• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.5
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• pp.284-294
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• 2012

Objectives: The anterior open bite with temporomandibular disorders (TMD) is one of the most challenging cases both orthodontically and surgically. We introduce an intermaxillary traction treatment for patients with anterior open bite and TMD using a skeletal anchorage system (SAS). Materials and Methods: This study was comprised of 52 patients with anterior open bite and TMD. A total of four mini-screws were inserted, two screws each into the maxilla and mandible, to obtain a class II pattern of elastic application with 120-200 g force. Adjunctive muscle relaxation treatments, such as splint therapy, medication, and botulinum toxin injection were applied during or before intermaxillary traction. At least one treatment among adjunctive muscle relaxation treatment, mentioned above, was applied to 96.2% of patients. We evaluated the clinical characteristics of patients, TMD symptom changes, amount of open bite improved. The degree of open bite improvement was compared between the open bite-reduced group (21 patients) and not-reduced group (5 patients). Results: TMD symptoms (muscle/joint pain, joint sound, mouth opening) remained or improved in most patients, and worsened in about 10% of patients for each items. Anterior open bite was improved by a mean of 1.75 mm (P<0.01) during treatment. The open bite-reduced group exhibited a significant open bite improvement compared to the not-reduced group (P<0.05), with 37% of open bite improvement occurring during the first 3 months of treatment. Conclusion: The intermaxillary traction technique using SAS is a valid modality for correction of anterior open bite and improvement of TMD symptoms.

• 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.

• The korean journal of orthodontics
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• v.39 no.1
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• pp.54-65
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• 2009

This paper describes the case of a 50-year-old female with a Class II malocclusion who presented with severe bimaxillary protrusion and generalized alveolar bone loss due to adult periodontitis. The treatment plan consisted of extracting both upper and lower first premolars and periodontal treatment. Anterior segmental osteotomy(ASO) of the mandible and upper anterior segment retraction using compression osteogenesis after peri-segmental corticotomy(Speedy orthodontics) was performed. Correct overbite and overjet, facial balance, and improvement of lip protrusion were obtained. However, a slight root resorption tendency was observed on the lower anterior dentition. The active treatment period was 9 months and the results were stable for 27 months after debonding. This new type of treatment mechanics can be an effective alternative to orthognathic surgery.

• The korean journal of orthodontics
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• v.48 no.3
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• pp.189-199
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• 2018

For patients with bimaxillary protrusion, significant retraction and intrusion of the anterior teeth are sometimes essential to improve the facial profile. However, severe root resorption of the maxillary incisors occasionally occurs after treatment because of various factors. For instance, it has been reported that approximation or invasion of the incisive canal by the anterior tooth roots during retraction may cause apical root damage. Thus, determination of the position of the maxillary incisors is key for orthodontic diagnosis and treatment planning in such cases. Cone-beam computed tomography (CBCT) may be useful for simulating the post-treatment position of the maxillary incisors and surrounding structures in order to ensure safe teeth movement. Here, we present a case of Class II malocclusion with bimaxillary protrusion, wherein apical root damage due to treatment was minimized by pretreatment evaluation of the anatomical structures and simulation of the maxillary central incisor movement using CBCT. Considerable retraction and intrusion of the maxillary incisors, which resulted in a significant improvement in the facial profile and smile, were achieved without severe root resorption. Our findings suggest that CBCT-based diagnosis and treatment simulation may facilitate safe and dynamic orthodontic tooth movement, particularly in patients requiring maximum anterior tooth retraction.

• The korean journal of orthodontics
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• v.30 no.4 s.81
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• pp.387-398
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• 2000

This study was aimed to observe the effect of Anterior J hook headgear on the craniofacial structures in mixed dentition with Class II malocclusion. The laterial cephalograms of 20 children treated by Anterior J hook headgear were traced, digitized and statistically analyzed. The results were as follows : 1. Forward growth of maxilla was inhibited. 2. Rotational effect of maxilla was not observed. 3. There was distal movement of maxillary dentition. 4. Maxillarly_dentoalveolar growth changes were more effective in anterior portion than posterior portion. 5. Mandible maintained a normal growth and mandibular plane angle was maintained during treatment period. 6. The ratio of anterior facial height to posterior facial height was almostly not changed.

• 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.

• The korean journal of orthodontics
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• v.52 no.3
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• pp.165-171
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• 2022

Objective: This cross-sectional study aimed to investigate the characteristics of malocclusions in scoliotic patients through clinical examinations. Methods: Fifty-eight patients with idiopathic scoliosis (IS) and 48 patients with congenital scoliosis (CS) participated in the study. A randomly selected group of 152 orthopedically healthy children served as the control group. Standardized orthodontic and orthopedic examination protocols were used to record the occlusal patterns and type of scoliosis. Assessments were made by three experienced orthodontists and a spinal surgery team. The differences in the frequency distribution of occlusal patterns were evaluated by the chi-squared test. Results: In comparison with patients showing IS, patients with CS showed a higher incidence of Cobb angle ≥ 45° (p = 0.020) and included a higher proportion of patients receiving surgical treatments (p < 0.001). The distribution of the Angle Class II subgroup was significantly higher in the IS (p < 0.001) and CS (p = 0.031) groups than in the control group. In comparison with the healthy controls, the CS and IS groups showed significantly higher (p < 0.05) frequencies of asymmetric molar and asymmetric canine relationships, upper and lower middle line deviations, anterior deep overbite, unilateral posterior crossbite, and canted occlusal plane, with the frequencies being especially higher in CS patients and to a lesser extent in IS patients. Conclusions: Patients with scoliosis showed a high frequency of malocclusions, which were most obvious in patients with CS.

• The korean journal of orthodontics
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• v.31 no.5 s.88
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• pp.535-548
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• 2001

The purpose of this study was to evaluate changes in soft tissue chin thickness and to investigate correlations between hard and soft tissues measurements after orthodontic treatment conducted by premolars extraction and incisor retraction. The sample consisted of 35 female adults with Angle classification class I or class II division 1 malocclusion. Using lateral cephalometric radiographs taken before and after treatment, hard and soft tissue structures were measured and reproducible six landmark on soft chin tissue were used to locate the various points of soft tissue contour of the chin. The res에ts were as follows : 1. There were signigicant correlations between pretreatment B-B', Pm-Pm' and pretreatment vortical skeletal measurements such as $MP{\perp}HP,\;MP{\perp}PP$, ALFH and between a-a', b-b', Me-Me' and measurements of sym-physeal morphology such as SL, SW, PL. 2. There were significant decreases at B-B', Pm-Pm' and significant increases at a-a', b-b' between pre-and posttreatment mea surements. 3. There were significant correlations among soft tissues changes and hard tissue changes except for changes at B-B' and the range of correlation coefficient was about 0.3-0.4. 4. There were significant differences at ${\Delta}UI-VP,\;LI{\perp}, and B-B' measurements between subgroups divided by posttreatment Pog-Pog' changes. 5. There were significant differences at ${\Delta}overbite,\;NPog{\perp}HP,\;and\;Me-Me'$ measurements between subgroups divided by posttreatment Me-Me' changes.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.2 no.1
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• pp.39-44
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• 2006

Cerebral palsy(CP) is one of the most common motor disease, due to brain injury during fetal and neonatal development which results in neuromotor paralysis and associated neuromuscular symptoms. Features of CP include motor disability due to the lack of muscle control, often accompanied by sensory disorders, mental retardation, speech disorders, hearing loss, epilepsy, behavior disorders, etc. There are increasing chances of treatment of dental patients with cerebral palsy, as the occurrence of CP is increasing with the decrease in infant mortality and an increase in immature birth and premature birth and also, there is a trend to pursue of higher quality of life. Reports on the relationship between CP and maxillofacial deformity are uncommon, but it is well known that the unbalance and discontrol of the facial muscles, lip, tongue and the jaws leads to malocclusion and temporomandibular joint disorders, and statistics show that class 2 relationship of the jaws and open bite is frequently reported. However, it is difficult to perform maxillofacial deformity treatment, which consists of orthodontic treatment, maxillofacial surgery and muscle adaptation training, due to difficulties in communication and problems of muscle adaptation caused by difficulties in motor control which leads to a high recurrence rate. This case report is to trearment of maxillofacial deformity in CP patient. A 26 year old female patient came to the department with the chief complaint of prognathism of the mandible and facial asymmetry. According to the past medical history, she was diagnosed as cerebral palsy 1 week after birth, classified as GMFC, classII accompanied with left side torticollis. The patient's intelligence was moderate, and there were no serious problems in communication. For two years time, the patient underwent lingual frenectomy, pre-operation orthodontic treatment and then bimaxillary orthognathic surgery to treat mandibular prognathism and facial asymmetry followed by rehabilitatory exercise of facial muscle. After 6 months of follow up, there was a good result. This is to report to the typical signs and symptoms of DFD in CP patient and the limitation of the usual method of the treatment of DFD in CP patient with literature review.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.3
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• pp.488-495
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• 2001

Treatment of class II malocclusions require distalization of maxillary molars into class I relationship. Intraarch distal molar movement techniques have recently assumed an important role in young patients. In this study, the dental and skeletal effects of the pendulum appliance were evaluated by means of cephalometric radiographs. The samples were consisted of 19 patients: 11 females and 8 males, mean age $11.68{\pm}1.52$ years. Measurements were obtained from cephalometric prior to and the day of removal of the pendulum appliance. Treatment changes were analyzed. The following results were obtain. 1. The pendulum appliance produced $2.94{\pm}1.54mm$ distal molar movement with a mean intrusion of $1.17{\pm}0.97mm$, mean period $18.13{\pm}7.95$ weeks. 2. The anchor tooth was $1.34{\pm}1.40mm$ forward movement and $0.48{\pm}0.99mm$ extrusion, and labial tilting of incisors. 3. The angle between palatal plane and mandibular plane increased significantly. 4. There was no significant difference in according to 2nd molar position. 5. Total movement was consisted of 74% distal movement of 1st molar and 26% forward movement of the anchor tooth.