• 제목/요약/키워드: craniofacial characteristics

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Gender Affirming Surgery in Nonbinary Patients: A Single Institutional Experience

  • Allison C. Hu;Mengyuan T. Liu;Candace H. Chan;Saloni Gupta;Brian N. Dang;Gladys Y. Ng;Mark S. Litwin;George H. Rudkin;Amy K. Weimer;Justine C. Lee
    • Archives of Plastic Surgery
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    • 제50권1호
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    • pp.63-69
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    • 2023
  • Background An increasing number of nonbinary patients are receiving gender-affirming procedures due to improved access to care. However, the preferred treatments for nonbinary patients are underdescribed. The purpose of this study was to investigate the goals and treatments of nonbinary patients. Methods A retrospective study of patients who self-identified as nonbinary from our institutional Gender Health Program was conducted. Patient demographics, clinical characteristics, surgical goals, and operative variables were analyzed. Results Of the 375 patients with gender dysphoria, 67 (18%) were nonbinary. Over half of the nonbinary patients were assigned male at birth (n = 57, 85%) and nearly half preferred the gender pronoun they/them/theirs (n = 33, 49%). A total of 44 patients (66%) received hormone therapy for an average of 2.5±3.6 years, primarily estrogen (n = 39). Most patients (n = 46, 69%) received or are interested in gender-affirming surgery, of which, almost half were previously on hormone therapy (n = 32, 48%). The most common surgeries completed or desired were facial feminization surgery (n = 15, 22%), vaginoplasty (n = 15, 22%), mastectomy (n = 11, 16%), and orchiectomy (n = 9, 13%). Nonbinary patients who were assigned male at birth (NB-AMAB) were more often treated with hormones compared to nonbinary patients assigned female at birth (NB-AFAB) (72% vs. 30%, p = 0.010). Conversely, patients who were AFAB weremore likely to complete or desire surgical intervention than those who were AMAB (100% vs. 63.0%, p < 0.021). Conclusion Majority of nonbinary patients were assigned male at birth. NB-AFAB patients all underwent surgical treatment, whereas NB-AMAB patients were predominantly treated with hormone therapy.

A Comparison of pre and post-surgical characteristics in skeletal Class III malocclusion patients using counterpart analysis (구조적 대응체 분석법에 의한 골격성 II급 부정교합 환자의 악교정 수술전후의 비교)

  • Sohn, Byung-Wha;Kyung, Seung-Hyun;Kim, Beom-soo
    • The korean journal of orthodontics
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    • 제34권1호
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    • pp.93-107
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    • 2004
  • Enlow's counterpart analysis explains the complex with anatomic and developmental characteristics where craniofacial aspect of Individuals has been developed. Counterpart analysis does not compare individual measurement with the normal value from the average of majority but analyzes by comparison of values that each individual has. In this study we examined surgical changes in skeletal Class III malocclusion patients(male 40, female 40) and compared them with normal occlusion patients using counterpart analysis. The results indicated that : 1. Skeletal anterior-posterior discrepancy was relieved by shortening of the ramus width(B3). 2. The ramus alignment(R3, R4) was displaced posteriorly and the occlusal plane angle(R5) was rotated clockwise. 3. Skeletal Class III pattern was relieved in the post-operative group, but differences in the level of the cranium(R1, R2) was remaining compared to the normal occlusion patients. 4. In the comparison of surgery methods, the two-jaw surgery group presented changes In the maxillary length(A4), ramus alignment(R3, R4) and occlusal plane angle(R5) compared to the one-jaw surgery group, but the differences were not significant. In the past study about Korean skeletal Class m patients, the skeletal characteristics are upward backward rotation of the cranial base, posterior displacement of the maxilla, forward inclination of the ramus and lengthening of the mandibular body, but in this study, skeletal Class m pattern was relieved by shortening of the ramus width and maxillary advancement by orthognathic surgery, because orthognathic surgery is usually performed on limited areas in the maxilla and the mandible.

A Study for the development of the Korean orthodontic bracket (한국형 교정치료용 Bracket의 개발에 관한 연구)

  • Chang, Young-Il;Yang, Won-Sik;Nahm, Dong-Seok;Moon, Seong-cheol
    • The korean journal of orthodontics
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    • 제30권5호
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    • pp.565-578
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    • 2000
  • The aim of this study was development of the Straight-Wire Appliance(SWA) suitable lot the treatment or Korean. To accomplish the object of this study, Korean adult with normal occlusion were selected with following criteria : 1) no functional abnormality in the craniofacial area, 2) good dental arch form and posterior occlusal relationship, 3) Angle Class I occlusal relationship, 4) no experience of orthodontic, nor prosthodontic treatment, especially, no dental treatment on labial and buccal surfaces of teeth, 5) good racial profile. Impression were taken for upper and lower dental arches or the selected normal occlusion samples and the orthodontic dental stone models were fabricated. 5 well-trained orthodontists had examined the acquired dental stone models to select study samples which satisfy the Six keys to optimal occlusion of Andrews. 155 pairs of dental stone models (92 pairs of Male, 63 of Female) were finally selected. 3 dimensional digitization were performed with the Coordinate Measuring Machine(CMM, MPC802, WEGU-Messtechnik, Germany) and measuring of Angulation, Inclination, In-and-Out, Molar offset angle and Arch form were accomplished with a measuring software to achieve data for the development of SWA. Before the measurement, error study was performed on the 3 dimensional digitization with CMM, and the analysis of reliability of computerized measuring method adapted in this study and conventional manual method Presented by Andrews was performed. Results of this study were as to)lows : 1. Equi-distance digitization with mesh size 0.25 mm, 0.5 mm and 1.0 mm were acceptable in 3 dimensional digitization of dental stone model with the CMM, and the digitization with 1.0 mm mesh size was recommendable in terms of efficiency. 2. Computerized measuring method with 3 dimensional digitization was more reliable than manual measuring method of Andrews. 3. Data were collected for the development of SWA suitable for the morphological characteristics of Korean with the computerized measuring method with 3 dimensional digitization.

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Characteristics of posteroanterior cephalometric analysis in children with skeletal Class I malocclusion (성장기 골격성 I 급 부정교합 환자의 정모두부방사선 계측의 특징)

  • Moon, Yoon-Shik;Kim, Jung-Kook;Jung, Hyun-Sung;Sung, Sang-Jin
    • The korean journal of orthodontics
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    • 제31권2호통권85호
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    • pp.159-172
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    • 2001
  • Three dimensional analysis of malocclusion and craniofacial deformation is essential for the successful orthodontic treatment. But the orthodontists are not familiar with diagnosis and treatment plane based on lateral cephalometric analysis. Since orthodontists do not posses a sufficient knowledge in standard value of posteroanterior cephalometric anaysis and of clinical importance for transverse jaw growth. In this study male(n=130) and female(n=171) aged from 6 to 16 and diagnosed as Class I malocclusion were selected to analysis width of cranium, maxilla and mandible on the posteroanterior cephalogram. The changes as a function of chronologic age and cervical vertebrae maturity index(CVXI) were examined. The Proper regression model was selected by sex with polynominal regression models and method of variable selection. Mean of each measurements and 70% confidence interval of individual measurement according to age was assesed and a graphs were made. Results are as follows :1. All the measurements for the width are gradually incresed as increase in chronologic age and CVMI. From the total amount of change between age 6 and 16, there is a tendency that mandibular width is broader than maxillary width and the width of male is broader than female. 2. There is no statistically significant sexual difference in Mx-Mn difference, Mx-Mn width differential, Mx/Mn ratio according to age and CVMI. 3. Mean of each measurement and 70% confidence interval of individual measurement according to age and sex were assessed and graphs were made for maxillary width, mandibular width, Mx-Mn difference, Mx/Mn ratio. 4. The width of maxilla and mandible in Korean children are broader than Western children during growth period.

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The objective and quantitative analysis of malocclusion - Part 2. Influence of malocclusion components to treatment difficulty (부정교합의 객관적 정량분석: Part 2. 부정교합 요소들의 치료난이도에 미치는 영향)

  • Joo, Bo-Hoon;Lee, Ki-Soo
    • The korean journal of orthodontics
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    • 제35권1호
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    • pp.69-81
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    • 2005
  • As one of the variations in growth and development of the craniofacial complex. malocclusion shows lack of concordance In the recognition and severity of malocclusion for dentists as well as the acceptance and need of orthodontic treatment for the patient The purposes of this study were 1) to examine the relationships between objective malocclusion severity aid subjective treatment difficulty. 2) to evaluate the effect of malocclusion components to the subjective perceived difficulty of treatment. 3) to establish the weighted values of malocclusion components to reflect the treatment difficulty 100 pairs of dental casts with the general characteristics of malocclusion. were selected from the orthodontic departments of Kyunghee University and Samsuug Medical Center. The severity of malocclusion was evaluated by the author with the PAR index The perceived treatment difficulty and the estimated treatment duration on these dental models were evaluated by 8 experienced orthodontists. The relationships between the objective malocclusion severity and the subjective treatment difficulty were statistically evaluated. and the weighted values of malocclusion components to reflect treatment difficulty were statistically formulated. There were significant relationships between objective malocclusion severity and subjective treatment difficulty The malocclusion components which significantly affected the treatment difficulty and their weighted values in parentheses were as follows upper anterior alignment(1). overbite (2). buccal occlusion (3) middline (4), and overjet (5). This study Provides the fundamental principle to evaluate the objective malocclusion severity which is reflected by the subjective treatment difficulty of Korean orthodontists.

THE DENTAL MATURATION OF MAXILLA IN CHILDREN WITH ANTERIOR CROSSBITE OF MAXILLARY UNDERGROWTH TYPE (상악 열성장형 전치부 반대교합 아동에 있어서의 상악 치아 성숙도)

  • An, Ul-Jin;Noh, Hong-Seok;Jeong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • 제38권2호
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    • pp.119-128
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    • 2011
  • In the process of assessing the children with anterior crossbite in early mixed dentition, it has frequently been detected that the stronger the skeletal pattern of the malocclusion is, the more markedly delayed the development and eruption of maxillary teeth are. If the anteroposterior characteristics of craniofacial skeleton has any relationship with dental maturation, the evaluation of dental development and eruption was thought to be able to contribute to early diagnosis of crossbite in children. This study was performed for the purpose of elucidating the relationship between dental maturation of maxillary teeth and some cephalometric values in children with anterior crossbite of maxillary undergrowth type in early mixed dentition. Among the children in Hellman dental age IIA and IIC who attended the Pediatric Dental Clinic of Pusan National University Hospital with orthodontic problems, cases with Class III malocclusion were classified and 50 cases of maxillary undergrowth type and type with normal maxilla respectively were randomly selected and studied as subjects. From their lateral cephalographs and panoramic radiographs, their anteroposterior skeletal features, the dental maturity and eruption rate were obtained of each group and data were analyzed to yield the results as follows: 1. Comparing the maturity of maxillary teeth of both groups, only the first molars of maxillary undergrowth group showed significantly slower development and eruption (p<0.05). 2. There was high correlation between maturation of maxillary 1st molar and chronological age(p<0.05). 3. Among the parameters of anteroposterior relationship of skeletal pattern in maxilla and mandible. Wits was revealed as a useful index to predict both the calcification and eruption rate of the 1st molars whereas SNA was to eruption rate(p<0.05).

Study on Korean skeletal Class III craniofacial pattern by counterpart analysis (구조적 대응체 분석법에 의한 한국인 골격성 III급 부정교합의 특징)

  • Sohn, Byung-Wha;Lee, Kee-Joon;Mo, Sung-Seo
    • The korean journal of orthodontics
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    • 제32권3호
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    • pp.209-225
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    • 2002
  • Enlow's counterpart analysis reflects the characteristics of each individual sample to find out the cause of the malocclusion and further applying them to the clinic. Enlow's counterpart analysis was performed on 100 Korean samples (50 male, 50 female) with normal occlusion and 100 skeletal class III patients (50 male, 50 female) scheduled for orthognathic surgery. The following conclusions were obtained. 1. The cause of malocclusion in skeletal class III patients were complex and interrelated : backward upward rotation of the cranial base, forward inclination of the ramus, increase in the mandibular body length, and posteriorly located maxilla. 2. Seen on R2 (male-1.68mm, female-2.33mm), in skeletal class III, the maxilla Is mote posteriorly located than the normal group. 3. The cause of malocclusion In skeletal class III patients, consists of retrognathic maxilla(A1) male $22\%$, female $26\%$, prognathic mandible(B1) male $44\%$, female $34\%$, and combination of an retrognathic maxilla and prognathic mandible were male $28\%$, female $38\%$. 4. There was no significant difference in the anterior-posterior length of the maxilla(A4) between skeletal class III males with the normal group, while in the female subjects, the skeletal class m group showed a smaller maxilla(A4) compared to the normal group. 5. In skeletal class III patients the proganthic mandible was primarily caused by the Inclination of the ramus(R3, R4) and mandibular body length(B4, B6) rather than ramus width(B3).

The study on the cleft lip and/or palate patients who visited Dept. of Orthodontics, Seoul National University Dental Hospital during last 11 years (1988.3-1999.2) (최근 11년간 서울대학교병원 교정과에 내원한 순구개열 환자의 내원 현황에 관한 연구(1988.3 - 1999.2))

  • Yang, Won-Sik;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • 제29권4호
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    • pp.467-481
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    • 1999
  • Cleft lip and/or palate is one of the most common congenital craniofacial anomalies. According to previous epidemiologic studies, incidence of cleft lip and/or palate has been increasing nowadays. However, there is no report about epidemiologic study of cleft lip and/or palate patients who visited dept. of orthodontics in Korea. So the purpose of this study was to provide the epidemiological characteristics and important basic clinical data for the diagnosis and the treatment of the cleft lip and/or palate patients. With the orthodontic and cleft charts, diagnostic models and X-ray films from 250 patients with cleft lip and/or palate who visited Dept. of Orthodontics, Seoul National University Dental Hospital during the last 11 years, the authors investigated patient's visiting yew, types of cleft, patient's gender, and Angle's classification of malocclusion, and surgery timing. The results were as follows ; 1. The number of cleft patients who visited Dept. of Orthodontics, SNUDH increased during 1988-1990 and then it declined until 1992. From 1993 to 1996, it showed a stationary trend. After 1997 it showed an overwhelmingly increasing trend. 2. In the cleft type, the ratio of cleft lip cleft lip and alveolus cleft palate : cleft lip and palate was 7.6:19.2:9.6:63.6. In cleft position, unilateral clefts were more than bilateral ones (cleft lip 79:21, cleft lip and alveolus 77:23, cleft lip and palate 75.5:24.5). In cleft side, left clefts were mote than right clefts (cleft lip 53.3:46.7 cleft lip and alveolus 59.5:40.5, cleft lip and palate 59.2:40.8). 3. In gender ratio, males were more than females in cleft lip (57.9:42.1), cleft lip and alveolus (68.8:31.2) and cleft lip and palate (76.1:23.9). But in cleft Palate females were more than males as 41.7: 58.3. 4. In the age groups, 7-12 year group was the most abundant as $52\%$, and then 0-6 year group ($20.4\%$), 13-18 year group ($17.2\%$), more than 18 yew group ($10.4\%$) were followed as descending order. 5. Most of the cleft lip repair surgeries were operated in 0-3 month ($60.3\%$) and 4-6 month ($17.9\%$). 6. The cleft palate repair surgeries were done in 1-2 year ($31.7\%$), 0-1 year ($25.6\%$), 2-3 year ($12.1\%$), more than 5 year ($11.6\%$) as descending order. 7. The lip scar revision surgeries were done before admission at elementary school in $60\%$. (4-6 you ($27.5\%$), 6-8 year ($19.6\%$), more than 10 year ($19.6\%$), 2-4 year ($13.7\%$) as descending order) 8. The rhinoplasties were done before admission at elementary school in $51.7\%$. (0-2 year ($7.1\%$), 2-4 year ($14.3\%$), 4-6 year ($21.4\%$), 6-8 year ($14.3\%$)). 9. The pharyngeal flap were done at 6 Y (72.5 months) after birth on average and there was even distribution of surgery timing. 10. In relationship between Angle's classification of malocclusion and cleft types, Class I was most abundant and Class III, Class II were followed as descending order in cleft lip group. But Class III was most abundant and Class I, Class II were followed as descending order in cleft lip and alveolus group, cleft palate group, and cleft lip and Palate group. The percentage of frequency in Class III malocclusion was overwhelmingly higher in cleft lip and palate group than any other groups. 11. Because the frequency of class III malocclusion was most prevalent in all age groups, anterior crossbite was the most common chief complaint of cleft patients.

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