• Title/Summary/Keyword: malocclusion

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CLINICAL STUDY OF THE SKELETAL CL III MALOCCLUSION PATIENTS AFTER 2-PHASE SURGICAL-ORTHODONTIC TREATMENT (골격성 제III급 부정교합 환자의 2단계 치료후 경과에 대한 임상적 연구)

  • Cho, Yun-Ju;Kim, Sang-Jung;Kim, Dong-Ryul;Suk, Geon-Jung;Hong, Kwang-Jin;Lee, Jeong-Gu;Sohn, Hong-Bum
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.6
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    • pp.628-635
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    • 2000
  • The purpose of this study was to evaluate the result after 2-phase surgical-orthodontic treatment without preoperative orthodontic treatment for the skeletal Cl III malocclusion patient and to obtain an adequate protocol on the bases of this result. This retrospective study of ten patients who underwent 2-phase treatment were done to evaluate 1) the surgical stability and relapse pattern 2) the facial esthetics 3) the TMJ problem 4) the total time of the treatment. Results were followed : 1) The horizontal relapse of the mandible was 26.8% and didn't show significant differences compared to the conventional 3-phase treatment. But, it was considered that this amount of relapse was the sum of true relapse and autoratation of mandible due to decreased vertical dimension during orthodontic treatment. 2) It was estimated that there's no difference on the ratio of anterior facial height between the subjects and the normal patients. On the horizontal analysis, the mandible of the subjects was located more anteriorly than that of the normal patients. This result showed that there was a need for the accurate preoperative esthetic evaluation and the additional methods for reducing the relapse due to the occlusal interference. 3) Wide variation was noted on the TMJ symptoms of the subjects, however, it was estimated that there's no significant differencees of symptoms compared to that of the conventional 3-phase treatment on literatures. 4) The average of the overall period of treatment was 20.8 months and we obtained reduction of the treatment time compaired to 3-phase treatment on many literatures. Most of the results of this study were similar to the findings of the 3-phase treatment(preoperative orthodontic-orthognathic surgery-postoperative orthodontic), but total time of the treatment was shorter in patients with 2-phase treatment than in those with the conventional 3-phase treatment. With 2-phase treatment, we experienced many advantages compared to the conventional method considering that it was favarable conditions for the teeth, it had the flexibility for the treatment, and it could be the adequate treatment approach for the stomatognathic system. Although this retrospective pilot study had some limitations, due to small samples, the authors would hope that it could serve as a guide for the future researches, and the clinical applications.

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A STUDY ON THE MORPHOLOGICAL CHANGES IN CHILDREN WITH CLASS I AND III MALOCCLUSIONS: CEPHALOMETRIC ANALYSIS (I급과 III급 부정교합 어린이의 두개안면골 형태의 변화에 관한 연구)

  • Hong, Han-Young;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.4
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    • pp.599-612
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    • 2007
  • The present study was designed to compare the morphological and structural differences of craniofacial structures among 146 children with Class I and Class III malocclusions. The results below were obtained from the study. 1. Sphenoethmoidal synchondrosis continues to grow later in Class III. 2. Anteroposterior length of the nasomaxillary complex was significantly shorter in Class III, but the height of the nasomaxillary complex was similar. 3. Mandibular length and mandibular body length were longer in Class III, but had no statistical significance. Lower anterior facial height was shorter in Class III, but had no statistical significance. 4. Dentoalveolar height was similar between Class I and Class III. 5. In Class I, anterior cranial base took part in the anteroposterior length of the nasomaxillary complex and the mandible. 6. In Class III, anterior cranial base and middle cranial base had higher correlation with the mandible with aging. These results suggest that there exist a little differences between Class I and Class III malocclusions at age $7{\sim}11$, but growth patterns are mostly similar. Therefore it is necessary to correct Class III malocclusions at an early age before skeletal differences appear.

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Soft Tissue Change in Frontal View after Orthognathic Surgery for Class III Malocclusion: Analysis Using Facial 'Phi' Mask (Facial 'Phi' Mask를 이용한 3급 부정교합 환자의 악교정수술 후 정면부 연조직의 변화)

  • Heo, Young-Min;Kim, Hong-Soek;Paeng, Jun-Young;Hong, Jong-Rak;Kim, Chang-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.6
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    • pp.490-496
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    • 2011
  • Purpose: Dr. Marquardt made the facial 'phi' mask using golden ratio. Most class III patients have bulky faces and want a smaller face. Using a facial golden mask, this study estimated and compared frontal photographs before and after operation for soft tissue measurement. The golden mask can be considered as a reference tool for facial esthetic analyses especially in lower face. Methods: Forty patients who had undergone orthognathic surgery at Samsung Medical Center from January 2006 to December 2009 were included in this study. These patients had Class III malocclusion. Lateral cephalometric radiographs, frontal clinical photos of pre-op and 8~12 month later post-op, and the facial 'phi' mask using golden ratio, were used for analysis. Reduction of the lower face area, occlusal plane changes, amounts of mandible setback and amounts of maxilla posterior impaction were estimated. Results: Lower facial reduction ratio and mandibular setback amounts were significantly different between 1-jaw and 2-jaw groups. Average postoperative changes in the area of lower face between bilateral sagittal split ramus osteotomy (BSSRO) and BSSRO combined maxilla posterior impaction were compared by using an independent simple t-test and $P$ value was 0.016. Therefore, the lower facial reduction ratio and mandibular setback amount were significantly different in maxilla posterior impaction. Conclusion: The two-jaw surgery group showed more reduction of the lower facial area than the 1-jaw surgery group. The amount of lower facial reduction was more related with the amount of mandibular setback. There was no significant relation in lower facial reduction with amount of maxilla posterior impaction, pre-op occlusal plane, post-op occlusal plane and the mandibular angle. A relationship between the change in the lower facial area and the amount of maxilla posterior impaction or the change of mandibular angle occlusal plane at pre-op could not be found because of the difference in the amount of setback between two groups.

A COMPARATIVE ANALYSIS OF CLASS II DIVISION 1 TREATMENTS : ADOLESCENTS CONTRASTED WITH ADULTS (성장기 아동과 성인에서의 II급 1류 부정교합치료양상에 관한 두부방사선 계측학적 비교연구)

  • Kang, Bo-Seon;Yang, Won-Sik
    • The korean journal of orthodontics
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    • v.25 no.3 s.50
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    • pp.247-261
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    • 1995
  • The purpose of this study was to quantitate differences in the nature of the correction of Angle's Class II div 1 malocclusion dependent on the patient's age at the time of treatment. The sample consisted of 27 female patients in the adolescent group with a mean initial records age of 11.8 years and 25 female patients in the adult group with a mean starting age of 21.1 yrs. Lateral cephalometric head films were taken before and after orthodontic treatment with four bicuspid extraction. The results were obtained as follows. 1. None of maxillary skeletal parameters exhibited a significantly different in treatment change between adolescents and adults. But, in mandibular skeletal measurements, there were significant differences between two groups. (P<0.05) 2. Measures of vertical dimension in the adults remained unchanged during treatment, reflecting the effective absence of growth. 3. The steepness of occlusal plane in the adults changed significantly.(P<0.05) In contrast, the adolescents displayed stability of the occlusal plane. 4. According to the Johnston analysis, there was a significant difference in the total molar correction between two groups.(P<0.05) 5. According to the Johnston analysis, differential mandibular growth in the adolescents contrubuted $63\%$ of the total molar correction, with orthodontic tooth movement accounting for the remaining $37\%$. In the adults, dental movement comprised $99\%$ of the correction.

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THE MORPHOLOGIC CHARACTERISTICS OF CLASS I, NON-EXTRACTION PATIENTS (비발치로 치료된 I 급 부정교합의 형태적 특성)

  • Chang, Young-Il;Shin, Soo-Jung
    • The korean journal of orthodontics
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    • v.28 no.3 s.68
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    • pp.343-351
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    • 1998
  • The purpose of this study was to investigate the pretreatment and posttreatment dentofacial characteristics of non-extraction patients with Class I malocclusion. And to compare this result with matched non-orthodontic normal occlusion and Class I premolar extraction patients. Such comparison might help identify morphologic characteristics of the non-extraction patients. Initial and final cephalometric evaluation were compared in a sample of 22 patients with Class I malocclusions treated in non-extraction manner with edgewise appliance and MEAW The mean age of the total population was 14 years 9 months and the average treatment time was 2 years 8 months. 32 landmarks were located and digitized on each cephalogram. From these landmarks, 24 linear and angular dimension were obtained. Student's t-test were used to compare the pretreatment - posttreatment results, Nonextraction - Normal groups, and nonextraction Extraction groups. Significance was predetermined at $p{\leq}0.05$. The results were as follows. 1. Before treatment, the mean value of the $ODI\;was\;69.9^{\circ},\;APDI\;was\;82.1^{\circ},\;CF\;was\;152^{\circ},\;EI\;was\;152^{\circ}$ in the non-extraction groups. 2. The skeletal pattern of the non-extraction groups were similar with non-orthodontic normal groupsr, but the non-extraction groups had larger interincisal angle. 3. Comparison between groups treated with and without extraction indicated at pretreatment, the extraction groups had more protrusive lips, smaller interincisal angle, and EI. 4. After treatment, there was no significant changes in the skeletal pattern of the non-extraction groups, but uprighting of the maxillary and mandibular first molar and decrease of the interincisal angle were seen.

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Non-extraction treatment in Class III malocclusion by using improved superelastic NiTi wire (III급 부정교합 환자에서 초탄성 Ni-Ti alloy wire를 이용한 비발치 치료)

  • Min, Sam;Chung, Chu-Ryung;Hwang, Chung-Ju;Cha, Jung-Yul
    • The korean journal of orthodontics
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    • v.41 no.4
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    • pp.297-306
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    • 2011
  • Nonextraction camouflage treatment in mild Class III malocclusion is achieved by backward movement of the lower dentition and forward movement of the upper dentition. Many camouflage treatment modalities have been used for distal tipping and distal movement of mandibular posterior teeth. The amount of distal movement of mandibular dentition can be improved in cases of severe crowding, even without the patient's cooperation, by using miniscrews for anchorage. However, miniscrew insertion may be unsuccessful, and it may contact the adjacent root because of the distal movement of dentition. Distal tipping of mandibular dentition can be achieved using multiloop edgewise archwires and intermaxillary elastics. However, the complexity of this wire design causes discomfort to patients. Recently, a new treatment using improved superelastic NiTi wires (ISWs) and intermaxillary elastics has been introduced. ISWs can deliver orthodontic force more effectively, and their use with molar tip-back treatment has several advantages-this approach is effective, simple, and easy to use and reduces patient discomfort. The aim of this study was to report a case of camouflage treatment using ISW with tip-back and intermaxillary elastics for distal tipping of mandibular posterior dentition and to evaluate the effectiveness of this treatment in a clinical setting.

An Epidemiologic Study of Symptoms of Temporomandibular Disorders in Korean College Students (경기도 지역 대학생의 측두하악장애증상에 관한 역학적 연구)

  • Park, Hye-Sook
    • Journal of Oral Medicine and Pain
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    • v.32 no.1
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    • pp.91-104
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    • 2007
  • An epidemiologic investigation was carried out to determine the prevalence of symptoms of temporomandibular disorders in college students that aged 19-31 years. 460 students were investigated with a questionnaire from September to December 2006. The obtained results were as follows : 1. The prevalence of symptoms of temporomandibular disorders was 80.6%. 2. The most frequently complained symptom was headache and joint sound was the next one without distinct difference between men and women. 3. While the rate of occurrence of symptom of acute malocclusion decreased with age in men, that of TMJ pain during chewing or speech increased with age in women. 4. Symptoms including TMJ pain during mouth opening, chewing or speech, TMJ fatigue and acute malocclusion occurred significantly more frequently in women than in men. Contributing factors including resting cheeks on hands, stressful state, gum chewing, insomnia and clenching occurred significantly more frequently in women than in men. 5. There was a highly significant relationship between symptoms and contributing factors including resting cheeks on hands, stressful state, unilateral chewing, insomnia and clenching. 6. There was a highly significant relationship between symptoms and general personality.

A Study on the Influence Factors in the Cooperation of the Orthodontic Patient in Sdolescence (청소년기 교정환자의 협조도에 영향을 미치는 변인분석)

  • Yoo, Hyun-Jung;Kim, Eun-Hee
    • Journal of dental hygiene science
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    • v.7 no.2
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    • pp.97-100
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    • 2007
  • In this study, to find the influencing factors of the cooperation affects the result of the orthodontic treatment, the questionnaires were collected from patients who were being treated with fixed orthodontic appliances at A dental clinic in Seoul area. The results of this study are below.1. The average of the total score of the cooperation was 8.04 with the range of between 2 and 14. 2. The gender and age of the patient did not show the meaningful significance in aspect of the cooperation. 3. The relation between the period of treatment time and the cooperation, the analysis showed that the longer the period of treatment, the lesser the cooperation (P < 0.05). 4. The average of the cooperation by decision maker, the patient himself was 9.17, mother was 7.69 and father was 7.77. This result showed that the treatment decision made by the patient himself, the cooperation was highest (P < 0.05). 5. In the relationship between the malocclusion classification and the cooperation, the Angle Class I was 8.77, Class II was 7.28, and Class III was 6.89. This result showed that the average cooperation of Angle Class I patients was higher than Angle Class III patients (P < 0.05). 6. All the influencing factors to the orthodontic treatment were analyzed by logistic regression analysis (RGA). The result showed that there is meaningful significance in the treatment period and malocclusion classification. The most influencing factor was treatment period and the longer the period, the lesser cooperation (P < 0.05).

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Improvement of Articulation Disorder Using Flexible Partial Denture in Intellectural Disability Patient with Missing Lower Incisors (하악 전치부 상실로 인한 조음장애를 보이는 경도 지적장애 환아에서 탄성의치를 통한 조음능력의 향상)

  • Choi, Haein;Choi, Byungjai;Choi, Hyungjun;Song, Jeseon;Lee, Jaeho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.4
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    • pp.306-313
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    • 2013
  • Speech is complex psycho-physiological mutual process which includes many orofacial organs. Especially, teeth play an especially important role as an articulation organ in conjunction with the lips and tongue. When teeth are missing, the position of tongue and mandible is adjusted to produce correct sound. If a patient's adaptive function is inadequate for modification of malocclusion, prosthodontic and orthodontic interventions are necessary. Missing teeth of young patients should be reconstructed bacause it can cause malocclusion, decreased masticatory efficiency, articulation disorders, esthetic problem, and temporomandibular disorder. Valplast$^{(R)}$(Valplast International Corp, New York, USA) flexible denture is useful for rehabilitation due to its excellent physical properties, esthetics, and small volume. This case is regardingan intellecturally disabled patient with anarticulation disorder caused by missing lower incisors due to trauma. The patient showed improvement in articulation by using flexible partial denture. The purpose of this report is to figure out the influence of missing lower anterior teeth on articulation.

SOFT TISSUE CHANGES FOLLOWING BIMAXILLARY SURGERY IN SKELETAL CLASS III MALOCCLUSION PATIENTS (골격성 III급 부정교합 환자에서 양악 수술후 연조직 변화에 대한 연구)

  • Park, Hong-Ju;Choi, Hong-Ran;Ryu, Sun-Youl
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.4
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    • pp.284-290
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    • 1998
  • The purpose of this study was to assess the soft tissue changes using twenty skeletal class III malocclusion patients who treated with bimaxillary surgery for the correction of dentofacial deformities. Patients were divided into two groups. One was impaction and advancement of maxilla with mandibular set-back (Group 1), the other was downward and advancement of maxilla with mandibular set-back (Group 2). Preoperative and postoperative one year cephalometric data were analyzed and compared. Results obtained were as follows: 1. The ratio of horizontal changes of soft tissue to hard tissue at Nt to ANS, Ls to UI, Li to LI, sPog to Pog were 1:0.60, 1:0.79, 1:0.47, 1:0.63 in group 1 respectively, and 1:0.59, 1:0.48, 1:0.83, 1:1.09 in group 2 respectively. Soft tissue changes were highly predictable at the upper lip, lower lip, and chin area. 2. The ratio of vertical changes of soft tissue to hard tissue at Nt to ANS, Li to LI were 1:0.72, 1:0.06 in group 1, and others showed no statistically significant difference. 3. The ratio of horizontal changes of Ls to hard tissue movements at LI(h) was 1:-0.82 in group 1 and at UI(h), LI(h) were 1:0.48, 1:0.01 in group 2. These ratios of group 1 were greater than those of group 2. 4. The direction of horizontal change of Li was the same as that of hard tissue change. The ratio of horizontal changes of Li to LI was 1:0.47 in group 1 and others showed no statistically significant difference. 5. The changes of upper lip thickness and length were -1.6mm, -1.4mm in group 1, and -1mm, -2.7mm in group 2. 6. The ratios of thickness of upper lip to ANS, UI, LI were 1:-0.83, 1:-0.37, 1:0.11 in group 1. There was similar trend in group 2, and there were no statistically significant difference. These results suggest that prediction of changes in soft tissue of upper lip, lower lip, and chin were 79%, 47%, and 63% in group 1, and 48%, 83%, and 109% in group 2. There was a tendency to decrease in thickness and increase in length of the upper lip.

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