• The korean journal of orthodontics
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• v.50 no.2
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• pp.75-85
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• 2020

Objective: The aim of this study was to evaluate changes in the nasal soft tissues, including movements of landmarks, changes in linear distances, and volumetric changes, using three-dimensional (3D) stereophotogrammetry after microimplant-assisted rapid palatal expansion (MARPE) in adult patients. Methods: Facial data were scanned using a white light scanner before and after MARPE in 30 patients. In total, 7 mm of expansion was achieved over a 4-week expansion period. We determined 10 soft tissue landmarks using reverse engineering software and measured 3D vector changes at those points. In addition, we calculated the distances between points to determine changes in the width of the nasal soft tissues. The volumetric change in the nose was also measured. Results: All landmarks except pronasale and subnasale showed statistically significant movement on the x-axis. Pronasale, subnasale, alar right, and alar left showed significant movement on the y-axis, while all landmarks except subnasale showed significant movement on the z-axis. The alar base width, alar width, and alar curvature width increased by 1.214, 0.932, and 0.987 mm, respectively. The average volumetric change was 993.33 ㎣, and the amount of increase relative to the average initial volume was 2.96%. Conclusions: The majority of soft tissue landmarks around the nasal region show significant positional changes after MARPE in adults. The nose tends to widen and move forward and downward. The post-treatment nasal volume may also exhibit a significant increase relative to the initial volume. Clinicians should thoroughly explain the anticipated changes to patients before MARPE initiation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.3
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• pp.217-227
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• 1992

The purpose of this paper is to investigate changes in soft tissue in 22 patients treated by vertical ramus osteotomy and sagittal split ramus osteotomy for the correction of mandibular prognathism. 22 individuals, 12 males and 10 females, were selected from the patients with mandibular prognathism at the Department of Oral and Maxillofacial Surgery, Colledge of Dentistry, Kyung Hee University. Patient were analyzed with cephalogram taken 1 week before and at least 6 weeks after surgery under the same condition. Measurements were made constructed hard tissue and sop tissue points located on each before-and-after film tracing. Comparision were made of these figures to estimate the amount that the soft tissue followed the hard tissue structures in each surgical procedure : ratio of sop and hard tissue changes were formulated. The results were as follows. 1. The horizontal changes of Pogs and Bs as a ratio of the horizontal changes of Pog and B point were 1.02 and 1.16 respectively. 2. One millimeter of posterior changes at Pog resulted in 0.86mm of posterior change at Li and 0.09mm of posterior change at Ls. The greatest amount of sop tissue change occurred at Pogs, with substantially less posterior displacement at Bs, even less at Li and at least at Ls. 3. The ratio of LI to Li was 1:0.81 and the ratio of LI to Ls was not significant.(1 : 0.17) 4. The ULA(Cm-Sn-Ls) and the relative lower lip projection (LLP) was incnease4 but the relative upper lip projection (ULP) was slightly decreased 5. The angular change of the upper lip inclined angle (Ls-Sn/ANS-PNS) and lower lip inclined angle(Li-Pogs/Me-Go) expressed as a ratio of the posterior change of Pog were 0.57 and 0.20 respectively. 6. The ratio of the lower anterior facial height change of the soft tissue(Sn-Mes) to the hard tissue(ANS-Gn) were 0.78 and and the ratio of vertical height changes of the hard tissue and sop tissue to the posterior change of the Pog were 0.18 and 0.19 respectively. 7. The sop tissue angular change of facial convexity(G-Sn-Pogs) expressed as a ratio of the angular change of the hard tissue angle of facial convexity(N-A-Pog) was 1.24.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.5
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• pp.311-319
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• 2012

Purpose: The aim of this study is to evaluate the vertical changes of the lip and perioral soft tissue, following orthognathic surgery in skeletal class III patients by a cephalometric analysis of a cone beam computed tomography (CBCT). Methods: A total of 20 skeletal class III patients, who had bimaxillary surgery with Le Fort 1 osteotomy and bilateral sagittal split ramus osteotomy, were included in this study. The surgical plan for maxilla was posterosuperior impaction with the anterior nasal spine, as the rotation center. Further, the surgical plan for mandible was also posterosuperior movement. The soft tissue changes between lateral cephalogram and CBCT were compared. And the correlations between independent variables and dependent variables were evaluated. Results: There were no significant differences of the soft tissues changes between lateral cephalogram and CBCT. Upper lip philtrum length (SnLs), nasolabial angle increased and upper lip vermilion length (LsStms), lower lip length (StmiB'), lower lip vermilion length (StmiLi), lower lip philtrum length (LiB') and soft tissue lower facial height (SnMe') decreased after surgery. Change of SnLs (${\Delta}$SnLs) was influenced by vertical change of menton (${\Delta}$MeV), and change of LsStms (${\Delta}$LsStms) was influenced by upper lip thickness (ULT). Change of StmiLi' (${\Delta}$StmiLi') were influenced by preoperative overjet. Change of StmiB' (${\Delta}$StmiB') were influenced by preoperative overjet, vertical change of lower incisor (${\Delta}$L1V) and horizontal change of posterior nasal spine (${\Delta}$PNSH). Change of LiB' (${\Delta}$LiB') was influenced by ${\Delta}$L1V and ${\Delta}$PNSH. Change of SnMe' (${\Delta}$SnMe') was influenced by ${\Delta}$MeV, horizontal change of upper incisor (${\Delta}$U1H) and horizontal change of lower incisor (${\Delta}$L1H). ${\Delta}$Nasolabial angle was influenced by change of ULT (${\Delta}$ULT). Conclusion: Both soft tissues and hard tissues can be evaluated by CBCT. Posterosuperior rotation of maxillomandibular complex resulted in increase of upper lip philtrum length and nasolabial angle, while the upper lip vermilion length, lower lip philtrum length, lower lip vermilion length, and soft tissue lower facial height showed a decrease.

• The korean journal of orthodontics
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• v.44 no.6
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• pp.281-293
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• 2014

Objective: Esthetic improvements during orthodontic treatment are achieved by changes in positions of the lips and surrounding soft tissues. Facial soft-tissue movement has already been two-dimensionally evaluated by cephalometry. In this study, we aimed to three-dimensionally assess positional changes of the adult upper lip according to simulated maxillary anterior tooth movements by white light scanning. Methods: We measured changes in three-dimensional coordinates of labial landmarks in relation to maxillary incisor movements of normal adults simulated with films of varying thickness by using a white light scanner. Results: With increasing protraction, the upper lip moved forward and significantly upward. Labial movement was limited by the surrounding soft tissues. The extent of movement above the vermilion border was slightly less than half that of the teeth, showing strong correlation. Most changes were concentrated in the depression above the upper vermilion border. Labial movement toward the nose was reduced significantly. Conclusions: After adequately controlling several variables and using white light scanning with high reproducibility and accuracy, the coefficient of determination showed moderate values (0.40-0.77) and significant changes could be determined. This method would be useful to predict soft-tissue positional changes according to tooth movements.

• Archives of Plastic Surgery
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• v.42 no.4
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• pp.419-423
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• 2015

Background Orthognathic surgery is required in 25% to 35% of patients with a cleft lip and palate, for whom functional recovery and aesthetic improvement after surgery are important. The aim of this study was to examine maxillary and mandibular changes, along with concomitant soft tissue changes, in cleft patients who underwent LeFort I osteotomy and sagittal split ramus osteotomy (two-jaw surgery). Methods Twenty-eight cleft patients who underwent two-jaw surgery between August 2008 and November 2013 were included. Cephalometric analysis was conducted before and after surgery. Preoperative and postoperative measurements of the bone and soft tissue were compared. Results The mean horizontal advancement of the maxilla (point A) was 6.12 mm, while that of the mandible (point B) was -5.19 mm. The mean point A-nasion-point B angle was $-4.1^{\circ}$ before surgery, and increased to $2.5^{\circ}$ after surgery. The mean nasolabial angle was $72.7^{\circ}$ before surgery, and increased to $88.7^{\circ}$ after surgery. The mean minimal distance between Rickett's E-line and the upper lip was 6.52 mm before surgery and 1.81 mm after surgery. The ratio of soft tissue change to bone change was 0.55 between point A and point A' and 0.93 between point B and point B'. Conclusions Patients with cleft lip and palate who underwent two-jaw surgery showed optimal soft tissue changes. The position of the soft tissue (point A') was shifted by a distance equal to 55% of the change in the maxillary bone. Therefore, bone surgery without soft tissue correction can achieve good aesthetic results.

• Journal of Periodontal and Implant Science
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• v.28 no.3
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• pp.507-517
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• 1998

This study was performed to investigate the soft tissue changes around single implant-supported crowns during followup periods. Twenty patients(31 implants) whose single missing tooth in the maxillary anterior region had been replaced with an single implant-supported crown were recruited for the study. Crown length, soft tissue level and papilla height at the single implant-supported crowns were measured at follow-up examination and calculated from the slides taken at time of crown placement. as well Papilla index was scored from the slides taken at the time of crown placement and follow-up examination. A very little amount of recession occurred and the soft tissue level moved more apically and the papilla height increased significantly (p<0.01). Especially, both mesial and distal papilla index at single implant-supported crowns increased significantly during follow-up periods (p<0.001). When the two slides taken at the time of crown placement and follow-up were compared simultaneously, except one site, papillae size increased at all sites. From the results of the study, the interdental papillae at the single implant-supported crowns seemed to regenerate significantly and their crown margins were stable during follow-up periods. Hence it is indicated that various surgical interventions at on early stage to enhance soft tissue esthetics arourd single implants may be unnecessary.

• The korean journal of orthodontics
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• v.52 no.1
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• pp.42-52
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• 2022

Objective: This study compared soft tissue changes after extraction of the four premolars followed by maximum retraction of the anterior teeth according to the type of anterior teeth movement: tipping and translation. Methods: Patients who had undergone orthodontic treatment involving the extraction of four premolars were retrospectively selected and divided into either the tipping (n = 27) or translation (n = 26) groups based on the retraction of the incisor root apex and the axis changes of the incisors during the treatment period. Lateral pre- and post-treatment cephalograms were analyzed. Results: There were no significant differences between the tipping and translation groups before treatment. The retraction amounts of the root apex of the upper and lower incisors in the tipping group were 0.33 and 0.26 mm, respectively, and 5.02 and 5.31 mm, respectively, in the translation group (p < 0.001). The posterior movements of soft tissue points A and B in the tipping group were 0.61 and 1.25 mm, respectively, and 1.10 and 3.25 mm, respectively, in the translation group (p < 0.01). The mentolabial sulcus angle increased by 5.89° in the tipping group, whereas it decreased by 8.13° in the translation group (p < 0.001). Conclusions: An increased amount of retraction of the incisor root apex led to the increased posterior movement of soft tissue points A and B, and this appeared more distinct in cases involving the lower incisor and lower lip.

• The Journal of the Korean dental association
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• v.38 no.4 s.371
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• pp.369-377
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• 2000

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.187-197
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• 2005

The aim of this study was to investigate the influence of peri-implant soft tissue and bone thickness on the early dimensional change of peri-implant soft tissue. Seventy-seven non-submerged implants of 39 patients which had been loaded more than 6 months were selected for the study. Following clinical parameters were measured; bucco-lingual bone width of the alveolar bone for implant placement before implant surgery; distance between implant shoulder and the first bone/implant contact at the surgery; presence of plaque, probing depth, bleeding on probing, width of keratinized mucosa, mucosa thickness, distance between implant shoulder and peri-implant mucosa, crown margin location at follow-up examination. The results showed that distance between implant shoulder and peri-implant mucosa (DIM) was correlated with probing depth and width of keratinized mucosa (p < 0.05). In addition, mucosa thickness was also correlated with probing depth (p<0.05). However, the bone width of alveolar bone and soft tissue thickness were not found to be correlated with DIM. It is important to understand the meaning of peri-implant tissue dimension in relation to dimensional changes of peri-implant soft tissue which designates appearance of implant-supported restorations. Future study is needed to elucidate the significance of the buccal bone thickness and soft tissue thickness with respect to the change of peri-implant soft tissue margin with the use of an instrument capable of measuring buccal bone thickness directly.

• The korean journal of orthodontics
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• v.29 no.5 s.76
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• pp.627-635
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• 1999

Soft tissue changes that occurred between presurgery to 5-years post-surgery in 49 orthognathic surgery patients whose maxillae were moved upward by Le Fort I osteotomy were examined by lateral cephalometric film. The objective of this paper was to document soft tissue changes at long-term follow-up after superior repositioning of the maxilla and to relate soft tissue and hard tissue changes in this group. The results were as follows. 1. On average, soft tissue landmarks in the nose and the upper lip were not changed statistically significantly except superior movement of superior labial sulcus and forward movement of pronasale between presurgery and 5 years postsurgery. 2. Upward and forward movement of the lower lip were found at 5 years postsurgery in comparison with presurgery and genioplasty added this effects. 3. Upper lip length and vertical dimension of upper vermilion didn't show any significant changes, but increase of lower lip length and decrease of vertical dimension of lower vermilion were statistically significant between presurgery and 5 years post-surgery. 4. The decrease of upper incisor exposure and interlabial distance from presurgery to 1 year were continued from 1 year to 5 years and the amount of the decrease was more than that of vertical movement of the maxilla by surgery. 5. Long term changes in soft tissue landmarks from 1 to 5 years postsurgery exceeded hard tissue changes, meaning soft tissue moved down more than skeletal changes.