• The Journal of the Korean dental association
• /
• v.52 no.10
• /
• pp.623-632
• /
• 2014

The facial asymmetries include maxillary, mandibular, and chin asymmetries, although the most common deformity is primarily in the mandible. Common causes of this type of asymmetry can include asymmetric growth of the condyle or the mandible. In these patients, the location of the Me would be deviated to the shorter side because of the asymmetric growth of the mandible, and, commonly, the maxillary occlusal plane would be tilted toward the deviated side because the maxilla likely grows asymmetrically according to the pattern of asymmetric mandibular growth. Three-dimensional CT images are ideal for evaluating the size and location of anatomic structures, and such reconstructed images allow the use of software that can show anatomic structures from numerous angles, allowing actual measurements of distances and angles without problems of magnification, distortion, or superimposition caused by 2-dimensional imaging. In the present study using 3D-CT imaging, the 8 parameters, including measurements of the upper midline deviation, maxillary canting in the canine and first molar regions, width of the upper arch, width of the mandible at the Go, vertical length of the ramus, inclination of the ramus, and deviation of the Me were easily measured. The dentition should be orthodontically decompensated and dental midline should ensure incisor midlines positioned in the midline of each jaw before surgical correction. Surgical correction could be considered such as canting or yawing correction in the frontal or horizontal aspect, respectively.

• The korean journal of orthodontics
• /
• v.29 no.1 s.72
• /
• pp.23-35
• /
• 1999

Lateral cephalograms or 251 males md 286 females were taken and pubertal growth pattern or cranial base, maxillary and mandible of 7 to 17 years old Korean children was evaluated. 10 landmarks and 16 analytical measurements were evaluated. Analytical measurement and annual difference for each age group was calculated and tested for statistical significance. Analytical measurements were classified into three groups which were cranial base, maxillary and mandibular measurements and also classified into make and female measurements. Following results were achieved. 1. The circumpuberal growth spurt was earlier in Korean females than in males. 2. Cranial base, maxilla and mandible showed circumpuberal growth. The cranial base showed a relatively smaller amount of growth than the facial complex. 3. Middle and posterior cranial base length showed a floater increase than anterior cranial base length and circumpuberal growth spurt was also more definite. 4. the forward and downward growth or maxilla results from maxillary growht itself and transposition or the maxilla due to circumsutural growth aroud the maxilla. Ar-ANS and Ar-Pr which represent maxillary position relative to the cranial base showed more growth than ANS-PNS which represents maxillary bone growth. 5. mandible showed more vertical growth than horizontal growth but without significance. 6. Alveolar gwoth of maxilla and mandible show maximum growth rate of the time of permanent teeth eruption following loss of deciduous teeth . After this period alveolar growth shows a decreasing tendency.

• The korean journal of orthodontics
• /
• v.20 no.3 s.32
• /
• pp.519-539
• /
• 1990

It is the aim of this study to observe the distribution of various facial types in class III malocclusion and to characterize the craniofacial features of the very facial types. Cephalometric headptates of a hundred and ten persons showing bilateral class III malocclusion whose mean age was 12.51 years and sixty nine persons of normal occlusion whose mean age was 12.23 years were measured and statistically analyzed. The following summary and conclusions were drawn. 1. Affording the bases for SNA and SNB, $35.45\%$ of sample showed normally positioned maxilla and protruded mandible, $30.00\%$ for retruded maxilla and normally positioned mandible, $15.45\%$ for retruded maxilla and protruded mandible, $10.90\%$ for both maxilla and mandible within normal range and $8.20\%$ for miscellaneous types were arranged in class III malocclusion. 2. $52.72\%$ of sample showed neutrodiveigent, $35.45\%$ for hyperdivergent and $11.81\%$ manifested hypodivergent mandible in class III malocclusion. 3. Providing the bases for facial and mandibular planes, $33.63\%$ of sample showed prognathic and neutrodivergent, $20.90\%$ for mesognathic and hyperdivergent, $17.27\%$ for prognathic and hyperdivergent and $15.45\%$ for mesognathic and neutrodivergent were arranged in class III malocclusion. 4. The class III malocclusion brought out shorter cranial base, smaller saddle angle, and larger articular and genial angle. It showed retropositioned maxilla and forward positioned mandible in spite of no significant differences in linear measurements of mandible. Anterior lower facial height was significantly larger in class III malocclusion, while posterior total facial and anterior total facial heights exhibited no significant differences. 5. It is suggested class III malocclusion was attributed to shorter cranial base, smaller saddle angle, maxillary deficiency and/or retrusion, mandibular excess and/or protrusion, excessive vertical growth of the anterior lower face, and their complex as well.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.38
• /
• pp.49.1-49.9
• /
• 2016

Background: The aim of this report is to present a new reference for aesthetic mandible surgery using three-dimensional cone-beam computed tomography-based treatment planning for orthognathic surgery which can be implemented in surgical planning and perioperative procedure. Methods: To make an objective standard for evaluating aesthetic mandibular outline, we make an aesthetic scoring criteria with consideration of asymmetry, broad mandibular border line, and prominent mandibular angle. Two maxillofacial surgeons and two orthodontists rated their aesthetical evaluation from 1 to 5. Experimental group consisting of 47 female and 38 male patients who had rotational orthognathic two-jaw surgery from 2010 to 2011 were chosen according to aesthetic scoring done by two maxillofacial surgeons and two orthodontists. A high aesthetic score (${\geq}16$) means the facial contour is symmetric, with no broad and narrow aesthetic mandible frontal profiles. Control A group consisted of ten female and ten male patients who had no orthognathic surgery experience and low aesthetic score (${\geq}10$). Control B group consisted of ten female and ten male patients who had no orthognathic surgery experience and had anaesthetic mandibular frontal profile and a high aesthetic score (${\geq}16$). The three-dimensional image of the patient was taken from dental cone-beam CT (DCT) scanning (experimental group and control A group: 6 months DCT after surgery, control B group: 1st visit DCT). Each DCT was reformatted to reorient the 3D image using 3D analyzing program (OnDemand3D, cybermed Inc, CA, USA). After selection of 12 landmarks and the construction of reoriented horizontal, vertical, and coronal reference lines, 15 measurements were taken in 3D analysis of frontal mandibular morphology. Afterwards, horizontal and vertical linear measurements and angular measurements, linear ratio were obtained. Results: Mean $Go^{\prime}_{Rt}-Me^{\prime}-Go^{\prime}_{Lt}$ angular measurement was $100.74{\pm}2.14$ in female patients and $105.37{\pm}3.62$ in male patients. These showed significant difference with control A group in both genders. Ratio of $Go^{\prime}_{Rt}-Go^{\prime}_{Lt}-Me^{\prime}$ length to some linear measurements (ratio of $Me^{\prime}-Cd^{\prime}_{Rt}Cd^{\prime}_{Lt}$ to $Me^{\prime}-Go^{\prime}_{Rt}Go^{\prime}_{Lt}$, ratio of $Me^{\prime}-Go^{\prime}$ to $Me^{\prime}-Go^{\prime}_{Rt}Go^{\prime}_{Lt}$, ratio of $Go^{\prime}_{Rt}-Go^{\prime}_{Lt}$ to $Me^{\prime}-Go^{\prime}_{Rt}Go^{\prime}_{Lt}$) showed significant difference with control A group in both genders. Conclusion: This study was intended to find some standard measurement of mandible frontal view in 3D analysis of aesthetic patient. So, these potential measurement value may be helpful for orthognathic treatment planning to have more aesthetic and perspective outcomes.

• The korean journal of orthodontics
• /
• v.19 no.1 s.27
• /
• pp.201-218
• /
• 1989

This study was focused on the distribution of different facial types of the Class II division I malocclusion groups and skeletal characteristics of the each group and those that anteropsterior relationship of the maxilla and mandible calculated from the analysis of ANB angle and Wits appraisal was quite different from each other, as well. Cephalometric headplates of 140 persons of Class II division 1 malocclusion whose mean age was 11.2 years and 69 persons of normal occlusion whose mean age was 12.2 years were utilize as materials. Measurements were recorded, tabulated and statistically analyzed employing the tracings of the lateral cephalograms, then Class II division 1 malocclusion group was divided into 9 Types according to the angle of SNA and SNB for the anteroposterior relationship of the maxilla and mandible, another 9 Types according to the FH-NPog and SN-MP for the horisontal and vertical relationship, and the other 9 Types according to the ANB and Wits appraisal for intermaxillary relationship as well, with which was based on $Mean{\pm}$ 1SD of those of normal occlusion. The result allowed the following conclusion: 1. $37.1\%$ of population demonstrated maxilla within nounal range and retrognathic mandible to the cranial base, $30\%$ for both maxilla and mandible within normal range, $20\%$ for retrognathic maxilla and mandible and $12.9\%$ of the rest were ananged in Class II division 1 maloccusion groups. 2. Retrognathic mandible and hyperdivergent face accounted for $30.7\%$, mesognathic mandible and neutrodivergent face for $29.3\%$, mesognathic mandible and hyperdivergent face for $16.4\%$, retrognathic mandible and neutrodivergent face for $13.6\%$, mesognathic mandible and hypodivergent face for $10\%$ of population were computed in Class II division 1 malocclusion groups. 3. It was suggested that skeletal Class II malocclusion might be due to anomaly in size and shape of cranial base, underdevelopment of mandible, retropositioning of mandible, underdevelopment of posterior face against anterior face, or any combination of these factors. 4. Population with underdevelopment and / or retropositioning of the mandible showed hyperdivergent tendency of facia profile. 5. The ANB angle and Wits appraisal did not coincide the severity of anteroposterior dysplasia in $35.7\%$ of Class II division 1 malocclusion group each other, and this inconsistency was suggested to be related with mandibular rotation, inclination of cranial base, and anteroposterior position of the maxilla.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.43 no.2
• /
• pp.100-105
• /
• 2017

Objectives: Localization of the mandibular canal (MC) and measurement of the height and width of the available alveolar bone at the proposed implant site in the posterior segment of the mandible using cone-beam computed tomography (CBCT) in patients with a single missing tooth. Materials and Methods: A cross-sectional study was performed where CBCT scans of the patients with a single missing tooth in the posterior segment of the mandible-premolar, I (1st) molar, and II (2nd) molar were used. The scans were assessed using OnDemand3D software (version 1.0; CyberMed Inc., Seoul, Korea) for localization of the MC asnd remaining alveolar bone both vertically (from the superior position of the MC to the crest of the alveolar ridge) and horizontally (buccolingual, 3 mm below the crest of the alveolar ridge). The findings were statistically analyzed using independent t-test. Results: A total of 120 mandibular sites (40 sites for each of the three missing premolar, I molar, and II molar) from 91 CBCT scans were analyzed. The average heights (from the alveolar crest to the superior margin of the MC) at the premolar, I molar, and II molar areas were $15.19{\pm}2.12mm$, $14.53{\pm}2.34mm$, and $14.21{\pm}2.23mm$, respectively. The average widths, measured 3 mm below the crest of the alveolar ridge, at the premolar, I molar, and II molar areas were $6.22{\pm}1.96mm$, $6.51{\pm}1.75mm$, and $7.60{\pm}2.08mm$, respectively. There was no statistically significant difference between males and females regarding the vertical and horizontal measurements of the alveolar ridges. Conclusion: In the study, the measurements were averaged separately for each of the single missing teeth (premolar, I molar, or II molar), giving more accurate information for dental implant placement.

• The korean journal of orthodontics
• /
• v.17 no.1
• /
• pp.7-13
• /
• 1987

This study was conducted to clarify the relationship of hyoid bone position to tongue position and mandible when malocclusion is categorized in the bilateral and in the vertical components. Five groups of samples (normal occlusion, unilateral and bilateral cross-bite, openbite, deep-bite) were selected for his investigation by utilizing the cephalograms. On the basis study, the following conclusions were obtained; 1. In the normal group. the mean hyoid position (H-M) was $9.83{\pm}4.27mm$. The mean distance of hyoid body to tongue dorsum (H-T) was $52.17{\pm}6.70mm$. The ratio of H-M/H-T was $18.59\%$. 2. In all malocclusion groups, the hyoid position (H-M) was found to be larger than that of the norm except the deep overbite group 3. The tongue dorsum position (H-T) was increased, compared to that of norm, in all malocclusion groups. 4. Hyoid position (H-M) was found to show high correlation to the ratio of H-M/H-T, H-T, PI-T (0.890, 0.699, 0.455). 5. The hyoid position (H-M) was found to show low correlation to the measurements of mandible, but among them the ODI was found to show conversely a little higher correlation against hyoid position (H-M).

• The korean journal of orthodontics
• /
• v.8 no.1
• /
• pp.49-58
• /
• 1978

This investigation was undertaken to know how the bony facial profile could be changed with age. The 5 serial lateral cephalometric roentgenograms of the fourteen boys and fourteen girls between 7 and 11 years of age were studied and the findings seems to warrant the following conclusions. 1. The manaible tended to become more prognathic in relation to the cranial base (S-N) during growth, but the maxilla showed very little change. 2. There was increase in the inclination of the lower border of mandible associated with the increase in mandibular prognathism. 3. There was a tendency to being straight in bony facial profile due to the decrease in angle ANB with age. 4. The chin portion had a tendency to forward and downward growth in relation to the cranial base but there was slight strong tendency in downward growth. 5. The vertical growth was more prominant in the maxilla than in the mandible. 6. There was uniform and gradual increase of all measurements during growth. 7. Dimension of the craniofacial complex was larger in the boys than in the girls but this difference was not statistically significant. 8. Individual variation in skeletal growth was a normal occurrence.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.22 no.4
• /
• pp.397-410
• /
• 2000

Skeletal class III had been classified by the position of the maxilla, the mandible, the maxillary alveolus, the mandibular alveolus and vertical development. This morphologic approach is simple and useful for clinical use, but it is insufficient to permit understanding of the pathophysiology of dysmorphoses. The author hypothesizes that there are different patterns of mutual relation of the skeletal components which have contributed pathologic equilibrium of skeletal class III. The purpose of this study are threefold: 1) to classify skeletal class III in subgroups, which can show the architectural characteristics of the deformity, 2) to analyse the craniofacial architecture of each subgroup on etio-pathogenic basis, and 3) to characterize and visualize the pattern as a prototype. Materials used in this study were lateral cephalograms of 106 skeletal class III adults, which were analysed with modified Delaire's architectural and structural analysis. Linear and angular measurements of the individual subject were obtained and cluster analysis was used for the subgrouping. Data were evaluated for verification of the statistical significances. The following results were obtained. 1. By the modified Delaire's architectural and structural analysis and cluster analysis, skeletal class III adults were classified into 7 clusters and presented as prototypes, which could show the pathophysiology of the skeletal architecture 2. There was significant relationship in measurement variables of each cluster, which could reflect characteristics of the skeletal pattern of growth. 3. The flexure of cranial base had a close relationship to the anterior rotational growth of the maxilla and contributes to understand the etio-pathology of skeletal class III. 4. The proportion of craniospinal area in cranial depth, craniocervical angle and vertical position of point Om had a close relationship to rotational growth of the mandible and direction of condylar growth. They contribute to understand the etio-pathology of skeletal class III. In summary, the cranium and the craniocervical area must be considered in diagnosis and treatment planning of dentofacial deformity. And the occlusal plane can be considered as a representative which shows the mutual relationships of the skeletal components.

• The korean journal of orthodontics
• /
• v.24 no.4 s.47
• /
• pp.799-817
• /
• 1994

The purpose of this study was to evaluate the initial skeletal pattern and growth change of whom had responsed well to chincap therapy. 93 patients seleted for this study were in mixed dentition and treated with chincap for more than 2 years. And 54 subjects were selected from these total samples and classified into two groups by the improvement of four measurements : ANB difference, APDI, Wits appraisal, and AF-BF. One was good response group which consisted of 26 children and the other was poor response group with 19 patients. Various measures of the craniofacial structure in the initial lateral cephalograms and the annual increments were calculated and analyzed by comparing two groups with t-test. The results were as follows : 1. Good response group had more horizontal growth pattern in initial stage of treatment than poor response group, and the contributing factors of this result were anterior posterior facial height ratio, gonial angle, lower genial angle and SN-mandibular plane angle. 2. The maxilla was positioned more anteriorly in good response group. 3. The amounts of vertical growth of maxilla was smaller but the horizontal growth of maxilla was larger in good response group. 4. The mandible rotated more infero-posteriorly in good response group. 5. The good response group had more vertical growth pattern of mandibular condyle.