• Title/Summary/Keyword: Maxillary retrognathism

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COMPARISON OF CRANIAL BASE MORPHOLOGY BETWEEN THE MANDIBULAR PROGNATHISM AND MAXILLARY RETROGNATHISM IN SKELETAL CLASS III PATIENTS (하악과성장형과 상악열성장형 골격성 Ⅲ급 부정교합군간의 두개저 형태 비교)

  • Kang, Dong-Hwa;Kwon, Tae-Geon;Lee, Sang-Han;Kim, Hyun-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.3
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    • pp.204-210
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    • 2007
  • This study was intended to compare the cranial base morphology between the mandibular prognathism and maxillary retrognathism in skeletal class III patients. The subject of the present study was composed of 88 patients divided into two groups; Group 1 (Skeletal Class III with mandibular prognathism. SNA within normal range, SNB over normal range, n=54) and Group 2(Skeletal Class III with maxillary retrognathism. SNA below normal range, SNB within normal range, n=34). Lateral cephalogram were taken immediate before surgery and 18 landmarks were used to analyze the characteristics of cranial base and maxillomandibular skeleton. The result revealed that cranial base angle is significantly smaller in Group 1 than Group 2, which implies the influence of the cranial base angulation on the mandibular position. However the posterior cranial base length did not influence the mandibular horizontal position and anterior cranial base length did not influence the maxillary horizontal position. As the anterior cranial base length was closely related with ramal height, it is recommendable to investigate the regulatory mechanism of chondrogenesis of cranial base and condyle cartilage in the future research.

A case of severe mandibular retrognathism with bilateral condylar deformities treated with Le Fort I osteotomy and two advancement genioplasty procedures

  • Nakamura, Masahiro;Yanagita, Takeshi;Matsumura, Tatsushi;Yamashiro, Takashi;Iida, Seiji;Kamioka, Hiroshi
    • The korean journal of orthodontics
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    • v.46 no.6
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    • pp.395-408
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    • 2016
  • We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR.

Comparison of the effects of rapid maxillary expansion and alternate rapid maxillary expansion and constriction protocols followed by facemask therapy

  • Ozbilen, Elvan Onem;Yilmaz, Hanife Nuray;Kucukkeles, Nazan
    • The korean journal of orthodontics
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    • v.49 no.1
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    • pp.49-58
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    • 2019
  • Objective: The aim of this retrospective study was to evaluate and compare the changes in the pharyngeal airway (PA), maxillary sinus volume, and skeletal parameters after rapid maxillary expansion (RME) and alternate rapid maxillary expansion and constriction (Alt-RAMEC) followed by facemask (FM) therapy. Methods: The records of 40 patients with skeletal Class III malocclusion due to maxillary retrognathism were collected, and the patients were assigned into two groups. The first group comprised 8 male and 12 female patients (mean age, $10.0{\pm}1.1years$) treated using RME/FM for an average of 10 months. The second group comprised 10 male and 10 female patients (mean age, $9.64{\pm}1.3years$) treated using Alt-RAMEC/FM for an average of 12 months. Cone-beam computed tomography images acquired before (T0) and after treatment (T1) were evaluated. Results: Regarding the skeletal effects, significant differences between the groups were the increase in ANS-HRP (perpendicular distance of ANS to the horizontal reference plane, 0.99 mm, p <0.05) in the Alt-RAMEC/FM group and the decrease in PP-SN (palatal plane to Sella-Nasion plane, $0.93^{\circ}$, p < 0.05) in the RME/FM group. Maxillary sinus volumes increased significantly in both the groups, and the increase was statistically significantly higher in the Alt-RAMEC/FM group. Although no significant intergroup differences were observed in PA volumes, both lower ($1,011.19mm^3$) and total ($1,601.21mm^3$), PA volume increased significantly in the Alt-RAMEC/FM group. Conclusions: The different expansion devices and protocols used with FM therapy do not seem to affect the forward movement of the maxilla and PA volumes. In contrast, the increase in maxillary sinus volume was greater in the Alt-RAMEC/FM protocol.

A new rationale for preservation of the mandibular third molar in orthognathic patients with missing molars

  • Baik, Un-Bong;Kim, Yoon-Ji;Chae, Hwa-Sung;Park, Je-Uk;Julian, Stefania;Sugawara, Junji;Lee, Ui-Lyong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.1
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    • pp.63-67
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    • 2022
  • Controversies exist regarding the need for prophylactic extraction of mandibular third molars in patients who plan to undergo orthognathic surgery. An 18-year-old male patient was diagnosed with mandibular prognathism and maxillary retrognathism with mild facial asymmetry. He had a severely damaged mandibular first molar and a horizontally impacted third molar. After extraction of the first molar, the second molar was protracted into the first molar space, and the third molar erupted into the posterior line of occlusion. The orthognathic surgery involved clockwise rotation of the maxillomandibular complex as well as angle shaving and chin border trimming. Patients who are missing or have damaged mandibular molars should be monitored for eruption of third molars to replace the missing posterior tooth regardless of the timing of orthognathic surgery.

Disturbances of maxillofacial and dental development after cancer therapy: Case reports (항암치료 후 악골 및 치아의 발육 장애: 증례보고)

  • Kim, Hyo-Jung;Kim, Chong-Chul
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.6 no.2
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    • pp.112-115
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    • 2010
  • Chemotherapy and radiotherapy proved conservative and effective in treating tumors. However, both the cancer therapies will also have aberrant effects on developing maxillofacial and dental organs of children. The purpose of this report is to describe the clinical cases of Disturbances of maxillofacial and dental development after Cancer therapy. The first case reported a 7-year-old female patient diagnosed at age 2 years with bilateral retinoblastoma, receiving chemotherapy and radiotherapy. She had agenesis of premolar, microdontia, short tapered teeth in lower anterior area and generalized root stunting. The second case presented a 12-year-old female patient treated with chemotherapy and radiotherapy for neuroblastoma in her early childhood. She presented with a class III malocclusion on a skeletal III base due to maxillary retrognathism. Contemporay oncology had improved survival of children with malignant disease. It will be needed prevention of these side effect after cancer therapy to improve the quality of life.

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TREATMENT OF CLASS II MALOCCLUSION IN THE MIXED DENTITION WITH CLASS II ACTIVATOR: CASE REPORT (II급 Activator를 이용한 혼합치열기 II급 부정교합아동의 치험례)

  • Yoo, Kun-Jung;Kim, Hyun-Jung;Nam, Soon-Heun;Kim, Young-Jin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.4
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    • pp.735-742
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    • 1997
  • Class II malocclusion can be treated via early orthopedic, orthodontic treatment or orthognathic surgery with orthodontic treatment. In the mixed dentition, early orthopedic treatment can be used. Especially, in the case of mandibular retrognathism, the functional appliances can be used, and in the case of maxillary protrusion is combined, they can be used together with headgear. After using activator and activator combined with headgear to the class II malocclusion paitent in the mixed dentition, the results were as follows: 1. Lateral profile was improved, and lower face height was increaed. 2. Overjet was decreased, and molar relationship was changed to class I molar relationship. 3. Growth can be undisturbed, and the aggravation of malocclusion can be prevented to make the 2nd phase orthodontic treatment be much easier.

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