• 치과방사선
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• 제19권1호
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• pp.105-121
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• 1989

The author analysed tomograms and submento-vertex radiograms of 90 temporomandibular joints from 45 asymptomatic young adults. 15 had Angle class Ⅰ malocclusion, 15 classⅡ and 15 class Ⅲ. Corrected lateral tomograms were obtained in three condylar positions; centric occlusion, centric relation and 1 inch mouth opening. The condylar angulation, depth of cut, joint spaces were analysed in each radiogram. The obtained results were as follows; 1. The mean condylar angulation in Angle class Ⅰ, Ⅱ, Ⅲ group was 17.55±5.51° 13.33±8.85° 16.25±6.60° respectively, and there was no significant difference in each group. The mean condylar angulation of right side (16.62±7.23°) was larger than left side (14.80±7.33°). 2. The mean depth of cut in Angle class Ⅰ, Ⅱ, Ⅲ group was 8.13±1.61㎝, 3.05±3.80㎝, 7.75±2.19㎝, respectively. Angle class Ⅰ and class Ⅱ group revealed significant difference in measurement (p<0.0l). 3. The mean height of articular fossa in Angle class Ⅰ, Ⅱ, Ⅲ group was 8.67±3.06㎜, 9.61±2.57㎜, 8.93±2.83㎜, respectively. And the mean width of articular fossa was 19.90±2.80㎜, 19.48±3.83㎜, 20.36±4.82㎜, respectively. 4. The mean height and width of condylar head was 5.11±1.16㎜, 11.20±2.26㎜, respectively. 5. In centric occlusion, the superior joint space was the largest (3.42±1.42㎜), followed by anterior joint space (2.94±1.95㎜) and the posterior joint space (2.64±1.19㎜. In centric relation, the anterior joint space was the largest (3.86±2.17㎜), followed by the superior joint space (3.64±3.68㎜) and the posterior joint space (1.18±0.77㎜). 6. The displaced measurement from centric relation to centric occlusion was 1.10±1.04㎜ anteriorly and 0.24±0.97㎜ inferiorly. In 1 inch mouth opening state, the condylar head displaced posteroinferiorly (2.49±2.49㎜ posteriorly, 1.17±1.34㎜ inferiorly) from the apex of articular eminence. And Angle class Ⅰ and Ⅱ group, Angle class Ⅱ and Ⅲ group revealed significant difference in posterior measurement, respectively (p<0.01).

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권2호
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• pp.191-205
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• 2000

The purpose of this study was undertaken to determine the effects of orthognathic surgery on speech. The hyposis stated herein is that functional behaviors of the dentofacial complex, such as speech production, may be adversely affected by deviations of a structural nature(especially, Class III malocclusion). Twenty adults with Class III malocclusion(13 female and 7 male) were studied preoperative, immediate postoperative and either 6 or 12 months postoperative lateral cephalograms. They had mandibular prognathism and had undergone mandible setback operation. The position of tongue, soft palate(Uvula), hyoid bone, respiratory track width, and pharyngeal depth were assessed on lateral cephalograms with 23 cephalometric variables, ANOVA, Paired t-tests and Pearson's product-moment correlation coefficient tests were used to evalute the operative changes in all cephalometric parameters. A experienced speech and language pathologists performed narrow phonetic transcriptions of tape-recorded words and sentences produced by each of the ninth patients and the recording tapes were analyzed by phonetic computer program(Computerized Speech Lab(CSL) Model 4300BI(U.S.A.)) These judges also recorded their ratings of each patient's overall consonants, hypernasality, hyponasality, and articulation proficiency. The results obtained are as follows; 1. There were significant changes in distance of posterior pharyngeal wall to tongue (TI-TW2, TS-TW3) after the surgery at 6 months postoperatively(each p<0.01 p<0.05). 2. The posterior tongue point(TI, TS, PPT) moved posteriorly after surgery and remained to its changed position at 6 months postoperatively(p<0.05). The displacement of tongue was correlated with the movement of mandibular setback amount(p<0.05). The hyoid bone moved posteriorly superiorly after immediate postoperative period. There was significant changes in hyoid bone movement after immediated postoperative period(p<0.05), but returned to its original position during the follow-up period(p>0.05) 3. The soft palate was displaced posteriorly superiorly after immediated operative period and remained to its changed position at 6 months postoperatively(p<0.05). ANS-PNS-SPT angle increasing, PPU-PPPo distance narrowing was showed after surgery, and remained its appearance 6 months postoperatively(p<0.05). 4. There were significant changes in formant value and squre diagram of vowel sound after the orthognathic surgery and the follow-up period. There were significant changes in /ㅅ/sound and posterior tongue sound. 5. The posterior movement of tongue and the posteriosuperior movement of soft palate was correlated with mandibular setback amount after orthognathic surgery. On the vowel squre diagram, the author found that the place of articulation after operation moved downward, backward, upward. 6. In assessing speech abnormalities, dental occlusion should be considered as a contributing factor. The vast majority of subjects with preoperative misarticulations eliminated or reduced their errors following orthognathic surgery. There was significant difference in speech impovement between pre- and postoperation.

• Journal of Oral Medicine and Pain
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• 제23권1호
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• pp.45-55
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• 1998

The author assessed the sagittal relationships between glenoid fossa of the temporal bone and mandibular condyle from lateral transcranial views of 74 TMJ with disc displacement and 16 TMJ with normal disc-condyle complex by the magnetic resonance image findings. All the subjects were female and also in their 3rd decades. The disc displacement group was subdivided into anterior disc displacement with reduction (ADWR) group and anterior disc displacement without reduction (ADWOR) group. The anterior, superior, and posterior joint spaces as well as anterior/posterior (A/P) ratio of the space at the closed jaw position and vertical and horizontal components of the condyle position relative to the articular eminence at the open jaw position were measured from all the subjects and the data were compared among groups. The result were as follows : 1. The mean posterior joint space of ADWR group was smaller than ADWOR group, but there were no significant differences in anterior and superior joint spaces between two groups. 2. There showed a tendency of higher A/P ratio in ADWR group which meant the condyle of ADWR was likely to take posteriorly displaced position. 3. There were higher proportion of neutral condylar position in glenoid fossa in normal group, but higher proportion of posterior condylar position in ADWR group. 4. There were no significant differences in the degree of condyle-fossa concentricity among groups.

• 대한치과교정학회지
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• 제27권2호
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• pp.231-243
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• 1997

본 연구는 거대 편도를 가진 기능성 III급 부정 교합자의 구대 편도 절제술 전후의 인두강, 설골, 두부 위치의 변화 양상에 대해 알아보기 위해 단국 대학교 부속 치과 병원 교정과에 내원한 남녀 환자 42명을 대상으로 연구하여 다음과 같은 결론을 얻었다. 1. Enlarged tonsil을 보이는 기능성 3급 부정교합자는 1급 부정교합자보다 혀는 전방에 위치하고 설골은 하방에 위치한다. 2. Tonsillectomy 후에 편도 절제술전과 비교하여 혀는 후방에 위치하고, nasopharynx은 증가 양상을 보이며, 설골은상, 후방에 위치하며 counterclockwise rotation 양상을 보인다. 3. Tonsillectomy 후에 nasopharynx depth변화와 하악 전치 경사도, 혀의 수직적 변화와 cranial base에 대한 hyoid axis, hyoid의 수직적, 수평적 변화와 두경부 경사도, 두경부 경사도와 하악 전치간에 95% 유의수준으로 상관성을 보인다. 4. Tonsillectomy 후에 설골 장축의 counterclockwise rotation시 hya-NL의 감소와 nasopharyx의 증가를 보이고, 혀의 거상시 hya-NL의 감소를 보이며, 혀의 후방위치시 h-h1의 증가와 hya-ba-n의 감소를 보인다.

• 대한치과보철학회지
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• 제31권3호
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• pp.394-410
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• 1993

This study was accomplished for appreciation of the mandibular moments according to antero- posterior movement of pivot placed on the lower natural dentition. For this study, 20 subjects(male, $21\sim30$ yrs., average age 24) in the category of normal occlusion were selected, and the intraoral Vitallium clutches were cast and fabricated for each subjects. A 2-dimension PSD(Position Sensitive Detector, Hamamatsu Photonics Co., Japan) was attached to maxillary clutch in a mode of three dimensional control and LED (Light Emit Diode, Hamamatsu Photonics Co., Japan) was set up on mandibular clutch. Both clutches were set into oral cavity of each subjects and adjusted. Then the subjects were allowed to intercuspated with maximal bite force while the pivoting ball in the mid-line moving from anterior toward posterior position. The displacement scales were recorded by CCD camera(Sony, CCD-TR-705) and VCR, The conclusions were as follows : 1. When the subject was allowed to bite the metal pivoting ball in the midline of lower dentition with maximal bite force voluntarily while moving from lower central incisor to canine, 1st premolar, End premolar, 1st molar and 2nd molar. The lever actions on the pivot were revealed in all subjects. The equilibrium of moment were revealed on the pivots of 1st premolar(14 subjects), End premolar(4 subjects), and canine(2 subjects) areas. 2. The changes of loading on the TMJ according to antero-posterior positional changes of metal pivoting ball were able to recognize as follow. Compression on the TMJ was increased when the pivot moves anteriorly from the equilibrium point, and tension on the TMJ was increased when posteriorly. 3. 13 subjects were recognized their habitual chewing sides(Rights, Left8), and 7 subjects were not. During maximal biting, mandible was displaced toward their habitual chewing sides on the metal pivoting ball in the frontal plane. 4. In cephalometric analysis, the average genial angle of 20 subjects was $116.75^{\circ}$ and the average mandibular body length was 79.77mm. The equilibrium points of mandibular moment were positioned more posteriorly in the subjects having larger Genial angle than in the smaller(p<0.05). Relationships among the angle between FH plane and occlusal plane, the angle between occlusal plane and mandibular plane , and mandibular body length were not significant(p>0.05).

• 치과방사선
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• 제20권2호
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• pp.299-313
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• 1990

The author analysed tomographic and cephalometric radiographs of 82 temporomandibular joints from 41 symptomatic patients and 40 temporomandibular joints from 20 asymptomatic young adults. The results were as follows; 1. The mean condylar angulation in control group and patient group was 21.72±6.48° 20.13±9.14° respectively and there was no significant difference between two groups. 2. The mean depth of cut was 6.63±0.38㎝ in control group and 6.57±0.46㎝ in patient group. 3. Mean height and width of condylar head were 6.66±1.83㎜, 12.42±0.49㎜ in control group and 6.22±1.36㎜, 11.93±l.92㎜ in patient group. 4. The mean height of articular fossa was 10.20±2.04㎜ in control group and 9.89±1.98㎜ in patient group. The mean width of articular fossa was 21.08±2.08㎜ in control group and 21.24±3.03㎜ in patient group. 5. In centric occlusion the superior joint space was largest (4.15±0.93㎜), followed by the posterior joint space (2.99±0.97㎜) and the anterior joint space (2.70±0.73㎜) in control group. The superior joint space (3.47±1.31㎜) and posterior joint space (3.47±7.07㎜) were same in patient group. There was significant difference in left superior joint spaces between two groups (p<0.05). 6. The condylar position in articular fossa was displaced anteroinferiorly (0.99±3.65㎜ anteriorly, 1.75±1.01㎜ inferiorly) in control group and posteroinferiorly (3.20±4.69㎜ posteriorly, 1.25±1.87㎜ inferiorly) in patient group with 1 inch opening. In maximum opening, it was displaced anteroinferiorly (6.09±3.55㎜ anteriorly, 1.38±2.47㎜ inferiorly) in control group and anteroinferiorly (1.70±5.96㎜ anteriorly, 1.37±1.85㎜ inferiorly) in patient group. There was significant difference in anteroposterior position of both condyles with 1 inch opening and maximum opening between two groups (p<0.01). 7. The mean inclination of upper central incisor and the posterior inclination of articular eminence in control group was 65.60±6.04° 58.88±9.18° in control group, and 67.14±8.41°, 59.70±9.08° in patient group respectively. There was no significant correlation between two groups.

• 대한치과교정학회지
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• 제24권4호
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• pp.827-839
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• 1994

This study was conducted to assess the positional changes of hyoid bone following the use of activator in Angles class III malocclusion patients with functional factors. For this study, 40 Angle's class I patients and 40 Angle's class III patients, totally 80 subjects were used. They are all in Hellman's dental age IIIB-IIIC ranges. In lateral cephalogram to compare Angle's class I group and Angle's class III group, and the positional changes of the hyoid bone before and after the use of activator in Angle's class III malocclusion group. The results were obtained as follows; 1. Comparison of Angle's class I group and Angle's class III group. In comparison to Angle's class I group, hyoid bone is more anteriorly and superiorly positioned in Angle's class III group. The hyoid bone showed reverse inclination to the mandibular plane in Angle's class III malocclusion group. 2. Comparison of the hyoid positional change before and after use of Activator in Angle's class III malocclusion group. The hyoid bone is displaced posteriorly and inferiorly in vertical relationship. The hyoid bone also showed counter-clockwise rotation. 3. No statistical difference was found between after Activator use data of Angle's class m malocclusion group and Angle's class I group. It is concluded that the hyoid bone in Angle's class III malocclusion group changed its position, similar to Angle's class I malocclusion group.

• 대한치과교정학회지
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• 제22권1호
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• pp.229-239
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• 1992

This study was performed to define the adaptation patterns of each skeletal components to the flexures of cranial bases, using 91 males from the ages of 17 to 36 and 64 females from the ages of 16 to 34, without orthodontic or prosthetic treatment experiences and with pleasant profiles as subjects. The conclusions are as follow: 1. When considering the changes of flexure of cranial base (Ba-SE-FMN) in both sexes, changes in the anterior cranial base angle to the PM Vertical line (SE-FMN/PMV) were greater than the changes in the posterior cranial base angle to the PM Vertical line (Ba-SE/PMV). Subsequently the nasomaxillary complex showed antero-superior rotating effect as the cranial base angles were increased and postero-inferior rotating effect as they were decreased. 2. Horizontal mandibular angle (Ba-SE-Me) was increased in both sexes as cranial base angle increases (Ba-SE-FMN) and it decreased as the latter was decreases. There by indicating compensatory effects. 3. Maxillary angle (SE-FMN-A) was decreased in both sexes as cranial base angle (Ba-SE-FMN) increases and it increased as the latter was decreased. There by indicating compensatory effects. 4. Mandibular ramus angle to posterior cranial base was decreased in both sexes as cranial base angle increases. There by indicating compensatory effect to anteriorly displaced maxilla and the mandibular ramus angle was increased as the cranial base angle decreases. There by indicating compensatory effect to posteriorly displace maxilla. 5. The length of posterior upper facial height was decreased in both sexes as the cranial base angle increases and it increased as the latter was decreased.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권6호
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• pp.545-551
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• 2005

Purpose: The effect of orthognathic surgery on the temporomandibular dysfunction has been controversial. The purpose of this study is to prove statistically that early removal of fixation plate at postoperative 2 weeks with active exercise of mouth opening could relieve preoperative temporomandibular dysfunction and reposition of temporomandibular joint. Patients and Methods: All 28 subject patients underwent mandibular setback with BSSRO in Kyunghee medical center by one surgeon. The fixation plates used for rigid fixation were removed at postoperative 2 weeks and we had the patients excercise active mouth opening with intermaxillary rubber rings for the guiding proper postoperative occlusion. Temporomandibular symptoms were checked and radiographs were taken before surgery, within a month after surgery, six to twelve months after surgery respectively. Results: The temporomandibular dysfunction symptoms were relieved after the surgery and the condyle was displaced inferior-posteriorly immediate after surgery and repositioned toward its original position during follow-up periods. Conculusion: Orthognathic surgery may benefit temporomandibular joint dysfunction by obtaining a postoperative stable occlusion and more physiologic neuromuscular function. The early removal of fixation plates after BSSRO could reposition the temporomandibular joint to physiologic position and relieve the symptoms of temporomandibular dysfunction by permitting movement of proximal segment.

• Anatomy and Cell Biology
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• 제56권4호
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• pp.456-462
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• 2023

Plate fixation has become the preferred approach for treating displaced midshaft clavicle fractures. However, plate fixation of the clavicle presents several unique challenges, including its complex bony architecture and its immediate subcutaneous location. In many cases, we have observed that precontoured implants do not conform to the clavicular anatomy, and many patients complain of postoperative implant-related discomfort. A total of 111 clavicles, both left and right sides, were examined to match two commonly used designs of anatomical pre-contoured superior anterior clavicle plates, with and without lateral extension. The anteroposterior (AP) plane congruence of the plate to the underlying bone, the vertical gap between the bone and plate, and the length of the plate that was off the bone either anteriorly and/or posteriorly at both ends of the clavicle were measured. The scoring system was used to determine the fit of the implant on the clavicle as anatomic, good, or poor. We found that the maximum superior bow of the clavicle was lateral to the midline by 30.75 mm and 30.5 mm on the right and left sides, respectively. The magnitude of the bow was 4.28 mm and 4.46 mm on the right and left sides, respectively. We also found that the plate was a poor fit in 75.86% of cases on the left side and 73.5% of cases on the right side. Manipulating the plates during surgery was very difficult in the AP plane.