• Title/Summary/Keyword: Skeletal class II

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Three-dimensional cone beam computed tomography analysis of temporomandibular joint response to the Twin-block functional appliance

  • Jiang, Yuan-yuan;Sun, Lian;Wang, Hua;Zhao, Chun-yang;Zhang, Wei-Bing
    • The korean journal of orthodontics
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    • v.50 no.2
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    • pp.86-97
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    • 2020
  • Objective: To propose a three-dimensional (3D) method for evaluating temporomandibular joint (TMJ) changes during Twin-block treatment. Methods: Seventeen patients with Class II division 1 malocclusion treated using Twin-block and nine untreated patients with a similar malocclusion were included in this research. We collected their cone beam computed tomography (CBCT) data from before and 8 months after treatment. Segmentations were constructed using ITK-SNAP. Condylar volume and superficial area were measured using 3D Slicer. The 3D landmarks were identified on CBCT images by using Dolphin software to assess the condylar positional relationship. 3D models of the mandible and glenoid fossa of the patients were constructed and registered via voxel-based superimposition using 3D Slicer. Thereafter, skeletal changes could be visualized using 3DMeshMetric in any direction of the superimposition on a color-coded map. All the superimpositions were measured using the same scale on the distance color-coded map, in which red color represents overgrowth and blue color represents resorption. Results: Significant differences were observed in condylar volume, superficial area, and condylar position in both groups after 8 months. Compared with the control group (CG), the Twin-block group exhibited more obvious condyle-fossa modifications and joint positional changes. Moreover, on the color-coded map, more obvious condyle-fossa modifications could be observed in the posterior and superior directions in the Twin-block group than in the CG. Conclusions: We successfully established a 3D method for measuring and evaluating TMJ changes caused by Twin-block treatment. The treatment produced a larger condylar size and caused condylar positional changes.

Esthetic improvement in patient with deep bite using porcelain laminate veneers and a full veneer crown (과개교합 환자에서 도재 라미네이트 비니어와 전부도재관을 이용한 심미수복 증례)

  • Yoon, Jong-Sang;Shin, Soo-Yeon;Lee, Jonghyuk
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.2
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    • pp.192-198
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    • 2014
  • This case is a porcelain laminate veneer (PLV) and all-ceramic crown treatment case on a female patient in her thirties who visited for esthetic improvement. The patient's chief complaint was protrusive and uneven anterior teeth, and she wanted minimum tooth reduction. The patient was in skeletal class II deep bite. Considering this, check bite method was used for mounting on articulator during diagnostic wax-up. Tooth reduction was done using mock-up base on diagnostic wax-up, and the amount of deletion was checked by index. For the accordance of shade, PLVs were restored in prior to all ceramic crown. After using all-ceramic crown, satisfactory esthetic improvement was obtained.

Severe bimaxillary protrusion with adult periodontitis treated by corticotomy and compression osteogenesis (치조골 소실과 심한 양악전돌을 동반한 성인환자에서의 피질골 절단술과 Compression osteogenesis를 이용한 교정치료)

  • Kim, Seong-Hun;Lee, Kye-Bok;Chung, Kyu-Rhim;Nelson, Gerald;Kim, Tae-Woo
    • The korean journal of orthodontics
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    • v.39 no.1
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    • pp.54-65
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    • 2009
  • This paper describes the case of a 50-year-old female with a Class II malocclusion who presented with severe bimaxillary protrusion and generalized alveolar bone loss due to adult periodontitis. The treatment plan consisted of extracting both upper and lower first premolars and periodontal treatment. Anterior segmental osteotomy(ASO) of the mandible and upper anterior segment retraction using compression osteogenesis after peri-segmental corticotomy(Speedy orthodontics) was performed. Correct overbite and overjet, facial balance, and improvement of lip protrusion were obtained. However, a slight root resorption tendency was observed on the lower anterior dentition. The active treatment period was 9 months and the results were stable for 27 months after debonding. This new type of treatment mechanics can be an effective alternative to orthognathic surgery.

Study of soft tissue changes in the upper lip and nose after backward movement of the maxilla in orthognathic surgery

  • Seon, Suyun;Lee, Hyun-Woo;Jeong, Bong-Jin;Lee, Baek-Soo;Kwon, Yong-Dae;Ohe, Joo-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.6
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    • pp.385-392
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    • 2020
  • Objectives: This study evaluates soft tissue changes of the upper lip and nose after maxillary setback with orthognathic surgery such as Le Fort I or anterior segmental osteotomy. Materials and Methods: All 50 patients with bimaxillary protrusion and skeletal Class II malocclusion underwent Le Fort I or anterior segmental osteotomy with backward movement. Soft and hard tissue changes were analyzed using cephalograms collected preoperatively and 6 months postoperatively. Results: Cluster analysis on the ratios shows that 2 lines intersected at 4 mm point. Based on this point, we divided the subjects into 2 groups: Group A (less than 4 mm, 27 subjects) and Group B (more than 4 mm, 23 subjects). Also, each group was divided according to changes of upper incisor angle (≥4°=A1, B1 or <4°=A2, B2). The correlation between A and B groups for A'/ANS and Ls/Is (P<0.001) was significant; A'/A (P=0.002), PRN/A (P=0.043), PRN/ANS (P=0.032), and St/Is (P=0.010). Variation of nasolabial angle between the two groups was not significant. There was no significant correlation of vertical movement and angle variation. Conclusion: The ratio of soft tissue to hard tissue movement depends on the amount of posterior movement in the maxilla, showing approximately two times higher rates in most of the midface when posterior movement was greater than 4 mm. The soft tissue changes caused by posterior movement of the maxilla were little affected by angular changes of upper incisors. Interestingly, nasolabial angle showed a different tendency between A and B groups and was more affected by incisal angular changes when horizontal posterior movement was less than 4 mm.

Rehabilitation with orthognathic surgery and orthodontic treatment in patient with severe occlusal disharmony: A case report (심한 교합 부조화를 보이는 환자에서 악교정수술 및 교정치료를 동반한 구강회복: 증례 보고)

  • Jung-Jin Lee;Kwang-Yeob Song;Seung-Geun Ahn;Ju-Mi Park;Jae-Min Seo
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.3
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    • pp.204-214
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    • 2023
  • The occlusal treatment including prosthetic treatment should be considered when the pathologic symptom was observed with the excessive discrepancy between the centric relation occlusion (CRO) and the maximum intercuspal position (MIP). Through careful diagnosis, the malocclusion and interarch relationship can be analyzed, and occlusal adjustment, restorative treatment, orthodontic therapy, or orthognathic surgery can be performed depending on the degree of disharmony. The patient in this case report complained the unstable occlusion and loss of masticatory function that had been occurring for several years. At the time of the visit, the patient showed severe occlusal disharmony, with only the upper right second molar contacting the lower jaw at the maximum intercuspal position. Based on the analysis of the occlusion, it was difficult to solve the problem with just occlusal adjustment or restorative treatment. In addition, the patient had the skeletal class II malocclusion between the upper and lower jaws. Therefore, for resolving the severe skeletal class II malocclusion, pre- and post-orthodontic treatment, bilateral sagittal split ramus osteotomy (BSSRO) was performed. After that, the occlusal adjustment was performed for stable occlusion, and the missing teeth area was restored with dental implants. During the follow-up period, a periodic follow-up visits and additional occlusal adjustments were performed to achieve a stable centric occlusion and harmonious anterior and lateral guidance. As a result, the final prosthodontic treatment was completed, and the patient's masticatory function was restored.

A study on treatment effects of different activator types in Angle's Class II div.1 malocclusion patients (2급 1류 부정교합 환자에서 activator유형에 따른 치료 효과에 관한 연구)

  • Kim, Duk-Sang;Lee, Jin-Woo;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.27 no.3 s.62
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    • pp.431-444
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    • 1997
  • This research was carried out to compares the treatment effects of Horizontal and Vertical type activators in Angle's Class II div. 1 maloccusion patients with mandibular retrusion dand to find out whether different treatment effects or growth pattern were observed between sexes in each study groups. The results were as follows: 1. In Horizontal activator group, forward positioning of mandible and vertical increase in anteror face as examplified by increase of LAFH and AEM were observed when pre and post-treatment datas were evaluated. 2. Males samples in Horizontal activator group showed increase in mandiular length accmpanied by posterior positioning of maxilla, wheras female samples in Horizontal activator group showed increase in mandibular body length, labial inclination of mandibular incisors and increase in lower anterior facial height .3. In vertical activator group, increase in AFH, LAFH, PFH and LPFH were observed when pre and post treatment datas were evaluated. 4. Male samples in Vertical activator group showed increase in mandibular body length and anterior and posterior facial heights, whereas females samples of Vertical activator group showed mainly increase in anterior facial height. 5. When pre and post treatment datas of Horizontal and Vertical activator groups were compared, skeletal difference were mainly observed in pretreatment datas but dental difference were observed in post treatment datas ,indicating that two actiators differ only in their effects to dental variables. 6. Difference between sexes were noted after treatment although no difference were observed between sexs in each groups before treatmentt. This indicates that inherent growth effects in each sex exerts more influence 1km appliances used for treatment.

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Pretreatment characteristics of adolescents with Class II malocclusion treated by maxillary second molar extraction (상악 제2대구치를 발거하고 치료한 성장기 II급 부정교합 환자의 치료전 특성)

  • Kim, Jae-Hyung;Kim, Joeng-Il;Lim, Yong-Kyu;Lee, Dong-Yul
    • The korean journal of orthodontics
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    • v.35 no.3 s.110
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    • pp.182-195
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    • 2005
  • The purpose of this retrospective study was to estimate the pretreatment characteristics of growing patients with Class II malocclusion. who had been treated with maxillary second molar extractions The sample comprised of 51 subjects; 18 subjects were classified into the molar extraction group, and 33 subjects were treated without extraction and classified into the nonextraction group. Pretreatment lateral cephalograms were calculated and analyzed by independent t-test and stepwise discriminant analysis. In measurements for skeletal pattern, no anteroposterior measurements and proportions of various vertical dimensions were significantly different. and only some measurements such as $AB-MP(^{\circ)$, Na-We(mm), AVD (mm) were significantly different between the two treatment groups (p<0.05). In measurements for dentoalveolar pattern. some measurements, which were related to the position and angulation of the upper and lower permanent first molars, and the angulation of the upper third molars, were significantly different between the two treatment groups In particular, the maxillary second molar extraction group exhibited more mesial angulation of maxillary first molar to the occlusal plane.

Changes in soft tissue chin resulting from premolar extraction and incisor retraction in adult female patients (성인 여성에서 소구치 발치와 전치부 후방 견인에 따른 이부 연조직 변화)

  • Kim, Yang-Hee;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.31 no.5 s.88
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    • pp.535-548
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    • 2001
  • The purpose of this study was to evaluate changes in soft tissue chin thickness and to investigate correlations between hard and soft tissues measurements after orthodontic treatment conducted by premolars extraction and incisor retraction. The sample consisted of 35 female adults with Angle classification class I or class II division 1 malocclusion. Using lateral cephalometric radiographs taken before and after treatment, hard and soft tissue structures were measured and reproducible six landmark on soft chin tissue were used to locate the various points of soft tissue contour of the chin. The res에ts were as follows : 1. There were signigicant correlations between pretreatment B-B', Pm-Pm' and pretreatment vortical skeletal measurements such as $MP{\perp}HP,\;MP{\perp}PP$, ALFH and between a-a', b-b', Me-Me' and measurements of sym-physeal morphology such as SL, SW, PL. 2. There were significant decreases at B-B', Pm-Pm' and significant increases at a-a', b-b' between pre-and posttreatment mea surements. 3. There were significant correlations among soft tissues changes and hard tissue changes except for changes at B-B' and the range of correlation coefficient was about 0.3-0.4. 4. There were significant differences at ${\Delta}UI-VP,\;LI{\perp}, and B-B' measurements between subgroups divided by posttreatment Pog-Pog' changes. 5. There were significant differences at ${\Delta}overbite,\;NPog{\perp}HP,\;and\;Me-Me'$ measurements between subgroups divided by posttreatment Me-Me' changes.

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The Three Dimensional Analysis on Nasal Airway Morphology in Class III Malocclusion (골격성 III급 부정교합자의 Nasal Airway 형태에 관한 3차원적 분석 연구)

  • Kim, Moon-Hwan;Lee, Jin-Woo;Cha, Kyung-Suk;Chung, Dong-Hwa
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.4
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    • pp.389-403
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    • 2008
  • In Angle's Class III malocclusion, which has higher incidence in Korean than Western, depressed midfacial profile with protruded lower lips and mandible may give rise to many functional, esthetic, psychological, social problems. Due to the different malocclusion incidence according to racial differences, many previous studies focused on the relationship between Class II malocclusion and nasal airway obstruction. Previous studies used lateral cephalography which has limitations of 2 dimensional image with projection error and identification error. Therefore, the purpose of this study was to analyze morphologic differences in the nasal airway between normal occlusion and Angle's Class III malocclusion patients using 3-dimensional facial computed tomography. Thirteen normal occlusion(7 men and 6 women) and sixteen skeletal Class III(7 men and 9 women) patients were selected and 3-dimensional facial computed tomography taking was performed. Comparison between two group in volume and sectional area of nasal airway were carried out. The results were followed. 1. In the comparison of absolute nasal airway volume, oropharyngeal space of experimental group were larger than control group but there are no significant difference in other. 2. In the comparison of relative nasal airway volume, oropharyngeal space of experimental group were larger than control group but there are no significant difference in other. 3. In the oropharyngeal space width on frontal and lateral view, the similar tendency was revealed between two groups. 4. In the lateral curvature of nasal airway, the similar tendency was revealed between two groups.

THE EFFECT OF DISTAL MOVEMENT OF UPPER MOLAR USING THE PENDULUM APPLIANCE (Pendulum 장치의 상악대구치의 원심이동에 대한 효과)

  • Lee, Chang-Seop;Kim, Jae-Gwang;Kang, Dug-Il;Song, Kwang-Chul;Jung, Hyun-Ku;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.488-495
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    • 2001
  • Treatment of class II malocclusions require distalization of maxillary molars into class I relationship. Intraarch distal molar movement techniques have recently assumed an important role in young patients. In this study, the dental and skeletal effects of the pendulum appliance were evaluated by means of cephalometric radiographs. The samples were consisted of 19 patients: 11 females and 8 males, mean age $11.68{\pm}1.52$ years. Measurements were obtained from cephalometric prior to and the day of removal of the pendulum appliance. Treatment changes were analyzed. The following results were obtain. 1. The pendulum appliance produced $2.94{\pm}1.54mm$ distal molar movement with a mean intrusion of $1.17{\pm}0.97mm$, mean period $18.13{\pm}7.95$ weeks. 2. The anchor tooth was $1.34{\pm}1.40mm$ forward movement and $0.48{\pm}0.99mm$ extrusion, and labial tilting of incisors. 3. The angle between palatal plane and mandibular plane increased significantly. 4. There was no significant difference in according to 2nd molar position. 5. Total movement was consisted of 74% distal movement of 1st molar and 26% forward movement of the anchor tooth.

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