• The korean journal of orthodontics
• /
• v.35 no.2 s.109
• /
• pp.91-105
• /
• 2005

For af accurate diagnosis and treatment planning of facial asymmetry, the use of 3-dimensional (3-D) image is indispensable. The purpose of this study was to get standard data for the 3-D analysis of facial asymmetry Computerized tomography (CT) was taken in the 60 normal occlusion individuals (30 male. 30 female) who did not have any apparent facial asymmetry. The acquired 2D CT DICOM data were input on a computer, and the reformatted 3-D images were created using a 3-D image software. Twenty three measurements were established in order to evaluate asymmetry; 15 ;omear measurements (6 for ramus length. 1 for condylar neck length, and 8 for mandibular body length) and 8 angular measurements (4 for gonial angle. 2 for frontal ramal inclination. and 2 for lateral ramal inclination) The right aid left difference of each measurement was calculated and analyzed. It is suggested that the right and left differences of the measurements obtained from the study could be used as references for the diagnosis of facial asymmetric patients.

• The korean journal of orthodontics
• /
• v.39 no.2
• /
• pp.72-82
• /
• 2009

Objective: The purpose of this study was to investigate the structural changes of the hyoid bone and upper airway after orthognathic surgery for skeletal class III anterior open bite patients, and make comparisons with normal occlusion. Methods: Pre- and post-operative computed tomography (CT) examinations were performed on 12 skeletal class III anterior open bite patients who were treated with mandibular setback osteotomy. Using the V-works $4.0^{TM}$ program, 3-dimensional images of the total skull, mandible, hyoid bone, and upper airway were evaluated. Results: In the Class III open bite group, the hyoid bone were all positioned anteriorly, compared to the Normal group (p < 0.05). The angle between the hyoid plane and mandibular plane in the Class III openbite group before surgery was greater than in the Normal group (p < 0.05), and the difference increased after surgery (p < 0.01). In the Class III openbite group, the volume of the upper airway decreased after surgery (p < 0.001) and the volume of the upper airway was smaller than the Normal group before and after surgery (p < 0.001). Conclusions: The narrow upper airway space in skeletal Class III openbite patients decreased after mandibular setback osteotomy. This may affect the post-surgical stability.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.24 no.4
• /
• pp.389-403
• /
• 2008

In Angle's Class III malocclusion, which has higher incidence in Korean than Western, depressed midfacial profile with protruded lower lips and mandible may give rise to many functional, esthetic, psychological, social problems. Due to the different malocclusion incidence according to racial differences, many previous studies focused on the relationship between Class II malocclusion and nasal airway obstruction. Previous studies used lateral cephalography which has limitations of 2 dimensional image with projection error and identification error. Therefore, the purpose of this study was to analyze morphologic differences in the nasal airway between normal occlusion and Angle's Class III malocclusion patients using 3-dimensional facial computed tomography. Thirteen normal occlusion(7 men and 6 women) and sixteen skeletal Class III(7 men and 9 women) patients were selected and 3-dimensional facial computed tomography taking was performed. Comparison between two group in volume and sectional area of nasal airway were carried out. The results were followed. 1. In the comparison of absolute nasal airway volume, oropharyngeal space of experimental group were larger than control group but there are no significant difference in other. 2. In the comparison of relative nasal airway volume, oropharyngeal space of experimental group were larger than control group but there are no significant difference in other. 3. In the oropharyngeal space width on frontal and lateral view, the similar tendency was revealed between two groups. 4. In the lateral curvature of nasal airway, the similar tendency was revealed between two groups.

• The korean journal of orthodontics
• /
• v.35 no.6 s.113
• /
• pp.409-419
• /
• 2005

Studies for diagnostic analysis using three-dimensional (3D) CT images are recently in progress and needs for 3D craniofacial analysis are increasing in the fields of orthodontics. It is especially essential to analyze the facial soft tissue after orthodontic treatment and orthognathic surgery. In this study 3D CT images of adults with normal occlusion were taken to analyze the facial soft tissue. Norms were obtained from CT images of adults with normal occlusion (12 males, 11 females) using a computer program named V works 4.0 program. 3D coordinate planes were established using soft tissue Nasion as the reference point and a total of 20 reproducible landmarks of facial soft tissue were obtained using the multiple reconstructive sectional images (axial, sagittal and coronal images) of the V works 4.0 program: soft tissue Nasion, Pronasale, Subnasale, Upper lip center, Lower lip center, soft tissue B, soft tissue Pogonion, soft tissue Menton, Endocanthion (Rt/Lt), Alare lateralis (Rt/Lt), Cheilion (Rt/Lt), soft tissue Gonion (Rt/Lt), Tragus (Rt/Lt), and Zygomatic point (Rt/Lt). According to the established landmarks and measuring method, the 3D CT images of adults with normal occlusion were measured and the normal positional measurements and their Net (${\delta}=\sqrt{{X^2}+{Y^2}+{Z^2}}$) values were obtained using V surgery program, In the linear measurement between landmarks, there was a significant difference between males and females except Na' -Sn and En(Rt)-En(Lt). The normal ranges of Na'-Zy, Na'-Ch and Na'-Go' (facial depth) were obtained, which was difficult to measure by two-dimensional (2D) cephalometric analysis and facial photographs. These data may be used as references for 3D diagnosis and treatment planning for patients with malocclusion and dentofacial deformity.

• The korean journal of orthodontics
• /
• v.39 no.1
• /
• pp.18-27
• /
• 2009

Objective: The purpose of this study was to understand the differences in masseter muscle(MM) between the shifted and non-shifted sides in facial asymmetry patients, and the changes shown by MM after mandibular surgery. Methods: Pre- and post-operative CT scans were performed on 12 Class III patients with facial asymmetry who were treated by intraoral vertical ramus osteotomy and 10 subjects with normal occlusion. Using the V-works 4.0 program(Cybermed, Seoul, Korea), 3-dimensional images of the mandible, and MM were reconstructed, and evaluated. Results: In the asymmetry group, the MM angle between the shifted and non-shifted sides was only significantly different(p<0.05). Compared with normal occlusion, the asymmetry group showed a significantly smaller volume and maximum cross-sectional area in both sides of MM(p<0.05). After mandibular surgery, the angle of MM(p<0.01) and differences in angle between the shifted and non-shifted sides of MM(p<0.05) were significantly decreased. The thickness in the maximum cross-sectional area was significantly increased(p<0.01). After surgery, MM in facial asymmetry patients was similarly changed to those in the normal occlusion group except for widths. Conclusions: MM in facial asymmetry was definitely different from those in normal occlusion. However, this study suggests that MM changed symmetrically in conjunction with the mandible after proper mandibular surgery.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.25 no.1
• /
• pp.61-71
• /
• 2009

Anchorage control is important in orthodontic treatment. Recently miniscrew is widly used as maximum anchorage in orthodontic treatment, and then it is important to install miniscrew safely without damaging adjacent anatomic structure. In a view of Miniscrew's stability, maxilla is unfavorable than mandible, and moreover maxillary soft buccal bone has disadvantage on stability. so palatal area comes into notice for installation area. We measured distance between palatal roots and bone thickness at midpalatal area using 3D computed tomography, and have found following results. 1. On the comparison of distance between palatal roots, the distance between 2nd premolar and 1st molar was significantly longest and the distance between premolars was significantly shortest. 2. Going toward lateral area from midpalatal suture and posterior area from zero point, bone thickness significantly became shorter and shorter. And 5.0mm palatal sagittal plane has more significance decrease of bone thickness than 2.5mm palatal sagittal plane. According to these results, we can conclude that the palatal installation of miniscrew between 2nd premolar and 1st molar is safest. And it is more safe that comes closer to midpalatal suture and to anterior area in regard to incisive canal.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.36 no.1
• /
• pp.119-125
• /
• 2009

Fusion and gemination are irregularities in tooth development. It is often difficult to differentiate between gemination and fusion and it is common to refer to these anomalies as 'double teeth'. The deciduous teeth are most commonly involved, but in 0.1% of cases permanent teeth are affected, in which case aesthetic, funtional and periodontal problems can result. Double teeth present great difficulties in management and required a multidisciplinary approach. The central groove on the labial and palatal surfaces of a double tooth is extremely prone to caries, therefore early 'fissure sealing' is essential. In permanent dentition, surgical separation of fused teeth may be possible with subsequent orthodontic alignment and restorative treatment as needed to reshape the crown. Reshaping or reduction of a double tooth with a single canal may be attempted by modifying the appearance of the labial groove and the use of composite tints but is often impossible and extraction may be the only alternative. Orthodontic treatment and prosthetic replacement is then required. Implants may be an option for adolescents. The present study describes three clinical cases of double teeth in the position of the maxillary permanent incisors. The first case demonstrates an example of multidisciplinary care including surgical intraoral hemisection, root canal therapy, restorative and orthodontic treatment. The second and third cases describe the external and internal morphology of the two fused teeth by means of three dimensional dental computer tomography.

• The korean journal of orthodontics
• /
• v.39 no.3
• /
• pp.136-145
• /
• 2009

Objective: CBCT has become popular for orthodontic diagnosis and treatment planning in recent times. The 3D pharyngeal airway space needs to be analysed using a 3D diagnostic tool. The aim of this study was to analyse the pharyngeal airway of different craniofacial morphology using CBCT. Methods: The sample compromised 102 subjects divided into 3 groups (Class I, II, III) and 6 subgroups according to normal or vertical craniofacial patterns. All samples had CBCT (VCT, Vatech, Seoul, Korea) taken for orthodontic treatment. The pharyngeal airway was assessed according to the reference planes: aa plane (the most anterior point on the anterior arch of atlas), $CV_2$ plane, and $CV_3$ plane (most infero-anterior point on the body of the second & third cervical vertebra). The intergroup comparison was performed with one-way ANOVA and duncan test as a second step. Results: The results showed the pharyngeal airway and anteroposterior width of group 2 (Class II) in aa plane, $CV_2$ plane, $CV_3$ plane were significant narrower than in group 3 (Class III). There was no significant difference between vertical and normal craniofacial patterns except for the anteroposterior pharyngeal width of Group 1 (Class I) in aa plane. Conclusions: Subjects with Class II patterns have a significantly narrower pharyngeal airway than those with Class III. However there was no difference in pharyngeal airway between vertical and normal craniofacial morphology.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.24 no.2
• /
• pp.203-211
• /
• 2008

Minimizing damage to anatomical structure is a prerequisite for skeletal anchorage system to install a miniscrew. This research has focused on evaluating the stability and safety of installation in the maxillary molar buccal area, in which most miniscrews are installed clinically and initial fixation is weak. CT (computerized tomography)images were taken for surveying the possibility of damaging to adjucent teeth in accordance with installation angle. If we install a mini-screw($1.2{\times}6.0mm$) in the maxillary molar buccal area, it would be located generally in the 5~8mm upper of CEJ and 3~5mm inner of the cortical bone surface. We has measured the space between roots And comparison has been made for gender and the space between roots in accordance with the 3 different angles of installation(30 degree, 40 degree, 60 degree) in 3 categories. Category 1 : between 1st molar and 2nd molar Category 2 : between 1st molar and 2nd premolar Category 3 : between 1st premolar and 2nd premolar The result are as follow; 1. The space for category 1 was significantly small. 2. For the installation angle, it was safer to install with steeper angle in category 1 and category 2, but not in category 3. According to these results, the installation a miniscrew in category 2, 3 is safer than in category 1. And it is safer to install with steeper angle in category 1 and category 2.

• The korean journal of orthodontics
• /
• v.40 no.3
• /
• pp.145-155
• /
• 2010

Objective: Lateral cephalometric radiographs have been the main form of resource for assessing two dimensional anteroposterior airway changes. The purpose of this study was to evaluate the three dimensional volumetric change in the upper airway space in Class III malocclusion patients who underwent mandibular setback surgery. Methods: Three dimensional cone-beam computed tomographs (CBCT) and their three dimensional reconstruction images were analyzed. The samples consisted of 20 adult patients (12 males and 8 females) who were diagnosed as skeletal Class III and underwent mandibular setback surgery. CBCTs were taken at 3 stages - Baseline (1.8 weeks before surgery), T1 (2.3 months after surgery), and T2 (1 year after surgery). Pharyngeal airway was separated according to the reference planes and reconstructed into the nasopharynx, the oropharynx and the hypopharynx. Measurements at Baseline, T1, and T2 were compared between groups. Results: The result showed the volume of the pharyngeal airway decreased significantly 2.3 months after surgery (p < 0.001) and the diminished airway did not recover after 1 year post-surgery. The oropharynx was the most decreased area. Conclusions: These findings suggest that mandibular setback surgery causes both short-term and long-term decrease in the upper airway space.