• Journal of Periodontal and Implant Science
• /
• 제41권2호
• /
• pp.60-66
• /
• 2011

Purpose: The aim of this study is to evaluate the buccal and lingual bone thickness in the anterior teeth and the relationship between bone thickness and the tissue biotype. Methods: Three male and two female human cadaver heads (mean age, 55.4 years) were used in this study. First, the biotype of periodontium was evaluated and categorized into a thick or a thin group. Next, full thickness reflections of the mandible and the maxilla to expose the underlying bone for accurate measurements in the anterior regions were performed. After the removal of the half of the alveolar bone, the probe with a stopper was used to measure the thickness of bone plate at the alveolar crest (AC), 3 mm apical to the alveolar crest (AC-3), 6 mm apical to the alveolar crest (AC-6), and 9 mm apical to the alveolar crest (AC-9). The thickness of the buccal plates at the alveolar crest were $0.97{\pm}0.18\;mm$,$0.78{\pm}0.21\;mm$, and $0.95{\pm}0.35\;mm$ in the maxillary central incisors, lateral incisors, and canines, respectively. The thickness of the labial plates at the alveolar crest were $0.86{\pm}0.59\;mm$, $0.88{\pm}0.70\;mm$, and $1.17{\pm}0.70\;mm$ in the mandibular central incisors, lateral incisors and canines, respectively. Conclusions: The thickness of the labial plate in the maxillary anteriors is very thin that great caution is needed for placing an implant. The present study showed the bone thickness of maxillary and mandibular anteriors at different positions. Therefore, these data can be useful for the understanding of the bone thickness of the anteriors and a successful implant placement.

• 대한구순구개열학회지
• /
• 제15권2호
• /
• pp.69-82
• /
• 2012

Our Team Approach consists of following five stages; (1) Peri-natal care until lip repair After ultrasound diagnosis, some obstetricians recommend the mother with CL/P fetus to undergo prenatal counseling in our CLP clinic. On the day the CL/P baby was born, our oral surgeon, nurse, and pedodontist visit the maternity clinic, and take counseling and take impression for a feeding plate. The cheiloplasty is performed in three months old. (2) From lip repair to palatal repair At one year of age, Otorhinolaryngologist checks middle-ear disease. Palatoplasty is carried out at 1.5 - 2 years old. (3) In deciduous and early mixed dentitions Speech is the most important issue in social life for the CL/P subjects, therefore the training of velopharyngeal function is essential. Orthodontist monitors dentofacial development from 5 years of age. In the case of severe maxillary under-growth or severe collapse, maxillary protractor or lateral expansion is indicative, respectively. In early mixed dentition, upper central incisor on the cleft area erupts with some torsion, and then the traumatic occlusion with tooth torsion must be corrected. (4) In mixed dentition Right before the eruption of upper canines, secondary bone grafting is performed. One year prior to the operation, maxillary fan-type expansion is carried out to correct the collapse of maxillary segments. Following the surgical operation, the erupted canine will be moved into the transplanted bone to avoid alveolar resorption. (5) In permanent dentition Final tooth alignment is carried out after eruption of second molars. Some cases may require orthognathic surgery after physical maturation. Prosthetic oral rehabilitation including the dental-implant is carried out after age eighteen.

• 대한치과교정학회지
• /
• 제41권5호
• /
• pp.361-370
• /
• 2011

Objective: Speedy surgical orthodontics (SSO), an innovative orthodontic treatment, involves the application of orthopedic forces against temporary skeletal anchorage devices following perisegmental corticotomy to induce movement of specific dental segments. Herein, we report the biological effects of SSO on the teeth and periodontal structures. Methods: Five beagle dogs were divided into 2 groups and their 6 maxillary incisors were retracted $en$ $masse$ by applying 500 g orthopedic force against a single palatal mini-plate. Retraction was performed without and with perisegmental corticotomy in groups I and II, respectively. All animals were killed on the 70th day, and their periodontal structures were processed for histologic analyses and scanning electronic microscopy (SEM). The linear distance between the third maxillary incisor and canine was used as a benchmark to quantify the retraction amount. Results: Retraction was markedly faster and retraction amount greater in group II than in Group I. Surprisingly, Group II did not show any root resorption despite extensive retraction, while Group I showed prominent root surface irregularities. Similarly, SEM showed multiple resorption lacunae in Group I, but not in Group II. Conclusions: SSO is an effective and favorable orthodontic approach for major en masse retraction of the maxillary anterior teeth.

• 대한구순구개열학회지
• /
• 제12권2호
• /
• pp.95-100
• /
• 2009

In spite of all fine methods developed for treating cleft lip, a certain percentage of cases might still need secondary correction. Generally, secondary revision of cleft lip is much difficult to produce esthetic outcome, because the cleft lip scar gives a variable symmetrical and anatomic defect that may not be possible to make inconspicuous of this scar and rebuild good esthetics. In this case report, a five year-old girl was underwent secondary cleft lip repair using straight line technique to correct unfavorable postoperative scar, peaking of Cupid's bow, notching of vermillion and shortened lip on cleft side with simultaneous repairing cleft palatal fistula. After operation, the secondary deformity was much improved, but, long term follow up is needed to evaluate the additional postoperative deformity might be happen during growth.

• 대한구순구개열학회지
• /
• 제11권1호
• /
• pp.13-22
• /
• 2008

Velopharyngeal insufficiency(VPI), characterized by hypernasal resonance and nasal air emission, is a speech disorder that can significantly compromise speech intelligibility. Cleft palate, previously repaired cleft palate and submucous cleft palate are associated with VPI. Less commonly, patients may acquire it after adenoidectomy with or without tonsillectomy or as a result of neuromuscular dysfunction. Comprehensive evaluation by a VPI team includes medical assessment focusing on airway obstructive symptoms, perceptual speech analysis, MRI and instrumental assessment. Options for intervention include speech therapy, intraoral prosthetic devices and surgery. Surgical methods can be categorized as palatal, palatopharyngeal or pharyngeal procedures. Each surgical approach has its strengths and limitations. Oro-maxillofacial surgeons are increasingly involved in the referral, evaluation, and treatment of velopharyngeal function. Therefore, understanding of physiology, anatomic structures, evaluation and treatment protocols in VPI is very important. This article presents protocol for evaluation of velopharyngeal function with a focus on indications for surgical interventions.

• 대한구순구개열학회지
• /
• 제7권1호
• /
• pp.47-61
• /
• 2004

The closure of a wide alveolar cleft and fistula in cleft patients and the reconstruction of a maxillary dentoalveolar defect in bilateral cleft lip and palate (BCLP) patients are challenging for both orthodontists and oromaxillofacial surgeons. It is due to the difficulty in achieving complete closure by using local attached gingiva (palatal flap) and the great volume of bone required for the graft. In this article, the authors used bifocal distraction-compression osteosynthesis(BDCO) to create a segment of new alveolar bone and attached gingiva for the complete approximation of a wide alveolar cleft/fistula and the reconstruction of a maxillary dentoalveolar defect. Since the alveoli and gingivae on both ends of the cleft were approximated after BDCO, the need for extensive alveolar bone grafting was eliminated. It also could create new alveolar bone and gingiva for orthodontic tooth movement and implant.

• 대한구순구개열학회지
• /
• 제3권2호
• /
• pp.67-73
• /
• 2000

The purpose of this survey was to obtain an overall view of the status of cleft lip and palate management in Oral and Maxillofacial Surgery(OMFS) in Korea. Korea Cleft lip and Palate Association conducted mailed survey which was composed of 29 questions conceming pre-operative and post-operative management in CLP surgery and completed by 58 training hospital. Of 58 questionnaires sent, 23 were returned(response rate of 40%). Authors compared this results with those of other similar surneys, which reveal much difference between OMFS and Plastic Surgery(PS) in CLP treatment. In OMFS, many surgeons were in favor of presugical orthopaedics than lip adhesion to manage protruded premaxilla. It reflects interdisciplinary team approach between OMFS and orthodontic department reduces the need of lip adhesion through presurgical orthopaedics. Timing of palatal surgery was later than that of PS, which reflects concern for an impediment of maxillaty growth. To our knowledge, this survey may be the first on organization and management for cleft patient in OMFS in Korea.

• 대한치과교정학회지
• /
• 제40권4호
• /
• pp.276-287
• /
• 2010

본 증례보고는 심한 양악 치아치조성 전돌과 전치부 치열밀집을 보이는 23세 8개월 여자 환자를 대상으로 한 변형된 형태의 설측 교정치료법인 설측 Biocreative therapy 치료를 소개하고자 한다. 양악 제1소구치 발치 후 구개천장에 식립된 C-플래이트에 lingual sheath가 달린 보조장치를 접착하여 상악구치부에 장치부착 없이 튜브역할을 대신하게 하였으며 상악 전치부의 decrowding과 견인을 위하여 설측 교정용 브라켓을 사용하지 않고 0.022 슬롯을 가진 순측 브라켓을 치아 설면에 부착한 후 납착된 설측 레버암을 이용하여 상악 전치부의 3차원적인 견인을 시행하였으며, 견인 후 finishing 기간동안 tooth positioner를 사용하였다. 상악 구치부의 장치부착 없이도 총 치료기간은 19개월 소요되었고, 안정적인 교합관계와 안모의 개선이 이루어졌다. 장치 제거 후 13개월 유지 후에도 양호한 결과가 유지되었다.

• 대한구순구개열학회지
• /
• 제5권1호
• /
• pp.43-58
• /
• 2002

A General survey on the cleft lip and/or palate patients in Pusan National University Hospital was done. The conclusions were as follow. 1. In gender ratio, male was higher than female. 2. In the cleft type, unilateral cleft lip and palate, cleft lip and alveolus, and bilateral cleft lip and palate in higher ratio order. Left unilateral cleft lip and palate was higher than right in ratio. 3. In first hospital visiting age for dental treatment, the group from 6 years old to 12 years old was most and in that the age group for attending elementary school (about 7-8 years old) showed especially higher ratio. The large majority of patient were born in 1980's and lived in Pusan metropolitan city, KyungSangNamDo. Especially, most of them lived in the neighboring Held of Pusan National University Hospital. 4. Class III skeletal pattern and Angle's Class III molar relationship was most prevalent. Angle's Class II molar relationship showed relative higher ratio because tooth loss and malposition. 5. Primary lip closure in 3 months, secondary lip closure in 6-7 years old, palatal closure in 12-16 months and bone graft in 8-10 years old were operated mostly. Rhinoplasty and scar revision were operated in too early age so the need of infantile orthopedics must be considered. 6. Maxillary expansion and protraction were operated mostly in 8-11 years old but operating in primary dentition must be considered. 7. Tooth alignment were started mostly in mixed dentition and consideration about prosthodontic treatment and retention will be need. 8. In tooth anomaly, tooth malformation and missing were most prevalent.

• Imaging Science in Dentistry
• /
• 제46권3호
• /
• pp.179-184
• /
• 2016

Purpose: In the present study, we coined the term 'alveolar dome' and aimed to demonstrate the prevalence of alveolar domes through digital periapical radiographs. Materials and Methods: This study examined 800 digital periapical radiographs in regard to the presence of alveolar domes. The periapical radiographs were acquired by a digital system using a photostimulable phosphor (PSP) plate. The ${\chi}^2$ test, with a significance level of 5%, was used to compare the prevalence of alveolar domes in the maxillary posterior teeth and, considering the same teeth, to verify the difference in the prevalence of dome-shaped phenomena between the roots. Results: The prevalence of alveolar domes present in the first pre-molars was statistically lower as compared to the other maxillary posterior teeth (p<0.05). No statistically significant difference was observed in the prevalence of alveolar domes between the maxillary first and second molars. Considering the maxillary first and second molars, it was observed that the palatal root presented a lower prevalence of alveolar domes when compared to the distobuccal and mesiobuccal roots (p<0.05). Conclusion: The present study coined the term 'alveolar dome', referring to the anatomical projection of the root into the floor of the maxillary sinus. The maxillary first and second molars presented a greater prevalence of alveolar domes, especially in the buccal roots, followed by the third molars and second pre-molars. Although the periapical radiograph is a two-dimensional method, it can provide dentists with the auxiliary information necessary to identify alveolar domes, thus improving diagnosis, planning, and treatment.