Kim, Young-Joo;Kim, Kyung-A;Yu, Yong-Jae;Ryu, Kyung-Sun;Ryu, Jeong-Min;Ohe, Joo-Young;Kim, Su-Jung;Kim, Seoung-Hun;Lee, Baek-Soo
Maxillofacial Plastic and Reconstructive Surgery
/
v.34
no.4
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pp.246-251
/
2012
Purpose: The purpose of the study is to evaluate the effectiveness of anterior segmental osteotomy (ASO) in bimaxillary protrusion (BP) patients by comparison between the mandibular soft and hard tissue changes from orthodontic treatment and ASO. Methods: All 44 patients were diagnosed with BP in Kyung-Hee Medical Center. Orthodontic treatment with teeth extractions were underwent by 23 patients (Group A) and 21 patients underwent ASO (Group B). Mandibular soft and hard tissue changes were measured and evaluated, which were based on the vertical and horizontal reference line in lateral cephalometric radiographs. Statistical significance between the changes and correlation between each measurement were analyzed. Results: The amount of B point movement was lesser than that of the lower incisal tip (LIT) retraction, and LIT was tilted lingually in group A. The posterior movement discrepancy between LIT and B point was insignificant, and the inclination of lower incisor was not changed in group B. The soft tissues, including the lower lip, showed a posterior movement and reduction in the depth of mento-labial groove. According to the correlation analysis, the movement of the lower incisor was significantly related to the movement of the lower lip in group A, and the movement of the lower incisor was significantly related to that of the movement of lower lip, B point and Pog in group B. Conclusion: The orthodontic treatment in BP patients results in posterior tilting movement of the lower incisor, but ASO results in the bodily movement of the lower incisor. Consequently, ASO is more effective in BP cases because it ensures the controlled movement of the lower incisors.
In many cases of orthodontic treatment the upper anterior teeth are retracted. Periodontal problems may arise during incisor retraction, if the amount of tooth movement and the amount of remodeling in the anterior cortical bone are not the same. Therefore in this study, to find out the relationship between the amount of tooth movement and the amount of bone remodeling during retraction of the upper anterior teeth, lateral cephalograms of 56 female patients over 18-year-old were taken before and after treatment. Among the 56 patients, two groups were divided according to the type of root movement during retraction. 26 patients mainly moved by tipping and 30 by bodily movement. The cephalograms taken before and after treatment were superimposed upon the true horizontal plane. In the Tip-Group, the horizontal bone remodeling/tooth movement ratio was 1:1.63, and in the Torque-Group it was 1:1.66. Because the amount of tooth movement and the amount of bone remodeling were not the same in both groups, in the Tip-Group the root apex moved away from the palatal cortical plate and closer to the labial cortical plate, whereas in the Torque-Group the root moved away from the labial cortical plate and closet to the palatal cortical plate. Therefore, there are limitations in the amount of incisor retraction in patients with a very thin anterior cortical plate in the maxilla, and in patients with severe skeletal discrepancies orthognathic surgery should be considered and when orthodontic camouflage treatment is the only possible method, the orthodontist must be aware of the limitations of treatment.
The purpose of this study was to evaluate the effect of specific head positions on the mandibular rotational torque movements in maximum mouth opening, protrusion and lateral excursion. Thirty dental students without any sign or symptom of temporomandibular disorders(TMDs) were included as a control group and 90 patients with TMDs were selected and examined by routine diagnostic procedure for TMDs including radiographs and were classified into 3 subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Mandibular rotational torque movements were observed in four head postures: upright head posture(NHP), upward head posture(UHP), downward head posture(DHP), and forward head posture(FHP). For UHP, the head was inclined 30 degrees upward: for DHP, the head was inclined 30 degrees downward: for FHP, the head was positioned 4cm forward. These positions were adjusted with the use of cervical range-of-motion instrumentation(CROM, Performance Attainment Inc., St. Paul, U.S.A.). Mandibular rotational torque movements were monitored with the Rotate program of BioPAK system (Bioresearch Inc., WI, U.S.A.). The rotational torque movements in frontal and horizontal plane during mandibular border movement were recorded with two parameters: frontal rotational torque angle and horizontal rotational torque angle. The data obtained was analyzed by the SAS/Stat program. The obtained results were as follows : 1. The control group showed significantly larger mandibular rotational angles in UHP than those in DHP and FHP during maximum mouth opening in both frontal and horizontal planes. Disc displacement with reduction group showed significantly larger mandibular rotational angles in DHP and FHP than those in NHP during lateral excursion to the affected and non-affected sides in both frontal and horizontal planes(p<0.05). 2. Disc displacement without reduction group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening as well as lateral excursion to the affected and non-affected sides in both frontal and horizontal planes. Degenerative joint disease group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening, protrusion and lateral excursion in both frontal and horizontal planes(p<0.05). 3. In NHP, mandibular rotational angle of the control group was significantly larger than that of any other patient subgroups. Mandibular rotational angle of disc displacement with reduction group was significantly larger than that of disc displacement without reduction group during maximum mouth opening in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group or degenerative joint disease group during maximum mouth opening in the horizontal plane(p<0.05). 4. In NHP, mandibular rotational angles of disc displacement without reduction group were significantly larger than those of the control group or disc displacement with reduction group during lateral excursion to the affected side in both frontal and horizontal planes. Mandibular rotational angle of disc displacement without reduction group was significantly smaller than that of the control group during lateral excursion to the non-affected side in frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group during lateral excursion to the non-affected side in the horizontal plane(p<0.05). 5. In NHP, mandibular rotational angle of the control group was significantly smaller than that of disc displacement with reduction group or disc displacement without reduction group during protrusion in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of the disc displacement with reduction group or degenerative joint disease group during protrusion in the horizontal plane. Mandibular rotational angle of the control group was significantly smaller than that of disc displacement without reduction group or degenerative joint disease group during protrusion in the horizontal plane(p<0.05). 6. In NHP, disc displacement without reduction group and degenerative joint disease group showed significantly larger mandibular rotational angles during lateral excursion to the affected side than during lateral excursion to the non-affected side in both frontal and horizontal planes(p<0.05). The findings indicate that changes in head posture can influence mandibular rotational torque movements. The more advanced state is a progressive stage of TMDs, the more influenced by FHP are mandibular rotational torque movements of the patients with TMDs.
Purpose: Reposition of the maxilla is a common technique for correction of midfacial deformities. To achieve the goal of the surgery, the maxilla should be repositioned based on the precisely planned position during surgery. The internal reference points (IRPs) and the external reference points (ERPs) are usually used to determine vertical dimension of maxilla, which is an important factor for confirming maxillary position. However, the IRPs are known to be inaccurate in determining the vertical dimension. In this study, we investigated the correlation of positional change of the modified IRPs with repositioned maxilla. Methods: The study group consisted of 26 patients with dentofacial deformities. For the simulation of the surgery, patient maxillary CT data and 3-D virtual surgery programs (V-$Works^{(R)}$ and V-$Surgery^{(R)}$) were used. IRPs of this study were set on both the lateral wall of piriform aperture, inferior margin of both infraorbital foramen, and the labial surfaces of the canine and first molar. The distance from the point on lateral wall of the piriform aperture to the point on the buccal surface of the canine was defined as IRP-C, and the distance from the point on the inferior margin of the infraorbital foramen to the point on the buccal surface of the $1^{st}$ molar was defined as IRP-M. After the virtual simulation of Le Fort I osteotomy, the changes in IRP-C and IRP-M were compared with the maxillary movement. All measures were analyzed statistically. Results: With respect to vertical movements, the IRP-C (approximately 98%) and the IRP-M (approximately 96%) represented the movement of the canine and the $1^{st}$ molar. Regarding rotating movement, the IRPs changed according to the movement of the canine and the $1^{st}$ molar. In particular, the IRP-C was changed in accordance with the canine. Conclusion: IRPs could be good indicators for predicting vertical movements of the maxilla during surgery.
The purpose of this study was undertaken to determine the effects of orthognathic surgery on speech. The hyposis stated herein is that functional behaviors of the dentofacial complex, such as speech production, may be adversely affected by deviations of a structural nature(especially, Class III malocclusion). Twenty adults with Class III malocclusion(13 female and 7 male) were studied preoperative, immediate postoperative and either 6 or 12 months postoperative lateral cephalograms. They had mandibular prognathism and had undergone mandible setback operation. The position of tongue, soft palate(Uvula), hyoid bone, respiratory track width, and pharyngeal depth were assessed on lateral cephalograms with 23 cephalometric variables, ANOVA, Paired t-tests and Pearson's product-moment correlation coefficient tests were used to evalute the operative changes in all cephalometric parameters. A experienced speech and language pathologists performed narrow phonetic transcriptions of tape-recorded words and sentences produced by each of the ninth patients and the recording tapes were analyzed by phonetic computer program(Computerized Speech Lab(CSL) Model 4300BI(U.S.A.)) These judges also recorded their ratings of each patient's overall consonants, hypernasality, hyponasality, and articulation proficiency. The results obtained are as follows; 1. There were significant changes in distance of posterior pharyngeal wall to tongue (TI-TW2, TS-TW3) after the surgery at 6 months postoperatively(each p<0.01 p<0.05). 2. The posterior tongue point(TI, TS, PPT) moved posteriorly after surgery and remained to its changed position at 6 months postoperatively(p<0.05). The displacement of tongue was correlated with the movement of mandibular setback amount(p<0.05). The hyoid bone moved posteriorly superiorly after immediate postoperative period. There was significant changes in hyoid bone movement after immediated postoperative period(p<0.05), but returned to its original position during the follow-up period(p>0.05) 3. The soft palate was displaced posteriorly superiorly after immediated operative period and remained to its changed position at 6 months postoperatively(p<0.05). ANS-PNS-SPT angle increasing, PPU-PPPo distance narrowing was showed after surgery, and remained its appearance 6 months postoperatively(p<0.05). 4. There were significant changes in formant value and squre diagram of vowel sound after the orthognathic surgery and the follow-up period. There were significant changes in /ㅅ/sound and posterior tongue sound. 5. The posterior movement of tongue and the posteriosuperior movement of soft palate was correlated with mandibular setback amount after orthognathic surgery. On the vowel squre diagram, the author found that the place of articulation after operation moved downward, backward, upward. 6. In assessing speech abnormalities, dental occlusion should be considered as a contributing factor. The vast majority of subjects with preoperative misarticulations eliminated or reduced their errors following orthognathic surgery. There was significant difference in speech impovement between pre- and postoperation.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.25
no.4
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pp.324-329
/
1999
The facial esthetics are much affected by nasal changes due to especially its central position in relation to facial outline and so appropriately evaluated should be the functional and esthetic aspects of the nose associated with the facial appearance. Generally, a maxillary surgical movement is known to induce the changes of nasolabial morphology secondary to the skeletal repositioning accompanied by muscular retraction. These changes can be desirable or undesirable to individuals according to the direction and amount of maxillary repositioning. We investigated the surgical changes of bony maxilla and its effects to nasal morphology through the analysis of the lateral cephalogram in the Le Fort I osteotomy. Subjects were 10 patients(male 2, female 8, mean age 22.3 years) and cephalograms were obtained 2 weeks before surgery(T1) and 6 months after surgery(T2). The surgical maxillary movement was identified through the horizontal and vertical repositioning of point A. Soft-tissue analysis of the nasal profile was performed employing two angles: nasal tip projection(NTP), columellar angle(CA). Also, alar base width(ABW) was assessed directly on the patients with a slide gauge. The results were as follows; 1. Both anterior and superior movement above 2mm of maxilla rotated up nasal tip above 1mm. Either anterior or superior movement above 2mm of maxilla made prediction of the amount & direction of NTP changes difficult. Especially, a correlation between horizontal movement of maxilla and NTP rotated-up was P<0.01. 2. Both much highly anterior and superior movement of maxilla is accompanied by more CA increase than either highly. Especially, the correlation between horizontal movement of maxilla and CA change was P<0.05. 3. Anterior and/or superior movement of maxilla was accompanied by the unpredictable ABW widening. 4. The amount of changes of NTP, CA, and ABW is not in direct proportion to amout of anterior and/or superior movement of maxilla. 5. Nasal morphologic changes following Le Fort I osteotomy are affacted by not merely bony repositioning but other multiple factors.
Journal of Dental Rehabilitation and Applied Science
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v.29
no.1
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pp.59-68
/
2013
The objective of this study was to analyze occlusal contact pattern of 33 young adult males with normal occlusion during lateral excursion using T-scan III system which can measure the dynamic occlusion. Occlusal contact patterns were examined and categorized in non-working side disclusion point(more functionally acceptable position) not canine-to-canine position. Disclusion time, occlusal force, and occlusal force distribution ratio of upper canine at disclusion point during lateral excursion movement was also measured and compared among the groups divided according to contact patterns. The results showed that group function was clearly more dominant than canine guidance and other occlusal contact patterns different with existing patterns were found. There were significantly difference between groups in variables of T-scan measurement. T-scan III system is effective tools to analyze and evaluate occlusal contact patterns, disclusion time, occlusal force, and occlusal force distribution ratio of upper canine at disclusion point.
The aim of this study was to evaluate driving performance of Healthy and disabled groups (with or without driver's license) to control steering wheel by using steering assistive devices in the driving simulator. The persons with partial loss of use of all four limbs have problems in operation of the motor vehicle because of functional loss to operate steering wheel. Therefore, if steering assistive devices for grasping the steering wheel are used to control the vehicle on the road in persons with disabilities, the disabled persons can improve mobility in their community life by driving a motor vehicle safely. Ten healthy subjects (with or w/o driver's license) and ten subjects with physical disabilities (with or w/o driver's license) were involved in this study to evaluate driving performance to operate steering wheel by using four types of steering assistive devices (Single-pin, V-grip, Palm-grip, Tri-pin) in driving simulator. STISim Drive 3 software was used to test the steering performance in four scenarios: straight road at low and high speed of vehicle (40 km/h and 80 km/h), curved road at low and high speed of vehicle (40 km/h and 80 km/h). This study used two-way ANOVA in order to compare the effects of two factors (type of steering assistive device and subject group) in the three dependent variables of driving performance (the lateral position of vehicle, standard deviation of lateral position representing the variation of the left and right movement of the vehicle and the number of line crossing). The mean values of the three dependent variables (lateral position, standard deviation of lateral position, the number of line crossing) of steering performance were statistically significantly smaller for the healthy or disabled groups with driver's license than the other groups without driver's license on the curved road at high speed of vehicle compared to low speed of vehicle.
This study was designed to investigate the reciprocal movement which was derived form application of active torque in ideal archwire by computer-aided three-dimensional finite element analysis of maxillary teeth and surrounding periodontal ligament composed of 2617 elements and 3725 nodes. Ideal archwire model was also made using the beam elements and the contact between the wire and the bracket slot was made using the gap element. In this study non-linear elastic behaviors of contact between the wire and the bracket slot were considered on. We put the active torque between the lateral and cenral incisor and between the second premolar and the first molar with/without cinch-back. The results were expressed by quantitative and visible ways. The findings of this study were as follows: 1. Reciprocal actions to active torque were complex system consisting of a combination of counter-torque, bucco-lingual linear displacement and tipping, rotation of the teeth, occluso-gingival linear displacement. 2. When active anterior crown labial torque was applied, crown labial tippings of the lateral were the greatest, and those of the central incisor was the next, Crown lingual tippings of the canine and the first premolar, mesial rotations and extrusion of the lateral and distal rotations and intrusion of the canine occurred. When anterior torque with the cinch-back was applied, amount of crown labial tippings of the lateral and central incisor were reduced. Amount of crown lingual tipping of the canine and the first premolar were increased. Mesial tippings and mesial rotations of the second molar occurred. 3. When active posterior crown lingual torque was applied, crown lingual tippings of the first moalr were the greatest, and crown labial tippings of the second premolar and the first premolar were the next, the crown lingual tipping of the second molar were a little. Mesial rotations of the second premolar occurred but those of the first premolar didn't occurred.
Journal of the Korean Society for Aeronautical & Space Sciences
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v.47
no.6
/
pp.422-428
/
2019
A tailless or Blended-Wing-Body(BWB) shaped configuration is highlighted for UCAV with low RCS characteristics. The BWB configuration is characterized by its directional static instability and low controllability. To control the directional movement of the BWB configured vehicle, directional thrust vectoring equipment or drag rudder typed control surfaces which utilize the drag differences of the wing can be considered. This paper deals with a BWB shaped configuration using a spoiler and describes the lateral-directional aerodynamic characteristics of the vehicle. In addition, it is shwon that the lateral-directional motion can be controlled effectively by using the classical PI control structure. This control law is verified by flight test and showed adequate for the tailless BWB shaped UAV.
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