• The korean journal of orthodontics
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• v.24 no.3 s.46
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• pp.547-554
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• 1994

This study was carried out in order to find out the soft tissue profile changes associated with maxillary incisor retraction in Angle's class I malocclusion patients. For this study fifty two female adult patients (Maximum Retraction Group 23, Minimum Retraction Group 29) who received orthodontic treatment were chosen. Following conclusions were obtained by analysing the changes of soft tissue and hard tissue before and after treatment. 1. When considering the mean changes of soft tissue and hard tissue, UP, LIP, Ls, Li (p<0.001), Point B, Si (p<0.01), Point A, Ss (p<0.05) were significant posterior movement in Maximum Retraction Group and UIP (p<0.001), LIP, Ls, Li (p<0.01), Point B, Si (p<0.05) were significant posterior movement in Minimum Retraction Group. 2. When considering the correlations between hard tissue and soft tissue changes, greater correlations were found in Minimum Retraction Group between UIP and Ls (p<0.01), Point A and Ss, UIP and Li, Point B and Si (p<0.05) than Minimum Retraction Group. 3. Correlations (p<0.01) were found between upper incisor retraction and posterior movement of the upper and lower lip in Thin Lip-Thickness Group, whereas no significant correlations were found in Thick Lip-Thickness Group. 4. Mean changes of the soft tissue thickness subsequent to incisor retraction were increased (p<0.01) in upper lip (Ls-Ls'), whereas no changes were found in lower lip.

• The korean journal of orthodontics
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• v.43 no.3
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• pp.113-119
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• 2013

Objective: To compare three-dimensionally the midfacial hard- and soft-tissue asymmetries between the affected and the unaffected sides and determine the relationship between the hard tissue and the overlying soft tissue in patients with nonsyndromic complete unilateral cleft lip and palate (UCLP) by cone-beam computed tomography (CBCT) analysis. Methods: The maxillofacial regions of 26 adults (18 men, 8 women) with nonsyndromic UCLP were scanned by CBCT and reconstructed by three-dimensional dental imaging. The frontal-view midfacial analysis was based on a $3{\times}3$ grid of vertical and horizontal lines and their intersecting points. Two additional points were used for assessing the dentoalveolar area. Linear and surface measurements from three reference planes (Basion-perpendicular, midsagittal reference, and Frankfurt horizontal planes) to the intersecting points were used to evaluate the anteroposterior, transverse, and vertical asymmetries as well as convexity or concavity. Results: Anteroposteriorly, the soft tissue in the nasolabial and dentoalveolar regions was significantly thicker and positioned more anteriorly on the affected side than on the unaffected side (p < 0.05). The hard tissue in the dentoalveolar region was significantly retruded on the affected side compared with the unaffected side (p < 0.05). The other midfacial regions showed no significant differences. Conclusions: With the exception of the nasolabial and dentoalveolar regions, no distinctive midfacial hard- and soft-tissue asymmetries exist between the affected and the unaffected sides in patients with nonsyndromic UCLP.

• Journal of Periodontal and Implant Science
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• v.44 no.3
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• pp.147-155
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• 2014

Purpose: In the anterior maxilla, hard and soft tissue augmentations are sometimes required to meet esthetic and functional demands. In such cases, primary soft tissue closure after bone grafting procedures is indispensable for a successful outcome. This report describes a simple method for soft tissue coverage of a guided bone regeneration (GBR) site using the double-rotated palatal subepithelial connective tissue graft (RPSCTG) technique for a maxillary anterior defect. Methods: We present a 60-year-old man with a defect in the anterior maxilla requiring hard and soft tissue augmentations. The bone graft materials were filled above the alveolar defect and a titanium-reinforced nonresorbable membrane was placed to cover the graft materials. We used the RPSCTG technique to achieve primary soft tissue closure over the graft materials and the barrier membrane. Additional soft tissue augmentation using a contralateral RPSCTG and membrane removal were simultaneously performed 7 weeks after the stage 1 surgery to establish more abundant soft tissue architecture. Results: Flap necrosis occurred after the stage 1 surgery. Signs of infection or suppuration were not observed in the donor or recipient sites after the stage 2 surgery. These procedures enhanced the alveolar ridge volume, increased the amount of keratinized tissue, and improved the esthetic profile for restorative treatment. Conclusions: The use of RPSCTG could assist the soft tissue closure of the GBR sites because it provides sufficient soft tissue thickness, an ample vascular supply, protection of anatomical structures, and patient comfort. The treatment outcome was acceptable, despite membrane exposure, and the RPSCTG allowed for vitalization and harmonization with the recipient tissue.

• The korean journal of orthodontics
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• v.27 no.1
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• pp.65-78
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• 1997

This study was carried out in order to determine soft tissue response to incisor movement and mandibular repositioning and to determine feasibility of predicting vertical and horizontal changes in soft tissue with hard tissue movement. For this study, cephalometric records of 41 orthodontically treated adult females who had Angle's Class II division 1 malocclusion were selected and stepwise multiple regression analysis was employed. Following conclusions were obtained by analysing the changes of soft tissue and hard tissue before and after treatment. 1. Hard tissue measurements that showed significant changes before and after treatment were horizontal and angular changes of maxillary incisor, horizontal,vertical and angular changes of mandibular incisor, overjet, overbite, interincisal angle, mandibular repositioning, A,B, skeletal convexity and soft tissue measurements that showed significant changes were horizontal, thickness and angular changes of upper lip, horizontal and angular changes of lower lip, interlabial angle, nasolabial angle labiomental angle, Sri, Ss, Si and soft tissue convexity(P<0.05). 2. All Soft tissue measurements changed significantly before and after treatment had between one and four hard tissue independent variables at statistically significant level, indicating that all soft tissue changes were direct relationship with hard tissue changes 3. Ova jet, horizontal change of maxillary incisor, horizontal change of maxillary root apex and horizontal change of pogonion entered into prediction equations most frequentely indicating that they were more significant variables in prediction of vertical and horizontal changes in the soft tissue with treatment, but vertical changes of mandibular incisor not entered any prediction equations, indicating that it was not considered a good predictor for soft tissue changes with maxillary incisor retraction. 4. Horizontal and vertical changes in subnasale were found to have most independent variables, significant at the 0.05 level in prediction-equations(${\Delta}$Sn(H):Ur, Is(H), Pg(H), UIA,${\Delta}$Sn(V): Is(H), Pg(H), overjet, A), indicating that subnasale changes are influenced by complex hard tissue interaction. 5. Multiple correlation coefficient($R^2$) of the soft tissue prediction equations ranges from 0.2-0.6.

• The korean journal of orthodontics
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• v.43 no.4
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• pp.178-185
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• 2013

Objective: To standardize the facial soft-tissue characteristics of South Korean adults according to gender by measuring the soft-tissue thickness of young men and women with normal facial profiles by using three-dimensional (3D) reconstructed models. Methods: Computed tomographic images of 22 men aged 20 - 27 years and 18 women aged 20 - 26 years with normal facial profiles were obtained. The hard and soft tissues were three-dimensionally reconstructed by using Mimics software. The soft-tissue thickness was measured from the underlying bony surface at bilateral (frontal eminence, supraorbital, suborbital, inferior malar, lateral orbit, zygomatic arch, supraglenoid, gonion, supraM2, occlusal line, and subM2) and midline (supraglabella, glabella, nasion, rhinion, mid-philtrum, supradentale, infradentale, supramentale, mental eminence, and menton) landmarks. Results: The men showed significantly thicker soft tissue at the supraglabella, nasion, rhinion, mid-philtrum, supradentale, and supraglenoid points. In the women, the soft tissue was significantly thicker at the lateral orbit, inferior malar, and gonion points. Conclusions: The soft-tissue thickness in different facial areas varies according to gender. Orthodontists should use a different therapeutic approach for each gender.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.457-463
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• 2011

Introduction: This study evaluate the soft tissue changes to the upper lip and nose after Le Fort I maxillary posterosuperior rotational movement. Materials and Methods: Twenty Skeletal class III patients, who had undergone bimaxillary surgery with a maxillary Le Fort I osteotomy and bilateral sagittal split ramus osteotomy, were included in the study. The surgical plan for maxilla was posterosuperior rotational movement, with the rotation center in the anterior nasal spine (ANS) of maxilla. Soft and hard tissue changes were measured by evaluating the lateral cephalograms obtained prior to surgery and at least 6 months after surgery. For cephalometric analysis, four hard tissue landmarks ANS, posterior nasal spine [PNS], A point, U1 tip), and five soft tissue landmarks (pronasale [Pn], subnasale [Sn], A' Point, upper lip [UL], stomion superius [StmS]) were marked. A paired t test, Pearson's correlation analysis and linear regression analysis were used to evaluate the soft and hard tissue changes and assess the correlation. A P value <0.05 was considered significant. Results: The U1 tip moved $2.52{\pm}1.54$ mm posteriorly in the horizontal plane (P<0.05). Among the soft tissue landmarks, Pn moved $0.97{\pm}1.1$ mm downward (P<0.05), UL moved $1.98{\pm}1.58$ mm posteriorly (P<0.05) and $1.18{\pm}1.85$ mm inferiorly (P<0.05), and StmS moved $1.68{\pm}1.48$ mm posteriorly (P<0.05) and $1.06{\pm}1.29$ mm inferiorly (P<0.05). The ratios of horizontal soft tissue movement to the hard tissue were 1:0.47 for the A point and A' point, and 1:0.74 for the U1 tip and UL. Vertically, the movement ratio between the A point and A' point was 1:0.38, between U1 tip and UL was 1:0.83, and between U1 tip and StmS was 1:0.79. Conclusion: Posterosuperior rotational movement of the maxilla in Le Fort I osteotomy results in posterior and inferior movement of UL. In addition, nasolabial angle was increased. Nasal tip and base of the nose showed a tendency to move downward and showed significant horizontal movement. The soft tissue changes in the upper lip and nasal area are believed to be induced by posterior movement at the UL area.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.3
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• pp.217-227
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• 1992

The purpose of this paper is to investigate changes in soft tissue in 22 patients treated by vertical ramus osteotomy and sagittal split ramus osteotomy for the correction of mandibular prognathism. 22 individuals, 12 males and 10 females, were selected from the patients with mandibular prognathism at the Department of Oral and Maxillofacial Surgery, Colledge of Dentistry, Kyung Hee University. Patient were analyzed with cephalogram taken 1 week before and at least 6 weeks after surgery under the same condition. Measurements were made constructed hard tissue and sop tissue points located on each before-and-after film tracing. Comparision were made of these figures to estimate the amount that the soft tissue followed the hard tissue structures in each surgical procedure : ratio of sop and hard tissue changes were formulated. The results were as follows. 1. The horizontal changes of Pogs and Bs as a ratio of the horizontal changes of Pog and B point were 1.02 and 1.16 respectively. 2. One millimeter of posterior changes at Pog resulted in 0.86mm of posterior change at Li and 0.09mm of posterior change at Ls. The greatest amount of sop tissue change occurred at Pogs, with substantially less posterior displacement at Bs, even less at Li and at least at Ls. 3. The ratio of LI to Li was 1:0.81 and the ratio of LI to Ls was not significant.(1 : 0.17) 4. The ULA(Cm-Sn-Ls) and the relative lower lip projection (LLP) was incnease4 but the relative upper lip projection (ULP) was slightly decreased 5. The angular change of the upper lip inclined angle (Ls-Sn/ANS-PNS) and lower lip inclined angle(Li-Pogs/Me-Go) expressed as a ratio of the posterior change of Pog were 0.57 and 0.20 respectively. 6. The ratio of the lower anterior facial height change of the soft tissue(Sn-Mes) to the hard tissue(ANS-Gn) were 0.78 and and the ratio of vertical height changes of the hard tissue and sop tissue to the posterior change of the Pog were 0.18 and 0.19 respectively. 7. The sop tissue angular change of facial convexity(G-Sn-Pogs) expressed as a ratio of the angular change of the hard tissue angle of facial convexity(N-A-Pog) was 1.24.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.4
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• pp.284-290
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• 1998

The purpose of this study was to assess the soft tissue changes using twenty skeletal class III malocclusion patients who treated with bimaxillary surgery for the correction of dentofacial deformities. Patients were divided into two groups. One was impaction and advancement of maxilla with mandibular set-back (Group 1), the other was downward and advancement of maxilla with mandibular set-back (Group 2). Preoperative and postoperative one year cephalometric data were analyzed and compared. Results obtained were as follows: 1. The ratio of horizontal changes of soft tissue to hard tissue at Nt to ANS, Ls to UI, Li to LI, sPog to Pog were 1:0.60, 1:0.79, 1:0.47, 1:0.63 in group 1 respectively, and 1:0.59, 1:0.48, 1:0.83, 1:1.09 in group 2 respectively. Soft tissue changes were highly predictable at the upper lip, lower lip, and chin area. 2. The ratio of vertical changes of soft tissue to hard tissue at Nt to ANS, Li to LI were 1:0.72, 1:0.06 in group 1, and others showed no statistically significant difference. 3. The ratio of horizontal changes of Ls to hard tissue movements at LI(h) was 1:-0.82 in group 1 and at UI(h), LI(h) were 1:0.48, 1:0.01 in group 2. These ratios of group 1 were greater than those of group 2. 4. The direction of horizontal change of Li was the same as that of hard tissue change. The ratio of horizontal changes of Li to LI was 1:0.47 in group 1 and others showed no statistically significant difference. 5. The changes of upper lip thickness and length were -1.6mm, -1.4mm in group 1, and -1mm, -2.7mm in group 2. 6. The ratios of thickness of upper lip to ANS, UI, LI were 1:-0.83, 1:-0.37, 1:0.11 in group 1. There was similar trend in group 2, and there were no statistically significant difference. These results suggest that prediction of changes in soft tissue of upper lip, lower lip, and chin were 79%, 47%, and 63% in group 1, and 48%, 83%, and 109% in group 2. There was a tendency to decrease in thickness and increase in length of the upper lip.

• Journal of Korean Dental Science
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• v.17 no.2
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• pp.84-91
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• 2024

Achieving both esthetic and functional implant rehabilitation is crucial for the successful treatment of the anterior maxilla. Adequate peri-implant alveolar bone and soft tissue are essential for optimal rehabilitation of the esthetic area, and there is a direct association between the implant position and prosthetic outcomes. Immediate provisionalization may also be advantageous when combined with augmentation. This case report described the implant placement in a 25-year-old female patient who had lost her right maxillary lateral incisor (#12) due to trauma-induced avulsion. The treatment involved simultaneous grafting and collagenated, deproteinized bovine bone mineral, along with subepithelial connective tissue taken from the right maxillary tuberosity. A polyetheretherketone abutment and non-functional immediate provisionalization were performed by removing both the proximal and occlusal contacts on the composite resin crown. Clinical and radiographic evaluations revealed maintenance of stable ridge contour aspects for six months following surgical treatment. In summary, implant rehabilitation in the esthetic zone can be successful using simultaneous soft and hard tissue grafts. Moreover, soft tissue stabilization post-subepithelial connective tissue grafting can be achieved through early or immediate visualization, along with immediate implant placement.

• Proceedings of the KOSOMBE Conference
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• v.1998 no.11
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• pp.275-276
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• 1998

In this paper, we present the software on the development of the computerized imaging system for diagnosis and treatment plannig of orthodontics and orthognathic surgery. Soft tissue changes followed by orthognathic surgery mainly depends on surgical movements of hard tissue. Then, the stepwise multiple regression method was used to investigate the soft tissue changes followed by hard tissue changes. As a result of this research, we were able to develop a system which diagnoses automatic X-ray images and predicts soft tissue changes after othognathic surgery.