• Title/Summary/Keyword: 하악골 전진

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Microimplant mandibular advancement (MiMA) therapy for the treatment of snoring and obstructive sleep apnea (OSA) (코골이 및 수면 무호흡 치료를 위한 마이크로 임프란트를 이용한 하악골 전진술)

  • Ngiam, Joachim;Kyung, Hee-Moon
    • The korean journal of orthodontics
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    • v.40 no.2
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    • pp.115-126
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    • 2010
  • This case report describes the treatment of a 66 year old adult patient with a diagnosis of severe obstructive sleep apnea who was intolerant of nasal continuous positive airway pressure (nCPAP) treatment and oral appliance therapy. An alternative treatment of snoring and obstructive sleep apnea (OSA) with 2 orthodontic microimplants anchored to the mandible providing skeletal anchorage for mandibular advancement was implemented. After a 2 week healing period, a custom designed facemask provided extraoral anchorage to which the microimplants were connected to for titratable mandibular advancement. Microimplant Mandibular Advancement (MiMA) therapy resulted in resolution of the symptoms of severe OSA with a reduction of the apnea-hypopnea index (AHI), snoring and OSA symptoms.

Changes in Soft Tissue Profile after Surgical Correction of Prognathic Mandible (하악전돌증의 악교정수술 후 연조직 형태변화에 대한 연구)

  • Sung, Sang-Jin;Park, Hyun-Do;Kim, Jae-Seung;Moon, Yoon-Shik
    • The korean journal of orthodontics
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    • v.30 no.3 s.80
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    • pp.355-365
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    • 2000
  • The treatment plan for orthognathic surgery must be based on accurate predictions, and this can be produced the most esthetic results. Treatment of prognathic mandible in adult is usually orthognathic surgery using mandible set back, but mandible with retruded chin point is needed additional chin augmentation. In this case, the directions between mandible and chin point are different therefore, the prediction of soft tissue reactions must be modified. In this study, we materialize the patients who was taken orthognathic surgery due to prognathic mandible, 11each(Group A) was taken only Bilateral Sagittal Sprit Ramus Osteotomy (BSSRO), 9each(Group B) was taken additional advancement genioplasty. The lateral cephalometric radiography taken 8 months later after orthognathic surgery by this patients were used. The results of this study were as follows : 1. The profile of lips was favorable after surgery due to upper lip to I-line became prominent and lower lip tc E-line was retruded. 2. In both group, upper lip moved posteriorly and nasolabial angle was increased. 3. The ratio of the soft tissue profile change in POGs point to skeletal B point movement was $84\%$ in group A and $66\%$ in group B, and there was statistical significance between group A and group B. 4. Vertical movement of hard tissue points is decreased in group A.

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A comparative study of soft tissue changes with mandibular one jaw surgery and double jaw surgery in Class III malocclusion (III급 부정교합자의 양악 수술과 하악 편악 수술 시 연조직 변화에 관한 비교 연구)

  • Chang, In-Hee;Lee, Young-Jun;Park, Young-Guk
    • 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.

Soft tissue changes in skeletal class II patients treated with bilateral sagittal split osteotomy advancement surgery (골격성 II 급 부정교합 환자의 하악골 전진술 후 연조직 변화 분석)

  • Shin, Hee-Jin;Kim, Jin-Wook;Park, Je-Uk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.2
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    • pp.94-99
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    • 2010
  • The purpose of this study was to examine the soft tissue changes in skeletal class II patients after mandibular advancement by bilateral sagittal split ramus osteotomy (BSSRO). In Asian population, the incidence of skeletal class II malocclusion is lower than that of skeletal class III malocclusion unlike the caucasians. This study was conducted to figure out the ratio at which hard tissue and soft tissue changes after mandibular advancement by analyzing cephalograms of 13 patients that have undergone the mandibular advancement surgery. As a result, change ratios of Li, B', Pog' according to the movement of li, B, Pog were found to be 0.59, 1.06, 0.82. Also, vertical height of vermilion zone (Si-Vb) and lower lip and chin (Si-Me') were measured to evaluate vertical changes. Vermilion zone showed tendency to decrease by 1.02 mm on the average postoperatively, whereas vertical length of lower lip and chin showed tendency to increase by 3.57 mm on the average.

Strategic surgical-combined orthodontic treatment planning of patient with missing incisors on maxilla: a case report (상악 전치부 결손 환자의 수술을 동반한 전략적 교정치료 증례)

  • Park, Je-Hyeok;Jeon, Jin;Zhao, Sen;Jeon, Young-Mi;Kim, Jong Ghee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.4
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    • pp.244-252
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    • 2019
  • Proper positioning of maxillary incisors is key to success of surgery combined treatment. Establishing surgery plan would be a difficult job if maxillary incisors are lost. Patient who lost all of her maxillary incisors due to accident came for orthodontic treatment. Through careful modification of maxillary archform, pre-surgical orthodontic treatment was conducted with four prosthetic space consolidation. Position of incisors was decided by help of 3D prosthetic set-up, and 1-jaw surgery was planned. After relative short treatment period of 28 months, final prosthesis was done. When alveolar bone loss happens, harmonious prosthesis of upper incisors is difficult. Utilizing mandibular set-back surgery and incisor positioning using 3D set-up could make a better environment for treatment outcome. Strategic pre-surgical orthodontic treatment can allow shorter time and less number of prosthetics.

MANDIBULAR ADVANCEMENT WITH DISTRACTION OSTEOGENESIS FOR ADULT CLASS II MALOCCLUSION PATIENT WITH CONDYLAR RESORPTION (악관절 흡수양상을 보이는 성인 하악 후퇴증 환자에서 양측 하악골 골신장술을 이용한 하악 전진술)

  • Paeng, Jun-Young;Lee, Sang-Woo;Lee, Jin-Yong;Myoung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.3
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    • pp.217-226
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    • 2007
  • Purpose: Distraction osteogenesis is considered to take favorable effect on the TMJ and be beneficial to prevent the relapse after the mandibular advancement of Class II malocclusion patient. This is the report with literature review on the mandibular advancement in the patients showing preoperative condylar resorption and who need larger amount of advancement. Patients and method: Distraction osteogenesis using intraoral device was performed for three mandibular hypoplasia patients (one male and two females). All patients were adult over 18 years old. The patients showed condylar bony resorption preoperatively. The distraction was performed intraorally with modified SSRO. After 7 days of latency period, activation was performed at the rate of 1.0 mm/day with twice turn. The devices were removed after 4-8 month consolidation period. Results: Total advancement of mandible was average 13 mm. One patient showed openbite immediately after removal of distraction device. It took long time to guide the openbite with elastics. The comparison between cephalometries immediately after device removal and postoperative six month revealed average 3.4 mm relapse. This means that mandibular advancement with distraction osteogenesis needs overcorrection and elastic rehabilitation even after enough consolidation periods. Conclusion: Larger amount of mandibular advancement could be achieved with distraction osteogenesis in severe mandibular hypoplasia with condylar resorption. However, some relapse was found during the follow-up period and the over correction is considered to be needed. The effect of distraction osteogenesis seems to be investigated with long-term follow-up.

A Comparison of pre and post-surgical characteristics in skeletal Class III malocclusion patients using counterpart analysis (구조적 대응체 분석법에 의한 골격성 II급 부정교합 환자의 악교정 수술전후의 비교)

  • Sohn, Byung-Wha;Kyung, Seung-Hyun;Kim, Beom-soo
    • The korean journal of orthodontics
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    • v.34 no.1 s.102
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    • pp.93-107
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    • 2004
  • Enlow's counterpart analysis explains the complex with anatomic and developmental characteristics where craniofacial aspect of Individuals has been developed. Counterpart analysis does not compare individual measurement with the normal value from the average of majority but analyzes by comparison of values that each individual has. In this study we examined surgical changes in skeletal Class III malocclusion patients(male 40, female 40) and compared them with normal occlusion patients using counterpart analysis. The results indicated that : 1. Skeletal anterior-posterior discrepancy was relieved by shortening of the ramus width(B3). 2. The ramus alignment(R3, R4) was displaced posteriorly and the occlusal plane angle(R5) was rotated clockwise. 3. Skeletal Class III pattern was relieved in the post-operative group, but differences in the level of the cranium(R1, R2) was remaining compared to the normal occlusion patients. 4. In the comparison of surgery methods, the two-jaw surgery group presented changes In the maxillary length(A4), ramus alignment(R3, R4) and occlusal plane angle(R5) compared to the one-jaw surgery group, but the differences were not significant. In the past study about Korean skeletal Class m patients, the skeletal characteristics are upward backward rotation of the cranial base, posterior displacement of the maxilla, forward inclination of the ramus and lengthening of the mandibular body, but in this study, skeletal Class m pattern was relieved by shortening of the ramus width and maxillary advancement by orthognathic surgery, because orthognathic surgery is usually performed on limited areas in the maxilla and the mandible.