The purposes of this study were to compare the soft tissue changes following hard tissue change after surgery between the one jaw and two-jaw surgery in skeletal class III patients and to get the reference of the incisal inclination at presurgical orthodontics. For this study 24 patients for the two-jaw surgery group and 18 patients for one jaw surgery group were selected. Lateral cephalograms were taken at pretreatment, after presurgical orthodontic treatment, immediately after surgical treatment and at least 6 months after surgery. They were traced and analyzed on skeletodental structure and soft tissue. The results were as follows: 1. After surgery, maxilla, maxillary incisors and upper lip were moved anteriorly and superiorly in two-jaw surgery group. Mandible and mandibular incisors were moved posteriorly and superiorly, and thickness of lower lip was increased in both group but there were no statistically significant difference. Anterior facial height was more decreased in two-jaw surgery group (p<0.05). At least 6 months after surgery, by the postorthodontic treatment, maxillary incisors were moved labially 1.44mm, mandible and mandiibular incisors were moved lingually 1.43mrn, 1.26mm respectively in one jaw surgery group. But there was no statistically significant changes of hard tissue in two :jaw surgery group. 2. The correlation coefficients of maxillary hard and soft tissue horizontal changes were high in two jaw surgery group and the ratios for soft tissue to A point were 19% at Sri, 80% at SLS, 82% at LS. The ratios for soft tissue to B point were 92% at LI, 104% at ILS in one jaw surgery group, 89% at LI, 101% at ILS in two-jaw surgery group. 3. The correlation coefficients and change ratios of mandibular incisors and LL HS on lower lip horizontal changes were 0 0.89 and 75%, 85% in one jaw surgery group, 0.93, 0.90 and 76%, 87% in two-jaw surgery group. The correlation coefficients of maxillary incisors and Sn, SLS and LS on upper lip horizontal changes were 072, 0.76 and 0.75 in two jaw surgery group and ratios of changes were 57%, 58% and 59%. 4. The regression equations between skeletal horizontal discrepancy and incisal inclinaton were taken in one jaw surgery group. Those were FMIA=57.48-2.17ANB, U1-SN=-75.02+2.17SNB and $R^2$ were 0.63, 063 respectively. So if there is skeletal horizontal discrepancy by mandibular prognathism in one jaw surgery case, we consider attaining more labial inclination of maxillary incisors than normal and more lingual inclination of mandibular incisors than normal. But correlation coefficient of the regression equations in two jaw surgery group was low, so, that equation was not reliable.
Cephalometric measureements have disadvantage of representing cranio-facial structures in two dimension only and therefore they pose limitations in describing three-dimentional structures of cranio-facial region. More interests have been put on the correlation between the two planes. This study evaluated correlations between facial type score, which allows effects on malocclusion, growth change prediction and establishment of treatment method and prognosis, and measurements from submentovertex view. Cephalometric view and submentovertex view were taken of skeletal Class I adults with optimal profile and correlations between them have been observed. Following results were obtained: 1. To learn about factors that influence average condylar angulation, FACE, INT-CO-ANG, MN-CORPUS, CON-RATIO, GON-RATIO, MN-RATIO were used as variables and underwent multiple regression analysis. As a result, the following equation was obtained : CON-AVE=.l73(FACE)-.322(INT-CO-ANG)+36.34(GON-RATIO) +.420(MN-CORPUS) (($R^2=.85451$) 2. The following equation was obtained concerning facial type score. FACE= .050(CON-ANG)+.023(INT-CO-ANG)-.075(MN-CORPUS)($R^2=.31547$) 3. Among the submentovertex measurements, MN-CORPUS, CON-RATIO, GON-RATIO, MN-RATIO showed close correlations. (P<0.05) 4. Average condylar angualtions were $23.37^{\circ}$ on the right and $20.71^{\circ}$ on left. There was a difference between the two. FACE : facial type soore. CON-ANG: mean value of condylar angulation. CON-AVE: mean value of Rt. Lt condylar angulation. INT-CO-ANG : angle between Rt. Lt condylar axis. MN-CORPUS : angle formed between RT. Lt gonion & pogonion. CON-RATIO: lntercondylar distance/mandibular body length. GON-RATIO : intergonion distanoe/mandibular body length. MN-RATIO: lntermylohyoid distance/mandibular body length. MX-RATIO: intermaxillary tuberosity distance/ANS-PNS distance.
In parallel with social and economic progress, motives of patients to consult dentists have increased and diversified. An increasing number of people visit dental clinics to improve their facial appearance and masticating functions deteriorated largely due to malocclusion. There is also greater interest in and concern as well as demand for teeth alignment treatment among people. Under this situation, it is required to find and suggest ways to enhance quality and profitability of dental care in view of managerial needs for dentists to cope with changing circumstances. This study, thus, aims to measure satisfactions of orthodontics patients and to determine the elements influencing their satisfactions. For this aim, a survey was performed for 20 days from March 7th to 26th, 2005 by means of questionnaires distributed to randomly selected samples, resulting in following conclusions: 1. From comparison of satisfactions with dental service by their elements, higher satisfaction was reported from orthodontics patients in the element of dental hygienists(4.21). Least satisfaction, however, was found in the procedure for treatment and waiting hours(3.73). 2. By gender, male orthodontics patients turned out to be more satisfactory with dental service than females. In terms of intention for return visits, both male and female orthodontics patients showed higher satisfaction than non-orthodontics ones. 3. As for satisfaction with dental service by age of orthodontics and non-orthodontics patients, with regard to intention for return visit, orthodontics patients of all ages showed to have higher grade of satisfaction. 4. Regarding satisfaction with dental treatment by orthodontics and non-orthodontics patients by monthly income, Dental hygienist with intention for return visit, the higher the satisfaction of orthodontics patients. 5. In regard to satisfaction with dental treatment by education, higher satisfaction was expressed by orthodontics patients with elementary school education kept dentist, dental hygienist and internal and external environments. As a result from this study, we knew that dental service of the orthodontics patients is higher satisfaction than that of the non-orthodontics patients.
The purpose of this study was to find out and evaluate discrepancies between preorthodontic prediction values and actual postorthodontic values and factors contributing to it in 45 patients(17 male, 28 female) who were diagnosed as skeletal Class III ma)occlusion and received presurgical orthodontic treatment and orthognathic surgery at Yonsei university dental hospital. Lateral cephalograms were analysed at pretreatment(T1), orthodontic Prediction(T2), immediately before surgery(T3) and designated the landmark as coordinates or X and Y axes. The samples were divided according to ALD, upper and lower incisor inclination(Ul to SN, IMPA), COS, extraction, the position of extracted teeth and the statistical significance was tested to find out the factors contributing to the prediction. The results were as follows: 1. Differences between preorthodontic prediction values and actual postorthodontic values(T2-T3) were statistically significant(p<0.05) in the x coordinates of U6mbc, L1x and in y coordinates of U1i, U1x, U6me, U6mbc, L6mbc 2. The accuracy of prediction is relatively higher in horizontal changes compared to vortical changes. 3. The statistical significance(p<0.05) between prediction and actual values is observed more in the landmarks of the maxilla than the mandible. 4. Differences between prediction and actual values of incisor and first molar were statistically significant(p<0.05) according to extraction vs non-extraction, extraction type, ALD in the maxilla and according to ALD, IMPA in the mandible. Discrepancies between preorthodontic prediction values and actual postorthodontic values and factors contributing to the prediction must be considered in treatment planning of Cl III surgical patients to increase the accuracy of prediction. Furthermore future investigations are needed on the prediction of vortical changes.
The purpose of this study was to evaluate the positioning errors according to the method of bonding lingual brackets. Dental models of twenty orthodontic patients with malocclusion were selected for this study. The positioning errors were measured on each model that brackets were bonded to. Three different bonding methods were used. For the first method the bracket was bonded intimately to the lingual surface of the model. For the second method, the bracket was bonded intimately to the lingual surface after setting up using articulator. The passive bracketing, bonding the bracket ligated first to ideal archwire, was used after setting up as the last method. The results were as follows: 1. The brackets bonded without setting up showed greater angulation errors in the upper 1st premolar and the lower canine than those in other bonding methods. The brackets bonded without passive bracketing showed greater positioning errors in upper central incisor, lower 1st and End premolars. 2. The brackets bonded without setting up showed greater torque error in lower 2nd premolar than those in other bonding methods. The brackets bonded without passive bracketing showed greater torque errors in all upper teeth, lower 1st and 2nd premolars. 3. The brackets bonded without passive bracketing showed greater rotation errors between upper central incisors, lower central incisors, lower lateral and central incisor, lower canine and lateral incisor. 4. The brackets bonded without setting up showed greater in-out errors between upper canine and lateral incisor than those in other bonding methods. The brackets bonded without passive bracketing showed greater in-out errors between upper central incisors, upper central and lateral incisors, upper 1st and 2nd premolars, lower lateral and central incisors, lower canine and lateral incisor. These results suggest that there is a large amount of positioning error in lingual brackets even by an indirect bonding technique, and it may be reduced by passive bracketing.
Objective: To evaluate the discrepancies between initial STO and final STO in Class III malocclusions and to find which factors are related to the discrepancies. Methods: Twenty patients were selected for the extraction group and 20 patients for the non-extraction group. They were diagnosed as skeletal Class III and received presurgical orthodontic treatment and mandibular set-back surgery at Pusan National University Hospital. The lateral cephalograms were analyzed for initial STO (T1s) at pretreatment and final STO (T2s) after presurgical orthodontic treatment, and specified the landmarks 3s coordinates of the X and V axes. Results: Differences in hard tissue points (T1s-T2s) in the X coordinates of upper central incisor edge, upper first molar mesial end surface, lower central incisor apex, lower first molar mesial end surface and mesio-buccal cusp and Y coordinates of upper central incisor edge, upper central incisor apex, upper first molar mesio-buccal cusp were statistically significant in the extraction group. Differences in hard tissue points (T1s-T2s) in the X coordinates of upper central incisor edge, lower central incisor apex, lower first molar mesial end surface and Y coordinates of lower central incisor apex were statistically significant in the non-extraction group. In the extraction group, the upper arch length discrepancy (UALD) had a statistically significant effect on maxillary incisor and first molar estimation. Lower arch length discrepancy and IMPA had statistically significant effects on mandibular incisor estimation in both groups. Conclusions: Discrepancies between initial STO and final STO and factors contributing to the accuracy of initial STO must be considered in treatment planning of Class III surgical patients to increase the accuracy of prediction.
Kim, Tae-Woo;Byun, Eun-Sun;Baek, Seung-Hak;Chang, Young-Il;Nahm, Dong-Seok;Yang, Won-Sik
The korean journal of orthodontics
/
v.30
no.2
s.79
/
pp.235-243
/
2000
Magnetic resonance imaging(MRI) of the temporomandibular joint(TMJ) is very useful method to diagnose internal derangement of the TMJ because of its high specificity foy identification of condyle-disc relationships. The purpose of this study was to evaluate the existence, incidence and severity o』 internal derangement o』 the TMJ by the MRI of Patients who are suspected to have TMJ disorder. MRI sample was composed of 50 subjects(10 males, 40 females) and the mean age was 22.9 years. 43 subjects of the sample were found to have positive findings. $56\%$ of the subjects with positive findings had ADD(anterior disc displacement) without reduction, and $65\%$ had internal derangement of bilateral joints. Distributions in the types of malocclusion in patients with positive findings, the Angle's classification had shown : the largest $41.9\%$ for Cl II ($39.6\%$ for Cl II div 1 and $2.3\%$ for Cl II div 2), $37.2\%$ for Cl I, $18.6\%$ for Cl III, and $2.3\%$ for the unidentified. $8.6\%$ of the subjects with positive findings had facial asymmetry and $55.8\%$ had openbite. We can conclude that the percentage of Cl II is the highest in patients with internal derangement of the TMJ. Openbite or facial asymmetry is considered to be uncompensated or compensated deformity which results from facial skeleton remodeling in the process of degenerative joint disease(DJD) due to TMJ degeneration. Therefore it is recommended to screen the patients with facial asymmetry or openbite by MRI before the beginning of orthodontic treatment. Differential diagnosis is essential because the tendency of relapse is high after the orthodontic treatment and continuous observation of TMJ is needed in patients with TMJ disorder.
Mandibular incisor crowding is one of the most common features of malocclusion and is interesting characteristic in view of relapse and stability after orthodontic treatment. There are many potential factors in the etiology of lower anterior crowding. The tooth size variation is one of them, but biologic significance for the faciolingual width of the teeth has been overlooked. Peck and Peck reported that persons with ideal mandibular incisor alignment were shown to have incisor with smaller mesiodistal and larger faciolingual dimensions than persons with incisor crowding. On the basis of these findings they suggested MD/FL index as a clinical guideline for the assessment for lower incisor crowding. The present study was undertaken to examine the relationship between mandibular incisor crowding and mandibular incisor dimension, and determine their correlation with arch length discrepancy. 154 dental casts of people from 11 to 17 years of age were made, and were divided into normal group with irregularity index less than of 1, and crowding group with irregularity index greater than 1.The casts were measured and analyzed statistically. The results were as follows. 1. The mean mesiodistal width for mandibular incisor was larger in crowding group, and has significant difference in central inciosr measurement. There are no significant differences in the faciolingul width and MD/FL index. 2. Irregularity index has significant correlation coefficients with mesiodistal width and MD/FL index for mandibular incisor in crowding group, but no correlation with faciolingual width. It also has correlation with maxillary and mandibular arch length discrepancy, total tooth material, mandibular intercanine width, and mandibular inter first premolar width. 3. Upper and lower arch length discrepancy have significant correlation with mesiodistal width of mandibular incisor and overbite, but have no correlation with faciolingual width. Lower arch lenth discrepancy has significant correlation with MD/FL index for mandibular incisor and upper arch length discrepancy has correlation with MD/FL index for mandibular lateral incisor. 4. Significant differences were observed between normal and crowding group for the mandibular arch length discrepancy and overbite.
Interdental enamel stripping is an usual method for correction of abnormal tooth shape and tooth size discrepancy which is one of the etiologic factors of malocclusion. Clinically it Is useful to correct the minor crowding in anterior teeth and posterior occlusion during finishing stage of orthodontic treatment. But this procedure has risks such as irreversible tooth reduction and remaining roughness of enamel surface can accumulate plaque which can evoke periodontal problem. Even if various methods were introduced to minimize the enamel surface roughness, their evaluation was limited in morphologic differences by scanning electronic microscope(SEM). The purpose of this study was to compare the various interdental enamel stripping method by SEM and to quantify the difference of surface roughness by use of Surfcorder SEF-30D(Kosaka Lab. Ltd.) which can measure the roughness of surface. The stripping methods were divided into mechanical and mechanical-chemical method. Air-rotor stripping and separating strip were used for mechanical stripping and $37\%$ phosphoric acid was used for chemical stripping. The enamel surface roughness after mechanical or mechanical-chemical stripping of interproximal surfaces of premolars which were extracted for orthodontic purpose were measured and compared by means of SEM and $Surfcorder^{\circledR}$, the results were as follows. 1. Enamel surface of primary treated by coarse diamond bur and separating strip groups showed highest value of roughness. 2. To compare the primary treated groups between mechanical and mechanical-chemical method, the latter group showed lower value of roughness remarkably. 3. Mechanical stripping groups which were treated both coarse and fine instrument showed lower value of roughness as much as non treated group. 4. The use of Pumice for final polishing did not show significantly smoothening the stripped enamel surface any more.
Surgical-orthodontic treatment is performed for the skeletal Class III patients with no remaining growth and too big a skeletal discrepancy (or camouflage treatment, and two jaw surgery is needed in order to have maximum effect in such patients. In two jaw surgery cases, surgical alteration of the occlusal plane is necessary to establish optimal function, esthetics and postoperative sability, therefore the establishment of the occlusal plane is essential in diagnosis and treatment. The object of this study is to evaluate the stability of the indiviual ideal occlusal plane bsaed on the architectural and structural craniofacial analysis of Delaires. Thus, the subjects of this study were 48 patients who underwent two jaw surgery, and divided in two groups. Each group were composed of 24patients, A group were operated with ideal occlusal plane and B group were not. Two groups were compared at the preoperative, immediate postoperative (average 4.3days), and long-term postoperative (average 1.3years) lateral cephalometric radiographs. The following results were obtained: 1. There was no significance in occlusal plane angulation between $T_2\;and\;T_3$. Average long term follow-up changes of occlusal Plane angle were $0.24^{\circ}{\pm}2.43$, with FH plane and $0.15{\circ}{\pm}2.16{\circ}$ with SN plane in all 48 patients. These results demonstrated that the occlusal plane after two jaw surgery in skeletal Class III malocclusion was stable. 2. There was no significance in postoperative stability of occlusal plane between A and B group. 3. There was no significance in postoperative stability of occlusal plane depending on surgeon and operative method within each group. 4. The postoperative changes of occlusal plane were correlated to the postoperative changes of jaw rather than tooth position. 5. There was no correlation between the postoperative changes of occlusal plane and maxillary impaction and mandibular setback with surgery.
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