This study was investigated to evaluate the morphologic characteristics of openbite and deep bite in Class I malocclusion patients and to find skeletodental factors which contributed to vertical discrepancy in Class I malocclusion. The subjects were consisted of 40 control subjects (male 20, female 20) and 40 Class I openbite patients and 40 Class I deep bite patients. Lateral cephalograms in centric occlusion were taken, traced and digitized lot each subjects. The computerized statistical analysis were carried out with SPSS program. The results were as follows. 1. The pattern of vortical discrepancy in Class I malocclusion is mainly influenced by the skeletodental factors under palatal plane. 2. In openbite group, vortical discrepancy is prominent on anterior lower face and is closely related with skeletal factors such as mandibular form and inclination. 3. In deep bite group, dental factors such as ewe of Spee, vertical height of maxillary molar and skeletal factor such as articular angle were contributed to the vertical discrepancy. 4. The multiple regression analysis showed that overbite in Class I molar relationship was determined mainly by dental factors such as lower incisor to occlusal plane angle, curve of Spee, interincisal angle, and ODI.
Objective: The purpose of this study was to evaluate the upper airway dimensional change according to maxillary superior movement after orthognathic surgery and to identify the relationship between the amount of maxillary movement and upper airway dimensional changes. Methods: The samples consisted of 24 adult patients (9 males and 15 females) who had a skeletal discrepancy and had received presurgical orthodontic treatment. They underwent Le Fort I superior impaction osteotomy and mandibular setback surgery. Cephalometric x-rays were taken at 3 stages - T0 (before orthognathic surgery), T1 (just or within 2 weeks after orthognathic surgery), T2 (6 months after surgery) Results: 1, Pharyngeal airway space (PAS (R)-nasopharynx) was decreased after surgery (T1) but recovered at 6 months after surgery; 2, Pharyngeal airway space (PAS (NL)-palatal plane) was increased after surgery and at 6 months after surgery; 3, Pharyngeal airway space (PAS (OL)-occlusal plane) was increased at T1 and was decreased at T2; 4, Soft palate thickness was increased at T1 but it became the same or thinner at T2; 5, There is no statistically significant relation between the amount of maxillary superior movement and pharyngeal airway space. Conclusions: These findings suggested that the maxillary superior movement of about an average of $4.40{\pm}1.14 mm$ did not affect upper pharyngeal airway space changes.
Aims: The present study investigated the relationship between condylar resorption and craniofacial skeleton types(especially vertical relationships), the differences of craniofacial skeleton types between with open bite group and without open bite group, and the associations of anterior disc dislocation with or without reduction to condylar resorption with MRI. Patients selection and methods: Clinical examination, magnetic resonance imaging (MRI), panorama, lateral transcranial and lateral cephalometric radiographs in 34 patients with condylar resorption were used to investigate this relationship. Results and Conclusions: Patients with the following specific facial morphologic characteristics appear to be most susceptible to condylar resorption: (1) females were predominant, (2) patients' age ranged from 12 to 50 years old with a strong predominance for 2nd and 3rd decades, (3) patients had high mandibular plane angle and high gonial angle, (4) patients had decreased vertical height of the ramus, (5) patients had generally significant antegonial notch, (6) patients had predominance of Class I occlusal relationship with or without open bite but mandible was retruded as mean ANB 5.54 degrees, (7) condylar resorption rarely occurs in lower mandibular plane angle facial types, (8) although no statistically significant difference was found, the open bite group had a tendency more hyperdivergent skeletal pattern than the non open bite group, and (9) imaging demonstrates from small resorbing condyles to idiopathic condylar resorption and TMJ articular disc dislocations. Thus, morphologic features of patients with vertical discrepancies may represent a risk factor for the development of condylar resorption.
Enlow's counterpart analysis explains the complex with anatomic and developmental characteristics where craniofacial aspect of Individuals has been developed. Counterpart 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. In this study we examined surgical changes in skeletal Class III malocclusion patients(male 40, female 40) and compared them with normal occlusion patients using counterpart analysis. The results indicated that : 1. Skeletal anterior-posterior discrepancy was relieved by shortening of the ramus width(B3). 2. The ramus alignment(R3, R4) was displaced posteriorly and the occlusal plane angle(R5) was rotated clockwise. 3. Skeletal Class III pattern was relieved in the post-operative group, but differences in the level of the cranium(R1, R2) was remaining compared to the normal occlusion patients. 4. In the comparison of surgery methods, the two-jaw surgery group presented changes In the maxillary length(A4), ramus alignment(R3, R4) and occlusal plane angle(R5) compared to the one-jaw surgery group, but the differences were not significant. In the past study about Korean skeletal Class m patients, the skeletal characteristics are upward backward rotation of the cranial base, posterior displacement of the maxilla, forward inclination of the ramus and lengthening of the mandibular body, but in this study, skeletal Class m pattern was relieved by shortening of the ramus width and maxillary advancement by orthognathic surgery, because orthognathic surgery is usually performed on limited areas in the maxilla and the mandible.
Journal of the korean academy of Pediatric Dentistry
/
v.31
no.1
/
pp.11-18
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2004
The eruption of permanent teeth represents the movement in the alveolar bone before appearance in oral cavity, to the occlusal plane after appearance in oral cavity, and additive movement after reaching th the occlusal plane. Tooth eruption is mostly controlled by genetic signals. The eruption stage is divided to preeruptive alveolar stage, alveolar bone stage, mucosal stage according to the process of growth and development. If the disturbance is occured in any stage of eruption, tooth does not erupt. The cause of eruption disturbance are ectopic position of the tooth germ, obstruction of the eruption path and defects in the follicle or PDL. In the treatment of eruption disturbance, surgical procedures are commonly used. There are three kind of surgical procedure ; surgical exposure, surgical repositioning, surgical exposure and traction Surgical exposure is basic procedure. This involves removal of mucosa, bone, lesion that are surrounding the teeth, dental sac when necessary to maintain a patent channel between the crown and the normal eruptive path into the oral cavity. To ensure this patency, many techniques including cementation of a celluloid crown, packing with gutta-percha or zinc oxide-eugenol, or a surgical pack, are used. When surgical exposure is conducted, operators should not expose any part of cervical root cement and not injure periodontium or root of adjunct tooth. After surgical exposure, tooth should be surrounded by keratinized gingiva. There is direct relationship between the extent of development of pathophysiologic aberrations and the intensity of the manipulative injury inflicted on the tooth by surgical treatment, so operator should consider this thing. In these cases, surgical exposure is conducted on Maxillary 1st milars that have a eruption disturbance and improve the eruption disturbance effectively.
Full mouth rehabilitation is re-organizing the occlusion of the remaining teeth and missing teeth considering the functions, esthetics, and neuromuscular harmony. With the loss of multiple teeth, the patient's occlusal plane gradually collapses and the vertical dimension can be reduced. Since reduced vertical dimension can be a potential etiology of the temporomandibular joint and masticatory muscles, prosthetic restoration with increased vertical dimension is required. This case report is about a 68 years old patient with vertical dimension loss due to worn dentition and multiple loss of teeth. In this case, the loss of vertical dimension is assessed carefully using the digital dentistry technology. Using CAD software in digital analysis step, the occlusal plane was established and evaluated using several criteria. Orienting the position of the bone and teeth using CBCT image, patient's condition was visualized in 3 dimension and treatment planning was possible virtually. The information that matches the patient's condylar position with the articulator, which is the virtual face bow, is reproduced on the actual articulator, and evaluated again. After the evaluation, provisional prosthesis was fabricated and it was confirmed that the patient adapts without any abnormality. This was implemented as a final prosthesis. As a result, the patient obtained satisfying results, utilizing the benefits of digital dentistry technology and traditional methods.
Park, Joon-Ho;Cho, In-Ho;Shin, Soo-Yeon;Choi, Yu-Sung
The Journal of Korean Academy of Prosthodontics
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v.53
no.1
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pp.19-25
/
2015
Nowadays, CAD/CAM is broadly used in dentistry for inlays, crowns, implant abutments and its spectrum is expanding to complete dentures. Utilizing CAD/CAM to fabricate complete dentures is expected to decrease chair time and the number of visits, thus decreasing total fabrication time, expenses and errors caused during fabrication processes. One of the systems using CAD/CAM, DENTCA$^{TM}$ CAD/CAM denture (DENTCA Inc. Los Angeles, USA) scans edentulous impressions, designs dentures digitally, fabricates try-in dentures by 3D printing and converts them into final dentures. Patients can wear final dentures after only 2 - 3 visits with satisfying adaptation. This case report introduces a 71-year-old male patient who visited to consult remaking of existing old dentures. Residual teeth with bad prognosis and root remnants were extracted and the patient used reformed existing mandibular denture for 2 months. And then DENTCA system started. One-step border molding was done using conventional tray of adequate size provided by DENTCA system and wash impression was taken. Gothic arch tracing was completed based on the vertical dimension of existing dentures. Both maxillary and mandibular trays were placed to the resultant centric relation and bite registration was taken. Then DENTCA scanned the bite registration, arranged the teeth, completed the festooning and fabricated the try-in dentures by 3D printing. The try-in dentures were positioned, occlusal plane and occlusal relations were evaluated. The try-in dentures were converted to final dentures. To create bilateral balanced occlusion, occlusal adjustment was done after clinical remounting using facebow transfer. The result was satisfactory and it was confirmed by patient and operator.
Statement of problem. Every effort has been continually made to obtain objectivity in measuring the longevity of fixed restorations, such as by establishing unified judgement standard for deciding success and adopting statistical method that analyzes the data of successful and failed cases at the same time. In Korea, however desired level of development has not to be made in this field yet. Purpose. This study, adopting California Dental Association (CDA) quality evaluation system, established objective standard for deciding success, and inferred the longevity of fixed restorations and their failure analysis through adopting Kaplan-Meier survival analysis. Material and method. In order to assess the longevity of flxed restorations serviced in Korea and causes of failure, a total of 1109 individuals (aged 15-74, 716 women and 393 men loaded with 2551 unit fixed restorations, and 1934 abutments) who lived in Kyung-In Province were examined and the findings were as follows : Results. 1. Length of service of fixed restorations serviced in Korea was 6.86$\pm$0.15 yr (mean), 5.5 yr (median), and the rate of success was 65.82% in 5 year survival, and 21.15% in 10 year survival. 2. When there was patient's need for replacing old prosthetics, longevity of fixed restorations was 7.51$\pm$0.27 yr (mean), 7 yr (median), and the rate of success was 61.08% in 5 year survival, and 17.57% in 10 year survival. 3. Longevity of fixed restorations was longest in the over-sixty age group(9.21$\pm$0.66) and that of the teen age group(3.39$\pm$0.28) was shortest (p<0.05). 4. Longevity of fixed restorations of women (7.38$\pm$0.18 years) was longer than that of men (6.00$\pm$0.26) (p<0.05). 5. As for the provider factor (such as unlicensed performers, university hospitals, and private clinic), there was no statistically significant difference in longevity of fixed restorations. 6. Defective margin (34.78%). periodontal disease (12.15%), periapical involvement (11.73%), was the most frequent causes of failure and poor esthetics group showed the longest life above all (p<0.05). Actual frequent causes of failure after removing old prosthetics were defective margin, periapical involvement, periodontal disease and uncemented restoration. In 75.67% of the cases, abutment state after removing old prosthetics was good enough for loading another prosthetics. 7. There was found to have statistically significant influence between longevity of single crown (6.35$\pm$0.20 yr) and that of 3 unit fixed restorations (7.60$\pm$0.30 y) (p<0.05). In each case the most frequent cause of failure was defective margin. 8. The number of cantilever pontic, pontic/abutment ratio, oral hygiene status were found to have no statistically significant influence on longevity of fixed restorations in all groups (p>0.05). 9. Longevity of fixed restorations made of non precious metal was longest (9.60$\pm$0.40 yr) semi precious and precious trailing behind(p<0.05). 10. Group function group (37.04%) and partial group function group (44.62%) were predominant in frequency but showed no correlation between them and among different types of occlusal plane and different types of occlusal surface (p>0.05). 11. Longevity of fixed restorations was longest in the centric interference group(9.35$\pm$0.62) (p<0.05) among different types of occlusal interference. Conclusion. We found that longevity of fixed restorations serviced in Korea is affected by age, gender and type of material, and that most frequent cause of failure is defective margin. In order to assess the accurate longevity of axed restorations, unified research design. overcoming inter-observer difference and establishing the objective research items are needed. Furthermore, it is thought that prospective approach through thorough study and regular follow-ups is needed just from the start of research. Nationwide detailed studies on length of service of fixed restorations manufactured in Korea are hoped to be conducted hereafter.
Journal of Dental Rehabilitation and Applied Science
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v.30
no.1
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pp.16-22
/
2014
Purpose: The purpose of this study was to assess the marginal and mesial fitness of zirconia single copings and 3-unit fixed partial dentures (FPDs) manufactured with an identical model. Materials and Methods: An epoxy model in which the maxillary right 2nd premolar is lost and maxillary 1st premolar and 2nd molar are formed as abutments was manufactured and scanned by using a laser scanner. A ten units of zirconia single copings were manufactured for maxillary 1st premolar and 2nd molar, respectively and the same number of 3-unit FPDs were manufactured. For the measurements of fitness, the manufactured silicone replicas were divided into four parts and the fitness were measured by digital microscope at measurement points (P1, P2, P3, P4 and P5) of each plane. The measured gaps were classified into three categories: marginal gap (MG, P1), axial gap (AG, average of P2 and P3), occlusal gap (OG, average of P4 and P5). Results: The ranges of MG, AG and OG for single copings were 18.47 - 40.54 ${\mu}m$, 39.73 - 73.61 ${\mu}m$ and 116.90 - 134.69 ${\mu}m$, respectively. The ranges of MG, AG and OG for 3-unit FPDs were 45.95 - 87.44 ${\mu}m$, 23.78 - 57.00 ${\mu}m$ and 99.89 - 131.06 ${\mu}m$, respectively. Conclusion: The result of the study shows that the MGs for 3-unit FPDs were higher than those of single copings, though they are within the range of clinical acceptance, indicating that the use of more homogeneous zirconia block and modification of sintering processes are needed to ensure the prevention of increase of gap in 3-unit FPDs.
This investigation examined the effect of lateral shift of mandible from functional occlusal interference on the growth of mandible and the growth pattern of mandible shown after the removal of occlusal interference. The followings were performed with the results below : the changes in mandible and condylar cartilage were studied in the experimental group with upper right, lower left incisors cut for 2 and 4 weeks- an 4-week-old rats and the experimental group which had cut for 4 weeks and suspended for 2 weeks. 1. In the 2-week experimental group, the left mandibular length, condylar length, mandibular height and condylar area seemed smaller than those on the right and the normal group ; the right mandibular length and condylar area were smaller than the normal group. 2. In the 4-week experimental group, left condylar area was smaller than the right, but due to the quick changes in adaptability of left mandible, right and left mandibular lengths were similar. compared with the normal group, however, mandibular length and condylar area still remained small. 3. In the 6-week experimental group, the left and the right appeared similar with the mandibular length remaining still shorter than the normal group. 4. In the sagittal plane, the proliferation of the cartilage layers of the left condylar cartilage of the 2-week group appeared to have general repression compared with the right and the normal group. The right side also showed repressed growth compared with the normal group. In the 4 and 6-week groups, however, it was similar to the normal group. 5. In condylar cartilage volume, no significant difference was noted in the comparisions of left and right of the experimental group, nor in the comparison of the same sides of experimental wand normal groups. Based on the above, in case of contralateral incisal cutting in rats, it was observed that the growth of mandible and condyle of the cutting side was repressed, at the same time, the quick adaptability led to similar changes of growth in left and right mandibles. But judging from the similar phenomena throughout the whole experimental period in the changes of condylar cartilage volume in the experimental, right and left, and normal groups, the general overall growth of condylar cartilage was found unrepressed. It was also recognized that the growth of condylar cartilage can take in various directions.
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