• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.48.1-48.7
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• 2019

Background: Soft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance. Lip canting could be improved by the correction of the occlusal canting or positional change of the mentum. Although there are many studies about changes of lip canting, however, postoperative changes of philtrum deviation have not been yet reported. In this study, we investigate the positional change of the philtrum after orthognathic surgery and influencing factors. Methods: Positional change of the philtrum was evaluated in 41 patients with facial asymmetry who underwent bimaxillary surgery, in relation to other anatomical soft tissue landmarks using a frontal clinical photo. The surgical movement of the maxillary and mandibular dental midline and canting were measured in postero-anterior cephalogram before and 1 day after surgery. The same procedure was repeated in patients with more than 1.5 mm perioperative change of the mandibular dental midline after bimaxillary surgery. Results: Maxillary dental midline shifting and canting correction did not have a significant correlation with lateral movement of the philtrum midline. However, the mandibular shift had a statistically significant correlation with a lateral movement of the philtrum (p < 0.05) as well as other linear parameters and angle values. Conclusion: The horizontal change of the philtrum is influenced by lateral mandibular movement in patients with facial asymmetry, rather than maxillary lateral movement.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.5
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• pp.217-223
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• 2013

Objectives: Buccal fracture of the mandibular proximal bone segment during bilateral sagittal split ramus osteotomy (SSRO) reduces the postoperative stability. The primary aim of this study is to evaluate the effect of this type of fracture on bone healing and postoperative stability after mandibular setback surgery. Materials and Methods: Ten patients who experienced buccal fracture during SSRO for mandibular setback movement were evaluated. We measured the amount of bone generation on a computed tomography scan, using an image analysis program, and compared the buccal fracture side to the opposite side in each patient. To investigate the effect on postoperative stability, we measured the postoperative relapse in lateral cephalograms, immediately following and six months after the surgery. The control group consisted of ten randomly-selected patients having a similar amount of set-back without buccal fracture. Results: Less bone generation was observed on the buccal fracture side compared with the opposite side (P<0.05). However, there was no significant difference in anterior-posterior postoperative relapse between the group with buccal fracture and the control group. The increased mandibular plane angle and anterior facial height after the surgery in the group with buccal fracture manifested as a postoperative clockwise rotation of the mandible. Conclusion: Bone generation was delayed compared to the opposite side. However, postoperative stability in the anterior-posterior direction could be maintained with rigid fixation.

• The korean journal of orthodontics
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• v.49 no.4
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• pp.254-264
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• 2019

Objective: To evaluate the short-term changes in masticatory muscle activity and mandibular movement patterns after orthognathic surgery in skeletal Class III patients with facial asymmetry. Methods: Twenty-seven skeletal Class III adult patients were divided into two groups based on the degree of facial asymmetry: the experimental group (n = 17 [11 male and 6 female]; menton deviation ${\geq}4mm$) and control group (n = 10 [4 male and 6 female]; menton deviation < 1.6 mm). Cephalography, electromyography (EMG) for the anterior temporalis (TA) and masseter muscles (MM), and mandibular movement (range of motion [ROM] and average chewing pattern [ACP]) were evaluated before (T0) and 7 to 8 months (T1) after the surgery. Results: There were no significant postoperative changes in the EMG potentials of the TA and MM in both groups, except in the anterior cotton roll biting test, in which the masticatory muscle activity had changed into an MM-dominant pattern postoperatively in both groups. In the experimental group, the amount of maximum opening, protrusion, and lateral excursion to the non-deviated side were significantly decreased. The turning point tended to be shorter and significantly moved medially during chewing in the non-deviated side in the experimental group. Conclusions: In skeletal Class III patients with facial asymmetry, the EMG activity characteristics recovered to presurgical levels within 7 to 8 months after the surgery. Correction of the asymmetry caused limitation in jaw movement in terms of both ROM and ACP on the non-deviated side.

• The korean journal of orthodontics
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• v.52 no.3
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• pp.210-219
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• 2022

Objective: The purpose of this study was to examine the effectiveness and mechanism of clear aligner therapy for the correction of anterior open bite in adult nonextraction cases. Methods: Sixty-nine adult patients with anterior open bite were enrolled and classified into Angle's Class I, II, and III groups. Fifty patients presented with skeletal open bite (mandibular plane angle [MPA] ≥ 38°), whereas 19 presented with dental open bite. Fifteen cephalometric landmarks were identified before (T1) and after (T2) treatment. The magnitudes of planned and actual movements of the incisors and molars were calculated. Results: Positive overbite was achieved in 94% patients, with a mean final overbite of 1.1 ± 0.8 mm. The mean change in overbite was 3.3 ± 1.4 mm. With clear aligners alone, 0.36 ± 0.58 mm of maxillary molar intrusion was achieved. Compared with the Class I group, the Class II group showed greater maxillary molar intrusion and MPA reduction. The Class III group showed greater mandibular incisor extrusion with no significant vertical skeletal changes. Conclusions: Clear aligners can be effective in controlling the vertical dimension and correcting mild to moderate anterior open bite in adult nonextraction cases. The treatment mechanism for Class III patients significantly differed from that for Class I and Class II patients. Maxillary incisor extrusion in patients with dental open bite and MPA reduction with mandibular incisor extrusion in patients with skeletal open bite are the most significant contributing factors for open bite closure.

• The Journal of Korean Academy of Prosthodontics
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• v.31 no.4
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• pp.549-564
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• 1993

The purpose of this study was to research the condylar path and the anterior angle of glenoid fossae and classify the patterns of condylar path. Thirty male and female dental students with normal occlesion and masticatory system ranging in age from 21 to 30, without present symptoms and an)r history of TM joint disturbance, were selected for this study. Transcranial radiographs of TM joints under mandibular lateral movement were obtained. By the computer analysis on the radiographs, the angle of posterior slope of articular eminance, the sagittal condylar guidance angie, condylar movement patterns and the height of glenoid fossa was measured respectively, and studied their interrelationship comparatively. The results obtained were as follows : 1. The total distance of condylar movement on balancing side during mandibular lateral movement was 4.55mm for Lt. and 4.78mm for Rt. when mandible moved from C.R. to canine to canine relation and 7.86mm for the Lt. and 8.10mm for the Rt. when mandible moved from C.R. to 7.5mm. 2. The horizontal distance of condylar movement on balancing side during mandibular lateral movements was 3.16mm for the Lt. and 3.52mm for the Rt. when mandible moved from C.R. to canine to canine relation and 6.10mm for the Lt. and 6.30mm for the Rt. when mandible moved from C.R. to 7.5mm. 3. The sagittal condylar guidance angle on balancing side during mandibular lateral movements was $45.96^{\circ}$ for the Lt. and $43.22^{\circ}$ for the Rt. when mandible moved from C.R. from canine to canine relation and $41.14^{\circ}$ for the Lt. and $39.77^{\circ}$ for the Rt. when mandible moved from C.R. to 7.5mm. 4. The height of glenoid fossa was 8.23mm for the Lt. and 7.80mm for the Rt. and the angle of posterior slope of articular eminence was $38.30^{\circ}$ for the Lt. and $38.79^{\circ}$ for the Rt. by method-A and $55.61^{\circ}$ for the Lt. and $55.64^{\circ}$ for the Rt. by method-B. 5. The sequence of the frequency of condylar movement patterns on balancing side during mandibular lateral movement were concave type(30 cases), convex type(16 cases), reverse S shape curve(9 cases) and S shape curve(5 cases) when mandible moved from C.R. to canine to canine relation and concave type(27 cases), 5 shape curve(13 cases), convex type(11 cases) and reverse S shape curve(9 cases) when mandible moved from C.R. to 7.5mm.

• Journal of Oral Medicine and Pain
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• v.26 no.1
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• pp.75-85
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• 2001

This study was performed to investigate the effect of mandibular midline shift and difference of mandibular height between both sides on the electromyo- graphic(EMG) activity of the masticatory muscles on clenching or gum chewing movement. For this study, 105 patients with temporomandibular disorders(TMD) were selected and panoramic radiograph were taken. Amount and side of the midline shift and height of the mandible from antegonial notch to the top of the condylar head were measured on panoramic view. $BioEMG^{(R)}$ (Bioresearch Inc., Milwaukee, USA) was used for recording of EMG activity(${\mu}V$) of the anterior temporalis and the superficial masseter on clenching or gum chewing movement. EMG activity on clenching during 533msec period were measured for activity of the starting point and the one second-after activity as the early EMG and the maximum EMG, respectively. EMG activity on gum chewing movement were measured for activity of the first and the second chewing stroke. The data collected were analysed by SPSS windows program, and the results of this study were as follows : 1. Height of the mandible was 8.06cm on right side and 8.03cm on left side, and showed no difference by age, but significantly differed by sex with higher in male subjects. 2. Mean value of the midline shift was 0.1mm with range of 0~5mm on both sides. The amount and side of the midline shift did not related with height difference of the mandible and/or the EMG activity of the masticatory muscles on clenching. 3. Prevalence of higher right side and higher left side of the mandible were almost same, and the EMG activity of higher side was not higher than that of the other side. 4. In the subjects with height difference of more than 5mm between both sides of the mandible, the early EMG activity on clenching were differed for the anterior temporalis, but the maximum activity were differed for the superficial masseter. 5. In the subjects with height difference of more than 5mm between both sides of the mandible, EMG activity of the anterior temporalis of the gum chewing side was not higher than that of the other side when chewing on the side of lower height, but in the subjects with height difference of less than 5mm, the EMG activity was higher than that of the other side.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.4
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• pp.547-552
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• 2001

Extracting mandibular incisors for orthodontic treatment may adversely affect the occlusion. However, when properly used, extraction of mandibular inciors is a selection for the correction of the malocclusion. Generally, treatment for crowding needs to select between nonextraction and four premolar extraction. Approaches for crowded mandibular incisors include distal movement of posterior teeth, lateral movement of canines, labial movement of incisors, interproximal enamel reduction, removal of premolars, removal of one or two incisors, and various combinations of the above. Extraction of incisors is used in case of crowding, anterior tooth size discrepancy, absent of maxillary lateral incisors, and ectopic eruption. But severe overjet. overbite, and space are the contraindication of it. A patient had severe crowding on upper anterior teeth, impacted upper left lateral incisor, palatal ectopic eruption of upper right incisor and severe crowding on lower anterior teeth. Lower lateral incisors are extracted for space availability and facial esthetics. We report the case of orthodontic treatment of upper and lower anterior crowding through extraction of lateral incisor.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.4
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• pp.419-426
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• 2017

In implant restorations, it is difficult for the patient to percept any symptoms. In addition, they are absent of shock absorbers, which can lead to mechanical failure if stress distribution is not considered. Since maxillary anterior multiple-implant restorations play a significant role in guiding the functional movement of the mandible by distributing lateral force, it is crucial to form appropriate occlusion. The use of the T-scan system is more advantageous in assessing 'dynamic occlusion', such as the change of occlusion over time, the amount of tooth contact during functional movement, and assessing the occlusion in the less-visible posterior teeth. The case is reported as it has satisfactory results in harmonious anterior guidance of a maxillary anterior multiple-implant restoration using T-scan analysis.

• The korean journal of orthodontics
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• v.52 no.2
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• pp.142-149
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• 2022

Objective: To evaluate clinical parameters and gingival crevicular fluid (GCF) cytokines in children with anterior open bite receiving passive orthodontic treatment with spurs. Methods: Twenty children with indications for interceptive orthodontic treatment, an anterior open bite, and good oral hygiene and periodontal health were included in this study. GCF samples were collected from the mandibular and maxillary central incisors before (baseline) and 24 hours and 7 days after spur bonding. Clinical and periodontal examinations and cytokine analyses were performed. Results: At 7 days after spur attachment, gingival bleeding in the mandibular group was increased relative to that in the maxillary group. Visible plaque was correlated with gingival bleeding at 7 days and the GCF volume at 24 hours after spur attachment. Compared with those at baseline, interleukin (IL)-8 levels in the maxillary group and IL-1β levels in both tooth groups increased at both 24 hours and 7 days and at 7 days, respectively. At 24 hours, IL-8, IL-1β, and IL-6 levels were higher in the maxillary group than in the mandibular group. Cytokine production was positively correlated with increased GCF volume, but not with gingival bleeding, visible plaque, or probing depth. Conclusions: Although orthodontic treatment with spurs in children resulted in increased gingival bleeding around the mandibular incisors, IL levels were higher around the maxillary incisors and not correlated with periodontal parameters. Increased cytokine levels in GCF may be associated with the initial tooth movement during open bite correction with a passive orthodontic appliance in children.

• The korean journal of orthodontics
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• v.19 no.2
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• pp.130-143
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• 1989

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.