• The korean journal of orthodontics
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• v.34 no.5 s.106
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• pp.394-407
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• 2004

The Purpose of this study was to evaluate the effect of the lower third molar on treatment time and distal en masse movement of the lower dentition in Giass III malocclusions. Thirty subjects (9 males and 27 females) were selected, all of whom were diagnosed as Glass III malocclusion and treated by fixed appliances without premolar and/or molar extraction. They were divided into three groups Group 1 consisted of 12 subjects. whose lower third molars were not extracted during the whole orthodontic treatment. Group 2 consisted of 8 subjects. whose lower third molars were extracted after WEAW application and before removal of the orthodontic appliances. Group 3 consisted of 10 subjects whose lower third molars were extracted before MEAW application. For each subject. overall treatment time and duration of MEAW application were determined. In addition. pre-treatment and post-treatment lateral cephalometric radiographs were analyzed. All data were Processed statistically with ANOVA, and the conclusions were as follows: There was no significant difference among the groups in overall treatment time However, duration of MEAW application was longer in Group 2 than in Group 1 or Group 3. The overjet that was established after orthodontic treatment was largest in Group 3, in which the lower third molars were extracted befor MEAW application. After orthodontic treatment, IMPA decreased in Group 3. but increased in Group 1 and Group 2. There was no significant difference among the three groups in the translation of lower second molars However the tipping movement of lower second molars was significantly different, highest in Group 2 and lowest in Group 1 Therefore. it is thought to be better for the orthodontic treatment of Class III malocclusions to extract the lower third molars before MEAW application. In Group 2, the mandibular plane angle was decreased as a result of forward rotation of the mandible This skeletal change was thought to bring about the difficulty of treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.1
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• pp.48-58
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• 2001

After performing mandibular setback surgery, we found some changes in patterns and organs of speech. This investigation was undertaken to investigate the aspect and degree of speech patterns according to the amount of surgical setback in mandibular prognathic patients. Thirteen patients with skeletal Class III malocclusion were studied preoperative and postoperative over 6 months. They had undergone the mandible setback operation via bilateral sagittal split ramus osteotomy(BSSRO). We split the patients into two groups. Group 1 included patients whose degree of mandibular setback was 6mm or less, and Group 2 above 6mm. Control group was two adults wish normal speech patterns. A phonetician performed narrow phonetic transcriptions of tape-recorded words and sentences produced by each of the patients and the acoustic characteristics of the plosives, fricatives, and flaps were analyzed with a phonetic computer program (Computerized Speech Lab(CSL) Model 4300B(USA)). The results are as follows: 1. Generally, Patients showed longer closure duration of plosives, shorter VOT(voice onset time) and higher ratio of closure duration against VOT. 2. Patients showed more frequent diffuse distribution than the control group in frication noise energy of fricatives. 3. In fricatives, frequency of compact from were higher in group 1 than in group 2. 4. Generally, a short duration of closure for /ㄹ/ was not realized in the patient's flaps. Instead, it was realized as fricatives, sonorant with a vowel-like formant structure, or trill type consonant. 5. Abnormality of the patient's articulation was reduced, but adaptation of their articulation after surgery was not perfect and the degree of adaptation was different according to the degree of surgical setback.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.457-463
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• 2011

Introduction: This study evaluate the soft tissue changes to the upper lip and nose after Le Fort I maxillary posterosuperior rotational movement. Materials and Methods: Twenty Skeletal class III patients, who had undergone bimaxillary surgery with a maxillary Le Fort I osteotomy and bilateral sagittal split ramus osteotomy, were included in the study. The surgical plan for maxilla was posterosuperior rotational movement, with the rotation center in the anterior nasal spine (ANS) of maxilla. Soft and hard tissue changes were measured by evaluating the lateral cephalograms obtained prior to surgery and at least 6 months after surgery. For cephalometric analysis, four hard tissue landmarks ANS, posterior nasal spine [PNS], A point, U1 tip), and five soft tissue landmarks (pronasale [Pn], subnasale [Sn], A' Point, upper lip [UL], stomion superius [StmS]) were marked. A paired t test, Pearson's correlation analysis and linear regression analysis were used to evaluate the soft and hard tissue changes and assess the correlation. A P value <0.05 was considered significant. Results: The U1 tip moved $2.52{\pm}1.54$ mm posteriorly in the horizontal plane (P<0.05). Among the soft tissue landmarks, Pn moved $0.97{\pm}1.1$ mm downward (P<0.05), UL moved $1.98{\pm}1.58$ mm posteriorly (P<0.05) and $1.18{\pm}1.85$ mm inferiorly (P<0.05), and StmS moved $1.68{\pm}1.48$ mm posteriorly (P<0.05) and $1.06{\pm}1.29$ mm inferiorly (P<0.05). The ratios of horizontal soft tissue movement to the hard tissue were 1:0.47 for the A point and A' point, and 1:0.74 for the U1 tip and UL. Vertically, the movement ratio between the A point and A' point was 1:0.38, between U1 tip and UL was 1:0.83, and between U1 tip and StmS was 1:0.79. Conclusion: Posterosuperior rotational movement of the maxilla in Le Fort I osteotomy results in posterior and inferior movement of UL. In addition, nasolabial angle was increased. Nasal tip and base of the nose showed a tendency to move downward and showed significant horizontal movement. The soft tissue changes in the upper lip and nasal area are believed to be induced by posterior movement at the UL area.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.4
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• pp.154-160
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• 2014

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.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.2
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• pp.270-277
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• 2005

The purpose of this study was to clarify the palatal volume and anterior palatal slope of the children with class II div.1 malocclusion and normal occlusion in mixed dentition(Hellman dental age III A) using three-dimensional laser scanner. Samples were consisted of 31 children with skeletal class II div.1 malocclusion in mixed dentition and 29 children with normal occlusion and profile among the contestants in 2000-2004 Healthy Dentition Contest in Seoul. Totally 60 maxillary study model were taken. Each cast was scanned by three-dimensional laser scanner (Breuckmann opto-TOP HE, INUS, Korea) and shaped into the three-dimension image by Rapidform 2004 program(INUS, Korea). And the palatal volume and anterior palatal slope of each cast were calculated by Rapidform 2004 program(INUS, Korea). The values were statistically compared and evaluated by independent samples t-test with 95% of significance level. The results were as follows: 1. Palatal volume was significantly lesser in children with class II div.1 malocclusion than that of normal occlusion in mixed dentition(p<0.05). 2. No significant difference in the anterior palatal slope and palatal height was found between the children with class II div.1 malocclusion and normal occlusion in mixed dentition(p>0.05). 3. Palatal length was significantly greater in children with class II div.1 malocclusion than that of normal occlusion in mixed dentition(p<0.01). 4. Intercanine and intermolar width were significantly lesser in children with class II div.1 malocclusion than those of normal occlusion in mixed dentition(respectively p<0.05 and p<0.01).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.6
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• pp.628-634
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• 2008

The purpose of this study is to examine reproducibility of operation plan and 3-dimentional jaw movement patterns by comparing jaw position of STO with post-operative jaw position. Twenty patients with class III dental and skeletal malocclusion who were treated with Le-Fort I osteotomy and B-SSRO were reviewed. Lateral cephalometric radiographs were taken within two weeks before operation and two days after operation. Cephalometric radiographs were compared and analyzed with orthognathic computer program '$V-Ceph^{TM}$'. Post-operative maxillary advancement was insufficient compared to maxillary advancement through STO. Post-operative setback movement was over compared to mandibular setback movement through STO. But statistically this is not significant. Maxillary vertical location is insignificant on the whole. Especially post-operative maxillary clockwise rotation is significant compared to maxillary rotation through STO. Post-operative maxillary clockwise rotation tendency is generally observed in all patients. So surgeons and staffs must consider this tendency when operation plan is established ans operation is being performed. Using intra or extra oral marking points, face bow, and bite plate will make exact surgery possible.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.4
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• pp.334-345
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• 2005

The purpose of this study was to compare the postoperative stability and relapse according to 2 different fixation methods after bilateral sagittal split ramus osteotomies in mandibular prognathic patients. Tweenty one patients with Class III dental and skeletal malocclusion who were treated with bilateral sagittal split ramus osteotomy were selected for this retrospective study. We classfied the patients into two groups according to the fixation methods of bony segments after osteotomies. Group W (n = 10) had the bone segments fixed with nonrigid wire and Group S (n = 11) had bicortical screws inserted in the gonial area through a transcutaneous approach. Cephalometric radiographs were taken preoperatively, immediate postoperatively and more than six months postoperatively in each patient. After tracing the cephalometric radiographs, various parameters were measured. Before surgery, both groups were balanced with respect to linear and angular measurements of craniofacial morphology. Mean posterior sagittal setback amounts of the mandibular symphysis was 8.6 mm in the wire group and 6.79 mm in the rigid group, Six months postoperatively, the wire group had 33.1% relapse of the mandibular symphysis and 22.8% in the rigid group relapse. Both groups experienced changes in the orientation and configuration of the mandible. It is thought that Rigid screw fixation is a more stable method than nonrigid wire fixation for maintaining mandibular setback after sagittal split ramus osteotomy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.2
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• pp.167-173
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• 2007

The temporalis fascia graft has been widely used in the correction of nasal deformities. The fascia can be used alone or combined for augmentation rhinoplasty. The fascia graft provides adequate coverage, contour, and bulk on the profile of the nose, as well as an inconspicuous donor site. A depressed radix area can be successfully corrected by the fascia graft. We present two cases of nasal radix augmentation by using temporalis fascia graft. Two male patients presented with the skeletal class III malocclusion and the depressed radix. A planned orthognathic surgery and the temporalis fascia graft to the radix were performed. The malocclusion and the profile of the patients were markedly improved after the operation. Not only the radix but also the nose was improved in its size and length. There was no noticeable resorption or displacement of the radix area at follow-up. The temporalis fascia graft could be an appropriate surgical technique in radix augmentation and nose lengthening.

• The korean journal of orthodontics
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• v.21 no.1 s.33
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• pp.17-29
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• 1991

The purpose of this study was to provide quantitative data describing the effect of rapid palatal expansion (RPE) on nasal airway resistance (NAR). RPE is an orthopedic procedure which is commonly used to widen the maxilla in skeletal Class III patients. 18 subjects (9 males and 9 females, mean age: 10 years 7 months) were selected from the Orthodontics in Yongdong Severance Hospital. Recordings of NAR were taken by active anterior method prior to expansion, immediately after desired maximum expansion, and after approximately 3 months and 6 months, and 1 year. All data was recorded and statistically processed with the SPSS program of IBM PC system. The results are as followings . 1. The average initial NAR of the subjects was 3.84 cm $H_2O/LPS\;(SD{\pm}1.34)$. It was greater than the average NAR of the normal subjects. 2. Among 18 subjects, 9 subjects showed reduction of NAR and 9 subjects showed no specific change of NAR after expansion. 3 An average reduction in NAR after immediately expansion was statistically significant at the 0.05 level. 4. The reduction appeared stable throughout the post treatment observation period of 1 year after expansion. From these results, it was suggested that RPE is a useful method to reduce NAR.

• The korean journal of orthodontics
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• v.50 no.5
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• pp.293-303
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• 2020

Objective: To investigate the three-dimensional (3D) surgical accuracy between virtually planned and actual surgical movements (SM) of the maxilla in two-jaw orthognathic surgery. Methods: The sample consisted of 15 skeletal Class III patients who underwent two-jaw orthognathic surgery performed by a single surgeon using a virtual surgical simulation (VSS) software. The 3D cone-beam computed tomography (CBCT) images were obtained before (T0) and after surgery (T1). After merging the dental cast image onto the T0 CBCT image, VSS was performed. SM were classified into midline correction (anterior and posterior), advancement, setback, anterior elongation, and impaction (total and posterior). The landmarks were the midpoint between the central incisors, the mesiobuccal cusp tip (MBCT) of both first molars, and the midpoint of the two MBCTs. The amount and direction of SM by VSS and actual surgery were measured using 3D coordinates of the landmarks. Discrepancies less than 1 mm between VSS and T1 landmarks indicated a precise outcome. The surgical achievement percentage (SAP, [amount of movement in actual surgery/amount of movement in VSS] × 100) (%) and precision percentage (PP, [number of patients with precise outcome/number of total patients] × 100) (%) were compared among SM types using Fisher's exact and Kruskal-Wallis tests. Results: Overall mean discrepancy between VSS and actual surgery, SAP, and PP were 0.13 mm, 89.9%, and 68.3%, respectively. There was no significant difference in the SAP and PP values among the seven SM types (all p > 0.05). Conclusions: VSS could be considered as an effective tool for increasing surgical accuracy.