• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.22.1-22.9
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• 2017

Background: Two-jaw surgery including mandibular and maxillary backward movement procedures are commonly performed to correct class III malocclusion. Bimaxillary surgery can reposition the maxillofacial bone together with soft tissue, such as the soft palate and the tongue base. We analyzed changes of pharyngeal airway narrowing to ascertain clinical correlations with the prevalence of snoring after two-jaw surgery. Methods: A prospective clinical study was designed including a survey on snoring and three-dimensional (3D) computed tomography (CT) in class III malocclusion subjects before and after bimaxillary surgery. We conducted an analysis on changes of the posterior pharyngeal space find out clinical correlations with the prevalence of snoring. Results: Among 67 subjects, 12 subjects complained about snoring 5 weeks after the surgical correction, and examining the 12 subjects after 6 months, 6 patients complained about the snoring. The current findings demonstrated the attenuation of the largest transverse width (LTW), anteroposterior length (APL), and cross-sectional area (CSA) following bimaxillary surgery given to class III malocclusion patients, particularly at the retropalatal level. The average distance of maxillary posterior movements were measured to be relatively higher (horizontal distance 3.9 mm, vertical distance 2.6 mm) in case of new snorers. Conclusions: This study found that bimaxillary surgery could lead to the narrowing of upper airway at the retropalatal or retroglossal level as well as triggering snoring in subjects with class III malocclusion. Based on the current clinical findings, we also found that upper airway narrowing at retropalatal level may contribute to increasing the probability of snoring and that polysonography may need to be performed before orthognathic surgery in subjects with class III malocclusion.

• The korean journal of orthodontics
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• v.53 no.2
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• pp.67-76
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• 2023

Objective: Morphometric and morphological evaluation of the mandibular condyle in adults and to identify its correlation with skeletal malocclusion patterns. Methods: Cone-beam computed tomography scans of 135 adult patients were used in this study and classified into groups according to four criteria: (1) sex (male and female); (2) sagittal skeletal discrepancy (Class I, Class II, and Class III); (3) vertical skeletal discrepancy (hyperdivergent, normodivergent, and hypodivergent); and age (group 1 ≤ 20 years, 21 ≤ group 2 < 30, and group 3 ≥ 30 years). The morphometrical variables were mandibular condyle height and width, and the morphological variable was the mandibular condyle shape in coronal and sagittal sections. Three-dimensional standard tessellation language files were created using itk-snap (open-source software), and measurements were performed using Meshmixer (open-source software). Results: The mandibular condyle height was significantly greater (p < 0.05) in patients with class III malocclusion than in those with class I or II malocclusion; the mandibular condyle width was not significantly different among different sexes, age groups, and sagittal and vertical malocclusions. There were no statistical associations between various mandibular condyle shapes and the sexes, age groups, and skeletal malocclusions. Conclusions: The condylar height was greatest in patients with class III malocclusion. The condylar height and width were greater among males than in females. The mandibular condyle shapes observed in sagittal and coronal sections did not affect the skeletal malocclusion patterns.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.3
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• pp.139-144
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• 2012

This study was performed in order to evaluate the occurrence of temporomandibular joint disorder after surgical correction of skeletal class II malocclusion. Materials and Methods: This study included 21 patients who underwent orthognathic surgery for the correction of dentofacial deformities by a single surgeon at Mokdong Hospital, Ewha Womans University from 2000 to 2010. They underwent bilateral sagittal split ramus osteotomy for the treatment of undesirable mandibular advancement. The temporomandibular disorder (TMD) symptoms prior to surgery were recorded and the radiographic evaluation (panorama, bone scan, and magnetic resonance imaging [MRI]) of the post-surgery temporomandibular joint (TMJ) were assessed in order to evaluate condylar resorption, remodeling and disc displacement. The minimum follow-up period, including orthodontic treatment, was 12 months. Orthognathic procedures included 1-jaw surgery (n=8 patients) and 2-jaw surgery (n=13 patients). The monocortical plate was used for bilateral sagittal split ramus osteotomy fixation. Results: Among class II malocclusion patients with TMD symptom, clicking improved in 29.1%, and maximum mouth opening increased from $34.5{\pm}2.1$ mm to $37.2{\pm}3.5$ mm. The differences were not statistically significant, however. Radiographic changes in bone scan improved slightly based on the report by radiologist but not in TMJ dynamic MRI. Conclusion: No particular improvements were found in patients with joint sound only. Patients with limitation of mouth opening showed an increase in the degree of opening, but the difference was not statistically significant (P>0.05).

• The korean journal of orthodontics
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• v.50 no.5
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• pp.304-313
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• 2020

Objective: The aim of this study was to evaluate the stability of bimaxillary surgery involving bilateral intraoral vertical ramus osteotomy performed with or without presurgical miniscrew-assisted rapid palatal expansion (MARPE) in adult patients with skeletal Class III malocclusion. Methods: A total of 40 adult patients with skeletal Class III malocclusion were retrospectively divided into two groups (n = 20 each) according to the use of MARPE for the correction of transverse maxillomandibular discrepancy during presurgical orthodontic treatment. Serial lateral cephalograms and dental casts were analyzed until 6 months after surgery. Results: Before presurgical orthodontic treatment, there was no significant differences in terms of sex and age between groups. However, the difference of approximately 3.1 mm in the maxillomandibular intermolar width was statistically significant (p < 0.001). Two days after surgery, the mandible had moved backward and upward without any significant intergroup difference. Six months after surgery, the maxillary intercanine (2.7 ± 2.1 mm), interpremolar (3.6 ± 2.4 mm), and intermolar (2.0 ± 1.3 mm) arch widths were significantly increased (p < 0.001) relative to the values before presurgical orthodontic treatment in the MARPE group; these widths were maintained or decreased in the control group. However, there was no significant difference in surgical changes and the postsurgical stability between the two groups. No significant correlations existed between the amount of maxillary expansion and postsurgical mandibular movement. Conclusions: MARPE is useful for stable and nonsurgical expansion of the maxilla in adult patients with skeletal Class III malocclusion who are scheduled for bimaxillary surgery.

• International Journal of Oral Biology
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• v.43 no.2
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• pp.101-111
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• 2018

Understanding the classification of malocclusion is a crucial issue in Orthodontics. It can also help us to diagnose, treat, and understand malocclusion to establish a standard for definite class of patients. Principal component analysis (PCA) and k-means algorithms have been emerging as data analytic methods for cephalometric measurements, due to their intuitive concepts and application potentials. This study analyzed the macro- and meso-scale classification structure and feature basis vectors of 1020 (415 male, 605 female; mean age, 25 years) orthodontic patients using statistical preprocessing, PCA, random matrix theory (RMT) and k-means algorithms. RMT results show that 7 principal components (PCs) are significant standard in the extraction of features. Using k-means algorithms, 3 and 6 clusters were identified and the axes of PC1~3 were determined to be significant for patient classification. Macro-scale classification denotes skeletal Class I, II, III and PC1 means anteroposterior discrepancy of the maxilla and mandible and mandibular position. PC2 and PC3 means vertical pattern and maxillary position respectively; they played significant roles in the meso-scale classification. In conclusion, the typical patient profile (TPP) of each class showed that the data-based classification corresponds with the clinical classification of orthodontic patients. This data-based study can provide insight into the development of new diagnostic classifications.

• The Journal of the Korean dental association
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• v.48 no.3
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• pp.196-204
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• 2010

To establish the ideal occlusal relationship, the values of tooth size and ratio must be in a normal range. In this study, the means and standard deviations of Bolton's anterior ratio and overall ratio using mesiodistal dimensions of teeth measured on diagnostic models of 334 Korean malocclusion patients were calculated and differences in Bolton ratio according to the groups of malocclusion patients were studied. Also the changes that can occur in overall ratio before and after hypothetical tooth extractions were observed. The results are as follows. 1. The mean anterior ratio of Korean malocclusion patients was $78.0\;{\pm}\;2.69%$, and the mean overall ratio was $91.56\;{\pm}\;2.28%$. 2. The largest value of tooth size ratio could be found in Class III group, followed by Class I and Class II groups in order. However there was no statically significant difference. 3. The values of overall ratio reduced significantly after premolar extractions in all malocclusion groups, which was much more significant in the extraction of upper second premolar and lower first premolar(U5L4) or upper second premolar and lower second premolar(U5L5). 4. The values of overall ratio reduced significantly after premolar extractions in all 3 groups divided based on Bolton ratio, which was much more significant in the extraction of upper second premolar and lower first premolar(U5L4) or upper second premolar and lower second premolar(U5L5).

• The korean journal of orthodontics
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• v.4 no.1
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• pp.13-19
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• 1974

In orthodontic view points, there were a few attempts to describe on the mandibular rest position with roentgenocephalometric studies for the persons with malocclusion. The purpose of the present study was to evaluate and interpret the difference in each of the Angle's classification of the malocclusion. The author has selected 115 malocclusion patients of the both sexes as subjects, whose dental ages were from III A. Two lateral cephalometric head films were taken mandible at rest and with the teeth in occlusion utilizing the Broadbent-Bolton cephalometer. Their linear and angular measurements were made directly. The author obtained the following results: 1) The change in the incisal overbite was of $-2.32\~-3.36mm$, and the overjet decreased similiarly in each class of the malocclusion. 2) The range of free-way space was of $1.97\~3.56mm$, and showed prominent in the Angle's class III malocclusion. 3) In the rest position, the mandible showed backward displacement, and it was prominent in the Angle's class III malocclusion. 4) In the change of Ar-Gn, the class I and II showed more increase of distance-than the class III. 5) In the change of ${\angel}SNL_1L_1'$, the class III showed smaller angle than the class I and II. 6) There was no significant difference between the male and female in each class of the malocclusion.

• The korean journal of orthodontics
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• v.44 no.6
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• pp.304-311
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• 2014

Objective: The purpose of this study was to evaluate the effect of malocclusion or orthodontic treatment on oral health-related quality of life (OHRQoL) in adults. Methods: The sample consisted of 860 adults (378 men and 482 women, aged 18-39 years) who were clinically evaluated for malocclusion or orthodontic treatment experience. Participants were divided into 4 groups as follows: normal occlusion, malocclusion, fixed treatment, and retention. OHRQoL was assessed with the short form of the Oral Health Impact Profile (OHIP-14) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Results: The malocclusion group and the fixed treatment group had significantly higher OHIP-14 scores than the normal occlusion group and the retention group (p < 0.001). The malocclusion group had the highest PIDAQ score, while the normal occlusion group and the retention group had the lowest PIDAQ score (p < 0.001). Women had higher OHIP-14 and PIDAQ scores than men. A significant positive correlation was found between OHIP-14 and PIDAQ scores (p < 0.01). Conclusions: Malocclusion has a negative impact on OHRQoL, but this could be improved in adults through orthodontic treatment. These OHRQoL questionnaires can provide additional useful information on specific aspects of orthodontic patients' psychological state.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.1
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• pp.45-52
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• 2015

The purpose of this study was to compare and evaluate facemask effects when two types of intraoral appliances were used for maxillary protraction for patients with class III malocclusion. Eighteen patients with class III malocclusion were treated with a facemask for an average of 12 months. Two types of intraoral appliances were used: nine patients were treated with bonded expander (Group 1), and nine patients with Hyrax (Group 2). Cephalometric radiographs were taken before and after treatment. Cephalometric radiographs were traced, analyzed, and the results such as sagittal, vertical and soft-tissue changes were compared between two groups. The amount of anchorage loss was also measured to evaluate the difference between two groups. All patients showed significant sagittal skeletal changes after treatment, and there was no statistically significant difference between the two groups. When anchorage loss was evaluated, no differences were shown between the two. Facemask with Hyrax or bonded expander is similarly an effective method as a treatment in class III malocclusion patients.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.243-247
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• 1986

174 patients who visited in the Department of Dentistry, College of Medicine, Yeungnam University from 1983. 7. 15 to 1986. 11. 30 were surveyed on the tendency of patient distribution and the state of Angle's classification. The results were as follows : 1. There was increased visiting rate of patient per year. Female outnumbered male by a ratio of 1.3 : 1. 2. 8-15 age group was 74% in total visiting in the most frequency. The average visiting numbers of each month were higher among the vacation and was about 74% in that period. 3. As showed the living distribution, Nam Gu and Su Sung Gu's patients were 53% of the total. 4. As the motive of visiting in Dental Department, patients of 30% in total patients visited for themself to receive orthodontic treatment and others was introduced patients. 5. By classification, Class I malocclusion was 63% in total visiting patient, Class II malocclusion 17%, ClassIII malocclusion 20%. Crowding among Class I malocclusion was 60%.