• 제목/요약/키워드: dental arch width

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Facial asymmetry: Critical element of clinical successful treatment (임상가를 위한 특집 4 - 안면비대칭의 외과적 교정)

  • Hong, Jongrak
    • The Journal of the Korean dental association
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    • v.52 no.10
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    • pp.623-632
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    • 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.

A STUDY ON THE EFFECTS OF THE 1st BICUSPID EXTRACTION ON THE CHANGES IN FACE AND DENIAL ARCH FORM IN ANGLE CLASS II DIV. 1 MALOCCLUSIONS (제1소구치 발거가 II급 1류 부정교합자의 안모와 치열궁에 미치는 영향에 관한 연구)

  • Choi, Nack Jun;Nahm, Dong-Seok
    • The korean journal of orthodontics
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    • v.16 no.1
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    • pp.167-177
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    • 1986
  • This study was undertaken to compare the main differences and its effects of the 4 first bicuspid extraction on the face and dental arch of the class II div 1 malocclusion. The subjects consisted of twenty two class II div 1 malocclusion, four males, eighteen females, were 14 Years 2 Months old at the stan of the treatment 16 Year 3 Months old at the end of the treatment. (mean age) Twenty one variables were observed by comparing the statistical data of the pretreatment records with postteratment records, which were consited of eight varibles on the study model digitation, thirteen variables on the tracing of the lateral cephalogram. The following results were obtained. 1. No significant change was observed in the intercanine width. 2. Intercuspal widths of the 1st. premolar and 2nd. premolar were decreased. 3. Change of the overjet was dependant upon upper anterior rather than lower anterior. 4. No significant changes were observed in facial plane angle and ANB angle. 5. Uprighting of the lower 1st. molar had an effect on the increase of the facial height.

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Correction of Transverse Discrepancy with Slowly Maxillary Expansion by Hyrax type expander in Adult Patient (성인에서 Hyrax 장치로 완속상악확장하여 폭경부조화를 개선한 증례)

  • Kwak, Kyoung Ho;Kim, Seong Sik;Kim, Yong-Il;Park, Soo-Byung;Son, Woo-Sung
    • The Journal of the Korean dental association
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    • v.55 no.6
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    • pp.400-410
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    • 2017
  • Approximately 30% of adult patients who want orthodontic treatment have transverse discrepancy with insufficient width of the maxilla. Particularly, in Class III patients requiring orthognathic surgery, the frequency of insufficient width of the maxillary arch related to respiratory problems is high. We report a case of non-surgical maxillary expansion using a Hyrax type expander with an orthognathic surgery, based on the reports that the ratio of non-fused midpalatal suture is not high in adults. A 30 years and 2 months old woman with a long face showed an Angle Class III with a vertical growth pattern. Class III molar and canine relation, anterior edge bite, and mandibular incisor compensatory lingual inclination were observed. The posterior buccal overjet seemed to be appropriate, but I diagnosed that there was a transverse discrepancy, for the following reasons. The inter-canine and inter-molar widths were sufficient but excessive lingual inclination of the mandibular molars was observed when assessing the bucco-lingual inclination based on the center of resistance of the maxillary and mandibular first molar. For this reason, it was expected that intercuspal interference would occur during orthodontic decompensation. Therefore, slow maxillary expansion using Hyrax type expander was performed and 2-jaw rotation surgery was performed to improve aesthetic and occlusion. Adults can also improve width discrepancy by non-surgical methods, which can avoid SARPE requiring additional surgery or segmental surgery lacking stability and predictability.

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Study of horizontal skeletal pattern and dental arch in skeletal Class III malocclusion patients (골격성 III급 부정교합자의 횡적인 골격과 악궁 형태에 관한 연구)

  • Park, Hee-Chan;Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.38 no.5
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    • pp.358-370
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    • 2008
  • Objective: The purpose of this study was to investigate the horizontal skeletal pattern and dental arch differences between Class III malocclusion patients and normal occlusion patients. Methods: Twenty skeletal Class III malocclusion patients and ten normal occlusion patients were selected and 3D facial CT were taken to analyze the horizontal skeletal differences between the two groups. Results: In the horizontal comparison of the maxilla, skeletal width and perimeter were significantly smaller in skeletal Class III patients on ANS and A point reference planes. The difference between maxillary width of ANS and A point reference planes showed that there was greater constriction of the first and second premolar in skeletal Class III patients. In the horizontal comparison of the mandible, the widths of the canine and premolar area were significantly larger in skeletal Class III patients on B point reference plane. The differences between width of the upper and lower jaws (comparison of A and B reference planes) were significantly large in the canine and premolar area. Conclusions: From this study, the characteristics of Class III malocclusion patients were shown through horizontal constriction of the maxilla. But to make clear further detailed characteristics of Class III malocclusion patients, additional studies are necessary.

A STUDY OF INTRAORAL ANATOMIC LANDMARKS OF KOREAN ADULT-UPPER JAW (성인 유치악자 상악골의 악궁과 치열궁의 형태에 관한 조사)

  • Oh, Yu-Ree;Lee, Sung-Bok;Park, Nam-Soo;Choi, Dae-Gyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.33 no.4
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    • pp.753-768
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    • 1995
  • For accurate impression taking of dental patient and esthetic denture treatment of ednetulous patient, measuring between intraoral anatomic landmarks is useful.In this study the subjects selected at a random were two-jundred forty persons with a mean age 22.5(range 21-24) and were taken impression of by irreversible hydrocolloid impression material(Alginate). On the study model made by dental stone, each individual tray was made and final impresion was taken by border moilding. On final model measurings were performed with 3-dimensional measuring device and the values were analyzed by t-test The results is following : ABOUT THE MEASURED VALUES. 1. The width between maxillary right and left canine cusp tip was average 36.44mm(s.d. 2.48), man 36.67mm, woman 35.83mm(p<0.05). 2. The width between labial height of contour of maxillary right and left canine was average 40.08mm(s.d. 2.42), man 40.29mm, woman 39.52mm(p<0.05). 3. The width between mesio-lingual cusps of maxillary first molar was average 43.14mm(s.d. 3.33), man 43.56mm, woman 42.05mm(p<0.05). 4. The width between buccal alveolar ridge on axis of mesiolingual cusp of right and left maxillary first molar was average 64.89mm(s.d. 3.88), man 65.58mm, woman 62.92mm(p<0.05). 5. The width between buccal alveolar ridge on axis of mesiolingual cusp of right and left maxillary second molar was average 68.58mm(s.d. 3.91), man 69.29mm, woman 66.30mm (p<0.05). 6. The width between right and left hamular notch was average 49.80mm(s.d. 3.96), man 50.70mm, woman 48.20mm(p<0.05). 7. The length from labial heigth of contour of maxillary central incisor to center of incisive papilla was average 9.52mm(s.d. 1.18), man 9.46mm, woman 9.63mm(p>0.05). 8. The length from labial heigth of contour of maxillary central incisor to palatine fovea was average 53.27mm(s.d. 2.93), man 53.93mm, woman 52.08mm(p<0.05). 9. The center of incisive papilla ws located posterior to intercanine line at 0.40mm(s.d. 1.16), man 0.51mm, woman 0.11mm(p<0.05). 10. The height from incisal edge of maxillary central incisor to the labial vestibule was average 21.84mm(s.d. 1.38), man 22.01mm, woman 21.00mm(p<0.05). 11. The height from mesiolingual cusp of maxillary first molar to buccalvestible was average 17.45mm(s.d. 1.42), man 17.56mm, woman 17.08mm(p>0.05). 12. The height from hamular notch to standard occlusal plane was average 6.84mm(s.d. 1.06), man 6.91mm, woman 6.70mm(p>0.05). 13. The height from the deepest point of palatal vault to standard occlsalplane was average 19.95 mm(s.d. 2.03), man 20.19mm, woman 19.12mm(p<0.05). ABOUT THE ARCH FORM 1. The arch form was able to classify into four typr by the rate of the measured values. Each arch form distribution was that the 1 group had 32.46% the 2 group 2.19%, the 3 group 52.83%, the 4 group 12.72%. The sexual composition was that in 1 group man had 73.5%, woman 26.5%, in 2 group man had 40.0%, woman 60.0%, in 3 group man had 83.3%, woman 16.7%, and in 4 group man had 55.17%, woman 44.83%. 2. When canine cusp tip was marked as point O, the intersection point between labial height of contour of maxillary central incisor and intermaxillary suture as point A, height of contour of maxillary second molar buccal alveolar ridge as B point, ${\angle}$AOB was measured $133.8^{\circ}$for the 1 group, $133.0^{\circ}$for the 2 group, $132.3^{\circ}$for the 3 group, $128.9^{\circ}$for the 4 group.

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CLINICAL STUDY OF MANDIBLE SYMPHYSIS WIDENING (외과적 하악 정중부 골신장술)

  • Kwon, Kyung-Hwan;Min, Seung-Ki;Oh, Sung-Hwan;Lee, Jun;Cha, Jae-Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.6
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    • pp.516-525
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    • 2004
  • Mandibular symphyseal distraction osteogenesis is an alternative approach for correcting mandibular transverse deficiencies and dental crowding. The traditional approaches for these are extraction of teeth and arch expansion with traditional orthodontic treatment. Also extractions are usually unavoidable in patients with severe crowding. The purpose of this study is to evaluate the effect of mandibular symphyseal distraction osteogenesis by use of tooth-borne expansion appliance. All of 12 patients had been performed distraction osteogenesis. The surgical procedures were accomplished under local anesthesia and intravenous sedation in an ambulatory surgical setting using a routine distraction protocol. The latency period was 5 days or 7 days after symphyseal osteotomies. The rate & rhyth is a intermittent, 0.75mm or 1.0 mm per day and stabilized for 6, 8 weeks after distraction. The time of orthodontic tooth movement after distraction was variable from 2 weeks to 8 weeks (mean 3 weeks). All patients had been evaluated with study casts, plain periapical films, panorama radiograms before & after surgery. Mandibular symphyseal distraction osteogenesis increased mandibular arch width and corrected dental crowding, with paralleling tooth-borne movement, without proclination of the mandibular incisors.

Three-dimensional assessment of the temporomandibular joint and mandibular dimensions after early correction of the maxillary arch form in patients with Class II division 1 or division 2 malocclusion

  • Coskuner, Hande Gorucu;Ciger, Semra
    • The korean journal of orthodontics
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    • v.45 no.3
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    • pp.121-129
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    • 2015
  • Objective: This study aimed to assess three-dimensional changes in the temporomandibular joint positions and mandibular dimensions after correction of dental factors restricting mandibular growth in patients with Class II division 1 or division 2 malocclusion in the pubertal growth period. Methods: This prospective clinical study included 14 patients each with Class II division 1 (group I) and Class II division 2 (group II) malocclusions. The quad-helix was used for maxillary expansion, while utility arches were used for intrusion (group I) or protrusion and intrusion (group II) of the maxillary incisors. After approximately 2 months of treatment, an adequate maxillary arch width and acceptable maxillary incisor inclination were obtained. The patients were followed for an average of 6 months. Intraoral and extraoral photographs, plaster models, and cone-beam computed tomography (CBCT) images were obtained before and after treatment. Lateral cephalometric and temporomandibular joint measurements were made from the CBCT images. Results: The mandibular dimensions increased in both groups, although mandibular positional changes were also found in group II. There were no differences in the condylar position within the mandibular fossa or the condylar dimensions. The mandibular fossa depth and condylar positions were symmetrical at treatment initiation and completion. Conclusions: Class II malocclusion can be partially corrected by achieving an ideal maxillary arch form, particularly in patients with Class II division 2 malocclusion. Restrictions of the mandible in the transverse or sagittal plane do not affect the temporomandibular joint positions in these patients because of the high adaptability of this joint.

DISTRACTION OSTEOGENESIS ON MANDIBLE SYMPHYSIS WIDENING WITH A BONE-BORNE TYPE DISTRACTOR (Bone-borne type distractor를 사용한 하악골 정중부 골신장술)

  • Cho, Jin-Hyoung;Chee, Young-Deok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.4
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    • pp.356-364
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    • 2006
  • Transverse mandibular deficiency has a many problem in growing patients. Therefore, Mandible symphysis widening is recommended. A new surgical technique has been developed to widen the mandible. The purpose of this study is to report the effect of mandibluar symphyseal distraction osteogenesis by use of bone-borne type distractor. The surgical procedure was accomplished under general anaesthesia with step-line osteotomy. Bone-borne type distractor was used to generally widen the mandible. The expansion achieved in the mandible was 8.31mm at the device, 6.32mm at the canines, 4.06mm at the first molars. The symphyseal distraction gaps were bridged by new bony regeneration. Mandibular symphseal distraction osteogenesis increased mandibular arch width, stabilized occlusion, and corrected dental crowding.

A study of the arch length discrepancy and the diagnostic analysis (치열궁내 공간 부조화와 진단적 평가에 관한 연구)

  • Ryu, Young-Kyu;Ahn, Kwang-Seok
    • The korean journal of orthodontics
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    • v.34 no.1 s.102
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    • pp.1-11
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    • 2004
  • Predicting the arch length discrepancy by simply comparing the available arch perimeter with tooth materials is merely a 2-dimensional analysis of the teeth movement. However, the real teeth movement takes place 3-dimensionally and is affected by various factors such as, the arch fen the curve of Spee and the axis of the incisors. The purpose of this study is to clarify the relationship between the decrease in the arch perimeter and the horizontal positional change of the incisors after extraction of the 1st bicuspids, for more analytic evaluation of the arch length discrepancy at pre-treatment model analysis stage. In addition to that to evaluate the effect of the curve of Spee, teeth axis to the basal plane, and the incisional crowding to the treatment outcome. All patients were treated at the department of orthodontics, dental hospital, Yonsei university. Inclusion criteria for patients selection were as follows. $\cdot$ Angle classification I malocclusion with bialveolar protrusion $\cdot$ Extraction of 4 1st bicuspids $\cdot$ No tooth anomaly or prosthesis $\cdot$ No abnormal attrition $\cdot$ No ectopically erupted teeth $\cdot$ Angle classification I canine and molar relationship $\cdot$ Less than 3mm of crowding Model analysis of the above patients was performed and the following conclusions were obtained. 1. When the intercanine distance was maintained, the available space for the distal movement of the mandibular incisors after the extraction of the 4 1st bicuspids was larger than the space provided by the extraction of the 4 1st bicuspids. However the difference was less than 1mm. The more tapered the anterior arch form, the larger the difference. 2. Compared to the situation in which the intercanine distance was maintained, when the intercanine distance was expanded to meet the width of the Posterior teeth, the incisors could move about 3mm more distally. 3. The positional difference of the incisal tip was insignificant whether the central incisors were moved by tipping or bodily movement. 4. When the anterior crowding was solved without changing the intercanine distance, the larger the anterior arch length was, the more the anterior movement of the incisors. 5. When the curve of Spee was levelled, the increase in the arch perimeter was less than half of the deepest curve of Spee.

A Study on the Fitness of Adjustable Dental Impression Trays on the Chinese and Japanese (중국인과 일본인에 대한 가변형 치과 인상용 트레이의 적합성에 관한 연구)

  • Kang, Han-Joong;Lee, Jin-Han;Choi, Jong-In;Lee, In-Seop;Dong, Jin-Keun
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.2
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    • pp.175-184
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    • 2008
  • Purpose: This study was designed to investigate the fitness of adjustable dental impression trays on the Chinese and the Japanese. Material and methods: Initial design of the adjustable dental trays was developed from the results of the dental arch size of Korean adults. This design was applied to the CAD-CAM process in order to create tray model samples. Simple silicon-base molds were then replicated based on these sample models. Polyurethane injection into the silicon- base molds completed the process of creating a large number of test products. 60 Chinese dental students (male:30, female:30) from the Shanghai Second Medical University and 60 Japanese alumni from the Kumamoto high school (male:30, female:30) were selected for taking irreversible hydrocolloid impression with these trays. The width and length of the impression body were measured on several measuring points by Vernier caliper. The results were analyzed statistically to evaluate the fitness of the trays. Results: 1. Uniform impression material thickness was achieved on the Chinese and Japanese by controlling the width of the tray using stops and beveled guides. The material thickness was generally within the range of 3 mm to 6 mm. 2. In the maxillary tray of the Chinese, average thickness of the impression material of the labial vestibule of the incisal teeth was 6.2 mm, the canine was 5.9 mm and the midpalatal part 10.5 mm and the posterior palatal part 9.7 mm. These were relatively large values. 3. In the mandibular tray of the Chinese, average length of the impression material of the lingual vestibule of first, second premolar contact point was 8.9 mm, the incisal teeth was 7.8 mm and thickness of the labial part of canine was 6.8 mm and premolars 7.0 mm. These were relatively large values. 4. In the maxillary tray of the Japanese, average thickness of the impression material of the labial vestibule of the incisal teeth was 7.4 mm, the canine was 7.7 mm and the midpalatal part 9.1 mm. These were relatively large values. 5. In the mandibular tray of the Japanese, average thickness of the impression material of the labial vestibule of first, second premolar contact point was 8.4 mm, and thickness of the labial part of canine was 7.4 mm. These were relatively large values. Conclusion: This adjustable dental tray shows good accuracy to Korean because it was designed by the analysis of the dental arch size of Korean adult model. With this result, it can be applied to Chinese and Japanese, we can take more easy and accurate dental impressions.