• Title/Summary/Keyword: Palatal arch length

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A novel modification of Bardach's two-flap palatoplasty for the repair of a difficult cleft palate

  • Mir, Mohd Altaf;Manohar, Nishank;Chattopadhyay, Debarati;Mahakalkar, Sameer S
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.75-79
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    • 2021
  • Bardach described a closure of the cleft utilizing the arch of the palate, which provides the length needed for closure and is most effective only in narrow clefts. Herein, we describe a case where we utilized Bardach's two-flap technique with a vital and easy modification, done to allow closure of a wide cleft palate and to prevent oronasal fistula formation at the junction of the hard and soft palate, which are otherwise difficult to manage with conventional flaps. The closed palate showed healthy healing, palatal lengthening, and no oronasal regurgitation. We advise using this modification to achieve the goals of palatal repair in difficult cases where tension-free closure would otherwise be achieved with more complex flap surgical techniques, such as free microvascular tissue transfer.

Three dimensional finite element analysis of continuous and segmented arches with use of orthodontic miniscrews (교정용 미니스크류를 이용한 연속호선과 분절호선의 유한요소분석)

  • Lee, Eon-Hwa;Yu, Hyung-Seog;Lee, Kee-Joon;Park, Young-Chel
    • The korean journal of orthodontics
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    • v.41 no.4
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    • pp.237-254
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    • 2011
  • Objective: The purpose of this study was to compare the displacement patterns shown by finite element analysis when the maxillary anterior segment was retracted from different orthodontic miniscrew positions and different lengths of lever arms in lingual continuous and segmented arch techniques. Methods: A three dimensional model was produced, the translation of teeth in both models was measured and individual displacement was calculated. Results: When traction was carried out from miniscrews in the palatal slope, lingual tipping of crowns and extrusion of the maxillary anterior segment were found in both continuous and segmented arches as the lever arms were made shorter. With miniscrews in the midpalatal suture area, the displacement patterns were similar to the palatal slope, but bodily movement of the upper incisors was observed in both continuous and segmented arches with the lever arm at 20 mm. When lever arms were longer, there was less extrusion of the incisors and more buccal displacement of the canines. Such displacement was shown less in the continuous arch than the segmented arch. The second premolar showed crown mesial tipping and intrusion, and the molars showed distal tipping in the continuous arch. The posterior segment was displaced three dimensionally in the segmented arch, but the amount of displacement was less than the continuous arch. Conclusions: It is recommended that lever arms of 20 mm in length be used for bodily movement of the anterior segment. Use of continuous or segmented arches affect the displacement patterns and induce differences in the amount of displacement.

DIAGNOSIS AND TREATMENT PLAN OF MAXILLARY IMPACTED CANINE (상악매복견치의 진단 및 처치)

  • Kyung, Seung-Hyun;Hwang, Chung-Ju
    • The korean journal of orthodontics
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    • v.23 no.2 s.41
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    • pp.165-177
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    • 1993
  • Upper canine is important because it protects and maintains the stability of the dental arch and also, joins the anterior with the posterior teeth. The incidence of impaction of upper canine is the second most frequent next to the third molar because it takes a long period of time to develop, and has a complicated path of eruption, and erupts lately. After the age of 10, clinical and radioglaphic examination can be used in revealing the possibility of impaction and efforts should be put to reduce the side effects. To prevent impaction, selective extraction of primary canine at the age of 8 to 9 could be considered and prolonged retention of primary canine in oral cavity should be avoided at this time. Once the impaction is iden, the first stage of the treatment is to lcocalize the lesion by radiographic examination and According to the severity, orthodontic traction or autotransplantation should be considered and comprehensive diagnosis and treatment plan of malocclusion should be established. Generally, labial impaction is due to arch length discrepancy and palatal impaction is due to malposition or morphologic pathosis of lateral incisors rather than arch length discrepancy. In surgical procedure, peridontal problems should be considered and the minimum amount of bone and soft tissue should be reduced and direct bonding method of many attachment methods should be recommended. Especially in traction of labially impacted canine, it should be guided to erupt through the keratinized zone and proper forced magnitude should be applied. The importance of periodontal condition should always be in mind following the patient education to mintain the good oral hygiene at each stage of treatment. Properly managed impacted canine can provide function and esthetic by proper diagnosis and treatment if extraction of canine is not indicated.

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RELATIONS BETWEEN POSTURE AND SIZE OF THE TONGUE AND DENTOALVEOLAR PATTERN (혀의 자세 및 크기와 치아치조골 패턴의 관계에 관한 연구)

  • Kim, Jeong-Hoon;Lee, Ki-Soo
    • The korean journal of orthodontics
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    • v.17 no.1
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    • pp.33-45
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    • 1987
  • This study was designed to examine relations between posture and size of the tongue and dentoalveolar pattern. The sample was consisted of three groups, the 34 subjects of Normal occlusion, the 31 subjects of Bimaxillary protrusion and the 31 subjects of Class III malocclusion. On the cephalograms, lengths, heights and areas of the tongue and intermaxillary space and on the study model, arch length, intercanine width, intermolar width and palatal height were measured. These data from measuring cephalograms and models were statistically analyzed. The results of the study were as follows; 1. Length of the tongue was the greatest in Bimaxillary protrusion and in order of Normal occlusion and Class III malocclusion. 2. Posture of the tongue was the lowest in Class III malocclusion and in order of Bimaxillary protrusion and Normal occlusion. 3. There were a tendency to be larger area of tongue and intermaxillary space in Class III malocclusion compared to Normal occlusion and Bimaxillary protrusion. 4. Size of the tongue and intermaxillary space showed low correlations with the dentoalveolar pattern.

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ORTHODONTIC TREATMENT OF THE PALATALLY IMPACTED MAXILLARY CANINE (구개측 매복된 상악 견치의 교정적 치험례)

  • Kam, Dong-Hoon;Kim, Jung-Wook;Hahn, Se-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.1
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    • pp.127-133
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    • 1998
  • An impacted tooth is defined pathologically as a tooth that remains under the mucosa of inside bone without eruption of the crown after a specific period of eruption. Clinically, the term includes those teeth, even before eruption period, that are not expected to erupt due to shape, position and alignment of tooth and lack of space. Canine is prone to impaction more than other teeth because it has the longest time to develop and a complex route from the place of formation to the site of eruption. The impaction incidence of maxillary canine is repoted 0.92$\sim$3.3% (Ferguson, 1990). In 1995 Orton reported that the incidence was 0.92$\sim$2.2% and palatal impaction was more frequent than labial impaction(85%:15%). In 1969 Johnston presented it was more common to woman than to man(3:1). The etiology includes systemic disease such as endocrine disorder, cleidocranial dysostosis, irradiation, Crouzon syndrome, ricketts, facial hemihypertrophy and hereditary and local problems such as ectopic position of the tooth, distance of tooth from its place of eruption, malformation of the tooth, presence of supernumerary teeth, trauma of tooth germ, infection of tooth germ, displacement of tooth germ or tooth by a neoplasm, ankylosis, overretention of deciduous predecessor, lack of space for the tooth in the dental arch and mucosal barrier due to gingival fibrosis. The maxillary canine is especially important as it has the longest root, provides guidance for lateral movement of the mandible and masticatory function and assumes an important role esthetically as it is located at mouth angle. If left untreated, it may cause migration and external, internal resorption of adjacent teeth, loss of arch length, formation of dentigerous cyst or tumors, infection and referred pain as well as malposition of the tooth. Therefore, periodic examination of the development and eruption of the maxillary canine is especially important in a growing child. This case study presents the results of treatment of palatally impacted maxillary canine utilizing surgical exposure and orthodontic tooth movement on patients visiting SNUDH dept. of pediatric dentistry.

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A THREE-DIMENSIONAL FEM COMPARISON STUDY ABOUT THE FORCE, DISPLACEMENT AND INITIAL STRESS DISTRIBUTION ON THE MAXILLARY FIRST MOLARS BY THE APPLICATION OF VAR10US ASYMMETRIC HEAD-GEAR (비대칭 헤드기어의 적용시 상악제 1 대구치에 나타나는힘과 변위 및 초기 응력분포에 관한 3차원 유한요소법적 연구)

  • Kim, Jong-Soo;Cha, Dyung-Suk;Ju, Jin-Won;Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.31 no.1 s.84
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    • pp.25-38
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    • 2001
  • The purpose of this study was to compare the force, the displacement and the stress distribution on the maxillary first molars altered by the application of various asymmetric head-gear. For this study, the finite element models of unilateral Cl II maxillary dental arch was made. Also, the finite element models of asymmetric face-bow was made. Three types of asymmetric face-bow were made : each of the right side 15mm, 25mm and 35mm shorter than the left side. We compared the forces, the displacement and the distribution of stress that were generated by application of various asymmetric head-gear, The results were as follows. 1. The total forces that both maxillary first molars received were similar in all groups. But the forces that mesially positioned tooth received were increased as the length of the outer-bow shortened, and the forces that normally positioned tooth received were decreased as the length of the outer-bow shortened. 2. In lateral force comparison, the buccal forces that normally positioned tooth received were increased as the length of the outer-bow shortened, and the buccal fortes that mesially positioned tooth received were decreased as the length of the outer-bow shortened. Though the net lateral force moved to the buccal side of normally positioned tooth as the length of the outer-bow shortened, both maxillary first molars received the buccal force. That showed 'Avchiai Expansion Effect' 3. The distal forces, the extrusion forces and the magnitudes of the crown distal tipping that mesially positioned tooth received were increased as the length of the outer-bow shortened, and the forces that normally positioned tooth received were decreased as the length of the outer-bow was shortened. 4. The magnitude of the distal-in rotation that normally positioned tooth received were increased as the length of the outer-bow was shortened. But, mesially positioned tooth show two different results. For the outer-bow 15mm shortened, mesially positioned tooth showed the distal-in rotation, hut for the outer-bow 25mm and 35mn shortened, mesially positioned tooth showed the distal-out rotation. Thus, the turning point exists between 15mm and 25mm. 5. This study of the initial stress distribution of the periodontal ligament at slightly inferior of the furcation area revealed that the compressive stress in the distobuccal root of the normally positioned tooth moved from the palatal side to the distal side and the buccal side successively as the length of the outer-bow shortened. 6. This study of the initial stress distribution of the periodontal ligament at slightly inferior of the furcation area revealed that the magnitudes of stress were altered but the total stress distributions were not altered in the mesiobuccal root and the palatal root of normally positioned tooth, and also three roots of mesially positioned tooth as the length of the outer-bow shortened.

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Finite element analysis of effectiveness of lever arm in lingual sliding mechanics (Lingual sliding mechanics의 lever arm 효과에 대한 유한요소분석)

  • Kim, Kyeong-Hee;Lee, Kee-Joon;Cha, Jung-Yul;Park, Young-Chel
    • The korean journal of orthodontics
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    • v.41 no.5
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    • pp.324-336
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    • 2011
  • Objective: The aim of this study was to conduct three-dimensional finite element analysis of individual tooth displacement and stress distribution when a posterior retraction force of 200 g was applied at different positions of the retraction hook on the transpalatal arch (TPA) of a molar, and over different lengths of the lever arm on the maxillary anterior teeth in lingual orthodontics. Methods: A three-dimensional finite element model, including the entire upper dentition, periodontal ligaments, and alveolar bones, was constructed on the basis of a sample (Nissan Dental Product, Kyoto, Japan) survey of Asian adults. Individual movement of the incisal edge and root apex was estimated along the x-, y-, and z-coordinates to analyze tooth displacement and von Mises stress distribution. Results: When the length of the lever arm was 15 mm and 20 mm, the incisal edge and root apex of the anterior teeth was displaced lingually, with a maximum lingual displacement at the lever arm length of 20 mm. When the posterior retraction hook was on the root apex, the molars showed distal displacement. When the length of the lever arm was 20 mm, anterior extrusion was reduced and the crown of the canine displaced toward the buccal side, in which case, the retraction hook was on the edge, rather than at the center, of the TPA. Conclusions: The results of the analysis showed that when 6 anterior teeth were retracted posteriorly, lateral displacement of the canine and lingual displacement of the incisal edge and root apex of the anterior teeth occur without the extrusion of the anterior segment when the length of the lever arm is longer, and the posterior retraction hook is in the midpalatal area.

A STUDY OF INTRAORAL ANATOMIC LANDMARKS OF KOREAN ADULT-UPPER JAW (성인 유치악자 상악골의 악궁과 치열궁의 형태에 관한 조사)

  • Oh, Yu-Ree;Lee, Sung-Bok;Park, Nam-Soo;Choi, Dae-Gyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.33 no.4
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    • pp.753-768
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    • 1995
  • For accurate impression taking of dental patient and esthetic denture treatment of ednetulous patient, measuring between intraoral anatomic landmarks is useful.In this study the subjects selected at a random were two-jundred forty persons with a mean age 22.5(range 21-24) and were taken impression of by irreversible hydrocolloid impression material(Alginate). On the study model made by dental stone, each individual tray was made and final impresion was taken by border moilding. On final model measurings were performed with 3-dimensional measuring device and the values were analyzed by t-test The results is following : ABOUT THE MEASURED VALUES. 1. The width between maxillary right and left canine cusp tip was average 36.44mm(s.d. 2.48), man 36.67mm, woman 35.83mm(p<0.05). 2. The width between labial height of contour of maxillary right and left canine was average 40.08mm(s.d. 2.42), man 40.29mm, woman 39.52mm(p<0.05). 3. The width between mesio-lingual cusps of maxillary first molar was average 43.14mm(s.d. 3.33), man 43.56mm, woman 42.05mm(p<0.05). 4. The width between buccal alveolar ridge on axis of mesiolingual cusp of right and left maxillary first molar was average 64.89mm(s.d. 3.88), man 65.58mm, woman 62.92mm(p<0.05). 5. The width between buccal alveolar ridge on axis of mesiolingual cusp of right and left maxillary second molar was average 68.58mm(s.d. 3.91), man 69.29mm, woman 66.30mm (p<0.05). 6. The width between right and left hamular notch was average 49.80mm(s.d. 3.96), man 50.70mm, woman 48.20mm(p<0.05). 7. The length from labial heigth of contour of maxillary central incisor to center of incisive papilla was average 9.52mm(s.d. 1.18), man 9.46mm, woman 9.63mm(p>0.05). 8. The length from labial heigth of contour of maxillary central incisor to palatine fovea was average 53.27mm(s.d. 2.93), man 53.93mm, woman 52.08mm(p<0.05). 9. The center of incisive papilla ws located posterior to intercanine line at 0.40mm(s.d. 1.16), man 0.51mm, woman 0.11mm(p<0.05). 10. The height from incisal edge of maxillary central incisor to the labial vestibule was average 21.84mm(s.d. 1.38), man 22.01mm, woman 21.00mm(p<0.05). 11. The height from mesiolingual cusp of maxillary first molar to buccalvestible was average 17.45mm(s.d. 1.42), man 17.56mm, woman 17.08mm(p>0.05). 12. The height from hamular notch to standard occlusal plane was average 6.84mm(s.d. 1.06), man 6.91mm, woman 6.70mm(p>0.05). 13. The height from the deepest point of palatal vault to standard occlsalplane was average 19.95 mm(s.d. 2.03), man 20.19mm, woman 19.12mm(p<0.05). ABOUT THE ARCH FORM 1. The arch form was able to classify into four typr by the rate of the measured values. Each arch form distribution was that the 1 group had 32.46% the 2 group 2.19%, the 3 group 52.83%, the 4 group 12.72%. The sexual composition was that in 1 group man had 73.5%, woman 26.5%, in 2 group man had 40.0%, woman 60.0%, in 3 group man had 83.3%, woman 16.7%, and in 4 group man had 55.17%, woman 44.83%. 2. When canine cusp tip was marked as point O, the intersection point between labial height of contour of maxillary central incisor and intermaxillary suture as point A, height of contour of maxillary second molar buccal alveolar ridge as B point, ${\angle}$AOB was measured $133.8^{\circ}$for the 1 group, $133.0^{\circ}$for the 2 group, $132.3^{\circ}$for the 3 group, $128.9^{\circ}$for the 4 group.

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Fitness of Adjustable Dental Impression Trays on the Caucasian and African American (백인과 흑인에 대한 가변형 치과 인상용 트레이의 적합성에 관한 연구)

  • Park, Yong-Suck;Kim, Yu-Lee;Oh, Sang-Cheon;Lee, In-Seop;Dong, Jin-Keun
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.2
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    • pp.185-192
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    • 2008
  • Purpose: This study was designed to investigate the fitness of adjustable dental impression trays on the Caucasian and African American. Material and methods: The size and shape of these trays were designed from the results of the dental arch size of Korean adults. Tray samples were made by CAD-CAM working. Sixty Caucasian (male:30, female:30) and sixty African American (male:30, female:30) were selected for taking irreversible hydrocolloid impression using these trays. The author measured the width and length of impression material on the several measuring points. Results: 1. Uniform impression material width was achieved by controling the width of the tray using stops and beveled guides. 2. In the maxillary tray on the Caucasian, the impression material thickness was measured to be rather great showing thickness of the midpalatal part 13.0 mm. 3. In the maxillary tray on the African American, the impression material thickness was measured to be rather great showing thickness of the midpalatal part 12.0 mm, posterior palatal part 11.0 mm and the labial frenum width was 11.0 mm. 4. In the maxillary tray on the African American, the impression material width of posterior border (0.8 mm) was measured to be small. 5. In the mandibular tray on the Caucasian, the impression material width was measured (2.7-6.7 mm) and posterior border width (2.1 mm) was measured small. The impression material length was measured (2.8-6.7 mm). 6. In the mandibular tray on the African American, the impression material width was measured to be rather great showing width of the labial frenum 9.2 mm and the width of posterior border was measured too small (0.3 mm). Conclusion: This adjustable dental tray shows good accuracy to Korean because it was designed by the analysis of the dental arch size of Korean adult model. With this result, it can be applied to Caucasian and African American, we can take more easy and accurate dental impressions.

A Study on the Fitness of Adjustable Dental Impression Trays on the Chinese and Japanese (중국인과 일본인에 대한 가변형 치과 인상용 트레이의 적합성에 관한 연구)

  • Kang, Han-Joong;Lee, Jin-Han;Choi, Jong-In;Lee, In-Seop;Dong, Jin-Keun
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.2
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    • pp.175-184
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    • 2008
  • Purpose: This study was designed to investigate the fitness of adjustable dental impression trays on the Chinese and the Japanese. Material and methods: Initial design of the adjustable dental trays was developed from the results of the dental arch size of Korean adults. This design was applied to the CAD-CAM process in order to create tray model samples. Simple silicon-base molds were then replicated based on these sample models. Polyurethane injection into the silicon- base molds completed the process of creating a large number of test products. 60 Chinese dental students (male:30, female:30) from the Shanghai Second Medical University and 60 Japanese alumni from the Kumamoto high school (male:30, female:30) were selected for taking irreversible hydrocolloid impression with these trays. The width and length of the impression body were measured on several measuring points by Vernier caliper. The results were analyzed statistically to evaluate the fitness of the trays. Results: 1. Uniform impression material thickness was achieved on the Chinese and Japanese by controlling the width of the tray using stops and beveled guides. The material thickness was generally within the range of 3 mm to 6 mm. 2. In the maxillary tray of the Chinese, average thickness of the impression material of the labial vestibule of the incisal teeth was 6.2 mm, the canine was 5.9 mm and the midpalatal part 10.5 mm and the posterior palatal part 9.7 mm. These were relatively large values. 3. In the mandibular tray of the Chinese, average length of the impression material of the lingual vestibule of first, second premolar contact point was 8.9 mm, the incisal teeth was 7.8 mm and thickness of the labial part of canine was 6.8 mm and premolars 7.0 mm. These were relatively large values. 4. In the maxillary tray of the Japanese, average thickness of the impression material of the labial vestibule of the incisal teeth was 7.4 mm, the canine was 7.7 mm and the midpalatal part 9.1 mm. These were relatively large values. 5. In the mandibular tray of the Japanese, average thickness of the impression material of the labial vestibule of first, second premolar contact point was 8.4 mm, and thickness of the labial part of canine was 7.4 mm. These were relatively large values. Conclusion: This adjustable dental tray shows good accuracy to Korean because it was designed by the analysis of the dental arch size of Korean adult model. With this result, it can be applied to Chinese and Japanese, we can take more easy and accurate dental impressions.