Degenerative joint disease(DJD) has hun known as one of the diseases which affect the middleor old-aged people. But as orthodontists are getting interested in the adult orthodontics, it is not rare for them to meet the open-bite patients with the TMJ DJD in their clinics. The purpose of this article is to investigate the cephalometric characteristics of the open-bite cases with TMJ DJD. Twelve TMJ DJD patients($15.1\~39.5$ years old) were selected from the patients who visited Department of Orthodontics, Seoul National University Hospital. Cephalograms were taken and means from 60 measurements were compared by t-test with those of the fifty four healthy adults($20.0\~26.7$ years old) who have normal occlusion and TMJ. In this study male and female are compared respectively, for in the normal samples 26 measurements showed significant differences between the male and the female. The results and conclusions axe as follows: 1 In DJD group, ANB and Angle of convexity decreased, which means the retruding of the mandible. The interincisal angle was smaller than that of the normal group. The means of the overbite were -2.1mm in male and -3.0mm in female, and the means of the overjet were 5.6mm in male and 6.7mm in female. The profile was similar to that of Angle's Class II div.1 open-bite. 2. SN-GoMe and FMA increased in DJD but SN-PP and FH-PP did not show any significant difference. In TMJ DJD open-bite cases, the bony structure lower than the palatal plane seemed to play an important role in developing open-bite. 3. In DJD group, PH-ArGo, SArGo and Y-sxis angle increased significantly, but genial angle showed no significant difference. The means of hか were 50.1mm in male and 40.2mm in female, which were significantly smaller than those of the normal(56.5mm in male, 50.9mm in female). These findings seemed to indicate the posterior rotation of mandible resulted from the shortening of the ramus height. 4. Anterior faical height(AFH), upper anterior facial height(UAFH) and lower anterior facial height (LAEH) of DJD showed no significant increase as compared with those of the noraml group. There was no significant difference in the ratio of upper anterior facial height to lower anterior facial height(UAFH/LAFH). But, lower posterior facial height(LPFH) was significantly smaller than that of the normal group. 5. It was thought that the peculiar profile of the TMJ DJD open-bite was resulted from the posterior rotation of mandible as the ramus became short following the degerative destruction of of the condylar head and neck.
Bolton analysis is widely used to predict tooth size discrepancy. but its accuracy has been challenged. The purpose of this study was to describe true anterior tooth size discrepancies among orthodontic patients and to evaluate the factors that affect true anterior tooth size discrepancies. The subjects consisted of 80 patients with varying malocclusions (Class I. Class II. Class III. and Class III surgery) who were treated orthodontically. Pre-treatment models. set-up models from post-treatment models. and lateral cephalometric radiographs were analyzed The results were as follows. The means. the standard deviations. and ranges of anterior Bolton ratio in the present study were somewhat higher than those of Bolton's samples and Korean normal samples. The number of patients showing maxillary deficiency was larger than that of patients showing maxillary excess in view of true anterior discrepancies. There was a significant difference between anterior Bolton discrepancy from pre-treatment models and true anterior discrepancy from set-up models (p < 0.05) There was no significant difference in true anterior discrepancies among malocclusion groups (p > 0.05). And there was also no significant difference between the male and female groups (p> 0.05). Overbite and the incisal edge thickness of maxillary anterior teeth have little relationship with true anterior discrepancies. Multiple regression analysis showed that true anterior discrepancy was mainly determined by anterior Bolton ratio, upper incisor to occlusal plane angle after treatment. interincisal angle after treatment. and upper right lateral incisor width.
Journal of the korean academy of Pediatric Dentistry
/
v.30
no.2
/
pp.204-209
/
2003
A 9-year old boy visited Department of Pediatric dentistry, Chonbuk National University Hospital due to unstable occlusion. He had permanent 1st molars destructed severely by dental caries and lost vertical stop. He could not occlude in the same position on closing of the jaw since he could not find his centric occlusion. The treatment plan was made, which was oral rehabilitation with crown restorations on permanent 1st molars based on clinical and radiographic examinations and centric relation of the jaw. Treatment plan consisted of endodontic treatment, crown lengthening and restoration of the occlusal vertical dimension (OVD) with gold crown by 3mm-increase of OVD. After endodontic and periodontal treatments, temporary crowns made of acrylic resin were set for assessment of tolerance to an increased OVD. After a month for tolerance, final prosthetics were made and set temporarily. In a month, gold crowns were set finally. Immediately after setting, the patient showed anterior open bite, but at the appointment after 4 months, he showed normal overjet, overbite and stable occlusion.
Journal of the korean academy of Pediatric Dentistry
/
v.40
no.4
/
pp.296-305
/
2013
For the purpose of evaluating the prevalence of malocclusion and self-esteem in adolescents, 1,380 middle-school students in the Yangsan area were surveyed by oral examination and questionnaires and the obtained results were as follows: The distribution of 1st molar occlusion by Angle's classification was 69.0, 19.4, 10.6% for Class I, II and III respectively. In the horizontal relationship, the prevalence of normal overjet and crossbite was 86.9% and 5.6% respectively whereas larger and extremely larger overjet was found in 6.6% and 0.8%. In the vertical relationship of anterior teeth, normal, deep overbite and openbite was shown in 94.1%, 4.7%, and 1.2%. For the midline discrepancy, the distribution of groups with 0~1 mm, 2~4 mm and over 5 mm was 98.2%, 1.4%, and 0.4%. Crowding only in the maxilla was found in 9.6%, while that only in the mandible and in both arches was 14.1% and 24.1% respectively. Spacing only in the maxilla was seen in 3.0%, while that only in the mandible and in both arches was 2.4% and 1.7% respectively. Significant difference in self-esteem was revealed in female and malocclusion groups of crossbite and openbite(p < 0.05).
Purpose: The efficiency of an anchor plate placed during orthognathic surgery via minimal presurgical orthodontic treatment was evaluated by analyzing the mandibular relapse rate and dental changes. Methods: The subjects included nine patients with Class III malocclusion who had bilateral sagittal split osteotomy at the Division of Oral and Maxillofacial Surgery, Department of Dentistry in Ajou University Hospital, after minimal presurgical orthodontic treatment. During orthognathic surgery, anchor plates were placed at both maxillary buttresses. The anchor plates were used to move maxillary teeth backward and for maximum anchorage of Class III elastics to minimize mandibular relapse during the postoperative orthodontic treatment. The lateral cephalometric X-ray was taken preoperatively (T0), postoperatively (T1), and one year after the surgery (T2). Seven measurements (distance from Pogonion to line Nasion-Nasion perpendicular [Pog-N Per.], angle of line B point-Nasion and Nasion-Sella [SNB], angle of line maxilla 1 root-maxilla 1 crown and Nasion-Sella [U1 to SN], distance from maxilla 1 crown to line A point-Nasion [U1 to NA], overbite, overjet, and interincisal angle) were taken. Measurements at T0 to T1 and T1 to T2 were compared and differences tested by standard statistical methods. Results: The mean skeletal change was posterior movement by $13.87{\pm}4.95mm$ based on pogonion from T0 to T1, and anterior movement by $1.54{\pm}2.18mm$ from T1 to T2, showing relapse of about 10.2%. There were significant changes from T0 to T1 for both Pog-N Per. and SNB (P<0.05). However, there were no statistically significant changes from T1 to T2 for both Pog-N Per. and SNB. U1 to NA that represents the anterior-posterior changes of maxillary incisor did not differ from T0 to T1, yet there was a significant change from T1 to T2 (P<0.05). Conclusion: This study found that the anchor plate minimizes mandibular relapse and moves the maxillary teeth backward during the postoperative orthodontic treatment. Thus, we conclude that the anchor plate is clinically very useful.
The purpose of this study was to analyze the growth changes of ODI and APDI with age on the three facial growth patterns. The biennial serial cephalometric radiographs of 19 male and 14 famale samples with normal occlusion during 10 years were used in this study. The samples were divided into three groups - drop type, neutral type, forward type - by the total change of the Y-axis during the periods of the study. The findings in this investigation indicated the following: 1. The mean values and standard deviations of each age group in each facial type of male and famale were obtained. 2. The difference of ODI and APDI among the 3 facial types was not significant through all observed ages(P)0.05). The size of ODI appeared large consistently in order of the drop, neutral, and forward type in both male and female through all observed ages. 3. The ODI and APDI were maintained without any charges with age during the periods of the study(p>0.05). 4. In correlation analysis between the total change of the Y-axis and 6 measurements, the AB plane angle and facial angle showed correlation in both male and female(p<0.05), the APDl in only female(p<0.001), but the ODI not appeared correlation in either male or female(p>0.05).
Preadjusted appliance, following the original concept of the Andrews Straight-Wire appliance, became increasingly common in the 1980s. In six phases of treatment, anchorage control, leveling and aligning, overbite control, overjet reduction, space closure, and finishing are very effective with using the preadjusted appliances. Space closure is the phase of treatment in which the difference between standard edgewise and preadjusted mechanics is most noticeable. Orthodontists have been able to reduce the use of closing loops and, because of the level slot lineup, enjoy the advantages of sliding mechanics. In 1990, Dr. John C. Bennett and Richard P. McLaughlin introduced the new space closure system, namely, elastic 'tiebacks'. They found an $.019'\times.025'$ working archwire most effective in an .022'-slot system. Hooks of .024' stainless steel or .028' brass wire are soldered to the upper and lower archwires. The force required for space closure is delivered by elastic 'tiebacks'. An elastic modulo stretched by 2-3mm(to twice its normal length) usually delivers 0.5-1.5mm of space closure per month. Group movement and sliding mechanics are combined for gentle, controlled space closure, so that about 0.5mm of incisor retraction and 0.5mm of mesial molar movement can be seen each month. The tiebacks are replaced every four to six weeks. By using the elastic 'tiebacks', the next two cases were treated during space closure. Even though we found some clinical problems of this mechanics, long treatment time, hard to control of vertical dimension and anchorage, the application method of this system is so simple that orthodontists can manage many patients during short chair time. But we must apply this mechanics after perfect understanding of the biomechanics in tooth movement.
Objective: A recent study suggested that rs6504340, a polymorphism within the homeobox B (HOXB) gene cluster, is associated with the susceptibility for malocclusions in Europeans. The resulting malocclusions require orthodontic treatment. The aim of this study was to investigate the association of rs6504340 and other dentition-implicated polymorphisms with dental and occlusal traits in Korean and Japanese populations. Methods: The study participants included 223 unrelated Koreans from the Busan area and 256 unrelated Japanese individuals from the Tokyo metropolitan area. DNA samples were extracted from saliva specimens. Genotyping for rs6504340 and four single nucleotide polymorphisms (SNPs) that have been shown to be associated with the timing of first tooth eruption and the number of teeth at 1 year of age (rs10506525, rs1956529, rs9674544, and rs8079702) was performed using TaqMan assays. The Index of Orthodontic Treatment Need (IOTN), overjet, overbite, arch length discrepancy, crown sizes, and length and width of the dental arches were measured. Spearman's correlation coefficients were calculated to evaluate relationships between rs6504340 and these dental/occlusal traits. Results: We evaluated the aesthetic components and dental health components of the IOTN in the Korean and Japanese populations and found that neither rs6504340 nor the other four SNPs showed any association with dental and occlusal traits in these East Asian populations. Conclusions: These negative results suggest that further research is needed to identify the genetic determinants of malocclusions in order to reach a consensus.
Objective : Condyle hypoplasia in temporomandibular joint(TMJ) is often observed in several radiographic views. Mandibular Condyle hypoplasia is frequently confused with osteoarthritis with bony changes in TMJ. This paper investigated clinical characteristics of mandibular condyle hypoplasia as compared with TMJ osteoarthritis. Material and method : 276 patients with TMD were taken clinical and radiological examination and were divided into study group, 189 patients diagnosed with mandibular condyle hypoplasia, and control group, 87 patients diagnosed with TMJ osteoarthritis. And clinical features(Onset, Overjet, Overbite, Noise, Locking, NAS of noise, LOM, pain, MCO, and site of diagnosis and pain)of the two groups were compared. Results : 1. Mandibular condyle hypoplasia and TMJ osteoarthritis were similar in many of the clinical features. 2. Mandibular condyle hypoplasia concordance rates of the radiographic diagnosis site and the pain site was significantly lower than TMJ osteoarthritis. 3. Bilateral mandibular condyle hypoplasia group had more occlusal discomfort, and clenching habits than unilateral mandibular condyle hypoplasia group. 4. Unilateral mandibular condyle hypoplasia group had more unilateral chewing habits and LOM than unilateral TMJ osteoarthritis group. Unilateral TMJ osteoarthritis group had more morning stiffness and higher concordance rates of the radiographic diagnosis site and the click sound site than unilateral mandibular condyle hypoplasia group. 5. Bilateral mandibular condyle hypoplasia group had more usual headaches and overjet than bilateral TMJ osteoarthritis group. Conclusion : Mandibular condyle hypoplasia has somewhat distinguishing clinical characteristics as compared with TMJ osteoarthritis.
Purpose: Maxillary hypoplasia is a common developmental problem of cleft lip and palate. Fair results with distraction osteogenesis have been reported especially when these patients need a large amount of maxillary advancement, instead of orthognathic surgery. The purpose of this study is to evaluate the clinical results with a relatively new distractor, $TS-MD^{(R)}$ (Trans-sinusoidal maxillary distractor, KLS Martin, Tuttlingen, Germany) which was used for the advancement of the maxilla in the cleft patients. Patients and Method: Distraction osteogenesis using $TS-MD^{(R)}$ was performed for four CLP patients (three males and one female) who had maxillary hypoplasia. All patients were over 16 years old. As three patients showed mandibular prognathism as well, bilateral sagittal split ramus osteotomy for mandibular setback was performed at the same time. After consolidation periods of 4 to 12 weeks, the distraction devices were removed and miniplates were placed for simultaneous internal fixation. Results: Three patients showed a large amount of incisal overbite but one patient did not have sufficient maxillary advancement. Le Fort I osteotomy, maxillary advancement and internal fixation should have been performed for the patient when removing the distraction devices. Different from the $clinician{\box}s$ expectation, the amount of maxillary advancement using $TS-MD^{(R)}$ was not sufficient, although the device has rigid mechanical property. Rotation of maxilla during distraction forward and downward was also observed. Conclusion: Even though the maxillary advancement with $TS-MD^{(R)}$ device could be achieved, the clinical control of some characteristics related with the device was necessary. More clinical studies on $TS-MD^{(R)}$ should be performed.
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