Orthodontic treatment of posterior bite collapse due to early loss of molars and the consequent drift of adjacent teeth is complicated. When the posterior bite collapse occurs in patients with facial asymmetry, both transverse and vertical compensation are necessary for camouflage orthodontic treatment. In such cases, posterior maxillary segmental osteotomy (PMSO) can be an effective alternative procedure that simplifies the orthodontic treatment and shows long-term stability through dental compensation within the alveolar bone housing. This case report aimed to describe the orthodontic treatment of maxillary occlusal plane canting caused by severely extruded maxillary teeth in a patient with skeletal facial asymmetry that was corrected with PMSO along with protraction of the lower second molar to replace the space of the extracted first molar. The treatment duration was 18 months, and stable results were obtained after 2 years of retention.
The Academic Congress of Korean Shoulder and Elbow Society
/
2009.03a
/
pp.74-74
/
2009
The purpose of this study was to estimate force of muscles that constituted the rotator cuff during elevation motion in scapula plane, using a skeletal muscle model and quantitatively evaluate rotator cuff function in vivo. A healthy volunteer was measured with an open MR and CT system at elevation positions in scapula plane (MR: $30^{\circ}$, $60^{\circ}$, $90^{\circ}$, $120^{\circ}$, $150^{\circ}$, CT: $0^{\circ}$). After reconstruction three-dimensional MRI-based and CT-based bone surface models, matched each models with registration technique. Then supraspinatus, infraspinatus, subscapularis, teres minor, deltoid (anterior, middle, posterior portions) represented as plural lines. These lines were proportional to physiologic cross-sectional area (PCSA) and defined straight line to bind origin and insertion. Force of supraspinatus became greatest at $59^{\circ}$ of elevation. Subsequently force of deltoid middle portion became greatest at $89^{\circ}$ of elevation. Infraspinatus and subscapularis were active at the meantime. In addition, supraspinatus was active during elevation. These results resembled clinical finding and were proved force couples that contribute to mobility and stability of shoulder complex.
Purpose: This study was performed to evaluate the stress distribution in the bone and the displacement distribution of the miniscrew under orthopedic force with two different types of miniplate design as skeletal anchorage for orthopedic treatment. Materials and methods: Finite element models were made for 6-hole miniplate (0.8mm in thickness), which were designed in two different shapes-one is curvilinear shaped (C plate, Jeil Medical Co., Korea) and another, Y shaped (Y plate), fixed with 3 pieces of miniscrew 2mm-diameter and 6mm-long respectively. A traction force of 4 N was applied in $0^{\circ}$, $30^{\circ}$ and $60^{\circ}$ to imaginary axis connecting two unfixed distalmost holes of the miniplate. Results: The maximum von Mises stress in the bone was much greater in the cortical portion rather than in the cancellous portion. C plate showed greater maximum von Mises stress in the cortical bone than Y plate. The maximum displacement of the miniscrew was greater in C plate than Y plate. The more increased the angle of the applied orthopedic force, the greater maximum von Mises stress in the bone and maximum displacement of the miniscrew. It was observed that in C plate, the von Mises stress in the bone and displacement of the miniscrew were distributed around the distalmost screw-fixed area. Conclusions: The results suggest that Y plate should have the advantage over C plate and in the placement of the miniplate, its imaginary axis should be placed as parallel as possible to the direction of orthopedic force to obtain its primary stability.
Purpose: Orthognathic surgery is required in patients with severe skeletal disharmony and facial asymmetry, which results in functional and esthetic improvement. Recently, bimaxillary surgery has become generalized. Establishment of the occlusal plane among several other factors included in the surgery plan is a major consideration for the diagnosis and treatment plan and it is also an important factor for postoperative stability. Methods: In this study, we assessed postoperative stability of occlusal plane, B-point, and pogonion point on 20 patients who underwent two-jaw surgery in the Chosun Dental Hospital from 2000 to 2007. Preoperative and postoperative states and at least a one year postoperative follow-up were compared. Results: The postsurgical relapse volume of the occlusal plane to the SN plane and the FH plane was $-0.26{\pm}2.8^{\circ}$ and $-0.44{\pm}3.29^{\circ}$, respectively and after two-jaw surgery, the stability of occlusal plane was maintained. The horizontal relapse degree was $0.85{\pm}0.46$ mm and $0.76{\pm}0.48$ mm, respectively, and the vertical relapse degree was $1.16{\pm}0.36$ mm and $1.13{\pm}0.71$ mm of the B point and the Pogonion point at the time after minimal 1 year. Conclusion: The vertical relapse amount was shown to be slightly larger than the horizontal relapse amount.
The purpose of this study is to analyze the spine stability by comparing muscle activation in various scaffold working conditions. The independent working conditions were designed by two levels of working height, existence and absence of safety handrail, and the two levels of expertise. The corresponding activities of the agonist and antagonist muscles of spine were simultaneously recorded by using EMG. As results, novice worker showed increased muscle activity while doing the task on the 2nd floor, absence of handrail. And expert showed the increase of co-contraction while working on the 2nd floor without handrail. Such co-contraction was found to increase the spine stability when the working condition become risky. On the other hand, the co-contraction was prolonged, the spine muscle fatique and disc pressure could be increased, which would increase the risk of musculo-skeletal disorder. The results of co-contraction in this study indicates that the motor control system responds to maintain the stability of the spine particularly when workers cognitively recognize the danger of falling or imbalance. This study also quantitatively accounted for the biomechanical cause of LBP among workers who has to prevent themselves from falling. Therefore, if can be said that safe environment preventing falling can also prevent workers from MSDs as well. Such knowledge can be applied to design ergonomic workplace environment as well as movable scaffold.
Surgical-orthodontic treatment is performed for the skeletal Class III patients with no remaining growth and too big a skeletal discrepancy (or camouflage treatment, and two jaw surgery is needed in order to have maximum effect in such patients. In two jaw surgery cases, surgical alteration of the occlusal plane is necessary to establish optimal function, esthetics and postoperative sability, therefore the establishment of the occlusal plane is essential in diagnosis and treatment. The object of this study is to evaluate the stability of the indiviual ideal occlusal plane bsaed on the architectural and structural craniofacial analysis of Delaires. Thus, the subjects of this study were 48 patients who underwent two jaw surgery, and divided in two groups. Each group were composed of 24patients, A group were operated with ideal occlusal plane and B group were not. Two groups were compared at the preoperative, immediate postoperative (average 4.3days), and long-term postoperative (average 1.3years) lateral cephalometric radiographs. The following results were obtained: 1. There was no significance in occlusal plane angulation between $T_2\;and\;T_3$. Average long term follow-up changes of occlusal Plane angle were $0.24^{\circ}{\pm}2.43$, with FH plane and $0.15{\circ}{\pm}2.16{\circ}$ with SN plane in all 48 patients. These results demonstrated that the occlusal plane after two jaw surgery in skeletal Class III malocclusion was stable. 2. There was no significance in postoperative stability of occlusal plane between A and B group. 3. There was no significance in postoperative stability of occlusal plane depending on surgeon and operative method within each group. 4. The postoperative changes of occlusal plane were correlated to the postoperative changes of jaw rather than tooth position. 5. There was no correlation between the postoperative changes of occlusal plane and maxillary impaction and mandibular setback with surgery.
The purpose of this study is to investigate the stability of counterclockwise rotation of mandible by sagittal split ramus osteotomy to correct the skeletal Class III malocclusion with anterior open bite. Twenty five skeletal Class III open bite patients(mean age 20.6 years) who were treated by the sagittal split ramus osteotonues with rigid fixation were examined in this study. Cephalometric radiographs were taken for each Patients Preoperative(T1), ewly Postoperative(T2), and late postoperative Period(T3). Mean postoperative period was 8.0 months. Cephalometric analysis was done and data from T1, T2, and T3 were analyzed statistically by Paired t-test and Pearson correlation analysis. The following results were obtained. 1. Mandibular plane angle decreased $2.9^{\circ}$ and mandibular occlusal plane angle related to SN Plane decreased $2.7^{\circ}$ after orthognathic surgery(T2). At 6 months after orthognathic surgery(T3), mandibular plane angle increased $1.0^{\circ}$, but mandibular occlusal plane angle did not changed. 2. The amount of horizontal relapse long time after orthognathic surgery(T3) was 1.6 mm at B point and it was $22\%$ of the total posterior movements. There was no vertical relapse in the anterior facial height. 3. The related factor with horizontal relapse at late postoperative period was mandibular plane angle(p<0.01). The related factors with decreasing posterior facial height were amount of mandibular setback(p<0.01), increasing of mandibular ramus height(p<0.01), and decrease of the mandibular plane angle during operation(p<0.01). 4. There was no relationship between the amount of changes in mandibular occlusal plan angle during operation and the amount of relapse after surgery.
In Patients with severe skeletal discrepancy, surgical orthodontic treatment must be accompanied, and recently two jaw surgery has become a common procedure, resulting in improved esthetics and function. Choosing the position of the occlusal plane in this two jaw surgery is an important factor in postoperative stability Therefore this must be taken into consideration during the diagnosis and treatment plan. In this study, among patients with skeletal Class III occlusion, 25 patients(8 male, 17 female, average age $23.2{\pm}3.17$) who have undergone two jaw surgery, setting the ideal occlusal plane according to Delaire's architectural and structural cranial analysis. In comparing preoperative($T_1$). postoperative($T_2$, average of 15.4 days), and long-term postoperative($T_3$, average of 32.6 months) lateral cephalometric radiography, the following conclusions have been made. 1. There were no significant changes of the occlusal plane angle after the two jaw surgery, and there were no significant differences between the surgical technique(SSRO and IVRO). 2. The postoperative changes of the occlusal Plane had no relationship with the amount of jaw movement, amount of posterior impaction, nor the time relapse after surgery. 3. After two jaw surgery, in the SSRO group there was significant forward movement of the mandible, and in the IVRO group the lower incisors extruded as the mandible moved backward and downward which makes the genial angle and the mandibular plane angle significantly increased
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.43
no.3
/
pp.152-159
/
2017
Objectives: The aim of this study was to investigate the effects of advancement magnitude and changes in mandibular plane angle on the stability of mandibular advancement. Materials and Methods: This retrospective cohort study evaluated the postoperative stability of mandibular advancement in class II skeletal subjects who underwent bilateral sagittal split osteotomy. Radiographs taken preoperatively, immediately postoperatively and 1 year postoperatively were traced and analyzed using linear and angular measurements. To determine horizontal and vertical relapse, an X-Y coordinate system was established in which the X-axis was constructed by rotating S-N downward by $7^{\circ}$ (approximation of the Frankfort horizontal plane) and the Y-axis was defined as a line perpendicular to the X-axis and passing through the point Sella. For certain reference points including point A, point B, pogonion and menton, the perpendicular distance between each point and both axes was determined and cephalometric variables were recorded as X and Y coordinates. Results: Twenty-five subjects were studied. A significant correlation between the amount of mandibular advancement and relapse in the B point (vertical and horizontal) and the pogonion point was observed (vertical and horizontal, P<0.001). Evaluation of data demonstrated a positive correlation between the mandibular plane angle (SN/ML) change and vertical relapse in the B point (P<0.05). A simple regression model demonstrated that 74% of horizontal relapse and 42.3% of vertical relapse in the B point was related to the amount of mandibular advancement. The receiver operating characteristic test showed that 8.5 mm mandibular advancement is related to a relapse rate of 1 mm or more in the pogonion, vertically or horizontally. Conclusion: The magnitude of mandibular advancement is a stronger surgical predictor for horizontal rather than vertical relapse at the B point. Changes in mandibular plane angle (SN/ML) during surgery affect vertical, but not horizontal relapse at the B point.
Objective : The purpose of this study was to investigate the biomechanical properties of shock absorption strategy and postural stability during the drop landing for each types. Methods : The motions were captured with Vicon Motion Capture System, with the fourteen infra-red cameras (100Hz) and synchronized with GRF(ground reaction force) data(1000Hz). Ten male soccer players performed a drop landing with single-leg and bi-legs on the 30cm height box. Dependent variables were the CoM trajectory and the Joint Moment. Statistical computations were performed using the paired t-test and ANOVA with Turkey HSD as post-hoc. Results : The dominant leg was confirmed to show a significant difference between the left leg and right leg as the inverted pendulum model during Drop Landing(Phase 1 & Phase 2). One-leg drop landing type had the higher CoM displacement, the peak of joint moment with the shock absorption than Bi-leg landing type. As a lower extremity joint kinetics analysis, the knee joint showed a function of shock absorption in the anterior-posterior, and the hip joint showed a function of the stability and shock absorption in the medial-lateral directions. Conclusion : These findings indicate that the instant equilibrium of posture balance(phase 1) was assessed by the passive phase as Class 1 leverage on the effect of the stability of shock absorption(phase 2) assessed by the active phase on the effect of Class 2 leverage. Application : This study shows that the cause of musculo-skeletal injuries estimated to be focused on the passive phase of landing and this findings could help the prevention of lower damage from loads involving landing related to the game of sports.
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