• The korean journal of orthodontics
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• v.46 no.4
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• pp.212-219
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• 2016

Objective: The purpose of this study was to evaluate treatment effects after distalization of the mandibular dentition using ramal plates through lateral cephalograms. Methods: Pre- and post-treatment lateral cephalograms and dental casts of 22 adult patients (11 males and 11 females; mean age, $23.9{\pm}5.52years$) who received ramal plates for mandibular molar distalization were analyzed. The treatment effects and amount of distalization of the mandibular molars were calculated and tested for statistical significance. The significance level was set at p < 0.001. Results: The mandibular first molar distalization at the crown and root were 2.10 mm (p < 0.001) and 0.81 mm (p = 0.011), respectively. In the evaluation of skeletal variables, there was a significant increase in the Wits appraisal (p < 0.001). In the evaluation of the soft tissue, there was no significant effect on upper lip position, but the lower lips showed a significant retraction of 2.2 mm (p < 0.001). Conclusions: The mandibular molars showed a significant amount of distalization accompanied by limited extrusion and mesiobuccal rotation of the crowns. A ramal plate may be a viable device for mandibular total arch distalization in Class III patients who are reluctant to undergo orthognathic surgery.

• The Journal of the Korean dental association
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• v.56 no.3
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• pp.134-141
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• 2018

Purpose: To measure the head tilting angle creating initial condylar cut-off and to find the head position inducing the superimposition of the cervical vertebrae over the mandibular ramus on panoramic radiograph. Materials and Methods: The panoramic radiographs were taken with Didactic skull on cervical spine model (Scientific GmbH, Hamburg, Germany) using Kodak 8000c Digital Panoramic radiography. For the inherent radiolucency of the plastic skull model, radiopaque 1 mm diameter lead wires were attached along the margin of the mandibular condyle, ramus, mandibular body, cervical vertebrae, and FH plane of the skull model. For measuring the head tilting angle creating the condylar head cutoff, panoramic radiographs were taken by tilting the FH plane downward in 5 degree increments. For finding the distance between transverse process of the third cervical vertebra and gonion inducing superimposition of cervical vertebrae on the mandibular ramus, panoramic radiographs were taken by decreasing the distance in 0.5 cm increments. Result and Conclusion: The condylar cutoff began to appear when the head of skull model was tilted downward by 15o. As the head tilting angle increasing, the condylar cutoff became more prominent. The superimposition of cervical vertebrae over the mandibular ramus began to appear when the distance between the gonion and third cervical vertebra was 1.0 cm. As the distance decreasing, the superimpostion became more prominent.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.2
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• pp.9-20
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• 1990

A series of 19 cases with maxillary hyperplasia and mandibular retrognathia were operated on by simultaneous superior repositioning of the maxilla after Le Fort I osteotomy and anterior repositioning of the mandible after bilateral sagittal split ramus osteotomies with or without osteotomy of the inferior border of the mandible. These were evaluated by retrospective cephalometric and computer analysis for the longitudinal skeletal and dental changes for an average of 17.1 months after surgery. For stabilization of the osteotomized segments, the authors used wire osteosynthesis by means of bilateral infraorbital and zygomatic buttress suspension wire at the maxilla, and direct interosseous wire at the split segments of the mandibular rami. Results show generally good stability after simultaneous maxillary and mandibular surgery with wire osteosynthesis, and a minimal to moderate tendency toward skeletal and dental relapse. This article is a preliminary study to defy the efficiency of the wire osteosynthesis (wo)compared with rigid internal fixation (RIF) for simultaneous maxillary and mandibular surgery. 1. The vertical relapse rate of the A point after superior repositioning of the maxilla is 2.2%. 2. The horizontal relapse rate of the B point after advancement of the mandible is 18.3%. 3. The condyle is distracted inferiorly and slightly posteriorly at the immediate postoperative period. 4. At the long term follow up examination, the condyle presents tendency of return to the preoperative position. 5. Condylar segment angle is decreased at the immediate postoperative period, and at the long term follow up evaluation, the angle is increased. 6. Gonial angle is increased at the immediate postoperative period, and then is decreased at the long term follow up evaluation. 7. The dentition is satisfactory with acceptable movement at the long term follow up evaluation. 8. At the mandibular free body analysis, genioplasty shows good stability. 9. Wire osteosynthesis provides excellent stabilization for the simultaneous maxillary and mandibular surgery.

• Journal of Oral Medicine and Pain
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• v.20 no.1
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• pp.185-194
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• 1995

The purpose of this study was to estimate primary diagnosis, prediction of prognosis and recognition fo treatment progress for treatment of TMD patients through measuring the various ranges of mandibular movement in normal and TMDs patients using Mandibular Kinesiograph K-6 Diagnostic system. In normal groups, 20 adults were selected, who have normal or class I molar relationship, and have no symptoms on TMJ and masticatory muscles, and have restorations less than 3 surfaces on each tooth, and have no other prosthetic restoration. In Patients group, we selected 31 outpatients who were confirmed to TMDs with clinical examination and radiographic findings. The obtained results were as follows : 1. In maximal opening, patient group was showed the limitation of vertical movement range (P<0.01) and lager lateral deviation than in normal group (P<0.05). And actual dimensional displacement of opening was calculated larger in normal group (P<0.05). 2. In protrusive movement, patients group was showed the limitation of anteroposterior movement range (P<0.001) and larger deviation than in normal group (P<0.01). And actual 3 dimensional displacement of protrusion was calculated larger in normal group (P<0.001). 3. In lateral maximum excursion, compared with normal group patient group was no significant differences to affected side, but was showed the limitation of lateral movement to unaffected side (P<0.001). 4. There was no significant difference in movement velocity of opening and closing in both groups. 5. Mandibular movement from physiologic rest position to centric occlusion was moved more anteroposteriorly in patient group. 6. Mandibular movement from centric relation to centric occlusion was no significant difference in both groups.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.5
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• pp.633-643
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• 2007

Statement of problem: Recently there are on an increasing trend of using implants-especially in edentulous mandible of severly alveolar bone recessed. Purpose: The aim of this study was to analyze the displacement and stress distribution of various mandibular implant-retained overdenture models supported by two implants in interforaminal region under the occlusion scheme load. Material and method: FEA models were made by the 3D scanning of the edentulous mandibular dentiform. The three models were named as Model M1, M2, and M3 accord ing to the position of implants: M1, Lt. incisor area, M2, Canine area, and M3, 1st Premolar area. Inter-implant angulation model was named as M4. Conventional complete denture was named M5 and used as a control group. Ball implant and Gold matrice were used as a retentive anchors. The occlusion type loads were applied horizontally over each tooth. Results: 1. In mandibular implant retained overdenture Canine Protected Occlusion type load resulted in higher levels of stress to the implants and female matrices than other types of loads. 2. The overdenture model M1, with implants in lateral incisor areas resulted in lower stress concentration to the implants and female matrices than other models. 3. In mandibular implant retained overdenture the stresses of the implant and female matrice were lower in mesially inclined implant than these of parallel installed implant. Conclusion: Lateral incisor areas could be the best site for the implants in mandibular implant-retained overdenture. The mandibular implant retained overdenture models mentioned above showed to the lowest stress to the implants and female matrices.

• The korean journal of orthodontics
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• v.45 no.3
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• pp.121-129
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• 2015

Objective: This study aimed to assess three-dimensional changes in the temporomandibular joint positions and mandibular dimensions after correction of dental factors restricting mandibular growth in patients with Class II division 1 or division 2 malocclusion in the pubertal growth period. Methods: This prospective clinical study included 14 patients each with Class II division 1 (group I) and Class II division 2 (group II) malocclusions. The quad-helix was used for maxillary expansion, while utility arches were used for intrusion (group I) or protrusion and intrusion (group II) of the maxillary incisors. After approximately 2 months of treatment, an adequate maxillary arch width and acceptable maxillary incisor inclination were obtained. The patients were followed for an average of 6 months. Intraoral and extraoral photographs, plaster models, and cone-beam computed tomography (CBCT) images were obtained before and after treatment. Lateral cephalometric and temporomandibular joint measurements were made from the CBCT images. Results: The mandibular dimensions increased in both groups, although mandibular positional changes were also found in group II. There were no differences in the condylar position within the mandibular fossa or the condylar dimensions. The mandibular fossa depth and condylar positions were symmetrical at treatment initiation and completion. Conclusions: Class II malocclusion can be partially corrected by achieving an ideal maxillary arch form, particularly in patients with Class II division 2 malocclusion. Restrictions of the mandible in the transverse or sagittal plane do not affect the temporomandibular joint positions in these patients because of the high adaptability of this joint.

• Imaging Science in Dentistry
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• v.33 no.2
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• pp.85-90
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• 2003

Purpose : To investigate the differences between the position of the mandibular condyles in temporomandibular joints of patients presenting with normal occlusion and skeletal class III malocclusion. Materials and Methods: Forty-two subjects with normal occlusion and thirty-seven subjects exhibiting skeletal class III malocclusion prior to orthodontic treatment were included in the study. Transcranial radiographs of each subject were taken at centric occlusion and 1 inch mouth opening. The positional relationship between the mandibular condyles with articular fossae and articular eminences at two positional states were evaluated and analyzed statistically. Results: The mandibular condyles of the skeletal class III malocclusion group were found to be located more anteriorly from the center of the articular fossae compared to the normal occlusion group in centric occlusion. The mandibular condyles of the skeletal Class III malocclusion group were located more superiorly from the middle of articular height than those of the normal occlusion group in centric occlusion. However, these differences were not statistically significant. At 1 inch mouth opening, the mandibular condyles of the skeletal class III malocclusion group were placed more posteriorly from the articular eminences than those of the normal occlusion group. The mean angle of the articular eminence posterior slope were 56.51 ° ± 6.29° in the normal occlusion group and 60.37° ± 6.26° in the skeletal Class III malocclusion group. Conclusions: The mandibular condyles of the skeletal Class III malocclusion group were placed more anteriorly at centric occlusion and more posteriorly at 1 inch mouth opening when compared with those of the normal occlusion group.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.27.1-27.9
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• 2020

Background: Mandibular setback surgery can change the position of the mandible which improves occlusion and facial profile. Surgical movement of the mandible affects the base of the tongue, hyoid bone, and associated tissues, resulting in changes in the pharyngeal airway space. The aim of this study was to analyze the 3-dimensional (3D) changes in the hyoid bone and tongue positions and oropharyngeal airway space after mandibular setback surgery. Methods: A total of 30 pairs of cone-beam computed tomography (CBCT) images taken before and 1 month after surgery were analyzed by measuring changes in the hyoid bone and tongue positions and oropharyngeal airway space. The CBCT images were reoriented using InVivo 5.3 software (Anatomage, San Jose, USA) and landmarks were assigned to establish coordinates in a three-dimensional plane. The mean age of the patients was 21.7 years and the mean amount of mandibular setback was 5.94 mm measured from the B-point. Results: The hyoid bone showed significant posterior and inferior displacement (P < 0.001, P < 0.001, respectively). Significant superior and posterior movements of the tongue were observed (P < 0.05, P < 0.05, respectively). Regarding the velopharyngeal and glossopharyngeal spaces, there were significant reductions in the volume and minimal cross-sectional area (P < 0.001). The anteroposterior and transverse widths of the minimal cross-sectional area were decreased (P < 0.001, P < 0.001, respectively). In addition, the amount of mandibular setback positively correlated with the amount of posterior and inferior movement of the hyoid bone (P < 0.05, P < 0.05, respectively). Conclusion: There were significant changes in the hyoid bone, tongue, and airway space after mandibular setback surgery.

• The korean journal of orthodontics
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• v.33 no.2 s.97
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• pp.73-84
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• 2003

This study was performed to find out how much projection errors in the cephalometric measurements were made by vertical head rotation in taking posteroanterior cephalograms. 25 adults without any apparent facial asymmetry or severe sagittal skeletal discrepancy were selected and the posteroanterior cephalograms were taken with the head rotated $5^{\circ},\;10^{\circ}$ superior and inferior each to the reference $position(0^{\circ})$. The 7 height, 5 width and 6 angular measurements were taken at each 5 positions. Through the statistical analysis of all measurements taken at each rotated position, folowing results were obtained.1. The projection errors of height measurements were remarkably target than those of width or angular measure nents. f. Among the height measurements, the farther to the rotation axis the measurements were, the larger the projection errors were. 3. Among the width measurements, mandibular width and mandibular width of mandibular first molars showed significant differences between the values taken at each rotated position, while nasal width, maxillary width and intermolar width of maxillary first molars did not. 4. Among the angular measurements, the angle between horizontal reference line and the line that is connected to crista galli and antegonion or maxillare showed significant differences between the values taken at each rotated Position. The above results suggest that it is needed to the effort to keep constant head position for taking the useful posteroanterior cephalogra, because projection errors are caused by vertical head rotation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.570-593
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• 1996

This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after BSSRO in 20 patients(males 9, females 11) using computed tomogram that were taken in centric occlusion before, immediate, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period intermaxillary fixation, 24hour after removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.45{\pm}4.01mm$ and horizontal long axis of condylar angle was $11.89{\pm}5.19^{\circ}$on right, $11.65{\pm}2.09^{\circ}$on left side and condylar lateral poles were located about 12mm and medial poles about 7mm from reference line(AA') on the axial tomograph. Mean intercondylar distance was $84.43{\pm}3.96mm$ and vertical axis angle of condylar angle was $78.72{\pm}3.43^{\circ}$on right, $78.09{\pm}6.12^{\circ}$on left. 2. No statistical significance was found on the condylar change(T2C-T1C) but it had definitive increasing tendency. There was significant decreasing of the distance between both condylar pole and the AA'(p<0.05) during the long term(TLC-T2C). 3. On the lateral cephalogram, no statistical significance was found between immediate after surgery and 24 hours after the removing of intermaxillary fixation but only the lower incisor tip moved forward about 0.33mm(p<0.05). Considering individual relapse rate, mean relapse rate was 1.2% on L1, 5.0% on B, 2.0% on Pog, 9.1% on Gn, 10.3% on Me(p<0.05). 4. There was statistical significance on the influence of the mandibular set-back to the total mandibular relapse(p<0.05). 5. There was no statistical significance on the influence of the mandibular set-back(T2-T1) to the condylar change(T2C-T1C), the condylar change(T2C-T1C, TLC-T2C) to the mandibular total relapse, the pre-operative condylar position to the condylar change(T2C-T1C, TLC-T2C), the pre-operative mandibular posture to the condylar change(T2C-T1C, TLC-T2C)(p>0.05). 6. The result of multiple regression analysis on the influence of the pre-operative condylar position to the total mandibular relapse revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condyalr head long axis angle, the more increasing of mandibular horizontal relapse(L1,B,Pog,Gn,Me) on the right side condyle. The same result was founded in the case of horizontal relapse(L1,Me) on the left side condyle.(p<0.05). 7. The result of multiple regression analysis on the influence of the pre-operative condylar position to the pre-operative mandibular posture revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condylar head long axis angle, the more increasing of mandibular vertical length on the right side condyle. and increasing of vertical lengh & prognathism on the left side condyle(p<0.05). 8. The result of simple regression analysis on the influence of the pre-operative mandibular posture to the mandibular total relapse revealed that the more increasing of prognathism, the more increasing of mandibular total relapse in B and the more increasing of over-jet the more increasing of mandibular total relapse(p<0.05). Consequently, surgical mandibular repositioning was not significantly influenced to the change of condylar position with condylar reposition method.