• The korean journal of orthodontics
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• 제46권1호
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• pp.42-54
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• 2016

The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects.

• The korean journal of orthodontics
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• 제43권4호
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• pp.193-200
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• 2013

Objective: To evaluate the psychosocial impact of malocclusion, determine its relationship with the severity of malocclusion, and assess the influence of gender and social class on this relationship in adolescents. Methods: A random sample of 627 Spanish adolescents aged 12 - 15 years underwent intraoral examinations by 3 calibrated examiners (intraexaminer and interexaminer kappa > 0.85) at their schools. Psychosocial impact was measured through a self-rated Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). The severity of malocclusion was measured by the Index of Orthodontic Treatment Need (IOTN). Gender and social class were also recorded. Results: The total PIDAQ score and those of its 4 subscales, social impact, psychological impact, aesthetic concern, and dental self-confidence, presented significant differences ($p{\leq}0.05$ by analysis of variance) and linear relationships with the IOTN grades ($p{\leq}0.05$ by linear regression). Stepwise linear regression models showed that the IOTN dental health component was a predictive variable of the total and subscale PIDAQ scores. Neither gender nor social class was an independent predictive variable of this relationship, except the linear model for psychological impact, where gender was a predictive variable. The occlusal conditions responsible for higher PIDAQ scores were increased overjet, impeded eruption, tooth displacement, and increased overbite. Conclusions: Malocclusion has a psychological impact in adolescents and this impact increases with the severity of malocclusion. Social class may not influence this association, but the psychological impact seems to be greater among girls.

• The Journal of Korean Academy of Prosthodontics
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• 제55권2호
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• pp.187-197
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• 2017

Deep overbite patients who do not have proper occlusal relationship may cause problems such as teeth wear and antagonist extrusion. These lead to the collapse of occlusal plane and esthetic problem. Increasing vertical dimension is frequently essential to resolve those problems. This case report demonstrates a full-mouth rehabilitation for a patient with severe deep bite that contacts surface to surface by increasing vertical dimension. Treatment procedures included diagnosis, treatment planning, implant surgery, and prosthodontic rehabilitation. Satisfactory results were obtained in functional and esthetic aspects.

• The Journal of Korean Academy of Prosthodontics
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• 제56권1호
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• pp.31-39
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• 2018

The collapse of the posterior occlusion destroys the normal occlusal plane and causes excessive wear reducing the vertical dimension. Reduced vertical dimension of occlusion causes not only aesthetic and functional problems but also overloading on the temporomandibular joints and abnormalities of muscle nerve system. In order to improve the collapsed occlusal relationship, it is necessary to consider the change of the vertical dimension. It is necessary to make a precise diagnosis and analysis before the treatment and to evaluate the adaption of patient to the new vertical dimension of occlusion. A patient with excessive overbite often has occlusal problems of tooth wear and tooth eruption. Considering these considerations, overall prosthodontic restoration is required to solve the problem. A patient of 68 year old man in this case who suffered major tooth wear and maxillary posterior teeth loss was treated with elevation of vertical dimension of occlusion by maxillary removable dental prosthesis and mandibular fixed prosthesis.

• Journal of the korean academy of Pediatric Dentistry
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• 제42권1호
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• pp.87-101
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• 2015

The premature loss of the mandibular primary canine is relatively frequent and a sign of the upcoming space problems in the transitional period. This situation is caused by the permanent lateral incisor resorbing the root of the primary canine during its eruption. Bilateral loss of primary canines in a crowded arch leads to the lingual tipping of the permanent incisors, with the consequent reduction in the arch perimeter and increase in overbite. When the loss of a primary canine is unilateral, tipping of the adjacent incisors occurs toward the space, resulting in midline deviation. In these situations, treatment possibilities, such as extraction of the antimeric tooth or placement of a passive lingual arch, can be applied; although there are some controversies concerning this. Most space problems with less than 4 mm can be resolved through preservation of the leeway space using sequential disking of the primary teeth and a passive lingual arch, regaining space or limited arch expansion in the late mixed dentition. In cases with 4~6 mm of space problems, arch expansion (A-P or transverse) can be applied. Space problems with more than 6 mm should be treated through diagnosis and treatment planning. Most of these cases will require extraction of permanent teeth including serial extraction (guidance of eruption).

• Journal of Dental Rehabilitation and Applied Science
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• 제20권2호
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• pp.95-107
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• 2004

The prosthodontic treatment of Class II division 2 malocclusions is challenging. Ideally, these malocclusions should be identified at an early age and corrected with orthodontic treatment; otherwise, the individual develops a habitual position characterized by deep overbite and significant retruded position of mandibular condyle at the TMjoint fossa. This article describes a clinical protocol for the occlusal rehabilitation of patients with Class II div.2 malocclusions. Within this protocol, an occlusal splint was used to locate the most suitable maxillary-mandibular relationship for function and range of motion. The splint increased the vertical dimension and reduced pain on TMjoints. After transfer this relationship to an articulator for fabrication of provisional restorations, the CR position and centric prematurity contact between maxilla and mandible was used to determine the tentative vertical dimension of occlusion(VDO). The amount of elevation of VDO was decided on the articulated model. The provisional restorations were accurately transfered to a patient's mouth in clinical procedures using tattoo points. The final restoration was delivered after some trial periods with provisional restorations. The theory behind this protocol and its associated clinical procedures is presented along with a discussion.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권2호
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• pp.141-147
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• 2007

The purpose of this study was to evaluate the effects of maxillary occlusal plane angle to postoperative skeletal stability by comparative analysis after two-jaw surgery of patients with skeletal CIII malocclusion. This study was made with lateral cephalometric radiography of 52 patients with skeletal class III malocclusion that were performed to Le Fort I osteotomy and BSSRO. And 52 patients were divided to Group A(n=30) and B(n=22). Maxillary posterior impaction was not conducted in Group A, which the pre-operative maxillary occlusal plane angle was in a normal range, and for Group B, which the pre-operative maxillary occlusal plane was low, the maxillary posterior impaction was conducted. The results were obtained as follows : 1. The relapse rate of Group A, which the pre-operative maxillary occlusal plane angle was in a normal range, was relatively stable compared to Group B, which the pre-operative maxillary occlusal plane was low. 2. The relapse rate of each measurement of Group B, which had the maxillary occlusal plane altered during the operation, was somewhat high, and of those, the post-operative relapse rate of overjet, overbite, mandibular plane angle appeared to be significantly high in the statistics. The analyzed results above, was thought to be indicating that the pre-operative maxillary occlusal plane angle was closely related to the post-operative skeletal stability, and that obtaining post-operative skeletal stability only through operative normalization of occlusal plane angle may meet limitations.

• The korean journal of orthodontics
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• 제21권1호
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• pp.131-170
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• 1991

This study was designed to analyze morphological characteristics of Korean young adults, norms and standard deviation of variables, sexual differences, correlationship between each area of face and correlationship between hard tissue and soft tissue. The primary sample consisted of 45 males and 57 females who were early and middle twenties and had acceptable profile, no history of previous orthodontic treatment, absence of remarkably large overjet and overbite, full complement of permanent teeth, Class I skeletal and dental relationships and good vertical facial proportions. Their cephalograms were analyzed morphologically with a computer morphometrics. Then the final sample - 25 males and 38 females - were selected within 1 S.D. of E-line, ANB, P/A facial height ratio, Interincisal angle, L1 to A-Pog, ODI and APDI. The results of the study were as follows: 1 In the form and proportion of facial skeleton there were no significant differences between males and females, but in the size males were larger than females. 2. The dental protrusion patterns had no significant sexual difference and no significant correlationship between protrusion of upper lip and inclination of upper incisor. But mentolabial angle had positively correlated with interincisal angle and negatively with inclination of upper and lower incisor. 3. In the relationship between nose and soft-tissue profile, males were larger than females in nasal length, height and angular measurements. 4. In analysis of soft-tissue profile, males were larger than females in the length and thickness. In the angular measurements and proportion of soft-tissue profile, there were no significant differences between males and females.

• The korean journal of orthodontics
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• 제29권1호
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• pp.37-49
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• 1999

Forty-four females with normal temporomandibular joint were compared with fifty-one females with abnormal temporomandibular joint. An orthodontic study model and lateral cephalometric radiographic were used to investigate the relationship between TMD group and non-TMD group in long face patterns. The result were followed that ; 1. There were no significant in overbite and overjet amount. 2. A mandibular 1'st molar inclination and height to the mandibualr plane were more mesial inclined in TMD groups. 3. The functional factors, which were craniocervical posture , tongue posture and hyoid bone position, were no significant.

• The korean journal of orthodontics
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• 제41권2호
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• pp.138-146
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• 2011

The purpose of this article is to introduce a new virtual orthodontic treatment (VOT) system, which can be used to construct three-dimensional (3D) virtual models, establish a 3D virtual setup, enable the placement of the virtual brackets at the predetermined position, and fabricate the transfer jig with a customized bracket base for indirect bonding (IDB) using the stereolithographic technique. A 26-year-old woman presented with anterior openbite, crowding in the upper and lower arches, and narrow and tapered upper arch, despite having an acceptable profile and balanced facial proportion. The treatment plan was rapid palatal expansion (RPE) without extraction. After 10 days of RPE, sufficient space was obtained for decrowding. After a 10-week retention period, accurate pretreatment plaster models were obtained using silicone rubber impression. IDB was performed according to the protocol of the VOT system. Crowding of the upper and lower arches was effectively resolved, and anterior openbite was corrected to normal overbite. Superimposition of the 3D virtual setup models (3D-VSM) and post-treatment 3D virtual models showed that the latter deviated only slightly from the former. Thus, the use of the VOT system helped obtain an acceptable outcome in this case of mild crowding treated without extraction. More cases should be treated using this system, and the pre- and post-treatment virtual models should be compared to obtain feedback regarding the procedure; this will support doctors and dental laboratory technicians during the learning curve.