Purpose: The authors report unusual one case of a patient presenting with maxillary sinus mucocele who had underwent Lefort I procedure 7 years ago. Methods: Case report and literature review Results: A 25 year old man came to us with fullness, pain and nasal obstruction on his left cheek area. He had a history of multiple operations due to cleft lip and palate since birth. Two jaw surgery was performed for correcting class III malocclusion 7 years ago. Computed tomography showed haziness, and fluid filled cystic mass on left maxillary sinus. Nasoendoscopy revealed the bulging of inferior turbinate and mucosa coincided in medial wall of maxillary sinus. Antrostomy with Caldwell-Luc approach was performed. Mucin contaning brownish exudate was leaked out. Severe inflammation of maxillary inner wall and exposure of 2 screws fixed previously were noticed. The curettage and marsupialization were accomplished. The symptoms of patient were improved after that procedure. Conclusion: Maxillary sinus mucocele is related with Lefort I procedure and it may occur even long after that procedure.
In non-growing Class III malocclusion, the critical aspects which determine the need of orthognatic surgery are the severity of skeletal discrepancy, incisor inclination, overbile and soft tissue profile. Two-jaw surgery is more effective in correcting severe sagittal, vertical, transverse skeletal discrepancies and facial asymmetry. And more esthetic and stable profile can be achieved by two-jaw surgery Some midfacial deficiency Patients can be treated by Pyramidal Le Fort II osteotomy to maintain infraorbital rim and malar complex and to advance nasomaxillary complex. Others who require advancement of infraorbital rim and malar complex can be treated by quadrangular Le Fort II osteotomy. On the following cases, patients who had represented midfacial deficiency and mandibular prognathism were treated with combined orthodontic-surgical therapy by Le Fort II osteotomy and BSSRO.
Mei Ling Fang;Sung-Hwan Choi;Yoon Jeong Choi;Kee-Joon Lee
The korean journal of orthodontics
/
v.53
no.4
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pp.276-285
/
2023
Objective: The aim of this retrospective study was to compare changes in hard tissue and soft tissue after the four first premolars were extracted with anterior teeth retraction according to the presence or absence of lip incompetence. Methods: Patients who underwent the four first premolars were extracted with anterior teeth retraction were divided into competent (n = 20) and incompetent lip (n = 20) groups. Cephalometric measurements for hard tissue and soft tissue changes were performed pre-treatment and post-treatment. Results: In the competent group, the upper and lower lips retreated by 2.88 mm and 4.28 mm, respectively, and in the incompetent group by 4.13 mm and 5.57 mm, respectively; the differences between the two groups were significant (p < 0.05). A strong positive correlation between retraction of the upper lip and upper incisors was observed in both groups (p < 0.05), whereas a correlation between retraction of the lower lip and lower incisors was only found in the incompetent group. A simple linear regression analysis showed that the pattern of lip retraction following the retraction of the anterior teeth was more predictable in the incompetent group than in the competent group. Conclusions: These findings suggest that the initial evaluation of lip incompetence in patients with skeletal Class II is essential for the accurate prediction of the soft tissue changes following retraction of the anterior teeth in premolar extraction treatment. Therefore, sufficient explanation should be provided during patient consultations.
Objective: The purpose of this prospective study was to evaluate the dentofacial effects of conventional and modified facemask therapies with rapid maxillary expansion, in a group of Class III patients; and compared with an untreated control group. Methods: The conventional facemask group (Group 1) comprised of 24 patients, 13 girls and 11 boys (mean age, $9.2{\pm}1.4$ years); the modified facemask treatment group (Group 2) comprised of 24 patients, 12 girls and 12 boys (mean age, $9.3{\pm}1.6$ years); and the control group (Group 3) comprised of 21 subjects, 11 girls and 10 boys (mean age, $9.8{\pm}1.9$ years). Treatment and control changes within the groups and the differences between the groups were analyzed statistically. Intra-group comparisons were evaluated using the non-parametric Wilcoxon's test and intergroup changes were analyzed using the Kruskal-Wallis test. The statistical significance of intergroup differences was further assessed with the Mann-Whitney test for independent samples and applying Bonferroni's correction (p < 0.016). Results: In group 1, SNB changes were less than the control. There were increases in SNA, ANB, SN-MP, A to N perp and Upper lip to E plane. In group 2, SNB, U1-NA (mm) U1-NA (${\circ}$) and Pog to N perp (mm) changes were less than the control. There were increases in SNA, ANB, SN-MP, A to N perp and Upper lip to E plane. Conclusions: Modified facemask appliance can be used effectively in Class III patients with a retrognathic maxilla. Facemask therapies with expansion resulted in an anterior advancement and translation of maxilla without rotation; and the mandible moved downward and backward ward in both treatment groups.
The present study was performed to prove the relationship between CO-CR discrepancy and facial skeletal type. In this study, 242 subjects were randomly selected and devided into 9 groups(devided into class I, II, III by ANB and each one devided into dolicho-, brachy-, mesofacial skeleton by Ricketts' vertical index). Lateral cephalometric radiographs with the mandible in centric occlusion were taken and measured and CO and CR bites were registered on all subjects. Diagnostic casts were mounted on Panadent articulator using an estimated face-bow and centric relation bite registration. The amount and direction of CO-CR discrepancy present was recorded using a Condylar Position Indicator(CPI) and a centric occlusion wax bite registration. CPI measurements and cephalometric measurements were statistically analyzed. The finding of this study can be summerized as follows : 1. There is little correlation between right and left sides for magnitude or direction of CO-CR discrepancies. The correlation between the magnitude of CO-CR discrepancy of left A-P and right A-P is higher than that of left S-I and right S-I. 2. Correlation of Class II malocclusion group was higher than that of the other groups between the magnitude of CO-CR discrepancy of left CPI and right CPI. 3. There is no difference between the pattern of CO-CR discrepancy of 9 malocclusion groups. 4. There is very little, if any, correlation between Skeletofacial measurements and CO-CR discrepancy. 5. In Class II brachyfacial skeleton and Class III mesofacial skeleton there was Lateral cephalometric measurements by that we predict CPI measurements was detected. That was overbite, overjet, upper genial angle, lower genial angle, saddle angle, articular angle, convexity of point A, ANS-Me/Na-Me, PCBL/RH, Posterior FH/anterior FH.
Craniofacial region is a musculodentoskeletal system that consists of many anatomical structures ; cranioskeletal structures, dental arches, and formation and functions of masticatory muscles have close correlations. Growth and development of craniofacial region are influenced by not only hereditory factors, but also environmental factors such as craniofacial muscles and surrounding tissues. On the contrary, however, study on changes in functions or adaptations of craniofacial muscles following changes of craniofacial skeletal structures has been somewhat insufficient. The author's purpose was to observe correlations between masticatory muscular functions and change patterns according to cranial skeletal structures and occlusion patterns, for this, comparative study of muscle activity changes of preand post- orthognathic surgery states in skeletal Cl III malocclusion patients was peformed. The selected sample groups were 15 normal male patients, 15 skeletal Cl III pre-orthognatic surgery patients and 15 skeletal Cl III post-orthognatic surgery patients. For each sample groups, cephalometric x-ray taking, masticatory efficiency test and measurements of muscle activities in anterior temporal muscle, masseter and upper lip in rest, clenching, chewing and swallowing were carried out. The following results were obtained : 1. In resting state of mandible, pre-surgery malocclusion group showed higher m. activities in ant. temporalis, masseter and upper lip than post-surgery group. Post-surg. malocc. group showed significantly high m. activity only in upper lip compared to the normal group. 2. In clenching state, post-surg. malocc. group showed higher m. activities in ut. temporalis, masseter and upper lip than pre-surg. malocc. group. 3. In chewing state, post-surg. malocc. group showed higher m. activities in ant. temporalis and masseter than pre-surg. malocc. group, on the other hand, decreased upper lip activity was noticed. 4. In swallowing state, post-surg. malocc. group showed lower upper lip activity than pre-surg. malocc. group but higher than that of the normal group. No significant difference in m. activities of ant, temporalis and masseter was noticed among the three groups. 5. Masticatory efficiency was lower in pre-surg. malocc. group than normal group, masticatory efficiency showed an increase in post-surg. malocc. group compared to the pre-surg. malocc. group. However, both groups showed significant differences compared to the normal group.
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.
Kim, Eun-Ja;Ki, Eun-Jung;Cheon, Hae-Myung;Choi, Eun-Joo;Kwon, Kyung-Hwan
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.39
no.4
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pp.168-174
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2013
Objectives: The aim of this study is to investigate the correlation between 2-dimensional (2D) cephalometric measurement and 3-dimensional (3D) cone beam computed tomography (CBCT) measurement, and to evaluate the availability of 3D analysis for asymmetry patients. Materials and Methods: A total of Twenty-seven patients were evaluated for facial asymmetry by photograph and cephalometric radiograph, and CBCT. The 14 measurements values were evaluated and those for 2D and 3D were compared. The patients were classified into two groups. Patients in group 1 were evaluated for symmetry in the middle 1/3 of the face and asymmetry in the lower 1/3 of the face, and those in group 2 for asymmetry of both the middle and lower 1/3 of the face. Results: In group 1, significant differences were observed in nine values out of 14 values. Values included three from anteroposterior cephalometric radiograph measurement values (cant and both body height) and six from lateral cephalometric radiographs (both ramus length, both lateral ramal inclination, and both gonial angles). In group 2, comparison between 2D and 3D showed significant difference in 10 factors. Values included four from anteroposterior cephalometric radiograph measurement values (both maxillary height, both body height) and six from lateral cephalometric radiographs (both ramus length, both lateral ramal inclination, and both gonial angles). Conclusion: Information from 2D analysis was inaccurate in several measurements. Therefore, in asymmetry patients, 3D analysis is useful in diagnosis of asymmetry.
Purpose: This study was performed to evaluate the position of impacted mandibular third molars in different skeletal facial types among a group of Iranian patients. Materials and Methods: A total of 400 mandibular third molars in 200 subjects with different types of facial growth were radiographically investigated for their positions according to their types of facial growth on the basis of the ${\beta}$ angle. The subjects were divided into three groups (class I, II, and III) according to ANB angle, representing the anteroposterior relationship of the maxilla to the mandible. Meanwhile, the subjects were also divided into three groups (long, normal, and short face) according to the angle between the stella-nasion and mandibular plane (SNGoGn angle). ANOVA was used for statistical analysis. Results: The mean ${\beta}$ angle showed no significant difference among class I, II, and III malocclusions (df=2, F=0.669, p=0.513). The same results were also found in short, normal, and long faces (df=1.842, F=2, p=0.160). The mesioangular position was the most frequent one in almost all of the facial growth patterns. Distoangular and horizontal positions of impaction were not found in the subjects with class III and normal faces. In the long facial growth pattern, the frequency of vertical and distoangular positions were not different. Conclusion: In almost all of the skeletal facial types, the mesioangular impaction of the mandibular third molar was the most prevalent position, followed by the horizontal position. In addition, ${\beta}$ angle showed no significant difference in different types of facial growth.
Jeong, Do-Min;Oh, Song Hee;Choo, HyeRan;Choi, Yong-Suk;Kim, Seong-Hun;Lee, Jin-Suk;Hwang, Eui-Hwan
The korean journal of orthodontics
/
v.51
no.4
/
pp.231-240
/
2021
Objective: This outcome analysis study evaluated the actual positions of the orthodontic miniplate and miniplate anchoring screws (MPASs) and the risk factors affecting adjacent anatomic structures after miniplate placement in the mandibular incisal area. Methods: Cone-beam computed tomographic images of 97 orthodontic miniplates and their 194 MPASs (diameter, 1.5 mm; length, 4 mm) in patients whose miniplates provided sufficient clinical stability for orthodontic treatment were retrospectively reviewed. For evaluating the actual positions of the miniplates and analyzing the risk factors, including the effects on adjacent roots, MPAS placement height (PH), placement depth (PD), plate angle (PA), mental fossa angle (MA), and root proximity were assessed using the paired t-test, analysis of variance, and generalized linear model and regression analyses. Results: The mean PDs of MPASs at positions 1 (P1) and 2 (P2) were 2.01 mm and 2.23 mm, respectively. PA was significantly higher in the Class III malocclusion group than in the other groups. PH was positively correlated with MA and PD at P1. Of the 97 MPASs at P1, 49 were in the no-root area and 48 in the dentulous area; moreover, 19 showed a degree of root contact (19.6%) without root perforation. All MPASs at P2 were in the no-root area. Conclusions: Positioning the miniplate head approximately 1 mm lower than the mucogingival junction is highly likely to provide sufficient PH for the P1-MPASs to be placed in the no-root area.
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