• The korean journal of orthodontics
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• v.13 no.2
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• pp.193-199
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• 1983

The purpose of orthodontic treatment is to produce functional occlusion and to create or maintain facial esthetic harmony. The soft-tissue covering of the face also plays an important role in facial esthetics, speech and other physiologic functions. The study of the soft-tissue profile is important for the planning of orthodontic treatment. The author studied cephalometric X-ray films on 49 patients (23boys, 26 girls) with Angle's class II division 1 malocclusion, ranged from 9 to 13 years of age. Roentgenocephalmetric X-ray films were taken pre and post orthodontic care. Tracings were made in usual manner. The obtained results were as follow. 1. There was no significant sexual difference on mean changes. 2. In the comparison of the soft-tissue thickness changes, Ls-Ls' and Si-Si' in male subjects were remarkable. 9. There were significant correlations between osseous (Ss') change and soft-tissue (Ss) chang, of maxilla in male and female subjects subsequent to orthodontic treatment. 4. The ratios between the protraction of the Ss' and that of the Ss were 1:1.5 in all sexes, the ratios between the Si' and that of the Si were 1:1.4 in male and 1:1.2 in female. 5. There were significant correlations between maxillary central incise. angulation change $({\angle}A)$ and upper lip inclination change $({\angle}B)$ in all sexes. 6. There were little correlations between change in distance difference of Is and Ii and change in distance difference of Ls and Li in all sexes in all sexes.

• The korean journal of orthodontics
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• v.53 no.1
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• pp.54-64
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• 2023

This case report describes skeletal anchorage-supported maxillary protraction performed with the Alternate Rapid Maxillary Expansion and Constriction (AltRAMEC) protocol over a treatment duration of 14 months in a 16-year-old female patient who was in the late growth-development period. Miniplates were applied to the patient's aperture piriformis area to apply force from the protraction appliance. After 9 weeks of following the Alt-RAMEC protocol, miniplates were used to transfer a unilateral 500-g protraction force to a Petit-type face mask. A significant improvement was observed in the soft tissue profile in measurements made both cephalometrically and in three dimensional photographs. Subsequently, the second phase of fixed orthodontic treatment was started and the treatment was completed with the retention phase. Following treatment completion, occlusion, smile esthetics, and soft tissue profile improved significantly in response to orthopedic and orthodontic treatment.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.614-621
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• 2021

Background Reconstruction of congenital microtia remains challenging, particularly in patients with a history of ear canaloplasty due to insufficient regional soft tissue. The insertion of a tissue expander prior to implantation of the cartilage framework has traditionally been employed. However, this procedure could induce additional morbidity. Herein, we present a method using V-Y advancement of a temporal triangular flap to gain additional soft tissue in these challenging cases. Methods Congenital microtia patients with a history of ear canaloplasty who underwent auricular reconstruction using the Nagata technique between 2016 and 2020 were reviewed. To obtain additional soft tissue, V-Y advancement of a temporal triangular flap was performed concurrently with implantation of the costal cartilage framework, without prior insertion of a tissue expander. The outcomes of these patients with respect to postoperative complications and esthetics were evaluated. Results Eight patients with bilateral lesions were included. No specific complications developed after the first-stage surgery. However, one patient experienced complications after the second stage (auricular elevation). An analysis of the esthetic results showed most patients had excellent outcomes, achieving a satisfactory convolution. The median number of operations needed to complete reconstruction was 2, which was fewer than required using the conventional method with prior insertion of a tissue expander. Conclusions In patients with a history of previous canaloplasty, V-Y advancement of a temporal triangular flap could serve as an alternative to tissue expansion for microtia reconstruction. This technique provided reliable and satisfactory results with a reduced number of surgical stages.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.4137-4140
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• 2012

The authors present five cases of combined oral mucosa-mandible defects reconstructed with the vascularized internal oblique-iliac crest myoosseous free flap. This technique has many advantages compared to other conventional methods such as the radial flap, scapula flap, and fibula flap. Vascularized iliac crest flaps provide sufficient high-quality bone suitable for reconstructing segmental madibular defects. Although fibular flaps allow longer donor bone tissue to be harvested, the iliac crest can provide an esthetic shape for mandibular body reconstruction and also provides sufficient bone height for dental implants. Conventional vascularized iliac crest myoosseous flaps have excessive soft tissue bulk for reconstruction of intraoral soft tissue defects. The modification discussed in the present article can reduce soft tissue volume, resulting in better functional reconstruction of the oral mucosa. Another advantage is that complete replacement of the oral mucosa is observed in as early as one month post-operation. The final mucosal texture is much better than that obtained with other skin paddle flaps, which is especially beneficial for the placement of dental implant prostheses. Donor site morbidity looks to be similar to, if not less than that observed for other modalities in terms of function and esthetics. For combined oral mucosa-mandible defects, the vascularized internal oblique-iliac crest myoosseous free flap shows good results with respect to hard and soft tissue reconstruction.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.1
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• pp.21-26
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• 2006

Considering the skeletal class III malocclusion that complains of mandibular prognathism, there have been some studies of the mandibular change for comparing the changes of pre operative with post operative state. Nowadays it is common to do the orthognathic 2-jaw surgery for the correction of the maxillary deficiency, the post operative stability and the esthetics. We compare and analyze the changes of soft tissue around the nose and the lip with the changes in the direction and the amount of maxilla. Patients who were diagnosed as maxillofacial deformity and received orthognathic surgery of both jaws at Yongdong Severance hospital from 2001 through 2003 were included in this study. Their lateral cephalograms were analyzed, and the post operative change of hard tissue and soft tissue were studied. Upon analyzing the preoperative cephalograms and 6 month post operative cephalograms, there were significant in the vertical change of Labialis superius(Ls) and Stomion(Stm) in soft tissue in relation to the vertical change of skeletal landmarks (Anterior Nasal Spine, Subspinale, Prosthion, Incision Superious). In addition, there were no significance in horizontal movement of the skeletal landmarks among groups. In terms of hard tissue landmarks, group 3(maxillary posterior impaction and advancement surgery group) showed significantly greater change in the vertical movement of Anterior Nasal Spine(ANS), Subspinale(A), Prosthion(Pr), and Incision Superious(Is) compared with other groups. In terms of soft tissue change, group 3 showed more significant change in the vertical movement of Ls and Stm. This study calculated the changes of the skeletal and soft tissue landmarks in order to act as a guide in planning and performing the surgery and as a reference in predicting the postoperative change of facial appearance.

• The Journal of the Korean dental association
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• v.54 no.2
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• pp.123-133
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• 2016

Currently increasing use of implants, especially in anterior implant esthetics has become a major concern for both the patient and dentist. In the case of thin biotype if the thickness of the gingival soft tissue is less than 2mm, human eye can detect differences of colors depends on underlying materials. The zirconia abutment can be use not only for better esthetics but also for the hygienic because it is less attractive for the plaque deposition when it compare to the metals. Zirconia itself has many advantages as a biomaterial but also has frequent mechanical problems when it use for abutment of internal connection implant. For prevention or reduction of mechanical failures, use of titanium-link with zirconia super-structure which part that connects directly into the implant can be a good alternative. In this literature, I would like to review the clinical considerations of use of titanium link - CAD/CAM zirconia abutment for dental implant in esthetically important areas.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.23 no.2
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• pp.70-76
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• 2014

After extraction of tooth, alveolar ridge resorption is inevitable in most cases. Clinicians confront with horizontal and vertical resorption of alveolar bone. Without massive amount of bone and soft tissue graft, dental implant will be placed apically to gain stability. In those cases, not only white esthetic part, but also pink esthetic part should be restored with pink porcelain. The margin of prosthesis should be located apically to reproduce natural look with adjacent teeth. However, when the margin is located apically, it is always hard to remove remaining cement, thus complications may arise. In this report, a novel design of implant prosthesis is introduced to solve those issues. The novel design is consisted of zirconia framework with pink porcelain and separate crowns on top of the framework. It eliminates the possibility of cement remnants by bringing the crown margin coronally. Pink esthetic part is incorporated in abutment part instead of crown part and the screw hole is covered with separate crowns.

• The Journal of the Korean dental association
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• v.51 no.11
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• pp.586-594
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• 2013

The critical factors affecting the esthetics of anterior implants can be summarized as following: 1) Correct positioning of implant fixture 2) Enough amount of alveolar bone 3) Optimum volume of soft tissue. The position of implant is probably the most important factor in obtaining esthetic treatment outcome. The 3-dimensional orientation of implant is determined by the position on the alveolar ridge and its direction. Clinicians often try to mimic natural teeth when fabricating restorations. During the course of esthetic diagnosis and treatment, however, one should not forget to consider the correlation between facial pattern, lips, gingiva, alveolar ridge, as well as remaining dentition. Since anterior region is biologically unfavorable when compared with posterior region, one minor discrepancy in positioning of implant can cause esthetically undesirable treatment outcome. If one understands the biological and prosthetic meaning of implant's 3-dimensional position, he or she can achieve superior esthetic outcome in anterior region.

• The korean journal of orthodontics
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• v.47 no.1
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• pp.31-38
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• 2017

Objective: This study aimed to quantitatively assess the relationship of smile esthetic variables with various types of malocclusion, and identify the cephalometric factors affecting smile measurements. Methods: This retrospective study included 106 patients who were treated with retention at the orthodontic department of Taipei Medical University Hospital. Hard-tissue variables were measured using lateral cephalographic tracings, and nine smile esthetic variables were measured using facial photographs. The patients were divided into three groups according to their overjet (< 0, 0-4, and > 4 mm). An analysis of variance was conducted to compare the pretreatment cephalometric variables and smile esthetic variables among the three groups. Multiple linear regression analysis was performed to identify the cephalometric factors affecting the smile measurements in each group. Results: Except the upper midline and buccal corridor ratio, all of the smile measurements differed significantly among the three groups before orthodontic treatment. Some of the smile characteristics were correlated with the cephalometric measurements in different types of malocclusion. The overjet was the major factor influencing the smile pattern in all three types of malocclusion. Conclusions: Smile characteristics differ between different types of malocclusion; the smile may be influenced by skeletal pattern, dental procumbency, or facial type. These findings indicate that establishment of an optimal horizontal anterior teeth relationship is the key to improving the smile characteristics in different types of malocclusion.

• 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.