• Title/Summary/Keyword: facial skeletal type

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Targeted presurgical decompensation in patients with yaw-dependent facial asymmetry

  • Kim, Kyung-A;Lee, Ji-Won;Park, Jeong-Ho;Kim, Byoung-Ho;Ahn, Hyo-Won;Kim, Su-Jung
    • The korean journal of orthodontics
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    • v.47 no.3
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    • pp.195-206
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    • 2017
  • Facial asymmetry can be classified into the rolling-dominant type (R-type), translation-dominant type (T-type), yawing-dominant type (Y-type), and atypical type (A-type) based on the distorted skeletal components that cause canting, translation, and yawing of the maxilla and/or mandible. Each facial asymmetry type represents dentoalveolar compensations in three dimensions that correspond to the main skeletal discrepancies. To obtain sufficient surgical correction, it is necessary to analyze the main skeletal discrepancies contributing to the facial asymmetry and then the skeletal-dental relationships in the maxilla and mandible separately. Particularly in cases of facial asymmetry accompanied by mandibular yawing, it is not simple to establish pre-surgical goals of tooth movement since chin deviation and posterior gonial prominence can be either aggravated or compromised according to the direction of mandibular yawing. Thus, strategic dentoalveolar decompensations targeting the real basal skeletal discrepancies should be performed during presurgical orthodontic treatment to allow for sufficient skeletal correction with stability. In this report, we document targeted decompensation of two asymmetry patients focusing on more complicated yaw-dependent types than others: Y-type and A-type. This may suggest a clinical guideline on the targeted decompensation in patient with different types of facial asymmetries.

Evaluation of skeletal maturity in the cervical vertebrae and hand-wrist in relation to vertical facial types

  • Lee, Ye-Seul;Choi, Sung-Hwan;Kim, Kyung-Ho;Hwang, Chung-Ju
    • The korean journal of orthodontics
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    • v.49 no.5
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    • pp.319-325
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    • 2019
  • Objective: To evaluate differences in skeletal maturity in relation to vertical facial types and to compare differences in the skeletal maturity of the cervical vertebrae and hand-wrist in females. Methods: This study included 59 females aged 7 to 9 years with skeletal Class I malocclusion. The participants were categorized into three groups (low, normal, and high) according to the mandibular plane angle. Skeletal maturity was measured using skeletal maturity indicators (SMIs) and the Tanner-Whitehouse III (TW3) method on hand-wrist radiographs and by using cervical vertebrae maturation indicators (CVMIs) on lateral cephalometric radiographs. Results: The SMI was higher in the high-angle group than in the low-angle group (p = 0.014). The median TW3 bone age was 11.4 months higher in the high-angle group than in the low-angle group (p = 0.032). There was no significant difference in CVMI among the three groups. Skeletal maturity showed a weakly positive correlation with the mandibular plane angle (SMI, r = 0.391; TW3, r = 0.333; CVMI, r = 0.259). Conclusions: The skeletal maturity of the hand-wrist in females with a high mandibular plane angle was higher than that in females with a low mandibular plane angle. Obtaining additional hand-wrist radiographs may facilitate evaluation of skeletal maturity of females. In females with a high mandibular angle, the time to commence orthodontic treatment may be earlier than that in females with a low mandibular angle.

CEPHALOMETRIC EVALUATION ON THE MAXILLOFACIAL TYPE IN KOREAN ADULTS (악안면의 형태에 관한 X선학적 연구)

  • Ahn Hyoung Kyu;You Dong Soo;Park Tae Won
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.3 no.1
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    • pp.29-34
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    • 1973
  • The study was made on the facial profile of the normal Korean adults using the roentgenographic cephalograms. The subjects ccnsisted of 50 males and 50 females with the normal occlusion. The measurements were made of the facial angles in skeletal pattern and depth, height and the length in the soft tissue profile. The mean and standard deviations from the subjects were calculated and compared with the samples of male and female. The authors have drawn the conclusions as follows: 1. Compared with the angulation in skeletal patterns, there were no differences between both sexes. 2. Individual variations of the lower face were larger than the upper face in most measuring points. 3. Generally, facial heights were lesser than facial depth in sexual differences. 4. Most dimensions of the facial depth, height and length of the male were larger than those of female.

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Facial soft tissue thickness among skeletal malocclusions: is there a difference?

  • Kamak, Hasan;Celikoglu, Mevlut
    • The korean journal of orthodontics
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    • v.42 no.1
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    • pp.23-31
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    • 2012
  • Objective: The purpose of this study was to determine the soft tissue thickness of male and female orthodontic patients with different skeletal malocclusions. Methods: Soft tissue thickness measurements were made on lateral cephalometric radiographs of 180 healthy orthodontic patients with different skeletal malocclusions (Class I: 60 subjects, Class II: 60 subjects, Class III: 60 subjects). Ten measurements were analyzed. For statistical evaluation, one-way ANOVA and Kruskal-Wallis tests were performed. Least significant difference (LSD) and Dunnet T3 post hoc tests were used to determine the individual differences. Results: Soft tissue thicknesses were found to be greater for men than for women. Statistically significant differences among the skeletal groups were found in both men and women at the following sites: labrale superius, stomion, and labrale inferius. The thickness at the labrale superius and stomion points in each skeletal type was the greatest in Class III for both men and women. On the other hand, at the labrale inferius point, for both men and women, soft tissue depth was the least in Class III and the greatest in Class II. Conclusions: Soft tissue thickness differences among skeletal malocclusions were observed at the labrale superius, stomion, and labrale inferius sites for both men and women.

Evaluation of Skeletal and Dental Maturity in Relation to Vertical Facial Types and the Sex of Growing Children (성장기 아동의 수직적 안모 형태와 성별에 따른 골격적 성숙도와 치아 성숙도 평가)

  • Jo, Seon-Gyeong;Kim, Byounghwa;Lee, Jewoo;Ra, Jiyoung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.48 no.4
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    • pp.414-424
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    • 2021
  • The purpose of this retrospective study was to evaluate the skeletal and dental maturity according to the vertical facial type and sex in Korean children in the developmental stage. In total, 184 participants aged 8 - 14 years were selected and divided into three groups based on the mandibular plane angle. For the comparison between the sexes, the three groups were each divided into male and female subgroups. The skeletal and dental maturity were assessed using lateral cephalograms, hand-wrist radiographs and panoramic radiographs. The vertical growth group showed significantly greater cervical vertebral and hand-wrist maturity than that in the horizontal growth group. Dental maturity was the highest in the vertical growth group. Girls showed greater skeletal maturity than boys, and no distinct difference was observed between the dental maturity of the sexes. Analysis of the vertical facial type in children can provide ancillary indicators that may help determine the optimal timing for orthodontic treatment initiation. Earlier initiation of orthodontic treatment may be considered for patients with vertical facial growth patterns.

Surgery-first Approach for Facial Asymmetry with Transverse Discrepancy Using Hyrax-type Palatal Expansion Appliance

  • Youn-Kyung Choi;Sung-Hun Kim;Yong-Il Kim
    • Journal of Korean Dental Science
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    • v.16 no.1
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    • pp.87-98
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    • 2023
  • This report presents a case of successful treatment of skeletal Class III malocclusion with transverse discrepancy in adult by surgery-first approach. Traditionally dental decompensation is necessary prior to surgery in 2-jaw surgery to correct transverse and rotational discrepancy. However, the hyrax-type palatal expansion appliance was used to improve maxillary expansion accuracy and postoperative stability in this surgery-first approach (segmental Le Fort I osteotomy and mandibular setback surgery). It was established to be an effective means of precisely predicting postoperative occlusion and achieving stable retention after surgery of skeletal Class III malocclusion with maxillary transverse discrepancy.

Osteogenesis imperfecta and combined orthodontics and orthognathic surgery: a case report on two siblings

  • Kim, Dong-Young;Baik, Unbong;Jeon, Ju-Hong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.1
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    • pp.70-77
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    • 2020
  • Osteogenesis imperfecta is a heterogeneous group of connective tissue diseases that is predominantly characterized by bone fragility and skeletal deformity. Two siblings with undiagnosed type I osteogenesis imperfecta underwent orthognathic surgery for the treatment of facial asymmetry and mandibular prognathism. The authors report two cases of combined orthodontics and orthognathic surgery in patients with type I osteogenesis imperfecta, mandibular prognathism, and facial asymmetry.

A CEPHALOMETRIC STUDY ON SUB-GROUPINGS IN KOREAN CHILDREN WITH CLASS I MALOCCLUSIONS : A COUNTERPART ANALYSIS (Angle 1급 부정교합 아동의 안면두개골 형태의 유형적 특징에 관한 연구)

  • Lee, Jeong-Ok;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.1
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    • pp.172-184
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    • 1999
  • The present study was performed to identify morphologic sub-groupings in Korean children with Class I malocclusions, and to find out anatomic differences between the sub-groups. Standardized lateral cephalometric radiographs of 152 Korean children, aged between 6 and 12 years, with Class I malocclusions were analyzed by the Counterpart Analysis. A statistical method, Ward's Minimum Variance Cluster Analysis, was employed to divide the sample into sub-groups those with similar morphologic characteristics. The results were as follows; 1. There appeared two facial types, Type I and Type II, in Korean children with Class I malocclusions, 48.7% and 51.3%, respectively. 2. In both sub-groups, there existed strong Class III skeletal patterns due to a counterclockwise rotation of the Middle Cranial Fossa alignment, and strong Class II skeletal patterns due to the long Posterior Maxillary vertical dimension and a clockwise rotation of the Ramus alignment. 3. There were no significant differences in Upper Anterior Facial Height between Type I and Type II, $52.6{\pm}2.92mm\;and\;52.8{\pm}3.23mm$, respectively. 4. The Lower Anterior Facial Height in Type II was longer ($66.0{\pm}4.03mm$) due to the long Posterior Maxillary vertical dimension, the clockwise rotation of the Ramus alignment, and a clockwise rotation of the Mandibular plane alignment than that of Type I ($64.2{\pm}4.15mm$).

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Characterization of facial asymmetry phenotypes in adult patients with skeletal Class III malocclusion using three-dimensional computed tomography and cluster analysis

  • Ha, Sang-Woon;Kim, Su-Jung;Choi, Jin-Young;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.52 no.2
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    • pp.85-101
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    • 2022
  • Objective: To classify facial asymmetry (FA) phenotypes in adult patients with skeletal Class III (C-III) malocclusion. Methods: A total of 120 C-III patients who underwent orthognathic surgery (OGS) and whose three-dimensional computed tomography images were taken one month prior to OGS were evaluated. Thirty hard tissue landmarks were identified. After measurement of 22 variables, including cant (°, mm), shift (mm), and yaw (°) of the maxilla, maxillary dentition (Max-dent), mandibular dentition, mandible, and mandibular border (Man-border) and differences in the frontal ramus angle (FRA, °) and ramus height (RH, mm), K-means cluster analysis was conducted using three variables (cant in the Max-dent [mm] and shift [mm] and yaw [°] in the Manborder). Statistical analyses were conducted to characterize the differences in the FA variables among the clusters. Results: The FA phenotypes were classified into five types: 1) non-asymmetry type (35.8%); 2) maxillary-cant type (14.2%; severe cant of the Max-dent, mild shift of the Man-border); 3) mandibular-shift and yaw type (16.7%; moderate shift and yaw of the Man-border, mild RH-difference); 4) complex type (9.2%; severe cant of the Max-dent, moderate cant, severe shift, and severe yaw of the Man-border, moderate differences in FRA and RH); and 5) maxillary reverse-cant type (24.2%; reverse-cant of the Max-dent). Strategic decompensation by pre-surgical orthodontic treatment and considerations for OGS planning were proposed according to the FA phenotypes. Conclusions: This FA phenotype classification may be an effective tool for differential diagnosis and surgical planning for Class III patients with FA.

A STUDY ON QUADRILATERAL ANALYSIS OF FACIAL CONFIGURATION IN KOREAN CHILDREN (한국인 아동의 악안면 구조의 사변형 분석에 관한 연구)

  • Choi, Seung-Hoon;Yang, Won-Sik
    • The korean journal of orthodontics
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    • v.18 no.1 s.25
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    • pp.235-252
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    • 1988
  • The quadrilateral analysis is a proportional analysis which evaluates the skeletal configuration of lower face on the relations between both jaws in the horizontal as we]1 as vortical dimensions. This study was undertaken to analyse the harmony and disharmony of quadrilateral patterns in normal occlusion and malocclusion. The present study was carried out on lateral cephalograms of 530 Korean children; the subjects consisted of 135 normal occlusions (63 male and 72 female), 105 Class II division 1 malocclusions (52 male and 53 female), 109 Class III malocclusions (50 male and 59 female), 91 hypodivergent facial types (44 male and 47 female) and 90 hyperdivergent facial types (45 male and 45 female). The following conclusions were reached: 1. Means and standard deviation in each group and sex were obtained from normal occlusion and malocclusion. 2. Quadrilateral mean diagram in normal occlusion was constructed for male and female, respectively. 3. In normal occlusion, 1:1 ratio exists between the maxillary base length (A' to Ptm') and mandibular base length (B' to J'), but lower facial height is targer than above. 4. Difference is effective to estimate the degrees of Class II and Class III malocclusion, and lower facial height (LFH) and sagittal angle is effective to recognize the hypodivergent and hyperdivergent facial type. 5. Quadrilateral analysis is able to visualize the anteroposterior and vertical dysplasia of lower face, and it is helpful to recognize certain problems in malocclusion.

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