• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.4
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• pp.319-324
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• 2009

Kole's Anterior segmental osteotomy of the mandible is commonly used to close an anterior open bite, to depress an elevated anterior dentoalveolar segment, or to retrude or advance a dentoalveolar segment. The procedure is often combined with an anterior maxillary segmental osteotomy to correct bimaxillary protrusion. We report 53-year-old woman who the extruded state of mandibular anterior alveolar segment was corrected using an mandibular anterior alveolar segmental osteotomy and dental implantation of the anterior maxilla. We planned to remove the old prosthesis, and then perform an anterior mandibular segmental osteotomy and implant restoration of the anterior maxilla. We suggest that anterior segmental osteotomy is very useful for rehabilitating edentulous patients with malaligned alveolar segment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.4
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• pp.246-251
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• 2012

Purpose: The purpose of the study is to evaluate the effectiveness of anterior segmental osteotomy (ASO) in bimaxillary protrusion (BP) patients by comparison between the mandibular soft and hard tissue changes from orthodontic treatment and ASO. Methods: All 44 patients were diagnosed with BP in Kyung-Hee Medical Center. Orthodontic treatment with teeth extractions were underwent by 23 patients (Group A) and 21 patients underwent ASO (Group B). Mandibular soft and hard tissue changes were measured and evaluated, which were based on the vertical and horizontal reference line in lateral cephalometric radiographs. Statistical significance between the changes and correlation between each measurement were analyzed. Results: The amount of B point movement was lesser than that of the lower incisal tip (LIT) retraction, and LIT was tilted lingually in group A. The posterior movement discrepancy between LIT and B point was insignificant, and the inclination of lower incisor was not changed in group B. The soft tissues, including the lower lip, showed a posterior movement and reduction in the depth of mento-labial groove. According to the correlation analysis, the movement of the lower incisor was significantly related to the movement of the lower lip in group A, and the movement of the lower incisor was significantly related to that of the movement of lower lip, B point and Pog in group B. Conclusion: The orthodontic treatment in BP patients results in posterior tilting movement of the lower incisor, but ASO results in the bodily movement of the lower incisor. Consequently, ASO is more effective in BP cases because it ensures the controlled movement of the lower incisors.

• Journal of Oral Medicine and Pain
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• v.20 no.1
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• pp.185-194
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• 1995

The purpose of this study was to estimate primary diagnosis, prediction of prognosis and recognition fo treatment progress for treatment of TMD patients through measuring the various ranges of mandibular movement in normal and TMDs patients using Mandibular Kinesiograph K-6 Diagnostic system. In normal groups, 20 adults were selected, who have normal or class I molar relationship, and have no symptoms on TMJ and masticatory muscles, and have restorations less than 3 surfaces on each tooth, and have no other prosthetic restoration. In Patients group, we selected 31 outpatients who were confirmed to TMDs with clinical examination and radiographic findings. The obtained results were as follows : 1. In maximal opening, patient group was showed the limitation of vertical movement range (P<0.01) and lager lateral deviation than in normal group (P<0.05). And actual dimensional displacement of opening was calculated larger in normal group (P<0.05). 2. In protrusive movement, patients group was showed the limitation of anteroposterior movement range (P<0.001) and larger deviation than in normal group (P<0.01). And actual 3 dimensional displacement of protrusion was calculated larger in normal group (P<0.001). 3. In lateral maximum excursion, compared with normal group patient group was no significant differences to affected side, but was showed the limitation of lateral movement to unaffected side (P<0.001). 4. There was no significant difference in movement velocity of opening and closing in both groups. 5. Mandibular movement from physiologic rest position to centric occlusion was moved more anteroposteriorly in patient group. 6. Mandibular movement from centric relation to centric occlusion was no significant difference in both groups.

• 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.

• The Journal of the Korean dental association
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• v.55 no.12
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• pp.850-860
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• 2017

Orthodontic treatment with premolar extraction is usually performed to correct bialveolar protrusion. These methods require the use of stiff rectangular working archwire which requires lengthy alignment and leveling before insertion. In this case report, interproximal reproximation was performed instead of extraction. To establish clearance between the archwire and resin domes fixing the archwire, an archwire was inserted into a water-soluble tube before fabricating resin domes. This tube is solved away by the saliva. During fabrication of resin domes, the archwire was deflected intentionally reflecting the displacement of teeth from their ideal position. This can be called as deflection-based bonding (DBB) technique. DBB is different from conventional method of positioning the brackets on its ideal position and then inserting an archwire to align the brackets. Because the orthodontic force of the archwire comes from its deflection from passive configuration, deflecting an archwire as needed can move the teeth more predictably than just bonding brackets on its ideal position. Also, areas with good alignment before orthodontic treatment can be maintained simply by not deflecting the archwire during bonding in these areas. After initial alignment, interproximal reproximation was performed to create 4.8 mm space in the maxillary arch and 4.2 mm space in the mandibular arch. These spaces were closed using orthodontic mini-implant anchorage thus retracting the maxillary incisors 4 mm posteriorly accompanied with 0.7 mm and 0.3 mm distal movement of right and left molars. By using interproximal reproximation and water-soluble tube with DBB, mild bialveolar protrusion was successfully treated without extraction.

• Speech Sciences
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• v.8 no.3
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• pp.161-172
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• 2001

Ankyloglossia (tongue-tie) limits movement of the tongue connected with feeding and has adverse impacts on both dental health and speech. For the patients with ankyloglossia, surgical intervention is recommended as primary treatment. This study suggests the efficient tool in determining indicatory factors for frenulotomy by quantifying Maximum Lingual Length-Protrusion (MLL-P) with boley gauge, and as a preliminary study, to show the measurement results with normal children using the tool. The subjects were 61 normal children, and the distance (MLL-P) between mandibular central incisor and tongue tip during tongue protrusion was measured with a boley gauge (Digimatic $Caliper^{(R)}$). The results of this study can be summarized as follows: (1) The mean value of MLL-P (N=61 normal children) was 21.44 mm, (2) The mean value of MLL-P was 20.69 mm in males (N=33) and 21.91 mm in females (N=28). There was no statistically significant difference between males and females, (3) The mean value of MLL-P was 19.34 mm, 21.19 mm, 22.33 mm, 22.61 mm for measurement of 3-, 4-, 5- and 6-year-old children, respectively, and (4) The mean value of MLL-P showed statistically significant difference between 3- and 5-year-old children, between 3- and 6-year old children.

• The Journal of the Korean dental association
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• v.57 no.6
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• pp.333-343
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• 2019

Many orthodontists face difficulties in aligning incisors in an esthetically critical position, because the individual perception of beauty fluctuates with time and trend. Temporary anchorage device (TAD) can aid in attaining this critical incisor position, which determines an attractive smile, the amount of incisor display, and lip contour. Borderline cases can be treated without extraction and the capricious minds of patients can be satisfied with regard to the incisor position through whole dentition distalization using TAD. Mild to moderate bimaxillary protrusion cases can be treated with TAD-driven en masse retraction without premolar extraction. Patients with Angle's Class III malocclusion can be the biggest beneficiaries because both sufficient maxillary incisal display, through intrusion of mandibular incisors, and distalization of the mandibular dentition are successfully achieved. In addition, TAD can be used to correct various other malocclusions, such as canting of the occlusal plane and dental/alveolus asymmetry.

• Journal of Yeungnam Medical Science
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• v.12 no.2
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• pp.393-399
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• 1995

Mandibular retrusion showing the facial problem with a marked maxillarry incisors protrusion and chin deficiency, resulting in a highly convex profile is uncommon in Korea.. The large incisor overjet and deep-bite create functional limitations and unpleasing esthetic result. The majority of theses cases are susceptible to correction by orthodontic therapeutic methods. But severe Class II retrognathic cases in which orthodontic treatment alone has not been capable of achieving good results. Orthognathic surgery offers several approaches. In this case, mandibular advancement by bilateral sagittal split ramus osteotomy and augmentation genioplasty has a special surgical problems. The suprahyoid muscle gorup are lengthened if the body of the mandible is surgically repositioned anteriorly. Instability of results and relapse return to original position shoud predicted during post-surgical muscular readjustment.. To maintain maximum correction with this technique, it is suggested that the mandibular body be well rotated forward at time of surgical intervention and overcorrected anteriory as much as possible. So, the authors report the case with review of concerned literature.

• The korean journal of orthodontics
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• v.41 no.2
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• pp.127-137
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• 2011

Objective: The aim of the study was to compare the opening and protrusive mandibular movements between Class I and Class II malocclusions in healthy adolescents by clinical and axiographic evaluations. Methods: Mechanical axiography was performed on non-orthodontically treated, temporomandibular disorder (TMD)-free adolescents (12 - 16 years) with Class I (n = 38, 16 boys, 22 girls) or Class II (n = 40, 19 boys, 21 girls) malocclusion. Opening and protrusive movements were measured clinically and axiographically. Intergroup comparisons were evaluated by t-tests. Results: In opening movement, the maximum clinical opening capacity was significantly different (p ${\leq}$ 0.05) between the groups. In protrusive movement, the Class II group had significantly greater maximum clinical protrusion (p < 0.001) and maximum axiographic protrusive length (p < 0.01) than the Class I group. No significant difference in the other opening and protrusive axiographic measurements was observed. Conclusions: TMD-free adolescents with Class II malocclusion have increased protrusive capacity compared with TMD-free adolescents with Class I malocclusion; however, the detected differences could be normal variations during adolescence.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.3
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• pp.288-297
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• 1999

This study has been carried out in order to measure the thickness of soft-tissue on lateral cephalographs based on body mass index(BMI) and the change in soft-tissue thickness after surgical correction of mandibular protrusion. The control material in cephalometric study comprised students at The Dental College, 38 persons, aged 21~24 years and the patient material comprised 20 women and 12men, aged 19~28 years with mandibular protrusion.The thickness of the soft-tissue based on BMI in control and study groups, the comparison between them, immediate postoperative change in the thickness, 6 months after surgery, ratio of soft-tissue response and correlation was established through various statistical methods. The result were as follows : 1. The groups based on BMI showed significant differences each other as regards the linear measurements. The thickest soft-tissue was measured 13.6mm, 15.47mm, 16.76mm at Ss, the thinnest at G' 6.0mm, 6.7mm, 7.26mm respectively. 2. The differences between control and experimental groups based on BMI showed to be significant. There were no differences at G'. The soft-tissue in prognathic patients was thicker at Ss, Ls and thinner at Li, Ls, Pg', Gn', Me'. Differential gap was greater in overweight groups. 3. The immediate soft-tissue change after surgery showed the increase at Li, Ls, Pg', Gn', Me' except G', Ls in all groups. 4. The postoperative soft-tissue change 6 months after surgery was similar with immediate change. The soft-tissue shows the increase in the thickness at Li, Pg', Gn', Me' and the greatest difference occurred at Li, 1.1mm, 0.98mm, 1.2mm respectively. 5. The patients with lower BMI index showed higher soft-tissue response to bony movement at Pg'. The immediate response ratio was 91%, 87%, 81% in A,B,C groups respectively, the response 6 months after surgery showed 96%, 91%, 84%.