• Title/Summary/Keyword: Lip position

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상악 측절치가 유실된 증례의 임상적 고찰과 치험일례

  • Lee, Gi-Soo;Yong, Yeol-Il
    • The Journal of the Korean dental association
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    • v.18 no.8 s.137
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    • pp.639-644
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    • 1980
  • In cases with maxillary lateral incisor missing, the problems were usually treated by the choice between space opening for prosthetic lateral incisor replacement and space closure with cuspid sub stitution for the alteral insicors. The decision of the choice could be perplexing in evaluation of the individual case. Therefore, various diagnostic criteria, such as occlusion, dental esthetics, canine position and inclination, tooth size relationship, maxillary lip length, and skeletal relation had to be evaluated. On the basis of this diagnostic information, the treatment planning could be established. A case was shown to illustrate the treatment of patient with congenitally maxillary lateral incisor missing.

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Perception of discrepancy in the upper midline position in conjunction with the gingival display according to various occupations in Iran

  • Hooman Zarif Najafi;Taraneh Estedlal;Maryam Saki;Maryam Azadi
    • The korean journal of orthodontics
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    • v.53 no.3
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    • pp.163-174
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    • 2023
  • Objective: This study evaluated the influence of various gingival displays on the esthetic perception in the presence of upper dental midline discrepancy. Methods: A smiling image of a male subject was altered digitally to produce five image series: normal smile (series A), decreased tooth show (series B), increased gingival show (series C), maxillary cant (series D), and asymmetric upper lip elevation (series E). In each image series, the midline was deviated to the right and left incrementally. A total of 210 raters (four professional groups and laypersons, n = 42 in each group) determined the midline deviation threshold and the attractiveness of midline position in each series. Results: The right and left thresholds were statistically similar for the symmetrical series (A, B, and C), while for series D, the right threshold was significantly lower. In most rater groups, the mean threshold order was: B > A > E > C > D. In all the series, the raters selected the coincident midline as the most attractive series except for series D, for which 1-2-mm deviations to the left were selected as the most attractive by almost all the groups. Conclusions: It is crucial to establish the coincident midline position in a symmetrical smile, especially when a gummy smile exists. In the asymmetrical gingival show, a coincident midline might not be the most esthetic midline position.

Repair of Unilateral Cleft Lip and Nose: Mulliken's Modification of Rotation Advancement (편측 구순열비의 교정술: Rotation Advancement 원칙에 근거한 Mulliken의 방법)

  • Jung, Young-Soo;Lee, Gyu-Tae;Jung, Hwi-Dong;Mulliken, John B.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.2
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    • pp.133-139
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    • 2012
  • This is a review regarding Mulliken's Modification using the Millard rotation-advancement principle for the repair of unilateral complete cleft lip and nasal deformity. All patients underwent prior labionasal adhesion and dentofacial orthopedics with a pin-retained (Latham) appliance used for infants with a cleft of the lip and palate. Technical variations concerning the operation are described. A high rotation and releasing incision in the columella lengthens the medial labial element and produces a symmetric prolabium with minimal transgression of the upper philtral column through the advancement flap. The orbicularis oris muscle is everted, from caudad to cephalad, to form the philtral ridge. A minor variation of unilimb Z-plasty is used to level the cleft side of Cupid's bow handle, and cutaneous closure proceeds superiorly from this junction. The dislocated alar cartilage is visualized though a nostril rim incision and suspended to the ipsilateral upper lateral cartilage. Symmetry of the alar base is addressed in three dimensions, including maneuvers to position the deviated anterior-caudal septum, configure the sill, and efface the lateral vestibular web. The authors believe the technical refinements described herein contribute favorably to the outcome of repair regarding unilateral cleft lip and nasal distortion.

QUANTITATIVE ASSESSMENT OF NASAL AND UPPER LIP CHANGES AFTER LE FORT I OSTEOTOMY SURGERY USING A 3-DIMENSIONAL COMPUTED TOMOGRAPHY (르포씨 1형 골절단술후 코와 상순의 연조직 변화의 삼차원 컴퓨터 단층촬영을 이용한 정량적 측정에 관한 연구)

  • Lee, Won-Deok;Yoo, Chung-Kyu;Choi, Jin-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.1
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    • pp.49-56
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    • 2010
  • Objective: To evaluate nasal and upper lip changes after Le Fort I surgery by means of images taken with a three-dimensional computed tomography (3D-CT). Methods: Fifteen patients (9 female and 6 male, mean age 21.9 years) with preoperative and postoperative 3D-CT were studied. The patients underwent maxillary movement with impaction or elongation, and advancement or setback. With the 3D-CT which presents reconstructive soft tissue images, preoperative and postoperative measurement and analysis were performed for nasal tip projection angle, columellar angle, supratip break angle, nasolabial angle, interalar width, internostril width, columella length and nasal tip projection. Results: Postoperative interalar and internostril widening was significant for all categories of maxillary movement. However, there was little significant relation in all parameters between the amount and direction of maxillary movement. Interestingly, movement of the maxilla with upward did show a little decrease in the columellar angle, supra tip break angle and nasolabial angle. Also movement of the maxilla with forward did show a little advancement in the upper lip position. Conclusion: Changes to the nose clearly occur after orthognathic surgery. There was a significant increase in postoperative interalar width and internostril width with maxillary movement. However, no clear correlation could be determined between amount of change and maxillary movement. Interestingly, maxillary impaction did show a little decrease in the columellar angle, supra tip break angle and nasolabial angle. In addition, we used 3D-CT for more precise analysis as a useful tool.

STABILITY OF ORTHOGNATHIC SURGERY FOR CLEFT LIP AND PALATE PATIENTS (구순구개열환자에 대한 악교정수술후 안정성에 대한 연구)

  • Kwon, Tae-Geon;Mori, Yoshihide;Minami, Katsuhiro;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.4
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    • pp.407-413
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    • 2000
  • To evaluate the stability after orthognathic surgery in cleft lip and palate patients using rigid fixation, 20 patients underwent primary repair in childhood and later developed a jaw deformity and malocclusion that required orthognathic surgery were reviewed. Two groups, one of 10 patients performed Le Fort I osteotomy with sagittal split ramus osteotomy and one of 10 patients with sagittal split ramus osteotomy of the mandible, were evaluated. Each group had unilateral cleft only and all alveolar cleft sites had been grafted with autogeneous bone before the orthognathic surgery. The amount of surgical movement and relapse were compared in both horizontal and vertical dimensions. Two-jaw surgery group was more stable than mandibular surgery only group in mandibular position (p< 0.05). Statistically significant relapse was observed in mandibular skeletal point in mandibular surgery group (p<0.05). There was no statistically significant relapse in the skeletal point of two-jaw surgery group. However, the correlation between the horizontal surgical movement and relapse was detected (r = 0.88). This correlation indicates the need of overcorrection. The presence of scar tissues and relatively deficient maxillary bone could be attributed to this close relation between the surgical change and relapse.

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Articulatory modification of /m/ in the coda and the onset as a function of prosodic boundary strength and focus in Korean

  • Kim, Sahyang;Cho, Taehong
    • Phonetics and Speech Sciences
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    • v.6 no.4
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    • pp.3-15
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    • 2014
  • An articulatory study (using an Electromagnetic Articulography, EMA) was conducted to explore effects of prosodic boundary strength (Intonational Phrase/IP versus Word/Wd), and focus (Focused/accented, Neutral, Unfocused/unaccented) on the kinematic realization of /m/ in the coda (${\ldots}$am#i${\ldots}$) and the onset (${\ldots}$a#mi${\ldots}$) conditions in Korean. (Here # refers to a prosodic boundary such as an IP or a Wd boundary). Several important points have emerged. First, the boundary effect on /m/s was most robustly observed in the temporal dimension in both the coda (IP-final) and the onset (IP-initial) conditions, generally in line with cross-linguistically observable boundary-related lengthening patterns. Crucially, however, in contrast with boundary-related slowing-down effects that have been observed in English, both the IP-final and IP-initial temporal expansions of Korean /m/s were not accompanied by an articulatory slowing down. They were, if anything, associated with a faster movement in the lip opening (release) phase (into the vowel). This suggests that the mechanisms underlying boundary-related temporal expansions may differ between languages. Second, observed boundary-induced strengthening effects (both spatial and temporal expansions, especially on the IP-initial /m/s) were remarkably similar to prominence (focus)-induced strengthening effects, which is again counter to phrase-initial strengthening patterns observed in English in which boundary effects are dissociated from prominent effects. This suggests that initial syllables in Korean may be a common focus for both boundary and prominence marking. These results, taken together, imply that the boundary-induced strengthening in Korean is different in nature from that in English, each being modulated by the individual language's prosodic system. Third, the coda and the onset /m/s were found to be produced in a subtly but significantly different way even in a Wd boundary condition, a potentially neutralizing (resyllabification) context. This suggests that although the coda may be phonologically 'resyllabified' into the following syllable in a phrase-medial position, its underlying syllable affiliation is kinematically distinguished from the onset.

Effects of the long-term use of maxillary protraction facemasks with skeletal anchorage on pharyngeal airway dimensions in growing patients with cleft lip and palate

  • Kim, Jung-Eun;Yim, Sunjin;Choi, Jin-Young;Kim, Sukwha;Kim, Su-Jung;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.50 no.4
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    • pp.238-248
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    • 2020
  • Objective: To investigate the effects of the long-term use of a maxillary protraction facemask with miniplate (FM-MP) on pharyngeal airway dimensions in growing patients with cleft lip and palate (CLP). Methods: The study included 24 boys with CLP (mean age, 12.2 years; mean duration of FM-MP therapy, 4.9 years), divided into two groups according to the amount of A point advancement to the vertical reference plane (VRP): Group 1, > 4 mm; Group 2, < 2 mm; n = 12/group. After evaluating the skeletodental and airway variables using lateral cephalograms acquired before and after FM-MP therapy, statistical analyses were performed. Results: Group 1 showed greater forward and downward displacements of the posterior maxilla (posterior nasal spine [PNS]-horizontal reference plane [HRP]; PNS-VRP), greater increase in ANB, more forward tongue position (tongue tip-Pt vertical line to Frankfort horizontal plane), and greater increase in the oropharynx (superior posterior airway space [SPAS]; middle airway space [MAS]) and upper nasopharynx (PNS-adenoid2) than did Group 2. While maxillary advancement (A-VRP and PNS-VRP) correlated with increases in SPAS, MAS, and PNS-adenoid2, downward displacement of the PNS (PNS-HRP) correlated with increases in SPAS, MAS, PNS-adenoid1, and PNS-adenoid2, and with a decrease in vertical airway length (VAL). Mandibular forward displacement and decrease in mandibular plane correlated with increases in MAS. Conclusions: FM-MP therapy had positive effects on the oropharyngeal and nasopharyngeal airway spaces without increases in VAL in Group 1 rather than in Group 2. However, further validation using an untreated control group is necessary.

Cephalometric predictors of future need for orthognathic surgery in Korean patients with unilateral cleft lip and palate despite long-term use of facemask with miniplate

  • Yu, Sang-Hun;Baek, Seung-Hak;Choi, Jin-Young;Lee, Jong-Ho;Kim, Sukwha;On, Sung-Woon
    • The korean journal of orthodontics
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    • v.51 no.1
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    • pp.43-54
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    • 2021
  • Objective: To investigate the cephalometric predictors of the future need for orthognathic surgery in Korean patients with unilateral cleft lip and palate (UCLP) despite long-term use of facemask with miniplate (FMMP). Methods: The sample consisted of 53 UCLP patients treated by a single orthodontist using an identical protocol. Lateral cephalograms were taken before commencement of FMMP therapy (T0; mean age, 10.45 years), after FMMP therapy (T1; mean age, 14.72 years), and at follow-up (T2; mean age, 18.68 years). Twenty-eight cephalometric variables were measured. At T2 stage, the subjects were divided into FMMP-Nonsurgery (n = 33, 62.3%) and FMMP-Surgery (n = 20, 37.7%) groups according to cephalometric criteria (point A-nasion-point B [ANB] < -3°; Wits-appraisal < -5 mm; and Harvold unit difference [HUD] > 34 mm for FMMP-Surgery group). Statistical analyses including discrimination analysis were performed. Results: In FMMP-Surgery group, the forward position of the mandible at T0 stage was maintained throughout the whole stages and Class III relationship worsened with significant growth of the mandibular body and ramus and counterclockwise rotation of the maxilla and mandible at the T1 and T2 stages. Six cephalometric variables at T0 stage including ANB, anteroposterior dysplasia indicator, Wits-appraisal, mandibular body length, HUD, and overjet were selected as effective predictors of the future need for surgical intervention to correct sagittal skeletal discrepancies. Conclusions: Despite long-term use of FMMP therapy, 37.7% of UCLP patients became candidates for orthognathic surgery. Therefore, differential diagnosis is necessary to predict the future need for orthognathic surgery at early age.

A comparative study of pre- and post-treatment cephalometric measurements: Upper premolar extraction only vs. upper/lower premolar extraction groups (상악 편악 소구치발치와 양악 소구치발치에 의한 교정치료 전후의 측모 두부방사선계측법적 비교 연구)

  • Kim, Young-Seok;Kim, Su-Jung;Kang, Seung-Goo;Lee, Young-Jun
    • The korean journal of orthodontics
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    • v.37 no.6
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    • pp.421-431
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    • 2007
  • The objective of this study was to provide guidelines for the diagnosis and successful treatment of orthodontic treatment with upper premolar extraction only Methods: The sample group consisted of 40 patients (20 with upper premolar extraction only, 20 with both upper and lower premolar extractions) who showed an overjet of more than 7 mm and were finished successfully. Lateral cephalographs were taken before and after orthodontic treatment. Landmarks showing the position of the upper and lower incisors and the position of the upper and lower lip were determined and angular measurement of these values were obtained for statistical analysis (Mann-Whitney test). Results: At pre-treatment, the position of the lower incisor was less labially inclined and the convexity of the lower lip was smaller in the upper premolar extraction only group than in the upper/lower premolar extraction group. At post-treatment, there was no difference in all measurements except for the position of the lower incisor. A comparison of changes between pre- and post-treatment showed that the retraction of upper & lower incisors and the decrease in convexity of the lower lip were greater in the upper/lower premolar extraction group. Conclusions: Treatment by upper premolar extraction can be of benefit for patients whose lower incisor proclination and lower lip protrusion are not excessive.

THE STDUY OF THE RELAPSE OF HARD AND SOFT TISSUE AFTER MAXILLARY PROTRACTION (상악골 전방견인 후 경조직과 연조직의 재발에 관한 연구)

  • Yang, Jun-Ho;Park, Soo-Byung;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.27 no.3 s.62
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    • pp.373-389
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    • 1997
  • The purpose of this stdudy was to evaluate the effect of maxillary protraction and the relapse of hard and soft tissue after maxillary protraction. For this study 29 patients who were treated with maxillary protractor and labiolingual archwire were selected. Their mean age was 9 years 4 months and mean treatment period was 8.5 months. Lateral cephalograms were taken at pretreatment, immediately after treatment and one to three months after removal of the maxillary protractor. They were traced on skeletodental and soft tissue structures based on Burstone's analysis and analyzed by Quick-Ceph Image Digitizing System(ORTHODONTIC PROCESSING). The mean and standard deviation between pretreatment and posttreatment and between posttreatment and retention period for each cephalometric variable were calculated. Student t-test was used to determine the statistical significance of the changes in each variable. Correlation coefficients between hard tissue and soft tissue were used to determine interrelationship. The results were as follows. 1. After maxillayy protraction, the maxilla and maxillary dentition moved antero-inferiorly, the mandibld and mandibular dentition moved postero-interiorly and palatal plane rotated antero-superiorly by $0.59^{\circ}$. 2. After maxillary protraction, the soft tissue of upper lip moved antero-interiorly with the movement of hard tissue but the antero-posterior position of lower lip was stable in spite of the change of hard tissue. The thickness of upper lip was decreased and that of lower lip was increased after maxillary Protraction. 3. During the retention period, the position of jaws was relatively stable but upper and lower anterior teeth and antero-superiorly rotated palatal plane relapsed to original position. 4. During the retention period, the soft tissue of lips was stable antero-posteriorly and moved mote inferiorly than posttreatment. 5. The correlation coefficients between the postion of upper and lower incisal edge and that position of lips were high, especially in horizontal change.

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