• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.1
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• pp.32-37
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• 1999

Twin blocks are bite-blocks that effectively modify the occlusal inclined plane to induce favorably directed occlusal forces by causing a functional mandibular displacement. One of the advantage is that full-time wear can be possible because of less interference with normal function such as eating and speaking. So rapid correction of malocclusion is expected. Reverse twin block appliance is modification for correction of class III malocclusion with sagittal component. For increased growth stimulation effort on premaxilla, lip pads can be added. But with lip pads, patients are incapable of full-time wear especially during mealtime. So, removable lip pads can be used for stimulation of growth on premaxilla without any restriction of function. The advantages of the reverse twin block appliance with removable lip pads are: 1. Full-time wear is possible (including mealtime). 2. Patients' cooperation and adaptation is excellent. 3. There is no period of dual bite. 4. Orthopedic correction is achieved by multiple modes, shortening the treatment time. The applied case shows that the reverse twin block appliance with removable lip pads is effective for treatment of class III malocclusion and can shorten the time of treatment.

• Imaging Science in Dentistry
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• v.50 no.1
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• pp.9-14
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• 2020

Purpose: The purpose of this study was to evaluate vertical bone loss and alveolar bone thickness in the maxillary and mandibular incisors of patients with skeletal class III malocclusion. This study also aimed to evaluate the periodontal condition of class III malocclusion patients who had not undergone orthodontic treatment. Materials and Methods: The sample included cone-beam computed tomography scans of 24 Korean subjects (3 male and 21 female). Alveolar bone thickness (ABT), alveolar bone area (ABA), alveolar bone loss (ABL), and fenestration of the maxillary and mandibular incisors were measured using 3-dimensional imaging software. Results: All incisors displayed an ABT of less than 1.0 mm from the labial surface to root level 7 (70% of the root length). A statistically significant difference was observed between the mandibular labial and lingual ABAs and between the maxillary labial and mandibular labial ABAs. The lingual ABA of the mandibular lateral incisors was larger than that of the mandibular central incisors. ABL was severe on the labial surface. A statistically significant difference was observed between the maxillary and mandibular labial ABL values(21.8% and 34.4%, respectively). Mandibular lingual ABL (27.6%) was significantly more severe than maxillary lingual ABL (18.3%) (P<0.05). Eighty-two fenestrations were found on the labial surfaces of the incisors, while only 2 fenestrations were observed on the lingual surfaces. Fenestrations were most commonly observed at root level 6. Conclusion: Careful evaluation is needed before orthodontic treatment to avoid iatrogenic damage of periodontal support when treating patients with class III malocclusion.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.1
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• pp.45-52
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• 2015

The purpose of this study was to compare and evaluate facemask effects when two types of intraoral appliances were used for maxillary protraction for patients with class III malocclusion. Eighteen patients with class III malocclusion were treated with a facemask for an average of 12 months. Two types of intraoral appliances were used: nine patients were treated with bonded expander (Group 1), and nine patients with Hyrax (Group 2). Cephalometric radiographs were taken before and after treatment. Cephalometric radiographs were traced, analyzed, and the results such as sagittal, vertical and soft-tissue changes were compared between two groups. The amount of anchorage loss was also measured to evaluate the difference between two groups. All patients showed significant sagittal skeletal changes after treatment, and there was no statistically significant difference between the two groups. When anchorage loss was evaluated, no differences were shown between the two. Facemask with Hyrax or bonded expander is similarly an effective method as a treatment in class III malocclusion patients.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.243-247
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• 1986

174 patients who visited in the Department of Dentistry, College of Medicine, Yeungnam University from 1983. 7. 15 to 1986. 11. 30 were surveyed on the tendency of patient distribution and the state of Angle's classification. The results were as follows : 1. There was increased visiting rate of patient per year. Female outnumbered male by a ratio of 1.3 : 1. 2. 8-15 age group was 74% in total visiting in the most frequency. The average visiting numbers of each month were higher among the vacation and was about 74% in that period. 3. As showed the living distribution, Nam Gu and Su Sung Gu's patients were 53% of the total. 4. As the motive of visiting in Dental Department, patients of 30% in total patients visited for themself to receive orthodontic treatment and others was introduced patients. 5. By classification, Class I malocclusion was 63% in total visiting patient, Class II malocclusion 17%, ClassIII malocclusion 20%. Crowding among Class I malocclusion was 60%.

• The korean journal of orthodontics
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• v.47 no.4
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• pp.256-267
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• 2017

Objective: To evaluate transverse skeletal and dental changes, including those in the buccolingual dental axis, between patients with skeletal Class III malocclusion and facial asymmetry after bilateral intraoral vertical ramus osteotomy with and without presurgical orthodontic treatment. Methods: This retrospective study included 29 patients with skeletal Class III malocclusion and facial asymmetry including menton deviation > 4 mm from the midsagittal plane. To evaluate changes in transverse skeletal and dental variables (i.e., buccolingual inclination of the upper and lower canines and first molars), the data for 16 patients who underwent conventional orthognathic surgery (CS) were compared with those for 13 patients who underwent preorthodontic orthognathic surgery (POGS), using three-dimensional computed tomography at initial examination, 1 month before surgery, and at 7 days and 1 year after surgery. Results: The 1-year postsurgical examination revealed no significant changes in the postoperative transverse dental axis in the CS group. In the POGS group, the upper first molar inclined lingually on both sides (deviated side, $-1.8^{\circ}{\pm}2.8^{\circ}$, p = 0.044; nondeviated side, $-3.7^{\circ}{\pm}3.3^{\circ}$, p = 0.001) and the lower canine inclined lingually on the nondeviated side ($4.0^{\circ}{\pm}5.4^{\circ}$, p = 0.022) during postsurgical orthodontic treatment. There were no significant differences in the skeletal and dental variables between the two groups at 1 year after surgery. Conclusions: POGS may be a clinically acceptable alternative to CS as a treatment to achieve stable transverse axes of the dentition in both arches in patients with skeletal Class III malocclusion and facial asymmetry.

• The korean journal of orthodontics
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• v.48 no.1
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• pp.63-70
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• 2018

Objective: The aim of this study is to quantitatively evaluate the stability of the skeletal and dental widths using cone-beam computed tomography (CBCT) after segmental Le Fort I osteotomy in adult patients with skeletal Class III malocclusion requiring maxillary expansion. Methods: In total, 25 and 36 patients with skeletal Class III malocclusion underwent Le Fort I osteotomy (control group) and segmental Le Fort I osteotomy (experimental group), respectively. Coronal CBCT images were used to measure the dental and skeletal widths before (T1) and after (T2) surgery and at the end of treatment (T3). The correlation between the extent of surgery and the amount of relapse in the experimental group was also determined. Results: In the control group, the dental width exhibited a significant decrease of $0.70{\pm}1.28mm$ between T3 and T2. In the experimental group, dental and skeletal expansion of $1.83{\pm}1.66$ and $2.55{\pm}1.94mm$, respectively, was observed between T2 and T1. The mean changes in the dental and skeletal widths between T3 and T2 were $-1.41{\pm}1.98$ and $-0.67{\pm}0.72mm$, respectively. There was a weak correlation between the amount of skeletal expansion during segmental Le Fort I osteotomy and the amount of postoperative skeletal relapse in the experimental group. Conclusions: Maxillary expansion via segmental Le Fort I osteotomy showed good stability, with a skeletal relapse rate of 26.3% over approximately 12 months. Our results suggest that a greater amount of expansion requires greater efforts for the prevention of relapse.

• Journal of the korean academy of Pediatric Dentistry
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• v.11 no.1
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• pp.121-130
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• 1984

Childrens between the ages of 13 and 15 years, living in Seoul, were examined in order to determine the prevalence and severity of malocclusion in the permanent dentition. This survey encompassed 981 children and an individual chart was prepared for each subject recording an original HMAR score and classification of occlusion according to Angle. Also, subjective evaluation of "treatment needs" was carried out in 581 children. The results were as follows: 1. Of the 981 children in this survey, 12,1 percent showed excellent occlusion. (0 point) 2. The 14 percent of the children who had a score of 24 and above all appeared to belong to the "treatment highly desirable" or "treatment mandatory" category. 3. The incorporation of SAR (Supplementary Assessment Record) into the HMAR can provide more sensitive method for evaluating severity of malocclusion. 4. According to Angle's classification 77.4 percent of all malocclusion belonged to Class I, 1.3 percent to Class II, Division 1, 0.9 percent to Class II, Division 2, and 11.3 percent to Class III. 5. The mean HMAR score for Class I was significantly lower than for either Class II, Division 1 or Class III. (P < 0.05) 6. A close relationship was found between the degree of "treatment needs" and the value obtained by the HMAR scoring. (chi-square test, p < 0.05) The differences between the mean HMAR scores of the various subjectively defined categories were statistically significant. (P < 0.001)

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.3
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• pp.139-144
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• 2012

This study was performed in order to evaluate the occurrence of temporomandibular joint disorder after surgical correction of skeletal class II malocclusion. Materials and Methods: This study included 21 patients who underwent orthognathic surgery for the correction of dentofacial deformities by a single surgeon at Mokdong Hospital, Ewha Womans University from 2000 to 2010. They underwent bilateral sagittal split ramus osteotomy for the treatment of undesirable mandibular advancement. The temporomandibular disorder (TMD) symptoms prior to surgery were recorded and the radiographic evaluation (panorama, bone scan, and magnetic resonance imaging [MRI]) of the post-surgery temporomandibular joint (TMJ) were assessed in order to evaluate condylar resorption, remodeling and disc displacement. The minimum follow-up period, including orthodontic treatment, was 12 months. Orthognathic procedures included 1-jaw surgery (n=8 patients) and 2-jaw surgery (n=13 patients). The monocortical plate was used for bilateral sagittal split ramus osteotomy fixation. Results: Among class II malocclusion patients with TMD symptom, clicking improved in 29.1%, and maximum mouth opening increased from $34.5{\pm}2.1$ mm to $37.2{\pm}3.5$ mm. The differences were not statistically significant, however. Radiographic changes in bone scan improved slightly based on the report by radiologist but not in TMJ dynamic MRI. Conclusion: No particular improvements were found in patients with joint sound only. Patients with limitation of mouth opening showed an increase in the degree of opening, but the difference was not statistically significant (P>0.05).

• The korean journal of orthodontics
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• v.45 no.3
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• pp.121-129
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• 2015

Objective: This study aimed to assess three-dimensional changes in the temporomandibular joint positions and mandibular dimensions after correction of dental factors restricting mandibular growth in patients with Class II division 1 or division 2 malocclusion in the pubertal growth period. Methods: This prospective clinical study included 14 patients each with Class II division 1 (group I) and Class II division 2 (group II) malocclusions. The quad-helix was used for maxillary expansion, while utility arches were used for intrusion (group I) or protrusion and intrusion (group II) of the maxillary incisors. After approximately 2 months of treatment, an adequate maxillary arch width and acceptable maxillary incisor inclination were obtained. The patients were followed for an average of 6 months. Intraoral and extraoral photographs, plaster models, and cone-beam computed tomography (CBCT) images were obtained before and after treatment. Lateral cephalometric and temporomandibular joint measurements were made from the CBCT images. Results: The mandibular dimensions increased in both groups, although mandibular positional changes were also found in group II. There were no differences in the condylar position within the mandibular fossa or the condylar dimensions. The mandibular fossa depth and condylar positions were symmetrical at treatment initiation and completion. Conclusions: Class II malocclusion can be partially corrected by achieving an ideal maxillary arch form, particularly in patients with Class II division 2 malocclusion. Restrictions of the mandible in the transverse or sagittal plane do not affect the temporomandibular joint positions in these patients because of the high adaptability of this joint.

• The korean journal of orthodontics
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• v.46 no.3
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• pp.137-145
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• 2016

Objective: The purpose of this study was to investigate the characteristics of orthodontic patients at Yonsei Dental Hospital from 2008 to 2012. Methods: We evaluated Angle's classification from molar relationships, classification of skeletal malocclusion from the A point-nasion-B point angle, facial asymmetry, and temporomandibular joint disorders (TMDs) from the records of 7,476 patients who received an orthodontic diagnosis. The orthognathic surgery rate, extraction rate, and extraction sites were determined from the records of 4,861 treated patients. Results: The patient number increased until 2010 and gradually decreased thereafter. Most patients were aged 19-39 years, with a gradual increase in patients aged ${\geq}40years$. Angle's Class I, Class II divisions 1 and 2, and Class III malocclusions were observed in 27.7%, 25.6%, 10.6%, and 36.1% patients, respectively, with a gradual decrease in the frequency of Class I malocclusion. The proportion of patients with skeletal Class I, Class II, and Class III malocclusions was 34.3%, 34.3%, and 31.4%, respectively, while the prevalence of facial asymmetry and TMDs was 11.0% and 24.9%, respectively. The orthognathic surgery rate was 18.5%, with 70% surgical patients exhibiting skeletal Class III malocclusion. The overall extraction rate among nonsurgical patients was 35.4%, and the maxillary and mandibular first premolars were the most commonly extracted teeth. Conclusions: The most noticeable changes over time included a decrease in the patient number after 2010, an increase in the average patient age, and a decrease in the frequency of Angle's Class I malocclusion. Our results suggest that periodic characterization is necessary to meet the changing demands of orthodontic patients.