The purpose of this study was observe the effects of excessive occlusal force on gingival fibroblasts and collagen fibers of dog. The experiment was performed in 5 dogs. 1 dog was used as control and 4 dogs as experimental group. In experimental group, high Sun Platinum casting metal crowns with 2.0mm thick were placed artificially onto the upper right third premolars to create the traumatic occlusion. After 3, 7, 15, 30 experimental days, the specimens were examined under electron microscope. The following results were observed: 1. In 3, 7, 15 day groups, swelling of the mitochondria in the fibroblast was observed. 2. In 7, 14, day groups, dilation of the endoplasmicreticulum in the fibroblast was observed. 3. There were no remarkable changes in the nucleus of the fibroblasts and collagen fibers. 4. In 30 day group, the changes of the mitochondria and the ER in the fibroblast were recovered to have the similar appearance with that of the control group.
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.
The establishment of an optimal and functional condylar position (centric relation) as the therapeutic and diagnostic reference position during occlusal treatment for patients with temporomandibular joint and muscle pain. dysfunction has long been an important subject in dentistry. The objective of this study was to compare the reproducibility md the changes of condylar position in normal group to those in patient group after use of the occlusal biteplane splint. For this study, 11 normal adults who had no symptoms of masticatory dysfunction and 18 patients who had visited at the department of occlusion in dental infirmary of Yonsei University were selected. For each subject three centric relation records were recorded before treatment, after 2 weeks and after symptoms were improved. And the condylar positions in centric relation were measured using articulators and a Vericheck. On the basis of this study, the following results were obtained. 1. In normal group, there was no significant difference of reproducibility in condylar position before and after the use of the occlusal biteplane splint for 2 weeks. 2. In patient group there was significant improvement in the reproducibility of condylar position after treatment (P<0.01). The reproducibility in patient group, however, was less than normal group. (P<0.01) 3. The mean distance of condylar movements was $0.38{\pm}0.22mm$ after 2 weeks in normal group. 4. In patient group, condylar movements were $1.36{\pm}0.70mm$ (P<0.01), significantly different from normal group. (P<0.01) 5. In patient group, the main direction of condylar movements after treatment was toward anterior and superior, preponderance being at superior direction.
The purpose of this study was to evaluate the change of before and after treatment of anterior openbite malocclusions treated by Multiloop Edgewise Archwire technique. The openbite sample consisted of 4 male and 12 female adults, treated with nonextraction or third molar extraction. The normal sample consisted of 58 subjects, which have pleasing facial profile and normal occlusion and no experience of orthodontic or prosthodontic treatment. The 58 subjects of normal sample were subdivided by cephalemetric vertical relationship of face. The 40 subjects, cephalometric vertical relationship of face was in normal range, classified as Normal Sample group 1. The 18 subjects, increased cephalometric vertical relationship of face, classified as Normal Sample group 2. The computerized cephalometric analysis was accomplished with 50 reference points for 22 skeletal measurements, 46 dentoalveolar measurements, 8 soft tissue measurements. Statistical analysis of the data was carried out with paired t-test, Student's t-test, and DUNCAN test using SAS(PC version), The results were as follows : 1. There were no statistically significant differences in skeletal measurement between before and after treatment. The major changes were in dentoalveolar region. 2. After treatment, the long axis of maxillary and mandibular posterior teeth were distally tipped-back, and uprighted to bisected occlusal plane. The interincisal angle was increased. 3. There were no statistically significant increase in the upper posterior dental height and statistically significant decrease in the lower posterior dental height. The upper anterior dental height was increased, but there was no statistically significant increase in the absolute upper anterior dental hight. The lower anterior dental height was increased. 4. After treatment, the maxillary occlusal plane to palatal plane angle and the mandibular occlusal plane to mandibular plane angle were statistically significant increased. Then, there were no statistically significant difference between after treatment group and normal sample group 2. 5. After treatment, the percentage of upper lip length to upper anterior dental height was decreased. Then, There were no statistically significant difference between after treatment group and normal sample group 2.
In this study, effects of incision of retrodiscal tissue and unilateral occlusal reduction on temporomandibular joint of rabbit were investigated. Twenty-seven adult New Zealand White Rabbits, weighing over 3.5kg, were utilized in this study. Temporomandibular joint surgery was performed in left temporomandibular joint of 24 rabbits to displace disc anteriorly through incising the retrodiscal tissue 1-2mm posterior to the disc. They were divided into two groups : twelve were left untreated after surgery, occlusal reduction was performed on left posterior teeth every 2 weeks in the other twelve rabbits, The remaining three served as the control group. The sample were sacrificed by 8, 12, and 16 weeks after surgery. Histologic examinations were performed after sacrificing them. The results were as follows : 1. Histologic findings which were manifested by flat articular fossa, broad articular surface, generalized recession of articular cartilage and sclerosis of subchondral bone were observed. These findings were similar to internal derangement. 2. In the rabbits untreated after surgery, thin cartilagenous layer and necrotic tissue were observed in 8 weeks group, calcifying cartilagenous layer was observed in 12 weeks group, and cartilagenous layer on anterior portion was observed in 16 weeks group. So, it showed gradual healing pattern into the normal tissue except displaced disc. 3. Occlusal trauma after surgery resulted in generalized recession of upper and lower articular surface. Necrosis and vertical split on condylar process of mandible were observed in 8 weeks group. Osteoclasts, exposure of subchondral bone due to erosion on upper and lower articular surface, and degenerative changes on retrodiscal tissue were observed in 16 weeks group. So, it showed continuous prowess pattern of osteoarthrosis.
Traumatic occlusion is a morbid condition that is caused by repeated occlusal stresses exerted on the periodontium that exceed the physiologic limits of tissue tolerance and contribute to the breakdown of the supporting tissue of the teeth. In reviewing these cases, the authors obtained the following results. 1. Roentgenographic examination revealed the typical signs of traumatic occlusion: severe resorption of roots, destruction of alveolar bone. 2. The major factor of traumatic occlusion is abnormal occlusal force. 3. The rsorptions of roots and periodontal changes which are caused by traumatic occlusion depend on the individual variation of the physical potential. 4. The pathologic features of traumatism are basically different from those of inflammation.
Because of the potential morbidity and complications associated with surgical procedures, limiting the extent of orthognathic surgery is a desire for many orthodontic patients. An eighteen-year-old woman had a severe Class III malocclusion and required bi-maxillary surgery. By changing the patient's maxillary occlusal plane using orthodontic mini-implants, she was able to avoid the maxillary surgery; requiring only a mandibular setback surgery. To accurately predict the post-surgery outcome, we applied a new soft tissue prediction method. We were able to follow and report the long-term result of her combined orthodontic and orthognathic treatment. The changes to her occlusal plane continue to appear stable over 6 years later.
Flexion of a metal/ceramic fixed partial denture(EPD) frameworks under function can cause fracture of porcelain or deterioration of the cement seal. This study evaluated the flexion characteristics of three-unit mandibular FPD frameworks, repacing the second pre-molar under compressive load(200g, 400g). Testing was accompished with real-time holographic interferometry, using 6 porcelain fused-to metal frameworks. Tested alloys were non-precious alloy(Heracles, Holland), semi-precious alloy(Degudent U, Germany) and precious alloy(Degudent H, Germany). Changes of the fringe patterns according to the heat treatment(porcelain firing cycle), various loads(200g, 400g), occlusal forms(occlusal porcelain veneering, facial porcelain veneering), various alloys and post-soldering units were compared. Dental study model(Nissan dental products, Inc. D51DP-500A, Japan) and six 3-unit metal/ceramic fixed partial denture frameworks were used as experimental materials. 36 holograms were taken on fixed dental study model by using the 10mW He-Ne laser and real-time holographic interferometry. On the basis of this study, the following conclusions can be drawn : 1. In the frameworks for facial porcelain veneering, the semi-precious alloy framework was least deformed and precious alloy framework, non-precious alloy framework orderly before heat treatment, and the deformation was not shown great difference among three alloys after heat treatment and post-soldering. 2. In the frameworks for occlusal porcelain veneering, the precious alloy framework was greatest deformed and the deformation was not difference between semi-precious alloy framework and non-precious alloy framework before, after heat treatment, and the deformation was not shown great difference among three alloys after post soldering. 3. In the non-precious alloy frameworks for facial porcelain veneering and occlusal porcelain veneering, the deformation was greatly decreased after heat treatment and conversely increased after post-soldering. 4. In the semi-precious alloy framework for facial porcelain veneering, the deformation was not detectable after heat treatment and increased after post-solder. And in the frame-work for occlusal porcelain veneering, the deformation was slightly decreased after heat treatment and increased after post-soldering. 5. In the precious alloy framework for facial porcelain veneering, the deformation was greatly decreased after heat treatment and increased after post-soldering, And in the framework for occlusal porcelain veneering, the deformation was greatly decreased after heat treatment and decreased after post-soldering.
This study was investigated the changes during treatment and retention period in the Class III malocclusion patients and explored the correlationship between factors that showed relapse tendencies and pre-treatment skeletal pattern and the changes during treatment period. Numbers of total sample were 24 and their Hellman's dental age at the start of treatment was over III B and were retained at least over 1 year 6 months. The following conclusion were obtained by comparing the differences between treatment period and retention period, and after analysing the correlationship of factors that manifested relapse tendencies. 1. The angles formed by FH plane and occlusal plane, FH plane and mandibular plane, and mandibular incisor and mandibular plane changes showed rebound effect during retention period and among them occlusal plane angle and IMPA show reverse correlationship. 2. Upward displacement of the occlusal plane at the end of treatment has returning tendency, is proportional to the displacement during treatment period, but the angle between maxillary and mandibular 1st molar to its basal bone have been constantlsy maintained during the retention period. 3. Mandibular plane decrease during retention period and downward backward rotation during treatment period show correlationship.
Purpose: The purpose of this study was to evaluate postsurgical facial hard tissue stability after orthognathic surgery with/without posterior impaction in skeletal class III malocclusion patients, and to evaluate the horizontal relapse tendency, according to changes in anteroposterior discrepancy and occlusal planes. Methods: Ninety patients, who had undergone orthognathic surgery in Pusan National University Dental Hospital, were enrolled in this study. Three main groups were classified as follows: Thirty patients underwent mandibular setback bilateral sagittal split ramus osteotomy (BSSRO) only (BSSRO group, BG); another thirty patients underwent mandibular setback BSSRO and Le Fort I osteotomy with posterior impaction (posterior impaction group, PG); and another thirty patients underwent mandibular setback BSSRO and Le Fort I osteotomy without posterior impaction (non-posterior impaction group, NPG). Preoperative (T0), immediate postoperative (T1) and six-month follow-up period (T2) lateral cephalograms were taken, and various parameters were measured. The analyses were done by linear and angular measurements between T0-T1 and T1-T2, to evaluate postsurgical facial hard tissue stability. Results: Mean horizontal relapse rates were distributed from 11.81% to 19.08%, and there were significant postsurgical changes (0.52 mm~2.44 mm) at the B point in all 3 groups. But, there were no statistical differences on relapse rate among BG, PG and NPG patients. Conclusion: In this study, the postsurgical stabilities of BSSRO and Le Fort I osteotomy with/without posterior impaction in skeletal class III malocclusion patients were acceptable. There were no significant statistical differences in mandibular stability according to changes in anteroposterior discrepancy and occlusal planes.
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