• Title/Summary/Keyword: malocclusion

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DENTAL TREATMENT UNDER GENERAL ANESTHESIA: AN OVERVIEW OF CLINICAL CHARACTERISTICS OF SPECIAL NEEDS PATIENTS (전신 마취 하 장애인 치과치료에 대한 임상적 고찰)

  • Chang, Juhea
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.2
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    • pp.61-67
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    • 2014
  • The aim of this study was to analyze the clinical characteristics of patients with cognitive and behavioral impairments receiving dental treatment under general anesthesia (GA-dental treatment). From August 2007 to April 2014, information was collected from 475 patients who received GA-dental treatment at the Clinic for Persons with Disabilities, Seoul National University Dental Hospital. The demographic factors (gender, age, disability, medication, GA history, residency type, caregiver, meal type, oral hygiene maintenance, and cooperation level) and dental status (operating duration, DMFT, malocclusion, periodontal disease, tooth defect, and treatment protocol) of the patients were evaluated. DMFT and malocclusion levels were compared among the patients with ANOVA and Sheffe's post-hoc test, and chi-square test, respectively. The correlation between the demographic characteristics and dental status of the patients were analyzed with the Pearson's correction test. The mean age of the patients was 27.1 (7 - 83) years and they had intellectual disabilities (55.4%), developmental disorders (17.9%), brain disorders (16.6%), neurocognitive disorders (4.6%), or others (5.5%). The mean DMFT (DT) was 8.6 (5.2) with a significant difference among the disability types (p<0.05). The incidence of malocclusion was higher in patients with intellectual disabilities and brain disorders than in the other types (p<0.05). The operation time ($191.4{\pm}91.2min$) was correlated with decayed or endodontically-treated teeth (p<0.05). Special needs patients requiring GA-dental treatment showed unfavorable oral conditions. Dental practitioners experience time restrictions and additional costs under a GA setting. Treatment planning and decision-making can be efficiently facilitated by evaluating the clinical characteristics of the patients.

Evaluation of Skeletal Stability Following Two-jaw Surgery via Surgery First Orthodontic Treatment in Class III Malocclusion (III급 부정교합에서 선수술 교정치료를 통한 양악 수술 후 안정성)

  • Hwang, Dae-Seok;Kim, Yong-Il;Lee, Jae-Yeol;Lee, Seong-Tak;Kim, Tae-Hoon;Lee, Joo-Min;Ahn, Kyung-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.5
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    • pp.407-412
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    • 2011
  • Purpose: The purpose of the present study was to evaluate the postoperative skeletal stability of two-jaw surgery (Le Fort I osteotomy and bilateral sagittal split ramus osteotomy) via surgery first orthodontic treatment (SFOT) in class III malocclusion. Methods: Thirty-two patients who had two-jaw surgery via SFOT were included in this study. Serial lateral cephalograms were obtained before (T0), immediately after (T1), and six months after (T2) surgery. Twelve variables were measured for horizontal and vertical skeletal stability as well as for dental change. All measurements were evaluated statistically by a paired t-test ($P$ <0.05). Results: The mean skeletal changes were $0.1{\pm}2.5$ mm at point A and $-12.0{\pm}7.4$ mm at the pogonion. The mean horizontal relapse was 11.6% at the pogonion, and the mean vertical surgical changes included an upward displacement of $2.1{\pm}7.1$ mm and a forward displacement of $1.4{\pm}4.6$ mm at the pogonion. Upper incisor inclination decreased after surgery and was maintained at T2, and lower incisors were proclined from T1 to T2 by postsurgical orthodontic treatment. Conclusion: Postoperative skeletal stability of two-jaw surgery via surgery first orthodontic treatment in class III malocclusion was clinically acceptable.

The Improvement and Completion of Outcome index: A new assessment system for quality of orthodontic treatment

  • Hong, Mihee;Kook, Yoon-Ah;Kim, Myeng-Ki;Lee, Jae-Il;Kim, Hong-Gee;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.46 no.4
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    • pp.199-211
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    • 2016
  • Objective: Given the considerable disagreement between the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation, we aimed to develop a novel assessment system-the Improvement and Completion of Outcome (ICO) index-to evaluate the outcome of orthodontic treatment. Methods: Sixteen criteria from 4 major categories were established to represent the pretreatment malocclusion status, as well as the degree of improvement and level of completion of outcome during/after treatment: dental relationship (arch length discrepancy, irregularity, U1-SN, and IMPA); anteroposterior relationship (overjet, right and left molar position, ANB); vertical relationship (anterior overbite, anterior open-bite, lateral open-bite, SN-MP); and transverse relationship (dental midline discrepancy, chin point deviation, posterior cross-bite, occlusal plane cant). The score for each criterion was defined from 0 or -1 (worst) to 5 (ideal value or normal occlusion) in gradations of 1. The sum of the scores in each category indicates the area and extent of the problems. Improvement and completion percentages were estimated based on the pre- and post-treatment total scores and the maximum total score. If the completion percentage exceeded 80%, treatment outcome was considered successful. Results: Two cases, Class I malocclusion and skeletal Class III malocclusion, are presented to represent the assessment procedure using the ICO index. The difference in the level of improvement and completion of treatment outcome can be clearly explained by using 2 percentage values. Conclusions: Thus, the ICO index enables the evaluation of the quality of orthodontic treatment objectively and consecutively throughout the entire treatment process.

Facial and occlusal esthetic improvements of an adult skeletal Class III malocclusion using surgical, orthodontic, and implant treatment

  • de Almeida Cardoso, Mauricio;de Molon, Rafael Scaf;de Avila, Erica Dorigatti;Guedes, Fabio Pinto;Filho, Valter Antonio Ban Battilani;Filho, Leopoldino Capelozza;Correa, Marcio Aurelio;Filho, Hugo Nary
    • The korean journal of orthodontics
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    • v.46 no.1
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    • pp.42-54
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    • 2016
  • The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects.

A Study on the Relationship between Malocclusion and the Prevalence of Temporomandibular Disorder (부정교합과 측두하악장애 유병상태와의 관련성에 관한 연구)

  • Kim, Hong-Sik;Park, Soo-Chul;Jung, Myung-Hee
    • Journal of Technologic Dentistry
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    • v.35 no.3
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    • pp.231-242
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    • 2013
  • Purpose: The study is to discover the relationship between malocclusion, which is known to cause temporomandibular disorder, and temporomandibular disorder and is aimed at college students who have retained their natural teeth. Methods: The study was aimed at 500 college students at two colleges located in Gyeongsangbuk-do and Daegu metropolitan city and survey research was conducted in order to discover any relationship between malocclusion and temporomandibular disorder. After excluding copies with insincere answers or errors out of the 500 copies of the questionnaire, the study used a total of 435 copies (87%) for research and analysis. Results: Females showed a prevalence of temporomandibular joint clicking and temporomandibular joint pain, and students who had crowding showed a high prevalence of temporomandibular joint pain, temporomandibular joint clicking, and trismus. Students whose occlusal condition was not good demonstrated a high prevalence of temporomandibular joint pain, temporomandibular joint clicking, and trismus. Students who had maxillary protrusion showed a prevalence of temporomandibular joint clicking and trimus, whereas students who had mandibular protrusion showed a high prevalence of temporomandibular joint clicking. Conclusion: Students whose dental condition was crowding and students whose occlusal condition was not good exhibited a high prevalence of three types of symptoms of temporomandibular disorder. Meanwhile student who had maxillary protrusion showed a high prevalence of temporomandibular joint clicking and trismus, while students who had mandibular protrusion showed a prevalence of temporomandibular joint clicking.

Surgical orthodontic treatment of skeletal Class III malocclusion using mini-implant: correction of horizontal and vertical dental compensation (Mini-implant를 이용한 III급 부정교합의 수술교정치료: 수평, 수직적 치성 보상의 조절)

  • Im, Dong-Hyuk;Park, Hyun-Jung;Park, Jae-Woo;Kim, Jeong-Il;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.36 no.5
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    • pp.388-396
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    • 2006
  • Treatment of skeletal Class III malocclusion with mini-implant anchorage is discussed in relation to vertical control of the maxillary posterior dentoalveolar region and horizontal control of mandibular anterior teeth. A midpalatal mini-implant provided anchorage for intruding the maxillary posterior teeth. Mandibular mini-Implant implants were used to bring about labioversion of mandibular anterior teeth. After mandibular setback surgery, improvement of the facial profile was obtained both horizontally and vertically, Total treatment time was 11 months. Stable occlusion was maintained after 18 months of retention, The effectiveness and efficacy of mini-implants for the treatment of skeletal Class III malocclusion are also discussed.

The Distribution and Trend of Malocclusion Patients Visited at Department of Dentistry in Orthodontics (영남대학교 의과대학 부속병원 치과교정과에 내원한 부정교합 환자의 분포 및 변동추이)

  • Kim, Jong-Sup;Park, Jin-Ho;Yun, Hong-Sik;Yim, Nan-Hee;Chin, Byung-Rho;Lee, Hee-Kyung
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.323-331
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    • 1994
  • 1,050 patients who visited orthodontic dental department from 1983 to 1994, were surveyed on the yearly tendency of orthodontic patient distribution and state by means of Angle's classification. The results were as follows: 1. There was increased visiting rate of patient per year and higher visiting rate in female than in male. 2. 8-15 age group was 61.4% in total visiting patients and over 20 age group was 18.5%, under 7 age group was 8.1% 3. Class I malocclusion was 42.2%, class II div 1 was 22.5%, class II-2 was 3.9%, class III was 29.1% and cleft lip & palate was 2.0% in total visiting patient. 4. As showed the living distribution, Namgu and Susunggu's patients were 43.7% of the total patients. 5. There was increased tendency for the number of the patient to be recieved orthognathic surgery.

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Study on Characteristics of Maxillofacial Growth in Class III Malocclusion Patients by Cranial Base Growth (3급 부정교합 환자에서 두개저 성장 양상에 따른 악골 성장 특성에 관한 연구)

  • Son, Do-Kyoung;Park, Sung-Won;Lee, Jae-Min;Kim, Eun-Ja;Choi, Sang-Mun;Kim, Young-Woon;Choi, Mun-Gi;Oh, Sung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.6
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    • pp.483-489
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    • 2011
  • Purpose: Craniofacial structure form results from the adaptation to morphologic and functional changes in their neighboring structures for a mutual balance. The purpose of this study is classification of maxillomandibular complex growth pattern follow by cranial base growth pattern. And this study is identifying the correlation between maxilla-mandibular complex growth pattern and orthodontic criteria. Methods: 142 Class III malocclusion patients had orthognathic surgery at Wonkwang University Dental Hospital during April 2004 to October 2010. Patients were divided into 4 groups and the correlation between cranial base and maxillomandibular growth patterns were evaluated. Results: There was a correlation between cranial base and maxillomandibular growth patterns. Positive relationships were found between the occlusal plane, Incisor mandibular plane angle, mandibular plane, positioning of pogonion and the saddle angle, indicating maxillary growth patterns. Negative relationships were found between SNA, SNB, maxillary incisor angle and saddle angle. Positive relationships were found between the ratio of the anterior and posterior cranium, positioning of pogonion and the percentage of cranial depth indicating mandibular growth patterns. Negative relationships were found between the occlusal plane, maxillary incisor angle, mandibular plane, mandibular angle and cranial depth. Conclusion: Cranial base and maxillofacial growth patterns were correlated and the classification should be adjusted before orthognathic surgery.