• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.11.1-11.6
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• 2017

Background: This case report discusses the unusual presentation of limited mouth opening as a result of bilateral coronoid process hyperplasia. Case presentation: A 14.5-year-old male patient of white Caucasian ethnicity presented with limited mouth opening, mandibular asymmetry, and dental crowding. Investigations confirmed bilateral coronoid process hyperplasia and management involved bilateral intraoral coronoidectomy surgery under general anaesthesia, followed by muscular rehabilitation. Mouth opening was restored to average maximum opening within 4 months of surgery. Conclusion: Limited mouth opening is a common presentation to medical and dental professionals. The rare but feasible diagnosis of coronoid impingement syndrome should not be overlooked.

• The korean journal of orthodontics
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• v.36 no.3 s.116
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• pp.218-227
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• 2006

Although the submentovertex radiograph and surface EMG are not often used due to the difficulty of interpretation, they are accepted as useful diagnostic and analytic aids for skeletal asymmetry. There have been reports which state that they were also useful for the evaluation of vertical skeletal relations. The purpose of this study was to evaluate the correlations between EMG data, measurements from submentovertex radiographs, facial types and facial asymmetry following examination of 60 asymmetric patients. The radiographic corpus length were greater in the nonaffected sides (p<0.001), gonion to interspinosum axis were greater in the affected sides and the mandibular condyle and gonion were located more anteriorly in the non-affected sides than in the affected sides but not significant (p=0.07). The activity of the anterior temporal muscle in rest position was higher in the affected sides than in the non-affected sides (p<0.01). The activity of the masseter muscle at maximum clenching was found to be nonsignificant but it was higher in the affected sides than in the non-affected sides (p=0.09). There was positive correlation between facial index and the intercondylar axes angle (p<0.01). There was positive correlation between masseter muscle activity in maximum occlusion and facial index in the affected and non-affected sides (p<0.05). The results demonstrate that the submentovertex radiograph and EMG can provide useful information for the evaluation of horizontal and vertical skeletal relations.

• The korean journal of orthodontics
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• v.41 no.2
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• pp.87-97
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• 2011

Objective: Facial asymmetry is usually evaluated from the difference in length and angulation of the maxilla and mandible. However, asymmetric position or shape of the condyle can also affect the expression of asymmetry. The purpose of this study was to evaluate the correlation between condylar asymmetry and chin point deviation in facial asymmetry. Methods: Cone-beam CT images of fifty adult skeletal Class III patients were studied. Thirty patients who had more than 4 mm menton deviation were categorized in the asymmetric group. Twenty patients with less than 4 mm menton deviation were assigned to the symmetric group. Anteroposterior and transverse condyle positions were evaluated from the cranial base. The greatest mediolateral diameter (GMD) of the condyle in the axial plane and angulation to the coronal plane were measured. The height and volume of the condyles were evaluated. Results: The symmetric group had no statistical difference between both condyles in position, angulation, GMD, height and volume. In the asymmetric group, the non-deviated side condyle was larger in GMD, height and volume than the deviated side. There was no statistical difference in condyle position and angulation. The GMD, height difference and condylar volume ratio (non-deviated/deviated) were positively correlated with chin deviation. From the linear regression analysis, condylar volume ratio was a significant factor affecting chin deviation. Conclusions: These findings suggests that the non-deviated side condyle is larger than the deviated side. In addition, condylar asymmetry can affect the expression of facial asymmetry.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.3
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• pp.382-388
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• 2002

In the present study, crown diameters and their sexual differences in deciduous teeth were investigated in children of Chon-ju city, Korea. Plaster casts of the deciduous dentitions obtained from 50 boys and 50 girls were examined. Mesiodistal and buccolingual crown diameters were measured using a digital caliper(0.01mm) according to the definitions of Seipel and Moorees et al. These measurements were performed three times, and intra-observer measurement errors were calculated by the single determination method. The crown index, module and area were calculated in order to provide a comparison of crown proportions. The results obtained were summarized as follows; 1. The mean values of intra-observer measurement errors were 0.255mm and are unlikely to have influenced the statistical analysis. 2. The mean values of mesiodistal and buccolingual crown diameters examined were larger in boys than girls. 3. The mean coefficient of variation was 5.6 in the deciduous dentition. There were a trend for the primary second molar to be the least variable in size of all teeth both in boys and girls. 4. Fluctuating asymmetry is the difference between left and right antimeres in individuals. Primary second molars were less asymmetrical than primary first molars in both dimensions. 5. In maxillary teeth, Crown index is larger in boys than in girls. In contrast, in mandibular teeth, except primary canine, it is larger in girls than in boys. Crown module is larger in boys than in girls and increased progressively from primary first incisor to primary second molar. Crown area is consistently larger in boys than in girls. The minimum crown area is mandibular primary incisor and maximum crown area is maxillary primary second molar.

• Imaging Science in Dentistry
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• v.44 no.1
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• pp.15-20
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• 2014

Purpose: This study aimed to assess the three-dimensional (3D) facial changes after orthognathic surgery by evaluating the spherical coordinates of facial lines using 3D computed tomography (CT). Materials and Methods: A 19-year-old girl was diagnosed with class III malocclusion and facial asymmetry. Orthognathic surgery was performed after orthodontic treatment. Facial CT scans were taken before and after orthognathic surgery. The patient had a menton deviation of 12.72 mm before surgery and 0.83 mm after surgery. The spherical coordinates of four bilateral facial lines (ramal height, ramal lateral, ramal posterior and mandibular body) were estimated from CT scans before and after surgery on the deviated and opposite side. Results: The spherical coordinates of all facial lines changed after orthognathic surgery. Moreover, the bilateral differences of all facial lines changed after surgery, and no bilateral differences were zero. Conclusion: The spherical coordinate system was useful to compare differences between the presurgical and postsurgical changes to facial lines.

• The korean journal of orthodontics
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• v.46 no.3
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• pp.137-145
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• 2016

Objective: The purpose of this study was to investigate the characteristics of orthodontic patients at Yonsei Dental Hospital from 2008 to 2012. Methods: We evaluated Angle's classification from molar relationships, classification of skeletal malocclusion from the A point-nasion-B point angle, facial asymmetry, and temporomandibular joint disorders (TMDs) from the records of 7,476 patients who received an orthodontic diagnosis. The orthognathic surgery rate, extraction rate, and extraction sites were determined from the records of 4,861 treated patients. Results: The patient number increased until 2010 and gradually decreased thereafter. Most patients were aged 19-39 years, with a gradual increase in patients aged ${\geq}40years$. Angle's Class I, Class II divisions 1 and 2, and Class III malocclusions were observed in 27.7%, 25.6%, 10.6%, and 36.1% patients, respectively, with a gradual decrease in the frequency of Class I malocclusion. The proportion of patients with skeletal Class I, Class II, and Class III malocclusions was 34.3%, 34.3%, and 31.4%, respectively, while the prevalence of facial asymmetry and TMDs was 11.0% and 24.9%, respectively. The orthognathic surgery rate was 18.5%, with 70% surgical patients exhibiting skeletal Class III malocclusion. The overall extraction rate among nonsurgical patients was 35.4%, and the maxillary and mandibular first premolars were the most commonly extracted teeth. Conclusions: The most noticeable changes over time included a decrease in the patient number after 2010, an increase in the average patient age, and a decrease in the frequency of Angle's Class I malocclusion. Our results suggest that periodic characterization is necessary to meet the changing demands of orthodontic patients.

• Journal of Oral Medicine and Pain
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• v.18 no.1
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• pp.55-62
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• 1993

The author has synchronously recorded the average electromyographic activities of the sternocleidomastoid muscles, the anterior temporal muacles and the masseter muscles. The marious levels of occlusal force were checked during clenching the resin plates which are made to fit each of the maxillary and the mandibular teeth. These activities were recorded in order to study the EMG activity pattern of the sternocleidomastoid muscle during the masticatory function of the jaw in 11 healthy subjects. The obtined results were as follows : 1. The electromyographic activities of the sternocleidomastoid muscles, the anterior temporal muscles and the masseter muscles were increased as the occlusal force increased, and the sternocleidomastoid muscles have a lineal correlationship with the occlusal force. 2. The sternocleidomastoid muscles and the masseter muscles showed higher EMG activity during clenching at the ventroflexed head position rather than at the extended head position. (p<0.05) However the EMG activities of the anterior temporal muscles showed no difference between the ventroflexed position and the extended position of the head. 3. The electromyographic activities of the sternocleidomastoid muscles, the anterior temporal muscles and the masseter muscles during clenching are similar at the habitual position and at the retruded condylar position. 4. The electromyographic activities of the sternocleidomastoid muscles, the anterior temporal muscles and the masseter muscles on the working side during mastication of gum and almonds are significantly higher than on the balancing side except the masseter muscles during mastication of almonds. (p<0.05, P<0.01) 5. The asymmetry of gum are lower than that during mastication of almonds. (p<0.05) The asymmetry indices of the sternocleidomastoid muscles are higher than those of the anterior temporal muscles and masseter muscles.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.21.1-21.6
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• 2020

Background: Fibula free flap mandible reconstruction is the standard procedure after wide resection of the mandible. Establishment and maintenance of normal occlusion are important in mandible reconstruction both intraoperatively and after surgery. However, scar formation on the surgical site can cause severe fibrosis and atrophy of soft tissue in the head and neck region. Case presentation: Here, we report a case of severe soft tissue atrophy that appeared along with scar formation after mandibular reconstruction through the fibular free flap procedure. This led to normal occlusion collapse after it was established, and the midline of the mandible became severely deviated to the affected side that was replaced with the fibula free flap, leading to facial asymmetry. We corrected the malocclusion with a secondary operation: a sagittal split ramus osteotomy on the unaffected side and a sliding osteotomy on the previous fibula graft. After a healing time of 3 months, implants were placed on the fibula graft for additional occlusal stability. Conclusion: We report satisfactory results from the correction of malocclusion after fibula reconstruction using sliding fibula osteotomy and sagittal split ramus osteotomy. The midline of the mandible returned to its original position and the degree of facial asymmetry was reduced. The implants reduced difficulties that the patient experienced with masticatory function.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.5
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• pp.316-323
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• 2009

Purpose: This study was performed to evaluate three-dimensional positional change of the condyle using 3D CT after bilateral sagittal split ramus osteotomy (BSSRO) in skeletal class III patients. Patients and methods: Nine patients who underwent BSSRO for mandibular set-back in skeletal class III malocclusion without facial asymmetry were examined. Miniplates were used for the fixation after BSSRO. 3-D CT was taken before, immediately after, and 6 months after undergoing BSSRO. After creating 3D-CT images using V-works $4.0^{TM}$ program, axial plane, coronal plane, & sagittal plane were configured. Three dimensional positional change, from each plane to the condyle, of the nine patients was measured before, immediately after, and 6 months after undergoing BSSRO. Results: 1. The mean value of mandibular set-back for nine mandibular prognathism patients was 7.36 mm (${\pm}\;2.42\;mm$). 2. In the axial view, condyle is rotated inward immediately after BSSRO (p < 0.05), comparing with preoperative but outward 6 months after BSSRO comparing with postoperative (p < 0.05). 3. In the axial view, condyle is moved laterally immediately after BSSRO (p < 0.05), comparing with preoperative but regressed 6 months after BSSRO comparing with preoperative (p > 0.05). 4. In the frontal & coronal view, there is changed immediately after and 6 months after BSSRO, comparing with preoperative but no statistical difference. Conclusion: These results indicate that three-dimensional positional change of the condyle in skeletal class III patients is observed lateral displacement & inward rotation immediate after BSSRO, but the condyle in 6 months after BSSRO tends to regress to preoperative position.

• The korean journal of orthodontics
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• v.39 no.5
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• pp.300-309
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• 2009

Objective: The purpose of this study was to evaluate the correlation between menton deviation and dental compensation in facial asymmetry. Methods: Tooth axis and distance of first molar and canine to the reference plane were investigated by cone-beam computerized tomography. The subjects consisted of 50 patients with asymmetric mandibles (male 21, female 29, mean age 24.3 years). Control groups were also assessed (male 11, female 9, mean age 25.6 years). Nine measurements (5 linear measurements and 4 angular measurements) were measured in order to evaluate the correlation between menton deviation and the linear and angular difference of first molar and canine in the deviated and none-deviated sides using the defined MPR images. The differences between deviated and non-deviated side, according to menton deviation, were statistically analyzed using stepwise multiple regression analysis. Results: From the result, Menton deviation was negatively correlated with mandibular first molar's angular measurement (${\Delta\angle}LM6$-Mn plane (dev.-ndev.)) and positively with maxillary fist molar's angular measurement (${\Delta\angle}UM6$-FH plane (dev.-ndev.)) (p < 0.01). Two angular measurements (${\Delta\angle}LM6$-Mn plane (dev.-ndev.), ${\Delta\angle}UM6$-FH plane (dev.-ndev.)) explained the variability in menton deviation with a significant $r^2$ value of 0.589. Conclusions: This study suggests that the tooth axis of upper and lower first molars leans towards the deviated side of Menton when there is mandibular asymmetry with Menton deviation.