentoalveolar, and soft tissue changes of Class III malocclusion cases treated by second molar extraction. The lateral cephalograms of 15 subjects with moderate Class III malocclusion by average ANB $-1.4^{\circ}\;and\;IMPA\;85^{\circ}$ were traced and the computerized superimposition of average craniofacial change was made. The data was gathered and statistically analyzed. The results were as follows: 1 Lower anterior facial height/anterior facial height increased by 0.6%(P<0.01), mandibular plane increased by $1.5^{\circ}$(P<0.05). 2. There was a slightly downward & backward rotation of the mandible. 3. Lower first molar tipped distally by 4.nm(P<0.001), lower anterior teeth lingually tipped by $3.2^{\circ}$(P<0.05). 4. Retracted lower lip improved facial profile. This study may suggest that second molar extraction could be effective for a moderate Class III malocclusion to make distalization of the lower first molar easier and avoid severe lingual tipping of the lower incisor, if the lower third molar has a normal shape, good direction of eruption and adequate time for lower second molar extraction
Statement of problem: The increasing demand for esthetic restorations has been required developing new materials for tooth colored restoration. Ceromer(Ceramic Optimized Polymer) has some advantages over porcelain, and has gained increasing popularity in restorative dentistry. However, there is little information on the dimensional changes in a clinical restoration in moist conditions. Purpose: This study examined the dimensional changes in Ceromer restorations with a clinical crown shape that were fabricated in a clinical manner. Material and methods: The crowns for the maxillary central incisor were fabricated with two Ceromers($BelleGlass^{(R)}$ and $Targis^{(R)}$) using a similar clinical restoration manufacturing technique. A total of twenty specimens were prepared and immersed in distilled water at room temperature to allow for water absorption. The weight, height and width were measured at 24, 72 and 168 hours. The accumulated ratios of the changes were calculated and evaluated using a paired t-test and an independent independent t-test. Results: The dimensions and weight increased with increasing soaking time. $Targis^{(R)}$ showed significant differences in height and weight between 24 hours and the other times(P<.05). $BelleGlass^{(R)}$ showed significant differences in width and weight between 24 hours and the other times. The two materials showed different changing patterns of the dimensions but there were no statistically significant differences between them. Conclusion: The dimensions and weight of the Ceromer restorations were changed by water absorption. The clinical crown shaped specimen showed more complicated dimensional changes than the simplified specimens.
Cause of skeletal Class III malocclusion in growing patients can be classified into maxillary deficiency, mandibular overgrowth, and combination of the two. Use of Protraction Head Gear(P.H.G.) has been recommended for treatment of growing Class III malocclusion patients, for it results in forward & downward movement of maxilla and backward & downward rotation of mandible. Numerous animal experiments were performed and clinical study data have been reported ; nevertheless, studies on soft tissue profile change and comparison of treatment effects among the patients who had undergone treatment are considered to be somewhat insufficient. The author selected 93 patients, who had been diagnosed as skeletal Class III malocclusion with maxillary deficiency and then treated with P.H.G. ; the sample group was divided according to sex, treatment beginning age, palatal suture opening(intraoral appliance), and facial growth pattern. For each group, changing patterns of hard and soft tissue profile observed, and comparision with 20 normal group(Angle's Class I) patients of statistical significance in amount of growth and treatment of hard and soft tissue was done. The following results were obtained. 1. Skeletal, dental, and soft tissue measurements indicated that more growth changes was induced in the sample group that used P.H.G. compared to the growth amount of normal group. 2. No statistical significance was observed in the amounts of maxillary forward movement and mandibular backward & downward rotation depending on treatment beginning age in both sex group. 3. R.P.E. showed more significant maxillary forward movement and less protrusion of upper incisor than La-Li. 4. There was no statistical significance in the amount of maxillary forward movement depending on facial growth pattern. On the other hand, measurements indicating mandibular downward & backward rotation indicated greater change in counterclockwise growth pattern group than the clockwise. 5. Changes in upper and lower lip thicknesses showed a close relationship with positional changes in underlying bone tissue and upper and lower teeth, and upper lip height and nasolabial angle increased and mentolabial angle decreased.
Kim, Keun-Ryoung;Kim, Seong-Sik;Son, Woo-Sung;Park, Soo-Byung
The korean journal of orthodontics
/
v.38
no.2
/
pp.104-120
/
2008
Purpose: The purpose of this study was to assess the hard and soft tissue changes associated with mandibular bilateral sagittal split osteotomy and genioplasty. Methods: This is a retrospective study of 40 patients who underwent either bilateral sagittal split osteotomy for mandibular setback (BSSO group, n = 20) or in combination with advancement genioplasty (Genio group, n = 20). Lateral radiographs, were taken before and immediately after surgery, and at least 6 months after surgery. Results: Comparing hard and soft tissue changes between the BSSO group and Genio group, there were significant differences in the lower incisor, soft tissue B point (B'), and soft tissue Pogonion (Pg') (p < 0.5). The mean ratio of hard and soft tissue changes for B/B', Pg/Pg', and Menton/soft tissue Menton after surgery in the BSSO group was 0.997, 0.965, and 1.022 respectively, and 0.824, 0.602, and 0.887 respectively in the genio group. Significant differences were found between the two groups. There were significant differences in lip thickness (B-B', Pg-Pg') in the Genioplasty group between pre and postsurgery, but not in the BSSO group. Pogonion to Labrale inferior and B' had a correlation coefficient of 0.833, 0.922, respectively for the BSSO group, and 0.775, 0.799 for the Genio group. Conclusions: The results indicate that there is a significant difference between bilateral sagittal split osteotomy with or without genioplasty in the lower facial esthetics values. The combination of mandibular setback and genioplasty had a smaller change in soft tissue thickness of the symphysis area after surgery than that of mandibular setback only.
Kim, Nam-Woo;Lee, Gung-Chol;Moon, Cheol-Hyun;Bae, Jung-Yoon;Kim, Ji-Yeon
The Journal of Korean Academy of Prosthodontics
/
v.54
no.1
/
pp.1-7
/
2016
Purpose: The aim of this study was to evaluate the effect of increased vertical dimension of occlusion on lower facial changes by facial type. Materials and methods: Lateral cephalograms from 261 patients were obtained and classified by sagittal (Class I, II, and III) and vertical (hypodivergent, normodivergent, and hyperdivergent) facial patterns. Retrusive displacement of soft tissue Pogonion and downward displacement of soft tissue Menton were measured in each group after 2 mm of vertical dimension of occlusion was increased at the lower central incisor using a virtual simulation program. The ratio of both displacements was calculated in all groups. The statistical analysis was done by 2-way ANOVA and Post hoc was done by Tukey test (5% level of significance). Results: Retrusive displacement of soft tissue Pogonion in Class III group was statistically different compared to Class I and II, and in vertical facial groups all 3 groups were significantly different (P<.05). Downward displacement of soft tissue Menton showed statistically significant difference between all sagittal groups and vertical groups (P<.05). The ratio of both displacements showed statistically significant difference in all sagittal groups and vertical groups (P<.05), and Class II hyperdivergent group had the highest value. Conclusion: Lower facial change was statically significant according to the facial type when vertical dimension of occlusion increased. Class II hyperdivergent facial type showed the highest ratio after increase in vertical dimension of occlusion.
This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after BSSRO in 20 patients(males 9, females 11) using computed tomogram that were taken in centric occlusion before, immediate, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period intermaxillary fixation, 24hour after removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.45{\pm}4.01mm$ and horizontal long axis of condylar angle was $11.89{\pm}5.19^{\circ}$on right, $11.65{\pm}2.09^{\circ}$on left side and condylar lateral poles were located about 12mm and medial poles about 7mm from reference line(AA') on the axial tomograph. Mean intercondylar distance was $84.43{\pm}3.96mm$ and vertical axis angle of condylar angle was $78.72{\pm}3.43^{\circ}$on right, $78.09{\pm}6.12^{\circ}$on left. 2. No statistical significance was found on the condylar change(T2C-T1C) but it had definitive increasing tendency. There was significant decreasing of the distance between both condylar pole and the AA'(p<0.05) during the long term(TLC-T2C). 3. On the lateral cephalogram, no statistical significance was found between immediate after surgery and 24 hours after the removing of intermaxillary fixation but only the lower incisor tip moved forward about 0.33mm(p<0.05). Considering individual relapse rate, mean relapse rate was 1.2% on L1, 5.0% on B, 2.0% on Pog, 9.1% on Gn, 10.3% on Me(p<0.05). 4. There was statistical significance on the influence of the mandibular set-back to the total mandibular relapse(p<0.05). 5. There was no statistical significance on the influence of the mandibular set-back(T2-T1) to the condylar change(T2C-T1C), the condylar change(T2C-T1C, TLC-T2C) to the mandibular total relapse, the pre-operative condylar position to the condylar change(T2C-T1C, TLC-T2C), the pre-operative mandibular posture to the condylar change(T2C-T1C, TLC-T2C)(p>0.05). 6. The result of multiple regression analysis on the influence of the pre-operative condylar position to the total mandibular relapse revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condyalr head long axis angle, the more increasing of mandibular horizontal relapse(L1,B,Pog,Gn,Me) on the right side condyle. The same result was founded in the case of horizontal relapse(L1,Me) on the left side condyle.(p<0.05). 7. The result of multiple regression analysis on the influence of the pre-operative condylar position to the pre-operative mandibular posture revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condylar head long axis angle, the more increasing of mandibular vertical length on the right side condyle. and increasing of vertical lengh & prognathism on the left side condyle(p<0.05). 8. The result of simple regression analysis on the influence of the pre-operative mandibular posture to the mandibular total relapse revealed that the more increasing of prognathism, the more increasing of mandibular total relapse in B and the more increasing of over-jet the more increasing of mandibular total relapse(p<0.05). Consequently, surgical mandibular repositioning was not significantly influenced to the change of condylar position with condylar reposition method.
Soft tissue changes that occurred between presurgery to 5-years post-surgery in 49 orthognathic surgery patients whose maxillae were moved upward by Le Fort I osteotomy were examined by lateral cephalometric film. The objective of this paper was to document soft tissue changes at long-term follow-up after superior repositioning of the maxilla and to relate soft tissue and hard tissue changes in this group. The results were as follows. 1. On average, soft tissue landmarks in the nose and the upper lip were not changed statistically significantly except superior movement of superior labial sulcus and forward movement of pronasale between presurgery and 5 years postsurgery. 2. Upward and forward movement of the lower lip were found at 5 years postsurgery in comparison with presurgery and genioplasty added this effects. 3. Upper lip length and vertical dimension of upper vermilion didn't show any significant changes, but increase of lower lip length and decrease of vertical dimension of lower vermilion were statistically significant between presurgery and 5 years post-surgery. 4. The decrease of upper incisor exposure and interlabial distance from presurgery to 1 year were continued from 1 year to 5 years and the amount of the decrease was more than that of vertical movement of the maxilla by surgery. 5. Long term changes in soft tissue landmarks from 1 to 5 years postsurgery exceeded hard tissue changes, meaning soft tissue moved down more than skeletal changes.
Kim, Myoung-Kyun;Choi, Yong-Sung;Chung, Song-Woo;Jeon, Young-Mi;Kim, Jong-Ghee
The korean journal of orthodontics
/
v.35
no.3
s.110
/
pp.216-226
/
2005
The purpose of this study was to test and compare the accuracy and reliability of soft tissue profile predictions generated from two computer software programs (Quick Ceph Image $Pro^{TM}$ (ver 3.0) and $V-Ceph^{TM}$(ver 3.5)) for mandibular set-back surgery. The presurgical and postsurgical lateral cephalograms of 40 patients (20 males and 20 females) were traced on the same acetate paper with the reference taken as the cranial base outline. The presurgical skeletal outlines were digitized onto each computer program and the mandible was moved to mimic the expected surgical procedure with reverence to the mandibular anterior border and lower incisor position of the actual postsurgical skeletal outline. The soft tissue profile was generated and the amount and direction of skeletal movement was calculated with each software. The predicted soft tissue profile was compared to the actual postsurgical soft tissue profile. There were differences between the actual and the predicted surgical soft tissue profile charges in the magnitude and direction, especially the upper lip. lower lip and the soft tissue chin (P<0.05). Quick Ceph had more horizontal measurement errors and thickness errors for the upper lip and lower lip, but V-Ceph had more vertical measurement errors of the lower lip (P<0.05). There was a positive correlation between the prediction errors and the amount of mandibular movements in the vertical position of Sn, the horizontal position of Ls and the upper lip thickness for V-Ceph, and there was a negative correlation in the horizontal position and the thickness of the lower lip for Quick Ceph (P<0.05). However all of the Prediction errors of both imaging softwares were ranged within 3mm, and this was considered to be allowable clinically.
The purpose of this study was to evaluate the differences of soft tissue profile changes between the growing patients and the adult who had passed the growth peak, in orthodontic treatment with four premolar extractions. The results which was taken by correlating the soft tissue changes with hard tissue changes, lip thickness, molar relationship and arch length discrepancy in both groups was like the followings. 1. Significant hard tissue changes were decrease of VIs, VIi, UlPP, LlMP, HIi and increase of HPog'in adults and decrease of VIs, VIi and increase of VA, VPog'and all the vertical measurements in adolescents. 2. Significant soft tissue changes were decrease of VLs, VLi, and VILS in adults and increase of VSn, VSLS, VLs, VPog' and almost all vertical measurements in adolescents, and ${\Delta}LsE,\;{\Denta}LiE$ in adults and ${\Delta}LsE,\;{\Denta}LiE,\;{\Delta}LiSP\;and\;{\Delta}Mang$ was also significant 3. Correlation coefficient between ${\Delta}VIs\;and\;{\Delta}VLs$ was the greatest in adults and the next was ${\Delta}Ii/{\Delta}Li,\;{\Delta}Ii/{\Delta}ILS,\;{\Delta}ID/{\Delta}Li\;and\;{\Delta}ID/{\Delta}ILS$. In contrast all the vertical and horizontal measurements of hard and soft tissue in adolescents showed statistically significant corerrlation. 4. There were differences in correlation between soft tissue changes and incisor inclination and retraction at both groups, but the lower lip, nasolabial angle and mentolabial angle were commonly less influenced by the hard tissue changes in both groups. 5. The thinner the upper lip was, the more the ${\Delta}LsSP$ was in both groups, and the thinner the lower lip was, the more the ${\Delta}LiE\;and\;{\Denta}LiSP$ was in adolescents. 6. Molar relationship didn't influence the soft tissue profile changes. 7. Arch length discrepancy didn't influence the soft tissue profile changes.
Objective: The purpose of this study was to examine how the mesio-distal angulation and the length of each tooth changes on panoramic radiograph at different bucco-lingual inclinations. Methods: After constructing an acrylic model based on the mean arch of 30 adults with normal occlusion, the wire was placed in the center of the teeth on the acrylic model. First, the wire was implanted in normal angulation and inclination and a panoramic radiograph taken. After changing the inclination from $I-5^{\circ}\;to\;I+15^{\circ}\;by\;5^{\circ}$, a panoramic radiograph was taken again and the mesio-distal angle and wire length on the panoramic radiograph were assessed. Results: When the wire was implanted at the normal angulation and inclination, the length measured in the panoramic radiograph was magnified $111{\sim}117%$ from the original length in the anterior region and $121{\sim}125%$ in the posterior region. Only the central and lateral incisors showed significant length differences when the inclination was changed from $l-15^{\circ}\;to\;I+15^{\circ}$ at fixed angulation. When the inclination was changed from $l-15^{\circ}\;to\;I+15^{\circ}$, the angulation of most teeth on panoramic radiograph appeared to be more disto-angulated than in reality, and the lateral incisor and canine showed the largest difference. Only $l-15^{\circ}\;to\;I+15^{\circ}$ groups of premolars and $I+15^{\circ}$ group of molars showed more mesio-angulation than in reality. As the labio(bucco)lingual inclination of all teeth were decreased, tooth angulation in the panoramic radiograph appeared to be more disto-angulated. Conclusion: The labio-liugual inclination of teeth should be considered because it affects panoramic image of teeth, such as length of incisors and angulation of other teeth.
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