The purpose of this study was to investigate the factors affecting the postsurgical mandibular stability for both one- and two jaw surgery. 18 for one-jaw surgerys and 24 for two-jaw surgerys among skeletal class III malocclusion patients who experienced orthodontic treatment and orthognathic surgery at Pusan National University Hospital were selected. Lateral cephalograms taken at the first visit, after presurgical orthodontic treatment, immediately after surgery and follow-up over 6 months, were traced. Based ANOVA, multiple linear regression analysis was completed for one-jaw surgery with postsurgical stability as the criterion and the magnitude of mandibular setback, the change of mandibular incisor height during surgery, the changes of mandibular plane angle and mandibular incisor angle during presurgical orthodontic treatment as affecting factors. Same analysis was completed for two-jaw surgery with postsurgical stability as the criterion and the magnitude of mandibular setback as affecting factor. The results were as follows : 1. In the one-jaw surgery cases, the magnitude of mandibular setback, the change of mandibular incisor height during surgery, the changes of mandibular plane angle and mandibular incisor angle during presurgical orthodontic treatment explained the variability in postsurgical stability with a significant $R^2$ value of 0.84. 2. In the two-jaw surgery cases, the magnitude of mandibular setback explained the variability in postsurgical stability with a significant $R^2$ value of 0,28.
Park, Soyoung;Jeong, Taesung;Kim, Jiyeon;Kim, Shin
Journal of the korean academy of Pediatric Dentistry
/
v.46
no.2
/
pp.209-218
/
2019
This study was aimed to evaluate orofacial morphologies on the cases of developmental disorders of maxillary first molars. Panoramic radiographs, lateral cephalographs, and clinical photos of 2983 children who attended the Pediatric Dental Clinic of Pusan National University Dental Hospital from 2006 to August 2017 were assessed retrospectively. 34 patients were selected whose maxillary first molars were missed or developmentally delayed unilaterally or bilaterally. Demirjian's method was used for estimating dental age, then which was compared to chronologic age of children. Parameters expressing skeletal and dentoalveolar disharmony were checked and compared with control. Additionally, occlusion relationship was evaluated. Maxillary dental age was significantly delayed compared to chronologic age. Several parameters which show skeletal open-bite tendency and skeletal class III malocclusion with maxillary retrusion were statistically significant. Anterior crossbite and edge-bite were expected in most of these cases, but compensation by occlusion and soft tissue was also verified which might mask skeletal class III tendency. Congenital missed or developmentally delayed maxillary first molars might be related with declined growth of maxilla. If developmental disorders of maxillary first molars were verified during clinical examination, careful monitoring of orofacial growth was necessary during puberty and timed orthopedic and orthodontic intervention were considered.
This study was to investigate the horizontal & vertical bone change pattern when using cervical headgear in Class II malocclusion of growing children and compared the skeletal features between the group with increased lower facial height and the group without increase in lower facial height. The results are as follows ; 1. Forward growth of maxilla was inhibited, downward tipping of anterior palatal plane could be seen and distal movement of maxillary first molar was observed. 2. There was relative forward movement of Mandible against the Maxillary cranial base, and relative forward movement of mandibular 1st molar against the Maxilla and vertical increase due to alveolar growth of Mandible. 3. There was significant increase in anterior and posterior facial heights but the ratio of facial height showed no significant difference. 4. The group with increased lower facial height has shorter ramus length, than the smaller palatal plane angle, and more distal movement of Maxillary 1st molar than the group without increase Ha-young Hyun
The aims of this study were to investigate the differences in the early craniofacial morphology of Class III malocclusions with good, fair and poor occlusal stability and to elucidate a key determinant for distinguishing the cases. Lateral cephalograms of 30 subjects with Class III malocclusion in the mixed dentition were analyzed at the start of treatment (mean age of $8.58\pm1.47$). All subjects were reevaluated after a mean period of $7.50\pm1.94$ years comprising active treatment and retention. At this time, the samples were divided into three groups: good (10 subjects), fair (10 subjects) and poor (10 subjects) occlusal stability groups. According to the results of ANOVA, there were significant morphological differences in the early stage among the good, fair and poor occlusat stability groups, especially in variables that represented the vertical skeletal relationships. As well, there were already more dental compensations in the poor occlusal stability group. Stepwise discriminant analysis on the measurements at the time of first observation identified only one predictive variable: AB to mandibular plane angle(AB-MP). With this discriminant function, $83.3\%$of the original grouped cases were correctly classified and the canonical correlation coefficient was 0.857. In conclusion, AB-MP can be a possible predictor for the eventual prognosis of early Class III treatment. If it is below 60, the prognosis of early Class III treatment is expected to be poor, while if it is above 65, a good prognosis is expected.
This study aimed at investigating the skeletal, dentoalveolar, and soft tissue changes of Class III malocclusion cases treated by second molar extraction. The lateral cephalograms of 15 subjects with moderate Class III malocclusion by average ANB $-1.4^{\circ}\;and\;IMPA\;85^{\circ}$ were traced and the computerized superimposition of average craniofacial change was made. The data was gathered and statistically analyzed. The results were as follows: 1 Lower anterior facial height/anterior facial height increased by 0.6%(P<0.01), mandibular plane increased by $1.5^{\circ}$(P<0.05). 2. There was a slightly downward & backward rotation of the mandible. 3. Lower first molar tipped distally by 4.nm(P<0.001), lower anterior teeth lingually tipped by $3.2^{\circ}$(P<0.05). 4. Retracted lower lip improved facial profile. This study may suggest that second molar extraction could be effective for a moderate Class III malocclusion to make distalization of the lower first molar easier and avoid severe lingual tipping of the lower incisor, if the lower third molar has a normal shape, good direction of eruption and adequate time for lower second molar extraction
Journal of the korean academy of Pediatric Dentistry
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v.37
no.3
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pp.359-366
/
2010
It was easy to find that children of a skeletal anterior crossbite in the early mixed dentition period showed a stark difference in the dental maturity between their maxillary and mandibular teeth, if they have stronger physical characteristics. If the difference of dental age between maxillary and mandibular teeth which can be identified via panoramic radiographs may serve as an early sign of class III malocclusion, this is considered valuable as a tool of early detection diagnosis. We obtained lateral cephalometric radiographs, panoramic radiographs, working model and clinical images of patients of Hellman dental age IIA and IIC who visited the department of pediatric dentistry, Pusan National University Dental Hospital and examined them to select 50 patents for normal occlusion group and skeletal anterior crossbite group, respectively. Their panoramic radiographs were used for the Demirjian's method to figure out dental ages of maxillary and mandibular teeth of each group and the eruption rate of the first molars. Their differences are as follows: 1. In both groups, the dental ages from Demirjian's method were advanced than the chronological ages. No sexual dimorphism was detected for the chronological or dental age in either group (p>0.05). 2. The difference of dental age of maxillary and mandibular teeth between the normal occlusion group and crossbite group was 0.22 and 0.69 years, respectively, with a higher difference in crossbite group(p<0.05). 3. Compared to the normal occlusion group, the crossbite group showed a higher difference in the eruption rate between maxillary and mandibular first molar(p<0.05).
Objectives: The purpose of the study is to investigate the psychological state of the patients according to skeletal class III malocclusion symptoms. Methods: The subjects were 200 skeletal class III malocclusion patients. The questionnaire consisted of general characteristics, clinical manifestation, and T score of Korean version of self-rated Symptom Checklist-90-Revision modified by Jae-hwan Kim. The data were analyzed using SAS version 9.2 and t-test, ANOVA, and ANCOVA were used. Clinical manifestation included subjective recognition and radiological analysis. The subjective recognition of the patients consisted of self-satisfaction of the appearance, phonation, mastication, and temporomandibular joint pain. T score consisted of somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. Results: The most serious factor in 9 scales was the severe TMJ pain by ANCOVA. Male patients had a higher T score in phobic anxiety, psyochoticism, somatization and depression than female patients. Those having low appearance satisfaction had the problem in interpersonal sensitivity. Obsessive-compulsive symptoms were conspicuous in phonation difficulty and temporomandibular pain. Conclusions: The patients with skeletal class III malocclusion have more satisfaction with appearance, pronunciation, and phonation than those with skeletal class III malocclusion and overjet. Proper dental treatment will improve the communication and quality of life.
This study was conducted to investigate the changes in the structural parts of the craniofacial skeleton subsequent to chincap therapy in the juvenile skeletal Class III patients. The subject consisted of 29 Korean children(14 males, 15 females) who had skeletal Class III malocclusion and were undergone chincap therapy from the beginning of the treatment (and an auxilliary upper removable appliance, if necessary). The control group was composed of 21 children(10 males, 11 females) with skeletal Class III malocclusion who had no orthodontic treatment. Cephalometric data at the mean age of 7 and 2 years later were analyized by finite element method, and compared between groups by independent group t-test(p<0.05). The results of the present study were as follows; 1. There were no significant changes in the cranial base, posterior face, upper anterior face, ramus, chin and soft tissues by the chincap therapy. 2. The mandibular body showed significant differences in the minimum extention ratio and the overall shape ratio. This means that the vertical direction of growth was retarded by the chincap therapy. 3. The major direction of the growth in the maxillary basal bone was significantly more horizontal in the experimental group, which suggests that the vertical growth of maxilla was inhibited. 4. There was statistical difference in the major direction of the growth of the anterior face between groups. This may be due to the significant difference in the major direction of growth of the lower anterior face, supposed to be resulted from the mandibular rotation and/or displacement by the chincap therapy. The change in the oral functional space seemed to be caused by the same reason. 5. From the standpoint of these results, the retardation of growth, the changes of the growth direction and the morphological changes could be accepted partly, but the major effect of the chincap seems to be the rotation and the displacement of the mandible.
Facial vertical dyscrepancies is decided on the relationship between the anterior vertical facial height and posterior vertical facial height. Thus this study was conducted to determine the factors that affect the FHI, and classify the Class II div.1, malocclusion, which success is dependent on the vertical control according to the FHI, which is the ratio of antero-inferior facial height, posterio-inferior facial height ratio, and to use this as a guideline for treatment. Angle between palatal plane and Mandibular plane were in the order of RH, ID. Thus showing that interrelated angle was more inportant than the independent angle of both, palatal plane and Mandibular plane. The tendency of Cl II div.1. Malocclusion according to FHI, showed the Low group to have Mx. protrusion, prominent development of Mn. ramus, and the Mn. body length and ant. post. position was normal. The Normo group showed slight protrusion of the Maxilla,. The development of the ramus was less than normal and the Mn. was in a slight retruded position. The High group showed the Mx. in a normal position, the development of the Mn. ramus and body was the lowest, and the Mn. was in a posterior position. In observation of the factors affecting the FHI between each groups of Cl II div.l, malocclusion; In the Low group the MP- PP angle was very small, the ID was smililar to the normal group, but the RH was very large thus the FHI was increased. In the Normo group, the PP-MP angle was normal, ID was slightly smaller than the normal group and the RH was slightly smaller than the normal group, thus maintaining a normal FHI ratio. In the High group the PP-MP angle was very large, the ID was similar to the normal group, but the RH was smaller than the normal group thus the FHI was small.
This study was conducted to discern differences of craniofacial, dentoalveolar structure and model measurements between sex and between class n openbite group and non-openbite group. The sample consisted of 49 adult patients with class Il malocclusion. 24 linear measurements, 22 angular measurements and 12 ratios were selected in lateral cephalometry. Also, arch width, length, anterior crowding, average molar relation were measured or calculated in diagnostic model. The data were evaluated by t-test and multiple discriminant analysis. The results were as follows, 1. Most linear measurements, with the exception of MnBL and AUDH, were significantly larger in male(p<0.05). but, intermaxillary relations and spatial position of maxilla and mandible relative to cranial base were not different for both sex. 2. With the exception of upper and lower anterior crowding, lower arch width, upper arch length, AMR, male exhibited significantly larger measurements in model analysis (p<0.05). 3. Size differences of maxilla and mandible between openbite and non-openbite group were not significant(p>0.05). but openbite group showed significantly increased genial angle(p<0.05), FH-CoGo(p<0.01), FH-NA(p<0.01) and FH-NB, FH-NPog (p<0.05). 4. ALFH and PUDH were larger(p<0.05) in openbite group. this result served as compensation for the spatial position of mandible relative to cranial base. AUPUDH (p<0.001) and ALPLDH(p<0.05) were lower in openbite group. upper anterior crowding was the only measurement which showed difference between openbite and non-openbite group(p<0.05). 5. For the purpose of classifying adult class n openbite and non-openbite group, multiple discriminant analysis was done genial angle, ALPLDH, AUPUDH, FH-NA were included in multiple discriminant equation. 39 cases($92.86\%$) were correctly classified when applied to the sample used in this study.
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