• The korean journal of orthodontics
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• v.38 no.2
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• pp.83-94
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• 2008

Purpose: The first objective of this study was to compare the upper midface morpholgy, focusing on the soft tissues, between skeletal Class III maloccusion patients with midfacial depression and the norm. The second objective was to estimate and analyze the change in the upper midface soft tissues following surgical correction with maxillary advancement by Lefort I osteotomy and mandibular setback by bilateral sagittal split osteotomy (BSSRO). Methods: The samples consisted of 34 adult patients (15 males and 12 females) with an average age of 21 years, who had severe anteroposterior discrepancy with midfacial depression. These patients had received presurgical orthodontic treatment and surgical treatment which consisted of simultaneous Lefort I osteotomy and BSSRO. Results: The correlation coefficient between changes in maxillary advancement and changes in Or' (soft tissue orbitale) was 0.599 (p < 0.05). Change in maxillary plane angle and vertical change of the maxilla were not correlated with the change in Or' (p < 0.05). The ratio of soft tissue change in Or' to maxillary advancement was 43.57 %, and 81.54 % in Sn. Regression equations between maxillary movement and Or' were devised. The $r^2$ value was 0.476. Conclusions: The majority of measurements in the upper midface in skeletal Class III maloccusions when compared to the norm, showed significant differences. In Class III malocclusion with midfacial depression, maxillary advancement produces soft tissue change in the upper midface.

• The korean journal of orthodontics
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• v.50 no.2
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• pp.98-107
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• 2020

Objective: The aim of this study was to compare posterior tooth inclinations, occlusal force, and contact area of adults with different sagittal malocclusions. Methods: Transverse skeletal parameters and posterior tooth inclinations were evaluated using cone beam computed tomography images, and occlusal force as well as contact area were assessed using pressure-sensitive films in 124 normodivergent adults. A linear mixed model was used to cluster posterior teeth into maxillary premolar, maxillary molar, mandibular premolar, and mandibular molar groups. Differences among Class I, II, and III groups were compared using an analysis of variance test and least significant difference post-hoc test. Correlations of posterior dental inclinations to occlusal function were analyzed using Pearson's correlation analysis. Results: In male subjects, maxillary premolars and molars had the smallest inclinations in the Class II group while maxillary molars had the greatest inclinations in the Class III group. In female subjects, maxillary molars had the smallest inclinations in the Class II group, while maxillary premolars and molars had the greatest inclinations in the Class III group. Occlusal force and contact area were not significantly different among Class I, II, and III groups. Conclusions: Premolar and molar inclinations showed compensatory inclinations to overcome anteroposterior skeletal discrepancy in the Class II and III groups; however, their occlusal force and contact area were similar to those of Class I group. In subjects with normodivergent facial patterns, although posterior tooth inclinations may vary, difference in occlusal function may be clinically insignificant in adults with Class I, II, and III malocclusions.

• The korean journal of orthodontics
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• v.30 no.3 s.80
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• pp.307-315
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• 2000

This study was performed to evaluate the reproducibility of natural head position according to skeletal malocclusion types and sex using cephalometric radiographs for establishing orthodontic diagnosis and treatment planning. The sample consisted of 90 young adults (male 45, female 45) who had the skeletal malocclusion. Cephalometric radiographs were taken in natural head position, and statistical analysis was performed and method error of 6 postural variables were estimated to evaluate the reproducibility of the natural head position. The following results were obtained : 1. In the reproducibility of the natural head position, postural variables had no statistical significance In male and female (P>0.05). 2. In the reproducibility of the natural head position, postural variables had no statistical significance in Class I, II, III, and total group (P>0.05). 3. The reproducibility of natural head position using method error was excellent in all groups.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.2
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• pp.149-153
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• 2010

The purpose of this retrospective study was to evaluate relapse, comparing large and small maxillary advancements with four-plate rigid fixation and without bone grafting. All patients had skeletal class III malocclusion, and underwent bimaxillary surgery. Standardized cephalometric analysis by one examiner was performed on serial radiographs of 14 patients immediately before surgery, and within 1 week and at least 6 months postoperatively (mean 10 months). The group was divided into two subsets to determine whether the magnitude of relapse. In group 1 ($\leq$ 5 mm, n = 8), the average advancement was $4.0{\pm}0.9\;mm$, with a mean relapse of $0.1{\pm}0.5\;mm$. In group 2 (6-8 mm, n = 4), the average advancement was $6.8{\pm}0.9\;mm$, with a mean relapse of $0.7{\pm}0.4\;mm$. There was no statistical difference in the measured relapse among the groups. Maxillary advancement with a 1-piece Le Fort I osteotomy is a relatively stable procedure.

• The korean journal of orthodontics
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• v.48 no.4
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• pp.224-235
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• 2018

Objective: The purpose of this study was to compare the skeletal, dental, and soft-tissue treatment effects of nonextraction therapy using the modified C-palatal plate (MCPP) to those of premolar extraction (PE) treatment in adult patients with Class II malocclusion. Methods: Pretreatment and posttreatment lateral cephalographs of 40 adult patients with Class II malocclusion were retrospectively analyzed. The MCPP group comprised 20 patients treated with total arch distalization of the maxillary arch while the PE group comprised 20 patients treated with four PE. Fifty-eight linear and angular measurements were analyzed to assess the changes before and after treatment. Descriptive statistics, paired t-test, and multivariate analysis of variance were performed to evaluate the treatment effects within and between the two groups. Results: The MCPP group presented 3.4 mm of retraction, 1.0 mm of extrusion, and $7.3^{\circ}$ lingual inclination of the maxillary central incisor. In comparison, the PE group displayed greater amount of maxillary central incisor retraction and retroclination, mandibular incisor retraction, and upper lip retraction (5.3 mm, $14.8^{\circ}$, 5.1 mm, and 2.0 mm, respectively; p < 0.001 for all). In addition, the MCPP group showed 4.0 mm of distalization and 1.3 mm of intrusion with $2.9^{\circ}$ distal tipping of the maxillary first molars. Conclusions: These findings suggest the MCPP is an effective distalization appliance in the maxillary arch. The amount of incisor retraction, however, was significantly higher in the PE group. Therefore, four PE may be recommended when greater improvement of incisor position and soft-tissue profile is required.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.2
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• pp.148-156
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• 2007

Purpose: The aim of this study is the changes of upper respiratory airway space in patients with mandibular prognathism after 2-jaw orthognathic surgery in patients with skeletal classs III malocclusion. Method: We measured the lines between selected upper airway landmarks on lateral cephalometric x-ray films of skeletal class III 64 persons who had not been operated yet, were 6 months after operation. The test subjects were divided into 3 groups according to maxillary movement, as follows; maxillary advancement (MA) group, maxillary posterior impaction (MPI) group, maxillary posterior impaction and superior repositioning (MPI+MSR) group. Result: In this study, nasopharyngeal airway space in MPI+MSR group was significantly increased after operation (p<0.05). Oropharygeal and hypopharyngeal airway space in MA group and MPI group were significantly decreased after operation (p<0.05). From hyoid bone to anterior mandible point distance in MA group and MPI group were significantly decreased after operation (p<0.05). Conclusion: Oropharygeal and hypopharyngeal airway space were influenced more by mandibular set-back than maxillary movement. Maxillary movement surgery as well as mandibular setback surgery should be taken into consideration in order to minimize symptoms related to obstructive sleep apnea syndrome after operation.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.2
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• pp.234-240
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• 2022

Floating-Harbor syndrome (FHS) is a rare genetic disorder. This report introduced in a patient with FHS. Distinctive facial characteristics, severe skeletal class 3 malocclusion with underdeveloped maxilla and protruded mandible, congenital missing teeth, microdontia and ectopic positions of maxillary teeth were presented in the patient. In his twin sister, mild skeletal class 3 malocclusion with protruded mandible was observed but congenital missing teeth and microdontia were not observed. High-arched palate, narrow V-shaped maxillary arch compared to wide and ovoid mandibular arch and inverse relationship between the maxillary and mandibular intermolar width resulted in posterior crossbite were confirmed by model analysis of the patient. These were not observed in the twins. Behaviorally, poor cooperation during dental treatment because of mental retardation was observed in the patient.

• The korean journal of orthodontics
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• v.42 no.2
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• pp.80-86
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• 2012

Objective: This study aimed to investigate the current data regarding age, sex, and Angle Classification of Korean orthodontic patients and influence of these factors on the tendency to undergo extraction and orthognathic surgery. Methods: The recent trends of Korean orthodontic patients were assessed using questionnaire survey. The questionnaires were e-mailed to orthodontists who met the study criteria; 58% of the orthodontists opened the e-mails, and 27.7% replied to the e-mails. In all, the medical records of 11,340 patients who underwent orthodontic treatment at private clinics and small dental hospitals in Korea were analyzed. Results: The percentage of female patients in the study sample was 69.6%, and the average age of the patients was 19.87 years. The percentage of patients who were older than 19 years was 50.2%. Class II and Class III malocclusions were noted in 33.6% and 23.6% of patients, respectively. Extraction and orthognathic surgery were performed in 60.4% and 6.9% of patients, respectively. Conclusions: The results showed that there were a high percentage of adult, Class II malocclusion and extraction patients in private practices and small dental hospitals during the study period. Further, a relatively high proportion of adult patients opted to undergo orthognathic surgery.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.1
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• pp.172-184
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• 1999

The present study was performed to identify morphologic sub-groupings in Korean children with Class I malocclusions, and to find out anatomic differences between the sub-groups. Standardized lateral cephalometric radiographs of 152 Korean children, aged between 6 and 12 years, with Class I malocclusions were analyzed by the Counterpart Analysis. A statistical method, Ward's Minimum Variance Cluster Analysis, was employed to divide the sample into sub-groups those with similar morphologic characteristics. The results were as follows; 1. There appeared two facial types, Type I and Type II, in Korean children with Class I malocclusions, 48.7% and 51.3%, respectively. 2. In both sub-groups, there existed strong Class III skeletal patterns due to a counterclockwise rotation of the Middle Cranial Fossa alignment, and strong Class II skeletal patterns due to the long Posterior Maxillary vertical dimension and a clockwise rotation of the Ramus alignment. 3. There were no significant differences in Upper Anterior Facial Height between Type I and Type II, $52.6{\pm}2.92mm\;and\;52.8{\pm}3.23mm$, respectively. 4. The Lower Anterior Facial Height in Type II was longer ($66.0{\pm}4.03mm$) due to the long Posterior Maxillary vertical dimension, the clockwise rotation of the Ramus alignment, and a clockwise rotation of the Mandibular plane alignment than that of Type I ($64.2{\pm}4.15mm$).

• The korean journal of orthodontics
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• v.22 no.3 s.38
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• pp.509-529
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• 1992

Skeletal Class III malocclusion is one of the most difficult type to treat and stabilize. For a child with developing skeletal Class III malocclusion, the treatment objective would be to stimulate maxillary growth, particulary one who has markedly deficient maxilla, and to restrain excessive mandibular growth. In order to stimulate the maxillary growth, maxillary protraction appliance is the one of the effective orthopedic appliances in skeletal Class III. The purposes of this study were as follows ; evaluation of the skeletal and dental changes of the maxillary protraction in children with Class III Maxillary deficiency , comparison of the clinical effects between the group with RPE and labiolingual intraoral appliances , comparison of the clinical effects and stability related to the ages of the patients : stability of the maxillary protraction about 1 year after retention. The subjects consisted of 60 children between the ages of 8 and 13.4 who were diagnosed as Class III with maxillary deficiency and were treated with Face Mask (Delaire Type) from the Dept. of Orthodontics Yong Dong Severance Hospital, Yonsei University. 48 children wore the RPE and 12 children wore Labiolingual Appliance. Lateral Cephalograms were taken for each patient at before and after correction of anterior cross-bite in 60 children, and after an observation period of 10 to 14 months in 19 children. X and Y coordinate of 10 landmarks were analyzed using a horizontal line through sella and rotated $6^{\circ}$ down anteriorly as the horizontal reference axis, and a perpendicular verticual line through sella as the vertical reference axis. Each of the 31 measurents (10 verticals, 10 horizontals, 2 angles and 9 others) was statistically analyzed using SPSS/PC statistics. The results are as follows; 1. After maxillary protraction the maxilla and maxillary teeth moved downward and forward, while the mandible and mandibular incisor rotated downward and backward. 2. Maxillary protraction with rapid palatal expansion appliance was more effective than with labiolingual appliance. 3. More downward movement of the posterior palatal plane obserbed with maxillary protraction doing the midpalatal suture opening than with protraction after finishing the palatal expansion 4. The clinical effects of protraction and changes of the retention periods were not statistically significant among the age groups. 5. During the retention period, maxilla and maxillary teeth, and mandible and mandibular teeth moved downward and forward, however the mandibular changes were larger than the maxillary changes.