Objective: We sought to determine the predictors of midpalatal suture expansion by miniscrew-assisted rapid palatal expansion (MARPE) in young adults. Methods: The following variables were selected as possible predictors: chronological age, palate length and depth, midpalatal suture maturation (MPSM) stage, midpalatal suture density (MPSD) ratio, the sella-nasion (SN)-mandibular plane (MP) angle as an indicator of the vertical skeletal pattern, and the point A-nasion-point B (ANB) angle for anteroposterior skeletal classification. For 31 patients (mean age, 22.52 years) who underwent MARPE treatment, palate length and depth, MPSM stage and MPSD ratio from the initial cone-beam computed tomography images, and the SN-MP angle and ANB angle from lateral cephalograms were assessed. The midpalatal suture opening ratio was calculated from the midpalatal suture opening width measured in periapical radiographs and the MARPE screw expansion. Statistical analyses of correlations were performed for the entire patient group of 31 subjects and subgroups categorized by sex, vertical skeletal pattern, and anteroposterior skeletal classification. Results: In the entire patient group, the midpalatal suture opening ratio showed statistically significant negative correlations with age, palate length, and MPSM stage (r = -0.506, -0.494, and -0.746, respectively, all p < 0.01). In subgroup analyses, a strong negative correlation was observed with the palate depth in the skeletal Class II subgroup (r = -0.900, p < 0.05). Conclusions: The findings of this study indicated that age, palate length, and MPSM stage can be predictors of midpalatal suture expansion by MARPE in young adults.
The purpose of this study was to evaluate the initial skeletal pattern and growth change of whom had responsed well to chincap therapy. 93 patients seleted for this study were in mixed dentition and treated with chincap for more than 2 years. And 54 subjects were selected from these total samples and classified into two groups by the improvement of four measurements : ANB difference, APDI, Wits appraisal, and AF-BF. One was good response group which consisted of 26 children and the other was poor response group with 19 patients. Various measures of the craniofacial structure in the initial lateral cephalograms and the annual increments were calculated and analyzed by comparing two groups with t-test. The results were as follows : 1. Good response group had more horizontal growth pattern in initial stage of treatment than poor response group, and the contributing factors of this result were anterior posterior facial height ratio, gonial angle, lower genial angle and SN-mandibular plane angle. 2. The maxilla was positioned more anteriorly in good response group. 3. The amounts of vertical growth of maxilla was smaller but the horizontal growth of maxilla was larger in good response group. 4. The mandible rotated more infero-posteriorly in good response group. 5. The good response group had more vertical growth pattern of mandibular condyle.
Objective: The purpose of this study was to investigate whether the craniofacial patterns of Korean children with snoring and adenotonsillar hypertrophy (ATH) could be categorized into characteristic clusters according to age. Methods: We enrolled 236 children with snoring and ATH (age range, 5-12 years) in this study. They were subdivided into four age groups: 5-6, 7-8, 9-10, and 11-12 years. Based on cephalometric analysis, the sagittal and vertical skeletal patterns of each individual were divided into Class I, II, and III, as well as the normodivergent, hypodivergent, and hyperdivergent patterns, respectively. Cluster analysis was performed using cephalometric principal components in addition to the age factor. Results: Three heterogeneous clusters of craniofacial patterns were obtained in relation to age: cluster 1 (41.9%) included patients aged 5-8 years with a skeletal Class I or mild Class II and hyperdivergent pattern; cluster 2 (45.3%) included patients aged 9-12 years with a Class II and hyperdivergent pattern; and cluster 3 (12.8%) included patients aged 7-8 years with a Class III and hyperdivergent pattern. Conclusions: This study found that the craniofacial patterns of Korean children with snoring and ATH could be categorized into three characteristic clusters according to age groups. Although no significantly dominant sagittal skeletal discrepancy was observed, hyperdivergent vertical discrepancy was consistently evident in all clusters.
Purpose: To perform a comparative analysis of the palatal bone thickness in Thai patients exhibiting class I malocclusion according to whether they exhibited a normal or open vertical skeletal configuration using cone-beam computed tomography (CBCT). Materials and Methods: Thirty CBCT images of Thai orthodontic patients (15-30 years of age) exhibiting class I malocclusion with a normal or open vertical skeletal configuration were selected. Palatal bone thickness was measured in a 3.0-mm grid pattern on both the right and left sides. The palatal bone thickness of the normal-bite and open-bite groups was compared using the independent t-test. The level of significance was established at P<.05. Results: The palatal bone thickness in the normal-bite group ranged from $2.2{\pm}1.0mm$ to $12.6{\pm}4.1mm$. The palatal bone thickness in the open-bite group ranged from $1.9{\pm}1.1mm$ to $13.2{\pm}2.3mm$. The palatal bone thickness was lower at almost all sites in patients with open bite than in those with normal bite. Significant differences were found at almost all anteroposterior sites along the 3 most medial sections (3.0, 6.0, and 9.0 mm lateral to the midsagittal plane)(P<.05). Conclusion: Class I malocclusion with open vertical skeletal configuration may affect palatal bone thickness, so the placement of temporary anchorage devices or miniscrew implants in the palatal area in such patients should be performed with caution.
Objective: The purpose of this study was to assess rotational patterns of dentofacial structures according to different vertical skeletal patterns by cone-beam computed tomography (CBCT) and analyze their influence on menton deviation in skeletal Class III deformity with mandibular asymmetry. Methods: The control group consisted of 30 young adults (15 men, 15 women) without any severe skeletal deformity. The asymmetry group included 55 adults (28 men, 27 women) with skeletal Class III deformity and at least 3-mm menton deviation from the midsagittal plane; it was divided into the hyperdivergent and hypodivergent subgroups using a mandibular plane angle cutoff of $35^{\circ}$. Fourteen rotational variables of the dental arches and mandible were measured and compared among the groups. Correlations between menton deviation and the other variables were evaluated. Results: The asymmetry group showed significantly larger measurements of roll and yaw in the mandible than the control group. The hypodivergent subgroup showed significant differences in maxillary posterior measurements of yaw (p < 0.01) and maxillary anterior shift (p < 0.05) compared with the hyperdivergent subgroup. All the mandibular measurements had significant correlations with menton deviation (p < 0.01). Most measurements of roll were positively correlated with one another (p < 0.01). Measurements of yaw and roll in the posterior regions were also positively correlated (p < 0.05). Conclusions: Menton deviation in skeletal Class III deformity with mandibular asymmetry is influenced by rotation of mandibular posterior dentofacial structures. The rotational patterns vary slightly according to the vertical skeletal pattern.
The purpose of this study was to evaluate the skeletal relapse pattern of the mandibular prognathic patients after mandibular set back surgery by sagittal split ramus osteotomy. The horizontal and vertical position of the cephalometric points were measured before, after surgery and after one-year follow up period. The next, the positional change of the proximal and distal mandibular segment were evaluated respectively. The obtained results were as follows; 1. The horizontal and vertical position of Cd was not changed before and after surgery, and it was maintained its original position during the observation periods. 2. As the mandibular prognathism of the patients was severe before surgery, the more skeletal relapse tendency was observed during follow-up period(p<0.05). 3. As the horizontal positional change of the mandible which was obtained by mandibular set-back surgery was large, the more horizontal relapse tendency was observed during follow-up period(p<0.05). 4. The corpus axis angle decreased by sagittal split ramus osteotomy(p<0.01), but it was kept its reoriented position during follow-up period. 5. During the follow-up period after mandibular set-back by sagittal split ramus osteotomy, the forward relapse of mandible correlated with not only the forward rotation of the proximal segment but also the forward movement of the distal segment(p<0.05).
To extract or not to extract permanent teeth for the correction of malocclusion has been a great debate in the history of orthodontics, and there is a variety of analytic methods and criteria to aid in the diagnosis. Extraction formulas that has been presented are many analytic methods that depend on arch length discrepancy, dental prominence, and skeletal pattern of the each patients. Of these analysis, the most important diagnostic factor is patient's skeletal pattern. Because the behavior of the dentition is closely dependent upon the skeletal pattern of each patient, dentition must be arranged within that person's skeletal frame. EI(Extraction Index) is composed of CF, interincisal angle, and lip position. CF is made of ODI and APDI that differentiate vertical and horizontal component of the skeletal pattern. So, EI not only represents patient's skeletal pattern, but also takes facial appearance into consideration. This study was undertaken to investigate EI and related cephalometric variables on the cephalogram of Korean adolescents which consisted of 153 persons with normal occlusion, harmonious skeleton and pleasing face. The following conclusions were obtained. 1. The mean value of the ODI is $73.5^{\circ}$, APDI $82.5^{\circ}$, CF $156.3^{\circ}$ 2. The mean value of the interincisal angle is $123.6^{\circ}$ 3. The mean distance of upper lip to E-line is 0.0mm, lower lip to E-line is 1.4mm. 4. The mean value of the EI is $153.8^{\circ}$.
Journal of the korean academy of Pediatric Dentistry
/
v.42
no.2
/
pp.126-135
/
2015
The purpose of this study was to evaluate the skeletal and dentoalveolar effects of facemask therapy and to compare the anchorage of a bonded expander in patients with Class III malocclusion and different vertical skeletal patterns. Twenty subjects with Class III malocclusion were included in this study and were treated with a facemask and bonded expander. Based on the FMA, subjects were divided into two groups of 10 patients each: a high vertical group (HV; mean FMA $33.56^{\circ}$) and an average vertical group (AV; mean FMA $24.88^{\circ}$). Lateral cephalograms were taken and evaluated before and after treatment. In both groups, forward movement of the maxilla and backward rotation of the mandible were observed after treatment, with no statistical differences between the groups. Vertical skeletal variables increased in both groups, but the increase of FMA was significantly larger in the HV group than the AV group. Mesial movement of maxillary molars and proclination of maxillary incisors which indicate anchorage loss of bonded expander were observed in both groups, with no significant differences between the groups. In conclusion, facemask therapy resulted in effective maxillary protraction in both HV and AV groups. However, the open bite tendency was increased more in the HV group.
The purpose of this study was to investigate the positional changes of the mandibular condyles after orthognathic surgery In patients with severe skeletal Class III malocclusion. This study was based on 21 patients who had received bilateral sagittal split osteotomy for mandibular setback. Among them 14 were fixated non - rigidly (W group), and 7 were fixated rigidly (R group). After submental vertex view analysis, each subject was given the T.M.J. Tomogram in both centric occlusion and centric relation immediate before, $4\~6$ weeks after and more than 6 months after surgery. The anteroposterior and vertical changes between each time interval were measured and analyzed statistically. Following results were obtained. 1. There was no significant difference between right and left condyles in their anteroposterior and vertical changes of the condylar position. 2. In anteroposterior changes of condylar position of the wire fixation group, the condyles were moved anteriorly 4-6 weeks after surgery, and then the pattern of reestablishment to their preoperative position was observed more than 6 months after surgery. In the rigid fixation group, there was no significant difference in any observation periods of centric occlusion and centric relation. 3. In vertical changes of condylar position of the wire fixation group. the condyles were moved inferiorly 4-6 weeks after surgery, and then the pattern of reestablishment to their preoperative position was observed more than 6 months after surgery. In the rigid fixation group, the condyles were moved inferiorly 4-6 weeks after surgery, and then the pattern of reestablishment to their preoperative position was observed more than 6 months after surgery in centric occlusion only.
In general, orthodontists make problem lists and treatment plans based on norms of several cephalometric standards. But consideration of dentoalveolar compensation, which tends to maintain normal dental arch relationship in various skeletal jaw relationships, helps orthodontists make more individualized treatment objectives and plans. The purpose of this study was to classify skeletal patterns of normal occlusion samples by cluster analysis and to investigate the dentoalveolar compensation according to skeletal patterns. The subjects were consisted of 125 subjects who were normal occlusion samples at Seoul National University Dental Hospital, Department of Orthodontics. Lateral cephalograms in centric occlusion were traced and digitized. The skeletal patterns of normal occlusion samples were classified into three horizontal groups and three vertical groups by cluster analysis and ANOVA on the skeletal and dentoalveolar measurements among the groups were carried out. The results were as follows ; 1. Anteroposterior and vertical skeletal relationships of normal occlusion samples were very variable. 2. As the mandibular position was anterior to the maxilla, the maxillary incisors inclined more labially, the mandibular incisors more lingually, and the occlusal plane was flattened due to the anteroposterior dentoalveolar compensation. dentoalveolar height was decreased and upper posterior teeth was uprighted to the palatal plane and lower incisors and lower posterior teeth to the mandibular plane. 4. Lower incisors were more strongly associated with the dentoalveolar compensation than upper incisors according to the anteroposterior and vertical skeletal relationship.
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