• Journal of Yeungnam Medical Science
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• v.21 no.2
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• pp.242-250
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• 2004

In general, the skeletal class III has the characteristics of mandibular overgrowth with a normal maxillary growth or maxillary undergrowth with a normal mandibular growth And clinical and radiographic evaluations of the patient are needed. However, the treatment plan is not dependent on these evaluations alone, because patient's general condition and hope for aesthetics varies. The aim of this report is to consider the treatment of a medically compromised patient with an anterior open bite and skeletal class III, which showed a severe mandibular overgrowth. In 2003, a 17-year-old boy with epilepsy, mental retardation presented at our clinic complaining of concave profile. A clinical examination showed severe mandibular prognathism with an anterior open bite. The radiographic examination revealed a short cranial base, a moderate maxillary overgrowth, severe mandibular overgrowth and skeletal open bite tendency. In 2004, he was verified to have no potential of growth by hand-and-wrist radiographs and an endocrine examination. He completed the preoperative orthodontic treatment and orthognathic surgery (sagittal split ramus osteotomy, genioplasty). He was evaluated on the first visit, the preoperative period and the postoperative period with a clinical and radiographic examination. At the first visit, the patient showed moderate overgrowth of the maxilla, severe overgrowth of the mandible, and a subsequential skeletal open bite. After the preoperative orthodontic treatment (preoperative period), the patient showed the same skeletal problem as before and a decompensated dentition for orthognathic surgery. After orthognathic surgery, his profile had improved, but he had still a skeletal openbite tendency because the maxillary orthognathic surgery was not performed. Severe mandibular prognathism with a maxillary overgrowth and anterior open bite should be treated by bimaxillary orthognathic surgery. However, one-jaw orthognathic surgery on the remaining the skeletal open bite tendency was performed for his medical problem and facial esthetics. This subsequential open bite should be resolved with a postoperative orthodontic treatment.

• Journal of dental hygiene science
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• v.7 no.4
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• pp.275-279
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• 2007

The purpose of this research, which was executed with 200 patients whose chief complaint was the extraction of the mandibular third molar, was to examine the effect that eruption state of the mandibular third molar has on the growth of pericoronitis. The conclusion about distribution of left and right mandibular third molar, angulation, impaction degree, anterior border of mandibular ramus and the interval from mandibular second molar to mandibular third molar was drawn by chi-square test. 1. There was correlation between pericoronitis and position of the mandibular third molar according to age. 2. In angulation of mandibular third molar, mandibular third molar most likely to be afflicted with pericoronitis is mesioangular. 3. The impaction degree between mandibular third molar and the growth of pericoronitis was given in the order of Level a, Level c and Level b. 4. In the anterior border of mandibular ramus with mandibular third molar, pericoronitis was easily generated in the order of Class II, Class I and Class III. 5. The shorter the interval from distal cementoenamel junction of mandibular second molar to mesial cementoenamel junction of third molar became, the more easily pericoronitis was generated.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.4
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• pp.231-239
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• 2012

Objectives: This study sought to provide guidelines in order to decrease the incidence of nerve injury during mandibular ramus bone harvesting, and to improve understanding of the anatomical structure of the inferior alveolar canal (IAC) to include its distance from the exterior buccal cortex. Materials and Methods: In January and February 2009, 20 patients who visited the Wonkwang University Department of Oral and Maxillofacial Surgery reporting various conditions underwent cone beam computed tomography and were included in this study. Patients with missing left or right mandibular first molars or incisors, or who had jaw fracture or bone pathologies, were excluded. The reference point (R point) was defined as the point where the occlusal plane reached the anterior ramus of the mandible. The position of the IAC in relation to the R point, the buccal bone width (BW), the alveolar crest distance (ACD), the distance from the alveolar crest to the occlusal plane (COD), and the distance from the IAC to the sagittal plane (CS) were determined using proprietary image analysis software which produced cross-sectional coronal and axial images. Results: The distance medially from the R point to the IAC along the axial plane was $6.19{\pm}1.21mm$. The HD from the R point, posteriorly to IAC, in the lateral view was $13.07{\pm}2.45mm$, the VD from the R point was $14.24{\pm}2.41mm$, and the ND from the R point was $10.12{\pm}1.76mm$. The pathway of the IAC was positioned almost in a straight line along a sagittal plane within $0.56{\pm}0.70mm$. The distance from the buccal bone surface to the IAC increased anteriorly from the R point. Conclusion: Marking osteotomy lines in the retromolar area in procedures involving bone harvesting should be discouraged due to the risk of damage to IAC structures. Our measurements indicated that the area from the R point in the ramus of the mandible to 10 mm anterior can be safely harvested for bone grafting purposes.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.1
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• pp.64-76
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• 2021

The purpose of this study is to evaluate the position of the mandibular foramen and location and morphological characteristics of the mandibular lingula using Cone-Beam Computed Tomography (CBCT). Mandibular CBCT images of children aged 6 - 16 years were collected. A total of 180 patients were divided into 3 groups, 6 - 7, 10 - 11 and 15 - 16 years, with 30 male and female patients per group. Either side of the ramus was analyzed. The shortest distances from the anterior, posterior, superior and inferior border of the ramus to the mandibular lingula were measured. The shortest distance between the mandibular lingula and the mandibular foramen was also measured. The vertical distance from the mandibular lingula and the mandibular foramen to the occlusal plane was measured. The shapes of the mandibular lingula was classified into 4 types according to the criteria. The distances of the mandibular lingula from the anteroposterior and vertical reference points of the ramus increased in all directions with age. The distance between the mandibular lingula and the mandibular foramen also increased with age. The location of the mandibular lingula and the mandibular foramen in relation to the occlusal plane moved upwards with age. The most common shape of the mandibular lingula was triangular, followed by nodular, truncated and assimilated, and there was no difference in the shape according to age. It is recommended that the horizontal insertion point of the anesthesia from the anterior border of the ramus increased to 17 mm, 18 mm, and 19 mm according to the age groups. It is also suggested that the vertical insertion point increased by 2 - 3 mm, 5 - 6 mm and 9 - 10 mm above the occlusal plane according to the age groups.

• The korean journal of orthodontics
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• v.22 no.1
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• pp.205-227
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• 1992

This study was aimed to investigate the characteristics & the causative areas of the adult skeletal class III malocclusions with different facial divergency. The lateral cephalograms of 80 subjects with skeletal class III malocclusion from 17 to 29 years of age were classified into 3 groups according to SN-MP angle; hypodivergent group $(21.65{\pm}3.52^{\circ})$, neutrodivergent group $(30.50{\pm}2.29^{\circ})$ and hyperdivergent group $(40.02{\pm}3.98^{\circ})$. The data were gathered by digitizing of the traced cephalograms and were statistically analyzed. The results were as follows: 1. The anterior cranial base of the hyperdivergent group was shortest & tipped upwardly to the FH plane. 2. The maxilla of hyperdivergent group was shortest anteroposteriorly and positioned posteriorly to the anterior cranial base. 3. The degree of the mandibular prognathism in hyperdivergent group was less than the hypodivergent group. The hyperdivergent group showed the downward & backward rotated mandible. 4. The mandibular ramus & body was short & slender in the hyperdivergent group and the gonial angle was greatest in the hyperdivergent group. 5. The temporomandibular joint was positioned more superiorly to the anterior cranial base in the hyperdivergent group. 6. The cranial base, palatal plane, occlusal plane and mandibular plane were diverged in the hyperdivergent group. And this group had a great anterior total facial height, especially anterior lower facial height. 7. The craniofacial characteristics of skeletal class III malocclusion were critical in the vertical structure than the horizontal.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.14 no.1
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• pp.81-87
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• 1984

This study was performed to observe the secondary images and to analyse the relationships between the primary and secondary images in panoramic radiograph. Using the Moritta's Panex-EC panoramic x-ray machine and the human dry skull, the author analysed 17 radiographs which were selected from 65 radiographs of the dry skull that attached the radiopaque materials, and the attached regions of the radiopaque materials were the normal anatomical structures which were important and selected as a regions for the evaluation of the secondary images effectively. The results were as follows; 1. The cervical vertebrae showed three images. The midline image was the most distorted and less clear, and bilateral images were slightly superimposed over the posterior border of the mandibular ramus. 2. In mandible, the secondary image of the posterior border of the ramus was superimposed on the opposite ramus region, and this image was elongated from the anterior border of the ramus to the lateral side of the posterior border of the ramus. The secondary image of the condyle was observed on the upper area of the coronoid process, the sigmoid notch and the condyle in opposite side. 3. In maxilla, the posterior region of the hard palate showed the secondary image on the lower part of the nasal cavity and the medial wall of the maxillary sinus. 4. The primary images of the occipital condyle and the mastoid process appeared on the same region, and only the secondary image of the occipital condyle was observed symmetrically on the opposite side with similar shape to the primary one. 5. In the cranial base, the anatomical structures of the midsagittal portions like a inferior border of the frontal sinus, sella turcica, inferior borderr of the sphenoid sinus and inferior border of the posterior part of the occipital bone showed the simillar shape between the primary and secondary images symmetrically. 6. The petrous portion of the temporal bone showed the secondary image on the lateral side of the sella-turcica, and the secondary images of the posterior border of lesser wing, superior border of greater wing of the sphenoid bone and posterior border were observed on the anterior-superior and inferior region of the sella-turcica.

• The korean journal of orthodontics
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• v.29 no.1 s.72
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• pp.113-127
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• 1999

The purpose of this study is to investigate the stability of counterclockwise rotation of mandible by sagittal split ramus osteotomy to correct the skeletal Class III malocclusion with anterior open bite. Twenty five skeletal Class III open bite patients(mean age 20.6 years) who were treated by the sagittal split ramus osteotonues with rigid fixation were examined in this study. Cephalometric radiographs were taken for each Patients Preoperative(T1), ewly Postoperative(T2), and late postoperative Period(T3). Mean postoperative period was 8.0 months. Cephalometric analysis was done and data from T1, T2, and T3 were analyzed statistically by Paired t-test and Pearson correlation analysis. The following results were obtained. 1. Mandibular plane angle decreased $2.9^{\circ}$ and mandibular occlusal plane angle related to SN Plane decreased $2.7^{\circ}$ after orthognathic surgery(T2). At 6 months after orthognathic surgery(T3), mandibular plane angle increased $1.0^{\circ}$, but mandibular occlusal plane angle did not changed. 2. The amount of horizontal relapse long time after orthognathic surgery(T3) was 1.6 mm at B point and it was $22\%$ of the total posterior movements. There was no vertical relapse in the anterior facial height. 3. The related factor with horizontal relapse at late postoperative period was mandibular plane angle(p<0.01). The related factors with decreasing posterior facial height were amount of mandibular setback(p<0.01), increasing of mandibular ramus height(p<0.01), and decrease of the mandibular plane angle during operation(p<0.01). 4. There was no relationship between the amount of changes in mandibular occlusal plan angle during operation and the amount of relapse after surgery.

• The korean journal of orthodontics
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• v.18 no.1 s.25
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• pp.79-88
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• 1988

The purpose of this study was to investigate the factors which might be related to mandibular third molar eruption and to predict the possibility of whether or not it will be erupted. The material of this study was lateral cephalometric radiograms, pantomograms and dental casts obtained from 70 patients (19 males, 51 females) ranging in age from 18.0 to 32.1 years. They were devided into erupted group and impacted group of mandibular third molars. For the comparison of each group, a total of 20 measurement items were employed and the data were analyzed by means of computer statistical method. As a result of this study, the following conclusion can be made; 1. The longer mandibular body length and narrower mandibular ramus width, the higher eruption tendency of the lower third molar, but the degree of genial angle was not related to mandibular third molar eruption. 2. The lower percentage of posterior mandibular body height to anterior mandibular body height, the higher eruption tendency of the lower third molar. 3. The total tooth size, including the lower second molar, appeared to be larger in the impacted group than in the erupted group of the lower third molar. 4. The arch length discrepancy of the impacted group was more severe in contrast with the erupted group of the lower third molar.

• The korean journal of orthodontics
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• v.33 no.1 s.96
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• pp.31-39
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• 2003

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.

• Journal of Oral Medicine and Pain
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• v.17 no.2
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• pp.37-49
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• 1992

80 patients who presented at Wonkwang University Dental Hospital with craniomandibular disorders were collected for this study. To observe the occlusal contact pattern such as contact numbers, contact force and presence or absence of anterior occlusal contact, the author used T-Scan system (Tekscan, Inc, U.S.A.) with are computerized occlusal analysing system. And to study the correlation between craniofacial profile and occlusal contact pattern, cephalogram were also taken, The cephalometric items related to growth pattern, jaw bone relation and denture pattern were measured and analysed according to routine method by computerized program. The obtained data were statistically processed with SPSS/PC+ package about anterior contact pattern and its craniofacial relationship. The obtained results were as follows : 1. In terms of growth pattern, patients without anterior tooth contacts showed a tendency to downward growth of craniofacial profile. The value in this subjects were significantly different from the value of patients with anterior tooth contacts in items of low gonial angle, Jarabak ratio, SN to GoMe angle, FMA, occlusal plane to mandibular plane angle and ramus height. 2. In terms of jaw bone relationship, patients without anterior tooth contacts showed a tendency to backward growth of craniofacial profile. The value of this patients were significantly different from the value of patients with anterior tooth contacts in items of SNB, ANB, mandibular plane to anterior cranial base ratio, SNPo, NAPo and APDI items. 3. But in denture pattern, no statistically significant difference by the presence or absence of anterior tooth contacts were showed between this patients groups. 4. From this study, it could be proposed that anterior open bite in the patients with craniomandibular disorders would be originated from not dental discrepancy but skeletal discrepancy.