• 대한치과교정학회지
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• 제42권2호
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• pp.56-63
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• 2012

Objective: To identify the right and left difference of the facial soft tissue landmarks three-dimensionally from the subjects of normal occlusion individuals. Materials and Methods: Cone-beam computed tomography (CT) scans were obtained in 48 normal occlusion adults (24 men, 24 women), and reconstructed into 3-dimensional (3D) models by using a 3D image soft ware. 3D position of 27 soft tissue landmarks, 9 midline and 9 pairs of bilateral landmarks, were identified in 3D coordination system, and their right and left differences were calculated and analyzed. Results: The right and left difference values derived from the study ranged from 0.6 to 4.6 mm indicating a high variability according to the landmarks. In general, the values showed a tendency to increase according to the lower and lateral positioning of the landmarks in the face. Overall differences were determined not only by transverse differences but also by sagittal and vertical differences, indicating that 3D evaluation would be essential in the facial soft tissue analysis. Conclusions: Means and standard deviations of the right and left difference of facial soft tissue landmarks derived from this study can be used as the diagnostic standard values for the evaluation of facial asymmetry.

• 대한치과의사협회지
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• 제54권3호
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• pp.217-229
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• 2016

Purpose: The aim of this study was to evaluate the soft-tissue change after the maxillary protraction therapy using threedimensional (3D) facial images. Materials and Methods: This study used pretreatment (T1) and posttreatment (T2) 3D facial images from thirteen Class III malocclusion patients (6 boys and 7 girls; mean age, $8.9{\pm}2.2years$) who received maxillary protraction therapy. The facial images were taken using the optical scanner (Rexcan III 3D scanner), and T1 and T2 images were superimposed using forehead area as a reference. The soft-tissue changes after the treatment (T2-T1) were three-dimensionally calculated using 15 soft-tissue landmarks and 3 reference planes. Results: Anterior movements of the soft-tissue were observed on the pronasale, subnasale, nasal ala, soft-tissue zygoma, and upper lip area. Posterior movements were observed on the lower lip, soft-tissue B-point, and soft-tissue gnathion area. Vertically, most soft-tissue landmarks moved downward at T2. In transverse direction, bilateral landmarks, i.e. exocanthion, zygomatic point, nasal ala, and cheilion moved more laterally at T2. Conclusion: Facial soft-tissue of Class III malocclusion patients was changed three-dimensionally after maxillary protraction therapy. Especially, the facial profile was improved by forward movement of midface and downward and backward movement of lower face.

• 대한치과교정학회지
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• 제50권2호
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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.

• 대한치과교정학회지
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• 제41권6호
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• pp.411-422
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• 2011

브라켓의 접착에 의한 입술 주위 연조직의 변화를 평가하기 위하여 심한 골격적 부조화가 존재하지 않는 18세 이상, 29세 미만의 성인 환자 중 포괄적 교정 치료를 위하여 상, 하악 치아의 순측에 브라켓을 접착한 45명을 대상으로 3차원 레이저 스캐너를 이용하여 브라켓의 접착 직전과 직후의 3차원 입체 영상을 획득하였다. 브라켓의 접착 전후 입술 및 입술 주위 연조직의 변화를 3차원 좌표계 상에서 분석하였다. 3차원 변화량(distance: 동일 계측점 간의 변화에 대한 최단 거리)에서 유의성을 보인 모든 계측점에서 전방 변화량이 가장 크게 나타났으며, 측면 계측점들은 측방으로 유의성 있는 변화가 나타났다. 상순의 계측점들은 상방으로, 하순의 계측점들과 B'는 하방으로 유의성 있는 변화가 나타났다. 하순의 Li (labrale inferius)에서 1.39 mm로 가장 큰 변화가 나타났고 ($p$ < 0.01), Li Rt (labrale inferius right), Li Lt (labrale inferius left)에서 1.15 mm, 1.09 mm의 변화가 나타났다 ($p$ < 0.01). 상순의 양측 ULP (upper lip point), Ls (labrale superius), Ls Rt (labrale superius right), Ls Lt (labrale superius left)에서 0.81 mm, 0.85 mm, 0.82 mm, 0.97 mm, 0.92 mm의 변화를 보여 ($p$ < 0.01), 하순에 비하여 상순의 변화가 작게 나타났다. 양측 Ch (cheilion)과 Stm (stomion)에서 1.17 mm, 1.16 mm, 1.02 mm ($p$ < 0.01), Sn (subnasale)와 B' (soft tissue B point)에서 0.46 mm, 0.63 mm ($p$ < 0.01, $p$ < 0.05)의 변화가 나타났다. 브라켓의 종류에 따른 연조직 변화량은 차이가 나타나지 않았다. 이상의 결과는 성인 교정 환자에서 브라켓의 접착에 의한 입술 및 입술 주위 연조직 변화의 예측에 참고 자료가 될 것이다.

• 대한치과교정학회지
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• 제36권1호
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• pp.1-13
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• 2006

3차원 레이저 스캐너는 두개안면부의 입체적인 영상을 구성할 수 있을 뿐만 아니라 컴퓨터의 조작을 통해 관찰이 용이하도록 원하는 위치로 회전과 축의 조정이 가능하여 면밀한 연조직 분석이 가능하다. 이에 본 연구에서는 Vivid 900 (Minolta, Tokyo, Japan) 3차원 레이저 스캐너와 Rapidform 프로그램 (Inus Technology Inc., Seoul, Korea)을 이용하여 마네킨의 3차원 영상을 채득하여 촬영 과정의 오차를 평가하고 3차원 레이저 스캔 영상의 정밀도 및 확대율을 평가하였으며, 마네킨과 정상교합자, 제II급 부정교합자, 제III급 부정교합자의 3차원 레이저 스캔 영상에서 지정이 용이하고 반복 재현성이 높은 연조직 계측점을 제안하고자 하였다. 마네킨을 6회 반복 촬영한 결과 촬영 과정에서의 평균 오차는 X축은 0.16 mm, Y축은 0.15 mm, Z축은 0.15 mm였다. 마네킨의 실측치와 3차원 스캔 영상에서의 계측치를 비교하여 본 결과, 평균오차 0.37 mm, 확대율 0.66%로 나타났다. 3차원 스캔 영상에서 마네킨의 오른쪽 연조직 gonion을 제외한 26개의 연조직 계측점의 평균 오차가 2.0 mm를 넘지 않았으며 glabella, 연조직 nasion, endocanthion, exocanthionm, pronasale, subnasale, nasal alare, upper lip point, cheilion, lower lip point, 연조직 B point, 연조직 pogonion, 연조직 menton, preaurale 등이 평균 오차가 적었다. 제안된 연조직 계측점들은 3차원 레이저 영상에서 반복 재현성이 높고 지정이 용이하며 안면의 해부학적 특징을 나타내주는 점들로 두개안면 구조의 3차원적인 연조직의 분석을 위해 유용하게 사용될 수 있을 것이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권1호
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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.

• 대한치과교정학회지
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• 제43권4호
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• pp.178-185
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• 2013

Objective: To standardize the facial soft-tissue characteristics of South Korean adults according to gender by measuring the soft-tissue thickness of young men and women with normal facial profiles by using three-dimensional (3D) reconstructed models. Methods: Computed tomographic images of 22 men aged 20 - 27 years and 18 women aged 20 - 26 years with normal facial profiles were obtained. The hard and soft tissues were three-dimensionally reconstructed by using Mimics software. The soft-tissue thickness was measured from the underlying bony surface at bilateral (frontal eminence, supraorbital, suborbital, inferior malar, lateral orbit, zygomatic arch, supraglenoid, gonion, supraM2, occlusal line, and subM2) and midline (supraglabella, glabella, nasion, rhinion, mid-philtrum, supradentale, infradentale, supramentale, mental eminence, and menton) landmarks. Results: The men showed significantly thicker soft tissue at the supraglabella, nasion, rhinion, mid-philtrum, supradentale, and supraglenoid points. In the women, the soft tissue was significantly thicker at the lateral orbit, inferior malar, and gonion points. Conclusions: The soft-tissue thickness in different facial areas varies according to gender. Orthodontists should use a different therapeutic approach for each gender.

• 대한치과교정학회지
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• 제35권6호
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• pp.409-419
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• 2005

최근 들어 3차원 전산화 단층 촬영(CT, Computed Tomography) 영상을 이용한 진단기법의 개발을 위한 연구가 활발히 진행되고 있으며 여러 분야에서 3차원적인 두개악안면 분석의 필요성이 증대되고 있다. 특히 교정 치료나 악교정 수술 후의 결과에 있어서 안면 연조직의 분석은 필수적이라 할 것이다. 본 연구에서는 정상교합을 가진 성인 남자 12명, 성인 여자 11명의 CT 영상을 촬영하여 개인용 컴퓨터 상에서 V works 4.0 프로그램(Cybermed Inc., Seoul, Korea)으로 3차원 CT 연조직 영상을 재구성한 후에 soft tissue Nasion을 기준 원점으로 하는 3차원 좌표평면의 좌표계를 설정하여 정중선상의 soft tissue Nasion. Pronasale, Subnasale, Upper lip center, Lower lip center, soft tissue B. soft tissue Pogonion. soft tissue Menton 등 8개의 계측점과 양측성인 Eudocanthion, Alare lateralis, Cheilion, soft tissue Gonion, Tragus. Zygomatic point등 총 20개의 재현 가능한 안면 연조직의 계측점을 지정하였으며 V surgery 프로그램(Cybermed Inc., Seoul Korea)을 이용하여 이들 계측점의 3차원적인 좌표와 기준 원점으로부터 각 계측점까지의 Net (${\delta}=\sqrt{{X^2}+{Y^2}+{Z^2}}$) 값의 평균과 표준편차를 구하였다. 안면 연조직 분석의 3차원적인 이해를 돕기 위해 주요 계측점 간의 거리 계측을 시행하였고, 그 결과 Na'-Sn과 En (Rt)-En(Lt)를 제외한 대부분의 계측값에서 남녀간의 유의한 차이가 있었으며, 2차원적인 두부 방사선 규격사진이나 안면 사진으로는 정확한 계측이 어려웠던 Na'-Zy, Na'-Ch, Na'-Go'(facial depth) 등의 정상치도 구하였다. 이상의 자료는 부정교합 환자와 악안면 기형 환자의 3차원적인 진단 및 치료 계획에 참고자료로 사용될 수 있을 것이다.

• 대한치과교정학회지
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• 제53권6호
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• pp.402-419
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• 2023

Objective: This study assessed the differences in soft tissue deviations of the nose, lips, and chin between different mandibular asymmetry types in Class III patients. Methods: Cone-beam computed tomography data from 90 Class III patients with moderate-to-severe facial asymmetry were investigated. The sample was divided into three groups based on the extent of mandibular rolling, yawing, and translation. Soft tissue landmarks on the nose, lips, and chin were investigated vertically, transversely, and anteroposteriorly. A paired t test was performed to compare variables between the deviated (Dv) and nondeviated (NDv) sides, and one-way analysis of variance with Tukey's post-hoc test was performed for intergroup comparisons. Pearson's correlation coefficient was calculated to assess the relationship between the soft and hard tissue deviations. Results: The roll-dominant group showed significantly greater differences in the vertical positions of the soft tissue landmarks between the Dv and NDv than other groups (P < 0.05), whereas the yaw-dominant group exhibited larger differences in the transverse and anteroposterior directions (P < 0.05). Moreover, transverse lip cant was correlated with the menton (Me) deviation and mandibular rolling in the roll-dominant group (P < 0.001); the angulation of the nasal bridge or philtrum was correlated with the Me deviation and mandibular yawing in the yaw-dominant group (P < 0.01). Conclusions: The three-dimensional deviations of facial soft tissue differed based on the mandibular asymmetry types in Class III patients with similar amounts of Me deviation. A precise understanding of soft tissue deviation in each asymmetry type would help achieve satisfactory facial esthetics.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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• pp.457-463
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• 2011

Introduction: This study evaluate the soft tissue changes to the upper lip and nose after Le Fort I maxillary posterosuperior rotational movement. Materials and Methods: Twenty Skeletal class III patients, who had undergone bimaxillary surgery with a maxillary Le Fort I osteotomy and bilateral sagittal split ramus osteotomy, were included in the study. The surgical plan for maxilla was posterosuperior rotational movement, with the rotation center in the anterior nasal spine (ANS) of maxilla. Soft and hard tissue changes were measured by evaluating the lateral cephalograms obtained prior to surgery and at least 6 months after surgery. For cephalometric analysis, four hard tissue landmarks ANS, posterior nasal spine [PNS], A point, U1 tip), and five soft tissue landmarks (pronasale [Pn], subnasale [Sn], A' Point, upper lip [UL], stomion superius [StmS]) were marked. A paired t test, Pearson's correlation analysis and linear regression analysis were used to evaluate the soft and hard tissue changes and assess the correlation. A P value <0.05 was considered significant. Results: The U1 tip moved $2.52{\pm}1.54$ mm posteriorly in the horizontal plane (P<0.05). Among the soft tissue landmarks, Pn moved $0.97{\pm}1.1$ mm downward (P<0.05), UL moved $1.98{\pm}1.58$ mm posteriorly (P<0.05) and $1.18{\pm}1.85$ mm inferiorly (P<0.05), and StmS moved $1.68{\pm}1.48$ mm posteriorly (P<0.05) and $1.06{\pm}1.29$ mm inferiorly (P<0.05). The ratios of horizontal soft tissue movement to the hard tissue were 1:0.47 for the A point and A' point, and 1:0.74 for the U1 tip and UL. Vertically, the movement ratio between the A point and A' point was 1:0.38, between U1 tip and UL was 1:0.83, and between U1 tip and StmS was 1:0.79. Conclusion: Posterosuperior rotational movement of the maxilla in Le Fort I osteotomy results in posterior and inferior movement of UL. In addition, nasolabial angle was increased. Nasal tip and base of the nose showed a tendency to move downward and showed significant horizontal movement. The soft tissue changes in the upper lip and nasal area are believed to be induced by posterior movement at the UL area.