• The korean journal of orthodontics
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• v.51 no.3
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• pp.145-156
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• 2021

Objective: The aim of this retrospective study was to assess the midfacial soft tissue changes following maxillary expansion using micro-implant-supported maxillary skeletal expanders (MSEs) in young adults by cone-beam computerized tomography (CBCT) and to evaluate the correlations between hard and soft tissue changes after MSE usage. Methods: Twenty patients (mean age, 22.4 years; range, 17.6-27.1) with maxillary transverse deficiency treated with MSEs were selected. Mean expansion amount was 6.5 mm. CBCT images taken before and after expansion were superimposed to measure the changes in soft and hard tissue landmarks. Statistical analyses were performed using paired t-test and Pearson's correlation analysis on the basis of the normality of data. Results: Average lateral movement of the cheek points was 1.35 mm (right) and 1.08 mm (left), and that of the alar curvature points was 1.03 mm (right) and 1.02 mm (left). Average forward displacement of the cheek points was 0.59 mm (right) and 0.44 mm (left), and that of the alar curvature points was 0.61 mm (right) and 0.77 mm (left) (p < 0.05). Anterior nasal spine (ANS), posterior nasal spine (PNS), and alveolar bone width showed significant increments (p < 0.05). Changes in the cheek and alar curvature points on both sides significantly correlated with hard tissue changes (p < 0.05). Conclusions: Maxillary expansion using MSEs resulted in significant lateral and forward movements of the soft tissues of cheek and alar curvature points on both sides in young adults and correlated with the maxillary suture opening at the ANS and PNS.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.4
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• pp.351-361
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• 1997

This study was performed to evaluate the change of the soft tissue facial profile after mandibular set back surgery during time intervals. For this study, 33 patient, 8 males and 25 females, were selected and their lateral cephalograms were taken and analyzed periodically. Hard and soft tissue changes during postoperative time intervals, correlation between surgical skeletal changes and postoperative soft tissue changes, and prediction for long-term soft tissue changes were established through varying statistical methods. The results were as follow : 1. There were meaningful changes of anteroposterior skeletal position at 6 months and 2 years after mandibular set back by mandibular ramus osteotomy. Two years postoperatively, there was 30%, 32%, 29% relapse on B point, pogonion, menton each. 2. Two years after the mandibular ramus osteotomy, the relative changes of the soft tissue to their osseous counterparts showed 76% on the lower lip and 91% on the pogonion. 3. The movements of the mandibular landmarks in correlation to anteroposterior position of the lower lip and soft tissue of the chin showed to be effective on a long-term basis. 4. Using surgical changes of pogonion, prediction of changes in soft and hard tissue pogonion was useful and the coefficient of determination was 0.46 each and their reliability decreased 2 years postoperatively. 5. The upper lip position after the mandibular set back surgery was somewhat anterior 2 years postoperatively, but that has no statistical meanings.

• The korean journal of orthodontics
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• v.51 no.4
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• pp.260-269
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• 2021

Objective: To identify the most favorable sites that optimize the initial stability and survival rate of orthodontic mini-implants, this study measured hard and soft tissue thicknesses in the median and paramedian regions of the palate using cone-beam computed tomography (CBCT) and determined possible sex- and age-related differences in these thicknesses. Methods: The study sample comprised CBCT images of 189 healthy subjects. The sample was divided into four groups according to age. A grid area was set for the measurement of hard and soft tissue thicknesses in the palate. Vertical lines were marked at intervals of 0, 1.5, and 3.0 mm lateral to the midpalatal suture, while horizontal lines were marked at 2-mm intervals up to 24 mm from the posterior margin of the incisive foramen. Measurements were made at 65 points of intersection between the horizontal and vertical lines. Results: The palatal hard tissue thickness decreased from the anterior to the posterior region, with a decrease in the medial-to-lateral direction in the middle and posterior regions. While the soft tissue was rather thick around the lateral aspects of the palatal arch, it formed a constant layer that was only 1-2-mm thick throughout the palate. Statistically significant differences were observed according to sex and age. Conclusions: The anterolateral palate as well as the midpalatal suture seem to be the most favorable sites for insertion of orthodontic mini-implants. The thickness of the palate differed by age and sex; these differences should be considered while planning the placement of orthodontic mini-implants.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.4
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• pp.344-350
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• 2010

A progressive hemifacial atrophy is characterized by progressive atrophy of subcutaneous fat and rarely muscle and bone. Its contour follows the underlying muscle. Unilateral involvement is common. The treatment goal has been focused on the augmentation of the soft tissue. Many materials such as implants, collagen, fat graft, fat injection, dermal fat graft, filler and vascualized autogenous graft have been used. Although these materials have been used, the best treatment hasn't been achived. In severe cases underlying soft tissue, muscle and bone may be atrophied and massive soft tissue graft, implant and orthognathic surgery must be used. The author used the dermal-fat tissue for the pupose of soft tissue augmentation. We can get the massive soft tissue by the dermolipectomy procedure through the mini-abdominoplsty. The facial augmentation was done by augmentation of the dermal-fat tissue. The progressive hemifacial atrophy is hard to treat by only one procedure and many modalites must be considered.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.1
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• pp.37-43
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• 1991

Cephalometric prediction tracing is the preoperative double checking procedure which can predict bony and soft tissue change. Soft tissue profile prediction is routinely performed according to the known ratios of the soft to hard tissue movement which can vary considerably in each individual. Besides interindividual variation of the ratios of the soft to hard tissue change, actual results of the postoperative soft tissue profile can reflect other important modifying factors if it is compared with prediction tracing used. The purpose of this study is to compare soft tissue prediction tracing used with postoperative tracing and to find intervening modifying factor via serial tracing. Review of 30 prediction tracing showed that the most important factor contributing to prodiction tracing inaccuracy was the skeletal and dental relapse. And, some factors which may be responsible for prediction tracing inaccuracy were discussed.

• The korean journal of orthodontics
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• v.14 no.1
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• pp.161-172
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• 1984

This study was undertaken to evaluate the cephalometric changes of the soft tissue and skeletal profile subsequent 10 the rapid palatal expansion in 25 Angle's Class III cases, ranging in age from six to fifteen years, with cross-bite of the anterior teeth, underdevelopment of maxilla and facial disharmony Following results were obtained: 1. ANS moved downward, Point A presented forward & downward movement increasing SNA and Point B presented backward & downward movement decreasing SNB. 2. Mandible was rotated to backward & forward and maxilla moved forward & downward with the bite opening and improvement of anterior teeth cross-bite. 3. Soft tissue on mandible was rotated to backward & forward following hard tissue changes causing the decrease of facial convexity angle and backward & downward rotation of Point B', Pog'. 4. Response of the upper lip was more significant in downward than forward direction, and correlated with the upper central incisor and mandible rotation. 5. Response of the lower lip was more significant in downward than backward direction, and correlated with the mandible rotation. 6. There was a rather high degree of correlation between skeletal profile and soft-tissue profile, 1 : LS, $\bar{1}$:Pog', Pog:LS, Pog:LI, Pog:Pog' in horizontal measurements and $\bar{1}$:Pog', Pog:LI, Pog:Pog' in vertical measurements.

• The korean journal of orthodontics
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• v.31 no.5 s.88
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• pp.535-548
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• 2001

The purpose of this study was to evaluate changes in soft tissue chin thickness and to investigate correlations between hard and soft tissues measurements after orthodontic treatment conducted by premolars extraction and incisor retraction. The sample consisted of 35 female adults with Angle classification class I or class II division 1 malocclusion. Using lateral cephalometric radiographs taken before and after treatment, hard and soft tissue structures were measured and reproducible six landmark on soft chin tissue were used to locate the various points of soft tissue contour of the chin. The res에ts were as follows : 1. There were signigicant correlations between pretreatment B-B', Pm-Pm' and pretreatment vortical skeletal measurements such as $MP{\perp}HP,\;MP{\perp}PP$, ALFH and between a-a', b-b', Me-Me' and measurements of sym-physeal morphology such as SL, SW, PL. 2. There were significant decreases at B-B', Pm-Pm' and significant increases at a-a', b-b' between pre-and posttreatment mea surements. 3. There were significant correlations among soft tissues changes and hard tissue changes except for changes at B-B' and the range of correlation coefficient was about 0.3-0.4. 4. There were significant differences at ${\Delta}UI-VP,\;LI{\perp}, and B-B' measurements between subgroups divided by posttreatment Pog-Pog' changes. 5. There were significant differences at ${\Delta}overbite,\;NPog{\perp}HP,\;and\;Me-Me'$ measurements between subgroups divided by posttreatment Me-Me' changes.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.25 no.1
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• pp.35-49
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• 2016

With the increasing demand for aesthetic implant dentistry, the importance of implant restoration is emphasized not only in the functional aspect but also in the aesthetic aspect. The aesthetic restoration of dental implants in the anterior maxilla is a challenge for clinicians because it requires proper harmony in three following conditions; reconstruction of hard tissue, soft tissue, and aesthetic prosthesis. The soft tissue aesthetics are dependent upon the condition of the supporting hard tissue because the osseous structure provides a framework for the development of a healthy and aesthetic soft tissue interface. Therefore, the augmentation of hard tissue is a first step and especially, optimal 3-dimensional position of implant is the most important factor in aesthetic implant restoration. The management of soft tissue is a second step, and the final step is a restoration of harmonic prosthesis using provisional restoration with proper emergence profile. This clinical report describes the procedure of bone augmentation in labial dehiscence defect, Vascularized Interpositional Periosteal-Connective Tissue (VIP-CT) flap for aesthetic anterior soft tissue, and the importance of provisional restoration and impression taking stage with customized impression coping.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.6
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• pp.385-392
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• 2020

Objectives: This study evaluates soft tissue changes of the upper lip and nose after maxillary setback with orthognathic surgery such as Le Fort I or anterior segmental osteotomy. Materials and Methods: All 50 patients with bimaxillary protrusion and skeletal Class II malocclusion underwent Le Fort I or anterior segmental osteotomy with backward movement. Soft and hard tissue changes were analyzed using cephalograms collected preoperatively and 6 months postoperatively. Results: Cluster analysis on the ratios shows that 2 lines intersected at 4 mm point. Based on this point, we divided the subjects into 2 groups: Group A (less than 4 mm, 27 subjects) and Group B (more than 4 mm, 23 subjects). Also, each group was divided according to changes of upper incisor angle (≥4°=A1, B1 or <4°=A2, B2). The correlation between A and B groups for A'/ANS and Ls/Is (P<0.001) was significant; A'/A (P=0.002), PRN/A (P=0.043), PRN/ANS (P=0.032), and St/Is (P=0.010). Variation of nasolabial angle between the two groups was not significant. There was no significant correlation of vertical movement and angle variation. Conclusion: The ratio of soft tissue to hard tissue movement depends on the amount of posterior movement in the maxilla, showing approximately two times higher rates in most of the midface when posterior movement was greater than 4 mm. The soft tissue changes caused by posterior movement of the maxilla were little affected by angular changes of upper incisors. Interestingly, nasolabial angle showed a different tendency between A and B groups and was more affected by incisal angular changes when horizontal posterior movement was less than 4 mm.

• The Journal of the Korean dental association
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• v.48 no.9
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• pp.670-679
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• 2010

Esthetic demands for dental treatment are increasing every day. The interdisciplinary relationship of the restorative treatment, periodontal therapy and other treatments such as endodontics, orthodontics and so on is more emphasized nowadays to reconstruct the hard and soft tissue foundation for the esthetic restorative treatment. This article will focus on the periodontal plastic surgery for esthetic restorative treatment. These followings will be discussed. 1. Understand the relationship between teeth and gingival scaffold for esthetics 2. Discuss the classification and treatment of gummy smile 3. Recognize the gingival margin irregularities by gingival recession and how to achieve the harmonic soft tissue margins 4. describe the hard and soft tissue augmentation for ridge augmentation.