• The korean journal of orthodontics
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• v.23 no.1 s.40
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• pp.101-113
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• 1993

For the purpose of interpretation of positional changes of craniofacial structures in Class III malocclusion between mixed and permanent dentition, 73 normal samples and 103 Class III samples of mixed dentition and 125 normal samples and 168 Class III samples of permanent dentition were selected. Comparative cephalometric analysis was undertaken between them respectively by mesh diagram method to evaluate the positional changes of maxilla and mandible in anteroposterior direction and vertical direction and also the inclination changes of maxillary and mandibular incisors in labio-lingual direction. The following results were obtained : 1. The antero-posterior positional changes of the maxilla and mandible were posterior direction of maxilla and anterior direction of mandible. 2. The vertical positional changes of the maxilla and mandible were superior direction of both maxilla and mandible. 3. The labio-lingual inclination changes of the maxillary and mandibular incisors were lingual direction of both maxillary and mandibular incisors.

• The korean journal of orthodontics
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• v.50 no.5
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• pp.324-335
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• 2020

Objective: To compare postoperative positional changes in the mandibular proximal segment between the conventional orthognathic surgery (CS) and the surgery-first approach (SF) using intraoral vertical ramus osteotomy (IVRO) in patients with Class III malocclusion. Methods: Thirty-eight patients with skeletal Class III malocclusion who underwent bimaxillary surgery were divided into two groups according to the use of preoperative orthodontic treatment: CS group (n = 18) and SF group (n = 20). Skeletal changes in both groups were measured using computed tomography before (T0), 2 days after (T1), and 1 year after (T2) the surgery. Three-dimensional (3D) angular changes in the mandibular proximal segment, condylar position, and maxillomandibular landmarks were assessed. Results: The mean amounts of mandibular setback and maxillary posterior impaction were similar in both groups. At T2, the posterior portion of the mandible moved upward in both groups. In the SF group, the anterior portion of the mandible moved upward by a mean distance of 0.9 ± 1.0 mm, which was statistically significant (p < 0.001). There were significant between-group differences in occlusal changes (p < 0.001) as well as in overjet and overbite. However, there were no significant between-group differences in proximal segment variables. Conclusions: Despite postoperative occlusal changes, positional changes in the mandibular proximal segment and the position of the condyles were similar between CS and SF, which suggested that SF using IVRO achieved satisfactory postoperative stability. If active physiotherapy is conducted, the proximal segment can be adapted in the physiological position regardless of the occlusal changes.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.190-197
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• 2018

Background and Objectives : Positional OSAS is characterized by an apnea-hypopnea index (AHI) score >5, which, while sleeping in the supine position, is double that in non-supine position. This study was performed to compare the clinical characteristics of positional OSAS and non-positional OSAS patients, and the effects of the modified jaw thrust maneuver during drug-induced sleep endoscopy (DISE) between positional OSAS and non-positional OSAS patients. Materials and Methods : 68 positional OSAS patients and 19 non-positional OSAS patients were included. They all underwent full-night polysomnography and DISE. The modified jaw thrust maneuver was introduced during DISE. Airway structural changes induced by the modified jaw thrust maneuver were evaluated and documented. Results : There were no statistically significant differences in Friedman stage or tonsil grade, body mass index, Epworth sleepiness scale (ESS) score, blood pressure, AHI, or obstructive pattern between the positional and non-positional OSAS patients. However, mean arterial oxygen saturation (SaO2), lowest SaO2, and total arousal index values were more severe in the non-positional OSAS patients. After introduction of the modified jaw thrust maneuver, retrolingual level obstruction showed a tendency toward a higher rate of airway opening in positional OSAS patients than in non-positional OSAS patients. Conclusions : The effects of a mandibular advancement device (MAD) can be estimated by carrying out a modified jaw thrust maneuver during DISE. The tendency toward a higher rate of airway opening in positional OSAS patients than non-positional OSAS patients in retrolingual level obstruction after jaw thrust maneuver introduced during DISE may be clinically important for MAD.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.4
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• pp.412-420
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• 1991

Seventeen rigid screw fixation and sixteen nonrigid wire fixation cases of mandibular sagittal slit ramus osteotomy were selected to compare postoperative dental and skeletal changes. A constructed horizontal plane was drawn seven degrees under sella-nasion plane and detailed cephalometirc assessment was applied to serial radiographic films taken before surgery($T_0$), immediately after surgery($T_1$), and at least six months after surgery($T_2$). Linear and angular positional changes were measured and analyzed statistically using paired t-test method and percent of positional changes(amount of post-op change/amount of intra-op change)${\times}100$. The results were as follows; 1. It was 29.4% in rigid fixation cases and 37.5% in nonrigid fixation cases comparing the postoperative positional change of more than 2mm at point B. So rigid fixation method was slightly more stable. 2. In nonrigid fixation cases, the positional change might be caused by incomplete bony union at the osteotomy site and soft tissue tension acting on this site. 3. In rigid fixation cases, the positional change might be caused by interaction between relapse tendency of protracted condyle-proximal segment and neighboring soft tissue tension.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.5
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• pp.359-367
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• 2004

Purpose: After the surgical correction with sagittal split ramus osteotomy, the position of the mandibular condyle in the glenoid fossa and the proximal segment of the mandible change because of bony gap between proximal and distal segment, especially in case of mandibular setback asymmetrically. In this study, positional changes in the condyle and proximal segment after BSSRO were estimated in the mandibular asymmetry patient by analyzing the in submentovertex view and P-A cephalogram for identification of ideal condylar position during surgery. Patients and Methods: The 20 patients were selected randomly who visit Dankook Dental Hospital for mandibular asymmetry. Bilateral sagittal split ramus osteotomy with rigid fixation was performed and P-A cephalogram and submentovertex view was taken at the time of preoperative, immediate postoperative, 3 month postoperative period. Results: Intercondylar length and transverse condylar angle was increased due to inward rotation of proximal segment and anteromedial rotation of lateral pole of condyle head. The condylar position had a tendency to return to the preoperative state and after 3 months return up to about half of the immediate post-operative changes, and all the results showed more changes in asymmetry patient and deviated part of the mandible. Conclusion: Based on all these results above, surgeon should make efforts to have a precise preoperative analysis and to have a ideal condylar position during rigid fixation after BSSRO.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.48.1-48.7
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• 2019

Background: Soft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance. Lip canting could be improved by the correction of the occlusal canting or positional change of the mentum. Although there are many studies about changes of lip canting, however, postoperative changes of philtrum deviation have not been yet reported. In this study, we investigate the positional change of the philtrum after orthognathic surgery and influencing factors. Methods: Positional change of the philtrum was evaluated in 41 patients with facial asymmetry who underwent bimaxillary surgery, in relation to other anatomical soft tissue landmarks using a frontal clinical photo. The surgical movement of the maxillary and mandibular dental midline and canting were measured in postero-anterior cephalogram before and 1 day after surgery. The same procedure was repeated in patients with more than 1.5 mm perioperative change of the mandibular dental midline after bimaxillary surgery. Results: Maxillary dental midline shifting and canting correction did not have a significant correlation with lateral movement of the philtrum midline. However, the mandibular shift had a statistically significant correlation with a lateral movement of the philtrum (p < 0.05) as well as other linear parameters and angle values. Conclusion: The horizontal change of the philtrum is influenced by lateral mandibular movement in patients with facial asymmetry, rather than maxillary lateral movement.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.4
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• pp.160-168
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• 2014

Objectives: The purpose of this study was to evaluate the condylar position in relation to the glenoid fossa before and after orthodontic-orthognathic surgical treatment and to investigate the relationship with skeletal relapse. Materials and Methods: Lateral cephalograms and temporomandibular joint tomograms from 19 patients with mandibular prognathism who received orthodontic-orthognathic surgery were included in this study. Samples were divided into two groups based on skeletal change during the retention period. The relapse group consisted of 7 patients (3 females and 4 males; mean age, 21.9 years) whose pogonion or menton displaced more than 1 mm during the retention period and the stable group consisted of 12 patients (5 females and 7 males; mean age, 21.7 years). Anterior joint space, posterior joint space, superior joint space, and anteroposterior index were measured on tomograms at pretreatment and posttreatment timepoints. Condyle position and frequency of the positional change were compared between both groups. Results: In the relapse group and stable group, 42.9% and 45.8% of the condyles, respectively, showed forward or backward displacement at posttreatment. However, the changes were small and the mean anterior, posterior, superior joint spaces and frequencies of the positional changes did not differ statistically between both groups. Conclusion: Our results suggest that small positional changes of the condyle, which may occur after orthodontic-orthognathic surgery treatment, may not be related to skeletal relapse after removal of the orthodontic appliances.

• The korean journal of orthodontics
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• v.25 no.6 s.53
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• pp.655-664
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• 1995

Sixty male patients with polysomnographically documented OSA were included in this study. A pair of cephalograms were obtained in the upright and supine positions. In the supine position, the ANB angle, lower facial height and the cross-sectional area of soft palate increased and there was a decrease in the vertical airway length and oropharynx cross-sectional area. Positional changes did not affect the cross-sectional area of tongue, but the cross-sectional area of the oropharynx decreased in the supine position. The obese group had higher AI and RDI. Maxillary unit length, C3-H, the cross-sectional areas of tongue, soft palate and oropharynx were significantly greater in the group Obese than in non-obese group. No correlation was noted between the mandibular unit length and OSA severity, The group of small mandibular unit length showed shorter lower facial height and maxillary unit length, and smaller cross-sectional area of tongue than the long mandibular unit length group. Hyold bone positioned more inferiorly and cross-sectional area of nasopharynx decreased as the OSA severity increased.

• The korean journal of orthodontics
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• v.21 no.2 s.34
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• pp.325-340
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• 1991

There are evidences that occlusal splint therapy is critical to diagnose hidden akeleto-occlusal disharmonies in malocclusion patients and capable of enhancing stability after orthodontic treatment. In addition, evidences have implicated occlusal splint therapy in condylar positional changes during TMJ disorder treatment. In view of these evidences, this study was performed to investigate the effect of occlusal splint therapy on condylar positional changes in malocclusion patients and the possible clinical application of the occlusal splint as an additional orthodontic tool. For this study, 8 Angle's Class I malocclusion patients, who had centric occlusion-centric relation discrepancy within 1.0 mm and had no clinical symptoms of TMJ disorder, were selected as control group. And 22 malocclusion patients who had centric occlusion-centric relation discrepancy over 1.0 mm were selected and subdivided as Class I Malocclusion group, Class II div. 1 malocclusion group, Class II div. 2 malocclusion group, Open bite group, and Mandibular asymmetry group. For each subject the occlusal splint with mutually protected type of occlusal scheme was applied for 3 months. Condylar positions in centric relation and centric occlusion were measured using Panadent articulators and Panadent condylar position indicator (CPI) before and after occlusal splint therapy. On the basis of this study, the following conclusions might be drawn: 1, In control group, Class II div. 2 malocclusion group, and mandibular assymetry group, there were no significant differences in condylar positions before and after occlusal splint therapy. 2. In Class I malocclusion group, condyles were moved $0.27{\pm}0.45mm$ forward (p < 0.05) and $0.98{\pm}0.25mm$ upward (p < 0.01) after occlusal splint therapy. 3. In Class I malocclusion group, condyles were moved $0.24{\pm}0.21mm$ backward (p < 0.05) and $1.01{\pm}0.33mm$ upward (p < 0.01) after occlusal splint therapy. 4. In open bite group, condyles were moved $1.24{\pm}0.30mm$ upward (p < 0.01) after occlusal splint therapy. 5. In both control and experimental groups, there were no significant differences in lateral condylar positions before and after occlusal splint therapy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.2
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• pp.100-105
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• 2012

Purpose: In general, the surgical treatment for mandibular retrognathism is represented by two methods, distraction osteogenesis (DO) and mandibular osteotomy surgery. The DO is mostly preferred when the degree of advancement of mandible is large. However, the postoperative stability of mandibular advancement using DO have not been actively investigated. Therefore, in the present study we have compared the postoperative stability between DO and bilateral sagittal split ramus osteotomy (BSSRO) in mandibular retrognathism. Methods: Seven patients who had been treated by DO and thirteen patients with BSSRO were included in this study. Serial lateral cephalograms were analyzed by manual tracing and the amount of the mandibular elongation was measured. To evaluate the postoperative stability, positional changes of the condylar position and B point were analyzed. Results: Mean amount of mandibular advancement was $6.51{\pm}3.57mm$ for BSSRO group and $12.43{\pm}4.35mm$ for DO group, respectively. There was no significant difference in age between the two groups (P>0.05). Mean follow up periods were 10.77 months for BSSRO group and 11.28 months for DO group, respectively. After mandibular advancement, mean positional changes in the condyle were $0.56{\pm}1.43mm$ horizontally and $0.72{\pm}1.61mm$ vertically for BSSRO group and $0.53{\pm}1.56mm$ horizontally and $0.56{\pm}1.75mm$ vertically for DO group, respectively. Mean change of distance from B point to Y-axis was $-1.76{\pm}0.83mm$ for BSSRO group and $-2.14{\pm}1.82mm$ for DO group, respectively. According to the condylar position and B point, there were no significant differences in postoperative stability between the two groups (P>0.05). Conclusion: There was no significant difference in postoperative stability between DO and BSSRO group according to condylar position and B point. Based on the results of the present study, it is hypothesized that DO would be a good treatment choice for severe mandibular retrognathism because DO could achieve more mandibular advancement and concurrent soft tissue elongation.