• Title/Summary/Keyword: class 2 malocclusion

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Study of soft tissue changes in the upper lip and nose after backward movement of the maxilla in orthognathic surgery

  • Seon, Suyun;Lee, Hyun-Woo;Jeong, Bong-Jin;Lee, Baek-Soo;Kwon, Yong-Dae;Ohe, Joo-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.6
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    • pp.385-392
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    • 2020
  • Objectives: This study evaluates soft tissue changes of the upper lip and nose after maxillary setback with orthognathic surgery such as Le Fort I or anterior segmental osteotomy. Materials and Methods: All 50 patients with bimaxillary protrusion and skeletal Class II malocclusion underwent Le Fort I or anterior segmental osteotomy with backward movement. Soft and hard tissue changes were analyzed using cephalograms collected preoperatively and 6 months postoperatively. Results: Cluster analysis on the ratios shows that 2 lines intersected at 4 mm point. Based on this point, we divided the subjects into 2 groups: Group A (less than 4 mm, 27 subjects) and Group B (more than 4 mm, 23 subjects). Also, each group was divided according to changes of upper incisor angle (≥4°=A1, B1 or <4°=A2, B2). The correlation between A and B groups for A'/ANS and Ls/Is (P<0.001) was significant; A'/A (P=0.002), PRN/A (P=0.043), PRN/ANS (P=0.032), and St/Is (P=0.010). Variation of nasolabial angle between the two groups was not significant. There was no significant correlation of vertical movement and angle variation. Conclusion: The ratio of soft tissue to hard tissue movement depends on the amount of posterior movement in the maxilla, showing approximately two times higher rates in most of the midface when posterior movement was greater than 4 mm. The soft tissue changes caused by posterior movement of the maxilla were little affected by angular changes of upper incisors. Interestingly, nasolabial angle showed a different tendency between A and B groups and was more affected by incisal angular changes when horizontal posterior movement was less than 4 mm.

PRE-ORTHODONTIC TREATMENT WITH MYOFUNCTIONAL APPLIANCE (근기능장치를 이용한 교정 전 치료)

  • Kim, Min-Soo;Yoo, Seung-Hoon;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.620-627
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    • 2005
  • The purposes of early orthodontic intervention are to correct obvious problems, to intercept developing problems and prevent them from becoming worse. Myofunctional influence on facial growth and the dentition change in muscle function and initiate morphologic variation in the normal configuration of the teeth and enhance an already existing malocclusion. Myofunctional therapy has been advocated since 1960's as the treatment for tongue thrust and other oral habits. Pre-orthodontic $TRAINER^{(R)}$ is introduced as functional device usable in children of mixed dentition to correct functional problems concerning soft tissue, tooth and skeleton. The most common cases to treat with Pre-orthodontic $TRAINER^{(R)}$ are lower anterior crowding, anterior open bite, Class II malocclusion and deep bite. Also, it can be used as correction of oral habits. Patients in this cases visited Department of Pediatric Dentistry, School of dentistry, Dankook University for orthodontic treatment. Pre-orthodontic treatment with Pre-orthodontic $TRAINER^{(R)}$ was carried out for correction of the oral habits.

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Anchor Plate Efficiency in Postoperative Orthodontic Treatment Following Orthognathic Surgery via Minimal Presurgical Orthodontic Treatment

  • Jeong, Tae-Min;Kim, Yoon-Ho;Song, Seung-Il
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.4
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    • pp.154-160
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    • 2014
  • Purpose: The efficiency of an anchor plate placed during orthognathic surgery via minimal presurgical orthodontic treatment was evaluated by analyzing the mandibular relapse rate and dental changes. Methods: The subjects included nine patients with Class III malocclusion who had bilateral sagittal split osteotomy at the Division of Oral and Maxillofacial Surgery, Department of Dentistry in Ajou University Hospital, after minimal presurgical orthodontic treatment. During orthognathic surgery, anchor plates were placed at both maxillary buttresses. The anchor plates were used to move maxillary teeth backward and for maximum anchorage of Class III elastics to minimize mandibular relapse during the postoperative orthodontic treatment. The lateral cephalometric X-ray was taken preoperatively (T0), postoperatively (T1), and one year after the surgery (T2). Seven measurements (distance from Pogonion to line Nasion-Nasion perpendicular [Pog-N Per.], angle of line B point-Nasion and Nasion-Sella [SNB], angle of line maxilla 1 root-maxilla 1 crown and Nasion-Sella [U1 to SN], distance from maxilla 1 crown to line A point-Nasion [U1 to NA], overbite, overjet, and interincisal angle) were taken. Measurements at T0 to T1 and T1 to T2 were compared and differences tested by standard statistical methods. Results: The mean skeletal change was posterior movement by $13.87{\pm}4.95mm$ based on pogonion from T0 to T1, and anterior movement by $1.54{\pm}2.18mm$ from T1 to T2, showing relapse of about 10.2%. There were significant changes from T0 to T1 for both Pog-N Per. and SNB (P<0.05). However, there were no statistically significant changes from T1 to T2 for both Pog-N Per. and SNB. U1 to NA that represents the anterior-posterior changes of maxillary incisor did not differ from T0 to T1, yet there was a significant change from T1 to T2 (P<0.05). Conclusion: This study found that the anchor plate minimizes mandibular relapse and moves the maxillary teeth backward during the postoperative orthodontic treatment. Thus, we conclude that the anchor plate is clinically very useful.

A CLINICAL CONSIDERATION ON THE EFFECT OF OCCIPITO-MENTAL ANCHORAGE (O. M. A (후두돈부(後頭頓部) 고정장치(固定裝置))의 치료(治療) 효과(效果)에 대(對)한 고찰(考察))

  • Sung, Jae-Hyun
    • The korean journal of orthodontics
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    • v.14 no.1
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    • pp.15-24
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    • 1984
  • The purpose of this study was to evaluate the effect of O.M.A on Angle's class III malocclusion. The author analysed the data obtained from pre- and post-treatment lateral cephalograms. The results obtained were as follows : 1. Forward growth of maxillary complex was accomplished. 2. The mandible showed few morphological changes in the presence of downward and backward swing. 3. It was assumed that the hooks attached to the intraoral appliance should be placed as far frontally as possibie. 4. Relations of the upper and lower jaws were improved resulting in better facial profiles.

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A removable partial denture treatment with the Dahl concept applied to a patient with a deep bite (과개교합 환자에서 Dahl concept을 적용한 가철성 보철 치료)

  • Kim, Chang-Hwan;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.2
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    • pp.110-120
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    • 2020
  • Although not all kinds of deep bite occlusions are considered pathological states, they can cause persistent wear and eruption of the anterior mandibular teeth if the anterior occlusal contact is unstable or accompanied by an occlusal disharmony. The patient was a 72-year-old man with no occlusal contact of the remaining anterior teeth in the centric relation position because of a skeletal class II malocclusion and loss of occlusal support. If the vertical dimension needs to be increased for prosthetic restoration in a patient with a deep bite, the amount of vertical dimension increase must be determined through precise diagnosis. This is because the overjet may increase and cause an unstable occlusion. In this review, we report the case of a patient with a stable occlusion and good treatment results achieved by using a removable partial denture prosthesis and applying the Dahl concept.

Miniscrews versus surgical archwires for intermaxillary fixation in adults after orthognathic surgery

  • Son, Sieun;Kim, Seong Sik;Son, Woo-Sung;Kim, Yong-Il;Kim, Yong-Deok;Shin, Sang-Hun
    • The korean journal of orthodontics
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    • v.45 no.1
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    • pp.3-12
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    • 2015
  • Objective: We compared the skeletal and dental changes that resulted from the use of two methods of intermaxillary fixation (IMF)-miniscrews and surgical archwire-in 74 adult patients who had Class III malocclusion and were treated with the same orthognathic surgical procedure at a hospital in Korea. Methods: All the patients underwent Le Fort I osteotomy and bilateral sagittal split ramus osteotomy with rigid fixation. They were divided into two groups according to the type of IMF used-group 1 underwent surgical archwire fixation and group 2 underwent orthodontic miniscrew fixation. In a series of cephalograms for each patient, we compared vertical and horizontal tooth-position measurements: (a) immediately after surgery ($T_0$), (b) 3 months after surgery ($T_1$), and (c) 6 months after surgery ($T_2$). Cephalometric changes within each group were examined using one-way analysis of variance (ANOVA) while the independent samples t -test procedure was used to compare the two groups. Results: After surgery, the maxillary incisors tended to be proclined in both groups although there were no significant differences. Incisor overbite increased significantly in both groups from $T_0$ to $T_1$, and the miniscrew group (group 2) showed slightly greater overbite than the archwire group (group 1). Conclusions: This study suggest that the use of orthodontic miniscrews and orthodontic surgical archwire for IMF in adult patients results in similar skeletal and dental changes.

Three-Dimensional Evaluation of Skeletal Stability following Surgery-First Orthognathic Approach: Validation of a Simple and Effective Method

  • Nabil M. Mansour;Mohamed E. Abdelshaheed;Ahmed H. El-Sabbagh;Ahmed M. Bahaa El-Din;Young Chul Kim;Jong-Woo Choi
    • Archives of Plastic Surgery
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    • v.50 no.3
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    • pp.254-263
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    • 2023
  • Background The three-dimensional (3D) evaluation of skeletal stability after orthognathic surgery is a time-consuming and complex procedure. The complexity increases further when evaluating the surgery-first orthognathic approach (SFOA). Herein, we propose and validate a simple time-saving method of 3D analysis using a single software, demonstrating high accuracy and repeatability. Methods This retrospective cohort study included 12 patients with skeletal class 3 malocclusion who underwent bimaxillary surgery without any presurgical orthodontics. Computed tomography (CT)/cone-beam CT images of each patient were obtained at three different time points (preoperation [T0], immediately postoperation [T1], and 1 year after surgery [T2]) and reconstructed into 3D images. After automatic surface-based alignment of the three models based on the anterior cranial base, five easily located anatomical landmarks were defined to each model. A set of angular and linear measurements were automatically calculated and used to define the amount of movement (T1-T0) and the amount of relapse (T2-T1). To evaluate the reproducibility, two independent observers processed all the cases, One of them repeated the steps after 2 weeks to assess intraobserver variability. Intraclass correlation coefficients (ICCs) were calculated at a 95% confidence interval. Time required for evaluating each case was recorded. Results Both the intra- and interobserver variability showed high ICC values (more than 0.95) with low measurement variations (mean linear variations: 0.18 mm; mean angular variations: 0.25 degree). Time needed for the evaluation process ranged from 3 to 5 minutes. Conclusion This approach is time-saving, semiautomatic, and easy to learn and can be used to effectively evaluate stability after SFOA.

Comparison of Soft Tissue Changes between Adolescents and Adults in Class II Malocclusion Treatment (청소년 및 성인 환자에서 II급 부정교합 치료시 연조직 변화에 관한 비교)

  • Chang, Na-Young;Cho, Jin-Hyoung;Lee, You-Mee;Kang, Kyung-Hwa
    • Journal of Oral Medicine and Pain
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    • v.34 no.3
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    • pp.277-294
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    • 2009
  • The purpose of this study was to evaluate the soft tissue changes of class II adolescents and adults in respect to extraction or nonextraction. The study included 68 patients from Wonkwang Dental Hospital were categorized to adolescent extraction group, adolescent nonextraction group, adult extraction group, adult nonextraction group. Cephalometric tracing of each patient was done to compare pretreatment and posttreatment of each group, to compare the changes between groups. And among the variables that showed significancy, correlation analysis and simple linear regression were done. The results were as follows. 1. In both adolescents and adults after extraction treatment, nasolabial angle significantly increased and in both subjects after non extraction treatment, nasolabial angle significantly decreased. 2. In extraction subjects, there were positive correlation between the amount of treatment changes of vertical-U1 and E line-upper lip, the changes of vertical-L1 and E line-lower lip, the changes of vertical-L1 and vertical-Li. 3. In extraction subjects, simple regression equations of E line-upper lip, E line-lower lip, Li were calculated by regression analysis. According to the results above, it could be considered that the effect of the extraction or nonextraction treatment was greater than the effect of growth.

Cephalometric study on head posture according to the Classification of Malocclusion (부정교합 분류에 따른 두경부 위치의 두부방사선 계측학적 연구)

  • Hwang, Chung-Ju;Kim, Suk-Hyun;Kil, Jae-Kyung
    • The korean journal of orthodontics
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    • v.27 no.2
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    • pp.221-230
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    • 1997
  • It has been known that head posture may influence directly and/or indirectly the growth and development of craniofacial morphology and can also be influenced by the funtional demand of physiologic activity. It was reported that facial morphology has close relationships with hyoid bone position and head posture. In many previous studies, Natural Head Posture(NHP) was guided, and also it was shown that NHP has high degree of reproducibility. Otherwise, There was few study about the relationship of head posture, with routine cephalometric film which is used for clinical orthodontic purpose. In this study, according to the Wits and ANB of initial cephalometric film which was taken with vertical pendulum as representative of true vertical reference line. We classified the subjects which is comprised of 60 adult female patients into Class I, II, III (Cl I, II, III)and we tried to find out the correlation of head posture and hyoid bone position according to the classification of malocclusion. As a result of our research, we found the followigs. 1. In comparison of vertical position of hyoid bone relative to the cranial base. the position of hyoid bone of Cl III was lower than that of Cl II. 2. In comparison of anteriorpostes or position of hyoid bone, relative to the cervical column. The position of hyoid bone of Cl III was more anterior than that of a II 3. in comparison of vertical position of hyoid bone relative to mandible. There was no significant correlation aumoug the groups of malocclusion. 4. ANB and Wits showed no significant correlation with hyoid bone position. 5. The relative extension of head, which was noted in Cl II, showed negative with Sum, ANB. 6. In Cl II and Cl III, Post to Ant facial height showed positive correlation with NSL/VER.

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A STUDY ON THE CHANCE OF POSTER10R AVAILBLE SPACE AND THE RELATIONSHIP BETWEEN POSTERIOR AVAILABLE SPACE AND CROWDING (Posterior available space의 crowding과의 상관관계 및 변화에 관한 연구)

  • Lee, Noh-Beom;Kim, Kwang-won
    • The korean journal of orthodontics
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    • v.24 no.3 s.46
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    • pp.535-546
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    • 1994
  • The research work has been conducted in order to establish facts on posterior available space in patients with crowding. The relation between crowding and posterior available space was worked out through a cross sectinal study of fifty eight patients showing class I malocclusion. In addition, a longitudinal overlapping study was done by examing twenty patients who had their bicuspid extracted and forty nine patients who did not, at the orthodontic department of dental clinic affiliated in Chosun University. The patients had been examined for three years and eight months on a regular basis, and the study yielded the following conculusion. 1. There was a great difference in posterior available space between patients with serious crowding and those with slight crowding. The former marked 15.2mm of posterior available space and the latter 19.9mm. 2. Posterior crowding index was acquired by joint consideration of the diameter of posterior teeth and posterior available space, and manifested the highest relationship with crowding among measured items. 3. Patients who had their bicuspids extracted exhibited increase in posterior available space of 1.6mm/year and those who did not 1.8mm/year. 4. The absorption of anterior border of ramus turned out to be most deeply related with the increase of posterior available space. 5. Anterior border of ramus was absorbed at the average rate of 0.7mm/year during the period of observation. 6. The extraction of bicuspids had little influnce on the change in posterior available space.

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