• The korean journal of orthodontics
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• v.53 no.2
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• pp.77-88
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• 2023

Objective: To develop a method for generating three-dimensional (3D) digital models of the periodontal ligament (PDL) using 3D cone-beam computed tomography (CBCT) reconstruction and to evaluate the accuracy and agreement of the 3D PDL models in the measurement of periodontal bone loss. Methods: CBCT data collected from four patients with skeletal Class III malocclusion prior to periodontal surgery were reconstructed at three voxel sizes (0.2 mm, 0.25 mm, and 0.3 mm), and 3D tooth and alveolar bone models were generated to obtain digital PDL models for the maxillary and mandibular anterior teeth. Linear measurements of the alveolar bone crest obtained during periodontal surgery were compared with the digital measurements for assessment of the accuracy of the digital models. The agreement and reliability of the digital PDL models were analyzed using intra- and interexaminer correlation coefficients and Bland-Altman plots. Results: Digital models of the maxillary and mandibular anterior teeth, PDL, and alveolar bone of the four patients were successfully established. Relative to the intraoperative measurements, linear measurements obtained from the 3D digital models were accurate, and there were no significant differences among different voxel sizes at different sites. High diagnostic coincidence rates were found for the maxillary anterior teeth. The digital models showed high intra- and interexaminer agreement. Conclusions: Digital PDL models generated by 3D CBCT reconstruction can provide accurate and useful information regarding the alveolar crest morphology and facilitate reproducible measurements. This could assist clinicians in the evaluation of periodontal prognosis and establishment of an appropriate orthodontic treatment plan.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.3
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• pp.125-134
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• 2023

Objectives: The aim of the study was to quantify and compare craniofacial asymmetry in subjects with and without symptoms of temporomandibular joint disorders (TMDs). Materials and Methods: A total of 126 adult subjects were categorized into two groups (63 with a TMDs and 63 without a TMDs), based on detection of symptoms using the Temporomandibular Joint Disorder-Diagnostic Index (TMD-DI) questionnaire. Posteroanterior cephalograms of each subject were traced manually and 17 linear and angular measurements were analyzed. Craniofacial asymmetry was quantified by calculating the asymmetry index (AI) of bilateral parameters for both groups. Results: Intra- and intergroup comparisons were analyzed using independent t-test and Mann-Whitney U test, respectively, with a P<0.05 considered statistically significant. An AI for each linear and angular bilateral parameter was calculated; higher asymmetry was found in TMD-positive patients compared with TMD-negative patients. An intergroup comparison of AIs found highly significant differences for the parameters of antegonial notch to horizontal plane distance, jugular point to horizontal plane distance, antegonial notch to menton distance, antegonial notch to vertical plane distance, condylion to vertical plane distance, and angle formed by vertical plane, O point and antegonial notch. Significant deviation of the menton distance from the facial midline was also evident. Conclusion: Greater facial asymmetry was seen in the TMD-positive group compared with the TMD-negative group. The mandibular region was characterized by asymmetries of greater magnitude compared with the maxilla. Patients with facial asymmetry often require management of temporomandibular joint (TMJ) pathology to achieve a stable, functional, and esthetic result. Ignoring the TMJ during treatment or failing to provide proper management of the TMJ and performing only orthognathic surgery may result in worsening of TMJ-associated symptoms (jaw dysfunction and pain) and re-occurrence of asymmetry and malocclusion. Assessments of facial asymmetry should take into account TMJ disorders to improve diagnostic accuracy and treatment outcomes.

• The korean journal of orthodontics
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• v.22 no.2 s.37
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• pp.413-426
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• 1992

In order to analyze the relationship between teeth and basal bone for the maintainance of the good occlusion, the mesiodistal width of teeth, the basal arch width and the basal arch length were measured on the study model of the normal occlusion group and Angle's class I malocclusion group (non-extraction group, extraction group) The Maximum tooth material, the percentage of basal arch width to maximum tooth material, the percentage of basal arch length to maximum tooth material and the percentage of basal arch width plus basal arch length to maximum tooth material were caculated, and then statistical analysis was done. From thie study, the obtained results were as follows; 1. In maxilla, the percentage of basal arch width to maximum tooth material was $46.9{\pm}2.6\%$ in normal occlusion group, $49.4{\pm}3.9\%$ in non-extraction group, and $42.5{\pm}3.3\%$ in extraction group. In mandible, that was $46.6{\pm}2.4\%$ in normal occlusion group, $47.5{\pm}4.0\%$ in non-extraction group, and $42.6{\pm}2.6\%$ in extraction group. 2. In maxilla, the percentage of basal arch length to maximum tooth material was $33.4{\pm}1.9\%$ in normal occlusion group, $33.9{\pm}1.8\%$ in non-extraction group, and $28.7{\pm}2.5\%$ in extraction group. In mandible, that was $34.4{\pm}4.3\%$ in normal occlusion group, $36.5{\pm}1.9\%$ in non-extraction group, and $31.5{\pm}2.5\%$ in extraction group. 3. In maxilla, the percentage of basal arch width plus basal arch length to maximum tooth material was $80.3{\pm}3.4\%$ in normal occlusion group, $83.3{\pm}4.8\%$ in non-extraction group, and $71.2{\pm}4.3\%$ in extraction group. In mandible, that was $81.0{\pm}5.2\%$ in normal occlusion group, $84.0{\pm}5.4\%$ in non-extraction group, and $74.1{\pm}4.1\%$ in extraction group. 4. In Maxilla, the $95\%$ confidence interval of the percentage of basal arch width to maximum tooth material was $46.3-47.5\%$ in normal occlusion group, $48.1-50.7\%$ in non-extraction group, and $41.7-47.2\%$ in extraction group. In mandible, that was $46.1-47.2\%$ in normal occlusion group, $46.1-48.8\%$ in non-extraction group, and $42.0-43.3\%$ in extraction group. 5. In maxilla, the $95\%$ confidence interval of the percentage of basal arch length to maximum tooth material was $32.9-33.9\%$ in normal occlusion group, $33.3-34.5\%$ in non-extraction group, and $28.1-29.2\%$ in extraction group. In mandible, that was $33.4-3.4\%$ in noraml occlusion group, $35.8-37.2\%$ in non-extraction group, and $30.9-33.1\%$ in extraction group. 6. In maxilla, the $95\%$ confidence interval of thepercentage of basel arch width plus basal arch length to maximum tooth material was $79.5-81.0\%$ in normal occlusion group, $81.6-84.9\%$ in non-extraction group, and $70.1-72.2\%$ in extraction group. In mandible, that was $79.8-82.2\%$ in normal occlusion group, $82.1-85.5\%$ in non-extraction group, and $73.1-75.1\%$ in extraction group. 7. There was correlation between maxilla and mandible in the maximum tooth material, the basal arch width, the basal arch length, the percentage of basal arch width to maximum tooth material, the percentage of basal arch length to maximum tooth material and the percentage of basal arch width plus basal arch length to maximum tooth material, but not in the basal arch length of male of the extraction group. * A thesis submitted to the Council of the Graduate School of Kyungpook national University in partial fulfillment of the requirements for the degree of Master of Dental Science in December, 1991.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.3
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• pp.191-200
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• 1998

This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after orthognathic surgery in 37 patients(male 13, female 24) using computed tomogram that were taken in centric occlusion before, immediate after, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period of intermaxillary fixation, at the 24 hours later removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.42{\pm}5.30mm$ and horizontal long axis of condylar angle was $12.79{\pm}4.92^{\circ}$ on the right, $13.53{\pm}5.56^{\circ}$ on the left side. Condylar lateral poles were located about 12mm and medial poles about 7mm away from the reference line(AA') on the axial tomogram. Mean intercondylar distance was $83.15{\pm}4.62mm$ and vertical axis angle of condylar angle was $76.28{\pm}428^{\circ}$ on the right, $78.30{\pm}3.79^{\circ}$ on the left. 2. In amount of set back, We found the condylar change(T2C-T1C) which had increasing tendency in group III (amount of setback : 10-15mm). but there was no statistical significance(p>0.05). 3. There was some correlation between condylar change(T2C-T1C) and TMJ dysfunction. It seemed that postoperative condylar change had influenced postoperative TMJ dysfunction, through there was no statistical significance (p>0.05). As we have observed the change of condylar axis in the group that complained of TMJ dysfunction in cases of large amount of mandibular setback. So we consider that the more trying to conserve condylar position will decrease occurrence rate of post operational TMJ dysfunction.

• The korean journal of orthodontics
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• v.27 no.5 s.64
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• pp.815-824
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• 1997

The purpose of this study is to develop the basic algorithm for the finite element method modeling of individual malocclusions. Usually, a great deal of time is spent in preprocessing. To reduce the time required, we developed a standardized procedure for measuring the position of each tooth and a program to automatically preprocess. The following procedures were carried to complete this study. 1. Twenty-eight teeth morphologies were constructed three-dimensionally for the finite element analysis and saved as separate files. 2. Standard brackets were attached so that the FA points coincide with the center of the brackets. 3. The study model of a patient was made. 4. Using the study model, the crown inclination, angulation, and the vertical distance from the tip of a tooth was measured by using specially designed tools. 5. The arch form was determined from a picture of the model with an image processing technique. 6. The measured data were input as a rotational matrix. 7. The program provides an output file containing the necessary information about the three-dimensional position of teeth, which is applicable to several finite element programs commonly used. The program for a basic algorithm was made with Turbo-C and the subsequent outfile was applied to ANSYS. This standardized model measuring procedure and the program reduce the time required, especially for preprocessing and can be applied to other malocclusions easily.

• The korean journal of orthodontics
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• v.30 no.1 s.78
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• pp.33-41
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• 2000

Although it is well known that the chincup, used to correct a skeletal class III malocclusion in growing children, reduce the mandibular prognathism by arresting the growth of the mandibular length and rotating the mandible posteroinferiorly, the majority of the studies about chincup is focused on condylar head that plays an Important role in mandibular growth. The aim of this study was to evaluate the morphologic change of the mandibular symphysis where extraoral force is applied directly during chincup treatment. The data lot this study were obtained from lateral cephalometric radiographs of 62 growing children(chincup group:32, control group:30) with mixed dentition who had been accepted lot the orthodontic treatment at Chonbuk National University Dental Hospital. The results were as follows : 1. Symphysis height was increased both in chincup therapy group and control group during treatment. Symphysis depth was decreased or maintained the initial values in chin cup therapy group, whereas increased in control group. Posterior symphysis depth was decreased both in chin cup therapy group and control group, but anterior svmphysis detph was increased in control group, whereas decreased in chincup therapy group. 2. Chin depth and chin curvature were increased in control group, whereas maintained or decreased in chincup therapy group during treatment. Chin angle, menton ang1e and symphysis angle were decreased in control group, whereas increased in chincup therapy group. It suggested that bone deposition in pogonion area that occur normally with mandibular growth was supressed by direct contact of chincup. 3. When growing children wear chincup, symphysis morphology was maintained due to inhibition of forward growth at mandibular symphysis. It may be due to the suppression of bone deposition in anterior part of symphysis.

• The korean journal of orthodontics
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• v.34 no.1 s.102
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• pp.1-11
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• 2004

Predicting the arch length discrepancy by simply comparing the available arch perimeter with tooth materials is merely a 2-dimensional analysis of the teeth movement. However, the real teeth movement takes place 3-dimensionally and is affected by various factors such as, the arch fen the curve of Spee and the axis of the incisors. The purpose of this study is to clarify the relationship between the decrease in the arch perimeter and the horizontal positional change of the incisors after extraction of the 1st bicuspids, for more analytic evaluation of the arch length discrepancy at pre-treatment model analysis stage. In addition to that to evaluate the effect of the curve of Spee, teeth axis to the basal plane, and the incisional crowding to the treatment outcome. All patients were treated at the department of orthodontics, dental hospital, Yonsei university. Inclusion criteria for patients selection were as follows. $\cdot$ Angle classification I malocclusion with bialveolar protrusion $\cdot$ Extraction of 4 1st bicuspids $\cdot$ No tooth anomaly or prosthesis $\cdot$ No abnormal attrition $\cdot$ No ectopically erupted teeth $\cdot$ Angle classification I canine and molar relationship $\cdot$ Less than 3mm of crowding Model analysis of the above patients was performed and the following conclusions were obtained. 1. When the intercanine distance was maintained, the available space for the distal movement of the mandibular incisors after the extraction of the 4 1st bicuspids was larger than the space provided by the extraction of the 4 1st bicuspids. However the difference was less than 1mm. The more tapered the anterior arch form, the larger the difference. 2. Compared to the situation in which the intercanine distance was maintained, when the intercanine distance was expanded to meet the width of the Posterior teeth, the incisors could move about 3mm more distally. 3. The positional difference of the incisal tip was insignificant whether the central incisors were moved by tipping or bodily movement. 4. When the anterior crowding was solved without changing the intercanine distance, the larger the anterior arch length was, the more the anterior movement of the incisors. 5. When the curve of Spee was levelled, the increase in the arch perimeter was less than half of the deepest curve of Spee.

• The korean journal of orthodontics
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• v.34 no.3 s.104
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• pp.241-251
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• 2004

Previous studies have focused on the causes of root resorption after orthodontic treatment and treatment methods to reduce this phenomenon, and have been mainly associated with developed, mature roots. As parents become increasingly interested in their children's' dentition, orthodontists are performing fixed orthodontic treatment on patients of less than 10 years and before the completion of the immature root. Thus, the author evaluated the changes of root length and root form of maxillary immature incisors after orthodontic treatment, compared with those of mature teeth, and investigated the correlation according to gender, treatment duration, and displacement of incisors. The sample consisted of an immature root group of twenty-eight persons (between 8 and 10 years old) and a mature root group of thirty-one persons (between 11 and 15 years old). The crown and root length of the maxillary four incisors were measured with a periapical radiograph, changes in root length and crown-root ratio were calculated, and root form was classified according to a scoring system. The results were as follows. 1. The development of immature roots was not affected by orthodontic treatment and mostly showed normal root length and apical form. 2. Root length of immature teeth was sustained or became shorter, partially in long treatment duration or with open bite patients. Even though the teeth reached their normal root length, they demonstrated a blunt form. 3. Most of the mature roots showed mild resorption, and the form of mature roots was more blunt than the developed form of the immature roots (p<0.05). 4. The developed form of the immature roots was statistically related to treatment duration, while the form of the mature roots was significantly related to the displacement of incisors (p<0.05). 5. In contrast, other variables such as gender, classification of malocclusion, changes in overbite, and changes of U1 to SN showed no correlation with the root resorption of both groups.

• The korean journal of orthodontics
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• v.36 no.1 s.114
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• pp.1-13
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• 2006

Three-dimensional (3-D) laser scans can provide a 3-D image of the face and it is efficient in examining specific structures of the craniofacial soft tissues. Due to the increasing concerns with the soft tissues and expansion of the treatment range, a need for 3-D soft tissue analysis has become urgent. Therefore, the purpose of this study was to evaluate the scanning error of the Vivid 900 (Minolta, Tokyo, Japan) 3-D laser scanner and Rapidform program (Inus Technology Inc., Seoul, Korea) and to evaluate the mean error and the magnification percentage of the image obtained from 3-D laser scans. In addition, soft tissue landmarks that are easy to designate and reproduce in 3-D images of normal, Class II and Class III malocclusion patients were obtained. The conclusions are as follows; scanning errors of the Vivid 900 3-D laser scanner using a manikin were 0.16 mm in the X axis, 0.15 mm in the Y axis, and 0.15 mm in the Z axis. In the comparison of actual measurements from the manikin and the 3-D image obtained from the Rapidform program, the mean error was 0.37 mm and the magnification was 0.66%. Except for the right soft tissue gonion from the 3-D image, errors of all soft tissue landmarks were within 2.0 mm. Glabella, soft tissue nasion, endocanthion, exocanthion, pronasale, subnasale, nasal alare, upper lip point, cheilion, lower lip point, soft tissue B point, soft tissue pogonion, soft tissue menton and preaurale had especially small errors. Therefore, the Rapidform program can be considered a clinically efficient tool to produce and measure 3-D images. The soft tissue landmarks proposed above are mostly anatomically important points which are also easily reproducible. These landmarks can be beneficial in 3-D diagnosis and analysis.

• The korean journal of orthodontics
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• v.36 no.1 s.114
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• pp.14-29
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• 2006

Developments in computer technology have made possible the 3-dimensional (3-D) evaluation of hard and soft tissues in orthodontic diagnosis, treatment planning and post-treatment results. In this study, Korean adults with normal occlusion (male 30, female 30) were scanned by a 3-D laser scanner, then 3-D facial images formed by the Rapidform 2004 program (Inus Technology Inc., Seoul, Korea.). Reference planes in the facial soft tissue 3-D images were established and a 3-D coordinate system (X axis-left/right, Y axis-superior/inferior, Z axis-anterior/posterior) was established by using the soft tissue nasion as the zero point. Twenty-nine measurement points were established on the 3-D image and 43 linear measurements, 8 angular measurements, 29 linear distance ratios were obtained. The results are as follows; there were significant differences between males and females in the nasofrontal angle $(male:\;142^{\circ},\;female:\;147^{\circ})$ and transverse nasal prominence $(male:\;112^{\circ},\;female:\;116^{\circ})$ (p<0.05). The transverse upper lip prominence was $107^{\circ}$ in males, $106^{\circ}$ in females and the transverse mandibular prominence was $76^{\circ}$ in both males and females. Li-Me' was 0.4 times the length of Go-Me'(mandibular body length) and the mouth height was also 0.4 times the width of the mouth width. The linear distance ratio from the coronal reference plane of FT, Zy, Pn, ULPm, Li, Me' was -1/-1/1/0.5/0.5/-0.6 respectively. The 3-D facial model of Korean adults with normal occlusion were be constructed using coordinate values and linear measurement values. These data may be used as a reference in 3-D diagnosis and treatment planning for malocclusion and dentofacial deformity patients and applied for 3-D analysis of facial soft tissue changes before and after orthodontic treatment and orthognathic surgery.