• Title/Summary/Keyword: Mandibular ramus

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Biomechanical analysis of distalization of mandibular molars by placing a mini-plate: A finite element study

  • Park, Myungsoon;Na, Yonghyun;Park, Minbong;Ahn, Janghoon
    • The korean journal of orthodontics
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    • v.47 no.5
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    • pp.289-297
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    • 2017
  • Objective: The objective of this study was to analyze the patterns of tooth movements when distalization of mandibular molars using a mini-plate took place. A finite element analysis was applied to analyze patterns of tooth movements. Methods: The model of the mandible and teeth were used to build a finite element analysis model, and a mini-plate was inserted in the mandibular ramus. Two different orthodontic forces were established for displacement of mandibular molars. Orthodontic forces were applied at the level of the bracket and at the level of the cemento-enamel junction in the mandibular canine respectively. Results: Applying orthodontic forces at the level of the cemento-enamel junction resulted in a greater biomechanical bodily movement in distalization of the mandibular molars compared to when the orthodontic forces were applied at the level of the bracket. Applying orthodontic forces to the cemento-enamel junction also resulted in unwanted greater extrusive movements in distalization of the mandibular molars compared to the bracket level. Conclusions: With considering the mode of orthodontic teeth movement, applying different vertical orthodontic forces for distalization of mandibular molars can lead to more effective distalization of teeth.

Comparison of Postoperative Stability between Distraction Osteogenesis and Bilateral Sagittal Split Ramus Osteotomy in Mandibular Retrognathism (하악후퇴증 환자에서 골신장술과 하악지 시상분할 골절단술의 술 후 안정성에 관한 비교 연구)

  • You, Myung-Su;Lee, Jee-Ho;Kim, Myung-Jin
    • 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.

TRANSVERSE CHANGE OF THE PROXIMAL SEGMENT AFTER BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY IN MANDIBULAR PROGNATHISM USING COMPUTED TOMOGRAPHY (하악전돌증환자에서 하악지시상분할골절단술 후 전산화단층촬영을 이용한 근심골편의 횡적인 변화에 관한 연구)

  • Kim, Young-Joon;Kook, Min-Suk;Park, Hong-Ju;Shet, Uttom Kumar;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.3
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    • pp.232-240
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    • 2008
  • Purpose: This study was performed to evaluate transverse changes of proximal segment after bilateral sagittal split ramus osteotomy (BSSRO) using 3-D CT in mandibular prognathism. Patients and methods: Twenty-two patients who underwent BSSRO for mandibular set-back in class III malocclusion without facial asymmetry were examined. Miniplates were used for the fixation after BSSRO. Facial CT was taken before and after BSSRO within 3 months. Frontal-ramal inclination (FRI), inter-gonial width (IGW) and intercondylar width (ICW) were measured in 3-D CT images using V-works $4.0^{TM}$ program. Student t-test was used to compare the changes between pre- and post-operative measurements using SPSS 10.0 program. Results: 1. Mean peroperative FRI value ($12.87{\pm}3.43^{\circ}$) was slightly increased to postoperative value ($14.13{\pm}3.72^{\circ}$) (p < 0.05). The average FRI increased 10.42% and the range was from $-2.46^{\circ}$ to $3.34^{\circ}$. 2. Mean peroperative IGW ($99.01{\pm}5.36$) was slightly decreased to postoperative IGW ($96.51{\pm}5.88mm$) (p < 0.05). The average IGW decreased 2.52 % and the range was from $-6.61^{\circ}$ to 0.91 mm. 3. Mean preoperative ICW ($125.01{\pm}5.30mm$) was slightly decreased to postoperative ICW ($125.40{\pm}5.45mm$) (p < 0.05). There is no significant difference between pre- and post-operative ICW. 4. There was significant correlationship between FRI difference and IGW difference (p < 0.05). Conclusions: These results indicate that the lower ramus of the proximal segment is moved inward after BSSRO procedure for mandibular set-back.

PANORAMIC IMAGE OF MANDIBULAR CONDYLE ACCORDING TO HEAD POSITION (두부 위치에 따른 하악 과두의 파노라마상)

  • Kim Jeong Hwa;Choi Soon Chul
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.20 no.2
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    • pp.219-225
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    • 1990
  • Panoramic radiography is convenient in clinic and visualizes those areas which other technique do not give. But the technique has limitation of image distortion which results from the relationship of the ramus to the focal trough and from the direction of the central ray. This study is, using 7 dry skulls, to determine the effect of rotation of patient's head on reducing those distortion and determine the magnification ratio of images of mandibular condyle in rotated patient head position. The obtained results were as follows: 1. Generally, in panoramic radiography the anterolateral portion of the mandibular condyle was best to be visualized. 2. There are no significant difference between the image readability of anteromedial portion and that of anterocentral portion of the mandibular condyle. 3. Anterolateral portion of the mandibular condyle was better visualized in rotated head position by 20 degree or horizontal condylar inclination than in conventional position or in rotated head position by 10 degree. 4. The magnification ratio of the anteroposterior diameter in the image of mandibular condyle was least in the rotated head position by horizontal inclination of the mandibular condyle and was largest by 20 degree.

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SOME FACTORS RELATED TO MANDIBULAR THIRD MOLAR ERUPTION (하악제 3대구치의 맹출에 미치는 요소에 관한 연구)

  • Kim, Jae-Seung;Chung, Kyu-Rhim
    • The korean journal of orthodontics
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    • v.18 no.1 s.25
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    • pp.79-88
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    • 1988
  • The purpose of this study was to investigate the factors which might be related to mandibular third molar eruption and to predict the possibility of whether or not it will be erupted. The material of this study was lateral cephalometric radiograms, pantomograms and dental casts obtained from 70 patients (19 males, 51 females) ranging in age from 18.0 to 32.1 years. They were devided into erupted group and impacted group of mandibular third molars. For the comparison of each group, a total of 20 measurement items were employed and the data were analyzed by means of computer statistical method. As a result of this study, the following conclusion can be made; 1. The longer mandibular body length and narrower mandibular ramus width, the higher eruption tendency of the lower third molar, but the degree of genial angle was not related to mandibular third molar eruption. 2. The lower percentage of posterior mandibular body height to anterior mandibular body height, the higher eruption tendency of the lower third molar. 3. The total tooth size, including the lower second molar, appeared to be larger in the impacted group than in the erupted group of the lower third molar. 4. The arch length discrepancy of the impacted group was more severe in contrast with the erupted group of the lower third molar.

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Pyogenic Granuloma with Severe Mandibular Bone Destruction (심한 하악골 파괴를 동반한 화농성 육아종)

  • Shin Jeong-Won;Heo Min-Suk;Lee Sam-Sun;Choi Soon-Chul;Park Tae-Won
    • Imaging Science in Dentistry
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    • v.30 no.2
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    • pp.123-126
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    • 2000
  • Pyogenic granuloma is a overzealous proliferation of a vascular type connective tissue as a result of some minor trauma and is a well circumscribed elevated, pedunculated or sessile benign inflammatory lesion of skin and mucous membrane. The clinical features of pyogenic granuloma are indicative but not specific and nearly all cases of pyogenic granulomas are superficial in nature, and there is little if any mention in the literature of these lesions producing alveolar bone even jaw bone loss. This case is somewhat unique in that the lesion was an obvious histologic pyogenic granuloma; however, it appeared to invade the mandibular bone which resulted in the loss of the adjacent teeth. A 12-year-old boy came to Seoul National University Dental Hospital with chief complaints of left facial swelling. The features obtained were as follows; Plain radiograms showed a large well-circumscribed radiolucent lesion on left mandibular ramus area, which made severe expansion of lingual cortex and displacement of lower left 3rd molar tooth germ. Computed tomograms showed large soft tissue mass involving left masticator space with destruction of left mandibular ramus. Histologically, sections revealed loose edematous stroma with intense infiltration of inflammatory cells and proliferation of vascular channels. Also, there were focal areas of extensive capillary proliferation, bone destruction and peripheral new bone formation.

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Cone-beam computed tomographic evaluation of the condylar remodeling occurring after mandibular set-back by bilateral sagittal split ramus osteotomy and rigid fixation

  • Ha, Man-Hee;Kim, Yong-Il;Park, Soo-Byung;Kim, Seong-Sik;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.43 no.6
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    • pp.263-270
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    • 2013
  • Objective: To evaluate condylar head remodeling after mandibular set-back sagittal split ramus osteotomy (SSRO) with rigid fixation in skeletal class III deformities. The correlation between condylar head remodeling and condylar axis changes was determined using cone-beam computed tomography (CBCT) superimposition. Methods: The CBCT data of 22 subjects (9 men and 13 women) who had undergone mandibular set-back SSRO with rigid fixation were analyzed. Changes in the condylar head measurements and the distribution of the signs of condylar head remodeling were evaluated by CBCT superimposition. Results: The subjects showed inward rotation of the axial condylar angle; reduced condylar heights on the sagittal and coronal planes; and resorptive remodeling in the anterior and superior areas on the sagittal plane, superior and lateral areas on the coronal plane, and anterior-middle and anterior-lateral areas on the axial plane (p < 0.05). Conclusions: The CBCT superimposition method showed condylar head remodeling after mandibular set-back SSRO with rigid fixation. In skeletal class III patients, SSRO with rigid fixation resulted in rotation, diminution, and remodeling of the condylar head. However, these changes did not produce clinical signs or symptoms of temporomandibular disorders.

STABILITY OF ORTHOGNATHIC SURGERY FOR CLEFT LIP AND PALATE PATIENTS (구순구개열환자에 대한 악교정수술후 안정성에 대한 연구)

  • Kwon, Tae-Geon;Mori, Yoshihide;Minami, Katsuhiro;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.4
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    • pp.407-413
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    • 2000
  • To evaluate the stability after orthognathic surgery in cleft lip and palate patients using rigid fixation, 20 patients underwent primary repair in childhood and later developed a jaw deformity and malocclusion that required orthognathic surgery were reviewed. Two groups, one of 10 patients performed Le Fort I osteotomy with sagittal split ramus osteotomy and one of 10 patients with sagittal split ramus osteotomy of the mandible, were evaluated. Each group had unilateral cleft only and all alveolar cleft sites had been grafted with autogeneous bone before the orthognathic surgery. The amount of surgical movement and relapse were compared in both horizontal and vertical dimensions. Two-jaw surgery group was more stable than mandibular surgery only group in mandibular position (p< 0.05). Statistically significant relapse was observed in mandibular skeletal point in mandibular surgery group (p<0.05). There was no statistically significant relapse in the skeletal point of two-jaw surgery group. However, the correlation between the horizontal surgical movement and relapse was detected (r = 0.88). This correlation indicates the need of overcorrection. The presence of scar tissues and relatively deficient maxillary bone could be attributed to this close relation between the surgical change and relapse.

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STABILITY AFTER SURGICAL CORRECTION OF MANDIBULAR PROGNATHISM USING BILATERAL SAGGITAL SPLIT RAMUS OSTEOTOMY AND FIXATION WITH POLY-L/DL-LACTIDE COPOLYMER SCREWS ($BIOSORB^{TM}FX$) (하악지 시상 골절단술 이후 흡수성 나사를 사용하여 고정한 환자에서 술 후 안정성에 대한 연구)

  • Kwon, Taek-Kyun;Kim, Yong-Deok;Shin, Sang-Hun;Kim, Uk-Kyu;Kim, Jong-Ryoul;Chung, In-Kyo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.2
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    • pp.160-163
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    • 2005
  • This study was designed to assess skeletal stabilily after surgical correction of mandibular prognathism by bilateral saggital split ramus osteotomy(BSSRO) and fixation with absorbable screws. From July 2001 to September 2003, 30 patients with Class III malocclusion were treated with BSSRO and mandibular setback. They underwent fixation with Biosorb$^{TM}$ FX screws. Cephalograms were obtained preoperatibely, 2 or 3 days postoperatively, and about 12 months after the operation. Changes in the position of lower incisor tip, B point, and pogonion were examined on lateral cephalograms. The mean mandibular setback just after surgery was 10.6mm. 12 months after surgery, mean relapse at pogonion represented 17.9% and 15.1% at B point. Our results suggest that fixation of the bony segments with absorbable screws after BSSO may be used effectively in properly selected cases.