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.
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.
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.
An, Ul-Jin;Noh, Hong-Seok;Jeong, Tae-Sung;Kim, Shin
Journal of the korean academy of Pediatric Dentistry
/
v.38
no.2
/
pp.119-128
/
2011
In the process of assessing the children with anterior crossbite in early mixed dentition, it has frequently been detected that the stronger the skeletal pattern of the malocclusion is, the more markedly delayed the development and eruption of maxillary teeth are. If the anteroposterior characteristics of craniofacial skeleton has any relationship with dental maturation, the evaluation of dental development and eruption was thought to be able to contribute to early diagnosis of crossbite in children. This study was performed for the purpose of elucidating the relationship between dental maturation of maxillary teeth and some cephalometric values in children with anterior crossbite of maxillary undergrowth type in early mixed dentition. Among the children in Hellman dental age IIA and IIC who attended the Pediatric Dental Clinic of Pusan National University Hospital with orthodontic problems, cases with Class III malocclusion were classified and 50 cases of maxillary undergrowth type and type with normal maxilla respectively were randomly selected and studied as subjects. From their lateral cephalographs and panoramic radiographs, their anteroposterior skeletal features, the dental maturity and eruption rate were obtained of each group and data were analyzed to yield the results as follows: 1. Comparing the maturity of maxillary teeth of both groups, only the first molars of maxillary undergrowth group showed significantly slower development and eruption (p<0.05). 2. There was high correlation between maturation of maxillary 1st molar and chronological age(p<0.05). 3. Among the parameters of anteroposterior relationship of skeletal pattern in maxilla and mandible. Wits was revealed as a useful index to predict both the calcification and eruption rate of the 1st molars whereas SNA was to eruption rate(p<0.05).
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.
Park, Sung-Hee;Kim, Young-Jae;Lee, Sang-Hoon;Kim, Chong-Chul;Jang, Ki-Taeg
Journal of the korean academy of Pediatric Dentistry
/
v.44
no.2
/
pp.129-137
/
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.
The purpose of this study was to investigate cephalometrically the short term static velopharyngeal changes in 25 patients (10 boys and 15 girls, aged from 5 years 9 months to 12 years 10 months in the beginning of treatment) with skeletal Class III malocclusions who underwent nonsurgical maxillary protraction therapy with a facemask. The linear, angular and ratio measurements were made on lateral cephalograms. Only the change in hard palatal plane angle was negatively correlated with the change in maxillary depth or N-perp to A (p<0.01). The change in velar angle showed a statistically significant increase (p<0.001). This change was influenced more by the soft palatal plane angle than by the hard palatal plane angle (p<0.001). The changes in soft tissue nasopharyngeal depth and hard tissue nasopharyngeal depth showed statistically significant increases (p<0.001). Correlations between the changes in soft tissue (or hard tissue) nasopharyngeal depth and the change in soft palatal plane angle were significant (p<0.05). The increase in hard palate length was statistically significant (p<0.001). The change in hard palate length was negatively correlated with the change in soft tissue nasopharyngeal depth (p<0.05). The change in need ratio S (C) showed a statistically significant increase (p<0.001). But this difference was within the normal range reported by previous studies. These findings indicate that the velopharyngeal competence was maintained even if the anatomical condition of the static velopharyngeal area were changed after maxillary protraction.
Kim, Ju-Mi;WhangBo, Min;Kim, Joo-Young;Eum, Jong-Hyuk;Rhee, Ae-Ryon;Kim, Shin;Seo, Soo-Jeong
Journal of the korean academy of Pediatric Dentistry
/
v.21
no.2
/
pp.555-560
/
1994
Among the permanent teeth. the first permanent molars play the greatest role in occlusion and function. So, the congenital missing, abnormal reuption or abnormal formation of the first permanent molars in the course of arch development would inflict normal development of dental arches. Therefore, early detection of abnormal cases related to first permanent molars and understanding of current and predictable clinical problems are essential for proper occlusal guidance in children. With the aim of investigating the clinical patterns of delayed eruption of first permanent molars in children, panoramic tomograms of the childern in mixed and early permanent dentition were observed and analyzed. The results were as follows: 1. Among the delayed eruption of first permanent molars, on tooth or bilateral teeths were affected most frequently. Delayed eruption was more prevalent in maxilla than in mandible. 2. The formation of tardily erupted teeth were also delayed. 3. Delayed eruption was generally limited in first molars or molar segments. 4. Delayed eruption of first permanent molars is accompanied by abnormal position of tooth germs, for example, ectopic eruption, delayed dental age, delayed localized tooth formation and generalized congenital missing. 5. There was a tendency of delayed formation or congenital missing of second molars distal to tardily erupted 1st molars. And that was more marked in maxilla than in mandible. 6. There was reported that affected 1st molars show various size and shapes. Maxillary 1st molars showing delayed eruption showed a tendency of having 3 cusps. But, tardily erupted mandibular 1st molars showed no significant reduction in mesiodistal dimension, as reported. 7. In some cases, the delayed eruption of 1st permanent molars was associated with ectopic eruption, but their formation was not usually retarded. 8. In skeletal class III cases, there showed a tendency of mandibular 1st molars to erupt earlier than maxillary 1st molars with greater interval than in normal occlusion.
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
/
v.37
/
pp.36.1-36.7
/
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.
The purpose of this study was to investigate the changes of mandibular movement and muscle activity following orthognathic surgery in patients with mandibular prognathism. Lateral cephalogram, M.K.G., E.M.G. recordings were obtained immediately before surgery, and 2 months and 8 months after surgery. Among the patients who received orthognathic surgery, 19(13 men, 6 women) were selected for this study. Statistical analysis for each time interval differences were performed with the SPSS package. The results were as follows: 1. Compared with the pre-operative group (opening 349.7mm/sec, closing 313.1mm/sec), the mean values of the maximum opening and closing velocity in the skeletal Class III surgery group were significantly decreased in the 2 months post-operative (opening 232.9mm/sec, closing 206.9mm/sec), but the values tended to increase in the 8 months post-operative group (opening 280.9 mm/sec, closing 319.1mm/sec). 2. Compared with the pre-operative group (61.7 mm/sec), the maximum velocity of the terminal tooth contact increased in the 2 months (72mm/sec) and 8 months (105.7mm/sec) postoperative groups. 3. In the mean value of vertical freeway space, there was significant difference between the normal group and the pre-operative group, but not between the normal group and the 8 months post-operative group. 4. In the mean values of the maximum opening, the maximum anterio-posterior movement from centric-occlusion, and the lateral deviation from centric occlusion, there was no significant difference between the normal group and the surgery group (the pre-operative and the 8 months post-operative groups). 5. The mature swallowing pattern was 58% in the pre-operative group, but 90% in the 2 months post-operative group, and 63% in the 8 months post-operative group. 6. In the comparison of muscle activity, there was no significant difference between the normal group and the surgery group during the rest position. However, during cotton roll clenching, there was significant difference between the normal group and the pre-operative group, but not between the normal group and the 8 months post-operative group.
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