• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권6호
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• pp.643-647
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• 2007

Purpose: The purpose of study was to investigate the correlationship between lip canting change and occlusal canting change after bimaxillary orthognathic surgery, and the ratio of lip canting change and occlusal canting change after the surgery. Patients and methods: The subjects for this study was obtained from a group of 25 patients who took bimaxillary orthognathic surgery for occlusal canting correction at the Department of the Oral and Maxillofacial Surgery, Samsung Medical Center in Seoul, Korea between January 2000 and December 2005 and a patient's chart had to contain a resting frontal facial photograph in natural head position and a corresponding PA cephalogram in occlusion on the same day before the surgery and post-op 6 months later. The lip canting change was assessed with the angle each labial commissure and the bipupilary reference line. And, the occlusal caning change in the frontal plane was assessed with the angle between the each maxillary first molar occulasal surface and the bi-frontozygomatic suture reference line. Results: In angular measurement, average occlusal canting change was $3.09^{\circ}$ and standard deviation was $1.05^{\circ}$, average lip canting change was $1.56^{\circ}$ and standard deviation was $1.05^{\circ}$. In linear measurement, average occlusal canting change was 2.41mm and standard deviation was 2.75mm, average lip canting change was 1.18mm and standard deviation was 0.43mm. Lip canting correction ration to occlusal canting correction was 51.5(${\pm}8.4$)% in angular measurement and 48.8(${\pm}9.1$)% in linear measurement. Under Pearson's correlation analysis, Pearson's correlation coefficient was 0.869 in angular measurement and 0.887 in linear measurement(p-value < 0.01). High correlationship was shown between occlusal canting change and lip canting change. Conclusion: First, Bimaxillary orthognathic surgery can correct lip canting as well as occlusal canting. Second, The average amount of lip canting correction is $51.5{\pm}8.4%,\;48.8{\pm}9.1%$ of occlusal canting correction in the study.

• 구강회복응용과학지
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• 제20권2호
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• pp.143-150
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• 2004

Endosseous implants have been used to provide anchorage control in orthodontic treatment without the need for special patient cooperation. However these implants have limitation like space requirement, cost, equipments. Recently titanium micro-implant for orthodontic anchorage was introduced. Micro-implants are small enough to place in any area of the alveolar bone, easy to implant and remove, and inexpensive. In addition, orthodontic force application can begin almost immediately after implantation. The mandibular first, maxillary first, mandibula second, and maxillary second molars were the four most commonly missing teeth in adult sample. In case of posterior molar teeth missing, deflective contacts in any position, over time, has produced pathologic change of occlusal scheme because of extrusion of opposing teeth. This case had interocclusal space deficiency by mandibular right molars missing over time. The micro-implants had been used for intrusion of maxillary right molars for interocclusal space. The micro-implant would be absolute anchorage for orthodontic movement. Therefore, the micro-implant would be effective method for correction of occlusal plane.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.21.1-21.3
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• 2019

Background: Treatment planning the correction of a transverse maxillary occlusal plane cant often involves a degree of qualitative "eyeballing", with the attendant possibility of error in the estimated judgement. A simple chair side technique permits quantification of the extent of asymmetry and thereby quantitative measurements for the correction of the occlusal plane cant. Methods: A measuring instrument may be constructed by soldering the edge of a stainless steel dental ruler at 90° to the flat surface of a similar ruler. With the patient either standing in natural head position, or alternatively seated upright in the dental chair, and a dental photographic retractor in situ, the flat under-surface of the horizontal part of this measuring instrument is placed on a unilateral segment of a bilateral structure, e.g. the higher maxillary canine orthodontic bracket hook. The vertical ruler is held next to the contralateral canine tooth, and the vertical distance measured directly from the canine bracket to the flat under-surface of the horizontal part of the measuring instrument. Results: This vertical distance quantifies the overall extent of movement required to level the maxillary occlusal plane. Conclusions: This measuring instrument and simple chair side technique helps to quantify the overall extent of surgical levelling required and may be a useful additional technique in our clinical diagnostic armamentarium.

• 구강회복응용과학지
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• 제16권2호
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• pp.149-159
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• 2000

Occlusal disease is comparable to periodontitis in that it is generally not reversible. Occlusal disease, however, like periodontitis, often maintainable. It does itself to treatment and when restorative dentistry is utilized it becomes, in that sense, reversible. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. An integrated treatment plan is first developed on one set of diagnostic casts, properly mounted on a semiadjustable articulator using jaw relationship records. This is accomplished by using wax to make reconstructive modifications to the casts. These modified casts become the blueprint for planned occlusal changes and the fabrication of provisional restorations. The treatment goals are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. This report shows the treatment procedures for a patient whose mandibular position has been altered due to posterior bite collapse. Migration of the maxillary anterior teeth had occurred, and the posterior occlusal contacts showed pathologic interference. Precise diagnosis using mounted casts was executed and prosthodontic reconstruction by the aid of an unconventional orthodontic correction on maxillary flaring was planned. An unconventional orthodontic correction can be accomplished by using preexisting natural teeth, which can be modified for use in active tooth movement or splinted together for orthodontic anchorage. This technique has an advantage over conventional fixed appliance orthodontic therapy because it can accomplish tooth movement concurrently with restorative and periodontal therapy. On occasion, minor tooth movement can be necessary to achieve the optimum occlusal scheme, crown form, and tooth position for the forces of occlusion to be displaced down the long axis of the periodontally compromised teeth. Once the occlusion, periodontal health, and crown contours for the provisional splinted restoration are acceptable, the final splinted restoration can be similarly fabricated, and it becomes an excellent orthodontic retainer.

• 대한치과의사협회지
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• 제19권11호통권150호
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• pp.907-911
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• 1981

• 대한소아치과학회지
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• 제21권2호
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• pp.577-585
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• 1994

The Twin Blocks technique was developed by Dr. William Clark of Scotland during the early 1980's. Twin Blocks are an uncomplicated system that incorporates the use of upper and lower bite blocks. These blocks reposition the mandible and redirect occlusal forces to achieve rapid correction of malocclusions. They are also comfortable and the patients wear them full-time-inducing eating time. Occlusal forces transmitted through the dentition provide a constant proprioceptive stimulus to influence the rate of growth and the trabecular structure of the supporting bone. The features of Twin Blocks mean easier and quicker treatment. The occlusal inclined plane is the fundamental functional mechanism of the natural dentition. Twin blocks are bite blocks that effectively modify the occlusal inclined plane to induce favorably directed occlusal forces by causing a functional mandibular displacement. Upper and lower bite blocks interlock at a $45^{\circ}$ angle and are designed for full-time wear to take advantage of all functional forces applied to the dentition including the forces of mastication. The patients who were treated with modified Twin Blocks, and following results were observed: 1. Large overjet and deep overbite were corrected. 2. Class II molar relationship was changed into Class I. 3. Labial inclination of upper incisors was corrected by adjustment of labial bow of upper bite block. 4. The profiles of two patients were improved by anterior displacement of mandible.

• 대한치과보철학회지
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• 제54권4호
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• pp.431-437
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• 2016

광범위한 보철 수복에서 교합접촉의 재설정이 필요한 경우가 많이 있으며, 교합접촉은 보철물 성공의 필수요소이다. 만약 교합접촉 관계가 잘못 부여된다면 다양한 교합외상의 증상이 발생할 수 있으며, 악관절 장애도 그 중 하나이다. 이런 악관절 장애의 흔한 증상의 하나로 저작근 장애 및 악관절 부위 통증이 발생될 수 있으며 이는 환자에게 많은 고통을 준다. 본 증례는 보철물의 잘못된 교합접촉으로 인한 지속적 악관절 통증을 가진 환자에서 교합 재설정한 보철물로 재수복하여 저작근 및 악관절 통증이 개선되는 등의 만족스러운 결과를 얻어 이를 보고하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권4호
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• pp.239-244
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• 2003

The common errors in preoperative treatment plan for the orthognathic surgery can be occurred during cast impression, cast mounting procedure with face-bow transfer, surgical stent fabrication, and so on. One of the most common errors exists during mounting process of the model on the articulator. Accurate mounting of dental casts to articulator should be achieved by transferring the 3-dimensional spatial relationship of the maxillary arch to an articulator. A face-bow is used for transfer this relationship to articulator, usually by relating the face-bow to a plane of reference of maxillary cast. The purpose of this study is evaluation of the accuracy of face-bow transferring of maxillary model to the articulator. The maxillary casts of thirty patients for orthognathic surgery were mounted on articulator with an face-bow instrument. The relationship of occlusal plane angle to Frankfort horizontal plane relations were compared the cephalogram with the cast-mounted articulator. As a result of this study, the significant difference between the maxillary occlusal planes angle in the cephalogram and articulator were found. The results were followed, 1. The mean occlusal plane angle in cast-mounted articulator was $13.5^{\circ}\;(SD{\pm}5.4)$. 2. The mean occlusal plane angle in cephalogram was $10.4^{\circ}\;(SD{\pm}4.3)$. 3. The mean difference of occlusal plane angle between cast-mounted articulator and cephalogram was $3.3^{\circ}\;(SD{\pm}4.6)$. According to the result, we should suggest that the occlusal plane angle to Frankfort plane in cast-mounted articulator is more steeper than that of cephalogram. And then, maxillofacial surgeon should try to get a more predictable result by suggesting the proper correction method and mounting the cast accurately.

• Journal of Oral Medicine and Pain
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• 제31권4호
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• pp.365-373
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• 2006

이 연구는 경찰사회에서의 측두장애환자의 교합상태를 평가하여 습관적인 최대교합시에 교합접촉 시기와 접촉수, 접촉힘을 분석하여 과도한 개구나 이악물기등의 악습관 교정을 제시 하는데 있다. 경찰사회에서는 일반 사회에는 다른 양상의 최대 개구, 습관적인 긴밀한 최대 교합상태 등으로 인하여 측두하악장애에 영향을 미칠 수 있다. 반복적인 훈련이나 일상생활에서의 변화는 그동안 유지되어 오던 저작근을 비롯한 악구강계 평형 상태에 변화를 초래하여 측두하악관절과 그에 따른 구조물에 동통을 유발 내지는 악화 시킬 수 있다. 본 연구는 측두하악장애에 영향을 미칠 수 있는 교합상태를 조사하기 위하여 T-scan II system(Tekscan Co., USA)을 이용하였으며, 최대 교합력을 발휘하기 위하여 약 20 mm 정도의 개구 상태에서 최대교합시까지 물었다. 경찰종사자의 측두하악장애환자는 일반 측두장애환자보다 최초 접촉부터 최대 접촉까지 걸리는 시간은 오래 걸리며, 최종 접촉까지의 시간은 보다 짧았으며, 최종 교합접촉력은 더 강하여, 더 짧은 시간에 강한 힘을 유지한 채 폐구가 이루어져 측두하악관절에 더 많은 잔존한 부하를 전달하였다. 이환 측과 교합접촉 시간, 교합 접촉 힘등의 교합양상과는 관계가 미약하였으며, 최대 접촉력이 가해진 시기에서 우측이 이환 측이면 우측 악궁에, 좌측이 이환측일 경우 좌측 악궁에 집중되는 좌, 우 악궁간 불균형을 보였다. 이상의 결과에서 측두하악장애를 가진 경찰 종사자들의 하악 운동에 보다 부드러운 움직임과 습관적인 최대 교합상태에서의 보다 적은 힘을 유지해야 할 것으로 생각되어진다.

• 대한두개안면성형외과학회지
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• 제22권1호
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• pp.45-51
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• 2021

Background: Mandibular deficiency leading to facial asymmetry causes cosmetic deformity as well as psychological stigma for the patient. Correction of these mandibular asymmetries is a major challenge. The study investigates the efficacy of bidirectional mandible distraction for the treatment of mandibular deficiency. Methods: This prospective study included six individuals aged between 17 and 24.4 years. Five patients had hemifacial microsomia and one had unilateral temporomandibular joint ankyloses. All patients underwent mandibular distraction osteogenesis. Postoperative skeletal changes in affected mandible, and changes in occlusal plane and oral commissure cant were evaluated using three-dimensional reconstruction. Patient satisfaction and understanding of the procedure were assessed through three questionnaires administered during pre-distraction, distraction and post-distraction phases. Results: In pre-distraction phase, aesthetic appearance seemed to be the primary indication for surgery. In distraction phase, pain while chewing was the primary handicap. In post-distraction phase all patients were satisfied with the aesthetic outcome. The facial deformity was improved through mandibular distraction osteogenesis. On the affected side in all the patients, height and length of the mandible increased. Canting of the occlusal plane and oral commissure was corrected. Conclusion: Bidirectional mandible distraction is an effective treatment for correction of mandible deformities in adult patients.