• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.1
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• pp.119-126
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• 2019

Sleep-disordered breathing (SDB) induces dysfunction of the orofacial muscles, leading to morphologic alteration of the face and dental malalignment. Early diagnosis and treatment of SDB is required in pediatric patients to ensure normal facial growth. Myofunctional therapy (MFT) is a modality for the treatment of SDB and prefabricated appliances can be used. Herein 2 cases of malocclusion with SDB, in which MFT with a prefabricated appliance was used for orthodontic treatment, have been described. SDB was diagnosed based on clinical symptoms taken by interview and home respiratory polygraphy. In both cases, SDB was improved using prefabricated appliance for MFT. However, resolution of crowding depended on the degree of crowding.

• Journal of the korean academy of Pediatric Dentistry
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• v.50 no.2
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• pp.142-154
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• 2023

The canine tooth is important both functionally and aesthetically, being positioned between the anterior and posterior teeth. The upper canine has the longest eruption path, forming in the deepest part of the maxillary bone and often experiencing eruption disorders, leading to significant aesthetic and functional issues. Early detection and management of canine impaction are crucial in pediatric dentistry, which focuses on tooth growth and eruption. The prevalence of maxillary canine impaction ranges from 1.1% to 3.0%. In Western populations, palatal impaction is twice as common as labial impaction, while some Korean studies report more labial impaction. Maxillary canine impaction occurs more frequently in women and is associated with various factors such as structural obstacles, pathological conditions in surrounding tissues, developmental abnormalities, and genetic factors. Labial displaced canines are linked to narrow maxillary intercanine width, total dental crowding, and skeletal Class III malocclusion. Maxillary palatal displaced canine impaction is more prevalent in patients with familial agenesis of lateral incisors or conical supernumerary lateral incisors. Understanding these factors aids in early diagnosis and appropriate intervention for canine tooth impaction, ensuring optimal oral health and aesthetics.

• 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.

• The korean journal of orthodontics
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• v.30 no.6 s.83
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• pp.669-675
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• 2000

Excessive production of parathyroid hormone causes bony disorder such as periosteal bone resorption and bone pain due to excessive skeletal demineralization. A Class III facial deformity case with generalized root resorption presented bete was fumed out to be due to hyperparathyroidism. Clinical and cephalometric analysis revealed a straight skeletal profile with a retruded maxilla and a prognathic mandible. The x-ray findings demonstrated generalized root resorption of entire dentition to different degree. There also appeared osteoporosis like immature trabecular structure with the evidence of ground glass appearance. Serum test showed elevated 1evel of parathyroid hormone and growth hormone. Change of cranial growth by hyperparathyroidism can be dependent up(In a decreased bone apposition in viscerocranial growth site and abnormalities in cranial suture growth. It is possible to hypothesize that growth retardation of maxilla at least partially be accounted lot hyperparathyroidism. Therefore, regarding to the definite etiology of skeletal Class III and orthodontic treatment planning considering root resorption and osteoporosis, the early diagnosis for the hyperparathyroidism should be carefully carried by clinical and laboratory studies.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.2
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• pp.119-128
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• 2011

In the process of assessing the children with anterior crossbite in early mixed dentition, it has frequently been detected that the stronger the skeletal pattern of the malocclusion is, the more markedly delayed the development and eruption of maxillary teeth are. If the anteroposterior characteristics of craniofacial skeleton has any relationship with dental maturation, the evaluation of dental development and eruption was thought to be able to contribute to early diagnosis of crossbite in children. This study was performed for the purpose of elucidating the relationship between dental maturation of maxillary teeth and some cephalometric values in children with anterior crossbite of maxillary undergrowth type in early mixed dentition. Among the children in Hellman dental age IIA and IIC who attended the Pediatric Dental Clinic of Pusan National University Hospital with orthodontic problems, cases with Class III malocclusion were classified and 50 cases of maxillary undergrowth type and type with normal maxilla respectively were randomly selected and studied as subjects. From their lateral cephalographs and panoramic radiographs, their anteroposterior skeletal features, the dental maturity and eruption rate were obtained of each group and data were analyzed to yield the results as follows: 1. Comparing the maturity of maxillary teeth of both groups, only the first molars of maxillary undergrowth group showed significantly slower development and eruption (p<0.05). 2. There was high correlation between maturation of maxillary 1st molar and chronological age(p<0.05). 3. Among the parameters of anteroposterior relationship of skeletal pattern in maxilla and mandible. Wits was revealed as a useful index to predict both the calcification and eruption rate of the 1st molars whereas SNA was to eruption rate(p<0.05).

• The korean journal of orthodontics
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• v.29 no.4 s.75
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• pp.467-481
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• 1999

Cleft lip and/or palate is one of the most common congenital craniofacial anomalies. According to previous epidemiologic studies, incidence of cleft lip and/or palate has been increasing nowadays. However, there is no report about epidemiologic study of cleft lip and/or palate patients who visited dept. of orthodontics in Korea. So the purpose of this study was to provide the epidemiological characteristics and important basic clinical data for the diagnosis and the treatment of the cleft lip and/or palate patients. With the orthodontic and cleft charts, diagnostic models and X-ray films from 250 patients with cleft lip and/or palate who visited Dept. of Orthodontics, Seoul National University Dental Hospital during the last 11 years, the authors investigated patient's visiting yew, types of cleft, patient's gender, and Angle's classification of malocclusion, and surgery timing. The results were as follows ; 1. The number of cleft patients who visited Dept. of Orthodontics, SNUDH increased during 1988-1990 and then it declined until 1992. From 1993 to 1996, it showed a stationary trend. After 1997 it showed an overwhelmingly increasing trend. 2. In the cleft type, the ratio of cleft lip cleft lip and alveolus cleft palate : cleft lip and palate was 7.6:19.2:9.6:63.6. In cleft position, unilateral clefts were more than bilateral ones (cleft lip 79:21, cleft lip and alveolus 77:23, cleft lip and palate 75.5:24.5). In cleft side, left clefts were mote than right clefts (cleft lip 53.3:46.7 cleft lip and alveolus 59.5:40.5, cleft lip and palate 59.2:40.8). 3. In gender ratio, males were more than females in cleft lip (57.9:42.1), cleft lip and alveolus (68.8:31.2) and cleft lip and palate (76.1:23.9). But in cleft Palate females were more than males as 41.7: 58.3. 4. In the age groups, 7-12 year group was the most abundant as $52\%$, and then 0-6 year group ($20.4\%$), 13-18 year group ($17.2\%$), more than 18 yew group ($10.4\%$) were followed as descending order. 5. Most of the cleft lip repair surgeries were operated in 0-3 month ($60.3\%$) and 4-6 month ($17.9\%$). 6. The cleft palate repair surgeries were done in 1-2 year ($31.7\%$), 0-1 year ($25.6\%$), 2-3 year ($12.1\%$), more than 5 year ($11.6\%$) as descending order. 7. The lip scar revision surgeries were done before admission at elementary school in $60\%$. (4-6 you ($27.5\%$), 6-8 year ($19.6\%$), more than 10 year ($19.6\%$), 2-4 year ($13.7\%$) as descending order) 8. The rhinoplasties were done before admission at elementary school in $51.7\%$. (0-2 year ($7.1\%$), 2-4 year ($14.3\%$), 4-6 year ($21.4\%$), 6-8 year ($14.3\%$)). 9. The pharyngeal flap were done at 6 Y (72.5 months) after birth on average and there was even distribution of surgery timing. 10. In relationship between Angle's classification of malocclusion and cleft types, Class I was most abundant and Class III, Class II were followed as descending order in cleft lip group. But Class III was most abundant and Class I, Class II were followed as descending order in cleft lip and alveolus group, cleft palate group, and cleft lip and Palate group. The percentage of frequency in Class III malocclusion was overwhelmingly higher in cleft lip and palate group than any other groups. 11. Because the frequency of class III malocclusion was most prevalent in all age groups, anterior crossbite was the most common chief complaint of cleft patients.

• The korean journal of orthodontics
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• v.26 no.4
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• pp.349-358
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• 1996

To extract or not to extract permanent teeth for the correction of malocclusion has been a great debate in the history of orthodontics, and there is a variety of analytic methods and criteria to aid in the diagnosis. Extraction formulas that has been presented are many analytic methods that depend on arch length discrepancy, dental prominence, and skeletal pattern of the each patients. Of these analysis, the most important diagnostic factor is patient's skeletal pattern. Because the behavior of the dentition is closely dependent upon the skeletal pattern of each patient, dentition must be arranged within that person's skeletal frame. EI(Extraction Index) is composed of CF, interincisal angle, and lip position. CF is made of ODI and APDI that differentiate vertical and horizontal component of the skeletal pattern. So, EI not only represents patient's skeletal pattern, but also takes facial appearance into consideration. This study was undertaken to investigate EI and related cephalometric variables on the cephalogram of Korean adolescents which consisted of 153 persons with normal occlusion, harmonious skeleton and pleasing face. The following conclusions were obtained. 1. The mean value of the ODI is $73.5^{\circ}$, APDI $82.5^{\circ}$, CF $156.3^{\circ}$ 2. The mean value of the interincisal angle is $123.6^{\circ}$ 3. The mean distance of upper lip to E-line is 0.0mm, lower lip to E-line is 1.4mm. 4. The mean value of the EI is $153.8^{\circ}$.

• The korean journal of orthodontics
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• v.26 no.4
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• pp.423-439
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• 1996

The purpose of this study was to evaluate the diagnostic value of $SONOPAK^*$ in internal derangement of TMJ by comparing the spectral analysis data of TMJ sounds recorded by SONOPAK with the results of MRI. From the patients who came to Department of Orthodontics, Seoul National University Dental Hospital for treatment of malocclusion, eighteen adult patients (five males and thirteen females) with TMD symptoms were selected. After joint sounds were checked by a pediatric stethoscope, they were recorded and analyzed by the SONOPAK. The spectral analysis of the SONOPAK provided SONOPAK INTERPRETATION data about the stage of internal derangement, which were compared with the results of MRI. Among the patients whose disc positions were diagnosed as 'normar by MRI, there were no false positive diagnosis by the SONOPAK INTERPRETATION, But in the cases of anterior disc displacements (reducible and/or nonreducible), most of SONOPAK INTERPRETATION data did not coincide with MRI results. In conclusion, it is not adequate to try to differentiate reducible and non-reducible anterior disc displacements on the basis of joint sounds. And it is recommended not to determine the stage of internal derangement according to the nature of sounds. We suggest that the diagnostic value of the SONOPAK will be enhanced when clinicians combine some other informations such as clinical signs/symptoms and other supplementary diagnostic tools), and that more data be incoporated into the SONOPAK INTERPRETATION software.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.356-360
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• 1999

PURPOSE : This is to review the complicated jaw fractures that had been referred for revision of the unsatisfactory results, and to provide proper managements for the easily complicated jaw fractures. MATERIALS & METHODS : Twenty-nine patients who had been revised due to malunion or complicated fractures of facial bones for last 3 years were reviewed. The main problems required for revision, type of fractures complicated, the primary managements to be reclaimed, the specialties to be involved, the management to be reclaimed, time elapsed to seek reoperation, type of revision surgeries, residual complication were analysed with medical records, radiographs and final examinations. RESULTS: The major complaints were malocclusion(79.3%), facial disfigurement(41.3%), TMJ problems (13.7%), neurologic problems(10.3%), non-union(10.3%), and infection(6.8%). Unsatisfactory results were occurred most frequently after improper management of the multiple fractures of the mandible (62.2%), combined fractures of maxilla and mandible (20.6%), fracture of zygomatico-maxillary complex and midpalate (17.2%). The complications to be corrected were widened or collapsed dental arches (79.3%), improperly reduced condyles (41.3%), painful TMJ (34.4%), limited jaw excursion (31.0%), over-reduction of zygoma (13.7%), and nonunion with infection(13.7%). and dysesthesia (10.3%). The primary managements were nendereet by plastic surgeons in 82.7%(24/29) and by oral surgeons in 7.6%(2/29). Main causes of malunion are inadequate ORIF in 76%, unawareness & delay in 17%, and delayed due to systemic cares in 17%. 76% of 29 patients had been in state of intermaxillary fixation for over 4 weeks. Revision were done by means of "refracture and ORIF"in 48.2%(14/29), orthognathic osteotomies with bone grafts in 55.1%(16/29), and camouflage countering & alloplastic implantations in 37.9%(11/29), TMJ surgeries in 17.2%, micro-neurosurgeries in 11.6%. Residual complications were limited mouth opening in 24.1% (7/29), paresthesia in 13.7%, resorption of reduced condyle in 10.3%. CONCLUSIONS : Failure of initial treatment of jaw fractures is due to improper diagnosis and inadequate treatment with lack of sufficient knowledge of stomatognathic system. It is crucial to judge jaw fracture and patients accurately, moreover, the best way of treatments has to be selected. Consideration of these factors in treatment could minimize the complication of jaw fractures.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.3
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• pp.306-313
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• 2012

Class III malocclusion or anterior crossbite is commonly seen in Asian. This problem is easily recognized by dentists and parents. During the primary dentition period, anterior crossbite with functional shift and deep overbite could develop to skeletal protrusive mandible. So, early and proper diagnosis of anterior crossbite which needs prompt treatment is important. These cases showed the early management of crossbite with functional shift in primary dentition using intraoral removable appliance resulting in improvement of intermaxillary relationship. And I analyzed the positional change and the dimensional change during treatment with lateral cephalometric x-ray analysis. Our patients showed vertical dimensional change of lower anterior facial height and clockwise rotation which results crossbite correction in 1 year of treatment period.