• Title/Summary/Keyword: mandibular asymmetry

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Mandibular skeletal posterior anatomic limit for molar distalization in patients with Class III malocclusion with different vertical facial patterns

  • Kim, Sung-Ho;Cha, Kyung-Suk;Lee, Jin-Woo;Lee, Sang-Min
    • The korean journal of orthodontics
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    • v.51 no.4
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    • pp.250-259
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    • 2021
  • Objective: The aim of this study was to compare the differences in mandibular posterior anatomic limit (MPAL) distances stratified by vertical patterns in patients with skeletal Class III malocclusion by using cone-beam computed tomography (CBCT). Methods: CBCT images of 48 patients with skeletal Class III malocclusion (mean age, 22.8 ± 3.1 years) categorized according to the vertical patterns (hypodivergent, normodivergent, and hyperdivergent; n = 16 per group) were analyzed. While parallel to the posterior occlusal line, the shortest linear distances from the distal root of the mandibular second molar to the inner cortex of the mandibular body were measured at depths of 4, 6, and 8 mm from the cementoenamel junction. MPAL distances were compared between the three groups, and their correlations were analyzed. Results: The mean ages, sex distribution, asymmetry, and crowding in the three groups showed no significant differences. MPAL distance was significantly longer in male (3.8 ± 2.6 mm) than in female (1.8 ± 1.2 mm) at the 8-mm root level. At all root levels, MPAL distances were significantly different in the hypodivergent and hyperdivergent groups (p < 0.001) and between the normodivergent and hyperdivergent groups (p < 0.01). MPAL distances were the shortest in the hyperdivergent group. The mandibular plane angle highly correlated with MPAL distances at all root levels (p < 0.01). Conclusions: MPAL distances were the shortest in patients with hyperdivergent patterns and showed a decreasing tendency as the mandibular plane angle increased. MPAL distances were significantly shorter (~3.16 mm) at the 8-mm root level.

Treatment of unilateral buccal crossbite with mandibular symphyseal distraction osteogenesis

  • Ozkalayci, Nurhat;Ozer, Mete;Sumer, Mahmut
    • The korean journal of orthodontics
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    • v.41 no.1
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    • pp.59-69
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    • 2011
  • The aim of this report is to present the treatment of a 14-year-old boy with scissors-bite. Mandibular symphyseal distraction osteogenesis (MSDO) with tooth-supported distractor was performed to expand the mandible, and intermaxillary cross elastics were used. The mandible was expanded approximately 9 mm. Asymmetric widening was done by using cross elastics and MSDO simultaneously. The buccal crossbite was corrected successfully. After a 2-year observation period, widening of the mandible using this procedure was judged to be stable.

SURGICAL TREATMENT FOR MANDIBULAR OSSIFYING FIBROMA (하악골에 발생한 골화성섬유종의 외과적 치험일례)

  • Lee, Yong-Oh;Byun, Sang-Gil
    • The Journal of the Korean dental association
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    • v.19 no.4 s.143
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    • pp.369-373
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    • 1981
  • This is a case of 25-year-old Korean female with a diagnosis of ossifying fibroma in the mandible. Chief complaint of the patient was facial asymmetry by slow growing mass on the right mandibular body. Diagnosis was obtained by incisional biopsy of affected mandible after taking several radiograms, which was ossifying fibroma. Patient was treated by subtotal mandiblectomy and resin splint implatation. We gained satisfactory result by secondary autogeneous cancellous and marrow bony graft from the iliac crest with titanium mesh for tray of bone chips.

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TAD driven whole dentition distalization with special considerations for incisal/gingival display and occlusal canting (전치부 및 치은의 노출량과 교합평면의 캔팅을 고려한 미니스크류를 이용한 전치열의 원심이동)

  • Paik, Cheol-Ho
    • The Journal of the Korean dental association
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    • v.57 no.6
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    • pp.333-343
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    • 2019
  • Many orthodontists face difficulties in aligning incisors in an esthetically critical position, because the individual perception of beauty fluctuates with time and trend. Temporary anchorage device (TAD) can aid in attaining this critical incisor position, which determines an attractive smile, the amount of incisor display, and lip contour. Borderline cases can be treated without extraction and the capricious minds of patients can be satisfied with regard to the incisor position through whole dentition distalization using TAD. Mild to moderate bimaxillary protrusion cases can be treated with TAD-driven en masse retraction without premolar extraction. Patients with Angle's Class III malocclusion can be the biggest beneficiaries because both sufficient maxillary incisal display, through intrusion of mandibular incisors, and distalization of the mandibular dentition are successfully achieved. In addition, TAD can be used to correct various other malocclusions, such as canting of the occlusal plane and dental/alveolus asymmetry.

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Relationship between Mandibular Midline Shift and First Moral Relation, and Their Effects on the Mandibular Height and the Occlusal Plane Angle (하악정중선의 편위와 제 1대구치 교합관계가 하악골의 높이 및 교합면 경사에 미치는 영향)

  • Han, Kyung-Soo;Kim, Chang-Hyun
    • Journal of Oral Medicine and Pain
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    • v.25 no.2
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    • pp.205-214
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    • 2000
  • This study was performed to investigate the relationship between mandibular midline shift and anteroposterior first molar occlusal relation, and their effects on the mandibular height and the occlusal plane angle. For this study, 49 patients with temporomandibular disorders were selected. They did not show facial asymmetry and their facial midline coincide with maxillary dental midline. Upper and lower mandibular impression were taken and the casts were fabricated. Amount and direction of the mandibular midline shift and the anteroposterior shift between the two occluding first molars were measured on the casts. Several items related to height such as mandibular height from top of the articular surface of the condyle to curve changing point between antegonial notch and mandibular angle, condylar height which was the vertical distance from the articular surface to retroepicondyle of the condyle, and sigmoid height from the deepest point of sigmoid notch to the curve changing point and the occlusal plane angle were also measured on the panoramic and on the transcranial radiographs. Correlation between midline shift and anteroposterior first molar relation and comparison between right and left mandibular height by the midline shift and the first molar relation were analysed by SPSS windows program. The results of this study were as follows : 1. Mean amount of midline shift in the subjects with midline shift were 2.0mm for both side, respectively. The first molar relation of the ipsilateral side of midline shift showed Angle class II tendency and the contralateral side showed Angle class III tendency, which meant drift of the dentition to the side of the midline shift. 2. The occlusal plane angle on the panoramic radiograph were $13.0^{\circ}$ in right, and $12.5^{\circ}$ in left side, and their were no correlation between occlusal plane angle and mandibular midline shift and the first molar occlusal relation. 3. Angle's classification for both sides of the first molar relation were same in about half of all the subjects. Amount of deviation from class I first molar relation, however, were decreased in the contralateral side of observed side. 4. Mandibular height of the ipsilateral side to which mandibular midline shift showed tendency of lower than that of the contralateral side, and there was a tendency that the height was higher in class III subjects, then class II subjects, and lower in class I subjects. However, condylar height did not show any difference in the subjects with midline shift and also show no difference by the first molar occlusal relation.

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하악 과두부에 발생한 종양의 외과적 치험 2례

  • Lee, Yong-Oh;Moon, Seon-Hye;Jang, Sae-Gyoung
    • The Journal of the Korean dental association
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    • v.24 no.5 s.204
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    • pp.439-447
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    • 1986
  • The occurrence of osteochondroma, osteoma in mandibular condlye is rare. Sign and symptoms of enlargement of condyle are open bite, cross bite, myofascial symptoms, facial asymmetry. They are treated via condylectomy, subcondylar ostetomy, etc. We treated osteochondroma with condylectomy, osteoma with condylectomy & arthroplasty with titanium mesh & resin ball. Followings are the results 1. Condylectomy of osteochondroma resulted in good function & esthetics except slight deviation of mandible to the operation side during mouth opening. 2. Condylectomy & arthroplasty with titanium mesh & resin ball resulted in good function & esthetics & no deviation of mandible.

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A CASE REPORT OF OSTEOCHONDROMA ON MANDIBULAR CONDYLE (하악골 과두에 발생한 골연골종의 치험례)

  • Kim, Mi-Suk;Lee, Mi-Hyang;Jang, Chang-Soo;Kim, Chul-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.2
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    • pp.298-307
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    • 1996
  • Osteochondroma is a common benign tumor of the axial skeleton, especially the distal metaphysis of the femur and the proximal metaphysis of the tibia, however, is occurred rarely on the facial skeleton. Development of the tumor is most frequently seen in the second or third decades of life. Typically, it arises directly from the cortex of the underlying bone, without any intervening zone of abnormal osseous tissue, and is covered by a cap composed of cartilage undergoing calcification. In case of osteochondroma of the mandibular condyle, its clinical features are occulusal change, facial asymmetry, headache, pain and click on temporomandibular joint, mouth opening limitation, and jaw deviation to involved site. This is a case report of a 13-year old woman who had mouth opening limitation and severe temporomandibular joint pain. We obtained successful results with surgical removal of the osteochondroma on the mandibular condyle.

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Three-dimensional Assessment of Facial Soft Tissue after Orthognathic Surgery in Patients with Skeletal Class III and Asymmetry

  • Lee, Jong-Hyeon;Choi, Dong-Soon;Cha, Bong-Kuen;Park, Young-Wook;Jang, Insan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.6
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    • pp.360-367
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    • 2013
  • Purpose: The purpose of this study was to perform three-dimensional (3D) assessment of facial soft tissue in patients with skeletal Class III and mandibular asymmetry after orthognathic surgery. Methods: Samples consisted of 3D facial images obtained from five patients with A point-nasion-B point angle less than 2 degrees, and more than 5 mm of menton deviation. All patients had been treated at Gangneung-Wonju National University Dental Hospital from 2009 to 2012. They had undergone orthognathic surgery of Lefort I, and sagittal split osteotomy for correction of skeletal deformity, and orthodontic treatment. Facial scanning was performed before treatment (T1) and post-surgical orthodontic treatment (T2). Linear and angle variables of soft tissue landmarks, antero-posterior facial depth, and facial volume were measured. Results: No significant differences in width of the alar base, mouth width, and nasal canting were observed between T1 and T2. However, lip deviation, menton deviation, alar canting, lip canting, and menton deviation angle were significantly reduced at T2. Antero-posterior facial depth on the axial plane parallel to the left cheilion was significantly reduced on the deviated side and significantly increased on the non-deviated side at T2. Volume of the lower lateral and lower medial parts of the face was reduced on the deviated side, and volume of upper lateral and lower lateral parts on the non-deviated side was significantly increased at T2. Conclusion: After orthognathic surgery, facial asymmetry of soft tissue was improved following skeletal changes, especially the mandibular region. Although the length of the alar base and mouth width did not change, lip and soft tissue menton were displaced to the medial side after treatment. Facial depth also became symmetric after treatment. Facial volume showed a decrease on the lower part of the deviated side and that on lateral parts of the non-deviated side showed an increase after treatment.

Correction of mandibular ramus height with frontal and lateral ramal inclinations in cephalograms and its effects on diagnostic accuracy of asymmetry (2차원 방사선 규격사진에서 하악골 상행지 고경의 보정분석에 관한 3차원 CT 영상 연구)

  • Hwang, Hyeon-Shik;Kim, Hyung-Min;Lee, Ki-Heon;Lim, Hoi-Jeong
    • The korean journal of orthodontics
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    • v.37 no.5
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    • pp.319-330
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    • 2007
  • Defining right and left side differences in mandibular ramus height is one of the key elements in the diagnosis of facial asymmetry. The purpose of the present study was to evaluate the effect of correction of ramus height with frontal and lateral ramal inclinations (FRI and LRI) in 2-dimensional cephalograms and observe how this affects the diagnostic accuracy of asymmetry. Methods: Frontal and lateral cephalograms were obtained in 40 individuals with chin deviation. FRI and LRI were measured on each side and ramus height measurement was corrected with these inclinations using Pythagorean's theorem. The results of diagnosis before and after correction on cephalograms were compared with the results in 3D CT images. Results: Both FRI and LRI showed greater values in the contralateral side than in the chin-deviated side and these contributed to an increase in the right and left side ramus height differences. After comparison of diagnostic results before and after correction on cephalograms with the results on 3D CT images, the sensitivity increased significantly (from 74 to 94 %) whereas the specificity decreased (from 44 to 22 %). Overall accuracy increased from 68 to 78 % with the correction using FRI and LRI. Conclusions: The results of the present study indicate that correction of ramus height with FRI and LRI is useful for an accurate diagnosis of facial asymmetry on frontal cephalograms.

Prediction of frontal soft tissue changes after mandibular surgery in facial asymmetry individuals (안면비대칭자의 하악골 악교정수술 후 정면 연조직 변화 예측을 위한 연구)

  • Hwang, Hyeon-Shik;Lee, Jessica J.;Hwang, Chung-Hyon;Choi, Hak-Hee;Lim, Hoi-Jeong
    • The korean journal of orthodontics
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    • v.38 no.4
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    • pp.252-264
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    • 2008
  • Objective: To aid the development of a frontal image simulating program, we evaluated the soft tissue frontal changes in relationship to movement of hard tissue with orthognathic surgery of facial asymmetry patients. Methods: Preoperative and postoperative frontal cephalograms and frontal view photographs of 45 mandibular surgery patients with facial asymmetry were obtained in a standardized manner. Vertical and horizontal changes of hard tissue and soft tissue were measured from cephalograms and photographs, respectively. Soft tissue change in result to hard tissue change was then analyzed. Results: Both vertical and horizontal correlation analysis showed a weak relationship between the changes. Hard tissue points that were picked for 1 : 1 mean ratio with soft tissue points did not show any significant relevance. For each soft tissue change, regressive equation was formulated by stepwise multiple regression analysis, and the equation for soft tissue Menton was most reliable in predicting changes. Both vertical and horizontal hard tissue changes were used together in prediction of vertical or horizontal soft tissue change. Conclusions: The results suggest that computerized image simulation using regression analysis may be of help for prediction of soft tissue change, while 1:1 mean ratio method is not useful.