• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.36.1-36.7
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• 2015

Background: This study was performed to evaluate three-dimensional positional change of the condyle using three-dimensional computed tomography (3D-CT) following unilateral sagittal split ramus osteotomy (USSRO) in patients with mandibular prognathism. Methods: This study examined two patients exhibiting skeletal class III malocclusion with facial asymmetry who underwent USSRO for a mandibular setback. 3D-CT was performed before surgery, immediately after surgery, and 6 months postoperatively. After creating 3D-CT images by using the In-vivo $5^{TM}$ program, the axial plane, coronal plane, and sagittal plane were configured. Three-dimensional positional changes from each plane to the condyle, axial condylar head axis angle (AHA), axial condylar head position (AHP), frontal condylar head axis angle (FHA), frontal condylar head position (FHP), sagittal condylar head axis angle (SHA), and sagittal condylar head position (SHP) of the two patients were measured before surgery, immediately after surgery, and 6 months postoperatively. Results: In the first patient, medial rotation of the operated condyle in AHA and anterior rotation in SHA were observed. There were no significant changes after surgery in AHP, FHP, and SHP after surgery. In the second patient, medial rotation of the operated condyle in AHA and lateral rotation of the operated condyle in FHA were observed. There were no significant changes in AHP, FHP, and SHP postoperatively. This indicates that in USSRO, postoperative movement of the condylar head is insignificant; however, medial rotation of the condylar head is possible. Although three-dimensional changes were observed, these were not clinically significant. Conclusions: The results of this study suggest that although three-dimensional changes in condylar head position are observed in patients post SSRO, there are no significant changes that would clinically affect the patient.

• 대한치과교정학회지
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• 제22권1호
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• pp.67-88
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• 1992

The purpose of this study was to investigate the changes of mandibular movement and muscle activity following orthognathic surgery in patients with mandibular prognathism. Lateral cephalogram, M.K.G., E.M.G. recordings were obtained immediately before surgery, and 2 months and 8 months after surgery. Among the patients who received orthognathic surgery, 19(13 men, 6 women) were selected for this study. Statistical analysis for each time interval differences were performed with the SPSS package. The results were as follows: 1. Compared with the pre-operative group (opening 349.7mm/sec, closing 313.1mm/sec), the mean values of the maximum opening and closing velocity in the skeletal Class III surgery group were significantly decreased in the 2 months post-operative (opening 232.9mm/sec, closing 206.9mm/sec), but the values tended to increase in the 8 months post-operative group (opening 280.9 mm/sec, closing 319.1mm/sec). 2. Compared with the pre-operative group (61.7 mm/sec), the maximum velocity of the terminal tooth contact increased in the 2 months (72mm/sec) and 8 months (105.7mm/sec) postoperative groups. 3. In the mean value of vertical freeway space, there was significant difference between the normal group and the pre-operative group, but not between the normal group and the 8 months post-operative group. 4. In the mean values of the maximum opening, the maximum anterio-posterior movement from centric-occlusion, and the lateral deviation from centric occlusion, there was no significant difference between the normal group and the surgery group (the pre-operative and the 8 months post-operative groups). 5. The mature swallowing pattern was 58% in the pre-operative group, but 90% in the 2 months post-operative group, and 63% in the 8 months post-operative group. 6. In the comparison of muscle activity, there was no significant difference between the normal group and the surgery group during the rest position. However, during cotton roll clenching, there was significant difference between the normal group and the pre-operative group, but not between the normal group and the 8 months post-operative group.

• 대한치과교정학회지
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• 제15권1호
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• pp.123-140
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• 1985

Variation in the facial pattern and effect of the rotational jaw growth on the facial proportion were studied in serial cephalometric radiographs of 40 Korean children (25 boys, 15 girls) ranging in age from 6 to 13 years. According to Y-axis (N-S-Gn) growth change during the 7 years of period, the subject who had exhibited 'wave-like' manner of Y-axis growth change within ${\pm}\;2^{\circ}$ was classified to the Parallelwise group and the subject who had exhibited Y-axis increase more than $+2^{\circ}$ was classified to the Clockwise rotation group and the subject who had exhibited Y-axis decrease more than $-2^{\circ}$ was classified to the Counterclockwise rotation group. For the comparison of each group, a total of 22 morphologic variables were employed and the data were analyzed by means of computer morphometrics and statistical methods. On the basis of the finding of this study, the following trends were established. 1. The Parallelwise group was $75\%$, the Clockwise rotation group was $12.5\%$ and the Counter-clockwise rotation group was $12.5\%$. 2. The growth pattern of cranial base was related to the rotation of mandible. 9. Maxillary prognathism was occured in the Counterclockwise rotation group and the rotation of palatal plane was occured in the Clockwise rotation group. 4. Mandibular prognathism was occured in the Parallelwise and the Counterclockwise rotation groups, especially in the Counterclockwise rotation group. 5. The degree of maxillo-mandibular divergency was constant in the Clockwise rotation group but decreased in the Counterclockwise rotation and the Parallelwise groups, especially in the Counterclockwise group. 6. There were no differences in the size of the anterior upper facial height (N-ANS) and the posterior lower facial height ((Go-Me)-PNS) but there were differences in the size of the anterior lower facial height (ANS-Me) and the posterior upper facial height ((S-N)-PNS) between each group. 7. The growth increment and the size of the facial depth was not related to the growth pattern of the face but the growth increment and the size of the facial height was related to the growth pattern of the face. 8. Proportional change due to the facial growth rotation was concentrated in the anterior lower face. 9. The most apparent difference between each group was happened in the size of the posterior cranial base (S-Ba) and the facial length (S-Gn).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권4호
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• pp.329-334
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• 2005

Polymethyl-methacrylate(PMMA; Artecoll$^{(R)}$) microspheres suspended 1 : 3 in a 3.5% collagen solution has been used as an injectable implant for long lasting correction of wrinkles and minor skin defects. The patients with mandibular prognathism have increased necessity for nasal augmentation. Usually these patients usually get an additional rhinoplasty after orthognathic surgery. The purpose of this study is to evaluate the result of PMMA injection for nasal ridge augmentation simultaneously with the orthognathic surgery. PMMAs were injected to the nasal dorsum of 13 patients with mandibular prognathism to augment the nasal ridge at the end of the orthognathic surgery. The cephalometric X-ray and clinical facial photograph were taken at 2, 4 and 6 months after operation. Using S-N line, we calculated the change of soft tisuue on the nasal ridge and also investigated the degree of patients satisfaction at 6 months after operation. Most of the patients were satisfied with their nasal ridge height status from moderate to good degree. The average amount of nasal ridge augmentation was $1.4{\pm}0.5$ mm immediately after operation, $1.2{\pm}0.4$ mm at 2 months after operation. The postoperative nasal ridge height seemed to be remained stable after 2 months. Intraoperative PMMA injection is considered to be simple and effective technique which can be used for the minor augmentation of nasal ridge in the orthognathic patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권6호
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• pp.552-558
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• 2005

Orthognathic surgery changes patient's mandibular position and environment of related anatomic structures. Many clinicians were interested in these changes and studied about this problem. However, most of them were based on two dimensional cephalogram. According to the development of image and computer system, it would be possible that the airway change is analyzed with three dimensional CT. So we tried to measure the volumetric change of airway and analyzed the relationship between the airway structure and volumetric change. Nineteen patients who experienced orthognathic surgery due to mandibular prognathism were analyzed with 3D CT data (preoperative and postoperative 6 months) and 2D lateral cephalometry. Volumetric change was measured and 3 dimensional change of related structure was assessed with simulation program ($V-works^{(R)}$, 4.0 Cybermed, Korea). Ten patients showed the decrease of airway volume change and nine showed the increase of airway volume change. Volumetric change was determined by dimensional change of mandible and hyoid bone. The dimensional positions of mandible and hyoid bone were the key factor for determining the airway change after surgery. Airway change is also predictable with the dimensional change of mandible and hyoid bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.13.1-13.8
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• 2018

Background: We evaluated change in the mandibular condyle after orthognathic surgery using cone-beam computed tomography (CBCT) in patients with facial asymmetry. Methods: Thirty patients with skeletal class III malocclusion and mandibular prognathism or facial asymmetry were classified into two groups according to the amount of menton deviation (MD) from the facial midline on anteroposterior (AP) cephalogram: group A (asymmetry, MD ≥ 4 mm; n = 15) and group B (symmetry, MD < 4 mm; n = 15). Position and angle of condylar heads on the axial, sagittal, and coronal views were measured within 1 month preoperatively (T0) and postoperatively (T1) and 6 months (T2) postoperatively. Results: On axial view, both groups showed inward rotation of condylar heads at T1, but at T2, the change was gradually removed and the condylar head returned to its original position. At T1, both groups showed no AP condylar head changes on sagittal view, although downward movement of the condylar heads occurred. Then, at T2, the condylar heads tended to return to their original position. The change in distance between the two condylar heads showed that they had moved outward in both groups, causing an increase in the width between the two heads postoperatively. Analysis of all three-dimensional changes of the condylar head positions demonstrated statistically significant changes in the three different CBCT views in group B and no statistically significant changes in group A. Conclusions: There was no significant difference between the two groups in condylar head position. Because sagittal split ramus osteotomy can be performed without significant change in symmetrical and asymmetrical cases, it can be regarded as an effective method to stabilize the condylar head position in patients with skeletal class III malocclusion and mandibular prognathism or facial asymmetry.

• Imaging Science in Dentistry
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• 제37권4호
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• pp.217-220
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• 2007

Purpose: The purpose of this study was to compare the location of the mandibular canal in Class III malocclusion to its location in normal occlusion for adults. Materials and Methods: For this study 32 skeletal Class III patients and 26 normal patients were observed. Four measurements were taken on cross sectional tomography between the first and second molars: the distance from the mandibular canal to the inner surface of both the buccal and lingual cortices, the distance from the mandibular canal to the inferior border of the mandible, and the buccolingual width of the mandible. The buccolingual location of the canals was classified as lingual, central, or buccal. Each measurement was analyzed with an independent t test to compare Class III malocclusion to normal occlusion. Results: Compared to the control group, the prognathic group had a shorter distance from the canal to the inner surface of the lingual cortex and to the base of the mandible. A higher percentage of the canals were located lingually in the prognathic group. Conclusion: This study showed that the mandibular canal was located more lingually and inferiorly in prognathic patients than in patients with normal occlusion. These results could help surgeons to reduce injuries to the inferior alveolar nerve.

• Journal of Korean Dental Science
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• 제3권1호
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• pp.39-42
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• 2010

This case report presents a case that underwent three-piece segmental maxillary osteotomy and sagittal split ramus osteotomy on a patient with severe facial asymmetry accompanied by maxillary prognathism, severe left scissor bite, and chin point deviation. The resulting facial appearance and occlusion were improved, thereby three-piece segmental maxillary osteotomy is regarded effective methed in treating severe facial asymmetry.

• 한국치위생학회지
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• 제10권4호
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• pp.655-661
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• 2010

Objectives : This study is aimed to prevent the damage to the inferior alveolar nerve during the orthognathic surgery. Methods : The control group consist of 50 patients with class I occlusion. The experimental group consist of 50 patients with class III malocclusion. The cepalometric radiography was used to evaluate the position of the mental foramina. Results : In the first, mental foramen position of class III was more inferior 0.85 mm in the distance between base of mandible and mental foramen. But the distance between occlusal plan and mental foramen had not statistically significant. Secondly, mental foramen location of Mandibular Prognathism was more anterior 0.91 mm in the distance between coronal plane of mandible included pogonion point and mental foramen. Also, the distance of occlusal-coronal plane of mandible included central incisor and mental foramen had statistically significant. The mental foramen location of class III was more anterior 4.81 mm than class I patients. Conclusions : The result of this study could help the clinicians to apprehend fundamental data with various facial skeletal types for any related researches about the location of the mental foramina for other purposes.

• 대한치과교정학회지
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• 제22권3호
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• pp.627-646
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• 1992

The purpose of this study was to investigate the relationship among the activity of the craniofacial muscle and craniofacial form and occlusal state. In this study, subjects were consisted of 23 male adults with skeletal Class III malocclusion and 30 male adults with normal occlusion. The measurements in oral exam, lateral ceghalogram, and E.M.G. recordings of anterior temporal, masseter, and upper lip muscles at rest position, clenching in centric occlusion, chewing of gum, swallowing of juice, were analyzed with SPSS system. The results were as follows: 1. At rest position upper lip muscle activity of skeletal Class III group was significantly higher than that of normal group. 2. Both clenching and chewing masseter and temporal muscle activity of normal group were significantly higher than that of skeletal Class III group. 3. During swallowing of juice, upper lip muscle activity of skeletal Class III group were significantly higher than that of normal group. 4. The activities of masseter and anterior temporal muscle during clenching and chewing were significantly correlated with hypodivergent facial form and number of occluded teeth. 5. The activity of upper lip during swallowing had positive correlation with mandibular prognathism.