• The korean journal of orthodontics
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• v.32 no.4 s.93
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• pp.241-255
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• 2002

This study was performed to evaluate horizontal and vertical characteristics according to lateral cephalometry of adult Korean skeletal Class II patients using a selected horizontal and vortical reference planes of Koreans. 60 males and 60 females consisting of freshman of Yonsei University from 1996 to 1997 and patients with history of orthognatic surgery at the Dental Hospital of Yonsei University with a skeletal Class II profile were chosen and compared with 70 males and 70 females with normal occlusion. The skeletal Class R group had the following conditions : 1. Profile composed of a retrognathic mandible or protrusive maxilla; 2. Class II molar and canine key; 3. ANB-greater than $4^{\circ}; 4$. Wits appraisal-greater than 1.0mm; Cephalometric analysis consisted of 22 skeletal, 25 soft tissue, 12 dental measurements. The results were as follows. 1. There was no considerable vortical measurement difference between the skeletal Class II malocclusion group and the normal occlusion group in skeletal analysis. But, some variations were found between the two groups in soft tissue analysis. 2. Mandibular length of the skeletal Class II malocclusion group was smaller than that of the normal occlusion group. Mandible was more posteriorly positioned in the Class II malocclusion group than in the normal occlusion group. 3. The length and antero-posterior position of the maxilla were not different between the Class II malocclusion and the normal occlusion group. 4. The antero-posterior position of the nose, upper lip and maxillary soft tissue, and nasolabial angle were not different between the two groups. 5. Mandibular soft tissue of the Class H malocclusion group was more posteriorly positioned than that of the normal. 6. The vertical measurements of the incisors(U1-HP, L1-HP) were bigger in the Class II malocclusion group than in the normal, but those of the molars(U6-HP, U6-MP) showed no significant difference between the two groups. 7 Classifying the skeletal Class II malocclusion group according to the antero-posterior position of both jaws, normally positioned maxilla and retruded mandible was 43.3%, both normally positioned maxilla and mandible 28.3%, both retruded maxilla and mandible 20.0%..

• The korean journal of orthodontics
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• v.36 no.1 s.114
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• pp.63-73
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• 2006

Numbers of postulations lie on the difference of integumental changes with two major surgical remedies of one jaw vs. two jaw surgery in skeletal Class III malocclusion. Accordingly it was the aim of the study to elucidate the skeletal profile changes with an accompanying disposition of soft tissues, consequently to yield the correlation and ratio of soft tissue changes with two types of surgical procedures, which in turn make it possible to predict the soft tissue outcomes by means of assembled regression equations. Cephalometric headfilms of fifty two adult skeletal Class III comprised of 26 maxillary advancement by Le Fort I osteotomy and mandibular setback by sagittal split ramus osteotomy simultaneously (double jaw surgery, group A), 26 mandibular setback alone (one jaw surgery, group B) were statistically analyzed. Group A manifested 72.4% soft tissue advancement to skeletal changes in the upper lip area, while group B appeared to have no statistically significant changes. The nasolabial angle showed more increment in group A than in group B, whereas the mentolabial angle illustrated more reduction in group B. The backward movement of soft tissue pogonion to skeletal change revealed 98% in group A, and 109% in group B. The double jaw surgery group characteristically revealed remarkable integ umental change in the upper lip area, while the one jaw surgery had major effects in the lower lip and soft tissue pogonion areas.

• Archives of Plastic Surgery
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• v.42 no.4
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• pp.419-423
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• 2015

Background Orthognathic surgery is required in 25% to 35% of patients with a cleft lip and palate, for whom functional recovery and aesthetic improvement after surgery are important. The aim of this study was to examine maxillary and mandibular changes, along with concomitant soft tissue changes, in cleft patients who underwent LeFort I osteotomy and sagittal split ramus osteotomy (two-jaw surgery). Methods Twenty-eight cleft patients who underwent two-jaw surgery between August 2008 and November 2013 were included. Cephalometric analysis was conducted before and after surgery. Preoperative and postoperative measurements of the bone and soft tissue were compared. Results The mean horizontal advancement of the maxilla (point A) was 6.12 mm, while that of the mandible (point B) was -5.19 mm. The mean point A-nasion-point B angle was $-4.1^{\circ}$ before surgery, and increased to $2.5^{\circ}$ after surgery. The mean nasolabial angle was $72.7^{\circ}$ before surgery, and increased to $88.7^{\circ}$ after surgery. The mean minimal distance between Rickett's E-line and the upper lip was 6.52 mm before surgery and 1.81 mm after surgery. The ratio of soft tissue change to bone change was 0.55 between point A and point A' and 0.93 between point B and point B'. Conclusions Patients with cleft lip and palate who underwent two-jaw surgery showed optimal soft tissue changes. The position of the soft tissue (point A') was shifted by a distance equal to 55% of the change in the maxillary bone. Therefore, bone surgery without soft tissue correction can achieve good aesthetic results.

• The korean journal of orthodontics
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• v.33 no.5 s.100
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• pp.323-337
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• 2003

This study was performed to establish Korean soft tissue cephalometric norms, to compare the norms between sexes and between races, and then to suggest a guideline to execute orthodontic diagnosis and treatment planning for dentofacial deformities in Korean. Young Korean adults were selected. They were 27 males $(23.8{\pm}2.6-year-old)$ and 20 females $(22.5{\pm}1.7-year-old)$ who had harmonious facial balance. After taking lateral cephalograms under the natural head position which is widely known as a highly reliable and reproducible reference position, films were traced and analysing factors were measured as introduced by Arnett et at. Comparisons were done between male and female groups and between Korean and Caucasian groups using unpaired t-test. From the results it was concluded that Korean male had generally thicker lower facial soft tissue and smaller nasolabial angle, longer facial height, deeper facial depth, and more protrusive lower face than Korean female. From the comparison with Caucasian norms adopted from the research of Arnett et al., both Korean male and female showed longer facial lengths generally except less exposed maxillary incisor, and shorter facial depth than Caucasian counterparts. Also, both races showed similar horizontal position of maxillary structures from TVL (true vertical line), but there were more significant anteroposterior differences of marilla-mandible in Korean groups. These results mean Korean had relatively more retruded mandibular structures from the reference line, TVL. Individuals who had harmonious facial balance showed similar facial angle, more or less 170 degree, regardless of sexes or races.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.457-463
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• 2011

Introduction: This study evaluate the soft tissue changes to the upper lip and nose after Le Fort I maxillary posterosuperior rotational movement. Materials and Methods: Twenty Skeletal class III patients, who had undergone bimaxillary surgery with a maxillary Le Fort I osteotomy and bilateral sagittal split ramus osteotomy, were included in the study. The surgical plan for maxilla was posterosuperior rotational movement, with the rotation center in the anterior nasal spine (ANS) of maxilla. Soft and hard tissue changes were measured by evaluating the lateral cephalograms obtained prior to surgery and at least 6 months after surgery. For cephalometric analysis, four hard tissue landmarks ANS, posterior nasal spine [PNS], A point, U1 tip), and five soft tissue landmarks (pronasale [Pn], subnasale [Sn], A' Point, upper lip [UL], stomion superius [StmS]) were marked. A paired t test, Pearson's correlation analysis and linear regression analysis were used to evaluate the soft and hard tissue changes and assess the correlation. A P value <0.05 was considered significant. Results: The U1 tip moved $2.52{\pm}1.54$ mm posteriorly in the horizontal plane (P<0.05). Among the soft tissue landmarks, Pn moved $0.97{\pm}1.1$ mm downward (P<0.05), UL moved $1.98{\pm}1.58$ mm posteriorly (P<0.05) and $1.18{\pm}1.85$ mm inferiorly (P<0.05), and StmS moved $1.68{\pm}1.48$ mm posteriorly (P<0.05) and $1.06{\pm}1.29$ mm inferiorly (P<0.05). The ratios of horizontal soft tissue movement to the hard tissue were 1:0.47 for the A point and A' point, and 1:0.74 for the U1 tip and UL. Vertically, the movement ratio between the A point and A' point was 1:0.38, between U1 tip and UL was 1:0.83, and between U1 tip and StmS was 1:0.79. Conclusion: Posterosuperior rotational movement of the maxilla in Le Fort I osteotomy results in posterior and inferior movement of UL. In addition, nasolabial angle was increased. Nasal tip and base of the nose showed a tendency to move downward and showed significant horizontal movement. The soft tissue changes in the upper lip and nasal area are believed to be induced by posterior movement at the UL area.

• The korean journal of orthodontics
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• v.28 no.2 s.67
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• pp.219-229
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• 1998

The purpose of this study is to define the characteristics of the skeleton and soft tissues of severe adult class III malocclusion. The materials selected for this study were lateral cephalograms of 112 adult class III malocclusion patients with ANB difference below -2 degrees. and the mean age was 22.9 years old. The normal control sampler consisted of lateral cephalograms of 50 adults in normal occlusion and the mean age was 22.1 years old. The Horizontal reference line was FH line and the vertical reference line was nasion perpendicular to FH line. The skeletal and soft tissue characteristics of Class III malocclusion are as follows : 1. In the skeletal profile evaluated by vertical reference line (Nasion perpendicular to FH), the forehead and maxilla was similar to normal, but the mandible was protruded significantly. 2. The soft tissue profile is concave. The thickness of soft tissue covering forehead area and nose is within normal range. but the upper lip is thicker and the nasolabial angle is smaller than normal. The lower lip and inferior labial sulcus is thinner than normal. The degree of eversion of lower lip is lesser than normal. 3. The cranial base of class III malocclusion is shorter and saddle angle is smaller than normal. 4. The location of midface evaluated in relations to cranial base is within normal range but, the length of midface is shorter than normal when compared from the deep portion of the facial skeleton. 5. The location of maxilla in reference to cranial base is within normal range but the length of maxilla was shorter in class III malocclusion. 6. The mandible was protruded, ramus height and body length, gonial angle were greater than normal, and the chin angle was smaller. 7. Upper incisor was proclined, lower incisor was retroclined.

• The korean journal of orthodontics
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• v.32 no.6 s.95
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• pp.383-393
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• 2002

The purpose of this study was to provide data on the normative values of some clinically important soft tissue dimensions for adult Korean females with aesthetically beautiful facial profiles. Lateral cephalograms of 18 Korean female models, who were selected for their well balanced and aesthetic facial profiles, were evaluated. All cephalograms were taken with the subjects in a natural head position with the teeth in occlusion and the lips at rest. The means and standard deviations were determined and presented. In addition, comparisons with the previous studies were performed The results of the present study were as follows: 1. The upper and lower lips were posteriorly located in relation to the Ricketts' E line (Upper lip to E line: -2.08, Lower lip to E line: -0.04). 2. Both lips were more posteriorly located than those in the results of previous studies on Korean females selected by normal occlusion, but more anteriorly located than in the results of studies selected on an aesthetic basis. 3. The nasolabial angle for this sample was 101.03 degrees with a standard deviation of 8.47 degrees.

• The korean journal of orthodontics
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• v.47 no.6
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• pp.375-383
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• 2017

Objective: The purpose of this study was to evaluate the dental and skeletal effects of the modified C-palatal plate (MCPP) for total arch distalization in adult patients with Class II malocclusion and compare the findings with those of cervical pull headgear. Methods: The study sample consisted of the lateral cephalograms of 44 adult patients with Class II Division 1 malocclusion, including 22 who received treatment with MCPP (age, $24.7{\pm}7.7years$) and 22 who received treatment with cervical pull headgear (age, $23.0{\pm}7.7years$). Pre- (T1) and post-treatment (T2) cephalograms were analyzed for 24 linear and angular measurements. Multivariate analysis of variance was performed to evaluate the changes after treatment in each group and differences in treatment effects between the two groups. Results: The mean amount of distalization at the crown and root levels of the maxillary first molar and the amount of distal tipping was 4.2 mm, 3.5 mm, and $3.9^{\circ}$ in the MCPP group, and 2.3 mm, 0.6 mm, and $8.6^{\circ}$ in the headgear group, respectively. In addition, intrusion by 2.5 mm was observed in the MCPP group. In both groups, the distal movement of the upper lip and the increase in the nasolabial angle were statistically significant (p < 0.001). However, none of the skeletal and soft tissue variables exhibited significant differences between the two groups. Conclusions: The results of this study suggest that MCPP is an effective treatment modality for total arch distalization in adults.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.324-329
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• 1999

The facial esthetics are much affected by nasal changes due to especially its central position in relation to facial outline and so appropriately evaluated should be the functional and esthetic aspects of the nose associated with the facial appearance. Generally, a maxillary surgical movement is known to induce the changes of nasolabial morphology secondary to the skeletal repositioning accompanied by muscular retraction. These changes can be desirable or undesirable to individuals according to the direction and amount of maxillary repositioning. We investigated the surgical changes of bony maxilla and its effects to nasal morphology through the analysis of the lateral cephalogram in the Le Fort I osteotomy. Subjects were 10 patients(male 2, female 8, mean age 22.3 years) and cephalograms were obtained 2 weeks before surgery(T1) and 6 months after surgery(T2). The surgical maxillary movement was identified through the horizontal and vertical repositioning of point A. Soft-tissue analysis of the nasal profile was performed employing two angles: nasal tip projection(NTP), columellar angle(CA). Also, alar base width(ABW) was assessed directly on the patients with a slide gauge. The results were as follows; 1. Both anterior and superior movement above 2mm of maxilla rotated up nasal tip above 1mm. Either anterior or superior movement above 2mm of maxilla made prediction of the amount & direction of NTP changes difficult. Especially, a correlation between horizontal movement of maxilla and NTP rotated-up was P<0.01. 2. Both much highly anterior and superior movement of maxilla is accompanied by more CA increase than either highly. Especially, the correlation between horizontal movement of maxilla and CA change was P<0.05. 3. Anterior and/or superior movement of maxilla was accompanied by the unpredictable ABW widening. 4. The amount of changes of NTP, CA, and ABW is not in direct proportion to amout of anterior and/or superior movement of maxilla. 5. Nasal morphologic changes following Le Fort I osteotomy are affacted by not merely bony repositioning but other multiple factors.

• The korean journal of orthodontics
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• v.27 no.6 s.65
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• pp.891-904
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• 1997

Today's orthodontic treatment goals lie in functional esthetics, and the importance of the latter is increasing gradually in trend. Considering such, study on growth and development of soft as well as hard tissues becomes inevitable. Early studies emphasize mainly on skeletal analysis using cephalometric data. However, more recent studies report that maxillofacial soft tissue, which plays a critical role in determining facial esthetics, is influenced by underlying hard tissue, and yet close relationship between them was not noticed. Cephalometric x-rays were taken of 137 Korean boys and 106 girls with no systemic disease, fair developmental status and normal occlusion for two consecutive years; afterwards, soft tissue analysis, which was divided into four parts, facial form lip position & posture, nose, and thickness, was done to correlate them with general growth.