• 대한치과교정학회지
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• 제50권2호
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• pp.129-135
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• 2020

Objective: This study aimed to evaluate the immediate effects of mandibular posterior displacement on the pharyngeal airway space (PAS) by using cephalometric evaluations and to investigate how the surrounding structures are schematically involved. Methods: In this retrospective study, 38 subjects with functional Class III malocclusion and two lateral cephalograms were selected. The first lateral cephalogram was taken with the mandible in the habitual occlusal position, and the second in anterior edge-to-edge bite. Paired t-test was used to analyze changes in the PAS, hyoid bone, tongue, and soft palate, followed by mandibular posterior displacement. Pearson's correlation analysis was used to determine the relationship between the amount of mandibular posterior displacement and other variables. Results: A statistically significant decrease was observed in the PAS following mandibular posterior displacement. Along with mandibular posterior displacement, the tongue decreased in length (p < 0.001) and increased in height (p < 0.05), while the soft palate increased in length, decreased in thickness, and was posteriorly displaced (p < 0.001). The hyoid bone was also posteriorly displaced (p < 0.05). There was no correlation between the amount of mandibular posterior displacement and the measured variables. Conclusions: The PAS showed a statistically significant decrease following mandibular posterior displacement, which was a consequence of retraction of the surrounding structures. However, there were individual variances between the amount of mandibular posterior displacement and the measured variables.

• Journal of Oral Medicine and Pain
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• 제41권2호
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• pp.41-47
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• 2016

Purpose: The purpose of this study was to analyze the size and morphology of mandibular condyle and mandibular fossa between temporomandibular joint (TMJ) disc displacement (DD) patients and healthy subjects using cone-beam computed tomography (CBCT). Methods: Twenty healthy subjects and twenty TMJ DD patients participated in this study respectively. We made five measurements in mandibular condyle (medio-lateral dimension, antero-posterior dimension, condyle height, intercondylar distance and intercondylar angle) and two measurements in mandibular fossa (mandibular fossa depth and articular eminence angle) using CBCT image. Results: There was no difference between two groups in medio-lateral dimension. In case of antero-posterior dimension, average of healthy controls was larger than that of TMJ DD patients, but that was not significant statistically. There were no significant differences between two groups in condyle height. Comparing intercondylar distance and intercondylar angle between two groups, there was no significant difference between two groups. In comparison of mandibular fossa depth and articular eminence angle, there was no significant difference between two groups. Conclusions: We couldn't find any definite relationship between TMJ morphology and TMJ DD.

• 대한치과교정학회지
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• 제19권1호
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• pp.45-59
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• 1989

This study was undertaken to analyze the displacement and stress distribution in the mandible according to the pulling directions during mandibular first molar cervical traction after mandibular second molar extraction. The 3-dimensional finite element method(FEM) was used for a mathematical model composed of 594 elements and 1019 nodes. An orthodontic force, 450 gm, was applied to the each mandibular first molar in parallel, and below the occlusal plane by $7^{\circ}\;and\;25^{\circ}$ and meet the midsagittal plane by $40^{\circ}$ toward posterior direction. The results were as follows: 1. Mandibular teeth were displaced in more downward, posterior and lateral direction. Especially high stress was noted in case of parallel pull than in case of below the occlusal plane by $7^{\circ}\;and\;25^{\circ}$. 2. Mandibular first molar was moved bodily. 3. Generally, alveolar bone, mandibular body, ascending ramus and mandibular angle portion were displaced in downward, posterior and lateral direction. But coronoid process was displaced in downward, forward and lateral direction, and anterior and inner middle portion of condyle head and neck were displaced in downward, forward and medial direction, and posterior and outer middle portion of condyle head and neck were displaced in upward, forward and medial direction. 4. Maximum stress was observed at the condyle head and neck portion. With steeper direction of force, condyle head and neck showed more stress than parallel relation to the occlusal plane.

• 대한치과의사협회지
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• 제51권6호
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• pp.302-312
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• 2013

It has been established that disk displacement of the temporomandibular joint(TMJ) can cause mandibular asymmetry in growing subjects. One of the causes of internal derangement of TMJ seems to be the result of poor positioning of the joint structure in unilateral cross bite, and the subsequent occlusal trauma transferred to the functioning unit of the mandible, the joint and disc. Transverse discrepancy of the maxillary and the mandibular posterior dentoalveolar units was often found in mandibular asymmetric subjects. Most of the asymmetry in growing subjects becomes worse with further growth if left untreated. However once sufficient posterior overjet is gained through orthodontic treatment, many cases have shown improvement in facial asymmetry. Furthermore, the position of condyles in computed tomogram(con-beam CT) changed from anatomically unfavorable position to more concentric position.

• 대한치과교정학회지
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• 제47권6호
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• pp.344-352
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• 2017

Objective: The purpose of this study was to compare the changes induced in the pharyngeal airway space by orthodontic treatment with bodily retraction of the mandibular incisors and mandibular setback surgery without extraction. Methods: This retrospective study included 63 adult patients (32 men and 31 women). Thirty-three patients who had been treated via four-bicuspid extraction and bodily retraction of the mandibular incisors (incisor retraction, IR group) were compared with 30 patients who had been treated via mandibular setback surgery (MS group) without extraction. Lateral cephalograms were acquired and analyzed before (T1) and after treatment (T2). Results: The superior pharyngeal airway space did not change significantly in either group during treatment. The middle pharyngeal airway space decreased by $1.15{\pm}1.17mm$ and $1.25{\pm}1.35mm$ after treatment in the IR and MS groups, respectively, and the decrease was comparable between the two groups. In the MS group, the inferior pharyngeal airway space (E-IPW) decreased by $0.88{\pm}1.67mm$ after treatment (p < 0.01). The E-IPW was larger in the MS group than in IR group at T1, but it did not differ significantly between the two groups at T2. No significant correlation was observed between changes in the pharyngeal airway space and the skeletal and dental variables in each group. Conclusions: The middle pharyngeal airway space decreased because of the posterior displacement of the mandibular incisors and/or the mandibular body. The E-IPW decreased only in the MS group because of the posterior displacement of only the mandibular body.

• 대한치과교정학회지
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• 제10권1호
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• pp.29-36
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• 1980

Inclined plane, one of frequently used orthodontic appliances, may cause posterior displacement of mandible and injure the normal growth of temporomandibular joint. So author carried out the mandibular posterior displacement experimentally induced by inserting inclined plane in the rat incisors in order to investigate the histological reactions occuring in the temporomandibular joint of experimental animals. Following results were obtained. 1. The posterior displacement of condyle resulted in the widening of anterior synovial space with anterior condylar hyperplasia and posterior condylar atrophy. In addition, tissue changes were more severe in young rats than in adult rats. 2. The tissue reactions were localized only to condylar head ana there were no evidence of traumatic features in young rats. In adult rats, hemorrhage was an additional finding 1 week after experiment. 3. The remodelling processes were accompanied by the increasing or reduction of fibrous layer and subsequent replacement by cartilage layer occured massively and abruptly in young rats, it occured slightly and slowly in adult rats. 4. The remodelling process of injured condyle occured from 1 week to 4 weeks after experiment and completed between 8 weeks after experiment.

• 대한치과보철학회지
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• 제29권1호
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• pp.233-248
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• 1991

The purpose of this study was to qunatatively analyze the stress patterns induced in the abutment, superstructure, supporting bone and to determine the deflection of abutment and superstructure by appling occlusal force to natural teeth supported fixed prostheses and implant-supported fixed prostheses. The analysis has been conducted by using the two dimensional finite element method. The implant and natural tooth-supported bridge has a first molar pontic supported by mandibular second bicuspid and implant posterior retainer, which were rigidly(Model A) or flexible(Model B). The natural teeth-supported bridge has a first molar pontic supported by mandibular second bicuspid and second molar, which were rigidly splinted together(Model C). 63.5kg(Load P1) of localized load on central fossa of first molar pontic and 24kg(Load P2) of distributed load on each occlusal surface were applied respectively. 1. The coronal portion of premolar pontic and posterior abutment in fixed partial denture deflected inferiorly in order of Model B, Model C and Model A under Load P1 and Load P2. 2. Mesial displacement of the coronal portion of premolar showed in Model A, Model B and Model C under Load P1, but mesial displacement of that in Model B and distal displacement of that in Model A and Model C showed under Load P2. 3. Mesial displacement of the coronal portion of the pontic and distal displacement of the coronal portion of posterior abutment showed in Model A, Model B and Model C under Load P1 and Load P2. Displacement in the case of Model B was greater than that of Model A and Model C. 4. In the case Model A under Load P1 and Load P2, high stress apically was concentrated in the mesiocervical portion of the posterior abutment than in the disto-cervical portion of the premolar. 5. In the case of Model B under Load P1 and Load P2 high stress was concentrated in the case of the premolar than in that of posterior abutment and high stress especially was concentrated in the connected portion of pontic and posterior abutment. 6. In the case of Model C under Load P1 and Load P2, high stress was concentrated in the distal area of the cornal portion of premolar and the mesial area of the coronal portion of posterior abutment, and stress pattern was anteroposterially symmetric around the pontic. 7. Load P1 and Load P2 compared, stress magnitude was different but stress pattern was similar in Model A, Model B and Model C. 8. Under Load P1 and P2, stress magnitude in the mesial distal portion and the portion of root apex of the posterior abutment was in order of Model B, Model A and Model C.

• 대한치과보철학회지
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• 제18권1호
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• pp.73-86
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• 1980

Recently, the controversy continues as to whether maximum intercuspation of teeth should occur at the terminal hinge position(the condylar theory) or at the myo-co(the neuromuscular theory). There is also much controversy regarding the antero-posterior position of myo-co. The object of this study was to measure and compare with the positional relations of centric relation, centric occlusion and myo-co, and free-way space using Mandibular Kinesiograph and Myo-monitor in the 40 subjects without stomatognathic problems. Mandibular Kinesiograph(M.K.G.) was originally conceived as a research instrument to track mandibular movement and position. As its use in research progressed, its great diagnostic value became apparent in case by case. And Myo-monitor was developed as a means of applying the neuromuscular approach to occlusion. Thus the Myo-monitor technique is an intra-systemic approach to occlusal positioning using patient's own musculature, and Myo-monitor is used to relax the musculature by a light myopulse induced electronically. From this experiment, the following results were obtained. 1. The adaptive free-way space before muscle relaxation was an average of $1.6{\pm}60mm$, and the true free-way space after muscle relaxation using Myo-monitor was an average of $2.4{\pm}0.74mm$. 2. It took an average of $25{\pm}3.11$ minutes to relax the mandibular musculature by Myo-monitor and administration of 5mg. Diazepam and an average of $38{\pm}4.73$ minutes by Myo-monitor without administration of Diazepam. 3. Myo-co existed anterior to centric occlusion, with an average of $0.53{\pm}0.31$ mm, and centric relation existed posterior to centric occlusion, with an average of $0.57{\pm}0.58mm$ before muscle relaxation and with an average of $0.57{\pm}0.43mm$ after muscle relaxation. 4. Centric relation coincided with centric occlusion in 5 of 40 subjects(12.5%), and posterior to centric occlusion in the rest of cases (87.5%). 5. Myo-co existed anterior to centric occlusion in 38 of 40 subjects(95%), except 1 subject that coincided with centric occlusion and 1 subject that existed posterior to centric occlusion. 6. Myo-co and centric relation existed inferior to centric occlusion and the lateral displacement was various with individual difference. 7. The total displacement from centric occlusion to centric relation was an average of $0.74{\pm}0.64mm$ before muscle relaxation, and an average of $0.68{\pm}0.53mm$ after muscle relaxation, and the total displacement from centric occlusion to myo-co was an average of $1.07{\pm}0.58mm$.

• Journal of Oral Medicine and Pain
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• 제23권1호
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• pp.45-55
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• 1998

The author assessed the sagittal relationships between glenoid fossa of the temporal bone and mandibular condyle from lateral transcranial views of 74 TMJ with disc displacement and 16 TMJ with normal disc-condyle complex by the magnetic resonance image findings. All the subjects were female and also in their 3rd decades. The disc displacement group was subdivided into anterior disc displacement with reduction (ADWR) group and anterior disc displacement without reduction (ADWOR) group. The anterior, superior, and posterior joint spaces as well as anterior/posterior (A/P) ratio of the space at the closed jaw position and vertical and horizontal components of the condyle position relative to the articular eminence at the open jaw position were measured from all the subjects and the data were compared among groups. The result were as follows : 1. The mean posterior joint space of ADWR group was smaller than ADWOR group, but there were no significant differences in anterior and superior joint spaces between two groups. 2. There showed a tendency of higher A/P ratio in ADWR group which meant the condyle of ADWR was likely to take posteriorly displaced position. 3. There were higher proportion of neutral condylar position in glenoid fossa in normal group, but higher proportion of posterior condylar position in ADWR group. 4. There were no significant differences in the degree of condyle-fossa concentricity among groups.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.27.1-27.9
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• 2020

Background: Mandibular setback surgery can change the position of the mandible which improves occlusion and facial profile. Surgical movement of the mandible affects the base of the tongue, hyoid bone, and associated tissues, resulting in changes in the pharyngeal airway space. The aim of this study was to analyze the 3-dimensional (3D) changes in the hyoid bone and tongue positions and oropharyngeal airway space after mandibular setback surgery. Methods: A total of 30 pairs of cone-beam computed tomography (CBCT) images taken before and 1 month after surgery were analyzed by measuring changes in the hyoid bone and tongue positions and oropharyngeal airway space. The CBCT images were reoriented using InVivo 5.3 software (Anatomage, San Jose, USA) and landmarks were assigned to establish coordinates in a three-dimensional plane. The mean age of the patients was 21.7 years and the mean amount of mandibular setback was 5.94 mm measured from the B-point. Results: The hyoid bone showed significant posterior and inferior displacement (P < 0.001, P < 0.001, respectively). Significant superior and posterior movements of the tongue were observed (P < 0.05, P < 0.05, respectively). Regarding the velopharyngeal and glossopharyngeal spaces, there were significant reductions in the volume and minimal cross-sectional area (P < 0.001). The anteroposterior and transverse widths of the minimal cross-sectional area were decreased (P < 0.001, P < 0.001, respectively). In addition, the amount of mandibular setback positively correlated with the amount of posterior and inferior movement of the hyoid bone (P < 0.05, P < 0.05, respectively). Conclusion: There were significant changes in the hyoid bone, tongue, and airway space after mandibular setback surgery.