• Title/Summary/Keyword: Skeletal Class III

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Incidence and management of condylar resorption after orthognathic surgery: An overview

  • Barone, Selene;Cosentini, Giorgio;Bennardo, Francesco;Antonelli, Alessandro;Giudice, Amerigo
    • The korean journal of orthodontics
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    • v.52 no.1
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    • pp.29-41
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    • 2022
  • Objective: Condylar resorption (CR) is one of the major post-surgical complications of orthognathic surgery. This systematic review (SR) aimed to evaluate epidemiological data, risk factors, and therapeutical management of CR. Methods: Six databases were screened by two investigators until September 2020 to obtain all SRs. After reading the titles and abstracts, eligible SRs were determined and data extraction was performed. Using the latest version of A Measurement Tool to Assess Systematic Reviews, the methodological quality of the included SRs was determined. Results: Ten SRs with low or critically-low methodological quality were included in this review. Mandibular hypoplasia on the sagittal plane and hyperdivergent growth pattern on the vertical plane were the most common skeletal alterations in which CR could occur after orthognathic surgery. Post-operative condylar changes were analyzed both on two-dimensional and three-dimensional (3D) radiographic examinations. The incidence of CR was not related to the fixation method. Based on the severity of the pathological conditions, management of CR can include conservative or surgical therapy. Conclusions: Despite the limited evidence in literature, CR is considered a consequence of orthognathic surgery. However, an accurate diagnosis of CR and a better orthognathic surgical planning must include 3D radiographic examinations to improve pre- and post-surgical comparison. Well-designed studies with long-term follow-up and 3D data are needed to clarify the findings of this analysis..

CAD-CAM technique based digital diagnosis and fixed partial denture treatment on maxillary congenital missing teeth with skeletal class III tendency patient: A case report (상악 선천성 결손과 하악 골격성 제3급 부정교합 경향성을 보이는 환자에게서 CAD-CAM 기법을 이용한 진단과 고정성 보철 수복 증례 보고)

  • Oh, SaeEun;Park, YoungBum;Park, JaeHan
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.354-361
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    • 2022
  • The development of digital technology is causing great changes in dentistry. This digital workflow combines various 3D data in the prosthetic treatment area for diagnosis and prosthetic manufacturing. The planned diagnosis and the fabrication of prosthesis in a virtual patient formed by synthesizing digital data can simulate the results of prosthetic treatment more intuitively than conventional methods, thereby increasing the predictability of aesthetic prosthetic treatment. In this case report, functionally and aesthetically satisfied clinical results were obtained by fabricating a fixed partial dentures through a digital workflow on congenital missing teeth in the maxillary anterior region.

Management of Maxillary Impacted Canines (매복 상악 견치의 처치)

  • Ki-Taeg Jang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.2
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    • pp.142-154
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    • 2023
  • The canine tooth is important both functionally and aesthetically, being positioned between the anterior and posterior teeth. The upper canine has the longest eruption path, forming in the deepest part of the maxillary bone and often experiencing eruption disorders, leading to significant aesthetic and functional issues. Early detection and management of canine impaction are crucial in pediatric dentistry, which focuses on tooth growth and eruption. The prevalence of maxillary canine impaction ranges from 1.1% to 3.0%. In Western populations, palatal impaction is twice as common as labial impaction, while some Korean studies report more labial impaction. Maxillary canine impaction occurs more frequently in women and is associated with various factors such as structural obstacles, pathological conditions in surrounding tissues, developmental abnormalities, and genetic factors. Labial displaced canines are linked to narrow maxillary intercanine width, total dental crowding, and skeletal Class III malocclusion. Maxillary palatal displaced canine impaction is more prevalent in patients with familial agenesis of lateral incisors or conical supernumerary lateral incisors. Understanding these factors aids in early diagnosis and appropriate intervention for canine tooth impaction, ensuring optimal oral health and aesthetics.

Prosthetic Treatment Strategies for Improving Denture Retention in Pediatric Patients with Hypohidrotic Ectodermal Dysplasia: a Report of Two Cases (저한성 외배엽 이형성증을 가진 소아 환자에서 의치 유지력 향상을 위한 보철 치료 전략: 두 가지 증례 보고)

  • Hongju Jeon;Seonmi Kim;Namki Choi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.4
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    • pp.483-494
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    • 2023
  • This report presents two cases concerning strategies for improving denture retention in pediatric patients with oligodontia caused by hypohidrotic ectodermal dysplasia (HED). Both patients presented with multiple missing teeth, conical canines, alveolar bone atrophy, and a skeletal Class III tendency. In the first case, a modified form of conical-crown-retained denture was used to cover the canines. This approach was carried out without tooth extraction or coping. In the second case of severe alveolar bone resorption and a distally tilted lower left canine, the tooth was restored with a hybrid ceramic crown. It was subsequently converted into a clasp-retained removable partial denture, utilizing a suction mechanism. Both patients are currently receiving regular check-ups for the maintenance of their prosthetic appliances and the evaluation of their growth patterns. This study presents innovative prosthetic treatment methods for pediatric patients with HED who have inadequate denture retention.

RETROSPECTIVE STUDY OF FACE MASK THERAPY (FACE MASK의 치료 효과에 대한 후향적 고찰)

  • Kim, Tae-Woo;Chang, Young-Il;Nahm, Dong-Seok
    • The korean journal of orthodontics
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    • v.26 no.5 s.58
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    • pp.547-556
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    • 1996
  • The purpose of this study was to evaluate the skeletal, dental and soft tissue profile changes following the face mask therapy in growing skeletal class III malocclusion patients. The fifteen patients with the good results were selected among the patients who visited the Department of Orthodontics in Seoul National University Hospital. The mean age was 10.63(range 7.25-13.25) years and the mean treatment duration was 9.84(range 2.00-27.00) months. Lateral cephalograms were taken just before and after face mask application. After tracing the cephalograms, thirty five items(twety angular and fifteen linear) were measured. The differences before and after the face mask therapy were compared statistically by the paired t-test(p<0.05). The results were as follows : SNA and Co-A(effective maxillary length) increased significantly after using the face mask(p<0.001), which reflects the orthopedic changes of maxilla. SNB and Co-Gn(effective mandibular length) also showed an increase(p<0.01), which may be a result of the strong growth trends of the samples. FMA, SN-GoGn and Y-axis angle increased significantly(p<0.01), which means the backward and downward rotation of the mandible. This positional change seemed to have compensated an increase of effective mandibular length. There was no statistically significant difference in angulation of upper and lower incisors between pre-treatment and post-treatment(p>0.05). In soft tissue profile, the upper lip was positioned anteriorly(p<0.01) after treatment and approximated to the normal standards.

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ORTHODONTIC AND PROSTHODONTIC TREATMENT IN CLEFT LIP AND PALATE PATIENT (순/구개열 환자에서의 교정-보철 치험례)

  • Chang, Weon-Suk;Choi, Yeong-Chul;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.3
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    • pp.388-393
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    • 2000
  • Cleft lip and palate is one of the most common congenital defects in oro-maxillo-facial region. Because most patients undergo surgical repair in early life, the sagittal jaw relationships used to be deteriorated gradually from palate surgery up to adulthood. Also, the maxillary lateral incisor may be absent or atypical-shaped in the cleft site and may not erupt or erupt ectopically, so multidisciplinary dental cares are needed for cleft lip and palate patients. The effects of the cleft lip and alveolus seem to be limited to that part of the dentofacial complex that surrounds the cleft area. In the maxillary arch, the anterior part of the non cleft segment has a tendency to be rotated forward. On the other hand, the cleft segment has a tendency to rotated slightly medially ; hence, the tendency for canines to be edge-to-edge and sometimes in crossbite. Lip and alveolus surgery adequetely correct these problems, with little untoward effect on the skeletal maxillary-mandible relationships. In this report, the patient has a repaired lip and cleft alveolus on the left side with congenital missing on '62, '22, oronasal fistula, and skeletal class III malocclusion which is not affected by lip surgery. Dental treatments for this patient including orthodontic(space supervision, functional regulator in mixed dentition, fixed therapy in permanent dentition) and prosthodontic(removable obturator with key and keyway attachment and Konus crown) therapy were performed to improve the patient's functions and esthetics.

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The relationship between condyle position, morphology and chin deviation in skeletal Class III patients with facial asymmetry using cone-beam CT (안면비대칭을 동반한 골격성 III급 부정교합자에서 하악 과두의, 위치 형태와 이부 편위의 관계: cone-beam CT를 이용한 연구)

  • Lee, Bo-Ram;Kang, Dae-Keun;Son, Woo-Sung;Park, Soo-Byung;Kim, Seong-Sik;Kim, Yong-Il;Lee, Kyung-Min
    • The korean journal of orthodontics
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    • v.41 no.2
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    • pp.87-97
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    • 2011
  • Objective: Facial asymmetry is usually evaluated from the difference in length and angulation of the maxilla and mandible. However, asymmetric position or shape of the condyle can also affect the expression of asymmetry. The purpose of this study was to evaluate the correlation between condylar asymmetry and chin point deviation in facial asymmetry. Methods: Cone-beam CT images of fifty adult skeletal Class III patients were studied. Thirty patients who had more than 4 mm menton deviation were categorized in the asymmetric group. Twenty patients with less than 4 mm menton deviation were assigned to the symmetric group. Anteroposterior and transverse condyle positions were evaluated from the cranial base. The greatest mediolateral diameter (GMD) of the condyle in the axial plane and angulation to the coronal plane were measured. The height and volume of the condyles were evaluated. Results: The symmetric group had no statistical difference between both condyles in position, angulation, GMD, height and volume. In the asymmetric group, the non-deviated side condyle was larger in GMD, height and volume than the deviated side. There was no statistical difference in condyle position and angulation. The GMD, height difference and condylar volume ratio (non-deviated/deviated) were positively correlated with chin deviation. From the linear regression analysis, condylar volume ratio was a significant factor affecting chin deviation. Conclusions: These findings suggests that the non-deviated side condyle is larger than the deviated side. In addition, condylar asymmetry can affect the expression of facial asymmetry.

Full mouth Rehabilitation with Orthognathic Surgery in Facial Asymmetry Patient : Case Report (안면 비대칭환자의 악교정 수술을 동반한 완전구강회복)

  • Im, So-Min;Shin, Hyoung-Joo;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.3
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    • pp.359-371
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    • 2010
  • Facial asymmetry has been found with a higher frequency (70~84%) in skeletal class III malocclusion patients. Anticipating the poor prognosis of prosthesis due to malocclusion, occlusal stability must be obtained by orthodontic treatment. Moreover, orthodontic surgery would be needed in some severe cases for better functional and esthetic results. The orthognathic surgery is performed on one jaw or two jaw depending on the results of facial diagnosis. Genioplasty may change the vertical, horizontal, sagittal position of chin by osteotomy or augmentation using implants, also. This case is about a 24 year-old male patient who visited our clinic to solve the facial asymmetry and mandibular prognathism. Skeletal class III malocclusion, maxillary canting and menton deviation to left by 13 mm were detected. Multiple ill-fitting prostheses, unesthetic maxillary anterior prostheses, and several dental caries were found. After pre-operative orthodontic treatment, Le-Fort I osteotomy, sagittal split ramus osteotomy, genioplasty, right mandibular angle augmentation were done for the correction of jaw relation and asymmetry. By diagnostic wax-up after post-operative orthodontic treatment, maxillary full mouth rehabilitation and mandibular posterior restorations were planned out. For better result, clinical crown lengthening procedure was done on #11, 12 and implant was placed on left mandibular first molar area. The patient was satisfied with the final prostheses. Because of his high caries risk, long-term prognosis will depend on the consistent maintenance of oral hygiene and periodic follow-up.

A study on the change of head posture and hyoid bone position before and after rapid maxillary expansions (상악골 급속확장술식 전후 두경부 자세와 설골위치의 변화에 관한 연구)

  • Bae, Hyeon-Cheol;Lee, Jin-Woo;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.27 no.4 s.63
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    • pp.569-584
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    • 1997
  • The present study assessed the effects of Rapid Maxillary Expansion on head posture and hyoid bone position. For this study, 32 Angle's class III patients - hellman 3c $\~$ adult stage, mean age 12y9m - were selected and divided into two groups, A,B according to craniocervical angulation. Craniocervical angulation Increased in Group A and decreased in Group B after the therapy. And 23 Angle's class I persons $\~$ same hellman stage, mean age 12y7m $\~$ were selected (or the control group. Cephalometric analysis of skeletal pattern, pharyngeal space, head posture, hyoid bone position was performed. The results were as follows, 1. Comparison of skeletal pattern and pharyngeal space 1) All two groups(A,B) had Mandibular plane inclined inferiorly and no pharyngeal space change was obseved after RME therapy 2) Skeletal pattern and pharyngeal space of Group A, B were normal before and after treatment. 2. Comparison of head posture 1) Craniocervical angulation of Group A was increased after treatment. That of Group B was decreased and mandibular plane was inclined inferiorly after treatment. 2) Before treatment, craniocervical inclination was normal in Group A but larger than normal in Group B. After treatment, all two groups(A, B) had normal craniocervical angulation. 3. Comparison of hyoid bone position 1) After treatment, long axis of hyoid in Group A, B was not changed. Antero- posteriorly, hyoid position was changed posteriorly in Group A but no change was founded in Group B after treatment. Vertically, hyoid bone position were not changed in two groups except increase in APHFH in Group A after treatment 2) Long axis of hyoid bone was normal in Group A, B before and after treatment. Anteroposteriorly, hyoid bone position was more anterior than Group B, C before treatment but all the position of two groups had normal position after treatment. Vertical position of hyoid bone was normal in all two groups before and after treatment.

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The effects of maxillary protraction appliance (MPA) depending on vertical facial patterns (수직적 안모 형태에 따른 상악골 전방 견인 장치의 효과 비교)

  • Ryu, Young-Kyu;Lee, Kee-Joon;Oh, Chang-Hun
    • The korean journal of orthodontics
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    • v.32 no.6 s.95
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    • pp.413-424
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    • 2002
  • Preadolescent children with deficient maxillae are suitable candidates for the maxillary protraction appliance(MPA). The theoretical effect of the MPA is protraction or anterior displacement of the maxilla. However, it is known that complex effects such as anterior displacement of the maxillary teeth, downward and backward rotation of the mandible, linguoversion of the mandibular anterior incisors, are known to play a role in improving the Cl III malocclusion. There have been much studies with regard to maxillary protraction, but the different effects of MPAs depending on the vertical facial pattern are not known precisely. This study was based on 67 patients (31 males, 36 females) aged from 6 years 6 months to 13 years 3months, who visited the Dept. of Orthodontics at Yonsei Univ., Dental Hospital and diagnosed as skeletal Class III with maxillary deficiency. They were divided into 3 groups (low, average, high angle groups) depending on genial angle and the SNMP (Go-Gn) angle, respectively. Pretreatment and post-treatment lateral cephalograms were used to compare the effects of MPA and the following conclusions were obtained: 1) A significantly large amount of backward movement of the B point was observed in patients with a low SNMP angle. Those with a high SNMP angle had significant forward movement at A point. 2) The patients with low genial angle had the least forward movement at the A point, and those with a high angle had more forward movement. 3) In comparing the arcTan of the A point, the high angle group showed more horizontal movement while the low angle group showed more vertical movement. 4) There was no significance between the treatment duration of the SNMP and the Genial angle groups.