• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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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.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.4
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• pp.416-426
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• 2020

The purpose of this study was to calculate uncertainty of orthodontic measurement in skeletal class III malocclusion children using lateral cephalometry analysis software which obtained traceability in previous study. Using this data, standard reference of measurement value for skeletal class III malocclusion was obtained. Lateral cephalometric data was collected from 144 children who visited Pediatric Dentistry from 2017 to 2020 for orthodontic treatment. Orthodontic measurement was analyzed with software which obtained traceability. Type A evaluation of uncertainty and type B evaluation of uncertainty was calculated to obtain combined standard uncertainty and expanded uncertainty. Standard reference of skeletal class III children was compared to standard reference of skeletal class I children. Distribution range for skeletal class III malocclusion children aged 6 to 10 with 95% confidence interval was provided using calculated uncertainty of orthodontic measurement value.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.3
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• pp.161-166
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• 2013

Purpose: This study was intended to perform a cephalometric comparison between the patients with and without obstructive sleep apnea (OSA). The factors influencing the OSA in the lateral cephalogram were also investigated. Methods: Fifty patients who had visited the Sleep Disorder Clinic at the Ajou University Hospital and evaluated with the polysomnograph (PSG) and cephalogram, were included in the study. The patients had the apnea-hypopnea episode over 5 times per hour (apnea-hypopnea index $[AHI]{\geq}5$) were diagnosed as OSA after the overnight PSG. To evaluate the hard and soft tissue profiles, the cephalometric radiograms were taken at the maximal intercuspation. The correlation between the patient's age, height, weight, body mass index (BMI) and AHI was inspected in the OSA and control group. The difference between the OSA and control group was evaluated (Mann-Whitney U Test). The cephalometric influencing factors to OSA were analyzed (Pearson's correlation coefficient) statistically using SPSS statistics. Results: The OSA Group had a significantly higher BMI than the control group. The mean lower facial height (ANS-Me) was longer in the OSA group; however, statistically significant difference was not detected in the anteroposterior craniofacial measurements. The distance between mandibular plane and hyoid bone of the OSA group was significantly longer than that of the control group. The hyoid position (MP-Hyoid) had a positive correlation between AHI (P<0.001). However, the measurements of oropharyngeal airway were not different between the two groups. The hypothesis, that the antero-posteriorly narrow oropharyngeal airway may aggravate the airway resistance and give rise to a higher AHI, was rejected in the study. Conclusion: We suggest that the lateral cephalogram may be utilized as a useful method to evaluate OSA. The patients with a lower hyoid position can be expected to have higher risks of OSA. However, a comprehensive intraoral inspection, including the soft palate and tonsilar hypertrophy, is emphasized, as the lateral cepahlogram cannot visualize the oropharyngeal status completely.

• Imaging Science in Dentistry
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• v.34 no.3
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• pp.151-157
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• 2004

Purpose : To evaluate the quantitative accuracy of three-dimensional (3D) images by means of comparing distance measurements on the 3D images with direct measurements of dry human skull according to slice thickness and scanning modes. Materials and Mathods : An observer directly measured the distance of 21 line items between 12 orthodontic landmarks on the skull surface using a digital vernier caliper and each was repeated five times. The dry human skull was scanned with a Helical CT with various slice thickness (3, 5, 7 mm) and acquisition modes (Conventional and Helical). The same observer measured corresponding distance of the same items on reconstructed 3D images with the internal program of V-works 4.0/sup TM/(Cybermed Inc., Seoul, Korea). The quantitative accuracy of distance measurements were statistically evaluated with Wilcoxons' two-sample test. Results: 11 line items in Conventional 3 mm, 8 in Helical 3mm, 11 in Conventional 5mm, 10 in Helical 5mm, 5 in Conventional 7mm and 9 in Helical 7mm showed no statistically significant difference. Average difference between direct measurements and measurements on 3D CT images was within 2mm in 19 line items of Conventional 3mm, 20 of Helical 3mm, 15 of Conventional 5mm, 18 of Helical 5mm, II of Conventional 7mm and 16 of Helical 7mm. Conclusion: Considering image quality and patient's exposure time, scanning protocol of Helical 5mm is recommended for 3D image analysis of the skull in CT.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.1
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• pp.65-74
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• 2018

The aim of this study was to obtain the traceability of the software used to analyze lateral cephalometry and to calculate the uncertainty of the measurements. Furthermore, this study aimed to provide a basis for obtaining standard references for measurement values for orthodontic treatment in children. Cephalometric data were collected from 100 children diagnosed with class I malocclusion between the ages 6 to 13 years who visited the pediatric dentist at Seoul National University Dental Hospital. To ensure traceability, a phantom device was created. Correction values were calculated by measuring the length and angle of the phantom device using the software. Type A uncertainty was calculated by obtaining the standard deviation of cephalometric measurements of 100 persons and the standard error of repeated measurements. Determination of the type B uncertainty was induced by minimum resolution and the position of the head. Using these, the combined standard uncertainty was obtained and the expanded uncertainty was calculated. The results of this study confirm that the currently used software has high accuracy and reliability. Furthermore, the uncertainty of orthodontic measurements in Korean children aged 6 to 13 years was calculated, and distribution range for class I malocclusion with 95% confidence interval was suggested.

• Imaging Science in Dentistry
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• v.42 no.3
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• pp.175-182
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• 2012

Purpose: The aim of this study was to provide sex-matched three-dimensional (3D) statistical shape models of the mandible, which would provide cephalometric parameters for 3D treatment planning and cephalometric measurements in orthognathic surgery. Materials and Methods: The subjects used to create the 3D shape models of the mandible included 23 males and 23 females. The mandibles were segmented semi-automatically from 3D facial CT images. Each individual mandible shape was reconstructed as a 3D surface model, which was parameterized to establish correspondence between different individual surfaces. The principal component analysis (PCA) applied to all mandible shapes produced a mean model and characteristic models of variation. The cephalometric parameters were measured directly from the mean models to evaluate the 3D shape models. The means of the measured parameters were compared with those from other conventional studies. The male and female 3D statistical mean models were developed from 23 individual mandibles, respectively. Results: The male and female characteristic shapes of variation produced by PCA showed a large variability included in the individual mandibles. The cephalometric measurements from the developed models were very close to those from some conventional studies. Conclusion: We described the construction of 3D mandibular shape models and presented the application of the 3D mandibular template in cephalometric measurements. Optimal reference models determined from variations produced by PCA could be used for craniofacial patients with various types of skeletal shape.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.6
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• pp.552-558
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• 2005

Orthognathic surgery changes patient's mandibular position and environment of related anatomic structures. Many clinicians were interested in these changes and studied about this problem. However, most of them were based on two dimensional cephalogram. According to the development of image and computer system, it would be possible that the airway change is analyzed with three dimensional CT. So we tried to measure the volumetric change of airway and analyzed the relationship between the airway structure and volumetric change. Nineteen patients who experienced orthognathic surgery due to mandibular prognathism were analyzed with 3D CT data (preoperative and postoperative 6 months) and 2D lateral cephalometry. Volumetric change was measured and 3 dimensional change of related structure was assessed with simulation program ($V-works^{(R)}$, 4.0 Cybermed, Korea). Ten patients showed the decrease of airway volume change and nine showed the increase of airway volume change. Volumetric change was determined by dimensional change of mandible and hyoid bone. The dimensional positions of mandible and hyoid bone were the key factor for determining the airway change after surgery. Airway change is also predictable with the dimensional change of mandible and hyoid bone.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.4
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• pp.357-367
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• 2022

Sleep disordered breathing (SDB) is a disease characterized by repeated hypopnea and apnea during sleep due to complete or partial obstruction of upper airway. The prevalence of pediatric SDB is approximately 12 - 15%, and the most common age group is preschool children aged 3 - 5 years. Children show more varied presentations, from snoring and frequent arousals to enuresis and hyperactivity. The main cause of pediatric SDB is obstruction of the upper airway related to enlarged tonsils and adenoids. If SDB is left untreated, it can cause complications such as learning difficulties, cognitive impairment, behavioral problems, cardiovascular disease, metabolic syndrome, and poor growth. Pediatric dentists are in a special position to identify children at risk for SDB. Pediatric dentists recognize clinical features related to SDB, and they should screen for SDB by using the pediatric sleep questionnaire (PSQ), lateral cephalometry radiograph, and portable sleep monitoring test and refer to sleep specialists. As a therapeutic approach, maxillary arch expansion treatment, mandible advancement device, and lingual frenectomy can be performed. Pediatric dentists should recognize that prolonged mouth breathing, lower tongue posture, and ankyloglossia can cause abnormal facial skeletal growth patterns and sleep problems. Pediatric dentists should be able to prevent these problems through early intervention.

• The korean journal of orthodontics
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• v.32 no.4 s.93
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• pp.241-255
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• 2002

This study was performed to evaluate horizontal and vertical characteristics according to lateral cephalometry of adult Korean skeletal Class II patients using a selected horizontal and vortical reference planes of Koreans. 60 males and 60 females consisting of freshman of Yonsei University from 1996 to 1997 and patients with history of orthognatic surgery at the Dental Hospital of Yonsei University with a skeletal Class II profile were chosen and compared with 70 males and 70 females with normal occlusion. The skeletal Class R group had the following conditions : 1. Profile composed of a retrognathic mandible or protrusive maxilla; 2. Class II molar and canine key; 3. ANB-greater than $4^{\circ}; 4$. Wits appraisal-greater than 1.0mm; Cephalometric analysis consisted of 22 skeletal, 25 soft tissue, 12 dental measurements. The results were as follows. 1. There was no considerable vortical measurement difference between the skeletal Class II malocclusion group and the normal occlusion group in skeletal analysis. But, some variations were found between the two groups in soft tissue analysis. 2. Mandibular length of the skeletal Class II malocclusion group was smaller than that of the normal occlusion group. Mandible was more posteriorly positioned in the Class II malocclusion group than in the normal occlusion group. 3. The length and antero-posterior position of the maxilla were not different between the Class II malocclusion and the normal occlusion group. 4. The antero-posterior position of the nose, upper lip and maxillary soft tissue, and nasolabial angle were not different between the two groups. 5. Mandibular soft tissue of the Class H malocclusion group was more posteriorly positioned than that of the normal. 6. The vertical measurements of the incisors(U1-HP, L1-HP) were bigger in the Class II malocclusion group than in the normal, but those of the molars(U6-HP, U6-MP) showed no significant difference between the two groups. 7 Classifying the skeletal Class II malocclusion group according to the antero-posterior position of both jaws, normally positioned maxilla and retruded mandible was 43.3%, both normally positioned maxilla and mandible 28.3%, both retruded maxilla and mandible 20.0%..

• The korean journal of orthodontics
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• v.27 no.3 s.62
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• pp.359-372
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• 1997

This study was conducted to discern differences of craniofacial, dentoalveolar structure and model measurements between sex and between class n openbite group and non-openbite group. The sample consisted of 49 adult patients with class Il malocclusion. 24 linear measurements, 22 angular measurements and 12 ratios were selected in lateral cephalometry. Also, arch width, length, anterior crowding, average molar relation were measured or calculated in diagnostic model. The data were evaluated by t-test and multiple discriminant analysis. The results were as follows, 1. Most linear measurements, with the exception of MnBL and AUDH, were significantly larger in male(p<0.05). but, intermaxillary relations and spatial position of maxilla and mandible relative to cranial base were not different for both sex. 2. With the exception of upper and lower anterior crowding, lower arch width, upper arch length, AMR, male exhibited significantly larger measurements in model analysis (p<0.05). 3. Size differences of maxilla and mandible between openbite and non-openbite group were not significant(p>0.05). but openbite group showed significantly increased genial angle(p<0.05), FH-CoGo(p<0.01), FH-NA(p<0.01) and FH-NB, FH-NPog (p<0.05). 4. ALFH and PUDH were larger(p<0.05) in openbite group. this result served as compensation for the spatial position of mandible relative to cranial base. AUPUDH (p<0.001) and ALPLDH(p<0.05) were lower in openbite group. upper anterior crowding was the only measurement which showed difference between openbite and non-openbite group(p<0.05). 5. For the purpose of classifying adult class n openbite and non-openbite group, multiple discriminant analysis was done genial angle, ALPLDH, AUPUDH, FH-NA were included in multiple discriminant equation. 39 cases($92.86\%$) were correctly classified when applied to the sample used in this study.