• The korean journal of orthodontics
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• 제37권3호
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• pp.182-191
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• 2007

Objective: The purpose of this study was to evaluate the validity of midsagittal reference (MSR) planes constructed in maxillofacial 3D images. Methods: Maxillofacial computed tomography (CT) images were obtained in 36 normal occlusion individuals who did not have apparent facial asymmetry, and 3D images were reconstructed using a computer software. Six MSR planes (Cg-ANS-Ba, Cg-ANS-Op, Cg-PNS-Ba, Cg-PNS-OP, FH${\perp}$(Cg, Ba), FH${\perp}$(Cg, Op)) were constructed using the landmarks located in the midsagittal area of the maxillofacial structure, such as Cg, ANS, PNS, Ba and Op, and FH plane constructed with Po and Or. The six pairs of landmarks (Z, Fr, Fs, Zy, Mx, Ms), which represent right and left symmetry in the maxillofacial structure, were selected. Statistically significant differences of the right and the left measurements were examined through t-test, and the difference of the right and the left measurement was compared among the six MSR planes. Results: The distances from the right and the left landmarks in each pair to each MSR plane did not show a statistically significant difference. The reproducibility of the landmark identification was excellent. Conclusion: All the six planes constructed in this study can be used as a MSR plane in maxillofacial 3D analysis, particularly, the planes including Cg and ANS.

• The korean journal of orthodontics
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• 제33권2호
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• pp.73-84
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• 2003

This study was performed to find out how much projection errors in the cephalometric measurements were made by vertical head rotation in taking posteroanterior cephalograms. 25 adults without any apparent facial asymmetry or severe sagittal skeletal discrepancy were selected and the posteroanterior cephalograms were taken with the head rotated $5^{\circ},\;10^{\circ}$ superior and inferior each to the reference $position(0^{\circ})$. The 7 height, 5 width and 6 angular measurements were taken at each 5 positions. Through the statistical analysis of all measurements taken at each rotated position, folowing results were obtained.1. The projection errors of height measurements were remarkably target than those of width or angular measure nents. f. Among the height measurements, the farther to the rotation axis the measurements were, the larger the projection errors were. 3. Among the width measurements, mandibular width and mandibular width of mandibular first molars showed significant differences between the values taken at each rotated position, while nasal width, maxillary width and intermolar width of maxillary first molars did not. 4. Among the angular measurements, the angle between horizontal reference line and the line that is connected to crista galli and antegonion or maxillare showed significant differences between the values taken at each rotated Position. The above results suggest that it is needed to the effort to keep constant head position for taking the useful posteroanterior cephalogra, because projection errors are caused by vertical head rotation.

• The korean journal of orthodontics
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• 제35권4호
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• pp.251-261
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• 2005

Enlargement is an inherent property of X-rays which occurs when straight hues diverse from small a focal spot. The purpose of the present study was to evaluate the validity of the correction of gonial angle width enlarged on frontal cephalogram, using frontal and lateral cephalograms taken orthogonally from each other. In 40 adult individuals, frontal and lateral cephalograms were taken at a $90^{\circ}$ angle using the Head Posture Aligner. The angle width was measured on the frontal cephalogram and subsequently. the corrected angle width was calculated using the magnification rate of two cephalograms. Measured and corrected angle widths were compared with the measurement from the 3D CT image. The measurement or the frontal cephalogram showed a 9.10mm of enlargement on average ranging from 7.92 to 11.31mm. Corrected angle width measurement showed a 0.14mm difference with the 3D CT image measurement, which was not statistically significant. The results of the study indicate that actual au91e width can be approached through calculation using frontal and lateral cephalograms taken orthogonally with the help of the Head Posture Aligner The study also showed that the magnitude of correction error did not show a significant correlation with the amount of menton deviation, and it suggests that the present correction method is valid even in individuals with severe facial asymmetry.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.25.1-25.4
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• 2016

Background: Bilateral sagittal split ramus osteotomy (BSSRO) is the most widely used mandibular surgical technique in orthognathic surgery and is easy to relocate the distal segments, accelerating bone repair by the large surface of bone contact. However, it can cause neurosensory dysfunction (NSD) or sensory loss by injury of the inferior alveolar nerve. The purpose of the present study was to evaluate NSD after BSSRO and modifiers at NSD recovery. Methods: In this study, NSD characteristics after BSSRO from 2009 to 2014 at the Kyung Hee University Dental Hospital were evaluated. The pattern of sensory recovery over time was also evaluated based on factors such as field of sensory dysfunction, surgical procedure, presence of pre-operative facial asymmetry, and postoperative medications. Results: Most of the patients had shown NSD immediately after orthognathic surgery. Among the 1192 sides of 596 patients, NSD was observed in 953 sides and 544 patients. Sexual predilection was shown in males (p value = 0.0062). In the asymmetric group of 132 patients, NSD was observed in 128 patients (96.97 %). In the symmetric group of 464 patients, NSD was observed in 416 patients (89.45 %); on the other hand, NSD was observed significantly higher in the asymmetric group (p = 0.025). NSD-associated factors were analyzed, and vitamin B12 may be beneficial for NSD recovery. Conclusions: There was a difference between the symmetric group and the asymmetric group in NSD recovery. Vitamin B12 can be regarded as an effective method to nerve recovery. However, a further prospective study is needed.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.49.1-49.9
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• 2016

Background: The aim of this report is to present a new reference for aesthetic mandible surgery using three-dimensional cone-beam computed tomography-based treatment planning for orthognathic surgery which can be implemented in surgical planning and perioperative procedure. Methods: To make an objective standard for evaluating aesthetic mandibular outline, we make an aesthetic scoring criteria with consideration of asymmetry, broad mandibular border line, and prominent mandibular angle. Two maxillofacial surgeons and two orthodontists rated their aesthetical evaluation from 1 to 5. Experimental group consisting of 47 female and 38 male patients who had rotational orthognathic two-jaw surgery from 2010 to 2011 were chosen according to aesthetic scoring done by two maxillofacial surgeons and two orthodontists. A high aesthetic score (${\geq}16$) means the facial contour is symmetric, with no broad and narrow aesthetic mandible frontal profiles. Control A group consisted of ten female and ten male patients who had no orthognathic surgery experience and low aesthetic score (${\geq}10$). Control B group consisted of ten female and ten male patients who had no orthognathic surgery experience and had anaesthetic mandibular frontal profile and a high aesthetic score (${\geq}16$). The three-dimensional image of the patient was taken from dental cone-beam CT (DCT) scanning (experimental group and control A group: 6 months DCT after surgery, control B group: 1st visit DCT). Each DCT was reformatted to reorient the 3D image using 3D analyzing program (OnDemand3D, cybermed Inc, CA, USA). After selection of 12 landmarks and the construction of reoriented horizontal, vertical, and coronal reference lines, 15 measurements were taken in 3D analysis of frontal mandibular morphology. Afterwards, horizontal and vertical linear measurements and angular measurements, linear ratio were obtained. Results: Mean $Go^{\prime}_{Rt}-Me^{\prime}-Go^{\prime}_{Lt}$ angular measurement was $100.74{\pm}2.14$ in female patients and $105.37{\pm}3.62$ in male patients. These showed significant difference with control A group in both genders. Ratio of $Go^{\prime}_{Rt}-Go^{\prime}_{Lt}-Me^{\prime}$ length to some linear measurements (ratio of $Me^{\prime}-Cd^{\prime}_{Rt}Cd^{\prime}_{Lt}$ to $Me^{\prime}-Go^{\prime}_{Rt}Go^{\prime}_{Lt}$, ratio of $Me^{\prime}-Go^{\prime}$ to $Me^{\prime}-Go^{\prime}_{Rt}Go^{\prime}_{Lt}$, ratio of $Go^{\prime}_{Rt}-Go^{\prime}_{Lt}$ to $Me^{\prime}-Go^{\prime}_{Rt}Go^{\prime}_{Lt}$) showed significant difference with control A group in both genders. Conclusion: This study was intended to find some standard measurement of mandible frontal view in 3D analysis of aesthetic patient. So, these potential measurement value may be helpful for orthognathic treatment planning to have more aesthetic and perspective outcomes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권4호
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• pp.321-329
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• 2001

To establish systematic diagnosis and treatment planning of dentofacial deformity patient including facial asymmetry or hemifacial microsomia patient, comprehensive analysis of three dimensional structure of the craniofacial skeleton is needed. Even though three dimensional CT has been developed, landmark identification of the CT is still questionable. In recent, a method for correcting cephalic malpositioning that enables accurate superimposition of the landmarks in different stages without using any additional equipment was developed. It became possible to compare the three-dimensional positional change of the maxillomandible without invasive procedure. Based on the principle of the method, a new program was developed for the purpose of diagnosis and treatment planning of dentofacial deformity patient via three dimensional visualization and structural analysis. This program enables us to perform following menu. First, visualization of three dimensional structure of the craniofacial skeleton with wire frame model which was made from the landmarks observed on both lateral and frontal cephalogram. Second, establishment of midsagittal plane of the face three dimensionally, with the concept of "the plane of the best-fit". Third, examination of the degree of deviation and direction of deformity of structure to the reference plane for the purpose of establishing surgical planning. Fourth, simulation of expected postoperative result by various image operation such as mirroring, overlapping.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권5호
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• pp.316-323
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• 2009

Purpose: This study was performed to evaluate three-dimensional positional change of the condyle using 3D CT after bilateral sagittal split ramus osteotomy (BSSRO) in skeletal class III patients. Patients and methods: Nine patients who underwent BSSRO for mandibular set-back in skeletal class III malocclusion without facial asymmetry were examined. Miniplates were used for the fixation after BSSRO. 3-D CT was taken before, immediately after, and 6 months after undergoing BSSRO. After creating 3D-CT images using V-works $4.0^{TM}$ program, axial plane, coronal plane, & sagittal plane were configured. Three dimensional positional change, from each plane to the condyle, of the nine patients was measured before, immediately after, and 6 months after undergoing BSSRO. Results: 1. The mean value of mandibular set-back for nine mandibular prognathism patients was 7.36 mm (${\pm}\;2.42\;mm$). 2. In the axial view, condyle is rotated inward immediately after BSSRO (p < 0.05), comparing with preoperative but outward 6 months after BSSRO comparing with postoperative (p < 0.05). 3. In the axial view, condyle is moved laterally immediately after BSSRO (p < 0.05), comparing with preoperative but regressed 6 months after BSSRO comparing with preoperative (p > 0.05). 4. In the frontal & coronal view, there is changed immediately after and 6 months after BSSRO, comparing with preoperative but no statistical difference. Conclusion: These results indicate that three-dimensional positional change of the condyle in skeletal class III patients is observed lateral displacement & inward rotation immediate after BSSRO, but the condyle in 6 months after BSSRO tends to regress to preoperative position.

• Journal of the korean academy of Pediatric Dentistry
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• 제35권4호
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• pp.718-724
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• 2008

Tooth impaction is a frequently observed eruption anomaly in pediatric dental practice. Young patients with impacted or unerupted teeth have more prediction for dentigerous cyst formation. Dentigerous cyst presents radiographic features, unilocular or multilocular radioluscency. Cysts occur most frequently in the premolar region except third molar. Dentigerous cysts can grow to a considerable size, and large cysts may be associated with a painless expansion of the bone in the involved area. Extensive lesions may result in facial asymmetry, osseous destruction, root resorption of proximal teeth and displacement of associated tooth. The nature of the causative tooth influences the type of surgical treatment required for the dentigerous cyst. If the cyst is associated with a supernumerary or wisdom tooth, complete enucleation of the cyst along with extraction of tooth may be the first treatment choice. Otherwise, preservation of the associated teeth should be considered to prevent a young patient from psychological and mental trauma because of the loss of tooth. We should consider the degree of tooth displacement, osseous destruction and growth pattern of oromaxillofacial area when planning treatment. Thus a proper and logical treatment planning can help a proper growth and development of oromaxillofacial area and can save the patient from a psychological and mental trauma. This report describes 4 cases of the management of impacted premolars and molars associated with dentigerous cysts in children.

• Journal of the korean academy of Pediatric Dentistry
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• 제34권4호
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• pp.658-665
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• 2007

Oligodontia is defined as the congenital absence of six or more teeth in dentition, excluding the third molars. The prevalence of congenital missing teeth is about 1.6 to 9.6% of population and the prevalence of oligidontia is about 0.08 to 1.1%. The mandibular second premolar is the most frequently absent after the third molar, followed by the maxillary lateral incisor and upper second premolar. Females seem to be affected slightly more than males. Oligodontia may occur either in isolation, or as a part of a syndrome such as ectodermal dysplasia. Different causes are possible for oligodontia: physical obstruction or distruction of the dental lamina, space limitation, functional abnormalities of the dental epithelium, failure of induction of the underlying mesenchyme, chemotherapy, radiotherapy or genetic factor. Because oligodontia would result in esthetic and functional problems, such as facial asymmetry or occlusal disharmony, early diagnosis from clinical and radiographic examination was necessary. And appropriate treatment plan should be followed. This case report was about oral conditions and treatment of the oligodontia patients who have no specific systemic disease.

• The korean journal of orthodontics
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• 제50권5호
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• pp.336-345
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• 2020

Objective: To investigate the treatment modalities (Tx-Mods) for patients with unilateral hemifacial microsomia (UHFM) according to Pruzansky-Kaban types and growth stages. Methods: The samples consisted of 82 Korean UHFM patients. Tx-Mods were defined as follows: Tx-Mod-1, growth observation due to mild facial asymmetry; Tx-Mod-2, unilateral functional appliance; Tx-Mod-3, fixed orthodontic treatment; Tx-Mod-4, growth observation due to a definite need for surgical intervention; Tx-Mod-5, unilateral mandibular or bimaxillary distraction osteogenesis (DO); Tx-Mod-6, maxillary fixation using LeFort I osteotomy and mandibular DO/sagittal split ramus osteotomy; Tx-Mod-7, orthognathic surgery; and Tx-Mod-8, costochondral grafting. The type and frequency of Tx-Mod, the number of patients who underwent surgical procedures, and the number of surgeries that each patient underwent, were investigated. Results: The degree of invasiveness and complexity of Tx-Mod increased, with an increase in treatment stage and Pruzansky-Kaban type (initial < final; [I, IIa] < [IIb, III], all p < 0.001). The percentage of patients who underwent surgical procedures increased up to 4.2 times, with an increase in the Pruzansky-Kaban type (I, 24.1%; IIa, 47.1%; IIb, 84.4%; III, 100%; p < 0.001). However, the mean number of surgical procedures that each patient underwent showed a tendency of increase according to the Pruzansky-Kaban types (I, n = 1.1; IIa, n = 1.5; IIb, n = 1.6; III, n = 2.3; p > 0.05). Conclusions: These findings might be used as basic guidelines for successful treatment planning and prognosis prediction in UHFM patients.