• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권6호
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• pp.379-384
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• 2020

Objectives: We sought to identify a clinically useful method of analyzing orbital dystopia to aid in diagnosis and treatment planning and to quantify vertical discrepancies in eye level and variations in canthal tilt in Koreans. Patients and Methods: In 76 Korean patients with a mean age of 23.12 years, mean differences in the level of the pupils, lateral canthi, medial canthi, and canthal tilt were measured. The difference in pupil level was calculated from the perpendicular lines drawn from the midpupil area of each eye to the midline of the face to determine the amount of skeletal discrepancy of the eye. Soft tissue discrepancies were determined according to the vertical difference between the lines drawn from the lateral or medial canthus of each eye perpendicular to the midline of the face. The canthal tilt was determined from the inclination of a line connecting the lateral and medial canthi, then classified as class I, II, or III. Results: Mean differences in pupil level, medial canthi, and lateral canthi were 1.57±1.10 mm, 1.14±1.07 mm, and 2.03±1.64 mm, respectively. The mean degree of canthal tilt were 8.45°±3.53° for the right side and 8.42°±3.81° for the left side. No study participants presented with class III canthal tilt. The mean canthal tilt values for those with class I tilt were 3.21°±1.68° for the right side and 3.18°±1.63° for the left side, while, for those who had class II tilt, the values were 9.60°±3.66° for the right side and 9.54°±2.99° for the left side. Conclusion: The presented diagnostic method of orbital dystopia can be used to effectively establish a treatment plan that takes into consideration the patient's skeletal and soft-tissue discrepancies.

• 대한치과의사협회지
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• 제54권3호
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• pp.217-229
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• 2016

Purpose: The aim of this study was to evaluate the soft-tissue change after the maxillary protraction therapy using threedimensional (3D) facial images. Materials and Methods: This study used pretreatment (T1) and posttreatment (T2) 3D facial images from thirteen Class III malocclusion patients (6 boys and 7 girls; mean age, $8.9{\pm}2.2years$) who received maxillary protraction therapy. The facial images were taken using the optical scanner (Rexcan III 3D scanner), and T1 and T2 images were superimposed using forehead area as a reference. The soft-tissue changes after the treatment (T2-T1) were three-dimensionally calculated using 15 soft-tissue landmarks and 3 reference planes. Results: Anterior movements of the soft-tissue were observed on the pronasale, subnasale, nasal ala, soft-tissue zygoma, and upper lip area. Posterior movements were observed on the lower lip, soft-tissue B-point, and soft-tissue gnathion area. Vertically, most soft-tissue landmarks moved downward at T2. In transverse direction, bilateral landmarks, i.e. exocanthion, zygomatic point, nasal ala, and cheilion moved more laterally at T2. Conclusion: Facial soft-tissue of Class III malocclusion patients was changed three-dimensionally after maxillary protraction therapy. Especially, the facial profile was improved by forward movement of midface and downward and backward movement of lower face.

• Journal of Yeungnam Medical Science
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• 제21권2호
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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.

• 대한치과교정학회지
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• 제50권1호
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• pp.3-12
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• 2020

Objective: This study compared three prominent midsagittal planes (MSPs) to identify the MSP that best approximates the true symmetrical MSP. Methods: Forty-three patients (mean age, 23.0 ± 8.20 years) were grouped as follows: group 1 consisted of 10 patients with skeletal Class I and a menton (Me) deviation of < 2 mm; group 2, 11 patients with skeletal Class III and a Me deviation < 2 mm; group 3, nine patients with skeletal Class III and a Me deviation of 2 to less than 4 mm; and group 4, 13 patients with skeletal Class III and an Me deviation ≥ 4 mm. The candidate MSPs were established by three-dimensional (3D) cone beam computed tomography (CBCT) reorientation methods (RMs): (1) the MSP perpendicular to the Frankfort horizontal (FH) plane while passing through the crista galli and basion; (2) the MSP including the nasion, incisive foramen, and basion; (3) the MSP including the nasion, anterior nasal spine, and posterior nasal spine. The mean absolute distances (MADs) to the MSPs were calculated from the coordinates of 1,548 points on 129 CBCT images. The differences in the values of the 3D coordinates among RMs were compared. Results: The MADs of the three RMs showed significant differences (p < 0.05). Most of the differences in values of the coordinates were not significant among RMs. Conclusions: Although the differences in distance among the three MSPs were minor, the MSP perpendicular to the FH plane while passing through the crista galli and basion best approximated the true symmetrical MSP.

• 대한치과교정학회지
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• 제24권3호
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• pp.695-707
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• 1994

This study investigates the effects of third molar on the occlusal plane in Angle's class El malocclusion with possibilities of posterior crowding and the interrelationships of occlusal plane inclinations to other skeletal patterns. Above investigations might showed that considerations should be given to third molars with possibilities of posterior crowding in establishing diagnosis and treatment plans for Angle's class III malocclusion patients. The following conclusions were obtained 1. In events of third molars causing possible posterior crowding, maxillary third molars showed more mesial inclinations than second molars, and compared to those with third molar missing cases, first molars were more mesially inclined and displaced more inferiorly from the palatal plane and OP-MP was increase , thus the occlusal plane was less steep. 2. In events of third molars causing possible posterior crowding, the anglulation between AB line and mandibular plane was decreased and ANB showed negative values. Thus chin points were more protruded, ramus were more anteriorly displaced, and increase in lower facial height, genial angle, effective mandibular length and mandibular plane angle were observed. This in all caused more vertical opening and more severe skeletal disturbance. 3. OP-MP was increased as the maxillary first molars were more inferiorly displaced from the palatal plane. As this angle was increased mandibular planes were more inferiorly inclined and LFH, genial angle, effective mandibular length were more increased and mandibular ramus was more anteriorly placed. 4. As the maxillary first molars were more inferiorly placed from the palatal plane, more increased OP-MP/PP-MP ratio made the occlusal plane less steep. As OP-MP/PP-MP was increased, mandibular ramus was more anteriorly placed and made longer, and facial angle and effective mandibular length were increased.

• Journal of Periodontal and Implant Science
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• 제29권3호
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• pp.519-540
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• 1999

The purpose of this study is to compare the healing aspects of the use of ePTFE membrane alone versus combination treatment of ePTFE membrane and bone grafts on class II furcation defects. Seventeen defects were applied ePTFE membrane alone on mxillary molar buccal class II furcation defects as Group I, seventeen defects were applied ePTFE membrane and bone grafts on maxillary molar buccal class II furcation defects as Group II, twenty-three defects were applied ePTFE membrane alone on mandibular molar buccal class II furcation defects as Group III, twenty defects were applied ePTFE membrane and bone grafts on mandibular molar buccal class II furcation defects as Group IV . Measurements were made to determine clinical attachment level, probing depth, gingival depth, SBI, mobility at baseline, 3, 6, 12 months postoperatively. Additional measurements were made to determine membrane exposure level at surgery, 1, 2, 6 weeks postoperatively. And then healing patterns and postoperative complications were evaluated. The result as follows : There were statistically significant differences in probing depth reduction, clinical attachment gain, mobility reduction at values of 3, 6, 12 months postoperatively compared to values of baseline(p<0.05), whereas no significant differences in SBI and gingival recession. In group II, membrane exposure level was increased at 1, 2, 6 weeks postoperatively compared to value of baseline(p<0.05). There were statistically significant differences in changes of probing depth at 3, 6, 12 months postoperatively in combination groups of ePTFE membrane and bone graft compared to groups of ePTFE membrane alone(p<0.05). The vast majority of cases fall into typical healing and delayed healing response when membranes were removed in all groups. Pain and swelling were common postoperative complications. In conclusion, this study was showed more effective healing aspects in combination treatment of ePTFE membrane and bone graft than ePTFE membrane alone and on mandibular molar class II furcation defects than maxillary molar.

• 대한소아치과학회지
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• 제42권2호
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• pp.126-135
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• 2015

본 연구의 목적은 3급 부정교합 환자에서 facemask 치료 시 수직적 골격 양상에 따른 치료 효과를 비교하고, 구내 장치로서 bonded expander의 고정원을 평가하는 것이다. Facemask 치료를 받은 20명의 환자를 대상으로 FMA를 기준으로 두 군으로 분류하였고(HV군; FMA > $27^{\circ}$, AV군; $23^{\circ}$ < FMA < $27^{\circ}$), 치료 전과 후 측모두부방사선사진을 촬영하여 계측치를 비교하였다. 치료 후 두 군 모두 상악의 전방이동 및 하악의 후하방 회전이 관찰되었고, 두 군간에 유의한 차이는 없었다. 두 군 모두 수직적 골격 계측치가 증가하였고, FMA의 증가량은 HV군이 AV군에 비해 유의하게 크게 관찰되었다. 고정원 소실로서 상악구치의 근심이동 및 상악 전치의 전방경사가 관찰되었고, 두 군간에 유의한 차이는 없었다. 결론적으로 수직적 골격 양상에 따라 상악의 전방이동 및 고정원 소실면에서는 유의한 차이가 없었으나, HV군에서 수직적 성장 경향이 더 증가하였다.

• 대한치과교정학회지
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• 제38권4호
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• pp.283-298
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• 2008

본 연구는 악교정수술을 받은 골격성 III급 부정교합자의 치료 전, 후의 하악치열궁 변화를 관찰하고, 이들이 초진 시의 측모두부방사선 규격사진 및 석고모형과 어떠한 상관성을 가지고 있는지를 알아보기 위해 골격성 III급 부정교합자로 진단받은 31명(남자 14명, 여자 17명, 평균 $21.8\;{\pm}\;3.3$세)을 대상으로 치료 전, 악교정수술 전, 악교정수술 후 채득한 측모두부방사선 규격사진과 치료 전, 후의 석고모형을 계측하여 상관분석과 회귀분석을 시행하였다. 연구 결과 Mn-LMMC, Mn-LIE, Mn-MnOcc는 술전교정치료에 의한 유의한 차이를 보이지 않았다. 치료 전의 계측치와 치료 후 변화된 계측치와의 상관관계에서는 치열궁공간부족(ALD)은 ICW, IPW1의 변화량과 순상관관계(r = 0.492, 0.615)를 보였으며, 치열궁장경(arch length)의 변화량과도 순상관관계(r = 0.641)를 보였다. 그러나 Spee 만곡은 전치부치축 각도 변화와 치열궁 폭경 및 장경 등 각각의 변화량과는 상관관계를 보이지 않았다. 이를 이용하여 회귀분석을 시행한 결과, 술전교정 후 Arch length, IPW1의 변화량은 치료 전의 계측치로 각각 64.0%, 75.8%를 설명할 수 있었다. 이상의 연구에서 골격성 III급 부정교합자의 치료 전, 후의 변화량과 치료 전 측모두부방사선 규격사진 및 석고모형 간에 관련성이 있었고 악교정수술을 동반한 교정치료 계획을 수립할 때 술전교정치료의 목표 설정과 악교정수술 결과의 예측에 도움이 될 것으로 판단된다.

• 대한치과교정학회지
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• 제22권3호
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• pp.509-529
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• 1992

Skeletal Class III malocclusion is one of the most difficult type to treat and stabilize. For a child with developing skeletal Class III malocclusion, the treatment objective would be to stimulate maxillary growth, particulary one who has markedly deficient maxilla, and to restrain excessive mandibular growth. In order to stimulate the maxillary growth, maxillary protraction appliance is the one of the effective orthopedic appliances in skeletal Class III. The purposes of this study were as follows ; evaluation of the skeletal and dental changes of the maxillary protraction in children with Class III Maxillary deficiency , comparison of the clinical effects between the group with RPE and labiolingual intraoral appliances , comparison of the clinical effects and stability related to the ages of the patients : stability of the maxillary protraction about 1 year after retention. The subjects consisted of 60 children between the ages of 8 and 13.4 who were diagnosed as Class III with maxillary deficiency and were treated with Face Mask (Delaire Type) from the Dept. of Orthodontics Yong Dong Severance Hospital, Yonsei University. 48 children wore the RPE and 12 children wore Labiolingual Appliance. Lateral Cephalograms were taken for each patient at before and after correction of anterior cross-bite in 60 children, and after an observation period of 10 to 14 months in 19 children. X and Y coordinate of 10 landmarks were analyzed using a horizontal line through sella and rotated $6^{\circ}$ down anteriorly as the horizontal reference axis, and a perpendicular verticual line through sella as the vertical reference axis. Each of the 31 measurents (10 verticals, 10 horizontals, 2 angles and 9 others) was statistically analyzed using SPSS/PC statistics. The results are as follows; 1. After maxillary protraction the maxilla and maxillary teeth moved downward and forward, while the mandible and mandibular incisor rotated downward and backward. 2. Maxillary protraction with rapid palatal expansion appliance was more effective than with labiolingual appliance. 3. More downward movement of the posterior palatal plane obserbed with maxillary protraction doing the midpalatal suture opening than with protraction after finishing the palatal expansion 4. The clinical effects of protraction and changes of the retention periods were not statistically significant among the age groups. 5. During the retention period, maxilla and maxillary teeth, and mandible and mandibular teeth moved downward and forward, however the mandibular changes were larger than the maxillary changes.

• 대한치과교정학회지
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• 제34권4호
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• pp.279-287
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• 2004

성장기 부정교합 환자의 치료시 다양한 악안면 성장은 치료성패의 중요한 요소이다. 따라서 치료를 시작하기 전에 안면성 장을 예측하는 것은 매우 중요하다. 본 연구는 III급 부정 교합을 보이 는 아동에서 성장을 예측할 수 있는 방법들 중의 하나로 두부방사선 계측사진 분석을 통해 유전적 요소의 관련여부를 알아보고자 50가족에서 부모자식간의 악안면 형태의 상관관계를 통계학적으로 분석하였다. 또한 자식과 부모간의 지문의 형태적 연관성을 조사하고 부모자식간의 악안면 형태와 지문의 형태적 연관성과의 유전적 상관관계를 조사하여 다음과 같은 결론을 얻었다. 1 부모자식간의 악안면 형태에서 치성관계보다는 악골관계에서 더 유전성향이 높았으며 아버지가 어머니에 비해 자식의 악골관계에 더 영향을 주었다. 2. 자식의 지문 형태는 아버지보다는 어머니와의 연관성이 더 높게 나타났다. 3. 부모와 자식간의 지문과 악안면 형태에서 유전적 상관관계가 있었으며(P<0.05-0.01), 딸보다는 아들에게서 연관성이 더 높게 나타났다.