• The korean journal of orthodontics
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• v.28 no.4 s.69
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• pp.547-561
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• 1998

Obstructive sleep apnea (OSA) is a disorder characterized by repetitive episode of upper airway collapse during sleep. Recent studies showed that not only the anatomic factors but the physiologic factors of the upper airway also have effcts on the occurrence of apnea and that the genioglossus muscle also plays an important role in the maintenance of the upper airway. A variety of therapies were performed to treat OSA, and among them the use of mandibular repositioning appliances showed reasonable results. But there is still a lack of research on the structural and physiological mechanism upon the use of mandibular repositioning appliances. The author selected 26(male 17, female 9) OSA patients that came to the Yonsei University Dental Hospital, Department of Orthodontics, and 20 normal adults (male 10, female 10) and took cephalometric radiographs of them in a supine position before and after the placement of the mandibular repositioning appliance to see the structural changes of the upper airway and compare the therapeutic effects between the two groups. We also studied the waking genioglossus muscle activity in OSA patients and investigated the difference in the electromyogram of the genioglosssus muscle upon the change in body posture and the use of mandibular repositioning appliance. Following results were obtained. 1. Among the cephalometric measurements of the upper airway structure, the length of the soft palate, maximum thickness of the soft Palate and SPAS, MAS, VAL, H-H1, MP-H showed statistically significant differences between the normal and OSA groups, but the IAS and EAS showed no statistically significant differences between the two groups. 2. In both the normal and OSA groups, as the epiglottis moved forward on wearing the mandibular repositioning appliance, the epiglottis level of the upper airway increased and the maximum thickness of the soft palate changed and the hyoid bone also moved forward, but the IAS in both groups showed various results and the effect of the mandibular repositioning appliance on the structure of the upper airway was different in the two groups. 3. Upon changing the position, the electromyogram of the genioglossus muscle showed a increasing tendency but there was no statistically significant differences, and when the mandibular repositioning appliance were worn there was a statistically significant increase in the electromyogram of the genioglossus muscle in both the upright and supine positions. The mandibular repositioning appliances not only have an effect on the anatomical structure of the upper airway but also on the physiology of the upper airway. There are different responses to the use of mandibular repositioning appliance between the normal and OSA groups therefore it could be considered to have the different physiology of the upper airway between the two groups.

• The korean journal of orthodontics
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• v.34 no.3 s.104
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• pp.229-240
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• 2004

The purpose of this study was to evaluate the compensatory changes of occlusal plane angle in relation to skeletal factors. Lateral cephalograms of 61 adults with normal occlusion and 92 adults with skeletal malocclusions were traced and measured to analyze skeletal factors and occlusal plane angles. In terms of horizontal relationships, the normal occlusion group and malocclusion group were classified Into subgroups of skeletal Classes I, II, and III, while in terms of vertical relationships, each group was also classified into horizontal , average, and vertical subgroups. Some measurements were evaluated statistically by ANOVA and Post Hoc, and the others were reviewed by Paired t-tests. In this study, only the occlusal plane angle to AB plane did not show a significant difference between the normal occlusion group and malocclusion group. After treatment, the occlusal plane angle to the AB plane of the malocclusion group was approximated to that of normal occlusion group. The LOP to AB plane angle of the normal occlusion group was 91.7 in skeletal Class I, 88.8 in skeletal Class II, and 93.5 in skeletal Class III. This study was done to assess the treatment changes of the occlusal plane in the malocclusion group, and to draw a comparison with the normal occlusion group in order to present a reference to establish a new occlusal plane inclination.

• The korean journal of orthodontics
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• v.31 no.2 s.85
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• pp.187-197
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• 2001

The change of the vertical dimension is of fundamental importance to the orthodontist. However, the choice between the two methods of treatment, extraction versus nonextraction, is not clear. It is not verified that the extraction method decreases vertical dimension, or nonextraction methods result in an increase in vertical dimension. The purpose of this study was to evaluate the changes of vertical dimension of face after the orthodontic treatment with standard edgewise technique, and to compare them in relation to facial types and bicuspid extraction. The subjects consisted of 165 orthodontic patients (77 of adolescents, 88 of adults), and was divided into vertical nonextraction (VN) group, vertical extraction (VE) group, horizontal nonextraction (HN) group, horizontal extraction (HE) group. Pre-and Post-treatment cephalograms were taken with standard method, traced, and digitized for each subject. The comparison of the measurements were statistically executed with Student's t-test. The results were as follows : 1. The facial height and molar height were increased after orthodontic treatment in the all groups. 2. No significant difference was found in the facial height change between the vertical and horizontal groups. 3. No significant difference was found in the facial height change between the extraction and nonextraction groups. 4. As the upper molars were extruded in adolescents group and lower molars were extruded in adults group, lower anterior facial height (LAFH) was increased. 5. None of the pretreatment variables correlates to the change of lower anterior facial height (LAFH).

• The korean journal of orthodontics
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• v.37 no.3 s.122
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• pp.192-203
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• 2007

Objective: The aim of this study was assessment of the relationship between airway space and facial morphology in Class III children with nasal obstruction. Methods: For this study, 100 Class III children (50 boys and 50 girls) were chosen. All subjects were refered to ENT, due to nasal obstruction. Airway space measurements and facial morphology measurements were measured on lateral cephalometric radiograph. Pearson correlation analysis was used to assess the relationship between airway space and facial morphology Results: Ramal height, SNA, SNB, PFH, FHR and facial plane angle were positively related to upper PAS, and sum of saddle angle, articular angle, and genial angle, SN-GoGn, Y-axis to SN and FMA negatively related to upper PAS. Genial angle, FMA were positively related to lower PAS, and articular angle, facial depth, PFH and FHR negatively related to lower PAS. PCBL, ramal height, Mn. body length, Mn. body length to ACBL, facial depth, facial length, PFH and AFH were positively related to tonsil size. Sum of saddle angle, articular angle, genial angle, facial length, AFH, FMA and LFH were positively related to tongue gap, and IMPA and overbite was negatively related to tongue gap. Upper PAS, related to size of adenoid tissue, was mainly related to posterior facial dimension following a vertical growth pattern of face and mandibular rotation. Lower PAS and tonsil size, related to anterior-posterior tongue base position, were significantly related to each other. Lower PAS was related to growth pattern of mandible, and tonsil size was related to size of mandible and horizontal growth pattern of face. Tongue gap was related to anterior facial dimension following a vertical growth pattern of face. Conclusion: Significant relationship exists between airway space and facial morphology.

• The korean journal of orthodontics
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• v.37 no.3 s.122
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• pp.220-230
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• 2007

Objective: The purpose of this study was to determine the changes of mandibular anterior alveolar bone thickness with age. Methods: Cephalometric radiographs of 160 skeletal class I patients (male 80, female 80) with normal vertical growth pattern was investigated by measuring the buccolingual thickness of mandibular alveolar bone on the basis of root axis. Results: As the age increases, both male and female showed a significant decrease in buccolingual width of the mandibular anterior alveolar bone and in the width of mandibular anterior lingual alveolar bone except the CEJ area of females. However, there was no significant difference in the thickness of mandibular anterior buccal alveolar bone and in the width of maximum prominence of mandibular symphysis with age. Conclusion: From the above results, it is concluded that Korean children whose growth pattern is sagittally skeletal class l with a vertical normal growth pattern have a greater mandibular anterior lingual alveolar bone width than Korean adults; therefore, lingual movement of mandibular incisors, which is usually accompanied in extraction treatment, is considered to be more preferable in younger patients.

• The korean journal of orthodontics
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• v.31 no.3 s.86
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• pp.301-309
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• 2001

Because many of patients seeking orthodontic treatment worry about the facial appearance and their chief motivation for orthodontic treatment is facial esthetics, it is critical to understand the influence of gender or culture on the evaluation of profile esthetics. The purpose of this study was to find out any influence of gender or culture on judging good facial profile. 4 different groups were asked to evaluate 133 facial profiles to test the influence of gender or culture on judging good facial profiles. Those 4 groups consisted of 10 Korean males, 10 Korean females, 10 Korean American males, and 10 Korean American females. 2 evaluation systems were introduced, absolute and relative. Soft tissues of selected good profile group were analyzed and statistic analysis was performed. Conclusions were as follows 1. Inter-evaluator difference for judging good facial profile was statistically significant, even if there was general agreement for the best profile among 40 raters. 2. Gender difference under the same cultural environment was not significant statistically. 3. The same ethnic groups with different cultural background showed statistically different preference on judging good Profile. 4. Good facial profile group had their own characteristics compared to remaining group in several soft tissue measurements which were vertical facial ratio, soft tissue facial convexity, and antero-posterior relative lip position.

• The korean journal of orthodontics
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• v.28 no.3 s.68
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• pp.343-351
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• 1998

The purpose of this study was to investigate the pretreatment and posttreatment dentofacial characteristics of non-extraction patients with Class I malocclusion. And to compare this result with matched non-orthodontic normal occlusion and Class I premolar extraction patients. Such comparison might help identify morphologic characteristics of the non-extraction patients. Initial and final cephalometric evaluation were compared in a sample of 22 patients with Class I malocclusions treated in non-extraction manner with edgewise appliance and MEAW The mean age of the total population was 14 years 9 months and the average treatment time was 2 years 8 months. 32 landmarks were located and digitized on each cephalogram. From these landmarks, 24 linear and angular dimension were obtained. Student's t-test were used to compare the pretreatment - posttreatment results, Nonextraction - Normal groups, and nonextraction Extraction groups. Significance was predetermined at $p{\leq}0.05$. The results were as follows. 1. Before treatment, the mean value of the $ODI\;was\;69.9^{\circ},\;APDI\;was\;82.1^{\circ},\;CF\;was\;152^{\circ},\;EI\;was\;152^{\circ}$ in the non-extraction groups. 2. The skeletal pattern of the non-extraction groups were similar with non-orthodontic normal groupsr, but the non-extraction groups had larger interincisal angle. 3. Comparison between groups treated with and without extraction indicated at pretreatment, the extraction groups had more protrusive lips, smaller interincisal angle, and EI. 4. After treatment, there was no significant changes in the skeletal pattern of the non-extraction groups, but uprighting of the maxillary and mandibular first molar and decrease of the interincisal angle were seen.

• The korean journal of orthodontics
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• v.38 no.2
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• pp.83-94
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• 2008

Purpose: The first objective of this study was to compare the upper midface morpholgy, focusing on the soft tissues, between skeletal Class III maloccusion patients with midfacial depression and the norm. The second objective was to estimate and analyze the change in the upper midface soft tissues following surgical correction with maxillary advancement by Lefort I osteotomy and mandibular setback by bilateral sagittal split osteotomy (BSSRO). Methods: The samples consisted of 34 adult patients (15 males and 12 females) with an average age of 21 years, who had severe anteroposterior discrepancy with midfacial depression. These patients had received presurgical orthodontic treatment and surgical treatment which consisted of simultaneous Lefort I osteotomy and BSSRO. Results: The correlation coefficient between changes in maxillary advancement and changes in Or' (soft tissue orbitale) was 0.599 (p < 0.05). Change in maxillary plane angle and vertical change of the maxilla were not correlated with the change in Or' (p < 0.05). The ratio of soft tissue change in Or' to maxillary advancement was 43.57 %, and 81.54 % in Sn. Regression equations between maxillary movement and Or' were devised. The $r^2$ value was 0.476. Conclusions: The majority of measurements in the upper midface in skeletal Class III maloccusions when compared to the norm, showed significant differences. In Class III malocclusion with midfacial depression, maxillary advancement produces soft tissue change in the upper midface.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.4
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• pp.431-441
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• 2021

Full-mouth rehabilitation with increasing vertical dimension can be used for patients with severely worn teeth. In severely worn teeth also, the alveolar process can be elongated to compensate for the reduced vertical dimension, and the patient's vertical dimension of occlusion can be kept constant. However, full-mouth rehabilitation with increasing vertical dimension must be carefully chosen, because the vertical dimension can be reduced by tooth wear. It is important to establish a treatment plan with the systematic diagnosis of the change in the vertical dimension and gain space for the prosthesis. It is necessary to change the vertical dimension to secure the restoration space and select the minimum vertical dimension elevation for the esthetic and functional goal. In this case report, the patient complained of difficulty during chewing due to a worn dentition and wanted esthetic improvement of the short mandibular anterior teeth. After systematic evaluation and diagnosis, we performed full-mouth rehabilitation with minimum vertical dimension elevation to obtain the space for restoration. This resulted in a stable and harmonious occlusion, and the functional and esthetic problems of the patient were solved after treatment. The patient was satisfied with the results of the treatment and maintained stable occlusion during the follow-up period.

• The korean journal of orthodontics
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• v.29 no.2 s.73
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• pp.251-265
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• 1999

Various types of horizontal reference planes are used for diagnosis, treatment planning and evaluation of treatment results. But these reference Planes lack accuracy and repro-ducibility, and are mainly for Caucasian. Unlike the adult patients who have completed growth, the horizontal reference planes for growing children may change continuously during growth. Therefore this must be considered in selecting the horizontal reference plane. The purpose of this study was to Investigate the angle formed by the Sella-Nasion(SN) plane and Frankfort-Horizontal(FH) plane and evaluate the angle formed by FH plane and other horizontal reference planes in relation to different skeletal maturity and malocclusion types. 540 subjects with no orthodontic treatment history were chosen, and hand -wrist X-rays and lateral cephalometric X-rays were taken. According to SMA(Skeletal Maturity Assessment) of hand-wrist X-rays, the subjects were classified into 3 skeletal maturity groups : SMI 1-4 for group A, SMI 5-7 for group B and SMI 8-11 for group C. A second classification was made according to cephalometric analysis of lateral cephalograms. The subjects were classified into 3 malocclusion groups : Skeletal Class I, II and III malocclusion group. 10 measurements were evaluated. The results were as follows. 1. The angle formed by the SN plane and FH plane showed no difference among skeletal maturity groups, malocclusion groups, and between .sexes. 2. The angles formed by the SN plane and FH plane were $8.27^{\circ}{\pm}2.31^{\circ}$ for males and $8.59^{\circ}{\pm}2.24^{\circ}$ for females. The average value for females and males was $8.42^{\circ}{\pm}2.28^{\circ}$. 3. The angle formed by the FH plane and palatal plane was almost constant showing no difference among skeletal maturity groups, malocclusion groups, and between sexes($1.09^{\circ}{\pm}3.21^{\circ}$).