• The korean journal of orthodontics
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• v.28 no.1 s.66
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• pp.75-83
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• 1998

This study was done to recognize the importance of errors in measurements of cephalometric radiograph and to find the anatomical structures those need special care to select as a reference points through the detection of the systematic errors and estimation of random errors. For this purose, 100 cephalometric radiographs were prepared by usual manner and 61 reference points, and 130 measurement variables were established. Measurement errors were detected and estimated by the comparison of the 25 randomly-selected samples for repeated measurements with the main sample. The following results were obtained : 1. In comparison of the repeated measurements, there were statistical significant differences in 24 variables which were 18.4% of 130 total variables. 2. The frequency of the difference in identification of the reference points between the repeated measurements was very high in the root apex of upper incisor(as), the most posterior wall of maxilla(tu), soft tissue nasion(n'), soft tissue frontal eminence(ft), and ad3 in airway. 3. After correction of reference points marking until the level of below 5% significance, the range of random errors were from 0.67 to 1.71 degree or mm. 4. The variable shown the largest random error was the interincisal angle(ILs-ILi). 5. Measurement errors were mainly caused by the lack of precision in anatomic definitions and obscure radiographic image. From the above results, the author could find the high possibility of errors in cephalometric measurements and from this point, we should include error analysis in all the studies concerning measurments. In is essential to have a concept of error analysis not only for the investigator but also for a reader of other articles.

• The korean journal of orthodontics
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• v.29 no.5 s.76
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• pp.575-587
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• 1999

This study was designed to evaluate the correlations between tongue with skeletal pattern and intermaxillary space in Class II malocclusion adult patients. Craniofacial skeletal pattern was analyzed on the lateral cephalometric radiograph and the subjects were devided two groups by facial ratio, the 30 subjects of hyperdivergent group and the 30 subjects of hypodivergent group. The size and posture of tongue and intermaxillary space were measured on the lateral cephalometric radiograph. These data were statistically analyzed to examine significant differences between both groups and compared the correlation between tongue with skeletal measurements and intermaxillary space in each group. The results of this study were as follows. 1. In comparison of the tongue and intermaxillary space, the measurement of TS/IS showed significantly larger in hyperdivergent group and PIH and IS showed significantly larger in hypodivergent group. There were no statistically significant differences in the measurements of the height and posture of tongue. 2. In correlation between tongue with craniofacial skeletal measurements, the length and height of tongue showed the highest correlation with AFH(anterior facial height) in both groups(p<0.01). And that measurements showed high correlation with PFH(posterior facial height) in hypodivergent group. 3. In both groups, most measurements of tongue showed high correlation with intermaxillary space and the height and space of tongue showed high correlation with AIH and PIH(p<0.01).

• The korean journal of orthodontics
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• v.24 no.1 s.44
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• pp.161-180
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• 1994

This study was performed to investigate the midline having the least difference between the right and left structure among the lines that had been used in the submentovertex analysis and secondarily to know the distribution of asymmetry and it's degree existed normal persons and asymmetric patients. The subjects consisted of 40 normal adult patients and 40 asymmetric adult patients. The computerized analyses from submentovertex cepholometric radiograph were carried out. The results were as follows : 1. The right and left difference of the perpendicular bisecting line between right and left foramen spinosum was larger than the other midlines in the anterior area and it was decreased gradually as it progressed posteriorly. Specially the difference of this line was the smallest in the area where there was foramen spinosum. 2. The right and left difference of the perpendicular line through crista gali to the line between right and left foramen spinosum was smaller than the other midlines in the anterior area and it was increased gradually as it progressed posteriorly. 3. The right and left difference of the line between crista gali and anterior process of atlas was constant and smaller than the other midlines. 4. Asymmetry was a common finding in both normal and asymmetry group and left or right dominance of asymmetry was not statistically singnificant. 5. When the analyses were undertaken after submentovertex radiogram was divided into cranial base, upper face and lower face, the more inferior part showed relative asymmetry than the more superior part.

• The korean journal of orthodontics
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• v.36 no.1 s.114
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• pp.74-83
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• 2006

Analysis of lateral cephalometric radiograph (cephalogram) has been used routinely to evaluate skeletal and dental relationships, but analysis of the lateral facial photograph has not been used frequently for evaluation of skeletal relationships. As concerns about harm of X-ray irradiation increases, this study was planned to evaluate the possibility of substituting analysis of the lateral cephalogram with analysis of the lateral facial photograph by comparing these two analyses. According to the ANB values from cephalometric analysis, subjects were divided into three groups: Class I malocclusion group (n=32). Class II malocclusion group (n=32), and Class III malocclusion group (n=31). After measurements of angles indicating horizontal and vertical relationships of the maxilla and mandible on the lateral cephalograms and photographs, differences between Class I, II and III groups were evaluated. To evaluate the similarity between two similar values in the cephalograms and photographs, t-test using standardized variable Z and correlation analysis were performed in the Class I malocclusion group. The results showed that 1) SnN'Pg' on the photograph can be used to evaluate the antero-posterior relationship of the maxilla and mandible (ANB), 2) N'-Sn/Sn-Pg' on the photograph can be used to evaluate facial convexity (NA/APg), 3) Sn-Tra-Me' on the photograph can be used as a measurement similar to FMA. In conclusion, partly substituting lateral cephalogram analysis with lateral facial photograph analysis was possible in the evaluation of the maxilla and mandible.

• The korean journal of orthodontics
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• v.27 no.2
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• pp.245-258
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• 1997

Cephalometric radiographs, frontal photographs and profile silhouette phogographs of 68 young adult female who were model or were recommended to have esthetic face were used in this study. 7 Students in department of Art of Kyungpook national university and 15 orthodontists estimated profile slides which were made of 3 Profile silhouettes in parallel with FH plane. Profile silhouettes were made of soft tissue profile line of cephalometric radiograph. Only orthodontists estimated frontal photographs. Students and orthodontists score 9 in excellent case, score 7 in good case, score 5 in average case, score 3 in poor case. Correlation analysis between orthodontists' esthetic concept and Artists' esthetic concept, between frontal view esthetics and profile view esthetics which estimated by orthotontists, between profile view esthetics and profile measurements which consisted of measurements of 38 female who were scored above 5 mean score in profile silhouette by orthodontists were done. And the finding in this study indicated the following 1. Correlation between orthodontists' esthetic concept and Artists' esthetic concept in profile silhouette was significant (r=0.67,P=0.0001). 2. Correlation between frontal view esthetics and profile view esthetics which estimated by orthodontist was significant (r=0.26,P=0.0381). 3. Measurements which had significant correlation between profile measurements and profile view esthetics wer Na-Pog, to N', BNV to Pog', BNV/B' -Pog', Ls-Li-Pog', Li-B'-Pog' Z angle(P<0.05). 4 Mean and standard deviation of profile measurements of 38 female were obtained.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.3
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• pp.337-342
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• 2000

Purpose : The purpose of this study was to analyze the lower third facial changes in frontal view after mandibular setback surgery. Materials and Methods : In this study, fifteen subjects(6 males and 9 females) with class III dental and skeletal malocclusions who were treated with BSSRO(Bilateral Sagittal Split Ramus Ostetomy) were used. Frontal cephalometric radiographs were taken preoperatively and more than 6 months postoperatively, and hard tissue(H2-Hl) and soft tissue changes (S2-S1) were measured on vertical and horizontal reference lines. In 15 cases, changes which developed more than 6 months after surgery were studied. Results : The results were as follows. 1. In the facial height, hard tissue $decreased(2.46{\pm}2.76mm)$ with statistical significance(P<0.01), and soft tissue also $decreased(1.64{\pm}3.66mm)$. As a result, the facial height generally becomes shorter after sagittal split ramus osteotomy. 2. In the mandibular width, hard tissue $decreased(2.08{\pm}3.59mm)$ with statistical sgnificance(P<0.05), but soft tissue $increased (2.14{\pm}5.73mm)$ without statistically significant difference(P>0.05) postoperatively. 3. In the facial index, hard tissue $decreased(0.23{\pm}2.21%)$, but soft tissue $increased(2.41{\pm}3.46%)$ with statistical significance. Conclusion : One of the main purpose of orthognathic surgery is to achieve facial esthetics and harmony. In order to fullfill this purpose, it is important to carry out a precise presurgical treatment planning by estimating the changes of frontal profile after surgery.

• The korean journal of orthodontics
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• v.36 no.3 s.116
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• pp.218-227
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• 2006

Although the submentovertex radiograph and surface EMG are not often used due to the difficulty of interpretation, they are accepted as useful diagnostic and analytic aids for skeletal asymmetry. There have been reports which state that they were also useful for the evaluation of vertical skeletal relations. The purpose of this study was to evaluate the correlations between EMG data, measurements from submentovertex radiographs, facial types and facial asymmetry following examination of 60 asymmetric patients. The radiographic corpus length were greater in the nonaffected sides (p<0.001), gonion to interspinosum axis were greater in the affected sides and the mandibular condyle and gonion were located more anteriorly in the non-affected sides than in the affected sides but not significant (p=0.07). The activity of the anterior temporal muscle in rest position was higher in the affected sides than in the non-affected sides (p<0.01). The activity of the masseter muscle at maximum clenching was found to be nonsignificant but it was higher in the affected sides than in the non-affected sides (p=0.09). There was positive correlation between facial index and the intercondylar axes angle (p<0.01). There was positive correlation between masseter muscle activity in maximum occlusion and facial index in the affected and non-affected sides (p<0.05). The results demonstrate that the submentovertex radiograph and EMG can provide useful information for the evaluation of horizontal and vertical skeletal relations.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.29 no.2
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• pp.387-396
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• 1999

In dentistry. RadioVisioGraphy was introduced as a first electronic dental x-ray imaging modality in 1989. Thereafter. many types of direct digital radiographic system have been produced in the last decade. They are based either on charge-coupled device(CCD) or on storage phosphor technology. In addition. new types of digital radiographic system using amorphous selenium. image intensifier etc. are under development. Advantages of digital radiographic system are elimination of chemical processing, reduction in radiation dose. image processing, computer storage. electronic transfer of images and so on. Image processing includes image enhancement. image reconstruction. digital subtraction, etc. Especially digital subtraction and reconstruction can be applied in many aspects of clinical practice and research. Electronic transfer of images enables filmless dental hospital and teleradiology/teledentistry system. Since the first image management and communications system(IMACS) for dentomaxillofacial radiology was reported in 1992. IMACS in dental hospital has been increasing. Meanwhile. researches about computer-assisted diagnosis, such as structural analysis of bone trabecular patterns of mandible. feature extraction, automated identification of normal landmarks on cephalometric radiograph and automated image analysis for caries or periodontitis. have been performed actively in the last decade. Further developments in digital radiographic imaging modalities. image transmission system. imaging processing and automated analysis software will change the traditional clinical dental practice in the 21st century.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.17.1-17.5
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• 2019

Background: Class II malocclusion patients with hyperdivergent facial types are characterized by short mandibular body lengths and anterior open bite. Accordingly, the treatment for hyperdivergent skeletal class II malocclusion is a lengthening of the mandibular body length and a counterclockwise rotation of the mandible. To prevent post-operative relapse, botulinum toxin-A (BTX-A) injection can be a retention modality. Case presentation: A class II open-bite patient received BTX-A injection to the anterior belly of her digastric muscle for the prevention of post-operative relapse. The relapse was evaluated via a clinical examination and a lateral cephalometric radiograph after the completion of post-surgical orthodontic treatment. The patient showed stable occlusion without any signs of relapse at 15 months post-operatively. Conclusion: In this case presentation, a single injection into the anterior belly of the digastric muscle was sufficient for the prevention of post-operative open bite.

• Journal of Oral Medicine and Pain
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• v.36 no.1
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• pp.39-51
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• 2011

The aims of this study were to investigate whether the facial skeletal patterns previously reported to be related to temporomandibular disorder (TMD) in other studies could be consistently observed in the TMD patients diagnosed according to Research Diagnostic Criteria for Temporomandibular Disorder (RDC/TMD) Axis I and evaluate its usability in the orthodontic clinics to examine the patients with TMD related symptoms. The clinical records and radiographs of female patients who visited the TMD and Orofacial Pain Clinic of Seoul National University Dental Hospital and were diagnosed as TMD were consecutively filed for this study. Patients were clinically examined and diagnosed according to the revised diagnostic algorithms of RDC/TMD Axis I and the lateral cephalogram, panoramic orthopantomogram, temporomandibular joint (TMJ) orthopantomogram, and transcranial radiograph of each patient were taken and digitalized. The data of patients who were under 18 years of age or had any systemic disease, trauma history involving the TMJ, or skeletal deformity at the time of the first examination were excluded. The remaining data of 96 female patients were finally analyzed. The obtained results were as follows: 1. There are no significant differences of cephalometric measurements between RDC I (muscle disorders) diagnostic groups. 2. Only the articular angle of the RDC group IIc (disk displacement without reduction without limited opening) patients was larger than patients of the no diagnosis of RDC II group (disk displacement). 3. Larger articular angle and smaller facial height ratio were observed in RDC IIIc group (osteoarthrosis) compared to IIIa group (arthralgia). Larger articular angle, larger Bjork sum, smaller posterior facial height, and smaller facial height ratio were observed in RDC group IIIc compared to no diagnosis of RDC III group (arthralgia, arthritis, and arthrosis). 4. According to the results of cephalometric analysis in simplified RDC groups, smaller overjet was observed in muscle disorders (MD) group. Facial height ratio and IMPA were smaller and articular angle was larger in disk displacements (DD) group than in no diagnosis of DD group. In arthrosis (AR) group, posterior facial height, and facial height ratio were smaller, and articular angle, gonial angle, facial convexity, FMA, Bjork sum, and ANB were larger than in no diagnosis of AR group. In joint pain (JP) group, only posterior facial height was smaller than no diagnosis of JP group. In conclusion, Facial morphologic patterns showing posterior-rotated mandible and lower posterior facial height is related to RDC group II and III diagnosis of the TMJ in female TMD patients. RDC/TMD Axis I diagnosis can provide a good clinical diagnostic tool for the standardized examination of the TMJ in orthodontic clinics.