• Title/Summary/Keyword: Mandible position

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A study of mandibular positional changes by the stabilization splint in TMD patients (측두하악장애환자에서 교합안정장치가 하악골위치변화에 미치는 영향에 관한 연구)

  • Cheon, Hun;Park, Young-Guk;Chung, Kyu-Rhim
    • The korean journal of orthodontics
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    • v.30 no.4 s.81
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    • pp.491-507
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    • 2000
  • The purpose of this study was to investigate if there were a significant differences in mandibular position between cephalometric measurements from a centric occlusion tracing compared to those of a acquired centric relation by stabilization splint on malocclusion patient with TMD. 60 malocclusion patients, who had TMD and CO-CR discrepancy beyond normal range, were selected and subdivided into Class I, II, III by Angle's classification and also subdivided into clockwise, straight downward, and counterclockwise group by Jarabak's posterior facial height/anterior facial height ratio. Lateral cephaolmetric radiographs with the mandible in centric occlusion were taken and measured, and for each Patient the stabilization splint with mutually protected occlusal scheme was applied for minimum 3months. After each patient's CO-CR discrepancy was in normal range, lateral cephalometric radiographs were retaken and measured. The comparison of the difference between CO-CR cephalometric measurements in all sample, Class I, II, III groups, and Clockwise, Straight downward, Counterclockwise groups were studied. The finding of this study can be summarized as follows: 1 In all sample, the value of cephalometric measurements was significantly different between CO-CR. The mandible rotated to down and posterior position and the vertical change was greater than the horizontal change (overjet-1.3mm increase, overbite-1.9mm decrease). 2. In Class II malocclusion group, most of the mean difference value between CO-CR is higher than that of the other groups and more measurements was statically significant. 3. In clockwise and counterclockwise group, some of the mean difference value is higher than that of straight downward group and more measurements was statically significant. 4. There ware no measurements that explain centric relation measurements from the type of malocclusion, facial pattern and centric occlusion measurements. Henceforth, it is strongly recommended that stabilization splint therapy for orthodontic treatment on TMD patient should be excuted upon overall facial types prior to orthodontic diagnosis and treatment planning.

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Assessment of antero-posterior skeletal relationships in adult Korean patients in the natural head position and centric relation (자연 두부 위치 및 안정위에서 한국 성인 환자 골격의 전.후 관계 결정)

  • Ahn, Jang-Hoon;Bae, Kwang-Hak;Park, Young-Ju;Hong, Ryoon-Ki;Nam, Joeng-Hun;Kim, Mi-Ja
    • The korean journal of orthodontics
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    • v.40 no.6
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    • pp.421-431
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    • 2010
  • Objective: This study aimed to verify the intra-individual reproducibility of the natural head position (NHP) in adult Korean patients in the centric relation (CR) position and to prove the inter-individual variability of the Frankfurt horizontal (FH) plane and sella-nasion (SN) line compared to the true horizontal line (THL). In addition, the study aimed to investigate the correlations between linear measurements from A-point and B-point to the nasion true vertical line (NTVL) and angular measurements from A-point and B-point to the SN line. Methods: Two lateral cephalograms were taken of 116 subjects (23 males, 93 females) with CR wax bites in a NHP at a one-week interval. Results: Method errors of three variables and intraclass correlation coefficients of six parameters proved the intra-individual reproducibility of NHP (p < 0.001). The angle of the FH to the THL was not significantly different from $0^{\circ}$ (p > 0.05), but it was clinically variable (SD $3.89^{\circ}$) on the inter-individual level. Conversely, the angle of the SN line to the THL was significantly different from $7^{\circ}$ (p < 0.05). Very low correlation was found between the linear measurements and angular measurements of A-point and B-point (p < 0.01). Conclusions: The NTVL could be a useful reference line for assessing the antero-posterior position of the maxilla and mandible of Korean adult patients in NHP and CR.

Finite Element Stress Analysis on the Supporting Tissues depending upon the Position of Osseointegrated Implants Supporting Fixed Bridges (고정성 보철물을 지지하는 골유착성 임플란트의 위치에 따른 지지조직에서의 유한요소적 응력분석)

  • Yoon, Dong-Joo;Shin, Sang-Wan;Suh, Kyu-Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.31 no.1
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    • pp.87-99
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    • 1993
  • Many studies have been reported on the successful replacement of missing teeth with osseointegrated dental Implants. However, little research has been carried out on the bio-mechanical aspect of the stress on the surrounding bone of the free-standing type of dental implant prostheses. This experimental study was aimed to analyze the stress distribution pattern on the supporting tissues depending upon the position of osseointegrated implants supporting fixed bridges. In the cases of unilateral partially edentulous mandible (the 2nd premolar and the 1st and 2nd molars missing), two osseointegrated implants were placed at the 2nd premolar and 2nd molar sites (Model A) , the 1st and 2nd molar sites (Model B, Anterior cantilevered type), the 2nd premolar and 1st molar sites (Model C, Posterior cantilevered type). Chewing forces of dentate patients and denture wearer were applied vertically on the 2nd premolar, the 1st molar, and the 2nd molar of each model. A 3-Unit fixed partial denture was constructed at each model and cantilevered extension parts were involved in Model B and Model C. Two dimensional finite element analysis was undertaken. The commercial software (Super SAP) for IBM 16 bit personal computer was utilized. The results were as follows : 1. The magnitude of applied load influenced on the total value of stresses, but did not in-fluence on the pattern of stress distribution. 2. The magnitude of stress developed from the supporting tissues were in order of Model C,Model A,Model B. 3. High stresses were concentrated on the cervical and apical portion of the implant/bone interface. 4. A difference of the stress magnitude on the implant/bone interface between mesial and distal implant was most prominant in Model C and in order of Model A and Model B. 5. The stresses developed in Model A were evenly distributed throughout both implants. 6. The stresses concentrated on the cervical portion of cantilevered side were higher in the posterior cantilevered type than in the anterior cantilevered type.

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THREE DIMENSIONAL FINITE ELEMENT ANALYSIS ON THE MANDIBULAR CANTILEVERED PROSTHESIS SUPPORTED BY IMPLANTS (임프란트로 지지된 하악 켄티레버 보철물의 3차원 유한요소 분석)

  • Cho, Chul;Shin, Sang-Wan;Kwon, Jong-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.38 no.5
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    • pp.724-743
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    • 2000
  • One of the biggest clinical problems of osseointegrated implant prosthesis is the excessive stress caused by bite forces which are transfered directly into the bone through the osseointegrated implant fixtures. So several biodynamic problems occur when there is an excessive fatigue stress. The factors of stress distribution are the number, kind, position, arrangement of the implants, and the distance between the implants, and the kind, quality of superstructure prosthesis and connection type between the rest implant and the superstructure. Recently, a distal short additional implant, socalled rest implant, is employed to reduced the stresses in conventional cantilevered prostheses. This study was undertaken to analyze the stresses transfered by osseointegrated implant cantilevered prostheses depending upon the number and the position of implants, the presence of rest implant, and the type of their connection. Three dimensional finite element analysis was attempted using ANSIS ver. 5.3 program under IBM INDIGO computer. The results were as follows : 1. The rest implant influenced on the pattern of stress distribution on the anterior area of the mandible and the superstructure. 2. In the group employing the rest implants, the fixed type of connection between the rest implant and the superstructure was more stable than the ball attachment type on the stress distribution. 3. In the group employing the ball attachment between the rest implant and the superstructure, the case with 4-implants(on canine, premolar) was little more stable than the case with 6-implants and the case with 4-implants(on incisor, premolar) on the stress distribution. 4. In the cantilevered group, the case with 4-implants(on incisor, premolar) and the case with 6-implants were more stable than the case with 4-implants(on canine, premolar) on the stress distribution. 5. In all of the group, the case with 6-implants and the fixed type of connection was the most stable and the case with 4-implants (on canine, premolar) was the most unstable on the stress distribution.

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THE SHORT-TERM REMOVABLE INTERMAXILLARY FIXATION CARE BY USE OF AN ADDITIVE INCISION & DRAINAGE ON THE ORAL LACERATION WOUNDS ADJACENT WITH MANDIBULAR COMPOUND FRACTURES: REPORT OF A CASE (하악골 복합 골절시 구내 열창부 상에 추가 절개 배농술을 이용한 단기간 가변적 악간고정 관리: 증례보고)

  • Mo, Dong-Yub;Yoo, Jae-Ha;Choi, Byung-Ho;Kim, Ha-Rang;Lee, Chun-Ui;Ryu, Mi-Heon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.3
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    • pp.260-264
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    • 2010
  • Treatment of the mandibular fracture consists of reduction and fixation. The apparatus that is used to keep the jaws together during healing will often reduce the fracture as well. When the jaws are brought together and intermaxillary elastic rubber traction is placed, the occlusion of the teeth will help to orient the fractured parts into good position. Intermaxillary fixation, that is, fixation obtained by elastic bands between the upper & lower jaws to which suitable anchoring devices have been attached, will successfully treat most fractures of the mandible. Arch bars are perhaps the ideal method for intermaxillary fixation. Several types of ready-made arch bars are used. But, daily occupational life and oral hygiene is difficult to maintain during the period of longterm immobilized intermaxillary fixation (commonly 6-8 weeks), owing to malnutrition and emotional disorders in a position of the patient with mandibular fractures. Most mandibular fractures heal well enough to allow removal of fixation in about 6 weeks. Though there are many complications of mandibular fracture, such as infection, hemorrhage, trismus, paresthesia and nonunion, it is favorable to attain the short-term removable intermaxillary fixation care by use of an additive incision & drainage establishment on the oral lacerated wounds of adjacent mandibular compound fractures. The purpose of an additive incision & drainge establishment is the prevention of wound infection & nonunion by removing the hematoma & seroma in the fracture sites.

Accuracy assessment of implant placement using a stereolithographic surgical guide made with digital scan (디지털 스캔을 이용하여 제작된 임플란트 수술가이드의 정확도)

  • Jeong, Seung-Mi;Fang, Jeong-Whan;Hwang, Chan-Hyeon;Kang, Se-Ha;Choi, Byung-Ho;Fang, Yiqin;Jeon, Hyongtae;An, Sunghun
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.2
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    • pp.111-119
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    • 2015
  • Purpose: The objective of this study was to evaluate the accuracy of a stereolithographic surgical guide that was made with information from intraoral digital impressions and cone beam CT (CBCT). Materials and methods: Six sets of resin maxilla and mandible models with missing teeth were used in this study. Intraoral digital impressions were made. The virtual models provided by these intraoral digital impressions and by the CBCT scan images of the resin models were used to create a surgical guide. Implant surgery was performed on the resin models using the surgical guide. After implant placement, the models were subjected to another CBCT scan to compare the planned and actual implant positions. Deviations in position, depth and axis between the planned and actual positions were measured for each implant. Results: The mean deviation of the insertion point and angulation were 0.28 mm and $0.26^{\circ}$, apex point were 0.11 mm and 0.14 mm respectively. The implants were situated at a mean of 0.44 mm coronal to the planned vertical position. Conclusion: This study demonstrates that stereolithographic surgical guides created without the use of impressions and stone models show promising accuracy in implant placement.

THE STUDY OF RELATIONSHIP BETWEEN SAGITTAL CONDYLAR GUIDE ANGLE AND INCISAL GUIDE ANGLE DURING MANDIBULAR PROTRUSION IN NORMAL KOREAN (정상 한국인의 하악 전방운동시 시상과로각과 절치로각에 관한 연구)

  • Kwon, Kung-Rock;Woo, Yi-Hyung;Choi, Dae-Gyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.27 no.2
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    • pp.11-36
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    • 1989
  • Mandibular movements are guided mainly by three determinants, namely the two posterior controls (the Temporomandibular joints) and the anterior control (the incisal guidance). The aim of this study was to evaluate the incisal guide angle in effort to reconcile a patient's condylar guide angle and incisu guide angle, to develop criteria for incisal guidance in clinical practice. 48 subjects (male 33, female 15) with intact intercuspation, without past history and symptoms of stomatognathic system, were selected for this study. All of the subjects had not anterior prostheses. The sagittal condylar guide angles and incisal guide angles were measured and estimated statistically by cephalogram and articulator (Whip-Mix 8500A). The results of this study were as follows: 1. Average of condylar guide angle was 43.33 degree by cephalogram, and was 35.18 degree by articulator. 95% confidence interval was from 40.43 to 46.23 degrees in cephalogram and was from 32.98 to 37.38 degrees in articulator. 2. Average of incisal guide angle was 51.51 degree by cephalogram, and was 44.11 degree by articulator. 95% confidence interval was from 49.12 to 54.95 degrees in cephalogram and was from 40.67 to 47.56 douses in articulator. 3. Difference between condylar and incisal guide angle was 8.18 degree by cephalogram, and was 8.94 degree by articulator. 95% confidence interval was from 4.61 to 11.74 degrees in cephalogram and was from 4.90 to 12.98 degrees in articulator. 4. In case of the incisal guide angle steeper than condylar guide angle, subjects were 69% (33 of 48) in cephatogram and 75% (36 of 48) in articulator. 5. By the multiple regression equation, condylar guide angle was more influenced by the anterior teeth. 6. When the mandible protrudes from the intercuspal position to the edge to edge position the incisal linear movement was 4.18mm (S.D.:1.30mm) and the condylar linear movement was 4.38mm (S.D.:1.26mm).

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Treatment strategies on Class III malocclusion based on Long term follow up study (III급 부정교합의 치료전략)

  • Sung, Jae-Hyun
    • The korean journal of orthodontics
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    • v.26 no.2 s.55
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    • pp.125-139
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    • 1996
  • The author obtained some useful information for the class III treatment from long term observation on the growing patients with class III malocclusion. 8 patients were selected for this study and presentation. From these observation so far my conclusions might be as follows: First in the early correction of the anterior crossbite, considerable forward growth changes were observed in the maxilla Second, as for the growth modification of jaws by orthopedic treatment only limited effects were recognized from the long-term observation Thrid, at early age of patients with anterior crossbite, any data couldn't make me predict the stability after treatment on the long-term basis. Fortunately, however, genial angle showed a marginal possibility of it prediction. Fourth, at an advanced age/ retraction orthopedic force on the mandible and the rapid change in the mandibular position may cause some trouble in the T.M.joint. Finally, the followings are recommendable. As for the anterior crossbite, correct it early as possible, and use orthopedic force under the age of ten. Do not enter the phase II treatment directly. Just wait and observe until the growth were almost completed, focusiong on some important factors such as airway problem, tongue position, and third molar development. Of course, these factors may have some effects on the mandibular growth. for the female, at the age of around 14 years old and the male, around 17 years old, make a final decision whether the patients will continue to be treated orthodontically or surgically Thereby, (I think) the relapse and retreatment problem after treatemnt we have observed so far might be minimized. Furthermore, the active treatment time may be also reduced.

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AN EVALUATION OF TREATMENT EFFECTS OF BIONATOR IN CLASS II DIVISION 1 MALOCCLUSION BY FINITE ELEMENT METHOD (II급 1류 부정교합에서 bionator의 치료효과에 관한 유한요소법적 연구)

  • Ahn, Sug-Joon;Suhr, Cheong-Hoon
    • The korean journal of orthodontics
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    • v.26 no.2 s.55
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    • pp.219-232
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    • 1996
  • The purpose of this study was to evaluate treatment effects of bionator in Class II division 1 malocclusion by FEM(Finite Element Method). The 73 subjects were classified into good result group and poor result group in reference to posttreatment molar relation, posttreatment overbite and overjet, posttreatment profile, and relapse. Pretreatment and posttreatment lateral cephalograms were taken and FEM was performed. The results were as follow; 1. There was no statistical significance in treatment changes between the sexes, and between the treatment result groups. 2. Treatment changes were not significantly different among the age groups. 3. The effect of treatment period groups on skeletal and dentoalveolar changes were analyzed using ANOVA. Body of maxilla, upper incisor, anterior face, ramus, upper anterior face, lower anterior face and treatment effect were correlated with the treatment period, but correlation coefficients were low. 4. The results of present investigation confirm that Class II bionator can assist in the correction of Class II division 1 malocclusion, mainly due to dentoalveolar changes. 5. There is significant difference in skeletal and dentoalveolar pattern between good result group and poor result group. In poor result group, maxilla was relatively downward and backward rotated, mandible was relatively backward rotated, upper incisor was in relatively lingual position, lower incisor was in relatively labial position.

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A 3-D finite element analysis on the mandibular movement pattern and stress distribution during symphyseal widening (하악 이부확장 시 하악골 이동 양상과 응력 분포에 관한 삼차원 유한요소법적 연구)

  • Lee, Do-Hoon;Hong, Hyun-Sil;Chae, Jong-Moon;Jo, Jin-Hyung;Kim, Sang-Cheol
    • The korean journal of orthodontics
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    • v.38 no.1
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    • pp.13-30
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    • 2008
  • Objective: The objective of this study was to evaluate the displacement pattern and the stress distribution of the finite element model 3-D visualization during symphyseal widening according to the osteotomy position, osteotomy type, and distraction device. Methods: The kinds of distraction devices used were tooth-borne type, hybrid type, bone-borne type and tooth-borne type $30^{\circ}$ angulated, and the kinds of osteotomy design were vertical osteotomy line between the central incisors and step osteotomy line through the symphysis. Results: All reference points of the mandible including the condyles were displaced laterally irrespective of the osteotomy position, osteotomy method and distraction device. The anteroposterior or vertical displacements showed small differences between the groups. The widening pattern of the osteotomy line in the tooth-borne type of device was v shaped, and that of bone-borne type was a reverse v shape. However, the pattern in the hybrid type was parallel. The lateral displacement of the mandibular angle by the bone-borne device was more remarkable than the other types of devices. The displacement by the $30^{\circ}$ angulated tooth-borne type was different between the left and right sides in both the transverse and anteroposterior aspects. Conclusion: The design of the distraction devices and osteotomy line can influence the displacement pattern and the stress distribution during mandibular symphyseal distraction osteogenesis procedures.