This research was performed to find out the adaptation patterns of maxillary and mandibular posterior teeth to the changes in relationships of vertical skeletal components, which constitute the skeletofacial complex. For this research, 61 adult malocclusion patients were chosen as subjects according to the Hellman's dental age with normally ranged FMN-A-B angle. These subjects were divided into 4 groups in maxilla and 3 groups in mandible according to mesiodistal inclinations of teeth. Following results were obtained after studying the relationships of the vertical skeletal components between each group. 1. Inspire of the fact that the FMN-A-B angle was within a normal range, the degree of mesiodistal inclinations of maxillary and mandibular posterior teeth showed differences in relation to the anteroposterior relationships of maxilla and mandible. In case where the FMN-A-B angle was large, the mesial inclinations of maxillary posterior teeth showed more increase from the posterior to the anterior, whereas in mandible it showed overall decrease. 2. The degrees of mesial inclinations of mandibular posterior teeth were increased when the angulations of lower facial height, occlusal plane angle and mandibular plane angle were greater. 3. The patterns of mesial inclinations of maxillary posterior teeth were varied according to the angulation of lower facial height. If relatively large, it showed more increase from the posterior to the anterior and it was decreased nearly consistent when the angulation was small. 4. The degrees of mesial inclinations of maxillary posterior teeth were decreased as the lower facial height, palatal plane angle, occlusal plane angle and the mandibular plane angle became greater.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.36
no.4
/
pp.320-324
/
2010
Introduction: The placement of a single miniplate is not sufficient to achieve rigid fixation in mandibular angle fractures. It often causes difficulties in reducing the intermaxillary fixation (IMF) period. Consequently, the placement of 2 miniplates is preferable. The intraoral approach in an open reduction and internal fixation (ORIF) of a mandibular angle fracture with 2 miniplates is often challenging. Accordingly, an alternative of transbuccal approach is performed. However, this method leaves a scar on the face and can result in facial nerve injury. This clinical study suggests a protocol that can maintain rigid fixation without a transbuccal approach in mandibular angle fractures. Materials and Methods: The subjects were 7 patients who sustained fractures of the mandibular angle and treated at Department of Oral and maxillofacial surgery, Sacred Heart Hospital, Hallym University. ORIF under general anesthesia was done using the intraoral approach. One miniplate was inserted on external oblique ridge of the mandible, and the other was placed on lateral surface of the mandibular body with contra-angle drill and driver. A radiographic assessment and occlusal contact point examination was carried out before surgery, and 2, 4 and 6 weeks after surgery. Results: The mean operation time was 80 minutes. Regarding the occlusion state, the number of contact points increased after surgery. Paresthesia and infection were reported to be complications before surgery. Conclusion: The placement of 2 miniplates using contra-angle drill for ORIF of mandibular angle fractures allows early movement of the mandible without IMF. We propose this approach to reduce the patients’discomfort and simplify the surgical procedure.
The primary objective of this study was to define the differences that exist. between different sexes on the dentoskeletal framework and the soft tissue profile around the mouth. For the purpose of this study, cephalometric radiographs were obtained from the centric occlusion with closed lip position, through the research on each 42 males and females aged from 17 to 22 years with normal occlusion and acceptable facial appearence. The results were as follows: 1. Maxillary to mandibular relationships. Among the angles formed by the long axis of the maxillary and mandibular anterior teeth, the maxillary and mandibular anterior alveolar bone, and the lower and upper lips (Fig.2), only the angle formed by the lips was more acute in males than in females. The males have a more rounded profile, and the females have a flatter profile in the lower third of the face. The differences is statistically significant for the angle formed by the lips. The fact that the lips have a difference greater than that of teeth or the alveolar bone indicates that the lip position is not entirely due to tooth and bony support. Possibly the thickness of the lips has an influence. 2. Occlusal plane. The occlusal plane was related to the anterior tooth inclination, anterior alveolar bone profile, and the lip contour, both maxillary and mandibular (Fig.3). Only the angle related to lower lip was statistically significant. The females again had the more obtuse angle, indicating a flatter profile than that of the males. 3.Skeletal planes. The angles formed by the anterior maxillary lips, teeth, and alveolar bone with the Frankfort plane and the angles of the mandibular lips, teeth, and, alveolar bone and the mandibular plane were investigated (Fig.4). Results were similar to those from maxillary to mandibular relationships. The results were statistically significant for the upper lip and the lower lip, only. 4. Esthetics. The facial line and the mandibular plane were compared with the esthetic line. These angles were different for the different sexes, but only the latter was statistically significant. This difference may be due to the profile contour of the nose.
Park, Jongohk;Choi, Hyungon;Shin, Donghyeok;Kim, Jeenam;Lee, Myungchul;Kim, Soonheum;Jo, Dongin;Kim, Cheolkeun
Archives of Craniofacial Surgery
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v.19
no.3
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pp.190-193
/
2018
Background: This study was conducted to determine the effect of the distributional relationship between dental roots and the mandibular bone on single mandibular bone fractures, which are common craniofacial fractures. Methods: This was a retrospective, single-center study in Seoul, Korea. Patients with single mandibular fractures in the symphysis, parasymphysis, body, and angle area, with tooth structure involvement were included. The control group included patients with simple, bone-level lacerations without fractures. In total, 94 patients (72 males and 22 females) were included in the treatment group, and 125 (71 males and 54 females) were included in the control group. The height of the mandibular bone and the dental root were measured with panoramic radiography. The central incisor represented the symphysis area, the canine represented the parasymphysis area, the first molar represented the body area, and the second molar represented the angle area. Results: In the treatment group, symphysis fractures occurred in 16 patients (17%), parasymphysis fractures in 36 patients (38%), body fractures in 17 patients (18%), and angle fractures in 25 patients (27%). The ratios of the dental roots to the total height of the mandibular bone in the treatment group were 30.35%, 39.75%, 39.53%, and 36.27% for symphysis, parasymphysis, body, and angle areas, respectively, whereas in the control group, they were 27.73%, 39.70%, 36.76%, and 35.48%. The ratios of the treatment group were significantly higher than those of the control group. Conclusion: The results show that the higher ratio of the dental root to the height of the mandibular bone increases the fracture risk.
Park, Jun-Woo;Choi, Jin-Young;Kim, Hyung-Wook;Kim, Jong-Sik;Choung, In-Won;Kang, Jin-Han;Hong, Soon-Min
Maxillofacial Plastic and Reconstructive Surgery
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v.29
no.4
/
pp.340-352
/
2007
In this systematic review on bone reduction procedures for the correction of the prominent mandibular angle, we collected and sorted the methods. The strength and weakness, indication, complication, and final esthetic result of each method were evaluated. After searching and filtering the literatures on the base of inclusion criteria, 9 eligible case series studies were included in this study. There were 3 types of curved ostectomies and 4 types of lateral cortical ostectomies. Surgical procedures for curved ostectomies were divided into 2 types. One was single curved ostectomy and the other was multistaged curved ostectomy. Lateral cortical ostectomies reported were all similar to sagittal split ramus osteotomy. The complications reported in the included studies were scarce, but curved ostectomies may be able to induce many complications. The prominent mandibular angle must be analyzed in the lateral dimension and frontal dimension, and curved ostectomy can reduce the mandibular angle laterally while lateral cortical ostectomy can reduce the bigonial distance frontally. Because curved ostectomies can induce complications and unnaturally large mandibular angle while can not reduce bigonial distance efficiently, the current trend for the angle reduction procedure is lateral cortical ostectomies.
Purpose: The aim of this study is to identify the usefulness of unilateral mandibular angle ostectomy, so-called "Lateral Angle Reduction", in asymmetric prognathism patients by the assessment of postoperative stability and esthetic results Patients and methods: For the retrospective study, 10 skeletal class III mandibular asymmetry patients who were performed SSRO and unilateral mandibular angle ostectomy, Lateral Angle Reduction, was selected. Lateral and posterioanterior cephalogram was taken before surgery (T0), 1day after surgery (T1) and 6month after surgery (T2). To know the esthetic results the facial width and lateral facial contour were examined on posterioanterior cephalogram and to know the postoperative stability B point and Incisor inferius was examined on lateral cephalogram. Statistical analysis was performed. Results: From T0 to T1, Intergonial width was significantly decreased, dominantly at shortened side but no significant changes at lengthened side. Those were well-maintained during 6 months. Lateral facial angle and Ramus angle was significantly decreased on only shortened side from T0 to T1. As a result, after surgery, there were no significant differences in all measurements between shortened side and lengthened side. Ramus deviation angle in shortened side and ramus angle in lengthened side which reflect the angulation of ramus on frontal plane didn't show significant changes after surgery and during postsurgical periods. Lower dental midline showed no statistical changes during postsurgical period. The relapse rate on B-point was 11.92%. Conclusion: Unilateral "Lateral angle reduction" in the asymmetric mandible is valuable to obtain the narrow lower face and symmetric facial contour with a good stability.
Purpose: To investigate the prevalence of bifid and trifid mandibular canals using cone-beam computed tomography (CBCT) images, and to measure their length, diameter, and angle. Materials and Methods: CBCT images of 500 patients, involving 755 hemi-mandibles, were used for this study. The presence and type of bifid mandibular canal was evaluated according to a modified classification of Naitoh et al. Prevalence rates were determined according to age group, gender, and type. Further, their diameter, length, and angles were measured using PACSPLUS Viewer and ImageJ 1.46r. Statistical analysis with chi-squared and analysis of variance (ANOVA) tests was performed. Results: Bifid and trifid mandibular canals were found in 22.6% of the 500 patients and 16.2% of the 755 sides. There was no significant difference between genders and among age groups. The retromolar canal type accounted for 71.3% of the identified canals; the dental canal type, 18.8%; the forward canal type, 4.1%; and the trifid canal type, 5.8%. Interestingly, seven cases of the trifid canal type, which has been rarely reported, were observed. The mean diameter of the bifid and trifid mandibular canals was 2.2 mm and that of the main mandibular canal was 4.3 mm. Their mean length was 16.9 mm; the mean superior angle was $149.2^{\circ}$, and the mean inferior angle was $37.7^{\circ}$. Conclusion: Bifid and trifid mandibular canals in the Korean population were observed at a relatively high rate through a CBCT evaluation, and the most common type was the retromolar canal. CBCT is suggested for a detailed evaluation of bifid and trifid mandibular canals before mandibular surgery.
Objective: To evaluate the relationship of gingival thickness (GT) and the width of keratinized gingiva (WKG) with different malocclusion groups and the level of crowding. Methods: A total of 187 periodontally healthy subjects (121 females and 66 males) who presented at the Faculty of Dentistry in $Y{\ddot{u}}z{\ddot{u}}nc{\ddot{u}}$ Yil University for orthodontic treatment were enrolled in the study. The individuals involved in the study were divided into three groups; Angle Class I malocclusion, Angle Class II malocclusion, and Angle Class III malocclusion. Each group was classified as mild, moderate, or severe according to the level of crowding. WKG was determined as the distance between the mucogingival junction and the free gingival margin. GT was determined by the transgingival probing technique. Factorial variance analysis and the Duncan multiple comparison test were employed to identify the extent to which a difference was apparent between the groups according to these parameters. Results: It was determined that teeth in the mandibular anterior region display the thin gingival biotype. WKG and GT were observed as being higher at the mandibular incisor teeth in the severe crowding group and at the mandibular canine teeth in the mild crowding group. The GT of the mandibular right central and lateral incisors was found to be thinner in the Angle Class III group. Conclusions: Within the limits of this study, the results demonstrate that, there is no significant relationship of WKG and the mean GT in the mandibular anterior region according to the Angle classification.
Purpose: A lower facial contouring surgery has become a commonly performed procedure in Asia. Currently, mandibular angle sagittal ostectomy and botulinum toxin type A treatment are main procedures for aesthetic correction of a broad lower face. There are a few date to show the differences in the mandibular contouring changes between mandibular angle splitting ostectomy and botulinum toxin type A treatment. Facial golden mask is easy to apply, inexpensive, and relatively objective for evaluation of facial contour analysis. This study was designed specifically to compare the changes in lower face width after two different forms of lower facial contouring procedure using facial golden mask. Methods: Seventeen patients, aged 18 to 55 years (mean, 28.6 years), 15 women and 2 men, consented to the study and receive a contouring procedure of lower face. The patients were classified in to 2 groups. In group A, the sample consisted of 10 patients with a prominent squared mandibular angle and mandibular angle splitting ostectomy was performed. In group B, the sample consisted of 7 patients with masseteric hypertrophy and botulinum toxin type A treatment was performed. Photographs of the face were taken to record the facial change at preoperative and postoperative. The postoperative photographs were taken to considered maximal effect at 2 years after surgery in group A and 4.8 months after treatment in group B. The authors applied the facial golden mask to preoperative and postoperative photographs and horizontal ratio, which compares facial width with golden mask width, were calculated. We made an analysis of the result of horizontal ratio using SPSS. Results: Overall average horizontal ratio of pre- and postoperative photos of group A were 1.24 and 1.11, whereas overall average horizontal ratio of pre- and postoperative photos of group B were 1.19 and 1.12. The horizontal ratio decreased 10.24% in group A and 5.93% in group B. There was a statistically significant change in before and after treatment, but there was no significant change in comparing the group A and group B. Conclusions: The result from this study suggest that mandibular angle sagittal ostectomy and botulinum toxin type A treatment showed relatively satisfactory clinical effects on lower facial contouring treatment. There was no statistical significant difference within two lower facial contouring treatment. Facial golden mask is easy to apply, inexpensive, and relatively objective, so we think that facial golden mask is a good method for evaluation of lower facial contouring treatment.
It is very important for the ideal restorations of anterior openbite patients to record the mandibular movement and to harmonize mandibular movement with other organs in stomatognathic systems. This study was designed to compare the mandibular movement of anterior openbite patients with that of normal bite(Angle Class I) patients, to ascertain which components of mandibular movement have differences between two groups, and to use for occlusal treatment of mandibular movement. Saphon Visi-trainer Model 3(Tokyo Shizaisha Co. Japan) and Denar Pantronic(Denar Corp.,U.S.A.) were used to record mandibular movement. Pantronic survey was peformed by using an arbitrary hinge axis according to manufacturer's direction. Twenty-eight adult who have physiologically normal occlusion(Angle Class I) and are free of TM dysfunction were selected as a control group(Group 1). Fifteen adult who are anterior openbite patient and have not anterior guidance function and have posterior interference at protrusion were selected as a experimental group(Group 2). The results are as follows : 1. There was no statistically significant difference between the average immediate and progressive side shift of anterior openbite patients(0.54mm, $7.57^{\circ}$) and those of normal group(0.49mm, $5.96^{\circ}$). 2. The average protrusive and orbiting condylar inclination of anterior openbite patient$(30.87^{\circ},\;32.27^{\circ})$ were significantly lower than those of normal group$(36.11^{\circ},\;39.04^{\circ})$ (P<0.05). 3. In the results of Visi-trainer recordings, the mean for the maximum protrusion, the maximum laterotrusion, the angle of laterotrusion and the angle of protrusion in the horizontal trajectory between group 1 and 2 did not differ significantly. 4. The mean for the angle of protrusion, the maximum opening in the frontal trajectory, the ICP-RCP(A-P) distance and the angle of protrusion in the sagittal trajectory differ significantly(P<0.05). 5. The significant correlation was found between orbiting condylar inclination and protrusive condylar inclination.
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