• 대한치과교정학회지
• /
• 제37권3호
• /
• pp.220-230
• /
• 2007

골격성 I급이면서 수직적으로 정상인 환자 160명(남자 80명, 여자 80명)의 측모 두부방사선 계측사진을 대상으로 하악 전치부 치조골의 협설측 두께를 치축을 기준으로 계측하여 연령에 따른 차이를 조사하여 다음과 같은 결과를 얻었다. 하악전치부 치조골의 협설측 두께와 하악 전치부 설측 치조골의 두께는 연령이 증가함에 따라 여자의 CEJ 하방 2 mm 부위를 제외하고는 남녀 모두에서 유의한 감소를 보였다. 반면에, 하악 전치부 협측 치조골의 두께와 하악 이부 최대 풍융부의 두께는 연령이 증가함에 따라 유의한 차이를 보이지 않았다. 이상의 연구를 통하여 한국인에 있어서 수평적으로 I급의 골격형태이면서 수직적으로 정상인 환자에서는 성인보다는 성장기환자에서 하악 전치의 설측 치조골의 두께가 더 두꺼워 발치치료에서와 같은 하악 전치의 설측이동이 유리할 것으로 사료된다.

• Journal of Periodontal and Implant Science
• /
• 제53권6호
• /
• pp.453-466
• /
• 2023

Purpose: This study aimed to quantify alveolar bone morphology, demonstrate the relationship between tooth angulation and alveolar bone thickness, and introduce a new classification for anterior mandibular teeth related to immediate implant placement (IIP). Methods: Cone-beam computed tomography (CBCT) images of 211 anterior mandibular teeth were analyzed in sagittal slices to measure the thickness of the facial alveolar bone crest (FAB1) and apex (FAB2), and the lingual alveolar bone crest (LAB1) and apex (LAB2). Tooth angulation was classified as 1°-10°, 11°-20°, and >20° according to the tooth's long axis and alveolar bone wall. Spearman correlation coefficients were used to evaluate correlations between the variables. Results: FAB1 and LAB1 were predominantly thin (<1 mm) (84.4% and 73.4%, respectively), with the lateral incisors being thinnest. At the apical level, FAB2 and LAB2 were thick in 99.5% and 99.1% of cases, respectively. Significant differences were documented in FAB2 (P=0.004), LAB1 (P=0.001), and LAB2 (P=0.001) of all mandibular teeth. At all apical levels of the inspected teeth, a significant negative correlation existed between TA and FAB2. Meanwhile, TA showed a significant positive correlation with LAB2 of the lateral incisors and canines. These patterns were then divided into class I (thick facial and lingual alveolar bone), class II (facially inclined teeth) with subtype A (1°-10°) and subtype B (11°-20°), and class III (lingually inclined teeth) with subtype A (1°-10°) and subtype B (11°-20°). Conclusions: Mandibular anterior teeth have predominantly thin facial and lingual crests, making the lingual bone apical thickness crucial for IIP. Although anchorage can be obtained from lingual bone, tooth angulation and tooth types had an impact on IIP planning. Hence, the new classification based on TA and alveolar bone wall may enable rational clinical planning for IIP treatment.

• Journal of Periodontal and Implant Science
• /
• 제41권2호
• /
• pp.60-66
• /
• 2011

Purpose: The aim of this study is to evaluate the buccal and lingual bone thickness in the anterior teeth and the relationship between bone thickness and the tissue biotype. Methods: Three male and two female human cadaver heads (mean age, 55.4 years) were used in this study. First, the biotype of periodontium was evaluated and categorized into a thick or a thin group. Next, full thickness reflections of the mandible and the maxilla to expose the underlying bone for accurate measurements in the anterior regions were performed. After the removal of the half of the alveolar bone, the probe with a stopper was used to measure the thickness of bone plate at the alveolar crest (AC), 3 mm apical to the alveolar crest (AC-3), 6 mm apical to the alveolar crest (AC-6), and 9 mm apical to the alveolar crest (AC-9). The thickness of the buccal plates at the alveolar crest were $0.97{\pm}0.18\;mm$,$0.78{\pm}0.21\;mm$, and $0.95{\pm}0.35\;mm$ in the maxillary central incisors, lateral incisors, and canines, respectively. The thickness of the labial plates at the alveolar crest were $0.86{\pm}0.59\;mm$, $0.88{\pm}0.70\;mm$, and $1.17{\pm}0.70\;mm$ in the mandibular central incisors, lateral incisors and canines, respectively. Conclusions: The thickness of the labial plate in the maxillary anteriors is very thin that great caution is needed for placing an implant. The present study showed the bone thickness of maxillary and mandibular anteriors at different positions. Therefore, these data can be useful for the understanding of the bone thickness of the anteriors and a successful implant placement.

• Imaging Science in Dentistry
• /
• 제51권2호
• /
• pp.175-185
• /
• 2021

Purpose: The primary objective of this study was to analyze the thickness and height of alveolar bone around the maxillary and mandibular incisors. Additionally, this study aimed to compare bone parameters between Caucasian (CC) and African American (AA) female patients. Materials and Methods: In this retrospective pilot study, 50 female subjects(25 CC and 25 AA) were included. The inclusion criteria were AA or CC women between the ages of 18 and 50 with a normo-divergent facial pattern and Angle's class I, end-on class II, or mild class III malocclusion. The distance from the cementoenamel junction (CEJ) to the buccal and lingual alveolar crest; the alveolar ridge thickness at the mid-root and apex; and the buccal and lingual bone thickness at 3, 6, and 9mm from the CEJ were measured. Results: No significant difference was found (P>0.05) in the cortical bone thickness at 3mm, 6mm, or 9mm from the alveolar crest between CC and AA populations for most measurements. A significant difference in bone thickness was found (P<0.05) for the lingual surface of the central incisor, with maxillary bone thickness found to be higher than mandibular bone thickness. The measurements of lingual thickness were larger than those of buccal thickness for both races. Conclusion: There were no differences in maxillomandibular anterior alveolar bone measurements between normo-divergent adult AA and CC women, except for a few parameters at varying locations. However, future studies can be planned based the current pilot study data, which may provide valuable information.

• 대한치과교정학회지
• /
• 제48권6호
• /
• pp.349-356
• /
• 2018

Objective: This study was performed to investigate the alveolar bone of lower incisors in skeletal Class III adults of different vertical facial patterns and to compare it with that of Class I adults using cone-beam computed tomography (CBCT) images. Methods: CBCT images of 90 skeletal Class III and 29 Class I patients were evaluated. Class III subjects were divided by mandibular plane angle: high (SN-MP > $38.0^{\circ}$), normal ($30.0^{\circ}$ < SN-MP < $37.0^{\circ}$), and low (SN-MP < $28.0^{\circ}$) groups. Buccolingual alveolar bone thickness was measured using CBCT images of mandibular incisors at alveolar crest and 3, 6, and 9 mm apical levels. Linear mixed model, Bonferroni post-hoc test, and Pearson correlation analysis were used for statistical significance. Results: Buccolingual alveolar bone in Class III high, normal and low angle subjects was not significantly different at alveolar crest and 3 mm apical level while lingual bone was thicker at 6 and 9 mm apical levels than on buccal side. Class III high angle group had thinner alveolar bone at all levels except at buccal alveolar crest and 9 mm apical level on lingual side compared to the Class I group. Class III high angle group showed thinner alveolar bone than the Class III normal or low angle groups in most regions. Mandibular plane angle showed negative correlations with mandibular anterior alveolar bone thickness. Conclusions: Skeletal Class III subjects with high mandibular plane angles showed thinner mandibular alveolar bone in most areas compared to normal or low angle subjects. Mandibular plane angle was negatively correlated with buccolingual alveolar bone thickness.

• 대한치과교정학회지
• /
• 제6권1호
• /
• pp.17-24
• /
• 1976

The primary objective of this study was to define the differences that exist. between different sexes on the dentoskeletal framework and the soft tissue profile around the mouth. For the purpose of this study, cephalometric radiographs were obtained from the centric occlusion with closed lip position, through the research on each 42 males and females aged from 17 to 22 years with normal occlusion and acceptable facial appearence. The results were as follows: 1. Maxillary to mandibular relationships. Among the angles formed by the long axis of the maxillary and mandibular anterior teeth, the maxillary and mandibular anterior alveolar bone, and the lower and upper lips (Fig.2), only the angle formed by the lips was more acute in males than in females. The males have a more rounded profile, and the females have a flatter profile in the lower third of the face. The differences is statistically significant for the angle formed by the lips. The fact that the lips have a difference greater than that of teeth or the alveolar bone indicates that the lip position is not entirely due to tooth and bony support. Possibly the thickness of the lips has an influence. 2. Occlusal plane. The occlusal plane was related to the anterior tooth inclination, anterior alveolar bone profile, and the lip contour, both maxillary and mandibular (Fig.3). Only the angle related to lower lip was statistically significant. The females again had the more obtuse angle, indicating a flatter profile than that of the males. 3.Skeletal planes. The angles formed by the anterior maxillary lips, teeth, and alveolar bone with the Frankfort plane and the angles of the mandibular lips, teeth, and, alveolar bone and the mandibular plane were investigated (Fig.4). Results were similar to those from maxillary to mandibular relationships. The results were statistically significant for the upper lip and the lower lip, only. 4. Esthetics. The facial line and the mandibular plane were compared with the esthetic line. These angles were different for the different sexes, but only the latter was statistically significant. This difference may be due to the profile contour of the nose.

• 대한치과교정학회지
• /
• 제24권2호
• /
• pp.275-294
• /
• 1994

The occlusal interference during adolescent period makes some effects on growth and development and morphological changes. And so, if we could predict the the timing and results of orthodontic treatment who have occlusal interference during adolescent period, it may be helpful for diagnosis and treatment planning of orthodontic treatment. For about those, the purpose of this study was to evaluate the effects of the posterolateral displacement by the metal casting crown with inclined pathway on the mandibular condyle and morphologic changes of mandible in the rat. The experimental animals were thirty six Sprague-Dawley male rats of 8 weeks old. Eight of them was used as control group, and experimental group 1 ( continuous appliance wearing group ) was composed of sixteen and experimental group 2 ( appliance removal group after worn the appliances during 3 months ) was composed of remaining twelve. The animals of experimental grouop 1 were sacrificed after 1, 2, 3, 6 months from beginning of the experiment and experimental group 2 were sacrificed 1, 2, 3 months after removal of the appliance from worn the appliance during 3 months. Both of mandible and temporomandibular joint were observed histologically and radiologically. The results were as follows : 1. In experimental group 1, the mandibular length and lower posterior height were decreased with experimental period, while the lower anterior height was increased, and the curvature of lower incisors and lingual inclination of anterior alveolar bone were profound as compared with control group. 2. In experimental group 1, both of the thickness of the condylar cartilage were thinned in the posterosuperior region, and this phenomenon was more prominent on right than left in 3-Mo experimental period and both sides were marked thinned in 6-Mo experimental period. 3. In experimental group 2, the lower anterior height was low and lower posterior height was high as compared with experimental group 1, and the curvature of lower incisors and lingual inclination of anterior alveolar bone were recovered to control group. 4. In experimental group 2, both of the thickness of the condylar cartilage were thickened in the posterosuperior region, and this phenomenon was more prominent with experimental period. 5. In experimental group 2, the mandibular length was short, lower anterior height was hight, the curvature of lower incisors were profound, and in histologically, both of the thickness of the condylar cartilage were thickened in the posterosuperior region as compared with control group. As shown above, the occlusal interfemce affected the condylar cartilage, curvature of lower incisor, inclination of anterior alveolar bone, mandibular length, and anterior and posterior height. When the interference was removed, significant recover was found in condylar cartilage, mandibular length, and posterior height. Although no significance was found, other items of measurement showed trends for recovery.

• 대한치과교정학회지
• /
• 제40권5호
• /
• pp.314-324
• /
• 2010

본 연구는 성인 환자를 대상으로 안면골의 수평적, 수직적 골격 형태에 따른 하악 전치부 치조골의 순설측 두께를 하악 전치 치축을 기준으로 계측하고, 하악 이부 치조골의 단면적을 비교해 형태학적 차이를 확인해 보기 위하여 시행되었다. 20세 이상 성인 환자들의 초진 시 측모두부 방사선 사진을 사용하여, 수평적, 수직적 분류 기준에 따라 9군으로 분류하여 무작위로 30명(남자 15명, 여자 15명)씩, 총 270명을 추출하였다. 수평적 골격 형태를 판단하는 기준으로 ANB 각도가 사용되었으며, 수직적 골격 형태를 판단하는 기준으로는 하악평면각(SN-MP 각도)을 사용하였다. 측모두부 방사선 사진에서 하악 전치부 치조골의 협설측 두께와 하악 이부 치조골의 단면적을 계측하여 형태학적 차이를 확인해 보았다. 연구 결과로 high angle group은 low angle group과 average group에 비해 CEJ 하방 2 mm 부위 아래의 협설측 치조골과 모든 부위의 설측 치조골에서 통계적으로 유의하게 얇은 두께를 보였으며 ($p$ < 0.05), low angle group과 average group 중에서 Class I, II group은 모든 부위에서 Class I average group에 비해 유사하거나 통계적으로 유의하게 두꺼운 치조골 두께를 보였다 ($p$ < 0.05). Average group 내에서 Class III group은 Class I, II group에 비해 치근 중간 부위의 협설측과 설측에서 통계적으로 유의하게 얇은 치조골 두께를 보였으며 ($p$ < 0.05), high angle group 중에서도 특히 Class III인 high angle group에서 더 얇은 평균 치조골 두께를 보였다. 수직적 안면 골격 형태에 따라 하악 이부 치조골의 단면적은 통계적으로 유의한 차이를 보이지 않았다 ($p$ > 0.05). 이상의 결과에서 성인의 교정 치료 시 Class III이면서도 high angle을 보이는 환자에서는 하악 전치부에서 얇은 치조골 두께를 가지게 되는 경우가 많으므로, 하악 전치의 위치를 결정할 때 주의를 기울여야 할 것으로 생각한다.

• Journal of Periodontal and Implant Science
• /
• 제31권3호
• /
• pp.581-595
• /
• 2001

In performing implant procedures in the anterior portion of the maxilla, many difficulties exist because of anatomical reasons, such as the proximity of the nasal floor, lateral extension of the incisive canal, and labial concavity. On the other hand, in the posterior region of the maxilla, there is often insufficient recipient bone between the maxillary sinus and alveolar ridge due to alveolar ridge resorption and pneumatization of the maxillary sinus. In order to perform implants in such regions, ridge augmentation procedures such as onlay bone graft, guided bone regeneration, and maxillary sinus grafting are performed. In studies of Caucasians, use of autograft from mandibular symphysis has been reported to be highly successful in maxillary sinus grafting. However, in a clinical study of Koreans, autograft of mandibular symphysis has been reported to have significantly low success rate. It has been hypothesized that this is because of insufficient cancellous bone due to thick cortical bone. In order to test this hypothesis, bone quality and morphology of Koreans can be compared with those of Caucasians. In this study, the bone density and morphology of the cortical bone and cancellous bone in the mandibular symphysis of 35 Korean cadavers were evaluated. The following results were obtained: 1. In terms of bone density, type I, type II, and type III consisted of 1.4%(3/213), 72.3%(154/213), and 26.3%(56/213) of the cross-sectioned specimens, respectively. In general, the bone density tended to change from type II to type III, as cross-sectioned specimens were evaluated from the midline to the canine. Type IV wasn't observed in this study. 2. The distance between the root apex and the lower border of the cancellous bone was 18.34mm-20.59mm. Considering that the bone has to be cut 5mm below the root apex during the procedure, autografts with about 15mm of vertical thickness can be obtained. 3. The thickness of cortical bone on the labial side increased from the root apex to the lower border of the mandible. The average values ranged from 1.43mm to 2.36mm. 4. The labio-lingual thickness of cancellous bone ranged from 3.43mm to 6.51mm. The thickness tended to increase from the apex to the lower border of the mandible and decrease around the lower border of cancellous bone. From the above results, the anatomic factors of the mandibular symphysis (bone density, thickness, quantity and length of the cortical bone and cancellous bone) didn't show any difference from Caucasians, and it cannot be viewed as the cause of failure in autografts in the maxillary sinus for implants.

• 대한치과교정학회지
• /
• 제43권3호
• /
• pp.134-140
• /
• 2013

Objective: To evaluate lower incisor position and bony support between patients with Class II average- and high-angle malocclusions and compare with the patients presenting Class I malocclusions. Methods: CBCT records of 79 patients were divided into 2 groups according to sagittal jaw relationships: Class I and II. Each group was further divided into average- and high-angle subgroups. Six angular and 6 linear measurements were performed. Independent samples t-test, Kruskal-Wallis, and Dunn post-hoc tests were performed for statistical comparisons. Results: Labial alveolar bone thickness was significantly higher in Class I group compared to Class II group (p = 0.003). Lingual alveolar bone angle (p = 0.004), lower incisor protrusion (p = 0.007) and proclination (p = 0.046) were greatest in Class II average-angle patients. Spongious bone was thinner (p = 0.016) and root apex was closer to the labial cortex in high-angle subgroups when compared to the Class II average-angle subgroup (p = 0.004). Conclusions: Mandibular anterior bony support and lower incisor position were different between average- and high-angle Class II patients. Clinicians should be aware that the range of lower incisor movement in high-angle Class II patients is limited compared to average- angle Class II patients.