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.
The change of the vertical dimension is of fundamental importance to the orthodontist. However, the choice between the two methods of treatment, extraction versus nonextraction, is not clear. It is not verified that the extraction method decreases vertical dimension, or nonextraction methods result in an increase in vertical dimension. The purpose of this study was to evaluate the changes of vertical dimension of face after the orthodontic treatment with standard edgewise technique, and to compare them in relation to facial types and bicuspid extraction. The subjects consisted of 165 orthodontic patients (77 of adolescents, 88 of adults), and was divided into vertical nonextraction (VN) group, vertical extraction (VE) group, horizontal nonextraction (HN) group, horizontal extraction (HE) group. Pre-and Post-treatment cephalograms were taken with standard method, traced, and digitized for each subject. The comparison of the measurements were statistically executed with Student's t-test. The results were as follows : 1. The facial height and molar height were increased after orthodontic treatment in the all groups. 2. No significant difference was found in the facial height change between the vertical and horizontal groups. 3. No significant difference was found in the facial height change between the extraction and nonextraction groups. 4. As the upper molars were extruded in adolescents group and lower molars were extruded in adults group, lower anterior facial height (LAFH) was increased. 5. None of the pretreatment variables correlates to the change of lower anterior facial height (LAFH).
Improvements in jaw relationship through clockwise rotation of the mandible may be desirable in some Class III patients with short low facial height. The aim of this study was to examine the treatment effect of face mask for Class III malocclusion patients according to their low facial morphology. Methods: Class III patients in their pubertal growth period were divided into two groups (Group 1, high LFH; Group 2, low LFH) according to lower facial height (LFH) by Ricketts (norm, 47). treatment changes between groups after face mask treatment was compared not only for hard tissue but also for soft tissue. Results: There were no significant differences between the two groups for the skeletal and soft tissues of the maxilla. There were no significant differences between the two groups for the skeletal posterior movement of the mandible, but posterior movement of the mandibular soft tissues in group 2 was larger than group 1. There were no significant differences between the two groups for the vertical hard tissue proportion changes of the mandible, but the vertical soft tissue proportion changes of the mandible in group 2 was larger than group 1. There was a significant correlation between the sagittal hard tissue and soft tissue changes of the maxilla and mandible, but there was no significant difference in the vertical changes. Conclusion: The clockwise rotation of the mandible occurred from use of the face mask, and posterior movement of soft tissues of the mandible was higher in Cl III patients with low LFH than with high LFH.
The purpose of this study was to find the characteristics of lateral crphalogram of skeletal class III malocclusion patients to whom orthognathic surgery was essential. For this study 37 patients with skeletal class III and going to treat or be treated orthognathic surgery(age 7-17) were selected to experimental group and 56 people with normal occlusion (age 8-13) were selected to normal group and the two groups were evaluated and statistically analyzed and the results were as follows 1. In comparison of experimental group and normal group in prepubertal group, there were significant differences in ANS-U1/Me-L1, Mx. Length/Mn. Length, S-N/Go-Me, Wits, ANB, SN-Pog, IMPA, Facial Convexity, APDI (p<0.05) 2. In comparison of experimental group and normal group in pubertal group, there were significant differences in ANS-U1/Me-L1, S-Go/N-Me, Mx.Length/Mn.Length, S-N/Go-Me, Wits, Saddle Angle, SNB, ANB, SN-Pog, IMPA, Interincisal Angle, Facial Convexity, APDI (p<0.05) 3. Among items showing characteristics of skeletal class III malocclusion, there were no significant differences between prepubertal group and pubertal group in other items except Mx. Length/Mn. Length,APDI (p<0.05) 4. The significant correlationship was the highest between Saddle Angle and SNB, SN-Pog and SNB, ANB and Facial Convexity in experimental group
Journal of the korean academy of Pediatric Dentistry
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v.47
no.1
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pp.17-24
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2020
The purpose of this study was to evaluate the accuracy and precision of the three-dimensional (3D) imaging system of children's facial soft tissue by comparing linear measurements. The subjects of the study were 15 children between the ages of 7 and 12. Twenty-three landmarks were pointed on the face of each subject and 16 linear measurements were directly obtained 2 times using an electronic caliper. Two sets of 3D facial images were made by the 3D scanner. The same 16 measurements were obtained on each 3D image. In the accuracy test, the total average difference was 0.9 mm. The precision of 3D photogrammetry was almost equivalent to that of direct measurement. Thus, 3D photogrammetry by the 3D scanner in children had sufficient accuracy and precision to be used in clinical setting. However, the 3D imaging system requires the subject's compliance for exact images. If the clinicians provide specific instructions to children while obtaining 3D images, the 3D device is useful for investigating children's facial growth and development. Also the device can be a valuable tool for evaluating the results of orthodontic and orthopedic treatments.
Objective: The aim of this study was to evaluate the volumes and areas of the upper airways in children with Class II malocclusion, using three dimensional cone-beam computed tomography (CBCT) and to compare the volumetric and cross-sectional measurements and cephalometric variables to investigate possible relationships between the upper airway and facial morphology. Methods: CBCT scans were obtained from 37 subjects (17 boys and 20 girls; average age, 11.02 years). The upper airway volumes and areas were measured, and compared with cephalometric variables. Results: The area of the PNS-posterior plane ($S_{PP}$) was significantly smaller in the Class II malocclusion group (p < 0.05). Also, the volumetric and cross-sectional measurements were lower in Class II than in Class I malocclusion groups, although the differences were not significant between the two groups (p > 0.05). The Class II malocclusion group showed significantly smaller values of PFH, mandibular body length, pog to N perp and showed larger values of FMA, ANB, and facial convexity than the Class I malocclusion group. The volume of the upper airway in front of PNS point (WN) showed negative correlation with ANB (p < 0.05). Conclusions: The Class II malocclusion group had a narrower upper airway associated with a decreased posterior facial height and a divergent growth pattern than the Class I malocclusion group.
Kim, Soo Young;Oh, Soo Min;Kim, Mi Jeong;Song, Eun Song;Kim, Young Ok;Choi, Young Youn;Woo, Young Jong;Hwang, Tai Ju
Clinical and Experimental Pediatrics
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v.52
no.2
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pp.242-246
/
2009
The clinical features of ring chromosome 13 include mental and growth retardation, CNS anomalies, facial dysmorphism, cardiac defects, genital malformations, limb anomalies, skeletal deformities and anal malformations. Although many cases of ring chromosome 13 have been reported worldwide, only 6 cases have been reported in Korea, and the latter cases were not mosaic but pure ring chromosome 13. Here we report a case with mosaic ring chromosome 13. The baby boy was born at 37 weeks of gestation by induced vaginal delivery due to intrauterine growth restriction (IUGR). He was the second baby of a 28-year-old hepatitis B carrier mother and a 32-year-old father. There was no family history of chromosomal anomalies. The baby was a symmetric IUGR with a birth weight of 1,860 g, length of 44.8 cm, and head circumference of 29.4 cm. The physical examination revealed microcephaly, trigonocephaly, flat occiput, large ears, short neck and dysmorphic facial features, including microophthalmia, hypertelorism, antimongoloid slanting palpebral fissures, a flat nasal bridge, and micrognathia. The karyotype of this patient performed by peripheral blood lymphocytes was 46,XY,r(13)(p13q34)/45,XY,-13/46,XY,dic r(13;13)(p13q34;p13q34). The baby showed failure to thrive, hypotonia, and developmental delay. We report the first case of mosaic ring chromosome 13 in a male baby in Korea and compare this case with other Korean cases of non-mosaic ring chromosome 13.
The present study has the purpose of investigating various growth and developmental aspects of rabbit snout with the aid of metallic implantation and of improving on the indirect method of growth and developmental studies of its skull. Sixty-eight growing albino rabbits were used. A head holder, film holder, cephalometer, metallic implanting device and implant materials were designed and constructed by the author. Eight metallic pins were implanted with a metallic implanting device in the rabbit snout under general anesthesia. Two metallic pins were implanted on each side of the interfrontal suture and another two were put on each side of the internasal suture near the frontonasal suture. Serial cephalograms were taken with a two-week interval, using the head holder, film holder and cephalometer. Eight items of linear measurement were obtained from the film. On the base of the results of the study, the following conclusions are obtained: 1. The metallic implant method is better than the other indirect methods for growth and developmental studies of the rabbit skull. 2. Most of the vertical growth of the rabbit snout is due to sutural growth at the frontonasal suture and the horizontal growth is at the interfrontal and the internasal suture. 3. The vertical growth of the rabbit snout is greater than the horizontal growth. 4. The horizontal growth of the rabbit snout is greater at the nasal bone than at the frontal bone. 5. The amount of vertical growth of the rabbit snout is almost same at inner and outer side of the interfrontal and internasal suture line, 6. Growth rate of the sutural growth of the rabbit snout tends to decrease by the growth of the rabbit. 7. Implant materials do not disturb growth and development of the rabbit snout, except a slight trauma effect during the first week of metallic implantation.
The purpose of this study was to evaluate the initial skeletal pattern and growth change of whom had responsed well to chincap therapy. 93 patients seleted for this study were in mixed dentition and treated with chincap for more than 2 years. And 54 subjects were selected from these total samples and classified into two groups by the improvement of four measurements : ANB difference, APDI, Wits appraisal, and AF-BF. One was good response group which consisted of 26 children and the other was poor response group with 19 patients. Various measures of the craniofacial structure in the initial lateral cephalograms and the annual increments were calculated and analyzed by comparing two groups with t-test. The results were as follows : 1. Good response group had more horizontal growth pattern in initial stage of treatment than poor response group, and the contributing factors of this result were anterior posterior facial height ratio, gonial angle, lower genial angle and SN-mandibular plane angle. 2. The maxilla was positioned more anteriorly in good response group. 3. The amounts of vertical growth of maxilla was smaller but the horizontal growth of maxilla was larger in good response group. 4. The mandible rotated more infero-posteriorly in good response group. 5. The good response group had more vertical growth pattern of mandibular condyle.
Background: Cleft lip and palate deformity have unknown patterns of maxillofacial growth and development. The maxillofacial growth can be affected either by congenital or environmental factors such as infection and trauma. Surgical repair of cleft lip and palate may interfere the subsequent growth and development of maxillofacial region. The purpose of this study is to evaluate the characteristics of maxillofacial growth patterns in adult cleft lip and palate patients. Materials and Methods: The material for this study consisted of 17 adult male patients with cleft lip and palate. Cephalometric tracing and measurements were done by one investigator. The relationship between 17 cleft lip and palate patients and Korean norms were evaluated statistically. Results: There were statistically differences in Na. perpendicular to point A, SNA angle, effective maxillary length, maxillofacial differencial. Wit's appraisal and upper incisor to point A(p < 0.01). Pogonion to Na. perpendicular also statistically differed(p < 0.05). Other measurements didn't statistically differ. Conclusion: It was evident that in adult cleft lip and palate patients, maxilla was retruded and short. Careful cleft lip and palate repair and treatment are recommended for facilitating normal growth of maxilla.
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