Aims: The present study investigated the relationship between condylar resorption and craniofacial skeleton types(especially vertical relationships), the differences of craniofacial skeleton types between with open bite group and without open bite group, and the associations of anterior disc dislocation with or without reduction to condylar resorption with MRI. Patients selection and methods: Clinical examination, magnetic resonance imaging (MRI), panorama, lateral transcranial and lateral cephalometric radiographs in 34 patients with condylar resorption were used to investigate this relationship. Results and Conclusions: Patients with the following specific facial morphologic characteristics appear to be most susceptible to condylar resorption: (1) females were predominant, (2) patients' age ranged from 12 to 50 years old with a strong predominance for 2nd and 3rd decades, (3) patients had high mandibular plane angle and high gonial angle, (4) patients had decreased vertical height of the ramus, (5) patients had generally significant antegonial notch, (6) patients had predominance of Class I occlusal relationship with or without open bite but mandible was retruded as mean ANB 5.54 degrees, (7) condylar resorption rarely occurs in lower mandibular plane angle facial types, (8) although no statistically significant difference was found, the open bite group had a tendency more hyperdivergent skeletal pattern than the non open bite group, and (9) imaging demonstrates from small resorbing condyles to idiopathic condylar resorption and TMJ articular disc dislocations. Thus, morphologic features of patients with vertical discrepancies may represent a risk factor for the development of condylar resorption.
The purpose of this study was to compare the arch width of the hyperdivergent group with that of the neutral group in Class III malocclusion based on the vertical patterns and to compare the arch width of Class III neutral group With that of normal occlusion group based on sagittal patterns. The subjects consisted of 118 pairs of studty casts, divided into three groups , 37 Class III hyperdivergent group(18 males and 19 females, SN-Mn plane angle>39.5$^{\circ}$), 40 Class III neutral group(20 males and 20 females, SN-Mn plane angle : 32 ${\pm}$ 2.5$^{\circ}$) and 41 Class I normal occlusion group(20 males and 21 females). The intercanine, interpremolar, and intermolar width of the maxillary and mandibular study casts were measured, then the ratios of dental width to basal width and mandibular width to maxillary width were obtained. Basal arch width and dental arch width were measured to obtain the pure basal arch relation in transverse plane as ruled out the transverse dental compensation. The results were as follows 1. There were no significant differences in any ratios between Class III hyperdivergent group and Class III neutral group as different vertical pattern. 2. As the ratios of dental arch width to basal arch width between normal occlusion group and Class III neutral group were compared, the maxillary teeth flared buccally to the basal bone, and the mandibular teeth tilted lingually to the basal bone in Class III neutral group. 3. The ratios of mandibular arch width to maxillary arch width in basal arch level were significantly different in all regions. Maxillary basal arch width of Class III neutral group was narrower than that of normal occlusion group. 4. The ratios of mandibular arch width to maxillary arch width in teeth level were not significantly different between normal occlusion group and Class III neutral group. In spite of discrepancies of maxillary and mandibular basal arch width, the dental arch width of Class III malocclusion group compensated very well. At the presurgical orthodontic treatment in clinic, it would not be desirable to decompensate for compensated dental arch width too much, for obtaining an appropriate arch compatibility and good results for orthognathic surgery.
This research was carried out to compares the treatment effects of Horizontal and Vertical type activators in Angle's Class II div. 1 maloccusion patients with mandibular retrusion dand to find out whether different treatment effects or growth pattern were observed between sexes in each study groups. The results were as follows: 1. In Horizontal activator group, forward positioning of mandible and vertical increase in anteror face as examplified by increase of LAFH and AEM were observed when pre and post-treatment datas were evaluated. 2. Males samples in Horizontal activator group showed increase in mandiular length accmpanied by posterior positioning of maxilla, wheras female samples in Horizontal activator group showed increase in mandibular body length, labial inclination of mandibular incisors and increase in lower anterior facial height .3. In vertical activator group, increase in AFH, LAFH, PFH and LPFH were observed when pre and post treatment datas were evaluated. 4. Male samples in Vertical activator group showed increase in mandibular body length and anterior and posterior facial heights, whereas females samples of Vertical activator group showed mainly increase in anterior facial height. 5. When pre and post treatment datas of Horizontal and Vertical activator groups were compared, skeletal difference were mainly observed in pretreatment datas but dental difference were observed in post treatment datas ,indicating that two actiators differ only in their effects to dental variables. 6. Difference between sexes were noted after treatment although no difference were observed between sexs in each groups before treatmentt. This indicates that inherent growth effects in each sex exerts more influence 1km appliances used for treatment.
The present study assessed the effects of Rapid Maxillary Expansion on head posture and hyoid bone position. For this study, 32 Angle's class III patients - hellman 3c $\~$ adult stage, mean age 12y9m - were selected and divided into two groups, A,B according to craniocervical angulation. Craniocervical angulation Increased in Group A and decreased in Group B after the therapy. And 23 Angle's class I persons $\~$ same hellman stage, mean age 12y7m $\~$ were selected (or the control group. Cephalometric analysis of skeletal pattern, pharyngeal space, head posture, hyoid bone position was performed. The results were as follows, 1. Comparison of skeletal pattern and pharyngeal space 1) All two groups(A,B) had Mandibular plane inclined inferiorly and no pharyngeal space change was obseved after RME therapy 2) Skeletal pattern and pharyngeal space of Group A, B were normal before and after treatment. 2. Comparison of head posture 1) Craniocervical angulation of Group A was increased after treatment. That of Group B was decreased and mandibular plane was inclined inferiorly after treatment. 2) Before treatment, craniocervical inclination was normal in Group A but larger than normal in Group B. After treatment, all two groups(A, B) had normal craniocervical angulation. 3. Comparison of hyoid bone position 1) After treatment, long axis of hyoid in Group A, B was not changed. Antero- posteriorly, hyoid position was changed posteriorly in Group A but no change was founded in Group B after treatment. Vertically, hyoid bone position were not changed in two groups except increase in APHFH in Group A after treatment 2) Long axis of hyoid bone was normal in Group A, B before and after treatment. Anteroposteriorly, hyoid bone position was more anterior than Group B, C before treatment but all the position of two groups had normal position after treatment. Vertical position of hyoid bone was normal in all two groups before and after treatment.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.26
no.6
/
pp.628-635
/
2000
The purpose of this study was to evaluate the result after 2-phase surgical-orthodontic treatment without preoperative orthodontic treatment for the skeletal Cl III malocclusion patient and to obtain an adequate protocol on the bases of this result. This retrospective study of ten patients who underwent 2-phase treatment were done to evaluate 1) the surgical stability and relapse pattern 2) the facial esthetics 3) the TMJ problem 4) the total time of the treatment. Results were followed : 1) The horizontal relapse of the mandible was 26.8% and didn't show significant differences compared to the conventional 3-phase treatment. But, it was considered that this amount of relapse was the sum of true relapse and autoratation of mandible due to decreased vertical dimension during orthodontic treatment. 2) It was estimated that there's no difference on the ratio of anterior facial height between the subjects and the normal patients. On the horizontal analysis, the mandible of the subjects was located more anteriorly than that of the normal patients. This result showed that there was a need for the accurate preoperative esthetic evaluation and the additional methods for reducing the relapse due to the occlusal interference. 3) Wide variation was noted on the TMJ symptoms of the subjects, however, it was estimated that there's no significant differencees of symptoms compared to that of the conventional 3-phase treatment on literatures. 4) The average of the overall period of treatment was 20.8 months and we obtained reduction of the treatment time compaired to 3-phase treatment on many literatures. Most of the results of this study were similar to the findings of the 3-phase treatment(preoperative orthodontic-orthognathic surgery-postoperative orthodontic), but total time of the treatment was shorter in patients with 2-phase treatment than in those with the conventional 3-phase treatment. With 2-phase treatment, we experienced many advantages compared to the conventional method considering that it was favarable conditions for the teeth, it had the flexibility for the treatment, and it could be the adequate treatment approach for the stomatognathic system. Although this retrospective pilot study had some limitations, due to small samples, the authors would hope that it could serve as a guide for the future researches, and the clinical applications.
Park, Song-Soo;Kim, Hyun-Deog;Lee, Dae-Hee;Kim, Jong-Ghee;Jeon, Young-Mi
The korean journal of orthodontics
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v.32
no.1
s.90
/
pp.33-42
/
2002
This study was performed to compare the pattern of dentoalveolar characteristics in different vertical and anteroposterior skeletal types in skeletal Class III malocclusion. The samples selected for this study were consisted of 60 subjects(29 males and 31 females, mean age; 19.7 years) in Class III group, 43 subjects(14males and 29 females, mean age : 20.5 years) in normal group. The findings of this study were as follows : 1. The IMPA of the Class III group was smaller than that of the Class I group(p<0.01). 2. In the Class III groups, SNB and NtoPog had negative correlation with IMPA(p<0.01). The SNB and NtoPog had correlations with SNU1, FHU1 and PalU1(p<0.01) in the male samples, and in the female samples, the SNB and NtoPog had correlations with SNU1(p<0.01). 3. In the Class III male samples, SNMP, FMA, PalMP had negative correlation with IMPA(p<0.01). SNMP, FMA, PalMP had not significant correlation with SNU1, FHU1, PalU1. In the Class III female samples, FMA, PalMP had negative correlation with IMPA(p<0.01). 4. In the high angle group of Class III samples, SNU1, IMPA is smaller than that of low angle group of Class III samples(p<0.05).
Jeong, Seo-Rin;Kim, Sehyun;Kim, Soo Yong;Lim, Sung-Hoon
International Journal of Oral Biology
/
v.43
no.2
/
pp.101-111
/
2018
Understanding the classification of malocclusion is a crucial issue in Orthodontics. It can also help us to diagnose, treat, and understand malocclusion to establish a standard for definite class of patients. Principal component analysis (PCA) and k-means algorithms have been emerging as data analytic methods for cephalometric measurements, due to their intuitive concepts and application potentials. This study analyzed the macro- and meso-scale classification structure and feature basis vectors of 1020 (415 male, 605 female; mean age, 25 years) orthodontic patients using statistical preprocessing, PCA, random matrix theory (RMT) and k-means algorithms. RMT results show that 7 principal components (PCs) are significant standard in the extraction of features. Using k-means algorithms, 3 and 6 clusters were identified and the axes of PC1~3 were determined to be significant for patient classification. Macro-scale classification denotes skeletal Class I, II, III and PC1 means anteroposterior discrepancy of the maxilla and mandible and mandibular position. PC2 and PC3 means vertical pattern and maxillary position respectively; they played significant roles in the meso-scale classification. In conclusion, the typical patient profile (TPP) of each class showed that the data-based classification corresponds with the clinical classification of orthodontic patients. This data-based study can provide insight into the development of new diagnostic classifications.
Objective: Condylar resorption (CR) is one of the major post-surgical complications of orthognathic surgery. This systematic review (SR) aimed to evaluate epidemiological data, risk factors, and therapeutical management of CR. Methods: Six databases were screened by two investigators until September 2020 to obtain all SRs. After reading the titles and abstracts, eligible SRs were determined and data extraction was performed. Using the latest version of A Measurement Tool to Assess Systematic Reviews, the methodological quality of the included SRs was determined. Results: Ten SRs with low or critically-low methodological quality were included in this review. Mandibular hypoplasia on the sagittal plane and hyperdivergent growth pattern on the vertical plane were the most common skeletal alterations in which CR could occur after orthognathic surgery. Post-operative condylar changes were analyzed both on two-dimensional and three-dimensional (3D) radiographic examinations. The incidence of CR was not related to the fixation method. Based on the severity of the pathological conditions, management of CR can include conservative or surgical therapy. Conclusions: Despite the limited evidence in literature, CR is considered a consequence of orthognathic surgery. However, an accurate diagnosis of CR and a better orthognathic surgical planning must include 3D radiographic examinations to improve pre- and post-surgical comparison. Well-designed studies with long-term follow-up and 3D data are needed to clarify the findings of this analysis..
Journal of the korean academy of Pediatric Dentistry
/
v.36
no.3
/
pp.412-419
/
2009
The purpose of this study was to provide the reference data evaluating the treatment effect of orthopedic appliances. The skeletal and dental growth increments were measured in 24 normal mixed dentition children (boys: 14, girls: 10) by three serial lateral cephalograms: initial mean age: 9${\pm}$1.3 years, mean observation period: 13${\pm}$1.3 months. Cephalometric changes were analysed. The results were as follows: 1. In boys, the maxilla showed forward and downward growth pattern and the mandible showed forward growth pattern (p<0.05). In girls, the maxilla and mandible showed forward and downward growth pattern(p<0.05). 2. Horizontal growth of both maxilla and mandible in girls was superior to those in boys (A point; girls: 2.39mm, boys: 1.26mm, with p<0.05), whereas vertical growth of both maxilla and mandible in boys was similar to those in girls. 3. The change in tooth axis showed labioversion of upper incisor (p<0.01) and comparatively stable lower incisor position.
The purpose of this study was to measure maximum bite force and to investigate its relationship with anteroposterior, vertical, and transverse facial skeletal measurements. From among the dental students at the College of Dentistry, forty subjects (26 male and 14 female) were selected. With two sets of strain gauge, maximum bite force at the right and left first molars and anterior teeth was measured in the morning and afternoon. After taking lateral and posteroanterior cephalograms, fifty and nineteen variables were evaluated, respectively Paired t-tests and an independent t-test were done and correlation coefficients were obtained. 1. The maximum bite force at the first molars was $68.0\pm13.9kg$. in males and $55.6\pm10.5kg$ in females (p<0.05) while the force at the anterior teeth was $8.4\pm4.9kg\;and\;1.1\pm3.4kg$ respectively (p<0.05). 2. Some tendency for a greater value of maximum bite force at the preferred side was observed but not statistically significant (p>0.05). 3. Significant difference was observed between the strong bite force group and the weak bite force group in some cephalometric and other measurements (p<0.05). N-S-Ar, S-Ar-Go, FH-Hl, IMPA and MMO showed a significant difference in posterior maximum bite force (P). N-S-Ar and FH-H1 also showed a significant difference in anterior maximum bite force (A). 4. Several cephalometric variables showed some correlation with maximum bite force (p<0.05). N-S-Ar, S-Ar-Go, UGA, FH-H6, FH-H1, body weight and MMO were significantly correlated with posterior maximum bite force (P). Go-Me, P-1 and IMPA were significantly correlated with anterior maximum bite force (A).
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