• Title/Summary/Keyword: functional occlusion

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Growth observation and orthodontic treatment of a hemifacial microsomia patient treated with distraction osteogenesis

  • Chung, Nam Hyung;Yang, So Jin;Kang, Jae Yoen;Jeon, Young-Mi;Kim, Jong Ghee
    • The korean journal of orthodontics
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    • v.50 no.2
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    • pp.136-144
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    • 2020
  • Hemifacial microsomia (HFM) patients may experience emotional withdrawal during their growth period due to their abnormal facial appearance. Distraction osteogenesis at an early age to improve their appearance can encourage these patients. Some abnormalities of the affected side can be overcome by distraction osteogenesis at an early age. However, differences in the growth rate between the affected and unaffected sides during the rest of the growth period are inevitable due to the characteristics of HFM. Therefore, re-evaluation should be performed after completion of growth in order to achieve stable occlusion through either orthognathic surgery or camouflage orthodontic treatment. An eight-year-old patient visited the clinic exhibiting features of HFM with slight mandibular involvement. He received phase I treatment with distraction osteogenesis and a functional appliance. Distraction osteogenesis was performed at the right ramus, which resulted in an open bite at the right posterior dentition. After distraction osteogenesis, a functional appliance and partial fixed appliance were used to achieve extrusion of the affected posterior dentition and settlement of the occlusion adjustment on the unaffected posterior dentition. The patient visited the clinic regularly for follow-up assessments, and at the age of 20 years, he showed facial asymmetry of the mandible, which had deviated to the right side. He received orthodontic treatment to improve the occlusion of his posterior dentition after the growth period. Without orthognathic surgery, stable occlusion and a satisfactory facial appearance were obtained through camouflage orthodontic treatment.

A STUDY ON THE INTERRELATIONSHIP OF THE CONDYLAR PATH, ANTERIOR OCCLUSION AND CRANIOFACIAL MORPHOLOGY (과로와 전치부 교합과 두개안면골 형태의 상관관계에 관한 연구)

  • Kim, Sang-Chul;Nahm, Dong-Seok
    • The korean journal of orthodontics
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    • v.18 no.1 s.25
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    • pp.7-24
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    • 1988
  • The stable occlusion in function is thought as important as the esthetics in form, in order to preserve the healthy oral condition. The stable occlusion requires the harmony between the condylar guidance factors and the anterior guidance factors. The aim of this study was to evaluate the quantitative relationship between the condylar guidance factors and the anterior guidance factors, estimating statistically the measurement of the condylar paths by Pantronic and those of the anterior guidance factors, craniofacial morphology by roentgenocephalometry in 46 relatively good functional occlusion. The results of this study were as follows. 1. The measurements of the protrusive condylar path inclinations were $36.41^{\circ}$ in the right, $35.63^{\circ}$ in the left, $36.28^{\circ}$ in the mean. The measurements of Fisher's angles were $8.17^{\circ}$ in the right, $6.43^{\circ}$ in the left, $6.87^{\circ}$ in the mean. 2. The anterior facial height and the lower anterior facial height made a negative correlation with the protrusive condylar path inclination. 3. The articular eminence angle relative to the artificial articulator plane showed a positive correlation with the maximum protrusive condylar path. 4. SNA and SNB made a negative correlation with the articular eminence angle, and AAP-GoMe, AAP-DcGn, the facial height ratio had a positive correlation with the articular eminence angle. 5. The angulation of maxillary incisor lingual slope, overbite and the ratio of overbite to overiet showed a positive correlation with the articular eminence angle. 6. The angulation of maxillary incisor lingual slope , overbite, and the ratio of overbite to overjet made a positive correlation with the inclination of occlusal plane, functional occlusal plane. 7. Overbite and the ratio of overbite to overjet had a positive correlation with the angulation of maxillary incisor lingual slope. 8. The anterior guidance factors were more influenced by the mean protrusive condylar path inclination and the maximum Fisher's angle, and the regression equations of those were made.

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Prosthetic rehabilitation of partially edentulous patient after hemimandiblectomy: Case report (하악골 부분절제술 시행한 부분 무치악 환자에서 보철 수복 증례)

  • Lee, Dong-Hun;Yoo, Dong-Soo;Lee, Jong-Hyuk
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.1
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    • pp.39-45
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    • 2015
  • Loss of continuity of the mandible destroys the balance and symmetry of mandibular function, leading to altered mandibular movements and deviation of the residual fragment towards the resected side. Apart from deviation, other dysfunctions include difficulty in swallowing, speech, mandibular movements, mastication, and respiration are accompanied. In general, surgical reconstruction is considered first then proceeds to the prosthetic restorations. However, patients with systemic disease such as BRONJ (Bisphosphonate related osteonecrosis of the Jaw), surgical reconstruction may be limited. Thus, the prosthetic restoration remains as the only resort. Numerous prosthetic methods are employed to minimize deviation and to improve masticatory efficiency, function and esthetics. If a removable partial denture is the selected treatment modality, maximum stability of the partial denture base may be accomplished with a functional impression procedure by means of eliminating lateral and horizontal forces caused by the functional movements of the lips, cheeks and tongue. Also, Twin occlusion is used to obtain a favorable occlusal relationship and check support for esthetics. The purpose of this case report is to demonstrate how neutral zone impression technique and twin occlusion scheme were applied to restore a hemi-mandiblectomy patient with BRONJ syndrome to achieve satisfactory results in functional and esthetic aspects.

Principles and considerations of orthodontics for Prosthodontic treatment (심미보철치료를 위한 교정치료의 원칙과 고려사항)

  • Chang, Won-Gun
    • The Journal of the Korean dental association
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    • v.56 no.9
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    • pp.503-511
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    • 2018
  • Outcome of esthetic ceramic restorations are affected by tooth size, gingival contour, occlusal relationship, etc. For this reason, demand of orthodontic treatment before esthetic ceramic restoration is increasing. If a Bolton ratio discrepancy, a problem of the maxillary incisor's vertical position, a problem of inclination of anterior teeth, a pathogenic occlusion is existed, a pre-prosthodontic orthodontics should be accomplished. These problems can be satisfactory only after the prosthetic treatment is performed after orthodontic treatment. When orthodontic treatment is given, it should be treated with the following principle. 1. Treat it in the direction of functioning occlusion. 2. Keep the patient's stable occlusal scheme. 3. Treat the teeth by considering the average tooth size and Bolton ratio. Ortho-Prostho combined treatment with optimal treatment plan can lead a patient's function, esthetics, and long-term stability.

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CASE REPORT ON TREATMENT OF CLASS II MALOCCLUSION WITH TWIN BLOCK APPLIANCES (Twin Block을 이용한 II급 부정교합의 치료증례)

  • Park, Soo-Jin;Jang, Ki-Taeg;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.1
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    • pp.134-143
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    • 1998
  • Twin Blocks are simple bite-blocks that effectively modify the occlusal inclined plane to induce favorably directed occlusal forces by causing a functional mandibular displacement. These devices use upper and lower bite-blocks that engage on occlusal inclined planes. Twin Blocks use the forces of occlusion as the functional mechanism to correct the malocclusion. To get an excellent result in the treatment by using the Twin Block appliances, proper case selection must be needed. Twin Block treatment is performed in two stages. Twin Blocks are used in the active phase to correct the anteroposterior relationship and establish the correct vertical dimension. Once this phase is accomplished, the Twin Blocks are replaced with an upper Hawley type of appliance with an anterior inclined plane, which is then used to support the corrected position as the posterior teeth settle fully into occlusion. The Twin Block is the most comfortable, the most esthetic ane the most efficient of all the functional appliances. Twin Blocks have many advantages compared to other functional appliances. Patients can wear Twin Blocks 24 hours per day and can eat comfortably with the appliances in place. From the moment Twin Blocks are fitted, the appearance is noticeably improved. There is less interference with normal function. Integration with conventional fixed appliances is simpler than with any other functional appliance. Twin Blocks allow independent control of upper and lower arch width. Appliance design is easily modified for transverse and sigittal arch development. The authors treated Class II malocclusion with Twin Blocks. and the results as follows; 1. Rapid profile improvement was achieved in 2-3 months. 2. There was excellent patient cooperation. 3. Severe overjet and overbite were reduced. 4. Class II molar relationship was changed to Class I.

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Clinical Features and Long-Term Outcome in Adult Stroke Patient due to Moyamoya Disease : A Single Subject Study

  • Kwon, Yong Hyun;Kim, Chung Sun
    • The Journal of Korean Physical Therapy
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    • v.25 no.3
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    • pp.126-131
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    • 2013
  • This case report described a single case of adult stoke patient due to Moyamoya disease through long-term follow-up observation, which included his demographics, brain images, and change of motor function and functional activities. The subject was the 54-year-old male diagnosed with left hemiparesis from a stroke due to multifocal encephalomalacia in both hemispheres. At the time of the stroke attack, he took brain surgery intervention including external ventricular drain. Physical and occupational therapy for stroke rehabilitation were admitted including muscle strengthening exercises, functional activity/ADL training, neurofacilitative techniques with bobath or proprioceptive neuromuscular facilitation concepts, and compensatory strategy. Patient's MRI showed that right frontal lobe, right peri-ventricular area, left parietal, and left occipital lobes were damaged, and MRA showed that abnormal collateral vessel was richly developed in both hemispheres by occlusion of proximal internal carotid arteries in both sides. His motor strength was improved from poor to good grade in all of upper and lower limb motions, that MBC was improved from stage 1 to stage 5. In FAC and barthel index, at the initial evaluation, he could not perform any functional movement, but his FAC and barthel index were on 3 and 14 points at present, respectively. During long-term follow-up for approximately 4 years, the subject's functional motor ability was improved, as similar with recovery progression of usual stroke patient. We believe that this single case report will provide clinical information and concern regarding Moyamoya disease with physical therapist, in terms of such as epidemiology, pathogenesis, diagnostic procedures, clinical features, recovery process, and prognosis.

Neuroprotective Effects of Guh-Poong-Chung-Sim-Hwan on Focal Cerebral Ischemia in Rats

  • Lim, Ha-Sup;Kim, Jeung-Beum
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.1
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    • pp.246-253
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    • 2005
  • This study was designed to investigate the neuroprotective effects of Guh-Poong-Chung-Sim-Hwan(GCH) on ischemia induced by middle cerebral artery occlusion(MCAO) in Sprague-Dawley rats. The effects of GCH administration on the size of the brain infarct and the functional status of the rats after ischemia were examined, as well as the expression of COX-2 in acute phase. The recovery of motor functions for 7 days and the brain infarct were examined to find out the delayed effects of daily GCH-administration as well. In conclusion, we found that GCH reduced both functional deficits and brain damage in the MCAO rat model of stroke. In addition, high doses of GCH reduced COX-2 expression in the penumbra. It is well known that herbal medication including GCH is very safe for humans. Accordingly, our results support the clinical use of this GKM for the treatment of stroke and offer the possibility that a potent neuroprotective agent could be developed from Korean herbal medicines.

The effect of physical training on glutamate transporter expression in an experimental ischemic stroke rat model

  • Kim, Gye-Yeop;Kim, Eun-Jung
    • Physical Therapy Rehabilitation Science
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    • v.2 no.2
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    • pp.87-91
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    • 2013
  • Objective: The present study was aimed at determining the effect of physical training on glutamate transporter activity in a middle cerebral artery occlusion (MCAO)-induced ischemia injury rat model. Design: Randomized controlled trial. Methods: In this study, we randomly divided them into three groups. Group I included non-occlusion sham controls (n=10), Group II included non-physical training after MCAO (n=10), and Group III included rats that were subjected to physical training after MCAO (n=10). Rats in the physical training group underwent treadmill training, which began at 24 h after MCAO and continued for 14 consecutive days. The training intensity was gradually increased from 5 m/min on the first day to 12 m/min on day 3, and it was maintained until day 14. Focal cerebral ischemia was examined in adult male Sprague-Dawley rats by using the MCAO model. We determined the functional outcomes for each rat on days 1, 7, and 14. Glutamate transporter-1 (GLT-1) activity in the cortex of rats from all three groups was examined at the end of the experiment. Results: Out result show that MCAO rats exhibited severe neurological deficits on the 1 day, and there was no statistically significant in each groups. We observed that the functional outcomes were improved at days 7 and 14 after middle cerebral artery occlusion, and GLT-1 activity was increased in the physical training group (p<0.05). Conclusions: These results indicated that physical training after focal cerebral ischemia exerts neuroprotective effects against ischemic brain injury by improving motor performance and increasing the levels of GLT-1 activity.

Maxillary anterior prosthetic treatment concerning anterior guidance of a patient who lost stable holding contact (안정적인 교합접촉을 잃은 환자에서의 전방유도를 고려한 치료증례)

  • Park, Jong-Hoon;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.467-474
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    • 2019
  • Recently, many patients undergo anterior prosthetic treatment for esthetic reasons. In some patients complain about functional reasons such as inaccurate pronunciation and occlusal discomfort after the treatment. Anterior teeth are important esthetically but in the occlusal point of view, anterior guidance is the second most important factor in occlusion, next to centric relation. Failure to determine an appropriate anterior guidance might lead to posterior occlusal interference, which can highly affect the stability of the posterior teeth. Also, discomfort might occur if the customized interior guidance is not in harmony with the patient's envelope of function. The patient in this case complained of overall discomfort in the maxillary anterior area after prosthetic treatment. The expressed difficulty in pronunciation, unstable occlusion due to lack of stable holding contact and discomfort of the facial muscles. Maxillary anterior prostheses were refabricated through systematic diagnosis and treatment and thus, this case presents esthetical and functional satisfaction to both the patient and the dentist.

Perfusion-Weighted MRI Parameters for Prediction of Early Progressive Infarction in Middle Cerebral Artery Occlusion

  • Kim, Hoon;Kim, Yerim;Kim, Young Woo;Kim, Seong Rim;Yang, Seung Ho
    • Journal of Korean Neurosurgical Society
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    • v.59 no.4
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    • pp.346-351
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    • 2016
  • Objective : Early progressive infarction (EPI) is frequently observed and related to poor functional outcome in patients with middle cerebral artery (MCA) infarction caused by MCA occlusion. We evaluated the perfusion parameters of magnetic resonance imaging (MRI) as a predictor of EPI. Methods : We retrospectively analyzed patients with acute MCA territory infarction caused by MCA occlusion. EPI was defined as a National Institutes of Health Stroke Scale increment ${\geq}2$ points during 24 hours despite receiving standard treatment. Regional parameter ratios, such as cerebral blood flow and volume (rCBV) ratio (ipsilateral value/contralateral value) on perfusion MRI were analyzed to investigate the association with EPI. Results : Sixty-four patients were enrolled in total. EPI was present in 18 (28%) subjects and all EPI occurred within 3 days after hospitalization. Diabetes mellitus, rCBV ratio and regional time to peak (rTTP) ratio showed statically significant differences in both groups. Multi-variate analysis indicated that history of diabetes mellitus [odds ratio (OR), 6.13; 95% confidence interval (CI), 1.55-24.24] and a low rCBV ratio (rCBV, <0.85; OR, 6.57; 95% CI, 1.4-30.27) was significantly correlated with EPI. Conclusion : The incidence of EPI is considerable in patients with acute MCA territory infarction caused by MCA occlusion. We suggest that rCBV ratio is a useful neuro-imaging parameter to predict EPI.