• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권6호
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• pp.643-647
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• 2007

Purpose: The purpose of study was to investigate the correlationship between lip canting change and occlusal canting change after bimaxillary orthognathic surgery, and the ratio of lip canting change and occlusal canting change after the surgery. Patients and methods: The subjects for this study was obtained from a group of 25 patients who took bimaxillary orthognathic surgery for occlusal canting correction at the Department of the Oral and Maxillofacial Surgery, Samsung Medical Center in Seoul, Korea between January 2000 and December 2005 and a patient's chart had to contain a resting frontal facial photograph in natural head position and a corresponding PA cephalogram in occlusion on the same day before the surgery and post-op 6 months later. The lip canting change was assessed with the angle each labial commissure and the bipupilary reference line. And, the occlusal caning change in the frontal plane was assessed with the angle between the each maxillary first molar occulasal surface and the bi-frontozygomatic suture reference line. Results: In angular measurement, average occlusal canting change was $3.09^{\circ}$ and standard deviation was $1.05^{\circ}$, average lip canting change was $1.56^{\circ}$ and standard deviation was $1.05^{\circ}$. In linear measurement, average occlusal canting change was 2.41mm and standard deviation was 2.75mm, average lip canting change was 1.18mm and standard deviation was 0.43mm. Lip canting correction ration to occlusal canting correction was 51.5(${\pm}8.4$)% in angular measurement and 48.8(${\pm}9.1$)% in linear measurement. Under Pearson's correlation analysis, Pearson's correlation coefficient was 0.869 in angular measurement and 0.887 in linear measurement(p-value < 0.01). High correlationship was shown between occlusal canting change and lip canting change. Conclusion: First, Bimaxillary orthognathic surgery can correct lip canting as well as occlusal canting. Second, The average amount of lip canting correction is $51.5{\pm}8.4%,\;48.8{\pm}9.1%$ of occlusal canting correction in the study.

• 대한치과교정학회지
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• 제50권4호
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• pp.258-267
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• 2020

Objective: This study aimed to analyze the correlation of horizontal and sagittal planes used in two-dimensional diagnosis with lip canting by using three-dimensional (3D) analysis. Methods: Fifty-two patients (25 men, 27 women; average age: 24 years) undergoing treatment for dentofacial deformity were enrolled. Computed tomography images were acquired, and digital imaging and communication in medicine files were reconstructed into a 3D virtual model wherein horizontal and sagittal craniofacial planes were measured. Subsequently, the correlations of lip canting with these horizontal and sagittal planes were investigated. Results: The mandibular symmetry plane, the occlusal plane, Camper's plane, the mandibular plane, Broadbent's plane, and the nasal axis plane were correlated with the amount of lip canting (Pearson's correlation coefficients: 0.761, 0.648, 0.556, 0.526, 0.438, and 0.406, respectively). Planes associated with the lower part of the face showed the strongest correlations; the strength of the correlations decreased in the midfacial and cranial regions. None of the planes showed statistically significant differences between patients with clinical lip canting (> 3°) and those without prominent lip canting. Conclusions: The findings of this study suggest that lip canting is strongly correlated with the mandibular symmetry plane, which includes menton deviation. This finding may have clinical implications with regard to the treatment of patients requiring correction of lip canting. Further studies are necessary for evaluating changes in lip canting after orthognathic surgery.

• 대한치과의사협회지
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• 제57권6호
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• pp.333-343
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• 2019

Many orthodontists face difficulties in aligning incisors in an esthetically critical position, because the individual perception of beauty fluctuates with time and trend. Temporary anchorage device (TAD) can aid in attaining this critical incisor position, which determines an attractive smile, the amount of incisor display, and lip contour. Borderline cases can be treated without extraction and the capricious minds of patients can be satisfied with regard to the incisor position through whole dentition distalization using TAD. Mild to moderate bimaxillary protrusion cases can be treated with TAD-driven en masse retraction without premolar extraction. Patients with Angle's Class III malocclusion can be the biggest beneficiaries because both sufficient maxillary incisal display, through intrusion of mandibular incisors, and distalization of the mandibular dentition are successfully achieved. In addition, TAD can be used to correct various other malocclusions, such as canting of the occlusal plane and dental/alveolus asymmetry.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.48.1-48.7
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• 2019

Background: Soft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance. Lip canting could be improved by the correction of the occlusal canting or positional change of the mentum. Although there are many studies about changes of lip canting, however, postoperative changes of philtrum deviation have not been yet reported. In this study, we investigate the positional change of the philtrum after orthognathic surgery and influencing factors. Methods: Positional change of the philtrum was evaluated in 41 patients with facial asymmetry who underwent bimaxillary surgery, in relation to other anatomical soft tissue landmarks using a frontal clinical photo. The surgical movement of the maxillary and mandibular dental midline and canting were measured in postero-anterior cephalogram before and 1 day after surgery. The same procedure was repeated in patients with more than 1.5 mm perioperative change of the mandibular dental midline after bimaxillary surgery. Results: Maxillary dental midline shifting and canting correction did not have a significant correlation with lateral movement of the philtrum midline. However, the mandibular shift had a statistically significant correlation with a lateral movement of the philtrum (p < 0.05) as well as other linear parameters and angle values. Conclusion: The horizontal change of the philtrum is influenced by lateral mandibular movement in patients with facial asymmetry, rather than maxillary lateral movement.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권5호
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• pp.518-523
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• 2007

Purpose: The purpose of this study is to prove that orthognatic surgery on asymmetric prognathism patients improve the temporomandibular dysfunction. Materials and methods: All 30 patients underwent mandibular setback with B-SSRO including 22 patients Le Fort I surgery in KyungHee medical center. Preoperative and postoperative PA cephalograms & transcranial radiographs were measured midline deviation in Mx and Mn, occlusal canting change, condyle position, the temporomandibular dysfunction were checked before surgery, within 1 month after surgery, $3{\sim}6$ months, 12-24 months after surgery respectively. Results: The temporomandibular dysfunction were relieved after surgery in 17 patients of 25 patients. Conclusion: Orthognatic surgery may benefit the temporomandibular joint dysfunction in facial asymmetry patients by obtaining a postoperative stable occlusion and better physiologic neuromuscular function. Specially impovement of occlusal canting may reduce condyle displacement of midline deviation side and the temporomandibular joint dysfunction.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권5호
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• pp.447-453
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• 2010

The hemifacial microsomia is characterized by variable underdevelopment of the craniofacial skeleton, external ear, and facial soft tissues. So, patients with hemifacial microsomia have an occlusal plane canting and malocclusion with facial asymmetry. Distraction osteogenesis (DO) with an intraoral or extraoral device is a technique using tension to generate new bone with gradual bone movement and remodeling. DO has especially been used to correct craniofacial deformities such as a hemifacial microsomia, facial asymmetry, and mandible defect that could not adequately be treated by conventional reconstruction with osteotomies. It has a significant advantage to lengthen soft and hard tissue of underdeveloped site without bone graft and a few complication such as nerve injury or muscle contracture. A 13-years old girl visited our clinic for the chief complaint of facial asymmetry. She had a left hypoplastic maxilla and mandible, occlusal plane canting and malocclusion. We diagnosed hemifacial microsomia and lanned DO to lengthen the affected side. Le Fort I osteotomy, left mandibular ramus and symphysis osteotomy were performed. The internal distraction devices fixed with screw on maxillary and mandibular ramus osteotomy sites. External devices were adapted to lower jaw for DO on symphysis osteotomy site and to upper jaw for rapid maxillary expansion (RME). At 7days after surgery, distraction was started at the rate of 1mm per day for 13days, and after 4months consolidation periods, distraction devices were removed. Simultaneous multiple maxillo-mandibular distraction osteogenesis with RME resulted in a satisfactory success in correcting facial asymmetry as well as occlusal plane canting for our hemifacial microsomia.

• 대한심미치과학회지
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• 제23권1호
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• pp.4-15
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• 2014

붕괴된 교합평면을 보철적으로 재구성하는 과정에 있어 face-bow와 교합기는 필수적으로 필요한 기구로 사용되어왔다. 일반적으로 Ear rod를 사용하는 face bow는 상악 정중선의 오차와 교합평면의 canting이 발생할 가능성이 있는데 이런 문제점을 해결하기위해 환자의 안면 정중선을 기준으로 하는 face bow가 개발되어왔다. Ear-bow를 이용한 mounting에서 종종 발생하는 오류를 보완하는 방법으로 환자 안면의 중심과 교합기의 중심을 일치시키려는 개념의 mounting technique이 시도되고 있으며 이를 esthetic mounting이라 한다. 이들 중 하나인OP finder 1(OP1)을 사용한 증례를 보고하고자 한다.

• 대한두개안면성형외과학회지
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• 제22권1호
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• pp.45-51
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• 2021

Background: Mandibular deficiency leading to facial asymmetry causes cosmetic deformity as well as psychological stigma for the patient. Correction of these mandibular asymmetries is a major challenge. The study investigates the efficacy of bidirectional mandible distraction for the treatment of mandibular deficiency. Methods: This prospective study included six individuals aged between 17 and 24.4 years. Five patients had hemifacial microsomia and one had unilateral temporomandibular joint ankyloses. All patients underwent mandibular distraction osteogenesis. Postoperative skeletal changes in affected mandible, and changes in occlusal plane and oral commissure cant were evaluated using three-dimensional reconstruction. Patient satisfaction and understanding of the procedure were assessed through three questionnaires administered during pre-distraction, distraction and post-distraction phases. Results: In pre-distraction phase, aesthetic appearance seemed to be the primary indication for surgery. In distraction phase, pain while chewing was the primary handicap. In post-distraction phase all patients were satisfied with the aesthetic outcome. The facial deformity was improved through mandibular distraction osteogenesis. On the affected side in all the patients, height and length of the mandible increased. Canting of the occlusal plane and oral commissure was corrected. Conclusion: Bidirectional mandible distraction is an effective treatment for correction of mandible deformities in adult patients.

• 대한치과의사협회지
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• 제52권10호
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• pp.623-632
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• 2014

안면비대칭의 주원인은 하악골이며, 하악골의 비대칭 성장에 대한 상악골의 보상성장에 따라 교합면 경사 등이 초래된다. 디지털 사진과 삼차원 CT 등 다양한 방법으로 정확한 진단을 하고 수술을 포함한 치료계획을 세운다. 술전 교정 치료는 상악골과 하악골 치열의 치성 보상(dental compensation)을 제거하면서 상악 치열의 중심은 상악골의 정중선에, 하악 치열의 중심은 하악골 정중선에 맞게 이동하여 술후 상하악 치열궁이 일치하면서 동시에 안모 정중선에 일치하게 맞추어야 한다. 악교정 수술은 일반적으로 상하악 동시 수술을 하게 되며 우각부 풍융도 교정과 이부 성형술(genioplasty) 등을 부가적으로 할 수 있으며, 교합면 경사 교정과 수평 회전 등의 이동이 상하악 위치에 서로 영향을 주면서 수술 후 안모 변화에 대한 예측을 어렵게 만들기 때문에, 다양한 분석을 통해 정확한 예측으로 최선의 결과를 얻는 것이 가장 중요하다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.33.1-33.9
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• 2015

Background: The porion (Po) is used to construct the Frankfort horizontal (FH) plane for cephalometrics, and the external auditory meatus (EAM) is to transfer and mount the dental model with facebow. The classical assumption is that EAM represents Po by the parallel positioning. However, we are sometimes questioning about the possible positional disparity between Po and EAM, when the occlusal cant or facial midline is different from our clinical understandings. The purpose of this study was to evaluate the positional parallelism of Po and EAM in facial asymmetries, and also to investigate their relationship with the maxillary occlusal cant. Methods: The 67 subjects were classified into three groups. Group I had normal subjects with facial symmetry ($1.05{\pm}0.52mm$ of average chin deviation) with minimal occlusal cant (<1.5 mm). Asymmetry group II-A had no maxillary occlusal cant (average $0.60{\pm}0.36$), while asymmetry group II-B had occlusal cant (average $3.72{\pm}1.47$). The distances of bilateral Po, EAM, and mesiobuccal cusp tips of the maxillary first molars (Mx) from the horizontal orbital plane (Orb) and the coronal plane were measured on the three-dimensional computed tomographic images. Their right and left side distance discrepancies were calculated and statistically compared. Results: EAM was located 10.3 mm below and 2.3 mm anterior to Po in group I. The vertical distances from Po to EAM of both sides were significantly different in group II-B (p=0.001), while other groups were not. Interside discrepancy of the vertical distances from EAM to Mx in group II-B also showed the significant differences, as compared with those from Po to Mx and from Orb to Mx. Conclusions: The subjects with facial asymmetry and prominent maxillary occlusal cant tend to have the symmetric position of Po but asymmetric EAM. Some caution or other measures will be helpful for them to be used during the clinical procedures.