• Title/Summary/Keyword: Craniofacial

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Development of 3D statistical mandible models for cephalometric measurements

  • Kim, Sung-Goo;Yi, Won-Jin;Hwang, Soon-Jung;Choi, Soon-Chul;Lee, Sam-Sun;Heo, Min-Suk;Huh, Kyung-Hoe;Kim, Tae-Il;Hong, Helen;Yoo, Ji-Hyun
    • Imaging Science in Dentistry
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    • v.42 no.3
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    • pp.175-182
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    • 2012
  • Purpose: The aim of this study was to provide sex-matched three-dimensional (3D) statistical shape models of the mandible, which would provide cephalometric parameters for 3D treatment planning and cephalometric measurements in orthognathic surgery. Materials and Methods: The subjects used to create the 3D shape models of the mandible included 23 males and 23 females. The mandibles were segmented semi-automatically from 3D facial CT images. Each individual mandible shape was reconstructed as a 3D surface model, which was parameterized to establish correspondence between different individual surfaces. The principal component analysis (PCA) applied to all mandible shapes produced a mean model and characteristic models of variation. The cephalometric parameters were measured directly from the mean models to evaluate the 3D shape models. The means of the measured parameters were compared with those from other conventional studies. The male and female 3D statistical mean models were developed from 23 individual mandibles, respectively. Results: The male and female characteristic shapes of variation produced by PCA showed a large variability included in the individual mandibles. The cephalometric measurements from the developed models were very close to those from some conventional studies. Conclusion: We described the construction of 3D mandibular shape models and presented the application of the 3D mandibular template in cephalometric measurements. Optimal reference models determined from variations produced by PCA could be used for craniofacial patients with various types of skeletal shape.

The effects of different pilot-drilling methods on the mechanical stability of a mini-implant system at placement and removal: a preliminary study (인조골에서 식립 방법이 교정용 미니 임플란트의 기계적 안정성에 미치는 영향에 대한 예비연구)

  • Cho, Il-Sik;Choo, Hye-Ran;Kim, Seong-Kyun;Shin, Yun-Seob;Kim, Duck-Su;Kim, Seong-Hun;Chung, Kyu-Rhim;Huang, John C.
    • The korean journal of orthodontics
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    • v.41 no.5
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    • pp.354-360
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    • 2011
  • Objective: To investigate the effects of different pilot-drilling methods on the biomechanical stability of self-tapping mini-implant systems at the time of placement in and removal from artificial bone blocks. Methods: Two types of artificial bone blocks (2-mm and 4-mm, 102-pounds per cubic foot [102-PCF] polyurethane foam layered over 100-mm, 40-PCF polyurethane foam) were custom-fabricated. Eight mini-implants were placed using the conventional motor-driven pilot-drilling method and another 8 mini-implants were placed using a novel manual pilot-drilling method (using a manual drill) within each of the 2-mm and 4-mm layered blocks. The maximum torque values at insertion and removal of the mini-implants were measured, and the total energy was calculated. The data were statistically analyzed using linear regression analysis. Results: The maximum insertion torque was similar regardless of block thickness or pilot-drilling method. Regardless of the pilot-drilling method, the maximum removal torque for the 4-mm block was statistically higher than that for the 2-mm block. For a given block, the total energy at both insertion and removal of the mini-implant for the manual pilot-drilling method were statistically higher than those for the motor-driven pilot-drilling method. Further, the total energies at removal for the 2-mm block was higher than that for the 4-mm block, but the energies at insertion were not influenced by the type of bone blocks. Conclusions: During the insertion and removal of mini-implants in artificial bone blocks, the effect of the manual pilot-drilling method on energy usage was similar to that of the conventional, motor-driven pilot-drilling method.

Cephalometric Characteristics of the Patients with Developed Anterior Open Bite Following Anterior Disc Dislocation without Reductions (비정복성 관절원판 전위와 연관되어 발생된 전치부 개교합 환자의 측방 두부방사선 계측)

  • Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.31 no.3
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    • pp.255-263
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    • 2006
  • Objectives: This article reported three patients developed anterior open bite seemed to be related to TMJ anterior disc dislocation without reduction(ADD WO R), but no evidence of condylar destructive or collapse and analyzed the craniofacial skeletal structure by means of cephalometric analysis. Results: All patients suddenly developed a centric relation/centric occlusion discrepancy, an increased overjet and an anterior open bite following ADD WO R. All patients had Angle's Class I occlusion and shallow bite, but they had skeletally Class III and Class II pattern and all were vertically significant hyperdivergent type. Conclusions: These 3 patients had characteristics of common facial morphology including:(1)Angle classification Class I and shallow bite,(2)high mandibular plane angle,(3)high gonial angle. Developed anterior open bite resulted from clockwise rotation of the mandible related TMJ ADD WO R, rather than a result from the eruption of posterior teeth. We hypothesize rotation may relate to attached direction of masticatory muscle.

A ROENTGENOCEPHALOMETRIC STUDY OF THE PHARYNX AND CRANIOFACIAL SKELETON IN KOREAN (인두와 두개안면골격에 관한 방사선학적 연구)

  • Kang Wou Ghon;Lee Sang Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.12 no.1
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    • pp.81-103
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    • 1982
  • The aim of this study was to investigate the variation in shape, size and area of the pharynx and adenoids, and to analyze the relationship between pharyngeal cavity and upper facial cranium which effected on morphology of those parts in Korean. Age changes and sex differences in those areas were comprised in this study. Materials included 272 lateral cephalograms, which were divided into 4 groups by age; (1) 7-year-old group consisted of 29 males and 30 females, (2) 12-year-old group consisted of 30 males and 30 females, (3) 17-year-old group consisted of 30 males and 40 females, (4) 20-year-old group consisted of 37 males and 46 females. In subjects each variable was measured and evaluated statistically introducing 17 reference points and 17 reference lines respectively. Conclusions from this study were as follows. 1. Linear measurements of the bony nasopharynx revealed that the depth and height were larger in male than those in female in 17 and 20-year-old groups. 2. Linear measurements of the upper facial cranium were larger in male than those in female in all age groups. 3. Angular measurements of the bony nasopharynx and upper facial cranium did not show, on an average, sex differences in each age group. 4. As regards area of the bony nasopharynx, it increased gradually with age in both sexes. And the area was greater in male than that in female in 17 and 20-year old groups. 5. There were sex differences in area of the adenoids of which the area was larger in male than that in female in 17 and 20-year-old groups. And the area reached a peak at 17-year-old group in male and at 12 year-old group in female. 6. Area of the pharyngeal cavity increased gradually with age in both sexes, but no sex differences were noted in each age group. 7. Rate of area of the adenoids to that of the pharyngeal cavity decreased continually with age, and no sex differences were noted in all age groups. 8. In amounts and its differences of the growth, there were sex differences in the posterior upper facial height, and were not in area of the bony nasopharynx, pharyngeal cavity and adenoids in each age group.

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THE USE OF DISTRACTION OSTEOGENESIS TO TREAT HEMIFACIAL MICROSOMIA: A CASE REPORT (반안면 왜소증 환자에서의 골신장술: 증례보고)

  • Baik, Sung-Mun;Kim, Su-Gwan;Kim, Hak-Kyun;Moon, Seong-Yong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.559-566
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    • 2007
  • Distraction osteogenesis(DO) is a surgical method of bone formation that involves an osteotomy and sequential stretching of the healing callus by gradual movement and subsequent remodeling. DO is used to correct facial asymmetry, such as in patients with hemifacial microsomia, maxillary or mandibular retrusion, cleft lip and palate, alveolar defects, and craniofacial deficiency. It is accomplished with the aid of a distraction device, which is secured with screws placed directly into bone, for a predetermined length of time. Hemifacial microsomia is characterized by unilateral facial hypoplasia, often with unilateral shortening of the mandible and subsequent malocclusion. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, tilted occlusal plane, and short mandible. Early treatment is necessary to avoid subsequent impaired midfacial growth. The standard treatment of these malformations consists of the application of bone grafts, which can lead to unpredictable growth. The new bone-lengthening procedure represents a limited surgical intervention and opens up a new perspective for treatment, especially in younger children with severe deformities. This report describes a case of hemifacial microsomia(Type-II left-sided hemifacial microsomia). The patient, a 10-year-old child, visited our clinic for facial asymmetry correction. He had a hypoplastic mandible, displaced ear lobe, 10 mm canting on the right side, and malocclusion. We planned DO to lengthen the left mandible in conjunction with a Le Fort I osteotomy for decanting and then perform a right intraoral vertical ramus osteotomy(IVRO). Progressive distraction at a rate of 0.5 mm/12 hours was initiated 7 days postoperatively. The duration of DO was 17 days. The consolidation period was 3 months. Satisfactory results were obtained in our case, indicating that DO can be used successfully for functional, aesthetic reconstruction of the mandible. We report a case involving DO in conjunction with orthognathic surgery for correcting mandibular hypoplasia with a review of the literature.

Lip Closing Force and the Related Factors in Elementary School Children (초등학교 어린이의 평균 구순폐쇄력과 이에 영향을 미치는 요소)

  • Lee, Haney;Baek, Kyounghee;Kim, Jaegon;Lee, Daewoo;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.4
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    • pp.343-352
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    • 2019
  • Abnormal orofacial functions such as lip incompetency in the period of growth and development can cause morphological anomalies of the craniofacial complex. Therefore, it is crucial to make an early diagnosis based on the evaluation of the myofunctional conditions, and to make appropriate treatment plans. The objectives of this study were to quantitatively evaluate the standard lip closing force (LCF) of each age in the elementary school children, and to evaluate the relationships between LCF and affecting factors. The sample consisted of 765 children who were 7 - 12 years old in Jeonju city. Clinical examination about occlusal conditions and lip competency, and LCF measurement were performed by a single examiner. LCF was measured three times for each children with the LCF measuring device. The LCF was correlated positively with age in both sexes. The distribution of LCF groups was correlated significantly with Angle's classes and lip competency (p = 0.016, 0.004). The proportion of children with high LCFs was greater in the "competent lip" group, whereas the proportion of those with low LCFs was greater in the "incompetent lip" group.

Anthropometric Analysis of Frontal Sinus Using 3D CT in Koreans (한국인 성인 남녀에서 3차원 전산화단층촬영술을 이용한 전두동의 형태학적 연구)

  • Shim, Byung-Kwan;Kim, Jun-Hyuk;Shin, Ho-Seong;Lee, Young-Man
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.594-601
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    • 2011
  • Purpose: The frontal sinuses are a pair of triangularly shaped, air-filled chambers lined by mucoperiosteum and located between the inner and outer tables of the frontal bone. Until recently, our understanding of gender variations in craniofacial anatomy has been chiefly built upon anthropometric studies, which typically employ facial surface measurements or plain film radiography. The aim of this study i to determine the sizes of the frontal sinus in both sexes in Koreans. Methods: 95 Korean subjects who underwent maxillofacial 3-Dimensional computed tomography (CT) between January 2009 and December 2009 were enrolled. Frontal sinus dimensions and forehead measurements were taken at midline and at 10, 20, and 30 mm to the left and right of midline using sagittal, coronal, and axial images. The data was analyzed for significant differences between measurements made at the selected points in the frontal sinus, for left to right variations, for gender variations, and for racial differences. Results: The mean thickness of the anterior table ranged from 2.31 to 3.23 mm. Mean anteroposterior depth of the frontal sinus ranged from 7.38 to 9.45 mm and did not vary significantly at any distance from midline. Frontal sinus height was greatest at midline (mean=29.24 mm) and progressively lessened at lateral distances. Mean total width at the level of the supraorbital ridge was 53.66 mm. For all measurements, no significant left to right variation was noted. Comparing the sexes, males were found to have greater dimensions in most frontal sinus measurements, though these differences were only found to be significant at or close to midline. The male forehead was marked by more acute nasofrontal angle ($133.3^{\circ}$ versus $141.6^{\circ}$) and a steeper posterior forehead inclination ($14.9^{\circ}$ versus $7.7^{\circ}$). Conclusion: Using CT imaging, forehead and frontal sinus dimensions have been described. Generally, males had larger overall frontal sinus dimensions. And Korean had similar sized frontal sinus to Caucasian in height and width. But in AP distance Korean had lesser measurement. The result of this study may be helpful in the comprehension of normal size of frontal sinus in Korean.

Developmental Roles of D-bifunctional Protein-A Zebrafish Model of Peroxisome Dysfunction

  • Kim, Yong-Il;Bhandari, Sushil;Lee, Joon No;Yoo, Kyeong-Won;Kim, Se-Jin;Oh, Gi-Su;Kim, Hyung-Jin;Cho, Meyoung;Kwak, Jong-Young;So, Hong-Seob;Park, Raekil;Choe, Seong-Kyu
    • Molecules and Cells
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    • v.37 no.1
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    • pp.74-80
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    • 2014
  • The peroxisome is an intracellular organelle that responds dynamically to environmental changes. Various model organisms have been used to study the roles of peroxisomal proteins in maintaining cellular homeostasis. By taking advantage of the zebrafish model whose early stage of embryogenesis is dependent on yolk components, we examined the developmental roles of the D-bifunctional protein (Dbp), an essential enzyme in the peroxisomal ${\beta}$-oxidation. The knockdown of dbp in zebrafish phenocopied clinical manifestations of its deficiency in human, including defective craniofacial morphogenesis, growth retardation, and abnormal neuronal development. Overexpression of murine Dbp rescued the morphological phenotypes induced by dbp knockdown, indicative of conserved roles of Dbp during zebrafish and mammalian development. Knockdown of dbp impaired normal development of blood, blood vessels, and most strikingly, endoderm-derived organs including the liver and pancreas - a phenotype not reported elsewhere in connection with peroxisome dysfunction. Taken together, our results demonstrate for the first time that zebrafish might be a useful model animal to study the role of peroxisomes during vertebrate development.

Early Diagnosis of KBG Syndrome Using Diagnostic Exome Sequencing (Diagnostic exome sequencing을 통한 KBG 증후군의 조기 진단)

  • Hong, Jun Ho;Kim, Se Hee;Lee, Seung Tae;Choi, Jong Rak;Kang, Hoon Chul;Lee, Joon Soo;Kim, Heung Dong
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.272-275
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    • 2018
  • KBG syndrome is a rare neurodevelopmental disorder characterized by intellectual disability, skeletal anomalies, short stature, craniofacial dysmorphism, and macrodontia. ANKRD11 gene mutation and 16q24.3 microdeletion have been reported to cause KBG syndrome. Here, we report two patients with ANKRD11 mutations who initially presented with neurologic symptoms such as developmental delay and seizures. Patient 1 was a 23-month-old boy who presented with a global developmental delay. Language delay was the most dominant feature. He had hypertelorism, hearing impairment, and behavior problems characterized as hyperactivity. A c.1903_1907delAAACA (p.Lys635GInfsTer26) mutation in ANKRD11 was identified with diagnostic exome sequencing. Patient 2 was a 14-month-old boy with developmental delay and seizure. He also had atrial septum defect, and ventricular septal defect. Generalized tonic seizures began at the age of 8 months. Electroencephalography showed generalized sharp and slow wave pattern. Seizures did not respond to antiepileptic drugs. A loss of function mutation c.5350_5351delTC (p.ser1784HisfsTer12) in ANKRD11 was identified with diagnostic exome sequencing. In both cases, characteristic features of KBG syndrome such as short stature or macrodontia, were absent, and they visited the hospital due to neurological symptoms. These findings suggest that more patients with mild phenotypes of KBG syndrome are being recognized with advances in diagnostic exome sequencing genetic technologies.

DENTAL MANAGEMENT OF A PATIENT WITH MUSCULAR DYSTROPHY UNDER GENERAL ANESTHESIA: CASE REPORT (근이영양증(muscular dystrophy) 환자의 전신마취 하 치과치료 : 증례보고)

  • Chae, Jong Kyun;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.50-54
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    • 2019
  • Muscular dystrophy (MD) is a heterogeneous group of inherited neuromuscular disorders, characterized by progressive muscle weakness. Severity of the disease ranges from mild to severe, and the disease is mostly caused by mutations in a number of genes. These genetic mutations cause lack of proteins which are essential for muscle cell stability. Muscle fibers are gradually replaced by fat and fibrous tissue. The muscles of the head and neck are affected in several types of MD that manifest as altered craniofacial morphology and dental malocclusion. A 3-year-10-month old, 15.0 kg boy with MD presented to Seoul National University Dental Hospital, Seoul, South Korea because of extensive carious teeth. A number of dental caries in primary dentition were identified during clinical oral examination. Due to dental anxiety and underlying systemic disease, general anesthesia was considered. General anesthesia was induced and maintained with intravenous anesthetics, propofol and remifentanil. Caries treatments - resin restoration, pulpectomy, zirconia crown restoration, stainless steel crown restoration - were performed. Under general anesthesia, successful dental procedure was done. Total intravenous anesthesia (TIVA) was performed instead of inhalation anesthesia in order to avoid risk of complications such as malignant hyperthermia and life-threatening rhabdomyolysis. With decreasing muscle function, plaque control becomes more difficult and leads to gingivitis. Especially, the open-mouth posture worsens gingivitis and can leads to malocclusions and problems in swallowing. Regular and periodic dental care is essential for maintaining oral health for patients with MD.