Pak, Choong-Je;Kim, Hyun-Jung;Nam, Soon-Hyeun;Kim, Young-Jin
Journal of the korean academy of Pediatric Dentistry
/
v.21
no.2
/
pp.540-546
/
1994
The authors treated three patients who chiefly complained functional anterior crossbite due to premature loss of primary molars by using removable space maintainer and functional appliances. In orthodontic practice, the mandibular rest position and the possibility of taking construction bite have been as the criteria for evaluation of functional factors involved in anterior crossbite. Functional anterior crossbites, if left untreated, may have deleterious effects on the development and function of craniofacial complex and TMJ. Objectives of the treatment were as follows: 1) to recover vertical dimension 2) to eliminate functional disharmony 3) to correct anterior reversed occlusion 4) to attain good facial esthetics 5) to prevent unfavorable growth of jaw & dentition Characterized craniofacial morphology resulting from the premature loss of deciduous molars could be recovered following the correction of crossbite. Therefore, it is recommended that in orthodontic diagnosis of functional anterior crossbite due to premature loss of deciduous molars, the craniofacial abnormality affected by that should be considered.
A Skeletal Class III malocclusion may be the result of a large mandible, a small maxilla or combination of the two. Protraction devices for the maxilla are used to promote the growth of a deficient maxilla by applying extraoral force to actively growing patients. This study has been performed to determine whether there are significant differences in skeletal and dental changes between FH/Pal 1 and FH/Pal 2 group, SNA 1 and SNA 2 group, SNB 1 and SNB 2 group, and LFH 1 and LFH 2 group after RME and facial mask therapy. The results of this study can be summarized and concluded as follows ; 1. In all patients after maxillary protraction, the maxilla and maxillary dentitions moved forward, and the mandible rotated backward and downward. In most of them, palatal plane is tends to have an upward inclination. 2. The FH/Pal group 1, having an upward inclination of the palatal plane as a result of Facial mast showed statistically significant maxillary forward movement compared to the FH/Pal group 2. 3. The SNA group 1 showed significantly less mandibular backward movement and there was a tendency for the palatal plane to upward inclination compared to SNA group 2. 4. The SNB group 1 showed significantly less maxillary forward movement, but the vertical dimension, especially the lower facial height increased by mandibular downward rotation compared to SNB group 2. 5. LFH group 1, which had large saddle angle and posterior positioned mandible in the pre-treatment stage, showed maxillary protraction effect without significant increase in lower facial height compared to LFH group 2.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.26
no.6
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pp.636-643
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2000
Facial asymmetry is the most frequent disease in craniofacial deformities. And the primary causing area of that is mostly placing in mandible. That is to say, it is known that primarily, mandible grows excessively or deficiently, and other facial region involving maxilla undergoes compensatory growth secondarily, so asymmetric face develops. In facial asymmetry, the surgical correction of undergrowth is more difficult than that of overgrowth and the reason of it is the postoperative relapse caused by stress of surrounding soft tissues. It means the stress of surrounding soft tissues occurring after bone lengthening and reducing above stress is the same meaning with reducing postoperative relapse. Among various areas, mandibular ramus is the most difficult area to lengthen vertically and maintain its length. The reason of it is considered by many authors as the stress of surrounding pterygomasseteric sling which is enveloping lower border of mandible and interrupting elongation of ramal height. So we applied two different surgical procedures in which pterygomasseteric slings have different stress respectively to monkeys which have similar masticatory function and anatomy to human being and compared relapse by radiographic film and observed periodically the histochemical change of masseteric muscle fiber. So we could see the following results. The relapse was less in EVRO group in which we separated pterygomasseric sling in inferior border and didn't approximate muscle sling after vertical lengthening to minimize the stress of soft tissues than IVRO group in which we elongated ramal height preserving pterygomassetric sling. Of course, we could see a problem in EVRO group such as bone resorption in inferior border caused by uncovering the periosteum of inferior border. But we expect that such problem will be solved by developing periosteum substitutes for covering the exposed bone and minimizing the surgical trauma. In histochemical study of masseteric muscle fiber, the fiber constituents of EVRO group in which we minimized soft tissue stress was changed immediately after operation and maintained it for 1 year, whereas that of IVRO group in which we preserved soft tissue stress was changed in more portion after operation and recovered it by 1 year. By the histochemical results, we can see that the recovery of fiber constituents reflect the recovery of muscle stress and it is closely related with relapse phenomenon.
The purpose of this study was to assess the early effect of FR III on the growing patients with anterior cross-bite. The lateral cephalograms and models were obtained from 7 patients at the time of pretreatment and correction of anterior cross-bite. The results were as follows: 1. A slight tendency of rotation toward anterosuperior direction and the growth to anterior direction were shown in maxilla. 2. There were a little change of mandibular vertical position and increase in lower facial height although some variations existed. 3. The bodily or labial tipping movement was shown in maxillary incisors. 4. The lingual tipping of mandibular incisors was shown in all cases. 5. Maxillary arch width increased while mandibular arch width usually changed a little although some variations existed. But it was difficult to summary in a word because variable responses were noted according to a wide variety of skeletal type, growth, and malocclusion.
This study was conducted to examine the growth change in external nose according to age which plays an important role in determining the facial profile, by analysing the biennial serial lateral cephalograms of 20 males and 20 females of mean 8.5 years old to 16.5 years old who have a normal occlusion. The results of this study were summarized as follows. $\cdot$ Both mean and standard deviation were obtained according to each item, sex and age for the male and female. $\cdot$ Nose heights of the male and female increased with increase in their age. The upper to lower nose height ratio somewhat decreased for both male and female with increase of age. The mean ratio was 3.69 : 1 for the male, respectively, and 3.83 : 1 for the female during this study.$\cdot$ The nose depth indicated the most significant increase of all items according to the increase of age, while the sagittal depth inicated higher value for the female than that of the male in the most age groups. $\cdot$ The nose inclination did not show a remarkable change during this study. $\cdot$ The proportions of growth completed at the earliest age showed the highest percentage for sagittal depth(male : $87.14\%$ & female : $91.29\%$). Also, the male indicated the lowest percentage in lower nose height $(73.04\%)$, while the female did the lowest in nose depth$(79.09\%)$. $\cdot$ There was shown the variable of the greatest correlation between the upper nose inclination and nose depth. $\cdot$ From this study, the whole external nasal growth was occurred downward and forward which was more frequent for forward growth than vertical growth.
Purpose: To compare the size of the masseter and lateral pterygoid muscle between the affected and the unaffected side of the patients who have the chief complaints of the mandibular asymmetry. Materials and Methods: Twenty two patients (male: 4, female: 18, average age: 21.3 year-old) were radiographed using posterior-anterior (P-A) cephalography and computed tomography (CT). On P-A cephalography, the degree of deviation was determined by the distance from the mentum to the vertical reference line through the crista galli and the anterior nasal spine. On the scanned tracing papers of the maximum cross-sectional area of the masseter and lateral pterygoid muscle using axial CT images, the pixel number was measured. The ratio of the affected : unaffected sides were obtained. For the masseter and lateral pterygoid muscle, the relationship between the muscular volume and degree of skeletal hypoplasia was studied. Results : The half cases showed no skeletal asymmetry. The lateral pterygoid muscle of the affected side was larger significantly than unaffected side (p<0.05). However, there was no significant difference between two sides in the cases of skeletal asymmetry. There was only significant difference in the cases without skeletal asymmetry (p<0.05). Conclusions : To some extent, the slight mandibular hypoplasia could affect the growth of some masticatory muscles.
Secondary deformities of the lip and nose in individuals with repaired unilateral and bilateral clefts may vary in severity, depending on the state of the original defect, the care taken in the initial surgical procedure, the pattern of the patient's facial growth, and the effectiveness of interceptive orthodontic technique. Because each patient has a unique combination of deformities, their surgical reconstruction usually requires the modification and combination of several surgical techniques. Residual lip deformities after primary repair may be esthetic or functional and include scars, skin shortage or excess(vertical and transverse), orbicularis oris muscle malposition or diastasis. The key to accurate repair of secondary cleft lip deformities is a precise diagnosis. This requires observation of the patient in animation and repose. The quality of the scar is not the only factor determining the overall appearance of the lip. Observing the patient in the animated position is critical to assess muscular function. Factors that require precise analysis include lip length, the appearance of the Cupid's bow and philtrum, and nasal symmetry. Only after this detailed analysis can a decision be made as to wether a major or minor deformity exists. We report successful cases using various techniques for the secondary lip deformities.
Orthodontic patients are individuals that grow and develop ;therefore selection of the proper time for orthodontic treatment Is considered to be one of the most difficult and yet difficult factor.Since the development of cephalometric X-ray, amount and pattern of craniofacial growth change with aging could be predicted and became useful in the process of orthodontic treatment. The relationship between the mean values of cephalometric measurements and body height and weight was studied among the groups(boys and girls) of Korean children from the ages of 3-years to 12-years. 126 boys and 90 girls with no abnormality in growth and development and no history of orthodontic treatment from the ages of 3 years to 12 years were chosen as subjects: Cephalometric X-ray were taken for 2 years and hard tissue analysis based on Burstone's COGS, which was divided into measurements of 6 parts (Cranial base, Maxillar and Mandible, Vertical measurements, Horizontal measurements, Basal bone relationship, Dental measurements). The relationship between craniofacial growth and body height & weight was studied. The following conclusions were obtained : 1. The maximum growth in the measurements of cranial base, N-Ar(FH), N-Ba(FH) corresponded with the age with the maximum increasein body height & weight in both boys and girls. 2. Genial angle gradually decreased with aging in both boys and girls. 3. N-ANS(L) showed greater amount of growth than ANS-Me(L), and this had greater influence on facial profile. 4. $N-A-Pog^{\circ}$ decreased with aging, and mandibular growth exceeded maxillary growth in amount and rate. 5. Length of Y-axis increased, but Y-axis to FH plane remained constant. This show that mandible grows at a constant angulation to cranial base. 6. As Permanent teeth erupt, interincisal angle deceased.
To establish the diagnosis and treatment plan for skeletal Class II malocclusion, patient's skeletal morphology, prognosis as well as the treatment effect is one of the important factor to consider. Therefore, the present study classified analyzed the difference between initial(T1) and after use of activator(T2), and after finish of direct multi-bonding system treatment(T3) for Class II malocclusion during growth period according to the treatment result(effective body length) and morphology of vertical skeletal type. The experimental group was classified into two groups(1 group, 2 group) according to the effective body length change between before and after use of activator, showed good treatment effect of activator for patient with small mandible and large differential between maxilla and mandible, and short anterior facial height. And the difference between 1 and 2 group in the experimental group before treatment(T1) disappeared in the finished treatment(T3). But in contrast, the initial difference of T1 stage between a and b group in the control group did not disappear in the finished treatment(T3). In short, experimental group's treatment effect was much better than contrast group and the treatment effect was maintained and got stable results at comparison experimental group with contrast group. Through this study, we can find activator's treatment effect and stable retention of that in growing Class II malocclusion patients. By estimate of activator treatment effect through these results, we can establish the correct diagnosis and treatment plan for adolescent Class II malocclusion estimate of activator treatment effect and lead the ideal facial growth pattern.
The purpose of this study was to evaluate the differences of soft tissue profile changes between the growing patients and the adult who had passed the growth peak, in orthodontic treatment with four premolar extractions. The results which was taken by correlating the soft tissue changes with hard tissue changes, lip thickness, molar relationship and arch length discrepancy in both groups was like the followings. 1. Significant hard tissue changes were decrease of VIs, VIi, UlPP, LlMP, HIi and increase of HPog'in adults and decrease of VIs, VIi and increase of VA, VPog'and all the vertical measurements in adolescents. 2. Significant soft tissue changes were decrease of VLs, VLi, and VILS in adults and increase of VSn, VSLS, VLs, VPog' and almost all vertical measurements in adolescents, and ${\Delta}LsE,\;{\Denta}LiE$ in adults and ${\Delta}LsE,\;{\Denta}LiE,\;{\Delta}LiSP\;and\;{\Delta}Mang$ was also significant 3. Correlation coefficient between ${\Delta}VIs\;and\;{\Delta}VLs$ was the greatest in adults and the next was ${\Delta}Ii/{\Delta}Li,\;{\Delta}Ii/{\Delta}ILS,\;{\Delta}ID/{\Delta}Li\;and\;{\Delta}ID/{\Delta}ILS$. In contrast all the vertical and horizontal measurements of hard and soft tissue in adolescents showed statistically significant corerrlation. 4. There were differences in correlation between soft tissue changes and incisor inclination and retraction at both groups, but the lower lip, nasolabial angle and mentolabial angle were commonly less influenced by the hard tissue changes in both groups. 5. The thinner the upper lip was, the more the ${\Delta}LsSP$ was in both groups, and the thinner the lower lip was, the more the ${\Delta}LiE\;and\;{\Denta}LiSP$ was in adolescents. 6. Molar relationship didn't influence the soft tissue profile changes. 7. Arch length discrepancy didn't influence the soft tissue profile changes.
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