• The korean journal of orthodontics
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• v.28 no.5 s.70
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• pp.763-774
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• 1998

The purpose of this study was to evaluate the morphology of mandibular symphysis and location of lower incisor under the influence of the craniofacial skeleton in skeletal Class III malocclusion. The sample consisted of 132 adults who have severe Class III malocclusion(prognathism group, 33 males and 33 females), and who have normal occlusion(normal group, 33 males and 33 females). They had not received any orthodontic treatment or orthognathic surgery. The lateral cephalograms were evaluated. The results were as follows : 1. Prognathism group were larger than normal group in comparison of facial skeleton (p<0.05) with the exception of ${\angle}FH-Pal$, ${\angle}SNA$. 2. In the morphology of symphysis, measurements of anteroposterior width(LaABBW, LiABBW, SW) of prognathism group were significantly less than that of normal group(p<0.001). 3. In the correlative analysis between the craniofacial skeleton and symphysis measurements of prognathism group, vertical measurements in relation with cranial base and mandibular plane showed reverse correlationship with anteroposterior width of symphysis(LiACBW, LaACBW, LiABBW, SW)(p<0.05). But, there was not distinct difference between horizontal skeletal measurements and symphysis measurements(p>0.05). 4. The probability by regression test between vertical measurements(${\angle}SN-Mn,\;{\angle}FMA,\;{\angle}Pal-Mn,\;{\angle}LFH$) and symphysis measurements(LiACBW, LiABBW, SW, ${\angle}LISA$) were very high(p<0.001).

• The korean journal of orthodontics
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• v.16 no.1
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• pp.85-106
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• 1986

The purpose of this investigation was to know the means of the T.M.J. space and to compare spational differences in centric relation and centric occlusion by the T.M.J. Tomogram and to study the correlation between the articular eminence slope and the lingual surface slope of the maxillary central incisor by the Cephalogram in near normal occlusion subjects. These results could give contribution for the diagnosis of orthodontic treatment and T.M.J. dysfunction and the assessment of orthopedic treatment and orthognathic surgery. 44 young adults (28 men and 16 women, 21 to 27 years of age) were selected from the Dental students in Yonsei Univ. Criteria for selection was normal occlusion, no clinical signs and T.M.J. dysfunction, no history of orthodontic treatment, and no missing tooth. After submental vertex view analysis. each subject was given the T.M.J. Tomogram in centric relation and centric occlusion and the Cephalogram was given with Quint Sectograph. All data was recorded and statistically processed with the CYBER computer system. Results were analyzed: the following findings and conclusions were derived. 1. The mean value for the combined right and left anterior joint space was 2.549mm, the posterior space was 2.260mm, and superior space was 3.31mm in centric relation. The anterior space was 2.316mm, posterior space was 2.474mm, and superior space was 3.435mm in centric occlusion. 2. In the centric relation position, both condyles were placed more posterioly and superioly in their fossae than in the centric occlusion position by the spatial difference. 3. In the centric occlusion position, both condyles were more symmetrically placed in their fossae with equal anterior-posterioly rather than in the centric relation position. 4. The mean articular eminence angle was $48.19^{\circ}$ and the mean fossa height was 7.911mm. A strong positive correlation between the articular eminence angle and fossa height in T.M.J. Tomogram was found. 5. In Cephalometric analysis, there was a strong positive correlation between the articular eminence slope and the lingual surface slope of the upper central incisor to the FH plane, occlusal plane, and S-N plane. 6. There was moderate positive correlation between the S-E measurements and the fossa height, articular eminence angle, and DcGn < F-H.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.1
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• pp.77-87
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• 2010

Skeletodental asymmetries are common and asymmetric orthodontic treatments are very difficult to correct successfully. The cause of asymmetries can be the skeletal asymmetry, dental, or functional, or combinations of these causes. Skeletodental asymmetries can be the result of congenital factors, such as hemifacial microsomia and environmental factors, such as trauma. Optimal treatment outcome of the severe facial asymmetry requires the orthognathic surgery. Mild asymmetry problem can be treated by only orthodontic treatment. The orthodontic treatment of asymmetry is usually difficult. Facial asymmetry orthodontic treatment are primarily based on proper diagnosis and careful treatment planning. Side effects of asymmetric elastic to treat midline discrepancies are canted occlusal plane, tipped incisors and unesthetic results. In the management of dental arch asymmetries, the clinician should select the appropriate force system and the appliance design necessary to address the asymmetry while minimizing undesirable side effects. This report presents treatment strategies for the treatment of skeletodental asymmetry. In this case report, the clinical case with midline discrepancies treated by optimal mechanics is described. Through diagnosis and strategic treatment mechanics can obtain proper midline correction with minimal side effects.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.3
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• pp.532-538
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• 2008

Lesch-Nyhan syndrome is a rare X-linked recessively inherited disorder, caused by complete absence or decrease in activity of hypoxanthine guanine phosphoribosyl transferase(HPRT), an enzyme involved in purine metabolism. This enzyme deficiency gives rise to nephropathy symptoms, such as hyperuricosuria and hyperuricemia by excessive uric acid production and neuropathy symptoms, such as mental retardation, choreoathetosis and self mutilation behavior. Patients with Lesch-Nyhan syndrome have tendency to bite their lip, tongue and finger. In severe cases, partial or even total amputation of tongue or finger occur. Self-inflicted bites are often complicated by secondary infection to the injured site as well as pain. Furthermore tissue loss by biting results in esthetic problems. The dental management of self mutilation includes treatment with appliances such as soft mouth guard or lip bumper, extraction of all the teeth, and orthognathic surgery. We report a case of a 13 year-old boy with Lesch-Nyhan syndrome, who severely injured himself on his tongue. At first, conservative treatment using soft mouth guard was considered, but it could not prevent trauma on his tongue. Therefore, extraction of the lower anterior and posterior teeth was carried out.

• The korean journal of orthodontics
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• v.31 no.1 s.84
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• pp.97-105
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• 2001

In many cases of orthodontic treatment the upper anterior teeth are retracted. Periodontal problems may arise during incisor retraction, if the amount of tooth movement and the amount of remodeling in the anterior cortical bone are not the same. Therefore in this study, to find out the relationship between the amount of tooth movement and the amount of bone remodeling during retraction of the upper anterior teeth, lateral cephalograms of 56 female patients over 18-year-old were taken before and after treatment. Among the 56 patients, two groups were divided according to the type of root movement during retraction. 26 patients mainly moved by tipping and 30 by bodily movement. The cephalograms taken before and after treatment were superimposed upon the true horizontal plane. In the Tip-Group, the horizontal bone remodeling/tooth movement ratio was 1:1.63, and in the Torque-Group it was 1:1.66. Because the amount of tooth movement and the amount of bone remodeling were not the same in both groups, in the Tip-Group the root apex moved away from the palatal cortical plate and closer to the labial cortical plate, whereas in the Torque-Group the root moved away from the labial cortical plate and closet to the palatal cortical plate. Therefore, there are limitations in the amount of incisor retraction in patients with a very thin anterior cortical plate in the maxilla, and in patients with severe skeletal discrepancies orthognathic surgery should be considered and when orthodontic camouflage treatment is the only possible method, the orthodontist must be aware of the limitations of treatment.

• Journal of Oral Medicine and Pain
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• v.23 no.3
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• pp.289-294
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• 1998

본 증례는 측두하악관절의 퇘행성 변화를 보이는 환자에서 악교정 수술의 시행 전에 중심위교합장치를 통해 측두하악관절의 안정화를 유도하고, 또한 골스캔을 이용하여 장치의 치료효과를 평가한 임상증례이다. 환자는 24세의 여성으로 5년 전부터 전치부 개교합이 발생되기 시작하였고, 고형식 저작시 좌측 전이부에 간헐적인 통증이 발생한다는 주소로 본원에 내원하였다. 임상검사상 촉진시 양측 관절낭 후방부에 압통을 호소하였으며, 각각 50, 45mm의 최대개구량 및 최대무통성 개구량을 보였다. 좌측 악관절부에서 단순 관절 잡음, 우측 악관절부에서 염발음이 청취되었으며, 저항검사 및 부하 검사에서는 특기할 반응을 보이지 않았다. 약 7mm의 전치부 개교합의 소견을 보였으며, 파노라마 사진과 횡두개 방사선 사진 소견상 양측 과두의 크기 및 하악지의 높이가 다소 작은 소견이 관찰되었고 자기공명영상 소견상 양측성 비정복성 관절원판의 전방전위가 관찰되었다. 1997년 10월 27일 첫 번째 골스캔 소견상 양측성 비정복성 관절원판의 전방위가 관찰되엇다. 골스캔의 전방 사진에서 Densitometer를 이용하여 좌, 우측 과두부위와 상악 골부위의 가장 어두운 부분의 흑화도를 측정하였다. 각각 3회씩 구하여 평균을 구하고 좌, 우측 과두 대 상악골의 흑화도의 비율을 계산하였다. 첫번째 골스캔의 평균 흑화도는 우측 과두, 좌측과두, 상악골이 각각 0.88, 0.81, 1.32 였다. 1997년 11월 4일 중심위교합장치를 장착하였고 지속적인 물리치료를 시행하였다. 1997년 12월 10일 두 번째 골 스캔을 평균 흑화도는 우측 과두, 좌측 과두, 상악골이 각각 0.33, 0.37, 088 이었다. 1998년 1월 30일 세 번째 골스캔 소견상 두 번째 골스캔과 비교하여 활성도가 감소된 소견을 보였다. 임상검사시 무통이었다. 1998년 2월 25일 술 전 교정 위해 중심위교합장치의 장작을 중지시켰다. 1998년 6월 5일 네 번째 골스캔 소견상 이전 검사들과 비교시 흡수가 감소된 소견을 보였다. 네 번째 골스캔의 평균 흑화도는 우측 과두, 좌측 과두, 상악골이 각각 0.24, 0.19, 0.85 였다. 현재 지속적인 관찰 중이며 본원 교정과에서 악교정수술 위한 술 전 교장을 시행중이다. 결국 첫 번째 골스캔의 과두 대 상악골의 평균 흑화도의 비율은 우측과 좌측이 각각 0.66, 0.61이었고 두 번째 골스캔에서는 우측과 좌측이 각각 0.37, 0.42였고, 네번째 골스캔에서는 우측과 좌측이 각각 0.28, 0.23 이었다. 각 골스캔의 과두 대 상악골의 평균 흑화도의 비율 사이에 유의한 차이가 있는지 검증하기 위해 Standard t-test 와 ANOVA를 시행하였다. 이상의 결과에서 첫 번째, 두 번째, 네 번째 골스캔으로 갈수록 좌, 우측 과두 대 상악골의 흑화도의 비율이 유의하게 감소했음을 알 수 있었다. 결론적으로 본 증례에서는 전치부 개교합이 발생되어 악교정수술이 필요한 환자에게 측두하악관절의 안정화를 위해 중심위교합장치를 사용함으로써 퇴행성 관절질환의 진행을 억제시킬 수 있고, 퇴행성 관절질환의 활성도에 대한 평가시 골스캔이 유용할 수 있음을 보여주었다고 사료된다.

• Imaging Science in Dentistry
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• v.46 no.1
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• pp.33-38
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• 2016

Purpose: Facial asymmetry has been measured by the severity of deviation of the menton (Me) on posteroanterior (PA) cephalograms and three-dimensional (3D) computed tomography (CT). This study aimed to compare PA cephalograms and 3D CT regarding the severity of Me deviation and the direction of the Me. Materials and Methods: PA cephalograms and 3D CT images of 35 patients who underwent orthognathic surgery (19 males and 16 females, with an average age of $22.1{\pm}3.3years$) were retrospectively reviewed in this study. By measuring the distance and direction of the Me from the midfacial reference line and the midsagittal plane in the cephalograms and 3D CT, respectively, the x-coordinates ($x_1$ and $x_2$) of the Me were obtained in each image. The difference between the x-coordinates was calculated and statistical analysis was performed to compare the severity of Me deviation and the direction of the Me in the two imaging modalities. Results: A statistically significant difference in the severity of Me deviation was found between the two imaging modalities (${\Delta}x=2.45{\pm}2.03mm$, p<0.05) using the one-sample t-test. Statistically significant agreement was observed in the presence of deviation (k=0.64, p<0.05) and in the severity of Me deviation (k=0.27, p<0.05). A difference in the direction of the Me was detected in three patients (8.6%). The severity of the Me deviation was found to vary according to the imaging modality in 16 patients (45.7%). Conclusion: The measurement of Me deviation may be different between PA cephalograms and 3D CT in some patients.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.2
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• pp.125-134
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• 2023

When the patient with class III malocclusion needs extensive oral rehabilitation due to multiple missing teeth, accurate diagnosis, and careful analysis, such as the patient's occlusal relationship, facial changes, and evaluation of the temporomandibular joint are essential. Orthognathic surgery is often performed for aesthetic improvement, depending on the patient's chief complaint. If it is not possible due to certain circumstances, partial aesthetic improvement can be achieved through minimal elevation of the vertical dimension. As this patient may have unexpected issues, such as temporomandibular joint disorder, oral habits like bruxism, and masticatory muscle tension, it was determined whether the patient could adjust to a reversible temporary removable partial denture. After this, the maxillary implant-supported fixed prostheses and the mandibular fixed prostheses were used to achieve stable posterior support and to partially improve the maxillary anterior esthetics. The patient was satisfied with the results both aesthetically and functionally. The prognosis is expected to be good if regular check-ups are conducted.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.570-593
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• 1996

This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after BSSRO in 20 patients(males 9, females 11) using computed tomogram that were taken in centric occlusion before, immediate, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period intermaxillary fixation, 24hour after removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.45{\pm}4.01mm$ and horizontal long axis of condylar angle was $11.89{\pm}5.19^{\circ}$on right, $11.65{\pm}2.09^{\circ}$on left side and condylar lateral poles were located about 12mm and medial poles about 7mm from reference line(AA') on the axial tomograph. Mean intercondylar distance was $84.43{\pm}3.96mm$ and vertical axis angle of condylar angle was $78.72{\pm}3.43^{\circ}$on right, $78.09{\pm}6.12^{\circ}$on left. 2. No statistical significance was found on the condylar change(T2C-T1C) but it had definitive increasing tendency. There was significant decreasing of the distance between both condylar pole and the AA'(p<0.05) during the long term(TLC-T2C). 3. On the lateral cephalogram, no statistical significance was found between immediate after surgery and 24 hours after the removing of intermaxillary fixation but only the lower incisor tip moved forward about 0.33mm(p<0.05). Considering individual relapse rate, mean relapse rate was 1.2% on L1, 5.0% on B, 2.0% on Pog, 9.1% on Gn, 10.3% on Me(p<0.05). 4. There was statistical significance on the influence of the mandibular set-back to the total mandibular relapse(p<0.05). 5. There was no statistical significance on the influence of the mandibular set-back(T2-T1) to the condylar change(T2C-T1C), the condylar change(T2C-T1C, TLC-T2C) to the mandibular total relapse, the pre-operative condylar position to the condylar change(T2C-T1C, TLC-T2C), the pre-operative mandibular posture to the condylar change(T2C-T1C, TLC-T2C)(p>0.05). 6. The result of multiple regression analysis on the influence of the pre-operative condylar position to the total mandibular relapse revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condyalr head long axis angle, the more increasing of mandibular horizontal relapse(L1,B,Pog,Gn,Me) on the right side condyle. The same result was founded in the case of horizontal relapse(L1,Me) on the left side condyle.(p<0.05). 7. The result of multiple regression analysis on the influence of the pre-operative condylar position to the pre-operative mandibular posture revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condylar head long axis angle, the more increasing of mandibular vertical length on the right side condyle. and increasing of vertical lengh & prognathism on the left side condyle(p<0.05). 8. The result of simple regression analysis on the influence of the pre-operative mandibular posture to the mandibular total relapse revealed that the more increasing of prognathism, the more increasing of mandibular total relapse in B and the more increasing of over-jet the more increasing of mandibular total relapse(p<0.05). Consequently, surgical mandibular repositioning was not significantly influenced to the change of condylar position with condylar reposition method.

• The korean journal of orthodontics
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• v.33 no.1 s.96
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• pp.63-72
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• 2003

Over the Past decades, the number of Patients seeking orthodontic treatment has increased markedly with socioeconomic development and change of recognition on appearance. The purpose of this study was to provide an epidemiologic data base related to the orthodontic treatment need. We could take an adequate information regarding the characteristics of orthodontic patients, and the changing trends about treatment mordality. Distrubution and treands were Investigated in 676 patients who had been examined and diagnosed at Department of orthodontics, Dental Hospital, Seoul National University from January to June in 1992 and 2002. 1. Sex distribution of patients changed from 1:2.1 to 1:1.5 (male female). 2. In 2002, are distribution had shown $7\~12$ year-old group being the largest$(32.0\%)$ and percentage of $19\~24,\;13\~18,\;over\;25,\;4\~6,\;0\~3$ year-old group were $24.0\%,\;21.6\%,\;14.2\%,\;5.8\%,\;2.4\%$ respctively. Compared with data in 1992, the number of adult patients highly increased. 3. With regard to Angle classification, each percentage of Class I, Class II div 1, Class II div 2, and Class III malocclusion were $25.0\%,\;20.9\%,\;3.4\%,\;and\;48.1\%$ respectively in 2002. 4. Geographic distribution showed that most of the patients visited $(37.0\%)$ lived in northeast of Seoul in 2002. 5. Mandibular prognathism showed the highest percentage in chief complaints. The percentages of crowding and facial asymmetry were $14.2\%\;and\;11.8\%$ in 2002. Patients with facial asymmetry increased significantly. 6. Percentages of patients treated with fixed appliance and orthognathic surgery were $38.0\%\;and\;25.0\%$ in 2002. Patients needed to observe the growth pattern comprised $13.0\%$ with increasing trends. The use of chin cap reduced and the percentage of ortognathic surgery and growth observation increased significantly.