• Title/Summary/Keyword: mandibular protrusion

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Prosthetic rehabilitation in a Class III malocclusion patient with increasing occlusal vertical dimension (3급 부정교합 환자의 교합수직고경 증가를 동반한 보철 수복)

  • Ha-Eun Choi;Han-Sol Song;Kyung-Ho Ko;Yoon-Hyuk Huh;Chan-Jin Park;Lee-Ra Cho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.3
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    • pp.133-145
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    • 2023
  • Class III malocclusion with mandibular protrusion can be divided into skeletal and pseudo malocclusion due to tooth displacement. For skeletal malocclusion, favorable treatment results can be obtained by establishing an appropriate vertical and horizontal intermaxillary relationship in order to secure a restoration space and obtain aesthetic and functional results. In this case, complete mouth rehabilitation was performed using an implant and a fixed prosthesis in a patient with mandibular protrusion and anterior teeth wear and reduced occlusal vertical dimension. After cast analysis and digital diagnosis, a provisional restoration with increased vertical dimension was fabricated to secure posterior support and evaluate stable centric occlusion. With the definitive prosthesis reflecting the provisional restoration, favorable function and aesthetics were obtained.

Open versus closed reduction of mandibular condyle fractures : A systematic review of comparative studies

  • Kim, Jong-Sik;Seo, Hyun-Soo;Kim, Ki-Young;Song, Yun-Jung;Kim, Seon-Ah;Hong, Soon-Min;Park, Jun-Woo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.1
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    • pp.99-107
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    • 2008
  • Objective : The objective of this review was to provide reliable comparative results regarding the effectiveness of any interventions either open or closed that can be used in the management of fractured mandibular condyle Patients and Methods : Research of studies from MEDLINE and Cochrane since 1990 was done. Controlled vocabulary terms were used. MeSH Terms were "Mandibular condyle" AND "Fractures, bone". Only comparative study were considered in this review using the "limit" function. According to the criteria, two review authors independently assessed the abstracts of studies resulting from the searches. The studies were divided according to some criteria, and following were measured: Ramus height, condyle sagittal displacement, condyle Towns's image displacement, Maximum open length, Protrusion & Lateral excursion, TMJ pain, Malocclusion, and TMJ disorder. Results : Many studies were analyzed to review the post-operative result of the two methods of treatment. Ramus height decreased more in when treated by closed reduction as opposed to open reduction. Sagittal condyle displacement was shown to be greater in closed reduction. Condyle Town's image condyle displacement had greater values in closed reduction. Maximum open length showed lower values in closed reduction. In protrusive and lateral movement, closed reduction was less than ORIF. Closed reduction showed greater occurrence of malocclusion than ORIF. However, post-operative pain and discomfort was greater in ORIF. Conclusion : In almost all categories, ORIF showed better results than CRIF. However, the use of the open reduction method should be considered due to the potential surgical morbidity and increased hospitalization time and cost. To these days, Endoscopic surgical techniques for ORIF (EORIF) are now in their infancy with the specific aims of eliminating concern for damage to the facial nerve and of reducing or eliminating facial scars. Before performing any types of treatment, patients must be understood of both of the treatment methods, and the best treatment method should be taken on permission.

A ROENTGENOCEPHALOMETRIC STUDY ON THE CONDYLAR DISPLACEMENT IN ANGLE′S CLASS Ⅰ & Ⅲ MALOCCLUSION (Ⅰ급 및 Ⅱ급 부정교합자의 과두변위에 관한 두부방사선계측학적 연구)

  • Lee Jeong Hwa;Park Chang Seo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.16 no.1
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    • pp.69-79
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    • 1986
  • The purpose of this investigation was to know correlation of mean values between centric occlusion and centric relation by the cephalogram in Angle's Class Ⅰ and Ⅲ malocclusion subjects. 22 adults with Angle's Class Ⅰ malocclusion (17 men and 5 women, 21 to 27 years of age) and 14 adults with Angle's Class Ⅲ malocclusion (10 men and 4 women, 21 to 27 years of age) were selected from the dental students in Yonsei University. Each subject was given two lateral cephalometric radiographies and cephalometric analysis was performed. All data from these analyses was recorded and statistically processed with CYBER computer system. 1. The results were obtained as follows: There was a strong positive correlation between centric occlusion and centric relation in all subjects with Angle's Class Ⅰ and Ⅲ malocclusion. 2. In Angle's Class Ⅰ malocclusion, measurements in lower facial height revealed significant difference between centric occlusion and centric relation (P<0.05). In Angle's Class Ⅲmalocclusion, measurements in facial axis angle, mandibular plane angle, convexity of A point, lower incisor protrusion, lower facial height revealed significant difference between centric occlusion and centric relation (P<0.05). 3. When the mandible was moved from centric occlusion to centric relation, the mean distance of mandibular movement was 1.27㎜ (0.2-2.8㎜) in Angle's Class Ⅰ malocclusion, 1.70㎜ (0.55-4.15㎜) in Angle's Class Ⅲ malocclusion, and 1.44㎜ (0.2-4.15㎜) in all subjects.

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Protrusive maxillomandibular fixation for intracapsular condylar fracture: a report of two cases

  • Jeong, Yeong Kon;Park, Won-Jong;Park, Il Kyung;Kim, Gi Tae;Choi, Eun Joo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.5
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    • pp.331-335
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    • 2017
  • Clinical limitations following closed reduction of an intracapsular condylar fracture include a decrease in maximum mouth opening, reduced range of mandibular movements such as protrusion/lateral excursion, and reduced occlusal stability. Anteromedial and inferior displacement of the medial condyle fragment by traction of the lateral pterygoid muscle can induce bone overgrowth due to distraction osteogenesis between the medial and lateral condylar fragments, causing structural changes in the condyle. In addition, when conventional maxillomandibular fixation (MMF) is performed, persistent interdental contact sustains masticatory muscle hyperactivity, leading to a decreased vertical dimension and premature contact of the posterior teeth. To resolve the functional problems of conventional closed reduction, we designed a novel method for closed reduction through protrusive MMF for two weeks. Two patients diagnosed with intracapsular condylar fracture had favorable occlusion after protrusive MMF without premature contact of the posterior teeth. This particular method has two main advantages. First, in the protrusive position, the lateral condylar fragment is moved in the anterior-inferior direction closer to the medial fragment, minimizing bone formation between the two fragments and preventing structural changes. Second, in the protrusive position, posterior disclusion occurs, preventing masticatory muscle hyperactivity and the subsequent gradual decrease in ramus height.

A Pantographic Study on the Mandibular Movements in Patients with Temporomandibular Joint Sounds (Pantograph를 이용한 악관절잡음자의 하악운동에 관한 연구)

  • Lee, Pung Ho;Han, Kyung Soo
    • Journal of Oral Medicine and Pain
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    • v.12 no.1
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    • pp.85-93
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    • 1987
  • The author studied on the effect of TMJ sounds to the patterns and ranges of mandibular border movements in horizontal plane with Pantograph (Denar Corp.). For study, 19 patients with TMJ sounds only and 16 students with no TM disorder were selected and classified as experimental group and control group, respectively. The subject performed right lateral movement, left lateral movement, and forward movement. Each movement were performed 3 times and the movement trajectory obtained with mechanical pantograph were observed for accordance of centric relation position, reproducibility and/or restriction of lateral movement paths, deviation of protrusive path in anterior table, restriction of protrusive condylar movement path in posterior horizontal table, presence of Fisher angle in posterior vertical table. And pantographic reproducibility Index (PRI) were obtained with pantronic by the same movement method as in the mechanical pantograph record. The obtained results were as follows : 1. In experimental group, PRI scores in those who show accordance of centric relation position were 14.4, and were 26.53 in those who did not show accordance of centric relation position. However, the PRI scores of the two subgroups show no statistically significant difference in control group. Therefore, in experimental group, the capability of accordance of centric relation position affected largely the PRI scores than in control group. 2. Deviation of protrusive path was opposite to the affected side in experimental group, and was left side in control group. 3. Restriction side of condylar movement in protrusion was ipsilateral to the deviation side in experimental group, but in control group, restriction side was not related to the deviation side. 4. PRI scores in experimental group were 23.2 (moderate dysfunction category), and in control group, were 17.8 (slight dysfunction category). The PRI scores in control group, however, implies that the evaluation of temporomandibular disorders by the PRI scores only may be unreasonable.

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HARD AND SOFT TISSUE CHANCES AFTER ORTHOGNATHIC SURGERY OF MANDIBULAR PROGNATHISM (하악전돌증 환자의 악교정 수술후 경조직과 연조직 변화에 관한 두부방사선 계측학적 연구)

  • Choe, Yoo-Kyung;Suhr, Cheong-Hoon
    • The korean journal of orthodontics
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    • v.23 no.4 s.43
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    • pp.707-724
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    • 1993
  • The purpose of the study is to estimate hard and soft tissue changes after orthognathic surgery for the correction of the mandibular prognathism and to describe interrelationship and ratios of soft and hard tissue changes. The presurgical and postsurgical lateral cephalograms of 31 treated patients(17 males and 14 females) was used ; these patients had received combined orthodontic-surgical treatment by means of a bilateral sagittal split ramus osteotomy. Their ages ranged from 16 to 31 years and mean age was 21.4 years. A computerized cephalometric appraisal was developed and used to analyse linear and angular changes of skeletal and soft tissue profile. The statistical elaboration of the data was made by means of $SPSS/PC^+$. The results of the study were as follows : 1. The correlations of soft and hard tissue horizontal changes were significantly high and the ratios were $97\%$ at LI, $107\%$ at ILS, and $93\%$ at Pog'. 2. The correlations of vertical changes at Stm, LI and horizontal changes at Pog were high$(26\%)$ and at the other areas were not statistically high. 3. The correlations of soft ad hard tissue vertical changes were not significantly high in all areas except Gn' $(30\%)$ and Me' $(56\%)$. 4. The soft tissue thickness was significantly decreased in upper lip and increased in lower lip, and the amount of changes after surgery was reversely correlated with initial thickness. 5. The facial convexity was increased and relative protrusion of upper lip was increased and that of lower lip was decreased. 6. The upper to lower facial height(Gl-Sn/Sn-Me') was increased and upper to lower jaw height(Sn-Stms/Stmi-Me') was increased.

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Incisor inclination indicator for anterior torque control during retraction in lingual orthodontic treatment (설측교정치료에 있어서 전치부 후방 견인시 토오크 조절을 위한 incisor inclination indicator)

  • Hong, Ryoon-Ki;Kim, Tae-Gun;Kim, Tae-Woo
    • The korean journal of orthodontics
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    • v.34 no.6 s.107
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    • pp.544-554
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    • 2004
  • A device called incisor inclination indicator to control the axial inclinations of the incisors in the diagnostic setup is introduced. It is used to control the retraction of the maxillary and mandibular incisors. In this article, we describe the use of the incisor inclination indicator to prescribe adequate torque into the anterior lingual brackets and evaluate the results of treatment in a bimaxillary dentoalveolar protrusion case that underwent orthodontic treatment with the pretorqued anterior lingual brackets. Retraction of the maxillary and mandibular incisors was achieved with careful control of the axial inclination. It is indicated that the use of the incisor inclination indicator is an effective adjunctive laboratory procedure for anterior torque control during retraction in lingual orthodontic treatment.

Changes in maximum lip-closing force after extraction and nonextraction orthodontic treatments

  • Choi, Tae-Hyun;Kim, So-Hyun;Kim, Cheul;Kook, Yoon-Ah;Larson, Brent E.;Lee, Nam-Ki
    • The korean journal of orthodontics
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    • v.50 no.2
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    • pp.120-128
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    • 2020
  • Objective: The aims of the present study were to evaluate the changes in the maximum lip-closing force (MLF) after orthodontic treatment with or without premolar extractions and verify the correlation of these changes with dentoskeletal changes. Methods: In total, 17 women who underwent nonextraction orthodontic treatment and 15 women who underwent orthodontic treatment with extraction of all four first premolars were included in this retrospective study. For all patients, lateral cephalograms and dental models were measured before (T0) and after (T1) treatment. In addition, MLF was measured at both time points using the Lip De Cum LDC-110R® device. Statistical analyses were performed to evaluate changes in clinical variables and MLF and their correlations. Results: Both groups showed similar skeletal patterns, although the extraction group showed greater proclination of the maxillary and mandibular incisors and lip protrusion compared to the nonextraction group at T0. MLF at T0 was comparable between the two groups. The reduction in the arch width and depth and incisor retroclination from T0 to T1 were more pronounced in the extraction group than in the nonextraction group. MLF in the extraction group significantly increased during the treatment period, and this increase was significantly greater than that in the nonextraction group. The increase in MLF was found to be correlated with the increase in the interincisal angle and decrease in the intermolar width, arch depth, and incisor-mandibular plane angle. Conclusions: This study suggests that MLF increases to a greater extent during extraction orthodontic treatment than during nonextraction orthodontic treatment.

Treatment of Gingival Invagination after Orthodontic Treatment with Extraction (발치 교정치료시 치은 함입에 관한 치은 처치)

  • Kim, Yun-Sang;Cho, Jin-Hyoung;Cho, Jin-Woo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.1
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    • pp.79-86
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    • 2012
  • In most patients with severe crowding or lip protrusion, orthodontic treatment with tooth extraction is done. In these patients, even though space is closed after orthodontic treatment, gingival invagination is observed on the extracted site. Since there are possibilities of space recurrence and regional periodontic problems occurrence, periodontic treatment is necessary on the gingival invagination region. This case was a 16 year old female with a chief complaint of crooked teeth. Since her maxillary premolars were already extracted a few years ago at a local dental clinic, orthodontic treatment was done by extracting mandibular premolars. Unlike maxillary premolar regions, gingival invagination occurred in mandibular premolar regions and gingival flattening was done by excising the gingival invaginated region. Gingival flattening was done once on the left side, twice on the right side and showed stable results. This is a case report of a patient that was prone to gingival invagination after orthodontic treatment with extraction and was treated with gingival flattening.

THE CEPHALOMETRIC STUDY OF FACIAL TYPES IN CLASS III MALOCCLUSION (III급 부정교합자의 안모유형에 관한 연구)

  • Kim, Soo-Cheol;Lee, Ki-Soo
    • The korean journal of orthodontics
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    • v.20 no.3 s.32
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    • pp.519-539
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    • 1990
  • It is the aim of this study to observe the distribution of various facial types in class III malocclusion and to characterize the craniofacial features of the very facial types. Cephalometric headptates of a hundred and ten persons showing bilateral class III malocclusion whose mean age was 12.51 years and sixty nine persons of normal occlusion whose mean age was 12.23 years were measured and statistically analyzed. The following summary and conclusions were drawn. 1. Affording the bases for SNA and SNB, $35.45\%$ of sample showed normally positioned maxilla and protruded mandible, $30.00\%$ for retruded maxilla and normally positioned mandible, $15.45\%$ for retruded maxilla and protruded mandible, $10.90\%$ for both maxilla and mandible within normal range and $8.20\%$ for miscellaneous types were arranged in class III malocclusion. 2. $52.72\%$ of sample showed neutrodiveigent, $35.45\%$ for hyperdivergent and $11.81\%$ manifested hypodivergent mandible in class III malocclusion. 3. Providing the bases for facial and mandibular planes, $33.63\%$ of sample showed prognathic and neutrodivergent, $20.90\%$ for mesognathic and hyperdivergent, $17.27\%$ for prognathic and hyperdivergent and $15.45\%$ for mesognathic and neutrodivergent were arranged in class III malocclusion. 4. The class III malocclusion brought out shorter cranial base, smaller saddle angle, and larger articular and genial angle. It showed retropositioned maxilla and forward positioned mandible in spite of no significant differences in linear measurements of mandible. Anterior lower facial height was significantly larger in class III malocclusion, while posterior total facial and anterior total facial heights exhibited no significant differences. 5. It is suggested class III malocclusion was attributed to shorter cranial base, smaller saddle angle, maxillary deficiency and/or retrusion, mandibular excess and/or protrusion, excessive vertical growth of the anterior lower face, and their complex as well.

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