• Title/Summary/Keyword: Skeletal class III openbite

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The structural change in the hyoid bone and upper airway after orthognathic surgery for skeletal class III anterior open bite patients using 3-dimensional computed tomography (3D-CT를 이용한 골격성 III급 개방교합자의 악교정 수술 전, 후 설골 및 상기도의 변화)

  • Lee, Yoon-Seob;Baik, Hyoung-Seon;Lee, Kee-Joon;Yu, Hyung-Seog
    • The korean journal of orthodontics
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    • v.39 no.2
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    • pp.72-82
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    • 2009
  • Objective: The purpose of this study was to investigate the structural changes of the hyoid bone and upper airway after orthognathic surgery for skeletal class III anterior open bite patients, and make comparisons with normal occlusion. Methods: Pre- and post-operative computed tomography (CT) examinations were performed on 12 skeletal class III anterior open bite patients who were treated with mandibular setback osteotomy. Using the V-works $4.0^{TM}$ program, 3-dimensional images of the total skull, mandible, hyoid bone, and upper airway were evaluated. Results: In the Class III open bite group, the hyoid bone were all positioned anteriorly, compared to the Normal group (p < 0.05). The angle between the hyoid plane and mandibular plane in the Class III openbite group before surgery was greater than in the Normal group (p < 0.05), and the difference increased after surgery (p < 0.01). In the Class III openbite group, the volume of the upper airway decreased after surgery (p < 0.001) and the volume of the upper airway was smaller than the Normal group before and after surgery (p < 0.001). Conclusions: The narrow upper airway space in skeletal Class III openbite patients decreased after mandibular setback osteotomy. This may affect the post-surgical stability.

Post-operative Stability of Counter Clockwise Rotation of the Mandibular Plane in Skeletal CIII with Anterior Openbite Patients (전치부 개교합을 가진 골격성 3급 부정교합 환자에서 하악의 반시계 방향 회전 시 술 후 안정성)

  • Ryu, Jeong-Min;Ryu, Kyung-Sun;Lee, Baek-Soo;Kwon, Yong-Dae;Choi, Byung-Joon;Kim, Yeo-Gab;Ohe, Joo-Young;Park, Seong-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.4
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    • pp.252-259
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    • 2012
  • Purpose: This study evaluated the postoperative stability of counter clockwise rotation of the mandibular plane in anterior openbite patients, who have had one jaw surgery performed. Methods: This study includes patients with skeletal class III malocclusion accompanied by anterior openbite among the patients who have had BSSRO performed, resulting in counter clockwise rotation of the mandibule. We excluded the patients with genioplasty and segmental surgery, and included 23 patients who underwent BSSRO. Results: We found no statistical significance between the amount of counter clockwise rotation in the mandible in the Pearson correlation test. Also, there was no significant difference between Group 1 (< $3^{\circ}$) and Group 2 (> $3^{\circ}$). Conclusion: This study evaluated the amount of horizontal relapse, and the degree of relapse. Stable results were obtained. Although there was no statistical significance between the degree of openbite and the amount of horizontal relapse, the group with a greater amount of openbite had a greater amount of relapse.

A STUDY ON THE CORRELATIONSHIP BETWEEN OVERBITE DEPTH AND SKELETAL FACTORS OF CRANIOFACIAL COMPLEX (OVERBITE와 안두개 복합체의 골격성 요소의 상관관계에 관한 연구)

  • Lee, Tei-Joon;Yang, Won-Sik
    • The korean journal of orthodontics
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    • v.15 no.2
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    • pp.279-289
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    • 1985
  • This study was undertaken to find out the factor highly correlated to the depth of overbite among the skeletal factors of the craniofacial complex using lateral roentgenocephalograms. The subjects cconsited of fifty normal occlusions, sixty Class I malocclusions, sixty Class II division I malocclustions and sixty Class III malocclusions. The results were as follows: 1. Ans-Go-Me angle and lower genial angle showed high correlation to the depth of overbite in the total malocclusion sample. 2. The mean values of Ans-Go-Me angle and lower goinal angle for the normal sample were $49.8^{\circ}\;and\;75.6^{\circ}$, respectively. 3. Ans-Go-Me angle above $56^{\circ}$ or lower gonial angle above $84^{\circ}$ indicated a tendency toward an openbite. Conversely, Ans-Go-Me angle below $48^{\circ}$ or lower goinal angle below $73^{\circ}$ indicated a tendency toward a deepbite.

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CONSIDERATION OF THE ANTERIOR OPENBITE AND DEEP BITE IN CLASS III AND THEIR TREATMENT WITH MULTILOOP EDGEWISE ARCHWIRE (MEAW) (골격형 III급 전치개교와 과개교합에 대한 비교고찰 및 MEAW에 의한 치험예)

  • Baek, Seung-Hak;Yang, Won-Sik
    • The korean journal of orthodontics
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    • v.21 no.3
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    • pp.685-699
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    • 1991
  • The purpose of this report is to review vertical dysplasia such as openbite or deep bite in skeletal Class III malocclusion and their treatment modality and to present two cases treated with MEAW. The results obtained were as follows A. Open bite case 1. The treatment time was 3 year 8 months. 2. Upper and lower incisors showed extrusion and especially lower anterior alveolar process showed remodelling. 3. The mesially inclined upper and lower molars were uprighted and especially lower first molars showed extrusion that means remodelling of alveolar bone. 4. Normal overbite and overjet were established. 5. Mandible showed slight clockwise rotation. 6. Maxilla showed slight downward bending of ANS part. 7. Upper lip showed downward drop and lower lip showed retraction and touch between upper and lower lip was established. 8. Tongue posture of post-treatment was more raised than pretreatment. B. Deep bite case 1. The treatment time was 1 year 8 months. 2. Upper incisors showed intrusion and labioversion and lower incisors showed slight intrusion and linguoversion. 3. The lower molars showed distal uprighting and intrusion and upper molars showed mesial movement and extrusion. 4. Normal overbite and overjet were established. 5. Maxilla did not show downward movement. 6. Mandible showed slight clockwise rotation. 7. Lower lip showed retraction and downward drop and upper lip showed downward drop.

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Treatment in Bimaxillary Prognathism with Anterior Open Bite: A Case Report (전치부 개방교합을 지닌 상악골 및 하악골 전돌증의 치료: 증례 보고)

  • Chun, Sang-Deuk;Chin, Byung-Rho
    • Journal of Yeungnam Medical Science
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    • v.21 no.2
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    • pp.242-250
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    • 2004
  • In general, the skeletal class III has the characteristics of mandibular overgrowth with a normal maxillary growth or maxillary undergrowth with a normal mandibular growth And clinical and radiographic evaluations of the patient are needed. However, the treatment plan is not dependent on these evaluations alone, because patient's general condition and hope for aesthetics varies. The aim of this report is to consider the treatment of a medically compromised patient with an anterior open bite and skeletal class III, which showed a severe mandibular overgrowth. In 2003, a 17-year-old boy with epilepsy, mental retardation presented at our clinic complaining of concave profile. A clinical examination showed severe mandibular prognathism with an anterior open bite. The radiographic examination revealed a short cranial base, a moderate maxillary overgrowth, severe mandibular overgrowth and skeletal open bite tendency. In 2004, he was verified to have no potential of growth by hand-and-wrist radiographs and an endocrine examination. He completed the preoperative orthodontic treatment and orthognathic surgery (sagittal split ramus osteotomy, genioplasty). He was evaluated on the first visit, the preoperative period and the postoperative period with a clinical and radiographic examination. At the first visit, the patient showed moderate overgrowth of the maxilla, severe overgrowth of the mandible, and a subsequential skeletal open bite. After the preoperative orthodontic treatment (preoperative period), the patient showed the same skeletal problem as before and a decompensated dentition for orthognathic surgery. After orthognathic surgery, his profile had improved, but he had still a skeletal openbite tendency because the maxillary orthognathic surgery was not performed. Severe mandibular prognathism with a maxillary overgrowth and anterior open bite should be treated by bimaxillary orthognathic surgery. However, one-jaw orthognathic surgery on the remaining the skeletal open bite tendency was performed for his medical problem and facial esthetics. This subsequential open bite should be resolved with a postoperative orthodontic treatment.

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Postoperative Stability and Occlusal Plane Alternation by Orthognathic Surgery of Skeletal Class III Malocclusion with Anterior Open Bite (전치부 개교를 동반한 골격성 III급 부정교합 환자의 악교정 수술 후 교합평면의 변화와 안정성에 관한 연구)

  • Shin, Soo-Jung;Hwang, Byung-Nam;Lee, Jung-Keun;Rhee, Seung-Hoon
    • The korean journal of orthodontics
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    • v.29 no.1 s.72
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    • pp.113-127
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    • 1999
  • The purpose of this study is to investigate the stability of counterclockwise rotation of mandible by sagittal split ramus osteotomy to correct the skeletal Class III malocclusion with anterior open bite. Twenty five skeletal Class III open bite patients(mean age 20.6 years) who were treated by the sagittal split ramus osteotonues with rigid fixation were examined in this study. Cephalometric radiographs were taken for each Patients Preoperative(T1), ewly Postoperative(T2), and late postoperative Period(T3). Mean postoperative period was 8.0 months. Cephalometric analysis was done and data from T1, T2, and T3 were analyzed statistically by Paired t-test and Pearson correlation analysis. The following results were obtained. 1. Mandibular plane angle decreased $2.9^{\circ}$ and mandibular occlusal plane angle related to SN Plane decreased $2.7^{\circ}$ after orthognathic surgery(T2). At 6 months after orthognathic surgery(T3), mandibular plane angle increased $1.0^{\circ}$, but mandibular occlusal plane angle did not changed. 2. The amount of horizontal relapse long time after orthognathic surgery(T3) was 1.6 mm at B point and it was $22\%$ of the total posterior movements. There was no vertical relapse in the anterior facial height. 3. The related factor with horizontal relapse at late postoperative period was mandibular plane angle(p<0.01). The related factors with decreasing posterior facial height were amount of mandibular setback(p<0.01), increasing of mandibular ramus height(p<0.01), and decrease of the mandibular plane angle during operation(p<0.01). 4. There was no relationship between the amount of changes in mandibular occlusal plan angle during operation and the amount of relapse after surgery.

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Orthodontic and orthopedic treatment for a growing patient with Tessier number 0 cleft

  • Baek, Seung-Hak;Park, Yoon-Hee;Chung, Jee Hyeok;Kim, Sukwha;Choi, Jin-Young
    • The korean journal of orthodontics
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    • v.48 no.2
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    • pp.113-124
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    • 2018
  • The purpose of this case report was to introduce the concept of orthodontic and orthopedic treatment for a growing patient with Tessier number 0 cleft. A 5-year-old boy patient with Tessier number 0 cleft presented congenitally missing maxillary central incisors (MXCI), a bony defect at the premaxilla, a constricted maxillary arch, an anterior openbite, and maxillary hypoplasia. His treatment was divided into three stages: management of the bony defect at the premaxilla and the congenitally missing MXCIs using a fan-type expansion plate, iliac bone grafting, and eruption guidance of the maxillary lateral incisors into the graft area for substitution of MXCIs; management of the maxillary hypoplasia using sequential facemask therapy with conventional and skeletal anchorage; and management of the remaining occlusal problems using fixed orthodontic treatment. The total treatment duration was 15 years and 10 months. Class I canine and Class II molar relationships and normal overbite and overjet were achieved at the end of treatment. Although the long-term use of facemask therapy resulted in significant protraction of the retrusive maxilla, the patient exhibited Class III profile because of continued mandibular growth. However, the treatment result was well maintained after 2 years of retention. The findings from this case suggest that interdisciplinary and customized approaches are mandatory for successful management of maxillary hypoplasia, bony defect, and dental problems in Tessier number 0 cleft. Moreover, considering the potential of orthognathic surgery or distraction osteogenesis, meticulous monitoring of mandibular growth until growth completion is important.