• Title/Summary/Keyword: Mandibular surgery

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Cephalometric analysis of skeletal Class II malocclusion in Korean adults (한국 성인 골격성 II급 부정교합자의 측모두부규격 방사선 계측학적 연구)

  • Kim, Kyung-Ho;Choy, Kwang-Chul;Yun, Hee-Sun
    • The korean journal of orthodontics
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    • v.32 no.4 s.93
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    • pp.241-255
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    • 2002
  • This study was performed to evaluate horizontal and vertical characteristics according to lateral cephalometry of adult Korean skeletal Class II patients using a selected horizontal and vortical reference planes of Koreans. 60 males and 60 females consisting of freshman of Yonsei University from 1996 to 1997 and patients with history of orthognatic surgery at the Dental Hospital of Yonsei University with a skeletal Class II profile were chosen and compared with 70 males and 70 females with normal occlusion. The skeletal Class R group had the following conditions : 1. Profile composed of a retrognathic mandible or protrusive maxilla; 2. Class II molar and canine key; 3. ANB-greater than $4^{\circ}; 4$. Wits appraisal-greater than 1.0mm; Cephalometric analysis consisted of 22 skeletal, 25 soft tissue, 12 dental measurements. The results were as follows. 1. There was no considerable vortical measurement difference between the skeletal Class II malocclusion group and the normal occlusion group in skeletal analysis. But, some variations were found between the two groups in soft tissue analysis. 2. Mandibular length of the skeletal Class II malocclusion group was smaller than that of the normal occlusion group. Mandible was more posteriorly positioned in the Class II malocclusion group than in the normal occlusion group. 3. The length and antero-posterior position of the maxilla were not different between the Class II malocclusion and the normal occlusion group. 4. The antero-posterior position of the nose, upper lip and maxillary soft tissue, and nasolabial angle were not different between the two groups. 5. Mandibular soft tissue of the Class H malocclusion group was more posteriorly positioned than that of the normal. 6. The vertical measurements of the incisors(U1-HP, L1-HP) were bigger in the Class II malocclusion group than in the normal, but those of the molars(U6-HP, U6-MP) showed no significant difference between the two groups. 7 Classifying the skeletal Class II malocclusion group according to the antero-posterior position of both jaws, normally positioned maxilla and retruded mandible was 43.3%, both normally positioned maxilla and mandible 28.3%, both retruded maxilla and mandible 20.0%..

STUDY ON THE KOREAN CRANIOFACIAL SKELETAL PATTERN BY COUNTERPART ANALYSIS (구조적 대응체 분석법(Counterpart Analysis)에 의한 한국인의 악안면 두개 골격형태에 관한 연구)

  • Sohn, Byung-Wha;Lee, Yoon-Jeong;Yang, Choon-Sik
    • The korean journal of orthodontics
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    • v.30 no.5 s.82
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    • pp.509-519
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    • 2000
  • Enlow's counterpart analysis explains the complex with anatomic and developmental characteristics where craniofacial aspect of individuals has been developed. The analysis does not compare individual measurement with the normal value from the average of majority but analyzes by comparison of values that each individual has. This study was to clarify the Korean craniofacial skeletal pattern using Enlow's counterpart analysis considering the fact that the craniofacial skeletal pattern has racial and regional variations. This research will be helpful in the future for growth research and research of the orthognathic surgery. For this study, the samples were consisted of 100 Korean adult subjects(50 males and 50 females) who had normal occlusion and pleasing face. Measurement points and lines were established using Enlow's counterpart analysis and they were statistically evaluated. The results indicated that : 1. The average angle between PCF and PMV was $38.54^{\circ}$ in males and $38.43^{\circ}$ in females, and the average Wits' appraisal was -2.51 in males and -2.3 in females. The ramus alignment(R4) was 1.89 in males and 2.36 in females. 2. It shows that females have a longer ramus than the PCF compared to the males, because there was a significant difference in Ramus/PCF horizontal dimensions (Skeletal A3-B3) between female and male subjects 3. It shows that males have a longer mandibular corpus than the maxilla compared to the females, because there was a significant difference in Maxillary/Mandibular arches(Skeletal A4-B4) between male and female subjects 4. In cranial floor+maxilla/ramus+corpus at A and B points(Al-Bl), which represents difference in total horizontal length between the maxilla and mandible, there was no significant difference between males and females. In conclusions, compared to Caucasian, Korean have more depressed midface, prognathic mandible, and ramus that rotates inferioposterior. Also, we observe that Korean women have target ramus posterior cranial base, as compared with Korean men. Consequently, the total length of maxilla and mandible does not show any difference, because man's mandible is longer than maxilla in comparison with woman's one.

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The differences of STO between before and after presurgical orthodontics in skeletal Class III malocclusions (골격성 III급 부정교합자에서 술 전 교정치료 전과 후의 수술계획의 차이)

  • Lee, Eun-Ju;Son, Woo-Sung;Park, Soo-Byung;Kim, Seong-Sik
    • The korean journal of orthodontics
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    • v.38 no.3
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    • pp.175-186
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    • 2008
  • Objective: To evaluate the discrepancies between initial STO and final STO in Class III malocclusions and to find which factors are related to the discrepancies. Methods: Twenty patients were selected for the extraction group and 20 patients for the non-extraction group. They were diagnosed as skeletal Class III and received presurgical orthodontic treatment and mandibular set-back surgery at Pusan National University Hospital. The lateral cephalograms were analyzed for initial STO (T1s) at pretreatment and final STO (T2s) after presurgical orthodontic treatment, and specified the landmarks 3s coordinates of the X and V axes. Results: Differences in hard tissue points (T1s-T2s) in the X coordinates of upper central incisor edge, upper first molar mesial end surface, lower central incisor apex, lower first molar mesial end surface and mesio-buccal cusp and Y coordinates of upper central incisor edge, upper central incisor apex, upper first molar mesio-buccal cusp were statistically significant in the extraction group. Differences in hard tissue points (T1s-T2s) in the X coordinates of upper central incisor edge, lower central incisor apex, lower first molar mesial end surface and Y coordinates of lower central incisor apex were statistically significant in the non-extraction group. In the extraction group, the upper arch length discrepancy (UALD) had a statistically significant effect on maxillary incisor and first molar estimation. Lower arch length discrepancy and IMPA had statistically significant effects on mandibular incisor estimation in both groups. Conclusions: Discrepancies between initial STO and final STO and factors contributing to the accuracy of initial STO must be considered in treatment planning of Class III surgical patients to increase the accuracy of prediction.

Experimental Study on the Effects of Ovariectomy and Estrogen on the Bone Pattern of Mandible in Rats (난소적출과 에스트로젠 투여가 백서의 하악골 구조에 미치는 영향)

  • Lee, Hyung-Soon;Hong, Sung-Gyu;Kim, Jong-Ghee
    • The korean journal of orthodontics
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    • v.29 no.1 s.72
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    • pp.83-94
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    • 1999
  • The purpose of this study was to evaluate the changes of cancellous and cortical bone and the effect of estrogen in ovariectomized rats. Fifty female rats, 250gm in body weight, were divided into three groups : ovariectomized group(OVE), ovariectomized and estrogen-injected group(OVE-EST), and sham operated and estrogen-injected group(EST). Bilateral ovariectomy was performed at the onset of the experiment. In OVE-EST group and EST group, estrogen was injected $50{\mu}g/kg$ B.W. every other days from 3 weeks after surgery to sacrifice. Each five rats were sacrificed after 5, 6, 7 weeks. One side of mandibular body was radiographed with a soft x-ray apparatus(Hitex Co., Ltd., Japan). Thereafter the obtained microradiographs were used for the morphometric analysis using a Image analyzer. The morphometric analysis was perforrmed for parameters such as total bone area, cortex bone area and medullary bone area. The other side of the mandibular bone was decalcified and embedded in paraffin as using a general method. The specimens were sectioned and stained with Mallory's anilline blue and observed light microscopically. The results were as follows. 1 In all groups, the proportion of cortex to total bone area was not significantly different. 2. In ovariectomized(OVE) group, the proportion of marrow cavity to medullary bone area increased significantly from 5 to 7 weeks(p<0.05). In ovariectomized and estrogen-injected(OVE-EST) group, it decreased significantly at 7 weeks, and in estrogen-injected(EST) group, it decreased significantly from 6 weeks(p<0.05). 3. Microradiogram and histopathologic findings revealed that marrow cavity was enlarged and osteoclasts were observed around irregular bone surface in OVE group. In OVE-EST group, the size of marrow cavity at 7 weeks was similar to that of control group. In EST group, as dense trabecular bone increased from 5 to 7 weeks, marrow cavity decreased.

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Study on Korean skeletal Class III craniofacial pattern by counterpart analysis (구조적 대응체 분석법에 의한 한국인 골격성 III급 부정교합의 특징)

  • Sohn, Byung-Wha;Lee, Kee-Joon;Mo, Sung-Seo
    • The korean journal of orthodontics
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    • v.32 no.3 s.92
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    • pp.209-225
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    • 2002
  • Enlow's counterpart analysis reflects the characteristics of each individual sample to find out the cause of the malocclusion and further applying them to the clinic. Enlow's counterpart analysis was performed on 100 Korean samples (50 male, 50 female) with normal occlusion and 100 skeletal class III patients (50 male, 50 female) scheduled for orthognathic surgery. The following conclusions were obtained. 1. The cause of malocclusion in skeletal class III patients were complex and interrelated : backward upward rotation of the cranial base, forward inclination of the ramus, increase in the mandibular body length, and posteriorly located maxilla. 2. Seen on R2 (male-1.68mm, female-2.33mm), in skeletal class III, the maxilla Is mote posteriorly located than the normal group. 3. The cause of malocclusion In skeletal class III patients, consists of retrognathic maxilla(A1) male $22\%$, female $26\%$, prognathic mandible(B1) male $44\%$, female $34\%$, and combination of an retrognathic maxilla and prognathic mandible were male $28\%$, female $38\%$. 4. There was no significant difference in the anterior-posterior length of the maxilla(A4) between skeletal class III males with the normal group, while in the female subjects, the skeletal class m group showed a smaller maxilla(A4) compared to the normal group. 5. In skeletal class III patients the proganthic mandible was primarily caused by the Inclination of the ramus(R3, R4) and mandibular body length(B4, B6) rather than ramus width(B3).

ULTRASTRUCTUAL ANALYSIS OF THE FIBROUS LAYER OF CONDYLE IN THE RAT TEMPOROMANDIBULAR JOINT WITH AGEING (가령에 따른 흰쥐 하악과두 섬유층의 미세구조 및 교원원섬유의 변화)

  • Byeon, Ki-Jeong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.4
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    • pp.305-315
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    • 1998
  • The fibrous layer of mandibular condyle of the neonatal, 1-, 7-, 14-, 27-, 55-days and 1 year old rats were examined in the electron microscope with particular attention to the ultrastructure and diameter of collagen fibrils. In the 1-day rats, most of the cells of the fibrous layer were undifferentiated mesenchymal cells and fibroblasts with rough a little developed rough endoplasmic reticulum(RER) and golgi apparatus(GA). In 7-, 17 and 27-days old rats, most of the fibroblast showed well developed GA and RER with widely distended cisternae containing granular materials. In many of these cells contained intracytoplasmic filaments among the cytoplamic organelle. In 55-day and 1-year old rats, three types of cells were observed, ie, cells containing well developed cytoplasmic organelle presumed to be involved in the collagen fibril synthesis, cells showing well developed lysosomes, golgi apparatus, mitochondria and short cytoplasmic process presumed to be involved in the active resorption of the injured collagen fibrils or cellular debris, cells containing many intracytoplasmic filaments and a little organelle presumed to be cells of inactive state. The average diameters of collagen fibrils were similar in 1- and 7-day old rats as $38.48{\pm}3.81nm$, $38.06{\pm}3.86nm$. That was thickest in 14 days old rats as $50.21{\pm}3.93nm$ among experimental groups. They were gradually thinner in 27-, 55-day rats as $40.05{\pm}2.52nm$, $43.63{\pm}1.20nm$ and thinnest in 1-year old rats as $37.38{\pm}2.17nm$. The distribution pattern of diameters of collagen fibrils were unimordal with peak of 30-60nm in rats from 1-day to 17-day old. With aging from 27-day to 1 year old rats, collagen fibril diameters showed wide distribution pattern and percentage of thin collagen fibrils increased. These results may show the functional adaptation of fibrous layer of mandibular condyle to the increased mechanical forces with aging.

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COMPARISON OF JAW BONE DENSITY IN YOUNG ADULTS AND POSTMENOPAUSAL WOMEN (젊은 성인과 폐경 여성간의 악골 골밀도에 관한 비교 연구)

  • Kim, Tae-Sung;Lee, Dong-Keun;Lee, Byung-Do;Jung, Sun-Kwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.2
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    • pp.107-114
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    • 2001
  • Objectives : To compare jaw bone density of young adults (control group) and post-menopausal women(experimental group) in periapical and panoramic film. Materials and Methods : The bone mineral density values of lumbar and femur were measured by dual-energy X-ray absorptiometry(DEXA) and T scores of lumbar were obtained. T scores were classified into 3 group (T<-2.5, $-2.5{\leqq}T<-1$, $-1{\leqq}T$). Radiographic densities of alveolar bones were measured from interdental bones of premolar, molar areas in the maxilla and mandible and expressed into copper step wedge thickness by Scion $Image^{(R)}$ program. We considered these values of step wedge thickness as bone density of alveolar bone. Panorama mandibular index(PMI) was calculated by the method that the height of the inferior cortex of the mandible was divided by the height from the lower border of the mandible to the superior edge of the mental foramen. Bone density of alveolar bone and PMI were analysed statistically. Results : There were significant differences in bone mineral density of lumbar and femoral neck between control and experimental groups. There were also significant differences in bone density of premolar and molar area of jaw between control and experimental groups by MANOVA test. When considered lumbar T variables, there was only difference in interdental bone density of maxillary molar area between control and experimental group, but there was interaction. Interdental bone density of experimental group was appeared higher in $-1{\leqq}T$ group and lower in T<-2.5 group than control group. There was significant difference in PMI between control and experimental groups, but there was also inter action, thus, PMI of experimental group was appeared higher in $-1{\leqq}T$ group and lower in T<-2.5 group than control group. Conclusion : There were significant differences of alveolar density and cortical bone thickness between young men and post-menopausal women in periapical and panoramic film. These differences were dependent on lumbar T.

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PERIPHERAL ODONTOMA IN A CHILD: CASE REPORT (소아에서 발생한 변연성 치아종의 증례보고)

  • Lee, Young-Ho;Park, Ho-Won;Lee, Ju-Hyun;Seo, Hyun-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.3
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    • pp.301-305
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    • 2012
  • The odontoma is a hamartoma of odontogenic origin and consists of enamel, dentin, cementum and pulp tissue. Two types of odonotma are histologically recognized: complex and compound. Odontoma may be the cause of noneruptoin or impaction of teeth, formation of cyst and resorption of adjacent bone. The recommended treatment for an odontoma is conservative surgical excision. No propensity for recurrence has been noted. Peripheral odontoma is relatively rare lesion and shows the histological characteristics of an intraosseous odontoma. This report described a 3-year-old Korean girl with a firm gingival mass in the posterior mandibular area, which had been gradually enlarging over 18months. Radiographic examination showed a radiopaque mass but no evidence of underlying intraosseous lesion. Excisional biopsy was performed for the mass removal and histopathological examination. The result of histopathological study was identified as hamartous supernumerary tooth germ. Based on the clinical presentation, radiographic and histopathologic findings, we concluded that the final diagnosis was peripheral odontoma. For three years after surgery, there is no clinical sign of recurrence.

RADIOGRAPHIC INTERPRETATION OF EXPERIMENTALLY PRODUCED BONY DEFECT ACCORDING TO kVp (관전압 변화에 다른 실험적 골결손부의 방사선사진상의 판독)

  • Nam Hye Kyung;Choi Karp Shik;Kim Chin Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.20 no.2
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    • pp.265-276
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    • 1990
  • The purpose of this experiment was to evaluate radiographic interpretation, of various sized 60 periapical and 60 cancellous lesions in 10 mandibular sections of 5 dogs according to kVp (65, 70, 75, 80 and 85 kVp). The results were as follows; The change of kilovoltage within 65kVp-85kVp range did not have influence on the radiographic interpretation of the same-sized bony defects at the constant radiographic density (p> 0.05). When the bony defects were less than the size of No.2 round bur, radiographic interpretation of bony defects prepared with No.2 round bur was easier than those prepared with No. 1 round bur at 80-85kVp in periapical region (p<0.05). However, in cancellous bone, this radiographic interpretation was easier at 65-75kVp (p<0.05). There were significant differences in the radiographic interpretation between the defects confined only to the cancellous, bone and the defects involved in the compact bone (p<0.05). However there were no significant differences between the defects confined only to the cancellous bone and the defects involved in junctional area of cancellous and compact bone (p>0.05). From the results of densitometric analysis, there was a difference in densitometric measurements at the same radiographic interpretation scores, and aluminum equivalent differences of 0.15-1.66㎜ thickness were needed for radiographic interpretation.

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CEPHALOMETRIC PREDICTORS OF OBSTRUCTIVE SLEEP APNEA (폐쇄성 수면 무호흡증에 있어 두부 규격 방사선 계측학적 기여 인자)

  • Kwon, Tae-Geon;Cho, Yong-Won;Ahn, Byung-Hoon;Suh, Young-Sung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.5
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    • pp.338-345
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    • 2003
  • Purpose : This study was intended to perform cephalometric comparison between the patients with and without obstructive sleep apnea (OSA). The factors influencing the OSA in the lateral cephalogram was also investigated. Patient and Method : Twenty four patients who visited Sleep Disorder Clinic in Dongsan Medical Center, Keimyung University and evaluated with polysomnograph(PSG) and cephalogram were included in the study. The patients had apnea-hypopnea episode(AHI) over 10 times per hour was diagnosed as OSA after overnight PSG. To evaluate hard and soft tissue profile, cephalometric radiogram were taken at maximal intercuspation(P1) and mandibular protruding position(P2). The diffefence between the OSA and normal group were evaluated statistically and the stepwise regression analysis was applied to analyse the cephalometric influencing factors to OSA. Result : The OSA Group(n=14) had significantly higher Body Mass Index(BMI) than control group(n=10). Lower facial height(ANSGn) was longer in OSA group. However statistically significant difference was not detected in other anteroposterior craniofacial measurements. The soft palate lenth (PNS-P), hyoid position (MP-Hyoid) had positive correlation between AHI (r=0.496, r=0.413, respectively, p<0.05). However, the measurements of oropharyngeal airway was not different between the two groups. The hypothesis, the antero-posteriorly narrow oropharyngeal airway might aggravate the airway resistance and can give rise to higher AHI, was not accepted in the study. This can be attributed by inclusion of the patients performed uvulopalatopharyngoplasty because of the tonsilar or soft palate hypertrophy in the present study. The results of regression analysis revealed that PNS-P, upper airway width(Nph1), upper facial heght(N-ANS), and lower facial height(ANS-Gn) could influence the degree of AHI (F value < 0.0001, $R^2$ = 0.829). Conclusion : We suggest lateral cephalogram may utilized as a useful method to evaluate OSA. The patient with long soft palate, narrow upper airway width, long upper & lower facial height can be expected to have high risk of OSA. However, it should be emphasized the comphrehensive intraoral inspection including soft palate and tonsilar hypertrophy because lateral cepahlogram cannot visualize oropharyngeal status completely.