The purpose of this study was to evaluate the relation between the treatment duration and cephalometric measurements and the PAR index in Class I malocclusion patients. In 100 Class I malocclusion patients, PAR score and cephalometric measurements were taken from study model and cephalometric radiographs and analyzed statistically. The results of this study were obtained as follows: 1. treatment duration was correlated with extraction and pre PAR index. 2. ANB, FMA, FMIA and IMPA exhibited positive correlation between pre PAR index and pretreatment cephalometric measurements. 3. $\underline{1}$ to FP exhibited positive correlation between post PAR index and posttreatment cephalometric measurements, and $\overline{1}$ to FP exhibited negative correlation. 4. $\underline{1}$ to SN, IIA and $\overline{1}$ to FP exhibited positive correlation between ${\%}\;PAR$ reduction and the change of cephalometric measurements and FMA FMIA, WITS and UL exhibited negative correlation. The results of this study indicate that PAR index taken from study model relate with items concerned with upper and lower incisors, and there are the tendency that pretreatment PAR index are larger in the patients with large Am value and hyperdivergent face.
Journal of the korean academy of Pediatric Dentistry
/
v.27
no.4
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pp.517-523
/
2000
Nasopharyngeal closure is a sphincter mechanism between the activities of the soft palate, lateral pharyngeal wall and the posterior pharyngeal wall, which divides the oral cavity and the nasal cavity. It participates in physiological activities such as swallowing, breathing and pronunciation. In case of an error in this mechanism, it is called a nasopharyngeal incompetence. The causes of this error are defects in (1) length, function, posture of the soft palate (2) depth and width of the nasopharynx, (3) activity of the posterior and lateral pharyngeal wall. The purpose of this study is to analyze the nasopharynx of cleft palate patients using lateral cephalograms and at the same time, evaluate the degree of hypernasality of each vowels to find its relationship with nasopharyngeal incompetence. The following results were obtained: 1. The length of the soft palate was markedly short than normal. 2. The adequate ratio was smaller than the normal value. 3. As the adequate ratio decreased, when articulating vowels, anatomic mVPI increased. 4. When articulating each vowels, anatomic VPI was in proportion with the degree of hypernasality. 5. The degree of hypernasality was greater in high vowels(/i/, /u/) than low vowel(/a/). From the above results, it can be concluded that in cleft palate patients, lateral cephalograms can be used effectively in diagnosing and evaluating nasopharyngeal incompetence. The anatomic structure of the nasopharynx has close relation to the degree of hypernasality.
Purpose : In order to perform craniospinal irradiation (CSI) in the supine position on patients who are unable to lie in the prone position, a new simulation technique using a CT simulator was developed and its availability was evaluated. Materials and Method : A CT simulator and a 3-D conformal treatment planning system were used to develop CSI in the supine position. The head and neck were immobilized with a thermoplastic mask in the supine position and the entire body was immobilized with a Vac-Loc. A volumetrie image was then obtained using the CT simulator. In order to improve the reproducibility of the patients' setup, datum lines and points were marked on the head and the body. Virtual fluoroscopy was peformed with the removal of visual obstacles such as the treatment table or the immobilization devices. After the virtual simulation, the treatment isocenters of each field were marked on the body and the immobilization devices at the conventional simulation room. Each treatment field was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR)/digitally composite radiography (DCR) images from the virtual simulation. The port verification films from the first treatment were also compared with the DRR/DCR images for a geometrical verification. Results : CSI in the supine position was successfully peformed in 9 patients. It required less than 20 minutes to construct the immobilization device and to obtain the whole body volumetric images. This made it possible to not only reduce the patients' inconvenience, but also to eliminate the position change variables during the long conventional simulation process. In addition, by obtaining the CT volumetric image, critical organs, such as the eyeballs and spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. The differences between the DRRs and the portal films were less than 3 mm in the vertebral contour. Conclusion : CSI in the supine position is feasible in patients who cannot lie on prone position, such as pediatric patienta under the age of 4 years, patients with a poor general condition, or patients with a tracheostomy.
The purpose of this study was to investigate if there were a significant differences in mandibular position between cephalometric measurements from a centric occlusion tracing compared to those of a acquired centric relation by stabilization splint on malocclusion patient with TMD. 60 malocclusion patients, who had TMD and CO-CR discrepancy beyond normal range, were selected and subdivided into Class I, II, III by Angle's classification and also subdivided into clockwise, straight downward, and counterclockwise group by Jarabak's posterior facial height/anterior facial height ratio. Lateral cephaolmetric radiographs with the mandible in centric occlusion were taken and measured, and for each Patient the stabilization splint with mutually protected occlusal scheme was applied for minimum 3months. After each patient's CO-CR discrepancy was in normal range, lateral cephalometric radiographs were retaken and measured. The comparison of the difference between CO-CR cephalometric measurements in all sample, Class I, II, III groups, and Clockwise, Straight downward, Counterclockwise groups were studied. The finding of this study can be summarized as follows: 1 In all sample, the value of cephalometric measurements was significantly different between CO-CR. The mandible rotated to down and posterior position and the vertical change was greater than the horizontal change (overjet-1.3mm increase, overbite-1.9mm decrease). 2. In Class II malocclusion group, most of the mean difference value between CO-CR is higher than that of the other groups and more measurements was statically significant. 3. In clockwise and counterclockwise group, some of the mean difference value is higher than that of straight downward group and more measurements was statically significant. 4. There ware no measurements that explain centric relation measurements from the type of malocclusion, facial pattern and centric occlusion measurements. Henceforth, it is strongly recommended that stabilization splint therapy for orthodontic treatment on TMD patient should be excuted upon overall facial types prior to orthodontic diagnosis and treatment planning.
Purpose : A new virtual simulation technique for craniospinal irradiation (CSI) that uses a CT-simulator was developed to improve the accuracy of field and shielding placement as well as patient positioning. Materials and Methods : A CT simulator (CT-SIM) and a 3-D conformal radiation treatment planning system (3D-CRT) were used to develop CSI. The head and neck were immobilized with a thermoplastic mask while the rest of the body was immobilized with a Vac-Loc. A volumetric image was then obtained with the CT simulator. In order to improve the reproducibility of the setup, datum lines and points were marked on the head and body. Virtual fluoroscopy was performed with the removal of visual obstacles, such as the treatment table or immobilization devices. After virtual simulation, the treatment isocenters of each field were marked on the body and on the immobilization devices at the conventional simulation room. Each treatment fields was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR) and digitally composited radiography (DCR) images from virtual simulation. Port verification films from the first treatment were also compared with the DRR/DCR images for geometric verification. Results : We successfully performed virtual simulations on 11 CSI patients by CT-SIM. It took less than 20 minutes to affix the immobilization devices and to obtain the volumetric images of the entire body. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with simulation films to within 5 mm. This not only reducee inconveniences to the patients, but also eliminated position-shift variables attendant during the long conventional simulation process. In addition, by obtaining CT volumetric image, critical organs, such as the eyes and the spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. Differences between the DRRs and the portal films were less than 3 m in the vertebral contour. Conclusion : Our analysis showed that CT simulation of craniospinal fields was accurate. In addition, CT simulation reduced the duration of the patient's immobility. During the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization by standard protocol for craniospinal irradiation.
Making a precise and ideal set-up model is an essential part in the indirect bonding procedure for lingual orthodontic treatment. To evaluate the accuracy of the making a set-up model, 22 adult patients who received lingual orthodontic treatment with 4 bicuspid extractions were selected, and 3 sets of dental models (before, set-up, and after treatment) were measured using the set-up model gauge, an instrument for measuring the inclination and angulation of the clinical crowns on the dental model. Two sets of lateral cephalograms (before and after) from each patient were also evaluated. The mean difference between the before treatment model and the set-up model was $-3.93{\pm}6.98^{\circ}$ for the inclination and $1.87{\pm}5.79^{\circ}$ for the angulation. And the mean difference between the set-up model and the after treatment model was $-4.31{\pm}5.91^{\circ}$ labiolingually and $-2.16{\pm}3.27^{\circ}$ mesiodistally, The after treatment model differed from the before treatment model about $-8.24{\pm}5.39^{\circ}$ in inclination. There were no significant difference between the measured gauge that measured from the dental model using the set-up model gauge and the calculated gauge angle measured from the lateral cephalogram using constructed points and lines. Using the set-up model gauge, it is possible to evaluate the study model 3-dimensionally in relation with the patient's lateral cephalogram and establish whether the doctor's prescription or overcorrection is built in the set-up model precisely.
This study was performed to evaluate whether growth Prediction method can be used to diagnose and make treatment plan in skeletal Class III malocclusion patients or not. The sample was consisted of 25 patients(13 males, 12 females) who had been diagnosed with skeletal Class III malocclusion at first visit and after that had returned to take ortognathic surgery. Growth prediction performed with Ricketts' growth prediction method from first cephaogram. was compared with actual growth of the second cephalogram. The findings of this study were as follows ; 1. There was significant difference between actual growth and growth prediction in Porion Location, Ramus Position, Facial Depth, Facial Axis, Mandibular Plane angle, Maxillary Convexity. So, for these items Ricketts' growth prediction method is not proper to predict growth. 2. Although the growth amount of mandibular body was similar to normal growth amount, mandible was positioned anteriorly because of Porion Location and Ramus Position. 3. In skeletal Class III malocclusion patients, the tendency of mandibular prognathism might be aggreviated because of anterior placement of ramus and anterosuperior rotation of Pogonion.
71 Class I malocclusion samples were selected and they were divided into premolar-extraction and non-extraction groups. Vertical and horizontal cephalometric evaluations on dental and soft tissue measurements were done before and after treatment. Also, treatment results in adolescent patients and adult patients were compared. The following conclusions were obtained: 1. In comparison of extraction and non-extraction groups, all the dental and soft tissue measurements, with exception of SN-MP angle, upper lip to E-line, vertical movement of upper first molar, md horizontal movement of lower first molar, showed statistically significant differences. 2. In comparison of extraction and non-extraction groups of adolescent samples, there were statistically significant differences in upper and lower incisor inclinations, horizontal dental movements from vertical reference line, positional changes in upper and lower lips, and mesial movements of upper first molar. 3. In comparison of extraction and non-extraction groups of adult samples, there were statistically significant differences in upper and lower incisor inclinations, horizontal dental movements from vertical reference line, positional changes in upper and lower lips from I-line and vertical reference line, vertical height of upper first molar, and mesial movement of lower first molar. 4. There was no statistically significant difference in SN-MP angle between extraction and non-extraction groups of both adolescent and adult samples.
Journal of the korean academy of Pediatric Dentistry
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v.26
no.2
/
pp.248-261
/
1999
In order to define a current set of Korean children norm with mixed dentition, following study was done. The subjects were 102 healthy dentition contestants(48boys, 54girls). Standardized lateral head roentgenograms were taken, and Ricketts analysis was done. Results were as follows: 1. Length of anterior cranial base, posterior facial height, corpus length were longer in male than in female(p<0.05), and Porion was located posteriorly in male than in female(p<0.01). 2. Through facial depth, Pogonion of male was more forwardly positioned(p<0.05), mandible was significantly steeper in female, and maxillary anterior teeth were significantly tipped forward in male(p<0.05). 3. Variables such as length of anterior cranial base, upper molar position(p<0.01) and corpus length(p<0.05) were significantly changed by age. 4. Maxillary height, facial depth, mandibular plane angle, convexity were changed by age, but not significantly(p>0.05).
The configuration of mandibular symphysis is likely to be dependent upon the genetic predeterminants and/or compensatory adjustments onto functional demands. The interrelation of morphological distinctives of symphysis in conjunction to the craniofacial skeleton had been scarcely anecdotal, therefore, the objective was to determine the correlation of morphological modifications between the mandibular symphysis and craniofacial complex. Lateral cephalometric headfilms of 212 subjects were employed for the conventional measurements. The proportion of chin height against chin depth length was referred as chin ratio, then, Low Symphysis (IS) and High Symphysis (HS) groups were turned out by means of the chin ratio. These samples yielded 35 in LS and 35 in HS groups. The data per capita were statistically analyzed and the following results were drawn ; 1. Overall characteristics of the craniofacial skeleton in HS group manifested hyperdivergence and LS group showed hypodivergence. 2. Gonial angle increased as chin ratio increased and was highly correlated to the chin ratio. 3. The chin ratio presented high correlation to the vertical face height, especially in terms of the chin height to anterior face height and the chin depth to posterior face height. 4. The morphological configuration of chin was hardly correlated with hyoid bone position.
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