• Title/Summary/Keyword: malocclusion

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Osteotomy and iliac bone graft for the treatment of malunion caused by failed mandibular fracture reduction

  • Hwang, Kun;Ma, Sung Hwan
    • Archives of Craniofacial Surgery
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    • v.21 no.6
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    • pp.384-386
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    • 2020
  • This report describes osteotomy and iliac bone graft for malunion caused by failed mandibular fracture reduction. A 27-year-old man was referred 3 months after a motor vehicle accident. At another hospital, two operations had been performed for symphyseal fracture using two resorbable plates. Malocclusion was noted, and panoramic radiography and computed tomography revealed a misaligned dental arch, with a 9.37-mm gap between the central and the lateral incisor of the left mandible. A wafer was made from the patient's dental model, and a maxillary arch bar was applied. Through a lower gingivolabial incision, osteotomy was performed between the malunited symphyseal fracture segments. Both segments were reduced to their original position using the wafer and fixed with titanium miniplates via intermaxillary fixation (IMF). The intersegmental gap was filled with cancellous bone from the iliac crest. The gingival defect was covered with a mucosal transposition flap from the gingivolabial sulcus. IMF and the wafer were maintained for 5 and 9 weeks, respectively. At postoperative week 13, the screws were removed from the mandible and satisfactory occlusion was noted. His mouth opening improved from 2.5 to 3 finger breadths (40 mm). This case demonstrates the need for sufficient IMF when using resorbable plates.

Effects of Natural Products on Acute Orofacial Pain Control Enhanced by Oral Disease

  • Choi, Ja-Hyeong;Lee, Min-Kyung
    • Biomedical Science Letters
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    • v.26 no.4
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    • pp.327-335
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    • 2020
  • As the interest in oral health is increasing with quality of life. The most representative oral diseases include dental caries, periodontal disease, and malocclusion, as well as dry mouth and oral mucosa. Cinnamaldehyde have an antioxidant effect that has been studied not only to treat rheumatism and hypertension, but also to protect liver, and gastrointestinal tract, but there are few studies related to the control of oral diseases. The purpose of this study was the effect of enhanced orofacial pain when oral administration of cinnamaldehyde in the oral diseases. Cinnamaldehyde (5, 12.5, 25, and 50 mg/kg) orally administered at a dose of 1 mL, and the change in biological response was confirmed after a week. In addition, 5% formalin (30, 50 μL) was injected into TMJ and subcutaneous areas of the whiskers of rats to observe the change in the threshold of the improved orofacial pain model. As a result of the experiment, in the xerostomia model, drinking water was decreased in the cinnamaldehyde-administered group, feed intake and weight increased, and saliva was also increased compared to the naïve group. In particular, the most significant increase trend was observed at the concentrations of 25 and 50 mg/kg. In addition, it was confirmed that the pain behavioral response of the orofacial area improved by oral diseases decreased depending on the concentration of cinnamaldehyde. Based on these results, cinnamaldehyde effectively reduced symptoms related to xerostomia and showed improved pain relief in the orofacial areas.

Conservative orthodontic treatment for severe pathologic migration following total glossectomy: A case report

  • Giap, Hai-Van;Jeon, Ji Yoon;Kim, Kee Deog;Lee, Kee-Joon
    • The korean journal of orthodontics
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    • v.52 no.4
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    • pp.298-307
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    • 2022
  • Glossectomy combined with radiotherapy causes different levels of tongue function disorders and leads to severe malocclusion, with poor periodontal status in cancer survivors. Although affected patients require regular access to orthodontic care, special considerations are crucial for treatment planning. This case report describes the satisfactory orthodontic management for the correction of severe dental crowding in a 43-year-old female 6 years after treatment for tongue cancer with total glossectomy combined with radiotherapy, to envision the possibility of orthodontic care for oral cancer survivors. Extraction was performed to correct dental crowding and establish proper occlusion following alignment, after considering the possibility of osteoradionecrosis. Orthodontic mini-implants were used to provide skeletal anchorage required for closure of the extraction space and intrusion of the anterior teeth. The dental crowding was corrected, and Class I occlusal relationship was established after 36 months of treatment. The treatment outcome was sustained after 15 months of retention, and long-term follow-up was recommended.

Camouflage treatment by backward rotation of the mandible for a severe skeletal Class III malocclusion with aplastic anemia: A case report

  • Choi, Dong-Soon;Lee, Dong-Hyun;Jang, Insan;Cha, Bong-Kuen
    • The korean journal of orthodontics
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    • v.52 no.5
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    • pp.362-371
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    • 2022
  • Orthognathic surgery is the primary treatment option for severe skeletal discrepancy. However, orthodontic camouflage should be considered as an alternative treatment option, considering the risks of surgery. A 19.5-yearold man presented with a severe prognathic mandible with a Class III molar relationship and an anterior crossbite. Orthognathic surgery could be considered because of his severe skeletal discrepancy and mandibular prognathism. However, the anesthetist for orthognathic surgery did not recommend surgery under general anesthesia because of risk factors associated with the patient's aplastic anemia, including bleeding and infections. Thus, a camouflage treatment to promote backward rotation of the mandible via orthodontic extrusion of the posterior teeth was planned. An anterior bite plate, intermaxillary elastics, and fixed orthodontic appliances were used to extrude the posterior teeth and to align the dentition. After 17 months of nonsurgical orthodontic treatment, normal occlusion was achieved, and the facial profile was dramatically improved. This case report describes the dentoskeletal and soft-tissue effects of mandibular rotation and its long-term stability.

Orthodontic treatment in a patient with Moebius syndrome: A case report

  • Lee, Sanghee;Moon, Cheol-Hyun
    • The korean journal of orthodontics
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    • v.52 no.6
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    • pp.451-460
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    • 2022
  • Moebius syndrome (MBS) is a congenital neurologic disorder that causes cranio-facial abnormalities. It involves paralysis of the VI and VII cranial nerves and causes bilateral or unilateral facial paralysis, eye movement disorder, and deformation of the upper and lower limbs. The orofacial dysfunctions include microstomia, micrognathia, hypotonic mimetic and lip muscles, dental enamel hypoplasia, tongue deformity, open bite or deep overbite, maxillary hypoplasia, high arched palate, mandibular hyperplasia or features indicating mandibular hypoplasia. This case report presents a 7-year-old male patient who was diagnosed with MBS at the age 2 years. The patient displayed typical clinical symptoms and was diagnosed with Class II malocclusion with a large overjet/overbite, tongue deformity and motion limitation, and lip closure incompetency. Treatment was initiated using a removable appliance for left scissor bite correction. After permanent tooth eruption, fixed appliance treatment was performed for correction of the arch width discrepancy and deep overbite. A self-ligation system and wide-width arch form wire were used during the treatment to expand the arch width. After 30 months of phase II treatment, the alignment of the dental arch and stable molar occlusion was achieved. Function and occlusion remained stable with a Class I canine and molar relationship, and a normal overjet/overbite was maintained after 9.4 years of retainer use. In MBS patients, it is important to achieve an accurate early diagnosis, and implement a multidisciplinary treatment approach and long-term retention and follow-up.

The study on the cleft lip and/or palate patients who visited Dept. of Orthodontics, Seoul National University Dental Hospital during last 11 years (1988.3-1999.2) (최근 11년간 서울대학교병원 교정과에 내원한 순구개열 환자의 내원 현황에 관한 연구(1988.3 - 1999.2))

  • Yang, Won-Sik;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.29 no.4 s.75
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    • pp.467-481
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    • 1999
  • Cleft lip and/or palate is one of the most common congenital craniofacial anomalies. According to previous epidemiologic studies, incidence of cleft lip and/or palate has been increasing nowadays. However, there is no report about epidemiologic study of cleft lip and/or palate patients who visited dept. of orthodontics in Korea. So the purpose of this study was to provide the epidemiological characteristics and important basic clinical data for the diagnosis and the treatment of the cleft lip and/or palate patients. With the orthodontic and cleft charts, diagnostic models and X-ray films from 250 patients with cleft lip and/or palate who visited Dept. of Orthodontics, Seoul National University Dental Hospital during the last 11 years, the authors investigated patient's visiting yew, types of cleft, patient's gender, and Angle's classification of malocclusion, and surgery timing. The results were as follows ; 1. The number of cleft patients who visited Dept. of Orthodontics, SNUDH increased during 1988-1990 and then it declined until 1992. From 1993 to 1996, it showed a stationary trend. After 1997 it showed an overwhelmingly increasing trend. 2. In the cleft type, the ratio of cleft lip cleft lip and alveolus cleft palate : cleft lip and palate was 7.6:19.2:9.6:63.6. In cleft position, unilateral clefts were more than bilateral ones (cleft lip 79:21, cleft lip and alveolus 77:23, cleft lip and palate 75.5:24.5). In cleft side, left clefts were mote than right clefts (cleft lip 53.3:46.7 cleft lip and alveolus 59.5:40.5, cleft lip and palate 59.2:40.8). 3. In gender ratio, males were more than females in cleft lip (57.9:42.1), cleft lip and alveolus (68.8:31.2) and cleft lip and palate (76.1:23.9). But in cleft Palate females were more than males as 41.7: 58.3. 4. In the age groups, 7-12 year group was the most abundant as $52\%$, and then 0-6 year group ($20.4\%$), 13-18 year group ($17.2\%$), more than 18 yew group ($10.4\%$) were followed as descending order. 5. Most of the cleft lip repair surgeries were operated in 0-3 month ($60.3\%$) and 4-6 month ($17.9\%$). 6. The cleft palate repair surgeries were done in 1-2 year ($31.7\%$), 0-1 year ($25.6\%$), 2-3 year ($12.1\%$), more than 5 year ($11.6\%$) as descending order. 7. The lip scar revision surgeries were done before admission at elementary school in $60\%$. (4-6 you ($27.5\%$), 6-8 year ($19.6\%$), more than 10 year ($19.6\%$), 2-4 year ($13.7\%$) as descending order) 8. The rhinoplasties were done before admission at elementary school in $51.7\%$. (0-2 year ($7.1\%$), 2-4 year ($14.3\%$), 4-6 year ($21.4\%$), 6-8 year ($14.3\%$)). 9. The pharyngeal flap were done at 6 Y (72.5 months) after birth on average and there was even distribution of surgery timing. 10. In relationship between Angle's classification of malocclusion and cleft types, Class I was most abundant and Class III, Class II were followed as descending order in cleft lip group. But Class III was most abundant and Class I, Class II were followed as descending order in cleft lip and alveolus group, cleft palate group, and cleft lip and Palate group. The percentage of frequency in Class III malocclusion was overwhelmingly higher in cleft lip and palate group than any other groups. 11. Because the frequency of class III malocclusion was most prevalent in all age groups, anterior crossbite was the most common chief complaint of cleft patients.

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THE POSTOPERATIVE CONDYLAR POSITION RELATED TO TEMPOROMANDIBULAR DISCOMFORT IN SAGITTAL SPLIT RAMUS OSTEOTOMY (하악지 시상 분할술에 있어 술후 하악과두의 위치와 측두 하악관절장애)

  • You, Jun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.2
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    • pp.130-134
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    • 1997
  • The sagittal split ramus osteotomy(SSRO) of the mandible has used one of the most popula methods for the correction of various dentofacial deformities, especially mandibular prognathism. In SSRO, there are produced bony gap following mandible setback because of mandibular flaring. For this reason, the condylar axis may be changed due to bony approximation both segment in three dimension more mesio-laterally. According to change of condylar position, the condition of TMJ structure are changed and change of TMJ symptoms are suggested theoretically, and the correction of malocclusion by SSRO may improve the TMJ symptoms by improvement of feeding difficulties. The pupose of this study was to determine relationship between expected alterations in condylar position and suggested TMJ symptoms produced by change of condylar position. TMJ symptoms of 15patients who had operated SSRO are checked at about postoperative 6 month ranging $5{\sim}11$ month. Anterior-posterior position of condyle which was comparison preoperative with postoperative position, was classified 5 groups. The author tried to identify relationship between positional change of condyle and TMJ discomfort.

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THE EVALUATION OF REPRODUCIBILITY OF OPERATION PLAN WITH THE COMPARISON BETWEEN STO AND POST-OPERATIVE JAW POSITION IN ORTHOGNATHIC SURGERY (악교정 수술에서 STO와 술 후 악골위치 비교를 통한 이동량 재현성에 대한 평가)

  • Kwon, Seok-Woo;Jee, Yu-Jin;Lee, Baek-Soo;Lee, Deok-Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.6
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    • pp.628-634
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    • 2008
  • The purpose of this study is to examine reproducibility of operation plan and 3-dimentional jaw movement patterns by comparing jaw position of STO with post-operative jaw position. Twenty patients with class III dental and skeletal malocclusion who were treated with Le-Fort I osteotomy and B-SSRO were reviewed. Lateral cephalometric radiographs were taken within two weeks before operation and two days after operation. Cephalometric radiographs were compared and analyzed with orthognathic computer program '$V-Ceph^{TM}$'. Post-operative maxillary advancement was insufficient compared to maxillary advancement through STO. Post-operative setback movement was over compared to mandibular setback movement through STO. But statistically this is not significant. Maxillary vertical location is insignificant on the whole. Especially post-operative maxillary clockwise rotation is significant compared to maxillary rotation through STO. Post-operative maxillary clockwise rotation tendency is generally observed in all patients. So surgeons and staffs must consider this tendency when operation plan is established ans operation is being performed. Using intra or extra oral marking points, face bow, and bite plate will make exact surgery possible.

Orthognathic surgery on Skeletal Class III patiens with collapsed vertical dimension: case report (수직고경이 붕괴된 골격성 III급 부정교합자의 악교정 수술 치험례)

  • Choi, Youn-Kyung;Kim, Yong-Deok;Park, Soo-Byung;Kim, Yong-Il;Kim, Seong-Sik;Son, Woo-Sung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.1
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    • pp.70-79
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    • 2016
  • Patients who lost posterior teeth due to periodontitis or dental caries have collapsed vertical dimension, unstable occlusion and change of the mandibular position. In particular, patients in orthognathic surgery, clinician should re-establish the pre-operative stable position of mandibular condyle in articular fossa and favorable vertical dimension for high post-operative stability of mandible. Therefore, interdisciplinary approach and co-operation, including prosthetics, orthodontics, oral and maxillofacial surgeon, from diagnosis and treatment plan is important to get a good outcome. This case report was patients who had collapsed occlusal plane due to severe dental caries on maxillary molars with skeletal Class III malocclusion. Before orthognathic surgery, resetting of maxillary occlusal plane with temporary removable denture was performed. Then successful multidisciplinary approach was done and lead to acceptable clinical outcome.

A comparative study of combined periodontal and orthodontic treatment with fixed appliances and clear aligners in patients with periodontitis

  • Han, Ji-Young
    • Journal of Periodontal and Implant Science
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    • v.45 no.6
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    • pp.193-204
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    • 2015
  • Purpose: With the increasing prevalence of orthodontic treatment in adults, clear aligner treatments are becoming more popular. The aim of this study was to evaluate the effect of orthodontic treatment on periodontal tissue and to compare orthodontic treatment with fixed appliances (FA) to clear aligner treatment (CAT) in periodontitis patients. Methods: A total of 35 patients who underwent orthodontic treatment in the Department of Periodontology were included in this study. After periodontal treatment with meticulous oral hygiene education, patients underwent treatment with FA or CAT, and this study analyzed patient outcomes depending on the treatment strategy. Clinical parameters were assessed at baseline and after orthodontic treatment, and the duration of treatment was compared between these two groups. Results: The overall plaque index, the gingival index, and probing depth improved after orthodontic treatment (P<0.01). The overall bone level also improved (P=0.045). However, the bone level changes in the FA and CAT groups were not significantly different. Significant differences were found between the FA and CAT groups in probing depth, change in probing depth, and duration of treatment (P<0.05). However, no significant differences were found between the FA and CAT groups regarding the plaque index, changes in the plaque index, the gingival index, changes in the gingival index, or changes in the alveolar bone level. The percentage of females in the CAT group (88%) was significantly greater than in the FA group (37%) (P<0.01). Conclusions: After orthodontic treatment, clinical parameters were improved in the FA and CAT groups with meticulous oral hygiene education and plaque control. Regarding plaque index and gingival index, no significant differences were found between these two groups. We suggest that combined periodontal and orthodontic treatment can improve patients' periodontal health irrespective of orthodontic techniques.