Variation in the facial pattern and effect of the rotational jaw growth on the facial proportion were studied in serial cephalometric radiographs of 40 Korean children (25 boys, 15 girls) ranging in age from 6 to 13 years. According to Y-axis (N-S-Gn) growth change during the 7 years of period, the subject who had exhibited 'wave-like' manner of Y-axis growth change within ${\pm}\;2^{\circ}$ was classified to the Parallelwise group and the subject who had exhibited Y-axis increase more than $+2^{\circ}$ was classified to the Clockwise rotation group and the subject who had exhibited Y-axis decrease more than $-2^{\circ}$ was classified to the Counterclockwise rotation group. For the comparison of each group, a total of 22 morphologic variables were employed and the data were analyzed by means of computer morphometrics and statistical methods. On the basis of the finding of this study, the following trends were established. 1. The Parallelwise group was $75\%$, the Clockwise rotation group was $12.5\%$ and the Counter-clockwise rotation group was $12.5\%$. 2. The growth pattern of cranial base was related to the rotation of mandible. 9. Maxillary prognathism was occured in the Counterclockwise rotation group and the rotation of palatal plane was occured in the Clockwise rotation group. 4. Mandibular prognathism was occured in the Parallelwise and the Counterclockwise rotation groups, especially in the Counterclockwise rotation group. 5. The degree of maxillo-mandibular divergency was constant in the Clockwise rotation group but decreased in the Counterclockwise rotation and the Parallelwise groups, especially in the Counterclockwise group. 6. There were no differences in the size of the anterior upper facial height (N-ANS) and the posterior lower facial height ((Go-Me)-PNS) but there were differences in the size of the anterior lower facial height (ANS-Me) and the posterior upper facial height ((S-N)-PNS) between each group. 7. The growth increment and the size of the facial depth was not related to the growth pattern of the face but the growth increment and the size of the facial height was related to the growth pattern of the face. 8. Proportional change due to the facial growth rotation was concentrated in the anterior lower face. 9. The most apparent difference between each group was happened in the size of the posterior cranial base (S-Ba) and the facial length (S-Gn).
The author obtained some useful information for the class III treatment from long term observation on the growing patients with class III malocclusion. 8 patients were selected for this study and presentation. From these observation so far my conclusions might be as follows: First in the early correction of the anterior crossbite, considerable forward growth changes were observed in the maxilla Second, as for the growth modification of jaws by orthopedic treatment only limited effects were recognized from the long-term observation Thrid, at early age of patients with anterior crossbite, any data couldn't make me predict the stability after treatment on the long-term basis. Fortunately, however, genial angle showed a marginal possibility of it prediction. Fourth, at an advanced age/ retraction orthopedic force on the mandible and the rapid change in the mandibular position may cause some trouble in the T.M.joint. Finally, the followings are recommendable. As for the anterior crossbite, correct it early as possible, and use orthopedic force under the age of ten. Do not enter the phase II treatment directly. Just wait and observe until the growth were almost completed, focusiong on some important factors such as airway problem, tongue position, and third molar development. Of course, these factors may have some effects on the mandibular growth. for the female, at the age of around 14 years old and the male, around 17 years old, make a final decision whether the patients will continue to be treated orthodontically or surgically Thereby, (I think) the relapse and retreatment problem after treatemnt we have observed so far might be minimized. Furthermore, the active treatment time may be also reduced.
The purpose of this study was to evaluate treatment effects of bionator in Class II division 1 malocclusion by FEM(Finite Element Method). The 73 subjects were classified into good result group and poor result group in reference to posttreatment molar relation, posttreatment overbite and overjet, posttreatment profile, and relapse. Pretreatment and posttreatment lateral cephalograms were taken and FEM was performed. The results were as follow; 1. There was no statistical significance in treatment changes between the sexes, and between the treatment result groups. 2. Treatment changes were not significantly different among the age groups. 3. The effect of treatment period groups on skeletal and dentoalveolar changes were analyzed using ANOVA. Body of maxilla, upper incisor, anterior face, ramus, upper anterior face, lower anterior face and treatment effect were correlated with the treatment period, but correlation coefficients were low. 4. The results of present investigation confirm that Class II bionator can assist in the correction of Class II division 1 malocclusion, mainly due to dentoalveolar changes. 5. There is significant difference in skeletal and dentoalveolar pattern between good result group and poor result group. In poor result group, maxilla was relatively downward and backward rotated, mandible was relatively backward rotated, upper incisor was in relatively lingual position, lower incisor was in relatively labial position.
This study aimed at investigating the skeletal, dentoalveolar, and soft tissue changes of Class III malocclusion cases treated by second molar extraction. The lateral cephalograms of 15 subjects with moderate Class III malocclusion by average ANB $-1.4^{\circ}\;and\;IMPA\;85^{\circ}$ were traced and the computerized superimposition of average craniofacial change was made. The data was gathered and statistically analyzed. The results were as follows: 1 Lower anterior facial height/anterior facial height increased by 0.6%(P<0.01), mandibular plane increased by $1.5^{\circ}$(P<0.05). 2. There was a slightly downward & backward rotation of the mandible. 3. Lower first molar tipped distally by 4.nm(P<0.001), lower anterior teeth lingually tipped by $3.2^{\circ}$(P<0.05). 4. Retracted lower lip improved facial profile. This study may suggest that second molar extraction could be effective for a moderate Class III malocclusion to make distalization of the lower first molar easier and avoid severe lingual tipping of the lower incisor, if the lower third molar has a normal shape, good direction of eruption and adequate time for lower second molar extraction
The purpose of this research is to evaluate and compare the plaque removal ability of sonic brushing and manual brushing in order to present a method for continuous and effective oral hygiene control during orthodontic treatment. Nonextracted adolescent patients (male: 23 persons, female: 37 persons) and adult patients (male: 15 persons, female: 45 persons) outfitted with a fixed orthodontic appliance from their incisors to second molar, in both the maxilla and mandible, were divided into manual brushing and sonic brushing groups. A Philips oral healthcare HX-4401 sonic toothbrush was used, and the application of brushing for the two groups was standardized at two minutes. After brushing, the plaque score was measured with a modified Wilkin's PHP. The following results were achieved after comparing each group's plaque score. 1. In patients with a fixed orthodontic appliance when age was not accounted for, the application of sonic brushing exerted a beneficially decreased effect on the plaque score. (adolescents : p<0.01, adults: p<0.05) 2. When comparing the adolescent and adult groups in regard to plaque score, the adolescent group showed a more decreased effect. 3. When using the same toothbrush type, there was no difference between the adolescent and adult groups.
Objective: This study was designed to analyze the primary and secondary stability characteristics of orthodontic mini-screws of tapered design when compared with the cylinder mini-screw. Methods: A total of 48 mini-screws were placed into the buccal alveolar bone of the mandible in 6 male beagle dogs. Comparison was made between tapered and cylinder type mini-screws (Biomaterials Korea, Seoul, Korea). Maximum insertion torque (MIT) was measured using a torque sensor (Mark-10, MGT 50, USA) during installation, and maximum removal torque (MRT) was recorded after 3 and 12 weeks of loading. Results: Taper mini-screws showed a higher MIT value of 22.3 Ncm compared with cylinder mini-screw showing 13.6 Ncm (p < 0.001). The MRT of the taper mini-screw showed a significantly higher value of 9.1 Ncm than those of cylinder mini-screw of 5.7 Ncm at 3-weeks after installation (p < 0.05). However, there was no difference in the MRT value between the taper and cylinder mini-screws at 12 weeks of loading. Conclusions: These results showed that the high insertion torque of the taper mini-screw design increases initial stability until 3 weeks of loading, but does not have any effect on the secondary stability at 12 weeks of loading.
Objective: The objective of this study was to evaluate the displacement pattern and the stress distribution of the finite element model 3-D visualization during symphyseal widening according to the osteotomy position, osteotomy type, and distraction device. Methods: The kinds of distraction devices used were tooth-borne type, hybrid type, bone-borne type and tooth-borne type $30^{\circ}$ angulated, and the kinds of osteotomy design were vertical osteotomy line between the central incisors and step osteotomy line through the symphysis. Results: All reference points of the mandible including the condyles were displaced laterally irrespective of the osteotomy position, osteotomy method and distraction device. The anteroposterior or vertical displacements showed small differences between the groups. The widening pattern of the osteotomy line in the tooth-borne type of device was v shaped, and that of bone-borne type was a reverse v shape. However, the pattern in the hybrid type was parallel. The lateral displacement of the mandibular angle by the bone-borne device was more remarkable than the other types of devices. The displacement by the $30^{\circ}$ angulated tooth-borne type was different between the left and right sides in both the transverse and anteroposterior aspects. Conclusion: The design of the distraction devices and osteotomy line can influence the displacement pattern and the stress distribution during mandibular symphyseal distraction osteogenesis procedures.
Objective: The aim of this retrospective study was to evaluate the pre- and postsurgical bone densities at alveolar and extra-alveolar sites following two-jaw orthognathic surgery. Methods: The sample consisted of 10 patients (mean age, 23.2 years; range, 18.0-27.8 years; 8 males, 2 females) who underwent two-jaw orthognathic surgery. A three-dimensional imaging program (Invivo 5) was used with multidetector computed tomography images taken pre- and postoperatively (obtained 32.3 ± 6.0 days before surgery and 5.8 ± 2.6 days after surgery, respectively) for the measurement of bone densities at the following sites: (1) alveolar bone in the maxilla and mandible, (2) extra-alveolar sites, such as the top of the head, menton (Me), condyle, and the fourth cervical vertebrae (C4). Results: When pre- and postsurgical bone densities were compared, an overall tendency of decrease in bone density was noted. Statistically significant reductions were observed in the densities of cancellous bone at several areas of the maxillary alveolar bone; cortical and cancellous bone in most areas of the mandibular alveolar bone; cortical bone in Me; and cancellous bone in C4. There was no statistically significant difference in bone density in relation to the depth of the alveolar bone. In a comparison of the bone densities between groups with and without genioplasty, there was almost no statistically significant difference. Conclusions: Accelerated tooth movement following orthognathic surgery may be confirmed with reduced bone density. In addition, this study could offer insights into bone metabolism changes following orthognathic surgery, providing direction for further investigations in this field.
Aims: The present study investigated the relationship between condylar resorption and craniofacial skeleton types(especially vertical relationships), the differences of craniofacial skeleton types between with open bite group and without open bite group, and the associations of anterior disc dislocation with or without reduction to condylar resorption with MRI. Patients selection and methods: Clinical examination, magnetic resonance imaging (MRI), panorama, lateral transcranial and lateral cephalometric radiographs in 34 patients with condylar resorption were used to investigate this relationship. Results and Conclusions: Patients with the following specific facial morphologic characteristics appear to be most susceptible to condylar resorption: (1) females were predominant, (2) patients' age ranged from 12 to 50 years old with a strong predominance for 2nd and 3rd decades, (3) patients had high mandibular plane angle and high gonial angle, (4) patients had decreased vertical height of the ramus, (5) patients had generally significant antegonial notch, (6) patients had predominance of Class I occlusal relationship with or without open bite but mandible was retruded as mean ANB 5.54 degrees, (7) condylar resorption rarely occurs in lower mandibular plane angle facial types, (8) although no statistically significant difference was found, the open bite group had a tendency more hyperdivergent skeletal pattern than the non open bite group, and (9) imaging demonstrates from small resorbing condyles to idiopathic condylar resorption and TMJ articular disc dislocations. Thus, morphologic features of patients with vertical discrepancies may represent a risk factor for the development of condylar resorption.
Lee Byung-Do;Hwang Eui-Hwan;Lee Sang-Rae;Hong Jung-Pyo
Journal of Korean Academy of Oral and Maxillofacial Radiology
/
v.25
no.2
/
pp.423-435
/
1995
The purpose of this study was to observe the effect of TGF-βl, which promotes differentiation and proliferation of osteoblasts, on bone regeneration. Experimental bone defects that measured 3 mm in diameter were created on the mandibles of guinea pig by removal of bone with the use of trephine burs. In one side of mandibular body, the experimental groups, bone defects were grafted with Biogran(Orthovita Co., U.S.A) and TGF-β1(R&D System Co., U.SA). In the remaining side of the mandiblar body, the control groups, bone defects were grafted with only Biogran. Guinea pigs in the control and experimental groups were serially terminated by fours on the 3 days, the 1 week, the 2 weeks, the 3 weeks, and the 4 weeks after experiment, and both sides of the mandibular bodies were removed and fixed with 10% neutral formalin. They were decalcified and embedded in paraffin as using the usual method. The specimen sectioned and stained with hematoxylin and eosin. Also, they were radiographed with a soft X -ray apparatus. The obtained results were as follows; 1. Hemorrhagic condition, observed in the granulation tissues, disappeared on the 1 week after experiment in both groups, and more prominent in the experimental group. The granulation tissues of the experimental group had larger number of cells than those of the control group. 2. Osteoblastic differentiation in the margin of grafted material and adjacent bone was observed on the 1 week after experiment in both groups. Also, bone formation was observed in immature form on the 1 week after experiment. and more prominent in the experimental group. 3. In the polarizing microscopic examination, bone matrix was very loose on the 1 week after experiment, but increase in density with time, and more prominent in the experimental group. 4. In the microradiographic examination, newly formed bone was observed in the experimental group on the 2 weeks after experiment, and this was observed earlier than in the control group. Newly formed bone was increased with time and defected area was markedly decreased on the 4 weeks after experiment.
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