• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.3
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• pp.266-275
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• 2008

Dental endosseous implants require sufficient alveolar bone volume and quality for complete bone coverage and initial stability. But, atrophy or resorption of alveolar bone height and width according to patient's age and period of tooth loss can prevent ideal implant placement. Bone graft procedure has been proposed before or simultaneously with the placement of dental implants in patients with insufficient alveolar bone volume. While allografts, xenografts, and alloplastic bone grafts have been proposed and studied for alveolar ridge augmentation, the use of autogenous bone grafts represents the 'gold standard' for bone augmentation procedures. Conventional bone grafts are usually harvested from distant sites such as the ilium or ribs. Recently there is a growing use of intraoral bone grafts from intraoral donor sites such as mandibular symphysis, mandibular ramus and maxillary tuberosity. We recommend that the mandibular ramus is a safe autogenous bone graft donor site for bone harvesting with low morbidity. We report various effective autogenous bone graft procedures from mandibular ramus for the implant placement on various atrophic alveolar ridges.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.5
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• pp.480-488
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• 2008

Orthodontists often treat cases which are difficult to treat with conventional orthodontics. In such cases, it could be treated with surgical procedures with the help of an oral surgeon. Especially, transverse deficiency of the mandible can be corrected by widening the transverse width of mandibular symphysis, using distraction osteogenesis. Transverse widening of mandibular sympysis is known as a safe treatment but still complications could occur during the treatment. We are reporting some complications of cases that mandibular symphysis transverse widening were applied. Some cases showed complications because of the inappropriate osteotomy line. Since straight vertical osteotomy line was inclined to the left, only the left bony segment was likely to expand. According to bio-mechanical considerations, it will be better to perform a step osteotomy, cutting the eccentric area of the alveolar crest and the centric area of the basal symphyseal area. Complications could also occur by the failure of the distraction device. The tooth borne distraction device was attached on the lingual side of the tooth with composite resin. During the distraction period, it was impossible to obtain appropriate distraction speed and rhythm because of frequent fall off of the distraction device. Therefore, distraction device should be attached firmly with orthodontic band or bone screw, etc. Tooth mobility increasement could also occur as a complication. 'Walking teeth phenomenon' was observed during the distraction period, showing severe teeth mobility and pain during mastication. These symptoms fade out during the consolidation period. Since the patient could feel insecure and uncomfortable, it should be notified to the patient before the procedure. Finally, alveolar crestal bone loss could occur. Alveolar crestal bone loss occurred because of lack of distraction device firmness and teeth trauma caused by lower lip biting habit. Therefore, adequate firmness of the distraction device and habit control will be needed.

• The korean journal of orthodontics
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• v.42 no.1
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• pp.47-54
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• 2012

Objective: To determine and compare the frequency distribution of various arch shapes in ethnic Malays and Malaysian Aborigines in Peninsular Malaysia and to investigate the morphological differences of arch form between these two ethnic groups. Methods: We examined 120 ethnic Malay study models (60 maxillary, 60 mandibular) and 129 Malaysian Aboriginal study models (66 maxillary, 63 mandibular). We marked 18 buccal tips and incisor line angles on each model, and digitized them using 2-dimensional coordinate system. Dental arches were classified as square, ovoid, or tapered by printing the scanned images and superimposing Orthoform arch templates on them. Results: The most common maxillary arch shape in both ethnic groups was ovoid, as was the most common mandibular arch shape among ethnic Malay females. The rarest arch shape was square. Chi-square tests, indicated that only the distribution of the mandibular arch shape was significantly different between groups (p = 0.040). However, when compared using independent t-tests, there was no difference in the mean value of arch width between groups. Arch shape distribution was not different between genders of either ethnic group, except for the mandibular arch of ethnic Malays. Conclusions: Ethnic Malays and Malaysian Aborigines have similar dental arch dimensions and shapes.

• Journal of Korean Dental Science
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• v.7 no.2
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• pp.66-79
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• 2014

Purpose: To analyze the amount and pattern of tooth movement and the changes in arch dimension of mandibular dentition after orthodontic treatment using a new three-dimensional (3D)-indirect superimposition method. Materials and Methods: The samples consisted of fifteen adult patients with class I bialveolar protrusion and minimal anterior crowding, treated by extraction of four first premolars with conventional sliding mechanics. After superimposition of 3D-virtual maxillary models before and after treatment using best-fit method, 3D-virtual mandibular model at each stage was placed into a common coordinate of superimposition using 3D-bite information, which resulted in 3D-indirect superimposition for mandibular dentition. The changes in mandibular dental and arch dimensional variables were measured with Rapidform 2006 (INUS Technology). Paired t-test was used for statistical analysis. Result: The anterior teeth moved backward, displaced laterally, and inclined lingually. The posterior teeth showed statistically significant contraction toward midsagittal plane. The amounts of backward movement of anterior teeth and forward movement of posterior teeth showed a ratio of 6 : 1. Although the inter-canine width increased slightly (0.8 mm, P<0.05), the inter-second premolar, inter-first molar, and inter-second molar widths decreased significantly with similar amounts (2.2 mm, P<0.05; 2.3 mm, P<0.01; 2.3 mm, P<0.001). The molar depth decreased (6.7 mm, P<0.001) but canine depth did not change. Conclusion: A new 3D-indirect superimposition of the mandibular dentitions using best-fit method and 3D-bite information can present a guideline for virtual treatment planning in terms of tooth position and arch dimension.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.25 no.1
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• pp.25-34
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• 2016

Treatment of missing mandibular 4 incisors is often thought to be easier then other place during surgical and prothetic procedure. But clinicians encounter unexpected difficulties such as restricted implant site due to mesio-distal width of mandibular incisors, limited space as a result of crowing and mesial drift, esthetic problem after severe alveolar bone resorption, and difficulties of provisionalization Through cases, possible treatment options for missing mandibular incisors would be discussed. Treatment options for missing mandibular 4 incisors Place narrow type implant or one body mini implant on exact tooth position when there is no bone resorption Regular size implant on interseptal bone area when there is severe bone resorption Consider using resin bonded bridge(resin retained bridge/resin bonded fixed partial denture) as a tentative prosthesis when patient resists extracting remaining incisors with poor prognosis.

• The korean journal of orthodontics
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• v.40 no.5
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• pp.314-324
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• 2010

Objective: The purpose of this study was to determine differences of mandibular anterior alveolar bone thickness and symphysial cross sectional area in 9 different horizontal and vertical facial types. Methods: By using the initial cephalometric radiographs of 270 adult patients (male 135, female 135), the authors measured the buccolingual thickness of anterior alveolar bone on the basis of the root axis and symphysial cross sectional distance. Results: The high angle group showed significantly thinner buccolingual alveolar bone width except for the CEJ area and lingual alveolar bone width ($p$ < 0.05). The low angle group and Class I, II average group showed similar or significantly thicker alveolar bone width than the Class I average group ($p$ < 0.05). The Class III average group showed significantly thinner buccolingual and lingual alveolar bone width than Class I and II average groups ($p$ < 0.05). The Class III high angle group showed minimal alveolar bone width in all facial skeletal types. No significant difference was found in the symphysial cross sectional area of the different vertical facial skeletal types ($p$ > 0.05). Conclusions: The results of this study found that Class III high angle patients have thinner mandibular anterior alveolar bone thickness; therefore, more attention will be needed to determine the incisor position during orthodontic treatment for this group of patients.

• The korean journal of orthodontics
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• v.27 no.4 s.63
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• pp.643-659
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• 1997

For the total treatment of skeletal malocclusions, 3-dimensional evaluation and diagnosis are essential. Although anteroposterior discrepancies can be evaluated through various methods, the satisfactory methods for evaluations of facial asymmetry and transverse discrepancies are yet to be found. The adequate diagnosis and treatment of transverse discrepancies may be more important in the maintenance of functional occlusion as well as for the stability of results obtained from orthognathic surgery than the anteroposterior or vertical discrepancies. Since the soft tissue effects from the transverse discrepancies may not be pronounced, especially when combined with anteroposterior or vertical discrepancies which have prominent characteristics, the differentiation of their effects may be difficult from visual inspection alone. Therefore it is essential that the normal facial proportions would be established from the posteroanterior cephalometry as a reference for the accurate diagnosis and treatment. The present study evaluates 76 subjects from Yonsei University freshmen with normal facial symmetry and occlusion. Posteroanterior cephalograms were taken from the subjects and the normal values and facial proportions are obtained. The results are as follows. 1. The transverse and vortical values from posteroanterior cephalometry and their ratio, with means and standard deviations are calculated. 2. The ratio of vertical values to transverse values is 0.837 (male 0.836, female 0.841). 3. The Proportion of maxillary and mandibular widths is 0.747 (male 0.745, female 0.752), with statistically significant correlation. 4. Various degree of significant correlations are observed in the following craniofacial widths; (Cranial width, Bizygomaticofrontal suture width, Facial width, Maxillary width, Upper & Lower Intermolar width, Mandibular width). 5. Although the facial height as well as other line measurements increase as the facial widths increase, angle measurement ($Bj\ddot{o}rk$ Sum, Mandibular Plane Angle, Gonial Angle), decreases and posterior to anterior facial height ratio increases, therefore indicating the tendency for a brachycephalic facial type. These results may be used as references for the treatment planning in orthognathic and orthodontic treatments for the dentofacial deformity patients.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.1
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• pp.69-76
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• 1999

The mandibular buccal frenum is defined as a fold of mucous membrane at the posterior labial vestibule and attaches the lips and the cheeks to the alveolar mucosa, gingiva, and underlying periosteum. The buccal frenum becomes a problem when its attachment is too close to the marginal gingiva. It may then pull on healthy gingiva, encourage plaque formation and interfere with tooth brushing. Especially, heavy buccal frenum mucogingivally results in insufficent attached gingiva, inadequate vestibular depth and high frenum attachment and also difficulty in eruption of mandibular premolar. Frenotomy, frenectomy and mucogingival surgery are used in treating heavy buccal frenum. Frenotomy with autogenous free gingival graft has been used popularly because of its stable result. But, it is difficult in younger children because of inadequate donor site, difficulty in making recipient site and behavior management. Frenotomy with apically positioned flap is considered as more efficient way for a very young child with heavy buccal frenum. Additionally, modified deep sedation with $N_2O-O_2$ can be used as an adjunct for the effective treatment outcome. Decrease in muscle pull, adequate width of attached gingiva and increased vestibular depth can be expected from this treatment approach.

• The korean journal of orthodontics
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• v.49 no.2
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• pp.89-96
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• 2019

Objective: The purpose of this study was to assess the long-term stability of rapid palatal expansion (RPE) followed by full fixed edgewise appliances. Methods: This study included 67 patients treated using Haas-type RPE and non-extraction edgewise appliance therapy at a single orthodontic practice. Serial dental casts were obtained at three different time points: pretreatment ($T_1$), after expansion and fixed appliance therapy ($T_2$), and at long-term recall ($T_3$). The mean duration of the $T_1-T_2$ and $T_2-T_3$ periods was $4.8{\pm}3.5years$ and $11.0{\pm}5.4years$, respectively. The dental casts were digitized, and the computed measurements were compared with untreated reference data. Results: The majority of treatment-related increases in the maxillary and mandibular arch measurements were statistically significant (p < 0.05) and greater than expected for the untreated controls. Although many measurements decreased postretention ($T_2-T_3$), the net gains persisted for all of the measurements evaluated. Conclusions: The use of RPE therapy followed by full fixed edgewise appliances is an effective method for increasing maxillary and mandibular arch width dimensions in growing patients.

• Proceedings of the Computational Structural Engineering Institute Conference
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• 2005.04a
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• pp.232-239
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• 2005

The objective of this study is to evaluate the simulated effects of axial and off-axial vertical loads at the implant/bone interface and the stress distribution according to the bone density of a single-unit dental implant in the cylinder and square thread implants by 3D FEA The implants were placed in the mandibular model with 25mm in height, 15mm in width and 20mm in length; then the mandibular bone density was classified into the bone type : I, II III and IV. In addition, the force were applied into 0mm, 2mm, 4mm away from the center of the implants.