• Title/Summary/Keyword: Malocclusions

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Effects of Facemask Therapy for Class III Malocclusions in Patients with Different Vertical Skeletal Patterns (3급 부정교합 환자의 수직적 골격 양상에 따른 facemask 치료 효과 비교)

  • Lee, Eunha;Park, Kitae
    • Journal of the Korean Academy of Pediatric Dentistry
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    • v.42 no.2
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    • pp.126-135
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    • 2015
  • The purpose of this study was to evaluate the skeletal and dentoalveolar effects of facemask therapy and to compare the anchorage of a bonded expander in patients with Class III malocclusion and different vertical skeletal patterns. Twenty subjects with Class III malocclusion were included in this study and were treated with a facemask and bonded expander. Based on the FMA, subjects were divided into two groups of 10 patients each: a high vertical group (HV; mean FMA $33.56^{\circ}$) and an average vertical group (AV; mean FMA $24.88^{\circ}$). Lateral cephalograms were taken and evaluated before and after treatment. In both groups, forward movement of the maxilla and backward rotation of the mandible were observed after treatment, with no statistical differences between the groups. Vertical skeletal variables increased in both groups, but the increase of FMA was significantly larger in the HV group than the AV group. Mesial movement of maxillary molars and proclination of maxillary incisors which indicate anchorage loss of bonded expander were observed in both groups, with no significant differences between the groups. In conclusion, facemask therapy resulted in effective maxillary protraction in both HV and AV groups. However, the open bite tendency was increased more in the HV group.

A CEPHALOMETRIC STUDY ON CHANGES OF FACIAL MORPHOLOGY IN THE FRONTAL VIEW FOLLOWING MANDIBLE SETBACK SURGERY ( BSSRO ) IN PATIENTS WITH SKELETAL CLASS III DENTOFACIAL DEFORMITIES (골격성 제3급 부정교합환자의 하악지 시상분할 골절단술후 하안면 폭경 및 고경의 변화에 대한 두부계측 방사선학적 연구)

  • Jang, Hyon-Seok;Rim, Jae-Suk;Kwon, Jong-Jin;Lee, Bu-Kyu;Son, Hyoung-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.3
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    • pp.337-342
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    • 2000
  • Purpose : The purpose of this study was to analyze the lower third facial changes in frontal view after mandibular setback surgery. Materials and Methods : In this study, fifteen subjects(6 males and 9 females) with class III dental and skeletal malocclusions who were treated with BSSRO(Bilateral Sagittal Split Ramus Ostetomy) were used. Frontal cephalometric radiographs were taken preoperatively and more than 6 months postoperatively, and hard tissue(H2-Hl) and soft tissue changes (S2-S1) were measured on vertical and horizontal reference lines. In 15 cases, changes which developed more than 6 months after surgery were studied. Results : The results were as follows. 1. In the facial height, hard tissue $decreased(2.46{\pm}2.76mm)$ with statistical significance(P<0.01), and soft tissue also $decreased(1.64{\pm}3.66mm)$. As a result, the facial height generally becomes shorter after sagittal split ramus osteotomy. 2. In the mandibular width, hard tissue $decreased(2.08{\pm}3.59mm)$ with statistical sgnificance(P<0.05), but soft tissue $increased (2.14{\pm}5.73mm)$ without statistically significant difference(P>0.05) postoperatively. 3. In the facial index, hard tissue $decreased(0.23{\pm}2.21%)$, but soft tissue $increased(2.41{\pm}3.46%)$ with statistical significance. Conclusion : One of the main purpose of orthognathic surgery is to achieve facial esthetics and harmony. In order to fullfill this purpose, it is important to carry out a precise presurgical treatment planning by estimating the changes of frontal profile after surgery.

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DENTAL MANAGEMENT OF A PATIENT WITH MUSCULAR DYSTROPHY UNDER GENERAL ANESTHESIA: CASE REPORT (근이영양증(muscular dystrophy) 환자의 전신마취 하 치과치료 : 증례보고)

  • Chae, Jong Kyun;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.50-54
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    • 2019
  • Muscular dystrophy (MD) is a heterogeneous group of inherited neuromuscular disorders, characterized by progressive muscle weakness. Severity of the disease ranges from mild to severe, and the disease is mostly caused by mutations in a number of genes. These genetic mutations cause lack of proteins which are essential for muscle cell stability. Muscle fibers are gradually replaced by fat and fibrous tissue. The muscles of the head and neck are affected in several types of MD that manifest as altered craniofacial morphology and dental malocclusion. A 3-year-10-month old, 15.0 kg boy with MD presented to Seoul National University Dental Hospital, Seoul, South Korea because of extensive carious teeth. A number of dental caries in primary dentition were identified during clinical oral examination. Due to dental anxiety and underlying systemic disease, general anesthesia was considered. General anesthesia was induced and maintained with intravenous anesthetics, propofol and remifentanil. Caries treatments - resin restoration, pulpectomy, zirconia crown restoration, stainless steel crown restoration - were performed. Under general anesthesia, successful dental procedure was done. Total intravenous anesthesia (TIVA) was performed instead of inhalation anesthesia in order to avoid risk of complications such as malignant hyperthermia and life-threatening rhabdomyolysis. With decreasing muscle function, plaque control becomes more difficult and leads to gingivitis. Especially, the open-mouth posture worsens gingivitis and can leads to malocclusions and problems in swallowing. Regular and periodic dental care is essential for maintaining oral health for patients with MD.

Three-dimensional analysis of the positional relationship between the dentition and basal bone region in patients with skeletal Class I and Class II malocclusion with mandibular retrusion

  • Jun Wan;Xi Wen;Jing Geng;Yan Gu
    • The korean journal of orthodontics
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    • v.54 no.3
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    • pp.171-184
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    • 2024
  • Objective: This study aimed to determine the maxillary and mandibular basal bone regions and explore the three-dimensional positional relationship between the dentition and basal bone regions in patients with skeletal Class I and Class II malocclusions with mandibular retrusion. Methods: Eighty patients (40 each with Class I and Class II malocclusion) were enrolled. Maxillary and mandibular basal bone regions were determined using cone-beam computed tomography images. To measure the relationship between the dentition and basal bone region, the root position and root inclination were calculated using the coordinates of specific fixed points by a computer program written in Python. Results: In the Class II group, the mandibular anterior teeth inclined more labially (P < 0.05), with their apices positioned closer to the external boundary. The apex of the maxillary anterior root was positioned closer to the external boundary in both groups. Considering the molar region, the maxillary first molars tended to be more lingually inclined in females (P = 0.037), whereas the mandibular first molars were significantly more labially inclined in the Class II group (P < 0.05). Conclusions: Mandibular anterior teeth in Class II malocclusion exhibit a compensatory labial inclination trend with the crown and apex relative to the basal bone region when mandibular retrusion occurs. Moreover, as the root apices of the maxillary anterior teeth are much closer to the labial side in Class I and Class II malocclusion, the range of movement at the root apex should be limited to avoid extensive labial movement.

Dental and skeletal characteristics and growth in Class III malocclusion between skeletal ages of 10 and 14 (10세에서 14세 사이 III급 부정교합자의 치아안면두개의 형태학적 특성에 대하여)

  • Min, Seungki;Lee, Young-Jun;Park, Young-Guk;Rothstein, Ted
    • The korean journal of orthodontics
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    • v.33 no.6 s.101
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    • pp.419-435
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    • 2003
  • The purpose of this study was to evaluate growth changes and skeletal characteristics of Korean children with Class III malocclusions from 10 to 14 years of skeletal age. Radiographs of 60 children with Class III malocclusion and 60 normal controls were assessed. Both groups were subdivided into 6 samples according to sex and skeletal age. Skeletal age was assessed using handwrist X-rays using the Greulich and Pyle norms. The Krogman-Walker plane (occipitale-maxillon) through Sella was used as a reference plane in this study with x-axis perpendicular to the x-axis. Sir Student t-tests were conducted to compare the control group with the Class III group according to each gender a:nd age. The characteristics of Class III malocclusion group compared to the control group included shorter anterior and posterior cranial base, shorter and retrusive maxilla, forger mandible, increased molar-incisor distance, retroclined lower incisors, labially proclined upper incisors, and anteriorly located mandibular molar, smaller upper and middle facial depth, and larger lower facial depth. Landmarks representing facial depth, size of maxilla and mandible, and their AP relationship including anterior facial height indicate that growth characteristic was determined early in life. But growth Pattern of cranial base and some of the dental landmarks showed progressive divergence between Control and Class III groups with age. The position of the posterior border of the mandible was found to be significantly forward in both females and males by the age of 14 and at the anterior border in males and females at all ages. Hyperdivergent mandibular plane, changes in anterior segment of mandible, small anterior cranial base, and decrease in cranial base flexure was also noted.

A STUDY ON THE EFFECT OF CHINCAP IN JUVENILE SKELETAL GLASS III MALOCCLUSION (유년기 III급 부정교합자에서 이모장치의 치료 효과에 관한 연구)

  • Nahm, Dong-Seok;Suhr, Chung-Hoon;Yang, Won-Sik;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.28 no.4 s.69
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    • pp.517-531
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    • 1998
  • The purpose of this study was to investigate the changes in the craniofacial skeleton subsequent to chincap therapy in the juvenile skeletal Class III malocclusion with more appropriate control samples. The experimental group consisted of 29 Korean children(14 males, 15 females) who had skeletal Class III malocclusion with prognathic mandible and were undergone chincap thorny from the beginning of treatment. The control group was composed of 21 Korean children(10 males, 11 females) who had no orthodontic treatment, but with similar skeletal discrepancies to experimental group. Lateral cephalometric radiographs at the age of 7, and 2 years later were analyized and compared with student's t-test(p<0.05). The results of this study were as follows; 1. The control group without chincap therapy had not shown any improvement of the skeletal discrepancies, but had grown to be much severe. This means that the untreated Class III patient with prognathic mandible would not be corrected by growth. For the experimental group with chincap therapy, the anterior-posterior skeletal discrepancies and mandibular prognathism were both improved. 2. Neither significant restraint nor acceleration of growth was found in the cranial base and maxilla by chincap treatment. 3. The inhibition of mandibular growth could not be accepted, but the changes of the direction of growth and morphological changes were found. 4. Vertical growth tendency was increased with chincap therapy. 5. When Putting together the results of the analyses , it seems to be the rotation and displacement of the mandible that the major treatment effects of chincap we. The changes of the direction of growth and the morphological changes also seems to contibute to the treatment effect partly. In summary, the chincap doesn't restrain the mandibular growth. But, it is considered as a useful treatment modality for correction of skeletal discrepancies and reduction of mandibular prognathism in growing Class III patients with madibular prognathism.

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THE EFFECT OF DISTAL MOVEMENT OF UPPER MOLAR USING THE PENDULUM APPLIANCE (Pendulum 장치의 상악대구치의 원심이동에 대한 효과)

  • Lee, Chang-Seop;Kim, Jae-Gwang;Kang, Dug-Il;Song, Kwang-Chul;Jung, Hyun-Ku;Lee, Sang-Ho
    • Journal of the Korean Academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.488-495
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    • 2001
  • Treatment of class II malocclusions require distalization of maxillary molars into class I relationship. Intraarch distal molar movement techniques have recently assumed an important role in young patients. In this study, the dental and skeletal effects of the pendulum appliance were evaluated by means of cephalometric radiographs. The samples were consisted of 19 patients: 11 females and 8 males, mean age $11.68{\pm}1.52$ years. Measurements were obtained from cephalometric prior to and the day of removal of the pendulum appliance. Treatment changes were analyzed. The following results were obtain. 1. The pendulum appliance produced $2.94{\pm}1.54mm$ distal molar movement with a mean intrusion of $1.17{\pm}0.97mm$, mean period $18.13{\pm}7.95$ weeks. 2. The anchor tooth was $1.34{\pm}1.40mm$ forward movement and $0.48{\pm}0.99mm$ extrusion, and labial tilting of incisors. 3. The angle between palatal plane and mandibular plane increased significantly. 4. There was no significant difference in according to 2nd molar position. 5. Total movement was consisted of 74% distal movement of 1st molar and 26% forward movement of the anchor tooth.

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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.

Comparisons of occlusal force according to occlusal relationship, skeletal pattern, age and gender in Koreans (한국인에서의 부정교합 여부와 골격형태, 연령, 성별에 따른 교합력의 비교)

  • Yoon, Hye-Rim;Choi, Yoon-Jeong;Kim, Kyung-Ho;Chung, Choo-Ryung
    • The korean journal of orthodontics
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    • v.40 no.5
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    • pp.304-313
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    • 2010
  • Objective: The aim of this study was to evaluate the occlusal force and contact area and to find its associating factors in Koreans. Methods: Occlusal force and contact area in maximum intercuspation were measured using the Dental $Prescale^{(R)}$ system in 651 subjects (15 with normal occlusion, 636 with various malocclusions divided into subgroups according to the skeletal pattern, Angle's molar relationship, age and gender). Results: Occlusal force of the normal occlusion group ($744.5{\pm}262.6N$) was significantly higher than those of the malocclusion group ($439.0{\pm}229.9N$, $p$ < 0.05). Occlusal force was similar regardless of differences in ANB angle or Angle's molar classification, however the increase in vertical dimension significantly reduced occlusal force ($p$ < 0.05). Conclusions: Occlusal force was significantly lower in the malocclusion group compared to the normal occlusion group, and in females compared to males, but it was not affected by age, antero-posterior skeletal pattern or molar classification. Although a hyperdivergent facial pattern indicated lower occlusal force compared to a hypodivergent facial pattern, the differences in skeletal pattern were not the primary cause of its decrease, but a secondary result induced by the differences in occlusal contact area according to the facial pattern.

A Posteroanterior Cephalometric Study on Craniofacial Proportions of Koreans with Normal Occlusion (한국인 정상 교합자의 정모 두부 방사선 사진을 이용한 안모비율에 관한 연구)

  • Baik, Hyoung-Seon;Yu, Hyung Seog;Lee, Kie-Joo
    • The korean journal of orthodontics
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    • v.27 no.4 s.63
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    • pp.643-659
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    • 1997
  • For the total treatment of skeletal malocclusions, 3-dimensional evaluation and diagnosis are essential. Although anteroposterior discrepancies can be evaluated through various methods, the satisfactory methods for evaluations of facial asymmetry and transverse discrepancies are yet to be found. The adequate diagnosis and treatment of transverse discrepancies may be more important in the maintenance of functional occlusion as well as for the stability of results obtained from orthognathic surgery than the anteroposterior or vertical discrepancies. Since the soft tissue effects from the transverse discrepancies may not be pronounced, especially when combined with anteroposterior or vertical discrepancies which have prominent characteristics, the differentiation of their effects may be difficult from visual inspection alone. Therefore it is essential that the normal facial proportions would be established from the posteroanterior cephalometry as a reference for the accurate diagnosis and treatment. The present study evaluates 76 subjects from Yonsei University freshmen with normal facial symmetry and occlusion. Posteroanterior cephalograms were taken from the subjects and the normal values and facial proportions are obtained. The results are as follows. 1. The transverse and vortical values from posteroanterior cephalometry and their ratio, with means and standard deviations are calculated. 2. The ratio of vertical values to transverse values is 0.837 (male 0.836, female 0.841). 3. The Proportion of maxillary and mandibular widths is 0.747 (male 0.745, female 0.752), with statistically significant correlation. 4. Various degree of significant correlations are observed in the following craniofacial widths; (Cranial width, Bizygomaticofrontal suture width, Facial width, Maxillary width, Upper & Lower Intermolar width, Mandibular width). 5. Although the facial height as well as other line measurements increase as the facial widths increase, angle measurement ($Bj\ddot{o}rk$ Sum, Mandibular Plane Angle, Gonial Angle), decreases and posterior to anterior facial height ratio increases, therefore indicating the tendency for a brachycephalic facial type. These results may be used as references for the treatment planning in orthognathic and orthodontic treatments for the dentofacial deformity patients.

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