Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.34
no.6
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pp.622-627
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2008
In orthognathic surgery, precise analysis and diagnosis are essential for successful results. In facial asymmetric patient, traditional 2D image analysis has been used by lateral and P-A Cephalometric view, Skull PA, Panorama, Submentovertex view etc. But clinicians sometimes misdiagnose because they cannot find exact landmark due to superimposition, moreover image can be magnified and distorted by projection technique or patient's skull position, when using these analysis and method. For overcome these defects, analysis by using of 3D CT has been introduced. In this way we can analysis precisely by getting the exact image free of artifact and finding exact landmark with no interruption of superimposition. So we want to review of relationship between various skeletal landmarks of mandible or cranial base and facial asymmetry by predictable analysis using 3D CT. We select the cases of the patients who visited our department for correction of facial asymmetry during 2003-2007 and who were taken image of 3D CT for diagnosis. 3D CT images were reconstructed to 3D image by using V-Work program (Cybermed Inc., Seoul, Korea). And we analysis the relationship between facial asymmetry and various affecting factor of skeletal pattern. The mandibular ramus hight difference between right and left was most affecting factor that express facial asymmetry. And in this research, there was no relationship between cranial base and facial asymmetry. The angulation between facial midline and mandibular ramus divergency has significant relationship with facial asymmetry
Orthopantomogram is commonly used to evaluate root parallelism. "Good parallelism" between roots is widely accepted as one of the guidelines of a successful orthodontic treatment. In case there was a large angle between crown axis and root axis, and if we valued only the position of crown in establishing occlusal relationship without considering of the situation of root, the problem of root arrangement between adjacent teeth would be occurred. The estimate of root parallelism in mesiodistal direction before and after orthodontic treatment must be emphasized. The intent of this study was to determine the clinical importance and correlation of the angle between crown axis and root axis. Orthopantomograms of 105 orthodontic patients being treated in Yonsei university were used in this study. Twenty-eight teeth in both maxilla and mandible were selected and analyzed quantitively to evaluate the angle between crown axis and root axis, and obtain the correlationship among the individual teeth. The results are as follows: 1. Among the teeth presenting normal distribution, the maxillary right canine showed the largest mean value( $5.73{\pm}4.42^{\circ}$), which was composed of the crown-root angles, and the mandibular left lateral incisor showed the smallest mean value( $0.60{\pm}3.76^{\circ}$). 2. The crown-root angles of the maxillary incisors and the first molars, and the mandibular central incisors and the first molars didn't show normal distribution and the ranges of these angles were dispersed. 3. Significant differences were present between the crown axis and the root axis except for lower first premolars. (p<0.05) 4. No significant difference was present for the crown-root angle between right and left side, (p<0.05) 5. No significant difference was present for the crown-root angle between male and female except for lower left first premolar. (p<0.05) 6. In the upper right quadrant, significant correlations were present between crown-root angles of the central incisor and lateral incisor, lateral incisor and canine. In the upper left quadrant, significant correlations were present between crown-root angles of the central incisor and lateral incisor. In the lower right quadrant, significant correlations were present between crown-root angles of the central incisor and lateral incisor, first molar and second molar. In the lower left quadrant, significant correlations were present between crown-root angles of the central incisor and lateral incisor, lateral incisor and canine, first molar and second molar. (p<0.05)
Yun, Yung Sang;Uhm, Ki Il;Kim, Jee Nam;Shin, Dong Hyeok;Choi, Hyun Gon;Kim, Soon Heum;Kim, Cheol Keun;Jo, Dong In
Archives of Plastic Surgery
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v.42
no.4
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pp.419-423
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2015
Background Orthognathic surgery is required in 25% to 35% of patients with a cleft lip and palate, for whom functional recovery and aesthetic improvement after surgery are important. The aim of this study was to examine maxillary and mandibular changes, along with concomitant soft tissue changes, in cleft patients who underwent LeFort I osteotomy and sagittal split ramus osteotomy (two-jaw surgery). Methods Twenty-eight cleft patients who underwent two-jaw surgery between August 2008 and November 2013 were included. Cephalometric analysis was conducted before and after surgery. Preoperative and postoperative measurements of the bone and soft tissue were compared. Results The mean horizontal advancement of the maxilla (point A) was 6.12 mm, while that of the mandible (point B) was -5.19 mm. The mean point A-nasion-point B angle was $-4.1^{\circ}$ before surgery, and increased to $2.5^{\circ}$ after surgery. The mean nasolabial angle was $72.7^{\circ}$ before surgery, and increased to $88.7^{\circ}$ after surgery. The mean minimal distance between Rickett's E-line and the upper lip was 6.52 mm before surgery and 1.81 mm after surgery. The ratio of soft tissue change to bone change was 0.55 between point A and point A' and 0.93 between point B and point B'. Conclusions Patients with cleft lip and palate who underwent two-jaw surgery showed optimal soft tissue changes. The position of the soft tissue (point A') was shifted by a distance equal to 55% of the change in the maxillary bone. Therefore, bone surgery without soft tissue correction can achieve good aesthetic results.
Skeletal Cl III malocclusion is an orthopedic appliance mainly used for growing children with maxillary undergrowth, which largely entails skeletal Cl III malocclusion. It improves anterior crossbite and maxillary position and thus, enables patients to attain favorable Profile but often involves unfavorable profile with protrusive upper and lower lips. Therefore, if orthodontists have knowledge of which condition helps obtain favorable occlusion and profile, they are able to predict the prognosis and limitation of the treatment. This study was done in order to help obtain favorable Profile after treating growing skeletal Cl III children. In the study, we classified childern into two groups, the one with favorable profile(Group 1, n=12) and the other with unfavorable profile(Group 2, n=14) and, with retrospective study using pre- and post-treatment lateral cephalogram, drew the following conclusions. 1. As patients had more serious labioversion of upper incisors, they were more unlikely to have favorable profiles after the treatment. Protrusion of prosthion, which was related with maxillary incisors, also affected profiles. 2. As the NL-ML angle before the treatment was small, it was more likely to get favorable profile. 3. As the degree of lower lip protrusion was high, it was likely to have bialveolar protrusion after the treatment. 4. As the degree of downward and backward rotation of mandible was high, it was likely to get unfavorable profile.
Journal of the korean academy of Pediatric Dentistry
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v.26
no.2
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pp.248-261
/
1999
In order to define a current set of Korean children norm with mixed dentition, following study was done. The subjects were 102 healthy dentition contestants(48boys, 54girls). Standardized lateral head roentgenograms were taken, and Ricketts analysis was done. Results were as follows: 1. Length of anterior cranial base, posterior facial height, corpus length were longer in male than in female(p<0.05), and Porion was located posteriorly in male than in female(p<0.01). 2. Through facial depth, Pogonion of male was more forwardly positioned(p<0.05), mandible was significantly steeper in female, and maxillary anterior teeth were significantly tipped forward in male(p<0.05). 3. Variables such as length of anterior cranial base, upper molar position(p<0.01) and corpus length(p<0.05) were significantly changed by age. 4. Maxillary height, facial depth, mandibular plane angle, convexity were changed by age, but not significantly(p>0.05).
If there are problems for us to sleep, we are faced with fatigue and dizziness in the day. Snoring and OSAS (obstructive sleep apnea syndrome) during sleeping are the main cause of sleep disorder. Treatments through surgical method and sleep splint can be performed to treat snoring and OSAS. Relapse of snoring and OSAS is common after treatment by surgical method. But, Recently sleep splint is frequently applied to treat snoring and OSAS with surgical treatment, because it is convenient and conservative. Sleep splint treat snoring and OSAS by ensuring airway through nose. As first step of fabrication occlusal bite is gained at a point that patient get feeling of increased nasal breathing in supined position, and next, the bite is transfered to sleep splint. This study surveyed the effect of sleep splint by questionnaire to the out-patients (the Dept. of Oral and Maxillofacial Surgery, Chonbuk National University Hospital) weared sleep splint and their partners, secondarily measured airflow through nose by aerophone II after wearing sleep splint and finally evaluated the effect of treatment of snoring and OSAS by sleep splint. The obtained result were as follows; 1. Though 'sleep splint' couldn't eliminate fundamental problems of snoring, it could improve the symptoms when patients were selected could using the 'Nakagawa's respiration method'. 2. Patients who used the sleep splint could breathe stably when patients are sleeping stably. Wearing a 'sleep splint' improved airflow by expanding the upper airway. 3. Even though sleep splint can be made with variable materials, the patients expressed the most satisfaction on the splint with '0.75mm hard shell'. 4. The 'Herbst' may allows the mandible to move the TMJ to relax. Nevertheless, some patients experienced a discomfort or irritation. 5. In Snoring and OSAS cases, it is recommended that patients should first explore non-surgical options prior to choosing a surgical treatment.
In this study, Receiver Operating Characteristic(ROC) analysis was used to evaluate the ability of cephalometric measurements to identify patients with Class III malocclusions. ROC analysis is the method for determining the validity of a diagnostic measure and for evaluating the relative value of diagnostic tests. The sample consisted of 496 patients with malocclusion. Class III malocclusion is defined as the dental relationship for which The mesiobuccal groove of the lower first molar is deviated mesially from the mesiobuccal cusp of the upper first molar. Of the total sample of 496 patients, 245 had Class III malocclusions. 16 cephalometric measurements were selected, each of which was treated as a diagnostic test. The ROC curves were generated for each cephalometric measurement with intervals of $1.0^{\circ}$ for angular measurements, 1.0mm for linear measurements. The area under the ROC curves was measured for direct comparison among different diagnostic tests. The results were as follows; 1. The 'Wits' appraisal was found to be a better diagnostic criterion for the presence of Class III malocclusion than any other commonly'used cephalometric measurement. 2. AB plane angle, ANB angle, App-Bpp distance, AF-BF distance, APDI, Distance of point A and Pog to N perpendicular, maxillomandibular differential had high diagnostic value. 3. Cephalometric measurements which evaluate the position of the mandible had moderate diagnostic value. 4. Cephalometric measurements related to the maxilla discriminated least between patients with and without Class III malocclusion.
Alvarez-Arenal, Angel;Gonzalez-Gonzalez, Ignacio;deLlanos-Lanchares, Hector;Martin-Fernandez, Elena;Brizuela-Velasco, Aritza;Ellacuria-Echebarria, Joseba
The Journal of Advanced Prosthodontics
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v.9
no.5
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pp.371-380
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2017
PURPOSE. The aim of this study is to evaluate and compare the stress distribution in Locator attachments in mandibular two-implant overdentures according to implant locations and different loading conditions. MATERIALS AND METHODS. Four three-dimensional finite element models were created, simulating two osseointegrated implants in the mandible to support two Locator attachments and an overdenture. The models simulated an overdenture with implants located in the position of the level of lateral incisors, canines, second premolars, and crossed implant. A 150 N vertical unilateral and bilateral load was applied at different locations and 40 N was also applied when combined with anterior load at the midline. Data for von Mises stresses in the abutment (matrix) of the attachment and the plastic insert (patrix) of the attachment were produced numerically, color-coded, and compared between the models for attachments and loading conditions. RESULTS. Regardless of the load, the greatest stress values were recorded in the overdenture attachments with implants at lateral incisor locations. In all models and load conditions, the attachment abutment (matrix) withstood a much greater stress than the insert plastic (patrix). Regardless of the model, when a unilateral load was applied, the load side Locator attachments recorded a much higher stress compared to the contralateral side. However, with load bilateral posterior alone or combined at midline load, the stress distribution was more symmetrical. The stress is distributed primarily in the occlusal and lateral surface of the insert plastic patrix and threadless area of the abutment (matrix). CONCLUSION. The overdenture model with lateral incisor level implants is the worst design in terms of biomechanical environment for the attachment components. The bilateral load in general favors a more uniform stress distribution in both attachments compared to a much greater stress registered with unilateral load in the load side attachments. Regardless of the implant positions and the occlusal load application site, the stress transferred to the insert plastic is much lower than that registered in the abutment.
Journal of Dental Rehabilitation and Applied Science
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v.27
no.4
/
pp.437-447
/
2011
In patients who used removable partial dentures for a long period of time, gradual alveolar bone resorption occurs in edentulous area. However, in residual teeth area, alveolar bone is maintained sound. This causes an imbalance in intermaxillary distance between a maxillae and a mandible which is intensified due to expansion in vertical and horizontal bone amount difference between the two area as time passes. As the result, this shows a substantial difference in vertical position according to the period of teeth loss even after residual teeth loss. As in this situation, a patient with bilaterally and anterio-posteriorly different intermaxillary distance, various prosthodontic problems can be caused in fixed implant prosthodontics and implant overdenture. This study shows a case in which implant-supported removable partial denture was fabricated considering residual alveolar bone height after teeth loss in a patient who had been using a distal extension removable partial denture for a long period of time. In anterior area with short intermaxillary distance, fixed prosthodontics were fabricated with implant placement and in posterior area with long intermaxillary distance, a removable partial denture was fabricated. Finally, a small number of implants were placed without additional surgery and economical and comfortable treatment results were shown.
Statement of problem: The position and length of cantilever influence on the stress distribution of implants, superstructure and bone. In edentulous mandible, implant-supported cantilever prostheses that based 4 or 6 implants between mental foramens has been attempted. Excessive bite force loaded at cantilever prosthesis causes bone resorption and breakage of superstructure prosthesis around posterior implants. To complement the cantilever length of conventional prosthesis, In 1992, (McCartney) introduced "cantilever-rest-implant" and Malo reported "All-on-Four" in 2003. Purpose: Analyze and compare the stress distribution of conventional cantilever prostheses with rest implant and All-on-$Four^{TM}$ implant prostheses. Material and method: The external loads(300 N vertically, 75 N horizontally) are applied to first molar area. The stress value, stress distribution and aspect of stress dispersion are analyzed by three-dimensional finite element analysis program, ANSYS ver. 10.0. Results: 1. The rest implant and "All-on-Four" implant system are superior to conventional cantilever prostheses to reduce stress on the bone and the superstructure around implants. 2. The rest implant was of the greatest advantage to stress distribution on bone, implant and superstructure. 3. With same number of implants, distally tilted implants are preferred to conventional cantilever prostheses for reducing the length of cantilever.
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