• Archives of Craniofacial Surgery
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• v.12 no.1
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• pp.6-11
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• 2011

Purpose: The cephalic index (CI) is used to classify the head and every race has its unique characteristics. Previous studies published in Korea were limited to demonstrating the periodical change of the CI. This study was done to determine the CI change in 0 to 20 year-old Koreans by sex and age. Methods: The measurement was done on 1,222 Koreans ranging from 0 to 20 years of age, randomly selected from 2,156 who were diagnosed with simple concussion, had no other diseases or anomalies, and took cephalographs from January, 2000 to July, 2008. The files were obtained from $Marosis^{(R)}$ and then photogrammetry was done by $Photoshop^{(R)}$. To standardize the cephalograph, the Frankfort horizontal line was selected as the reference line on lateral view and the line connecting both lateral-orbitales on AP view. The maximal length was obtained from the lateral cephalograph and the maximal breadth from the AP cephalograph. Results: The CI showed no difference by sex (p=0.4848). The CI and age showed negative correlation (p<0.0001). Analyzed separately by the male and the female, the CI showed statistical significance in the male (p<0.0001), but not in the female (p=0.4741) group. Comparing the CI above the age of 11, the CI of the female became greater than that of the male. Conclusion: This study contributes to the standardization of CI measurement and the authors were able to obtain the average CI by age. We concluded that the CI decreased according to age and most Koreans belonged to barchycephalic or hyperbrachycephalic.

• Journal of Oral Medicine and Pain
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• v.21 no.1
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• pp.197-206
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• 1996

This study ws performed to investigate the relationship between cervical curvature and the spatial position of the posterior part of the atlas imaged in the lateral cephalograph. Sixty six patients with temporomandibular disorders(TMD) and twenty dental students were selected for patients group and control group, respectively. The average age of patients group was 26.3 years, and 24.9 years in control group. Measured variables were cervical depth, upper space between the atlas and the base of the occiput, lower space between the atlas and the spinous process of the axis, rea of the posterior part of the atlas imaged in the lateral cephalograph, and the cervical curvature passing through the uppermost point in dorsal side of Dens of the Axis to the lowermost and rearmost point of the 5th cervical vertebra. The reliability of the method used for measuring cervical curvature with curved ruler was also tested. The results obtained were as follows : 1. Cervical depth of patients group was 122.9mm and significantly shorter than that of control group, in which cervical depth was 131.9mm, and cervical depth was significantly correlated with other variables in all subjects. 2. Upper space was greater in patients group, but total space including upper and lower space showed no difference between the two groups. The average value of total space was 26.5mm. 3. Area of the posterior part of the atlas was 168.2$\textrm{mm}^2$ in patients group, and 186.5$\textrm{mm}^2$ in control group with significant difference between the two groups. 4. Average range of radius of cervical curvature were 33-40cm and there was no difference between the two groups. 5. There was no significant correlation between the cervical curvature and the area of the posterior arch of the atlas. 6. The method using curved ruler for measuring cervical curvature could be accepted as a reliable method.

• The Journal of the Korean dental association
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• v.56 no.2
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• pp.94-102
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• 2018

The present study was conducted to assess the growth changes of human chin in childhood and adolescence at various stages of skeletal maturation using metallic implant installed in mandibular body. Lateral cephalographs including 23 subjects (9 males and 14 females) between 7-18 years old were used, which had been taken at University of California in San Francisco and kept at University of the Pacific. Three lateral cephalographs were chosen for each subject according to CVM (Cervical Vertebral Maturation) method (CVM stage 1 to 2, CVM stage 3 to 4, and CVM stage 5 to 6) which assess the extent of the skeletal maturation using the second, third, and fourth cervical vertebrae. V-ceph was used in order to mark the 8 landmarks (S, N, A, B, Pog, Me, Go, Imp) on lateral cephalographs and obtain 8 angular and linear measurements(ANB, SNPog, SN-GoMe, Imp-B, Imp-Pog, B-Pog//GoMe, $GoMe{\bot}B$, $GoMe{\bot}Pog$). Among 8 measurements, ANB, SNPog, SN-GoMe, B-Pog//GoMe, $GoMe{\bot}B$ showed statistically significant growth changes at various stages of skeletal maturation according to CVM method, while there were no significant differences on Imp-B, Imp-Pog, $GoMe{\bot}Pog$. The results suggest that the increasing prominence of human chin is greatly influenced by the vertical growth of B point area, in addition to the change and growth in chin and mandible proper.

• The korean journal of orthodontics
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• v.28 no.2 s.67
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• pp.285-295
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• 1998

In clinical orthodontics, it is significant to understand the stage of growth in a growing patient. In order to assess the skeletal maturity of the patients, the hand-wrist radiograph and the cervical vertebrae (Cervical Vertebrae Maturation Indicators : CVMI) was evaluated from the lateral cephalograph and the skeletal maturity determined from the hand-wrist X-ray (Skeletal Maurity Indicators : SMI) taken on the same day in the same patients, and its interrelationship examined to come up with the following results: 1. The skeletal maturity evaluated from the hand-wrist radiograph and the maturation of the cervical vertebrae from the lateral cephalograph showed a significant interrelationship with each other. 2. In the evaluation of the skeletal maturity using the SMI and CVMI, the CVMI 1 showed a siginificant correlation with SMI 1, 2, the CVMI 2 with SMI 3, 4, CVMI 3 with SMI 6, 7, CVMI 4 with SMI 7, 8, CVMI 5 with 9, 10 and CVMI 6 with SMI 11. 3. When the morphological changes in the 2nd and 3rd cervical vertebrae were separately observed, it was seldom that the concavity appeared in the lower border of the 2nd cervical vertebra and at the same time not appear in the 3rd cervical vertebra (CVMI 2 : 10.38%, CVMI 3 : 6.56%) 4. In each of the skeletal maturation stage evaluated from the hand-wrist and the cervical vertebra, the average age and its standard deviation in male and female patients appeared to have large differences among individuals. Skeletal maturation seemed to appear earlier for the girls than for the boys, and its termination 24 months faster for girls.

• Journal of Oral Medicine and Pain
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• v.23 no.2
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• pp.127-141
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• 1998

This study was performed to investigate the clinical features of internal derangement of temporomandibular joint. For this study, 117 patients with temporomandibular disorders and 81 dental students without any signs and symptoms of temporomandibular disorders were selected as the patients group and as the control group, respectively. Preferred chewing side, Angle's classification, lateral guidance pattern, maximal mouth opening range, and affected side were recorded clinically. Head and shouldeer posture was measured in a groundplate on which square diagram of five centimeters each had been drawn, and cephalograph was also taken for measurement of head and neck posture. Sonopak of Biopak system (Bioresearch inc., USA) was used to record joint vibration for evaluation of internal healthy status of temporomandibular joint. The data collected were analyzed by SAS statistical program. The results of this study were as follows : 1. Frequency of left side chewing subjects was higher in patients than in control group, but there was no difference in distribution of subjects by Angle's classification. Other types was prvalent in patients whereas group function was more in control group for lateral guidance pattern. 2. As to lateral guidance pattern by clinical diagnosis, patients with internal derangement and/or degenerative joint disease showed higher frequency was consistent with the result by Sonopak impression. 3. There was no difference for shoulder height between the two groups, however, tilting of head and backward extension of cervical spine was more frequent in control group. 4. Acromion was positioned more anteriorly in patients with internal derangement and/or degenerative joint disease than in control group and angle between eye and tragus was larger in patients. Patients with degenerative joint disease showed more flexed head posture than control group did in cephalometric profile. 5. Maximal mouth opening range in patients with internal derangement was the least in all subgroups in patients classified by Sonopak impression.

• The korean journal of orthodontics
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• v.21 no.2 s.34
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• pp.367-397
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• 1991

This study was aimed to investigate the occlusal plane inclination in relation to the skeletal and dental assessment measurements in order to provide a reference in orthodontic treatment planning as the occlusal plane should be reconstructed orthodontically or gnathologically. The sample consisted of 73 normal occlusions and 113 malocclusions of adults. The computerized statistical analysis of 38 occlusal plane's and 29 skeletal and dental measurements were carried out with SPSS. The conclusions were as follows; 1 In normal occlusion, COP-NaPog was average $83.63^{\circ}$ (2.44) and occlusal plane inclination had a strong negative correlation with SNB and FH-NaPog. 2. In normal occlusion, ArANS plane was nearly parallel to the occlusal plane. 3. In malocclusion, the larger the mandibular plane angle and the shorter the ramus height was, the more downward the occlusal plane had a tendency to tip anteriorly. 4. Occlusal plane was more horizontal in deep bite group, while it was steeper in openbite group. 5. The curve of Spee was severe in deep bite group but in openbite group mandibular occlusal plane showed average reverse curvature, where it was found that the configuration of the occlusal plane contributed to the excess or deficiency of anterior overbite.

• The korean journal of orthodontics
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• v.23 no.3 s.42
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• pp.341-358
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• 1993

This study was investigated to evaluate the morphologic characteristics of deepbite tendency as multiple factors. The subjects consisted of 60 control subjects(male 25, female 35) and 137 deephite patients(68 male, 69 female). The deepbite group was composed of 4 subgroups(Class I 44, Class II div. 1 40, Class II div. 2 13, Class III 40). The mean age was 21.57 year for the control group 21 year for deepbite group lateral cephalograph in centric occlusion were taken, traced, and digitized for each subject. The statistically computerized analysis was carried out with SAS program. The results were as follows ; 1. In deepbite group, saddle angle is lesser than that of normal group. 2. The vertical dysplasia is prominent on anterior lower face and is closely related with mandibular form and inclination. 3. Without consideration of sagittal relationship, the dental factors such as curve of Spee, interincisal angle, U1 to upper lip length were prominent in the deepbite group. 4. Although there were individual variances in the perioral soft tissue profile, the lip presented more protruded pattern. 5. There was no significant difference in hyoid bone position and inclination between normal and deepbite group. 6. The multivariate discriminant analysis between normal and Class I deepbite group showed that curve of Spee, AB-MP angle, interincisal angle, articular agnle were critical in the determination of deepbite as multiple factors.

• Journal of Oral Medicine and Pain
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• v.21 no.2
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• pp.305-315
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• 1996

This study was performed to investigate the changes of head posture according to natural standing or sitting posture. Twenty seven healthy dental students without any signs and symptoms of temporomandibular disorders participated in this study. Cervical resting posture (CRP) of the head in sagittal plane was measured by Cervical-Range-of-Motion $^\textregistered$(CROM, U.S.A.) and lateral cephalograph was taken in natural posture. The items related to angle in cephalograph were the angles of cranial and cervical inclination to true vertical line(VER/NSL, VER/AML), the angles of cervical inclination to nasion-sella line(CVT/NSL, OPT/NSL), the angles of comical inclination to horizontal line(CVT/HOR, OPT/HOR), the angle of cervical lordosis(CVT/OPT). The items related to line measurement were the distance from subocciput to Cl(Dl), Cl to C2(D2), C2 to C3(D3), C3 to C4(D4), the upper(PNS to posterior pharyngeal wall) and the lower(tongue base to posterior pharyngeal wall) pharyngeal space, the distance from nation to mention(Na-Me), and the radius of comical curvature from the first comical vertebra(Cl ) to the fifth cervical vertebra(C5). The data were analyzed with SAS/STAT program. The obtained results were as follows : 1. Most items related to angular measurement showed significant difference between in standing and sitting posture. The angles of CRP, CVT/NSL, OPT/NSL, CVT/HOR, OPT/HOR, and CVT/OPT were high in sitting posture, but the angles of VER/NSL, VER/NSL were low in sitting posture. 2. In vertebral distance, only the distance between C3 and C4 was differed by the posture, which decreased in sitting posture. In sitting posture, the distance from nasion to menton(Na-Me) was longer, but the radius was shorter than in standing posture. 3. Correlationship in angular measurements was almost same in both postures. Ceervical resting posture(CRP) was correlated with VER/NSL, VER\ulcornerNSL was correlated with CRP, CVT/NSL, and OPT/NSL, VER/AML was correlated with CVT/HOR, OPT/HOR, CVT/OPT, and the angle of cervical lordosis(CVT/OPT) was correlated with the radius. 4. Correlationship in linear measurement was observed only in among D3, D4, and radius. And the Na-Me was not correlated with any other items. From this results, The author concluded that the head posture in sitting was mote backward extended than in standing.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.6 no.2
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• pp.94-98
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• 2010

Axenfeld-Rieger syndrome is a rare autosomal dominant disorder characterized by various ocular and extraocular malformations. The incidence of Axenfeld-Rieger syndrome has been estimated to be 1 per 200,000. The syndrome is characterized by short body stature, delayed bone age, and deficient or arrested development of neural crest cells involving the anterior chamber of the eyes, facial bones, teeth, periumbilical skin, and cardiovascular system. This is a case of a 6 year-old girl, who came to the department of the pediatric dentistry, Yonsei University Dental Hospital, for evaluation and treatment of multiple congenital missing permanent teeth. The patient presented typical dental, craniofacial, and systemic features of Axenfeld-Rieger syndrome, such as glaucoma, oval pupil, heterochromatic iris, umbilical hernia, and delayed bone age. On the panoramic view, 3 primary teeth were missing and 13 permanent tooth germs were absent. On the lateral cephalograph, underdevelopment of the maxilla and normal growth pattern of the mandible were confirmed. Periodic dental follow-up is planned for evaluation and interceptive treatment of her dental and craniofacial problems. Denture or removable space maintainer with a pontic is considered for esthetic and functional restoration. In addition, orthognathic surgery is also planned in future to prevent further midfacial skeletal deformation. Early diagnosis of Axenfeld-Rieger syndrome is very important to prevent exacerbation of complications, such as glaucoma and skeletal deformities.

• Journal of Oral Medicine and Pain
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• v.21 no.2
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• pp.393-405
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• 1996

This study was performed to investigate the effects of changes of head posture and cervical spine shape on the mandibular resting or clenching electromyographic(EMG) activity in anterior temporalis(TA), masseter(MM), sternocleidomastoid muscle(SCM) and trapezius insertion(TI). 30 patients with Temporomandibular Disorders(TMDs) participated in this study. EMG activity($\mu$V) at rest and clenching was observed in four head postures, namely natural head posture(NHP), forward head posture(FHP), upward head posture(UHP), and downward head posture(DHP). For taking in upward or downward head posture head was inclined 10$^{\circ}$ upward or downward and CROM$^\textregistered$(cervical-range-of motion, Performance attainment Inc., USA) was used to maintain same posture during the procedure, and BioEMG$^\textregistered$ (Bioelectromyograph, Bioresearch Inc., USA) was used to record EMG activity in the above four muscles at eight locations on both sides. The recorded EMG activity($\mu\textrm{V}$) were compared and analyzed by cervical spine shape such as the head position from plum line, cervical curvature, and cervical inclination. Head position from plum line was measured in vertical plate calibrated with cm scale, comical curvature by radius was measured with adjustable curved ruler, and cervical inclination by cervical vertebrae tangent(CVT)was measured in lateral cephalograph. The results obtained were as follows : 1. Mean value of head position from plum line, cervical curvature, and cervical inclination were 4.8cm, 26.7cm, and 86.6$^{\circ}$, respectively, And There were no correlationship among these items. 2. For resting EMG activity by head posture, the value in anterior temporalis was higher at FHP than at DHP, the value in masseter was higher at FHP than at NHP, and DHP, the value in sternocleidomastoid muscle was higher at UHP than at NHP, and the value in trapezius insertion was higher at FHP and DHP than, NHP and UHP. The clenching EMG activity, however, did not show any difference by head posture. 3. Comparison of resting and clenching EMG activity between higher and lower groups by head position from plum line, cervical curvature, and cervical inclination did not show any significant difference. From this result, the author concluded that the cervical spine shape had not significantly affected to EMG activity in usual patients with TMDs.