• Title/Summary/Keyword: Arch discrepancy

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A Case Report of Maxillary Retrusion and Mandibular Protrusion Corrected by Simultaneous Maxillary and Mandibular Osteotomies (상악후퇴증 및 하악전돌증의 악교정수술예)

  • Kim, Jae-Seung
    • The Journal of the Korean dental association
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    • v.23 no.11 s.198
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    • pp.979-986
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    • 1985
  • This is a case report of orthognathic surgery for the correction of maxillary retrusion and mandibular protrusion. The summary and results are as follows, 1. The maxillary retrusion was corrected by LeFort I osteotomy. 2. The mandibular protrusion was corrected by sagittal split osteotomies in the rami. 3. And, for the correction of the discrepancy between max8llary and mandibular arches, the mandibular arch was widened by the midsymphyseal step osteotomy. 4. The ratios of horizontal changes of soft tissue to hard tissue at the points, Subnasale (Sn), Labrale superius (Ls), Labrale inferius (L9), and Supramentale (B) were 67.6%, 43.2$, 70.2% and 87.7%, respectively.

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ORTHODONTIC CONSIDERATION ON THE SPACING OF ANTERIOR TEETH (전치부(前齒部) 치간리개(齒間離開)에 관(關)한 교정학적(橋正學的) 고찰(考察))

  • Choi, Byung Taik;Yang, Won Sik
    • The korean journal of orthodontics
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    • v.14 no.1
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    • pp.25-32
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    • 1984
  • Anterior spacing is one of the interesting phenomena in clinical orthodontics and presents difficulties in determining the etiology and the retention method. Only through the careful examination can orthodontists reach the correct diagnosis and treatment plan and every orthodontist should get rid of the cause to obtain good results. The author considered about the treatment and the retention method of the anterior spacing according to etiology and presented two eases of anterior spacing. In the first ease, the etiology was simple arch length discrepancy with excessively protruded anteriors. In the second ease, the etiology was the same as the above but the patient had the tongue thrusting habit. Both the eases showed the thin fibrous tissue bands between the upper central incisors but only the second case was thought to be associated with this tissue. The permanent retention loop which is non-surgical was applied to the ease and the results were acceptable.

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An evaluation of the adequacy of pont's index (Pont 지수의 임상적 적합성에 대한 평가)

  • Kim, Seong-Hun;Lee, Ki-Soo
    • The korean journal of orthodontics
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    • v.30 no.1 s.78
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    • pp.115-126
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    • 2000
  • Dental arch expansion is one of the method used to solve the dental crowding problem by non-extraction. Many formulae using tooth size have been suggested to predict ideal inter-premolar and inter-molar width. The purpose of this study was to evaluate the adequacy of some upper dental arch width prediction methods, namely Pont's method, Schmuth's method and Cha's method. The sample consisted of the casts of 119 Korean young adults who had no muscular abnormality, no skeletal discrepancy, and Angle's Class I molar relationships. Measurements were obtained directly from plaster casts; they Included mesiodistal crown diameters of the four maxillary incisors, as well as maxillary inter-first-premolar and inter-first-molar arch widths as specified by Pont. The correlation coefficients between the sum of incisors(SI) and upper dental arch width were calculated. The differences between predicted width and actual width were classified as overestimated, properestimated, and underestimated. The data obtained from each group were analyzed for statistical differences. The results were as follows : 1. Upper dental arch width indices were calculated from SI in normal occlusion (81.96 : premolar index, 62.55 : molar index). 2. Low correlations between SI and arch width were noted in normal occlusion (0.50 in the inter-premolar width, 0.39 in the inter-molar width). 3. Pont's formula and Schmuth's formula tended to overestimate the inter-premolar width. A more even distribution of estimates was noted in Cha's fomula. 4. Cases within $\pm$1 mm range of observed inter-premolar width were $45\%$ in the Cha's formula, $40\%$ in the Pont's formula, and $39\%$ in the Schmuth's formula. 5. All formulae had a tendency to underestimate the inter-molar width, but Cha's formula had better predictability than others. 6. Cases within $\pm$1 mm range of observed inter-molar width were $40\%$ in the Cha's formula, $29\%$ in the Pont's formula, and $13\%$ of Schmuth's formula. The data presented in this study does not support the clinical usefulness of ideal arch width prediction methods using the mesiodistal width of maxillary incisors.

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Rationale and criteria for excellent finishing (양호한 Finishing을 위한 이론적 근거 및 기준)

  • Ryu, Young-Kyu;Kim, Young-Joon
    • The korean journal of orthodontics
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    • v.29 no.6 s.77
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    • pp.637-648
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    • 1999
  • Finishing is usually accomplished about four to seven months before the removal of orthodontic appliance in order to achieve ideal occlusion and excellent aesthetics. This process, called finishing, is the key to obtain excellent final results. Some of orthodontists believe it can be accomplished at the final stage of orthodontic treatment, and they complete it without their special rationale and criteria for finishing. However, it should be considered as a part of the total treatment plan from the beginning to end, and a guideline for finishing, which is based on rationale and criteria for the removal of orthodontic appliance, is needed to obtain the desired results. The guideline should include a checklist for finishing. This checklist is divided into four categories: occlusal, aesthetic, periodontal, and habitual factors. Occlusal fators include alignment, marginal ridge discrepancy, interproximal contact, anterior inclination, posterior inclination, over-jet over-bite, arch fen and functional occlusion. Aesthetic factors include gingival form, crown fen crown width, and crown length. Periodontal factors include root angulation, bone level, and black hole in periodontal factors. Habitual factors consist of mouth breathing, tongue position at rest, tongue thrust, lip biting, nail biting, and finger sucking

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The establishment of orthodontic web server multimedia database system for continuing education (임상교정 교육용 멀티미디어 데이터베이스 웹서버 구축에 관한 연구)

  • Park, Jae-Woo;Lee, Jong-Ki;Chang, Young-Il;Nahm, Dong-Suk;Kim, Myung-Ki;Yang, Won-Sik;Kim, Tae-Woo;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.30 no.2 s.79
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    • pp.245-260
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    • 2000
  • The Objective of this research was to construct the multimedia database system that was necessary for the education of the practitioners and the students. To establish this system, there were technical problems as follows 1) The processing of the images, 2) The rapid processing of the information with the computer network, 3) The development of diagnosis tools, 4) The technique to establish the database system, 5) The link between the database system and the internet, and 6) The method to educate through many cases. The analysis for diagnosis and treatment planning were provided as two parts : model analysis and cephalometric analysis. As a model analysis, arch length discrepancy and Bolton tooth ratio were provided for the part of patient information. Cephalometric analyses were provided in the part of initial diagnosis. The Cephalometric analysis ver 2.0 and the PowerCeph pro 3.3.5 were used to show Tweed, Steiner and Jarabak analysis. In the main part, Kim's analysis and some measurements were added. In the post-treatment or retention part, we show the superimposition of the cephalometrics with which you can find the effectiveness of the various orthodontic treatment The address of this home page is "http://damis.snu.ac.kr/orthodontics"

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The Improvement and Completion of Outcome index: A new assessment system for quality of orthodontic treatment

  • Hong, Mihee;Kook, Yoon-Ah;Kim, Myeng-Ki;Lee, Jae-Il;Kim, Hong-Gee;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.46 no.4
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    • pp.199-211
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    • 2016
  • Objective: Given the considerable disagreement between the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation, we aimed to develop a novel assessment system-the Improvement and Completion of Outcome (ICO) index-to evaluate the outcome of orthodontic treatment. Methods: Sixteen criteria from 4 major categories were established to represent the pretreatment malocclusion status, as well as the degree of improvement and level of completion of outcome during/after treatment: dental relationship (arch length discrepancy, irregularity, U1-SN, and IMPA); anteroposterior relationship (overjet, right and left molar position, ANB); vertical relationship (anterior overbite, anterior open-bite, lateral open-bite, SN-MP); and transverse relationship (dental midline discrepancy, chin point deviation, posterior cross-bite, occlusal plane cant). The score for each criterion was defined from 0 or -1 (worst) to 5 (ideal value or normal occlusion) in gradations of 1. The sum of the scores in each category indicates the area and extent of the problems. Improvement and completion percentages were estimated based on the pre- and post-treatment total scores and the maximum total score. If the completion percentage exceeded 80%, treatment outcome was considered successful. Results: Two cases, Class I malocclusion and skeletal Class III malocclusion, are presented to represent the assessment procedure using the ICO index. The difference in the level of improvement and completion of treatment outcome can be clearly explained by using 2 percentage values. Conclusions: Thus, the ICO index enables the evaluation of the quality of orthodontic treatment objectively and consecutively throughout the entire treatment process.

Stability of bimaxillary surgery involving intraoral vertical ramus osteotomy with or without presurgical miniscrew-assisted rapid palatal expansion in adult patients with skeletal Class III malocclusion

  • Ahn, Yoon-Soo;Choi, Sung-Hwan;Lee, Kee-Joon;Jung, Young-Soo;Baik, Hyoung-Seon;Yu, Hyung-Seog
    • The korean journal of orthodontics
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    • v.50 no.5
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    • pp.304-313
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    • 2020
  • Objective: The aim of this study was to evaluate the stability of bimaxillary surgery involving bilateral intraoral vertical ramus osteotomy performed with or without presurgical miniscrew-assisted rapid palatal expansion (MARPE) in adult patients with skeletal Class III malocclusion. Methods: A total of 40 adult patients with skeletal Class III malocclusion were retrospectively divided into two groups (n = 20 each) according to the use of MARPE for the correction of transverse maxillomandibular discrepancy during presurgical orthodontic treatment. Serial lateral cephalograms and dental casts were analyzed until 6 months after surgery. Results: Before presurgical orthodontic treatment, there was no significant differences in terms of sex and age between groups. However, the difference of approximately 3.1 mm in the maxillomandibular intermolar width was statistically significant (p < 0.001). Two days after surgery, the mandible had moved backward and upward without any significant intergroup difference. Six months after surgery, the maxillary intercanine (2.7 ± 2.1 mm), interpremolar (3.6 ± 2.4 mm), and intermolar (2.0 ± 1.3 mm) arch widths were significantly increased (p < 0.001) relative to the values before presurgical orthodontic treatment in the MARPE group; these widths were maintained or decreased in the control group. However, there was no significant difference in surgical changes and the postsurgical stability between the two groups. No significant correlations existed between the amount of maxillary expansion and postsurgical mandibular movement. Conclusions: MARPE is useful for stable and nonsurgical expansion of the maxilla in adult patients with skeletal Class III malocclusion who are scheduled for bimaxillary surgery.

Surgical and Orthognathic Treatment of Skeletal Class III Featuring Severe Transversal and Sagittal Discrepancy: A Case Report (심한 상하악 치열궁 부조화 환자의 수술적 해결: 증례보고)

  • Ryu, Kyung-Sun;Lee, Baek-Soo;Kim, Yeo-Gab;Kwon, Yong-Dae;Choi, Byung-Joon;Ohe, Joo-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.2
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    • pp.124-129
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    • 2013
  • Multiple segment osteotomy orthognathic surgery serves to combine the total or segmental maxillary and mandibular correction of the dentofacial deformities with concurrent procedures to provide immediate repositioning to the dento-osseous elements. In addition, splitting the palate may often be necessary to correct a functionally poor relationship of the maxilla to the mandible or the facial skeleton by realigning the maxillary arch. In this case, the discrepancy in a bimaxillary horizontal relationship and the space between the 2nd premolar and 2nd molar was retained after lengthy preoperative orthodontic treatment. However, we could correct these dento-osseous discrepancies immediately by performing midpalatal expansion, anterior segmental osteotomy and symphyseal osteotomy with bimaxillary osteotomies. If the blood supply to each segment segments was maintained and primary closure of the operation site was feasible, multiple segment osteotomy was considered as a very effective technique for treating dentofacial deformities in vertical, transverse, and sagittal dimensions with differential repositioning of all segments.

Malocclusion with Congenital Missing of Lower Incisors (하악 전치의 선천적 결손을 동반한 부정 교합의 치험례)

  • Kim, Kyung-Ho;Choy, Kwang-Chul;Chung, Kil-Yong;Yun, Hee-Sun
    • The korean journal of orthodontics
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    • v.28 no.6 s.71
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    • pp.981-989
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    • 1998
  • Positions, angulation and mesiodistal dimension of lower incisors are important in esthetics, occlusion and post-treatment stability of tower arch. When lower incisor is congenitally missing, problems such as increased overjet and overbite, closing in of adjacent teeth and size/space discrepancies may occur. When creating treatment plans, incisor position and angulation, lip support, anteroposterior skeletal relationship canine-molar relationship, overjet overbite, remaining growth potential, crowding and anterior tooth ratio have to be considered. For an accurate analysis of incisal size discrepancy, diagnostic model set-up may be helpful. The two patients in this presentation both had two lower incisor missing, but the degree of crowding, skeletal relationship, lip support, molar relationship are different and therefore treatment plan was different as well. Long term follow-up may be necessary for stability and retention.

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TREATMENT OF TRANSVERSE DEFICIENCY WITH SURGICALLY ASSISTED RAPID PALATAL EXPANSION IN AN OPEN BITE PATIENT SHOWING PSEUDOMACROGLOSSIA (상대적 거대설을 보이는 전치부 개방교합 환자의 외과적 급속 구개확장술을 통한 횡적 부조화의 치험례)

  • Kim, Yoon-Ji;Lee, Kyu-Hong;Park, Jun-Woo;Rhee, Gun-Joo;Cho, Hyung-Jun;Park, Yang-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.376-382
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    • 2008
  • Anterior open bite is a condition in which maxillary and mandibular incisors do not occlude at central occlusion. It is a vertical discrepancy of the jaws and dental arches that has many etiologic factors making it difficult in diagnosis, treatment and prediction of prognosis. One of the causes of open bite is abnormal size and shape of the tongue. Macroglossia, a condition in which tongue is oversized, is caused by several factors which are not clearly identifiable, and it may be a major factor of anterior and posterior open bite. Macroglossia is subdivided into true, functional and pseudomacroglossia depending on its relative size in the oral cavity. In this case report, a patient was diagnosed as skeletal Class II with pseudomacroglossia, and was treated with SARPE in order to expand the narrowed maxillary arch and Quad helix for the mandibular arch. As a result the transverse deficiency was treated. In the adult patients where no skeletal growth is expected, SARPE has shown to be effective in treating maxillomandibular transverse discrepancies in which macroglossia was accompanied as in this case.