• Title/Summary/Keyword: Skeletal Class III malocclusion

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THE RETROSPECTIVE STUDY ON THE INDICATION OF THE CHIN CAP THERAPY (이모장치의 적응증에 관한 후향적 고촬)

  • Yang, Won-Sik;Kim, Byoung-Ho
    • The korean journal of orthodontics
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    • v.25 no.1 s.48
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    • pp.1-12
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    • 1995
  • The purpose of this study was to predict the respose to the chincap therapy from the initial cephalometric measurements and to obtain the indication of chincap therapy. 40 patients selected for this study were classified into two groups by the occlusal stability after completion of permanent dentition and the improvement of facial profile, after chincap therapy. One was good response group which consisted of 25 children and the other was poor response group with 15 patients. Various measurements of the craniofacial structure in the initial lateral cephalogram were calculated and analyzed by t-test and discriminant analysis. The results were as follows: 1. Good response group had more horizontal growth pattern in initial stage of treatment, and the contributing measurements were $Bj\ddot{o}rk$ sum anterior-posterior facial height ratio, genial angle, lower genial angle and occlusal plane to AB plane angle. 2. The critical points and predictive values of the influential skeletal measurements were calculated. 3. The discriminant function was obtained from three major influential measurements; $Bj\ddot{o}rk$ sum, genial angle and occlusal plane to hn plane angle, and this function could discreminate correctly in $85\%$ of this samples.

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A study on the position of tongue and hyoid bone in relation to vertical facial patterns in skeletal Class III malocclusion (골격성 III급 부정교합에서 수직적 안모형태에 따른 혀와 설골의 위치 비교)

  • Woo, Kwang-Su;Yoon, Jeong-Hyun;Kim, Sang-Cheol;Moon, Seong-cheol
    • The korean journal of orthodontics
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    • v.30 no.5 s.82
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    • pp.579-589
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    • 2000
  • The purpose of this study was to evaluate the position of tongue and hyoid bone in relation to vortical facial patterns in the adult and child. Lateral cephalograms taken in adults(63 cases, 11.7 years in average age) and children(69 cases, 22.6 years in average age) were traced and measured about position and posture of tongue and hyoid bone using the horizontal and vertical reference lines. The angle of mandibular plane to SN Plane was employed to classify the samples into groups of hypodivergent and hyperdivergent. The comparison of the tongue/hyoid bone measurements between hypodivergent group and hyperdivergent group in the adult and child were statistically executed with Student's f-test. The results were as follows, 1. The tongue height was lower in the hyperdivergent group than in hypodivergent group, and higher in children than in adults. 2. The vertical height of hyoid bone was higher in hypodivergent group than in hyperdivergent group and also higher in children than in adults. 3. The anteroposterior position was of no significant difference in relation to age or vortical facial pattern. 4. The inclination of hyoid bone in relation to cranial base was steeper in children than in adults.

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The Simple Regression Model of Gonial Angles : Comparison between Panoramic Radiographs and Lateral Cephalograms (Gonial Angle의 단순 회귀 모델: 파노라마 영상과 측모두부 영상간의 비교)

  • Park, Sung-Hee;Kim, Young-Jae;Lee, Sang-Hoon;Kim, Chong-Chul;Jang, Ki-Taeg
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.2
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    • pp.129-137
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    • 2017
  • The aim of this study was to enhancing the panoramic radiograph's clinical use for assessing mandibular measurements and formulating a function of those measurements from panoramic radiographs and lateral cephalograms in children. The panoramic radiographs and lateral cephalograms of 99 former orthodontic patients with skeletal class III malocclusion were selected. In each radiograph, gonial angles, ramus heights, and distance between lower incisors and symphysis were measured. The values of the studied parameters were compared by paired t-test, Pearson's correlation test and regression analysis. The mean value of the gonial angle in panoramic radiographs was $125.49^{\circ}$, and the value in lateral cephalograms was $127.50^{\circ}$. The Pearson's correlation coefficient (${\rho}$) between mean values of gonial angle in each radiograph was 0.945 (p < 0.001). The relationship between the gonial angle measurements obtained from each radiographs was represented as 'Gonial angle (Lateral cephalograms) = 0.920 ${\times}$ Average gonial angle (Panoramic radiographs) + 12.072' in the linear function. The coefficients of ramus heights, and distance between lower incisors and symphysis portrayed weaker correlations than gonial angles. A panoramic radiograph could be used to determine the gonial angle as accurately as a lateral cephalogram, and each gonial angle showed a strong positive relation. A panoramic radiograph is a useful tool for examining vertical growth pattern of patients, as well as a lateral cephalogram.

Condylar positioning changes following unilateral sagittal split ramus osteotomy in patients with mandibular prognathism

  • Kim, Myung-In;Kim, Jun-Hwa;Jung, Seunggon;Park, Hong-Ju;Oh, Hee-Kyun;Ryu, Sun-Youl;Kook, Min-Suk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.36.1-36.7
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    • 2015
  • Background: This study was performed to evaluate three-dimensional positional change of the condyle using three-dimensional computed tomography (3D-CT) following unilateral sagittal split ramus osteotomy (USSRO) in patients with mandibular prognathism. Methods: This study examined two patients exhibiting skeletal class III malocclusion with facial asymmetry who underwent USSRO for a mandibular setback. 3D-CT was performed before surgery, immediately after surgery, and 6 months postoperatively. After creating 3D-CT images by using the In-vivo $5^{TM}$ program, the axial plane, coronal plane, and sagittal plane were configured. Three-dimensional positional changes from each plane to the condyle, axial condylar head axis angle (AHA), axial condylar head position (AHP), frontal condylar head axis angle (FHA), frontal condylar head position (FHP), sagittal condylar head axis angle (SHA), and sagittal condylar head position (SHP) of the two patients were measured before surgery, immediately after surgery, and 6 months postoperatively. Results: In the first patient, medial rotation of the operated condyle in AHA and anterior rotation in SHA were observed. There were no significant changes after surgery in AHP, FHP, and SHP after surgery. In the second patient, medial rotation of the operated condyle in AHA and lateral rotation of the operated condyle in FHA were observed. There were no significant changes in AHP, FHP, and SHP postoperatively. This indicates that in USSRO, postoperative movement of the condylar head is insignificant; however, medial rotation of the condylar head is possible. Although three-dimensional changes were observed, these were not clinically significant. Conclusions: The results of this study suggest that although three-dimensional changes in condylar head position are observed in patients post SSRO, there are no significant changes that would clinically affect the patient.

ANALYSIS OF FACIAL SOFT-TISSUE CHANGES AFTER MANDIBULAR SAGITTAL SPLIT RAMUS OSTEOTOMY (하악 전돌증 환자의 하악지 시상 골절단술후 경조직 변화에 따른 안모 연조직 변화 분석)

  • Park, Hee-Dae;Kwon, Tae-Geon;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.1
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    • pp.87-108
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    • 1996
  • This study was intended to perform cephalometric analysis of the facial soft tissue profile after surgical correction of skeletal Class III malocclusion after SSRO in 29 patients (Males 12, females 17). Lateral cephalograms were taken in centric occlusion before and immediate, long term after surgeries. 1. Counter-clockwise rotation of mandible was observed after the surgery, average relapses of mandibular set back were 1.23-1.28mm. The net effects of the mandibular set-back after surgeries were 81.7-82.2%. Because these relapse tendencies may reduce the effects of the surgical outcomes, surgeon must consider these net before the surgical treatment planning. 2. The ratio of horizontal changes of hard tissue to soft tissue at lower lip, mentolabial sulcus, pogonion were 72.7-93.7%, 100.3%, 99.1-102.1% respectively. There were little changes at upper lip position anteroposteriorly. 3. The relationship of upper and lower lips were improved after surgery. Lower lip was posteriorly repostioned and upper lip was flattend and elongated in conjunction with deepening of inferior lobial sulcus. But profile of chin was still prominent after surgery. 4. Hard tissue horizontal changes and tissue vertical changes were significantly correlated with each other and there were reverse correlations with hard tissue vertical changes and soft tissue horizontal changes.

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Accuracy of three-dimensional periodontal ligament models generated using cone-beam computed tomography at different resolutions for the assessment of periodontal bone loss

  • Hangmiao Lyu;Li Xu;Huimin Ma;Jianxia Hou;Xiaoxia Wang;Yong Wang;Yijiao Zhao;Weiran Li;Xiaotong Li
    • The korean journal of orthodontics
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    • v.53 no.2
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    • pp.77-88
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    • 2023
  • Objective: To develop a method for generating three-dimensional (3D) digital models of the periodontal ligament (PDL) using 3D cone-beam computed tomography (CBCT) reconstruction and to evaluate the accuracy and agreement of the 3D PDL models in the measurement of periodontal bone loss. Methods: CBCT data collected from four patients with skeletal Class III malocclusion prior to periodontal surgery were reconstructed at three voxel sizes (0.2 mm, 0.25 mm, and 0.3 mm), and 3D tooth and alveolar bone models were generated to obtain digital PDL models for the maxillary and mandibular anterior teeth. Linear measurements of the alveolar bone crest obtained during periodontal surgery were compared with the digital measurements for assessment of the accuracy of the digital models. The agreement and reliability of the digital PDL models were analyzed using intra- and interexaminer correlation coefficients and Bland-Altman plots. Results: Digital models of the maxillary and mandibular anterior teeth, PDL, and alveolar bone of the four patients were successfully established. Relative to the intraoperative measurements, linear measurements obtained from the 3D digital models were accurate, and there were no significant differences among different voxel sizes at different sites. High diagnostic coincidence rates were found for the maxillary anterior teeth. The digital models showed high intra- and interexaminer agreement. Conclusions: Digital PDL models generated by 3D CBCT reconstruction can provide accurate and useful information regarding the alveolar crest morphology and facilitate reproducible measurements. This could assist clinicians in the evaluation of periodontal prognosis and establishment of an appropriate orthodontic treatment plan.

EVALUATION OF CONDYLAR DISPLACEMENT USING COMPUTER TOMOGRAPHY AFTER THE SURGICAL CORRECTION OF MANDIBULAR PROGNATHISM (전산화단층촬영법을 이용한 하악전돌증 환자의 외과적 악교정술후 하악과두 위치 변화 검토)

  • Lee, Ho-Kyung;Jang, Hyun-Jung;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.191-200
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    • 1998
  • This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after orthognathic surgery in 37 patients(male 13, female 24) using computed tomogram that were taken in centric occlusion before, immediate after, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period of intermaxillary fixation, at the 24 hours later removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.42{\pm}5.30mm$ and horizontal long axis of condylar angle was $12.79{\pm}4.92^{\circ}$ on the right, $13.53{\pm}5.56^{\circ}$ on the left side. Condylar lateral poles were located about 12mm and medial poles about 7mm away from the reference line(AA') on the axial tomogram. Mean intercondylar distance was $83.15{\pm}4.62mm$ and vertical axis angle of condylar angle was $76.28{\pm}428^{\circ}$ on the right, $78.30{\pm}3.79^{\circ}$ on the left. 2. In amount of set back, We found the condylar change(T2C-T1C) which had increasing tendency in group III (amount of setback : 10-15mm). but there was no statistical significance(p>0.05). 3. There was some correlation between condylar change(T2C-T1C) and TMJ dysfunction. It seemed that postoperative condylar change had influenced postoperative TMJ dysfunction, through there was no statistical significance (p>0.05). As we have observed the change of condylar axis in the group that complained of TMJ dysfunction in cases of large amount of mandibular setback. So we consider that the more trying to conserve condylar position will decrease occurrence rate of post operational TMJ dysfunction.

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Changes of symphysis morphology after chincup treatment (이모장치 착용 후 하악 이부의 헝태변화)

  • Kang, Sun;Park, Dong-Cheol;Kim, Jong-Ghee
    • The korean journal of orthodontics
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    • v.30 no.1 s.78
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    • pp.33-41
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    • 2000
  • Although it is well known that the chincup, used to correct a skeletal class III malocclusion in growing children, reduce the mandibular prognathism by arresting the growth of the mandibular length and rotating the mandible posteroinferiorly, the majority of the studies about chincup is focused on condylar head that plays an Important role in mandibular growth. The aim of this study was to evaluate the morphologic change of the mandibular symphysis where extraoral force is applied directly during chincup treatment. The data lot this study were obtained from lateral cephalometric radiographs of 62 growing children(chincup group:32, control group:30) with mixed dentition who had been accepted lot the orthodontic treatment at Chonbuk National University Dental Hospital. The results were as follows : 1. Symphysis height was increased both in chincup therapy group and control group during treatment. Symphysis depth was decreased or maintained the initial values in chin cup therapy group, whereas increased in control group. Posterior symphysis depth was decreased both in chin cup therapy group and control group, but anterior svmphysis detph was increased in control group, whereas decreased in chincup therapy group. 2. Chin depth and chin curvature were increased in control group, whereas maintained or decreased in chincup therapy group during treatment. Chin angle, menton ang1e and symphysis angle were decreased in control group, whereas increased in chincup therapy group. It suggested that bone deposition in pogonion area that occur normally with mandibular growth was supressed by direct contact of chincup. 3. When growing children wear chincup, symphysis morphology was maintained due to inhibition of forward growth at mandibular symphysis. It may be due to the suppression of bone deposition in anterior part of symphysis.

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Three Dimensional Study on the Postoperative Stability after Advancement of Maxilla Using Le Fort I Osteotomy (Le Fort I 골절단술을 이용한 상악골 전진 후 안정성에 관한 3차원적 연구)

  • Oh, Chul-Jung;Hur, Jung-Woo;Chung, Kwang;Cho, Min-Sung;Jung, Seunggon;Park, Hong-Ju;Oh, Hee-Kyun;Ryu, Sun-Youl;Kook, Min-Suk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.2
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    • pp.82-87
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    • 2013
  • Purpose: This study evaluated postoperative maxillary stabilities in patients with skeletal Class III malocclusion who were taken both maxillary advancement surgery and mandibular retrusive surgery, using Le Fort I osteotomy, through three-dimensional computed tomography. Methods: We selected 14 patients who were taken postoperative three-dimensional computerized tomography at the time before surgery, immediately after surgery, six months after surgery among the patients undergone both maxillary advancement surgery using Le Fort I osteotomy and mandibular retrusive surgery using bilateral sagittal split ramus osteotomy. We measured and compared the vertical distance of A-point and posterior nasal spine (PNS), the horizontal distance of A-point and PNS in transverse plane and coronal plane of the three-dimensional reconstructed images, respectively. Results: In transverse plane, the distance difference between immediately after surgery ($S_1$) and immediately before surgery ($S_0$) of A-point was $-0.04{\pm}1.80$ mm, $S_2$ and $S_0$ was $-0.15{\pm}1.69$ mm, and between $S_1$ and $S_2$ was $0.11{\pm}0.58$ mm. There were no significant differences between these data (P>0.05). In transverse plane, the distance between $S_1-S_0$ of PNS was $-3.87{\pm}2.37$ mm, $S_2-S_0$ of PNS was $-3.79{\pm}2.39$ mm, and $S_1-S_2$ of PNS was $-0.08{\pm}0.18$ mm. There were significant differences between these data (P<0.05). In coronal plane, the distance between $S_1-S_0$ of A-point was $3.99{\pm}0.86$ mm, $S_2-S_0$ was $3.57{\pm}1.09$ mm, and $S_1-S_2$ was $0.42{\pm}0.42$ mm. There were significant differences between these data (P<0.05). In coronal plane, the distance between $S_1-S_0$ of PNS was $3.82{\pm}0.96$ mm, $S_2-S_0$ was $3.43{\pm}0.91$ mm, and $S_1S_2$ was $0.39{\pm}0.49$ mm. There were significant differences between these data (P<0.05). In transverse plane, it was estimated that PNS has no statistical postoperative stability in the same direction. In coronal plane, it was estimated that both A-point and PNS had no statistical postoperative stability (P<0.05). Conclusion: Clinically, the operation plan needs to take into account of the maxillary relapse.

EVALUATION OF CONDYLAR POSITION USING COMPUTED TOMOGRAPH FOLLOWING BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY (전산화단층촬영법을 이용한 하악 전돌증 환자의 하악지 시상 골절단술후 하악과두 위치변화 분석)

  • Chol, Kang-Young;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.570-593
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    • 1996
  • This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after BSSRO in 20 patients(males 9, females 11) using computed tomogram that were taken in centric occlusion before, immediate, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period intermaxillary fixation, 24hour after removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.45{\pm}4.01mm$ and horizontal long axis of condylar angle was $11.89{\pm}5.19^{\circ}$on right, $11.65{\pm}2.09^{\circ}$on left side and condylar lateral poles were located about 12mm and medial poles about 7mm from reference line(AA') on the axial tomograph. Mean intercondylar distance was $84.43{\pm}3.96mm$ and vertical axis angle of condylar angle was $78.72{\pm}3.43^{\circ}$on right, $78.09{\pm}6.12^{\circ}$on left. 2. No statistical significance was found on the condylar change(T2C-T1C) but it had definitive increasing tendency. There was significant decreasing of the distance between both condylar pole and the AA'(p<0.05) during the long term(TLC-T2C). 3. On the lateral cephalogram, no statistical significance was found between immediate after surgery and 24 hours after the removing of intermaxillary fixation but only the lower incisor tip moved forward about 0.33mm(p<0.05). Considering individual relapse rate, mean relapse rate was 1.2% on L1, 5.0% on B, 2.0% on Pog, 9.1% on Gn, 10.3% on Me(p<0.05). 4. There was statistical significance on the influence of the mandibular set-back to the total mandibular relapse(p<0.05). 5. There was no statistical significance on the influence of the mandibular set-back(T2-T1) to the condylar change(T2C-T1C), the condylar change(T2C-T1C, TLC-T2C) to the mandibular total relapse, the pre-operative condylar position to the condylar change(T2C-T1C, TLC-T2C), the pre-operative mandibular posture to the condylar change(T2C-T1C, TLC-T2C)(p>0.05). 6. The result of multiple regression analysis on the influence of the pre-operative condylar position to the total mandibular relapse revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condyalr head long axis angle, the more increasing of mandibular horizontal relapse(L1,B,Pog,Gn,Me) on the right side condyle. The same result was founded in the case of horizontal relapse(L1,Me) on the left side condyle.(p<0.05). 7. The result of multiple regression analysis on the influence of the pre-operative condylar position to the pre-operative mandibular posture revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condylar head long axis angle, the more increasing of mandibular vertical length on the right side condyle. and increasing of vertical lengh & prognathism on the left side condyle(p<0.05). 8. The result of simple regression analysis on the influence of the pre-operative mandibular posture to the mandibular total relapse revealed that the more increasing of prognathism, the more increasing of mandibular total relapse in B and the more increasing of over-jet the more increasing of mandibular total relapse(p<0.05). Consequently, surgical mandibular repositioning was not significantly influenced to the change of condylar position with condylar reposition method.

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