• Imaging Science in Dentistry
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• v.47 no.4
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• pp.261-267
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• 2017

Purpose: Analyzing different patterns of maxillary sinus septa in cone-beam computed tomography (CBCT) images and predicting maxillary sinus membrane perforations. Materials and Methods: In this cross-sectional study, CBCT images of 222 patients ranging from 20 to 81 years old were evaluated. One hundred fifty-two patients (93 females and 59 males) who had maxillary sinus septa in axial views were included in this study. Cross-sectional images were used to determine classifications of sinus septa and the risk of membrane perforation using a method modified from Al-Faraje et al. Variables of sex, age, and dental status were considered. Chi-squared and Kruskal-Wallis tests were used for data analysis(P<.05). Results: In this study, 265 maxillary sinus septal patterns were found. The mean age of the patients was $44.1{\pm}14.7$ years old. The Class I and VII-div II patterns had the greatest and least prevalence, respectively. Furthermore, there was a significant relationship between the location of septa and the frequency of membrane perforation risk (P<.05). In this study, the relationship of different patterns of septa with dental status did not differ significantly (P>0.05). Conclusion: A higher prevalence of moderate risk of membrane perforation in the molar region relative to the premolar region was observed. Furthermore, maxillary sinus septa occur most frequently in the molar region, demonstrating the importance of paying attention to this region during sinus lift surgery. This study did not show any relationship between tooth loss and the presence of septa.

• Korean Journal of Cleft Lip And Palate
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• v.6 no.1
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• pp.27-34
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• 2003

Patients with maxillary hypoplasia secondary to cleft lip and palate present numerous challenging problems for the oral and maxillofacial surgeon, These patients present with maxillary hypoplasia in multiclimensions, and often have thin or structually weak bone. This deformity has been traditionally corrected by Le Fort I osteotomy and acute skeletal advancement with wide surgical exposure. The long-term results of cleft patients with maxillary deficiency treated with this traditional approach has been sometimes disappointing, and an increased relapse tendency has been reported, Distraction osteogenesis for these cleft patients offers successful results while potentially minimizing the risk of relapse. Advancing the maxilla via distraction forces requires only a minor surgical procedure that maintains vascularity and neurosensory integrity. Moreover, the response of the facial soft tissues during maxillary distraction has proven to be more favorable than with a conventional LeFort I osteotomy. The purpose of this report is to present the use of maxillary distraction osteogenesis by rigid external distraction (RED) system for the treatment of patient with maxillary deficiency secondary to cleft lip and palate.

• The Journal of Advanced Prosthodontics
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• v.5 no.4
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• pp.409-415
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• 2013

PURPOSE. The midline fracture of maxillary complete dentures is a frequently encountered complication. The purpose of this study was to assess the effect of frenulum height on midline strains of maxillary complete dentures. MATERIALS AND METHODS. A removable maxillary complete denture was fabricated and duplicated seven times. Four different labial frenulum heights were tested for stresses occurring on the palatal cameo surface. The strains were measured with strain gauges placed on 5 different locations and the stresses were calculated. To mimic occlusal forces bilaterally 100 N of load was applied from the premolar and molar region. RESULTS. A statistically significant association between the height of the labial frenulum and the calculated stresses and strains was shown (P<.05) predominantly on the midline and especially on the incisive papilla. The results showed that stress on the anterior midline of the maxillary complete denture increases with a higher labial frenulum. CONCLUSION. Within the limitations of this in vitro study, it can be concluded that the stress on the anterior midline of the maxillary complete denture increases with a higher labial frenulum. Surgical or mechanical precautions should be taken to prevent short-term failure of maxillary complete dentures due to stress concentration and low cycle fatigue tendency at the labial frenulum region.

• The korean journal of orthodontics
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• v.35 no.6 s.113
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• pp.485-494
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• 2005

Maxillary anterior teeth were intruded and lingually root torqued with two maxillary anterior microimplants between the lateral incisors and canines. Overerupted maxillary canines were intruded with two other microimplants between the maxillary canines and first premolars. Maxillary posterior teeth and canines were distalized, then the maxillary incisors were retracted with two maxillary posterior microimplants between the first and second molars. The mandibular anterior teeth were intruded and the mandibular posterior teeth were extruded with conventional method such as anterior bite plane, intrusion arch and Class II elastics. The mandible moved slightly forward after the correction of deep bite and retroclination of the upper incisors. Consequently, microimplant anchorage (MIA) provided absolute anchorage for simultaneous correction of Class II canine and molar relationships and deep overbite.

• The korean journal of orthodontics
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• v.50 no.5
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• pp.346-355
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• 2020

The treatment of skeletal Class III malocclusion in adolescents is challenging. Maxillary protraction, particularly that using bone anchorage, has been proven to be an effective method for the stimulation of maxillary growth. However, the conventional procedure, which involves the surgical implantation of mini-plates, is traumatic and associated with a high risk. Three-dimensional (3D) digital technology offers the possibility of individualized treatment. Customized mini-plates can be designed according to the shape of the maxillary surface and the positions of the roots on cone-beam computed tomography scans; this reduces both the surgical risk and patient trauma. Here we report a case involving a 12-year-old adolescent girl with skeletal Class III malocclusion and midface deficiency that was treated in two phases. In phase 1, rapid maxillary expansion and protraction were performed using 3D-printed mini-plates for anchorage. The mini-plates exhibited better adaptation to the bone contour, and titanium screw implantation was safer because of the customized design. The orthopedic force applied to each mini-plate was approximately 400-500 g, and the plates remained stable during the maxillary protraction process, which exhibited efficacious orthopedic effects and significantly improved the facial profile and esthetics. In phase 2, fixed appliances were used for alignment and leveling of the maxillary and mandibular dentitions. The complete two-phase treatment lasted for 24 months. After 48 months of retention, the treatment outcomes remained stable.

• Korean Journal of Cleft Lip And Palate
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• v.12 no.2
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• pp.85-94
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• 2009

Cleft lip and palate patients show midface hypoplasia, maxillary hypoplasia due to scar of previous surgery, and manifest as a class III malocclusion, retruded midface and shallow palate. These deformities have been treated with traditional orthognathic surgery. Although conventional Le Fort I osteotomy was performed on most cleft patinets with midface hypoplasia, it showed limited amount of maxillary advancement and high relapse tendency. Recently, when great amount of advancement are required in severe maxillary hypoplasia, distraction osteogenesis using RED system is widely used. But, several months of consolidation period is needed after distraction osteogenesis, occlusal relationship is not stable until mandibular setback surgery has done in mandibular hyperplasia cases and during these period, patients may feel discomfort. We present clinical cases of immediate rigid internal fixation after completion of maxillary distraction using RED system and simultaneous mandibular setback procedure in adult cleft and lip patients who show both maxillary hypoplasia and mandibular prognathism.

• The korean journal of orthodontics
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• v.45 no.5
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• pp.245-252
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• 2015

Objective: To assess the labial and lingual alveolar bone thickness in adults with maxillary central incisors of different inclination by cone-beam computed tomography (CBCT). Methods: Ninety maxillary central incisors from 45 patients were divided into three groups based on the maxillary central incisors to palatal plane angle; lingual-inclined, normal, and labial-inclined. Reformatted CBCT images were used to measure the labial and lingual alveolar bone thickness (ABT) at intervals corresponding to every 1/10 of the root length. The sum of labial ABT and lingual ABT at the level of the root apex was used to calculate the total ABT (TABT). The number of teeth exhibiting alveolar fenestration and dehiscence in each group was also tallied. One-way analysis of variance and Tukey's honestly significant difference test were applied for statistical analysis. Results: The labial ABT and TABT values at the root apex in the lingual-inclined group were significantly lower than in the other groups (p < 0.05). Lingual and labial ABT values were very low at the cervical level in the lingual-inclined and normal groups. There was a higher prevalence of alveolar fenestration in the lingual-inclined group. Conclusions: Lingual-inclined maxillary central incisors have less bone support at the level of the root apex and a greater frequency of alveolar bone defects than normal maxillary central incisors. The bone plate at the marginal level is also very thin.

• Archives of Plastic Surgery
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• v.39 no.3
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• pp.198-202
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• 2012

Background : Maxillary hypoplasia refers to a deficiency in the growth of the maxilla commonly seen in patients with a repaired cleft palate. Those who develop maxillary hypoplasia can be offered a repositioning of the maxilla to a functional and esthetic position. Velopharyngeal dysfunction is one of the important problems affecting speech after maxillary advancement surgery. The aim of this study was to investigate the impact of maxillary advancement on repaired cleft palate patients without preoperative deterioration in speech compared with non-cleft palate patients. Methods : Eighteen patients underwent Le Fort I osteotomy between 2005 and 2011. One patient was excluded due to preoperative deterioration in speech. Eight repaired cleft palate patients belonged to group A, and 9 non-cleft palate patients belonged to group B. Speech assessments were performed preoperatively and postoperatively by using a speech screening protocol that consisted of a list of single words designed by Ok-Ran Jung. Wilcoxon signed rank test was used to determine if there were significant differences between the preoperative and postoperative outcomes in each group A and B. And Mann-Whitney U test was used to determine if there were significant differences in the change of score between groups A and B. Results : No patients had any noticeable change in speech production on perceptual assessment after maxillary advancement in our study. Furthermore, there were no significant differences between groups A and B. Conclusions : Repaired cleft palate patients without preoperative velopharyngeal dysfunction would not have greater risk of deterioration of velopharyngeal function after maxillary advancement compared to non-cleft palate patients.

• Journal of Periodontal and Implant Science
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• v.36 no.3
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• pp.639-651
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• 2006

This study was performed to investigate the survival rate of single implant used in maxillary anterior region during follow up periods. 231 patients whose single missing tooth in maxillary region had been replaced with 237 implant at the periodontal dept. of Yonsei University Hospital between February 1993 and December 2004. The following results are compiled from 231 patients who received single implant surgery. 1. The major cause of single tooth loss in maxillary anterior region is trauma, followed by periodontal disease and congenital missing. 2. The total survival rate of single implant placed in maxillary anterior region is 94.5%. 3. The survival rate of single implant placed in type II and type IV was 100% and in type III was 92.7%. As for the bone quantity, the survival rate in type A(100%) was most, followed by type B(97.3%) and type C, D (93.5%). 4. The survival rate of implant placement combined with advanced surgery was 94.4%. The results showed that the placement of single implant is considered as a reliable treatment option for a single missing tooth in maxillary anterior region except in certain extreme conditions especially with poor bone quality and quantity.

• Journal of Periodontal and Implant Science
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• v.24 no.1
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• pp.165-177
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• 1994

To investigate the depth of the root concavity and root surface area of the maxillary first premolar, 40 maxillary first premolars were used. All the teeth which extracted because of advanced periodontal disease and orthodontic treatment procedure, were sectioned every 1.5mm from cementoenameljunction to the apex with hard tissue microtome. Each sectioned root was taken photograph with slide film, and projected for measuring with a calibrated digital Curvi-Meter. The root surface area, percentage of the RSA and the linear variation of the RSA were calibrated for each 1.5mm section. Linear variation of the depth of root concavity was measured on mesial and distal root surface for each section using computer-aided digitizer. The results were as follows. 1. The total mean root length of maxillary first premolar was 13.48mm. Mean buccal root length of 2-rooted tooth was 12.59mm, mean palatal root length was 12.73mm, and mean root length of single rooted tooth was 13.78mm. 2. The total mean root surface area of maxillary first premolar was $194.17mm^2$, mean root surface area for 2-rooted tooth was $205.97mm^2$ and mean root surface area for single rooted tooth was $188.49mm^2$. 3. It was 59.93% of the total root surface area that the area from CEJ to coronal 6mm. And, the coronal half of the root length accounted for approximately 71.76% of the total root surface area. 4. Most deepest concavity of the mesial root surface was 0.65mm at apical 3.0mm, 4.5mm level in maxillary first premolar. And, that of the distal root surface was 0.37mm at apical 4.5mm level. 5. All of the maxillary first premolar had mesial root surface concavity. This mesial root surface concavity appeared to be more pronounced in 2-rooted tooth than single rooted tooth.