• The korean journal of orthodontics
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• v.31 no.5 s.88
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• pp.499-504
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• 2001

Transverse skeletal deficiency is a common clincal problem associated with narrow basal and dentoalveolar bone. The clinical characteristics of transverse deficiency presents with anterior crowding and posterior buccal crossbite. Orthodontic expansion, using lip bumper and functional devices, was recommanded for younger ages. However, expansion of lower anterior area in older Patients is unstable and tends to relapse toward the original dimension. Distraction osteogenesis is a unique form of clincal tissue engineering and biologic process of new bone formation between bone segments that are gradually separately by incremental traction. Distraction osteogenesis was considered that great potential for correcting transverse mandibular deficiencies. In this Paper, a case of treated transverse deficiency patients with distraction osteogenesis using tooth-borne and tooth & bone-borne distractor is presented.

• The korean journal of orthodontics
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• v.50 no.5
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• pp.304-313
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• 2020

Objective: The aim of this study was to evaluate the stability of bimaxillary surgery involving bilateral intraoral vertical ramus osteotomy performed with or without presurgical miniscrew-assisted rapid palatal expansion (MARPE) in adult patients with skeletal Class III malocclusion. Methods: A total of 40 adult patients with skeletal Class III malocclusion were retrospectively divided into two groups (n = 20 each) according to the use of MARPE for the correction of transverse maxillomandibular discrepancy during presurgical orthodontic treatment. Serial lateral cephalograms and dental casts were analyzed until 6 months after surgery. Results: Before presurgical orthodontic treatment, there was no significant differences in terms of sex and age between groups. However, the difference of approximately 3.1 mm in the maxillomandibular intermolar width was statistically significant (p < 0.001). Two days after surgery, the mandible had moved backward and upward without any significant intergroup difference. Six months after surgery, the maxillary intercanine (2.7 ± 2.1 mm), interpremolar (3.6 ± 2.4 mm), and intermolar (2.0 ± 1.3 mm) arch widths were significantly increased (p < 0.001) relative to the values before presurgical orthodontic treatment in the MARPE group; these widths were maintained or decreased in the control group. However, there was no significant difference in surgical changes and the postsurgical stability between the two groups. No significant correlations existed between the amount of maxillary expansion and postsurgical mandibular movement. Conclusions: MARPE is useful for stable and nonsurgical expansion of the maxilla in adult patients with skeletal Class III malocclusion who are scheduled for bimaxillary surgery.

• The korean journal of orthodontics
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• v.48 no.2
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• pp.113-124
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• 2018

The purpose of this case report was to introduce the concept of orthodontic and orthopedic treatment for a growing patient with Tessier number 0 cleft. A 5-year-old boy patient with Tessier number 0 cleft presented congenitally missing maxillary central incisors (MXCI), a bony defect at the premaxilla, a constricted maxillary arch, an anterior openbite, and maxillary hypoplasia. His treatment was divided into three stages: management of the bony defect at the premaxilla and the congenitally missing MXCIs using a fan-type expansion plate, iliac bone grafting, and eruption guidance of the maxillary lateral incisors into the graft area for substitution of MXCIs; management of the maxillary hypoplasia using sequential facemask therapy with conventional and skeletal anchorage; and management of the remaining occlusal problems using fixed orthodontic treatment. The total treatment duration was 15 years and 10 months. Class I canine and Class II molar relationships and normal overbite and overjet were achieved at the end of treatment. Although the long-term use of facemask therapy resulted in significant protraction of the retrusive maxilla, the patient exhibited Class III profile because of continued mandibular growth. However, the treatment result was well maintained after 2 years of retention. The findings from this case suggest that interdisciplinary and customized approaches are mandatory for successful management of maxillary hypoplasia, bony defect, and dental problems in Tessier number 0 cleft. Moreover, considering the potential of orthognathic surgery or distraction osteogenesis, meticulous monitoring of mandibular growth until growth completion is important.

• The korean journal of orthodontics
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• v.22 no.3 s.38
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• pp.509-529
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• 1992

Skeletal Class III malocclusion is one of the most difficult type to treat and stabilize. For a child with developing skeletal Class III malocclusion, the treatment objective would be to stimulate maxillary growth, particulary one who has markedly deficient maxilla, and to restrain excessive mandibular growth. In order to stimulate the maxillary growth, maxillary protraction appliance is the one of the effective orthopedic appliances in skeletal Class III. The purposes of this study were as follows ; evaluation of the skeletal and dental changes of the maxillary protraction in children with Class III Maxillary deficiency , comparison of the clinical effects between the group with RPE and labiolingual intraoral appliances , comparison of the clinical effects and stability related to the ages of the patients : stability of the maxillary protraction about 1 year after retention. The subjects consisted of 60 children between the ages of 8 and 13.4 who were diagnosed as Class III with maxillary deficiency and were treated with Face Mask (Delaire Type) from the Dept. of Orthodontics Yong Dong Severance Hospital, Yonsei University. 48 children wore the RPE and 12 children wore Labiolingual Appliance. Lateral Cephalograms were taken for each patient at before and after correction of anterior cross-bite in 60 children, and after an observation period of 10 to 14 months in 19 children. X and Y coordinate of 10 landmarks were analyzed using a horizontal line through sella and rotated $6^{\circ}$ down anteriorly as the horizontal reference axis, and a perpendicular verticual line through sella as the vertical reference axis. Each of the 31 measurents (10 verticals, 10 horizontals, 2 angles and 9 others) was statistically analyzed using SPSS/PC statistics. The results are as follows; 1. After maxillary protraction the maxilla and maxillary teeth moved downward and forward, while the mandible and mandibular incisor rotated downward and backward. 2. Maxillary protraction with rapid palatal expansion appliance was more effective than with labiolingual appliance. 3. More downward movement of the posterior palatal plane obserbed with maxillary protraction doing the midpalatal suture opening than with protraction after finishing the palatal expansion 4. The clinical effects of protraction and changes of the retention periods were not statistically significant among the age groups. 5. During the retention period, maxilla and maxillary teeth, and mandible and mandibular teeth moved downward and forward, however the mandibular changes were larger than the maxillary changes.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.28 no.1
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• pp.27-36
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• 1998

The purpose of this study was to obtain information on the clinical and radiographic features of the fibro-osseous lesions in the jaws. For this study, the author examined and analysed the clinical records and radiographs of 71 cases of 68 patients in fibrous dysplasia, 35 cases of ossifying fibroma and 30 cases of 16 patients of periapical cemental dysplasia diagnosed by clinical and radiographic or histopathological examinations. The obtained results were as followings: L Fibrous dysplasia occurred most frequently in the 2nd decade (30.0％), ossifying fibroma in the 3rd-4th decades, periapical cemental dysplasia in the 4th decade, and all of three lesions showed slight predilection in females. In most cases, chief complaints were painless facial swelling in fibrous dysplasia and ossifying fibroma, and periapical cemental dysplasia was found accidentally in radiographs. 2. Fibrous dysplasia was occurred more frequently in maxilla, ossifying fibroma in mandible and both lesions in premolar-molar area. Periapical cemental dysplasia was occurred most frequently in the mandibular anterior area. The size of fibrous dysplasia was larger than that of ossifying fibroma, and the shape of ossifying fibroma was more round and elliptical than fibrous dysplasia whose was fusiform. 3. Fibrous dysplasia was shown homogeneous radiopaque shadow of 57.6％ and ossifying fibroma & periapical cemental dysplasia were shown mixed appearance of radiolucency and radiopacity shadows at 74.2％, 60.0％, respectively. 4. Fibrous dysplasia was entirely shown poorly defined at 87.7％, but ossifying fibroma & periapical cemental dysplasia were shown well outlined at 60.0％, 70.0％, respectively. 5. Cortical thinning and expansion were observed in fibrous dysplasia and ossifying fibroma, and severe in ossifying fibroma than fibrous dysplasia, and those signs were not seen in periapical cemental dysplasia. Loss of lamina dura was dominant in fibrous dysplasia and root resorption was dominant in ossifying fibroma. Displacement of mandibular canal and the degree of the increase of vertical dimension were alike in both lesions. Displacement of maxillary sinus or nasal cavity, thinning & expansion of the maxillary sinus were dominant in fibrous dysplasia. 6. Polyostotic fibrous dysplasia was occurred at 5.9％, Multiple periapical cemental dysplasia at 43.7％. Occurrence rate in the edentulous area of fibrous dysplasia and ossifying fibroma were 7.0％, 8.6％, respectively.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.4
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• pp.407-421
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• 2012

Orthodontic problems of the oral maxillofacial area could be classified into skeletal and dental problems. Dental problems might cause various occlusal disharmony and among them congenital missing or eruption failure might cause not only functional problems but also esthetic problems. Additional psychological problems are also one of the reasons for patients seeking treatment. In cases showing eruption failure of many teeth in the maxilla, not only occlusal and esthetic problems but also difficulty in alveolar bone maintainment could occur. Therefore, successive approach is necessary when multiple teeth show eruption problems. In this case, a patient with eruption problems of #13, 12, 11, 23, 43 was successfully treated by surgical exposure and successive orthodontic extrusion resulting perfect occlusion. By additional periodontal treatment, gingival recession that occurred along with teeth eruption was solved. The impacted right mandibular canine was erupted successfully only by natural arch expansion and leeway space without any special surgical treatment.

• The korean journal of orthodontics
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• v.30 no.5 s.82
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• pp.553-563
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• 2000

Horseshoe Expander is one of Slow Maxillary Expansion(SME) which aims to accommodate the contra- lateral expansion and midpalatal suture expansion or the palate. The appliance consists of skeleton type strew embedded in split Horseshoe appliance. It is the objectives of the presentation to manifest the changes in dental & craniofacial components subsequent to the application of Horseshoe Expander. The subjects for this study consisted of 32 patients (mean age : 12.7). frontal, lateral cephalometric headfilm were taken and study casts were fabricated before and after expansion. 24 items were measured, compared preexpansion with postexpansion. Especially, palatal volume was measured by means of 'Hydro-measurement method'. Tooth axis measurement on the dental casts were made with Universal bevel protractor, and Horseshoe Expander group were compared with RME group. This study of changes to maxillary expansion with Horseshoe Expander revealed the following significant results. 1. Triangular-shaped expansion pattern appeared in frontal cephalometric headfilm. 2. Palatal plane, occlusal plane, mandibular plane and upper incisor to FH increased in lateral cephalometrir headfilm. 3. Palatal volume increased significantly. A slight bite opening, reduction of occlusal contact points showed in dental casts. 4. A 2.2:1 ratio of the amount of intermolar width in maxilla(orthodontic movement) to maxillary width (orthopedic movement) was determined. 5. Horseshoe Expander group has less buccal tipping tendency than RME group, by taking high correlation coefficients in the upper second premolar and first molar. It was suggested that Horseshoe Expander showed less orthodontic changes, less buccal tipping tendency. In addition, it was effective in maxillary expansion.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.2
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• pp.169-179
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• 2004

The purpose of this study was to discriminate clinically and radiographically among the three groups of dentigerous cysts studied. First, Group I, involved area of dentigerous cyst was successive permanent tooth area beneath deciduous tooth. Second, Group II, involved permanent molar area, and the last, Group III involved maxillary anterior supernumerary tooth area. The author observed and compared the clinico-radiographic features of 49 cases of Group I, 36 cases of Group II, and 15 cases of Group III of dentigerous cyst and this observation and comparison had been done by based on the charts and panoramic films. The obtained results were as follows: 1. The cases of Group I were 29 cases and, those of Group II were 36 and those of Group III were 15. 2. The incidence of dentigerous cyst is high in first decade. In Group I, before first decade and early first decade was 87.8%, in Group II and Group III, was discovered more lately. 3. The frequency of dentigerous cyst is 2.5 times higher in male than in female. 4. The sequence of chief complaint was swelling(50%), routine examination(32%), and pain(9%). 5. When considering the type of the cyst, lateral type is many most in Group I (71.4%) and central type is many most in Group II (94.4%) and Group III (100%). 6. The most size of dentigerous cyst was 2 crown size in Group I, 1 crown size in Group II, above of 4 crown size in Group III. 7. Almost involved teeth showed displacement and some tooth of displaced teeth showed delayed root development and dilaceration of root. 8. The most many response of alveolar bone was buccal bone expansion in Group I (67.3%), no bone expansion in Group II(66.7%) and palatal bone expansion in Group III (60.0%). 9. The percentage of involved teeth were as follows : The mandibular third molar was 31% and many most. The mandibular second premolar was 30%. Mesiodens of maxillary anterior area was 15%. The maxillary canine was 8%. The mandibular first premolar was 5%. 10. In the Group I, causes suggesting of dentigeous cyst are pulpotomized deciduous tooth(59.2%), severe dental caries of deciduous tooth, untreated traumatic history on the deciduous tooth etc. 11. The treatment method of dentigerous was marsupialization in 61.2% of cases of Group I and that was enucleation in 61.1% of cases of Group II and in 80.0% of cases of Group III.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.357-366
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• 2008

Posterior cross-bite is a relatively frequent malocclusion in primary and early mixed dentition and the reported prevalence of posterior cross-bite varies from 7% to 23%. It has been defined as a transverse discrepancy in arch relationship which the palatal cusp of the upper posterior teeth do not occlude in the central fossa of the opposing lower teeth, and can be manifested in a single tooth or in a group of teeth. Posterior cross-bite does not often self-correct and therefore immediate treatment is recommended. Occlusal adjustment to eliminate premature contact that causes mandibular deviation, expansion of narrow maxillary arch, arrangement of the individual teeth to treat asymmetry within the dental arch are the methods of treating cross-bite. In the present case, functional posterior cross-bite was observed in the primary and the early mixed dentition children. The children were treated by the slow maxillary expansion and occlusal adjustment. The outcome of periodic examinations after the correction of cross-bite was favorable.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.2
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• pp.399-408
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• 1995

The purpose of this study was to obtain information on the clinical and radiographic features of the dentigerous cysts in the jaws. For this study, the authors examined and analysed the clinical records and radiographs of 233 patients who had lesions of dentigerous cyst diagnosed by clinical and radiographic or histopathological examinations. And the obtained results were as follows: 1. Dentigerous cysts occurred the most frequently in the 2nd decade(38.2％) and occurred more frequently in males(67.4％) than in females(32.6％). 2. The most common clinical symptom was swelling of the jaw(33.9％), and the lesions were treated by the method of surgical removal. 3. The type of lesions was mainly observed as central type(72.5％), and size of the lesion was most frequently observed 2 - 2.9cm in the widest length. 4. The lesions were most frequently observed well-defined outline with hyperostotic border(49.8％), and smooth margin(73.4％), and homogeneous lesional radiolucency(79.4％). 5. Cortical thinning and expansion of the lesions(82.0％) were observed, and their direction were most frequently observed toward buccal side(64.0％). 6. The effect on the causative tooth were observed as tooth displacement(41.2％) and delayed root development(l9.3％), and the distance between cemento-enamel junction and lesional wall attachment of the causative tooth was mainly observed as below 2mm(79.6％). 7. The effect on the adjacent tooth were observed as loss of lamina dura(66.8％), root resorption(33.9％), and tooth displacement(31.5％). 8. The effects on the adjacent anatomic structures were observed as displacement of the mandibular canal(46.5％) and maxillary sinus or nasal cavity(72.2％).