• Archives of Plastic Surgery
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• 제32권5호
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• pp.547-554
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• 2005

Orthognathic surgery for Class III malocclusion requires an elaborate preoperative planning using cephalometries or Mock surgery models which enable the surgeon to anticipate postoperative skeletal changes of maxilla and mandible as well as dentition. After surgery, patient's satisfaction is greatly influenced by appearance of soft tissue change. Therefore, it is imperative to predict a relatively accurate soft tissue change prior to surgery. A 5 year retrospective study was designed to evaluate the soft tissue change after sagittal split osteotomy of ramus(SSRO) for class III malocclusion. Analyses of preoperative and postoperative anthropometric measurements were performed. Patients who were treated only by SSRO for class III malocclusion and could follow up for 6 months were studied. Among them, the patients who had history of cleft palate and lip or hemifacial microsomia were excluded. Soft tissue changes were estimated by using the frontal and lateral photographs. Skeletal changes were observed by measuring amount of set back and angular changes of mandible to the reference line by using cephalometries. Relapses were also measured 6 months after the operation. We could observe skeletal changes were more profound than soft tissue changes concerning amount of set back, but soft tissue changes were also profound in angle. Relapse was more profound in skeleton than soft tissue but the amount was not significant. In spite of the variables which may affect proper assessment of the soft tissue change after skeletal relocation, this study can serve as a guide for exact prediction of the postoperative change of soft tissue and skeleton.

• 대한치과교정학회지
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• 제21권1호
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• pp.113-130
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• 1991

This study was undertaken to investigate soft tissue profile changes by orthodontic treatment in female patients. Traditional cephalometric appraisal yields data of dubious scientific value, the soft tissue profile forms were evaluated by finite element method. The subject was divided into three groups according to Angle's classification and each group was composed of 25 female patients averaged aged 12-14 years at the start of treatment. The changes in soft tissue form were evaluated by computing the degree of distortion in each triangle after treatment compared with the triangle before treatment. The conclusions were as follows; 1. The soft tissue profile forms were evaluated by finite element method and independent evaluation of each element by local changes was possible. 2. Maximum and minimum principal strains showed marked variability depending on the particular finite element and each group and Class II, III sample was greater than Class I sample. 3. Soft tissue size changes as a result of orthodontic treatment was not related to those of shape. 4. Soft tissue changes by orthodontic treatment were variable in individual patient, and were not related to Angle's classification.

• 대한치과교정학회지
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• 제23권4호
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• pp.707-724
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• 1993

The purpose of the study is to estimate hard and soft tissue changes after orthognathic surgery for the correction of the mandibular prognathism and to describe interrelationship and ratios of soft and hard tissue changes. The presurgical and postsurgical lateral cephalograms of 31 treated patients(17 males and 14 females) was used ; these patients had received combined orthodontic-surgical treatment by means of a bilateral sagittal split ramus osteotomy. Their ages ranged from 16 to 31 years and mean age was 21.4 years. A computerized cephalometric appraisal was developed and used to analyse linear and angular changes of skeletal and soft tissue profile. The statistical elaboration of the data was made by means of $SPSS/PC^+$. The results of the study were as follows : 1. The correlations of soft and hard tissue horizontal changes were significantly high and the ratios were $97\%$ at LI, $107\%$ at ILS, and $93\%$ at Pog'. 2. The correlations of vertical changes at Stm, LI and horizontal changes at Pog were high$(26\%)$ and at the other areas were not statistically high. 3. The correlations of soft ad hard tissue vertical changes were not significantly high in all areas except Gn' $(30\%)$ and Me' $(56\%)$. 4. The soft tissue thickness was significantly decreased in upper lip and increased in lower lip, and the amount of changes after surgery was reversely correlated with initial thickness. 5. The facial convexity was increased and relative protrusion of upper lip was increased and that of lower lip was decreased. 6. The upper to lower facial height(Gl-Sn/Sn-Me') was increased and upper to lower jaw height(Sn-Stms/Stmi-Me') was increased.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권4호
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• pp.351-361
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• 1997

This study was performed to evaluate the change of the soft tissue facial profile after mandibular set back surgery during time intervals. For this study, 33 patient, 8 males and 25 females, were selected and their lateral cephalograms were taken and analyzed periodically. Hard and soft tissue changes during postoperative time intervals, correlation between surgical skeletal changes and postoperative soft tissue changes, and prediction for long-term soft tissue changes were established through varying statistical methods. The results were as follow : 1. There were meaningful changes of anteroposterior skeletal position at 6 months and 2 years after mandibular set back by mandibular ramus osteotomy. Two years postoperatively, there was 30%, 32%, 29% relapse on B point, pogonion, menton each. 2. Two years after the mandibular ramus osteotomy, the relative changes of the soft tissue to their osseous counterparts showed 76% on the lower lip and 91% on the pogonion. 3. The movements of the mandibular landmarks in correlation to anteroposterior position of the lower lip and soft tissue of the chin showed to be effective on a long-term basis. 4. Using surgical changes of pogonion, prediction of changes in soft and hard tissue pogonion was useful and the coefficient of determination was 0.46 each and their reliability decreased 2 years postoperatively. 5. The upper lip position after the mandibular set back surgery was somewhat anterior 2 years postoperatively, but that has no statistical meanings.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권3호
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• pp.250-259
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• 1997

The purpose of this study was to evaluate the interrelationship of the soft and hard tissue changes after both maxillary and mandibular anterior segmental surgery in bimaxillary protrusion patients. 11 patients had received both maxillary and mandibular anterior segmental surgery and were investigated radiologically with lateral cephalogram. The results were as follows : 1. The correlation of maxillary hard and soft tissue horizontal changes were relative high. : Coefficient between UIE and Stms was 0.89 (p<0.001). 2. The correlation of mandibular hard and soft tissue horizontal changes were very high, especially at the chin. : Coefficients were over 0.90 (p<0.001) 3. All points were moved superiorly except SLS, LS, Stms. 4. Upper and lower lip convexity to the E-Line were decreased (p<0.001) and postsurgical facial profiles were changed very esthetically.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권1호
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• pp.51-55
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• 2000

Purpose : The purpose of this study is to setup a standard treatment protocol in surgical correction of skeletal malocclusion with Angle Class III patients. We asessed the soft tissue changes according to skeletal changes of patients who have undergone orthognathic surgery with bilateral split sagittal ramus osteotomy (BSSRO) and advancing genioplasty. Materials & Methods : The soft tissue change of 9 skeletal Class III patients was assessed after BSSRO and advancing genioplasty. The patient group was skeletal Class III who was surgically treated by BSSRO & advancing genioplasty. The average follow up period is 13 months with the range of 6 and 30 months. All patients have undergone preoperative and postoperative orthodontic treatment. The assessment was devided into two groups. One was antero-posterior relationship and the other was vertical relationship of dimensional changes of soft tissue after orthognathic surgery. Results : In antero-posterior dimensional changes after surgery, the percentage of soft tissue change in comparison to hard tissue was 89%. Vertical ratio after surgery, 86% soft tissue changes were assessed.

• 대한치과교정학회지
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• 제24권3호
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• pp.547-554
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• 1994

This study was carried out in order to find out the soft tissue profile changes associated with maxillary incisor retraction in Angle's class I malocclusion patients. For this study fifty two female adult patients (Maximum Retraction Group 23, Minimum Retraction Group 29) who received orthodontic treatment were chosen. Following conclusions were obtained by analysing the changes of soft tissue and hard tissue before and after treatment. 1. When considering the mean changes of soft tissue and hard tissue, UP, LIP, Ls, Li (p<0.001), Point B, Si (p<0.01), Point A, Ss (p<0.05) were significant posterior movement in Maximum Retraction Group and UIP (p<0.001), LIP, Ls, Li (p<0.01), Point B, Si (p<0.05) were significant posterior movement in Minimum Retraction Group. 2. When considering the correlations between hard tissue and soft tissue changes, greater correlations were found in Minimum Retraction Group between UIP and Ls (p<0.01), Point A and Ss, UIP and Li, Point B and Si (p<0.05) than Minimum Retraction Group. 3. Correlations (p<0.01) were found between upper incisor retraction and posterior movement of the upper and lower lip in Thin Lip-Thickness Group, whereas no significant correlations were found in Thick Lip-Thickness Group. 4. Mean changes of the soft tissue thickness subsequent to incisor retraction were increased (p<0.01) in upper lip (Ls-Ls'), whereas no changes were found in lower lip.

• 대한치과교정학회지
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• 제13권2호
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• pp.177-183
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• 1983

The soft tissue covering of the face plays an important role in facial esthetics, speech and other physiologic functions. Thus, it is recognised by all clinical orthodontists that success of orthodontic treatment is closely related to the changes in soft tissues of the face. The purpose of this study was to evaluate the changes of bony and soft tissues in prepost treatment of Angle's Class III malocclusion. The sample consisted of 18 males and 37 females, pretreatment age of 9 years to 11 years. For this study 11 landmarks were plotted, 14 linear length, 4 soft tissue thickness and 2 angles were measured. The obtained results were as follows; 1. In the linear measurements of bony and soft tissue changes, A, Is, Ss, Ls and Li were located more anteriorly in both sexes. However Si and B showed more remarkable anterior movement in female. 2. In the comparison of the changes of the soft tissue thickness, Ss and Li in male subjects and Ss in female subjects increased. 3. In the degree of correlation between changes in the soft tissue profile and changes in the skeletal profile, Is: Ls, Il: Li and B: Si in both sexes had significant correlations. However A:Ss had remarkable significant correlation in female. 4. There were significant correlations between change in ${\angle}A$ and change in ${\angle}B$ in all sexes. 5. There were little correlation between changes in distance difference of Is and Ii and Change in distance difference of Ls and Li in all sexes.

• 대한치과교정학회지
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• 제38권4호
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• pp.252-264
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• 2008

본 연구는 안면비대칭 환자의 악교정수술 시 경조직 이동에 따른 연조직 변화를 정면에서 평가함으로써 정면 얼굴 이미지 시뮬레이션 프로그램 개발에 도움이 되고자 시행되었다. 안면비대칭이 동반된 하악골 수술 예정 환자 45명을 대상으로 정모 두부방사선규격사진과 얼굴사진(photo)을 술전 및 술후에 각각 같은 각도로 촬영한 후, 술전 및 술후의 방사선사진을 이용하여 경조직 계측점의 변화를, 얼굴사진을 이용하여 연조직 계측점의 변화를 수평 및 수직으로 구분하여 각각 측정한 후 경조직 변화에 따른 연조직 변화를 비교 분석하였다. 연조직 변화와 경조직 변화의 상관성을 살펴본 결과 수평 방향, 수직 방향 모두에서 전반적으로 낮은 상관성을 보였으며, 1 : 1 mean ratio 산출을 위하여 서로 상관성이 가장 높은 경조직 계측점을 연조직 계측점별로 선택한 결과 직하방에 있는 경조직보다는 다소 멀리 떨어져 있는 경조직 계측점이 선택되는 경우가 많이 나타났다. 경조직 변화를 이용하여 연조직 변화를 예측할 수 있는 회귀방정식을 연조직 계측점별로 산출한 결과 연조직 수평변화 예측에 경조직 수직변화도 사용되고 연조직 수직변화 예측에 경조직 수평변화도 사용되었으며, 수평과 수직변화 모두에서 가장 설명력이 높은 방정식은 연조직 menton에서 나타났다. 이상의 연구결과 하부 경조직 계측점과 상부 연조직 계측점의 비율을 이용하는 1 : 1 mean ratio 방법은 불가능한 것으로 나타난 반면 회귀분석을 이용한 연조직 변화 예측은 임상에 도움이 될 수 있는 것으로 나타나 정면 이미지의 경우 컴퓨터를 이용한 시뮬레이션 프로그램이 반드시 필요함을 시사하였다.

• 대한치과교정학회지
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• 제27권1호
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• pp.65-78
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• 1997

본 연구는 성장에 의한 효과를 배제한 교정치료시의 연조직 변화와 치아 및 악골의 수평적, 수직적 움직임과의 상관 관계를 알아보고 예측 가능성을 검토하기 위해 Angle씨 2급 1류 부정 교합 환자 41명을 대상으로 치아 및 악골, 연조직의 수평, 수직이동의 평균 변화량을 측정하고 연조직에 대한 계단식 다중 회귀분석을 시행하였으며 다음과 같은 결론을 얻었다. 1. 경조직 계측항목 중 상악 중절치의 수평이동 및 기울기, 하악 중절치의 수평 및 수직이동, 수평피개량, 수직피개량, interincisal angle, 하악골 위치, 변화, A, B, 경조직 측모 돌출각 등의 항목에서, 연조직 계측항목 중 상순의 두께 및 후방이동, 기울기, 하순의 후방이동 및 기울기, interlabial angle, 비순각, 이순각, Sn, Ss, Si, 연조직 측모 돌출각등의 항목에서 치료 전과 후에 유의성 있게 변하였다(P<0.05). 2. 치료 전 후 유의한 변화를 보인 연조직 계측항목을 분석한 결과 모든 항목에서 경조직의 변화에 대해 영향을 받는 것으로 나타났다(P<0.05). 3. 연조직 회귀방정식에 중절치 수평피개량, 상악 전치 절단연의 후방이동량, 상악 전치 치근의 후방이동량, Pg의 수평변화량이 가장 높은 빈도로 포함됨으로써 이들은 연조직의 수직 및 수평변화에 영향을 많이 미치는 요소로 나타났으며 하악 전치의 수직이동량은 포함되지 않음으로써 연조직 변화와 관련성이 적은 것으로 나타났다. 4. Sn의 수직 및 수평변화는 경조직의 가장 많은 항목과 연관됨으로써 (A, B, Pg(H), overjet, upper incisor angle, Ur, Is(H)) 여러 경조직 변화의 복합적인 영향을 받는 것으로 나타났다. 5. 연조직 계측항목에 대한 상관계수($R^2$)의 범위는 0.2-0.6으로 중등도의 상관정도를 나타내었다.