• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.27 no.4
• /
• pp.350-359
• /
• 2005

Sagittal split ramus osteotomy(SSRO) has been commonly performed in the mandibular prognathism. The previous studies of the mandibular anatomy for SSRO have mostly been used in dry skull without consideration of age, sex or jaw relationship of patients. This study was performed to evaluate the location of mandibular canal and the anatomy of ramus, such as the location of mandibular lingula and the ramal bone marrow, which were associated with SSRO procedures, in the patients with mandibular prognathism and normal young adults by using computerized tomographs(CT) and 3D images. The young adults at their twenties, who were considered to complete their skeletal growth, and seen in the Department of Orthodontics and Oral and Maxillofacial Surgery in Chonnam National University Hospital between March 2000 and May 2003, were selected. This study was performed in 30 patients (15men, 15women) who were diagnosed as skeletal class I normal relationship, and another 30 patients (15men, 15women) who were diagnosed as skeletal class III relationship upon clinical examination and lateral cephalometric radiographs. The patients were divided into 2 groups : Class I group, the patients who had skeletal class Ⅰ normal relationship(n=30, 15men, 15women), and Class III group, the patients who had skeletal class III relationship(n=30, 15men, 15women). Facial CT was taken in all patients, and pure 3D mandibular model was constructed by V-works version 4.0. The occlusal plane was designed by three points, such as the mesiobuccal cusp of both mandibular 1st molar and the incisal edge of the right mandibular central incisor, and used as a reference plane. Distances between the tip of mandibular lingula and the occlusal plane, the sigmoid notch, the anterior and the posterior borders of ramus were measured. The height of ramal bone marrow from the occlusal plane and the distance between mid-point of mandibular canal and the buccal or lingual cortex of the mandible in the 1st and 2nd molars were measured by V-works version 4.0. Distance(Li-OP) between the occlusal plane and the tip of mandibular lingula of Class III Group was longer than that of Class I Group in men(p<0.01), but there was no significant difference in women between both groups. Distance(Li-SN) between the sigmoid notch and the tip of mandibular ligula of Class III group was longer than that of Class I Group in men(p<0.05), but there was no significant difference in women between both groups. Distance(Li-RA) between the anterior border of ramus and the tip of mandibular lingula of Class III Group was shorter than that of Class I Group in men and women(p<0.01). Distance(Li-RP) between the posterior border of ramus and the tip of mandibular lingula of Class III Group was slightly shorter than that of Class I Group in men(p<0.05), but there was no significant difference in women between both groups. Distance(RA-RP) between the anterior and the posterior borders of ramus of Class III Group was shorter than that of Class I Group in men and women(p<0.01). Longer the distance(SN-AN) between the sigmoid notch and the antegonial notch was, longer the vertical ramal length above occlusal plane, higher the location of mandibular lingula, and shorter the antero-posterior ramal length were observed(p<0.01). Height of ramal bone marrow of Class III Group was higher than that of Class I Group in men and women(p<0.01). Distance between mandibular canal and buccal cortex of Class III Group in 1st and 2nd lower molars was shorter than that of Class I Group in men and women (p<0.05 in 1st lower molar in men, p<0.01 in others). These results indicate that there are some anatomical differences between the normal occlusal patients and the mandibular prognathic patients, such as the anterior-posterior length of ramus, the height of ramal bone marrow, and the location of mandibular canal.

• The korean journal of orthodontics
• /
• v.27 no.5 s.64
• /
• pp.697-709
• /
• 1997

This study was designed to investigate the stress intensity and distribution produced by 1mm activation of retraction archwire with $0^{\circ},\;7^{\circ},\;14^{\circ}$ torque and application of high polk J-hook headgear during retraction of four maxillary incisors using the photoelastic stress analysis. The photoelastic model was made with a PL-3 type epoxy resin which was substituted by alveolar bone portion. Each retraction archwire was fabricated from .020' X .025' stainless steel wire which had vertical loops in 7mm height and hooks for high pull J-hook headgear between central and lateral incisors. The high pull J-hook headgear was applied 35 degree backward and upward to occlusal plane with 200gm pet each side The findings of this study were as follows: 1. In case of $0^{\circ}$ torque, the stress was distributed from cervical 1/8 to apex of roots of central and lateral incisors which were the forms of arc mode. When the high pull J-hook headgear was applied, the stress distributed by arc mode was presented from cervical 1/2 to apex of roots of central and lateral incisors. And the stress distributed by following the root surface was presented from alveolar crest to cervical 1/2 of roots of central and lateral incisors. The stress between apecies of central and Lateral incisors was presented also. 2. In case of $7^{\circ}$ torque, the stress distributed by arc mode was presented from cervical 1/2 to apex of roots of central and lateral incisors. And the stress distributed by following the root surface was presented from alveolar crest to cervical 1/2 of roots of central and lateral incisors. When the high pull J-hook headgear was applied, the stress distributed by following the root surface was presented mote apically than without headgear. The stress between apecies of central and lateral incisors was presented also. 3. In case of $14^{\circ}$ torque, the stress distributed by following the root surface was Presented from alveolar crest to apex of roots of central and lateral incisors. When the high pull J-hook headgear was applied, the stress distributed by following the root surface was presented stronger than without headgear The stress between apecies of central and lateral incisors was presented also.

• The korean journal of orthodontics
• /
• v.30 no.5 s.82
• /
• pp.657-668
• /
• 2000

The purpose of this study was to evaluate the amount and interrelationship of the soft tissue of nose and maxillary changes and to identify the nasal morphologic features that indicate susceptibility to nasal deflection in such a manner that they would be useful in presurgical prediction of nasal changes after maxillary advancement surgery in skeletal Class III malocclusion. The sample consisted of 25 adult patients (13 males and 12 females) who had severe anteroposterior skeletal discrepancy. The patients had received presurgical orthodontic treatment. They underwent a Le Fort I advancement osteotomy, rigid internal fixation, alar cinch suture and V-Y advancement lip closure. The presurgical and postsurgical lateral cephalograms and lateral and frontal facial photographs were evaluated. The computerized statistical analysis was carried out. Soft tissue of nose change to h point change ratios were calculated by regression equations. The results were as follows 1. The correlation of maxillary hard tissue horizontal changes and nasal soft tissue vortical changes were high and the ${\beta}_0$ for soft tissue to ADV were 0.228 at ANt, 0.257 at SNt. 2. The correlation of maxillary hard tissue and nasal soft tissue horizontal changes were high and the ${\beta}_0$ for soft tissue to ADV were 0.484 at ANt, 0.431 at SNt, 0.806 at Sn. 3. The correlation of maxillary hard tissue horizontal changes and width changes of ala of nose were high and the ${\beta}_0$ lot alar base width ratio to ADV were 0.002. 4. The DRI, Prominence of nose, Pre-Op CA is not a quantitative measure that can be used clinically to improve the predictability of vertical and horizontal nasal tip deflection. In this study, increases in nasal tip projection and anterosuperior rotation occur when there is an anterior vector of maxillary movement. These nasal changes were Quantitatively correlated to magnitude of maxillary(A point) movement.

• The korean journal of orthodontics
• /
• v.26 no.4
• /
• pp.359-371
• /
• 1996

The purpose of this study was to investigate the changes about the cellular activity on DNA synthesis in the periodontal ligament of dog, in which experimental tooth movement was performed. A control and 5 experimental dogs, one and half year in age, were studied. Light force (50-75g) was applied by placing open-coil spring between left mandibular premolars ; heavy force (250-300g), between right mandibular premolars. Experimental dogs were sacrificed after infusion of bromodeoxyuridine(BrdU), at 12 hours, 1, 3, 7 and 14 days after force application, respectively. And the histologic and the immunohistochemical evaluation were performed on the obtained periodontal tissue around mandibular premolars, using anti-romodeoxyuridine antibody, which can indicate proliferating cells. The results were as follows: 1. The tearing of periodontal ligament and the vascular dilatation at tension side were observed in 12 hours, increasing until 3 days. After then it decreased; Such a finding was more evident in heavy force group than in light force group. 2. The hyalinization of the periodontal ligament and the activity of osteoclast at pressure side were observed in 12 hours, increasing until 3 days. But from 7 days on, it decreased; Such a finding was more evident in heavy force group than in light force group. 3. The BrdU expression in the control group was positive, mainly in the oral epithelium and the fibroblasts in the periodontal ligament, but negative in bone cells in periodontal ligament. 4. The BrdU expression in the experimental group was more positive in tension side than in pressure side; The expression was a little more positive in the periapical area than in the cervical area of tooth. 5. The BrdU expression in light force group was the highest in 1 day, after which it decreased; In heavy force group, it was the highest in 12 hours, after which it decreased. But in 14 days, there was no difference between the experimental group and control group.

• The korean journal of orthodontics
• /
• v.27 no.2
• /
• pp.209-219
• /
• 1997

This investigation was designed to analyze the degree of dental compensation according to horizontal components of craniofacial skeleton and to investigate correlation between dental compensation and craniofacial pattern in skeletal class III malocclusion. The material selected for this study consisted of standard lateral cephalogram of 59 subjects in normal occlusion group, 91 subjects in mild skeletal class III malocclusion group and 58 subjects in severe skeletal class III malocclusion group. The mild skeletal class III malocclusion group was divided into two groups, one was class III malocclusion without anterior crossbite group and the other was class III malocclusion with anterior crossbite group. The data were analyzed by Quick-ceph image program. The results were as follows. 1. Mild skeletal class III malocclusion without anterior crossbite group showed the most labial inclination of upper incisors, followed by severe skeletal class III malocclusion group and mild skeletal class III malocclusion with anterior crossbite group, the Latter showing the least. The amount of lingual inclination of lower incisors was the largest in severe skeletal class III malocclusion group, and there was no statistically significant difference between mild skeletal claw III malocclusion without anterior crossbite group and mild skeletal class III malocclusion with anterior crossbite group. 2. There were little differences in vertical skeletal structure between mild skeletal class III malocclusion without anterior crossbite group and mild skeletal class III malocclusion with anterior cwssbite group, they showed statistically significant differences in the upper incisors measurements. 3. The measurements of lower incisors in mild skeletal class III malocclusion without anterior crossbite group and upper incisors in mild skeletal class III malocclusion with anterior crossbite group represented a high correlation with skeletal structure. Especially, ∠IMPA and ∠FMIA of lower incisor measurements, and ∠U1-FH ∠U1-SN of upper incisor measurements showed high correlation with skeletal structure in each group. 4. ∠IMPA and ∠FMIA of lower incisor measurements showed high correlation with skeletal structure in all groups. ∠U1-FH, ∠U1-SN and U1-facial plane(mm) of upper incisor measurements represented higher correlation with skeletal structure than any other upper incisor measurements.

• The korean journal of orthodontics
• /
• v.29 no.2 s.73
• /
• pp.239-249
• /
• 1999

In orthognathic surgery to obtain proper functional and esthetic form after skeletal discrepancy treatment, precise diagnosis and treatment plan are essential. Especially in two jaw surgeries that have serious upper and lower jaw problems, maxilla and mandible are arranged in three dimensions. Based on the maxillary rearrangement, mandibular sagittal and transverse positions are determined, and thus new occlusal plane is established. The object of this study is to evaluate the stability of the indiviual ideal occlusal plane based on the architectural and structural craniofacial analysis of Delaires. The subjects of this study were 48 patients who underwent two jaw surgeries, and they were equally divided into two groups, A and B. A group was operated with ideal occlusal plane and B group was not. Two groups were compared at the preoperative, immediate postoperative (average 4.3days), and long-term postoperative (average 1.3years) lateral cephalometric radiographs. The following results were obtained: 1. ANS was lower than that of PNS for both A and B after the surgery. That is, maxilla and mandible are rotated in posterior and superior direction. 2. Significances were found between $T_2$ and $T_3$ for both A and B are HRP-Me at vortical measurements, articular angle(p<0.01), gonial angle(p<0.01), and Mn. plane angle(p<0.05) at angular measurement. Mn. plane angle is increased at HRP-Me is decreased for both A and B. 3. There is no significance in skeletal stability aster the surgery between group A and B. 4. Horizontal movements of B and Pog by surgery have statistically significant inverse correlations with horizontal relapse of B and Pog, and vertical relapse of PNS, as well as Mn. Plane angle, and gonial angle after the surgery.

• The korean journal of orthodontics
• /
• v.29 no.5 s.76
• /
• pp.627-635
• /
• 1999

Soft tissue changes that occurred between presurgery to 5-years post-surgery in 49 orthognathic surgery patients whose maxillae were moved upward by Le Fort I osteotomy were examined by lateral cephalometric film. The objective of this paper was to document soft tissue changes at long-term follow-up after superior repositioning of the maxilla and to relate soft tissue and hard tissue changes in this group. The results were as follows. 1. On average, soft tissue landmarks in the nose and the upper lip were not changed statistically significantly except superior movement of superior labial sulcus and forward movement of pronasale between presurgery and 5 years postsurgery. 2. Upward and forward movement of the lower lip were found at 5 years postsurgery in comparison with presurgery and genioplasty added this effects. 3. Upper lip length and vertical dimension of upper vermilion didn't show any significant changes, but increase of lower lip length and decrease of vertical dimension of lower vermilion were statistically significant between presurgery and 5 years post-surgery. 4. The decrease of upper incisor exposure and interlabial distance from presurgery to 1 year were continued from 1 year to 5 years and the amount of the decrease was more than that of vertical movement of the maxilla by surgery. 5. Long term changes in soft tissue landmarks from 1 to 5 years postsurgery exceeded hard tissue changes, meaning soft tissue moved down more than skeletal changes.

• The korean journal of orthodontics
• /
• v.27 no.3 s.62
• /
• pp.391-399
• /
• 1997

Rapid palatal expansion(RPE) is a method of inducing the new bone formation in the palate by separation of the midpalatal suture, which can be done conveniently by placing heavy force across the maxillary dental arch. This experiment was undertaken to examine the histologic changes after RPE and during retention period. Four young adult dogs(a control dog, three experimental dogs) aged 4 to 6 months old were used for this experiment. Expansion screw($Hyrax^{\circledR}$, Dentarum Inc.) was delevered to the palate and fumed 180 degrees every morning and evening for 8 days, giving a total expansion of 7.2mm. A control dog was sacrified at the starting point of this study without any treatment and three experimental dogs were sacrified after RPE, 14-day retention, and 28-day retention in each. Thereafter, those samples were observed with hematoxylin-eosin(H-E) stain, ground section(Villanueva stain), alkaline phosphatase(ALP) stain, tartrate-resistant acid phosphatase(TRA) stain. The results were as followings: 1. After RPE, collagen fiber bundles were stretched along the midpalatal suture and few osteoblasts were flattened-inactive state and also, a little osteoid tissues was observed. Few multinucleated osteoclasts which had TRAP-positive activity in their cytoplasm were seen in horizontal section, whereas a few osteoclasts were seen in frontal section, especially in the nasal floor side of palatal bone. 2. After 14-day retention, collagen fiber bundles were stretched along the midpalatal suture and few osteoblasts which had ALP-positive activity in their cytoplasm were seen. Few multinucleated osteoclasts which had TRAP-positive activity in their cytoplasm were seen in horizontal section, whereas a few osteoclasts were seen in frontal section, especially in the nasal floor side of palatal bone. 3. After 28-day retention, collagen fiber bundles were arranged like those of control dog and osteoblasts which showed a lot of immature bone formation were cuboidal shape and exhibited ALP-positive activity in their cytoplasm. Few multinucleated osteoclasts which had TRAP-positive activity in their cytoplasm were seen in horizontal section, whereas a few osteoclasts were seen in frontal section, especially in the nasal floor side of palatal bone. According to the above results, the new bone formation after rapid palatal expansion was examined after 14-day retention and significantly increased after 28-day retention.

• The korean journal of orthodontics
• /
• v.33 no.5 s.100
• /
• pp.359-370
• /
• 2003

The purpose of this study was to evaluate the bond strength of orthodontic brackets bonded to metal bar with chemically cured adhesive (Ortho-one, Bisco Co, USA) in various types and directions of force application. Three types of metal bracket with different bracket base configurations; Micro-Loc base(Tomy Co, Japan), Chessboard base(Daesung Co, Korea), Non-etched Foil-Mesh base(Dentaurum, Germany); were used in this study. Peel, shear, tensile bond strengths were measured by universal testing machine and compared each other. The peel force directions applied were $0^{\circ},\;15^{\circ},\;30^{\circ},\;45^{\circ},\;60^{\circ},\;75^{\circ},\;90^{\circ}$ And then, in consideration of the different surface area of the bracket bases, the bond strength Per unit area were calculated and compared. The results obtained were summarized as follows: 1. The bond strengths according to the types and the directions of the forces were greatest at the shear forces in all three bracket base configuration groups(p<0.01). 2. As the peel force direction grew higher in degree, peel bond strength decreased. The Patterns of peel bond strength change according to force direction was similar in all three bracket base configurations. The minimum bond strength was 60 degree-peel bond strengths in all three bracket base configurations. 3. In Micro-Loc base group, minimum peel bond strength$(_{60}PBS)$ was in $29\%$ level of shear bond strength and $52\%$ level of tensile bond strength. In Chessboard base group, $_{60}PBS$ was in $34\%$ level of shear bond strength and $61\%$ level of tensile bond strength. In Non-etched Foil-Mesh base group, $_{60}PBS$ was in $34\%$ level of shear bond strength and $55\%$ level of tensile bond strength. 4. The bond strengths per unit area were lowest in Non-etched Foil-Mesh base group and highest in Chessboard base group(p<0.05). However, there were no differences in shear bond strength, tensile bond strength, $75^{\circ}\;and\;90^{\circ}$ per unit area between Micro-Loc and Chessboard base groups.

• The korean journal of orthodontics
• /
• v.31 no.5 s.88
• /
• pp.517-523
• /
• 2001

Titanium miniscrews we being used increasingly as an anchorage for tooth movement, because they ate easy to place and to remove, increase the number of sites available, give minimum strain to patients regarding surgical procedures, and offer uneventful healing alter removal. The use of titanium miniscrews as an orthodontic anchorage has been reported in clinical case reports, but clinicians have experienced screw loosening when using such screws.' To our knowledge, there are no published reports evaluating the stability of miniscrews. Information about the length of miniscrews used in relation to the location is of some importance, as stability will vary depending on bone duality The purpose of this study was to evaluate a variety of Lengths of miniscrews (dimeter: 2mm) which were inserted in maxilla or mandible and to demonstrate in a dog model which miniscrew provides fundamental stability in the jaws. 10 mm long miniscrews in the maxilla and 8mm long: miniscrews in the mandible showed no clinical mobility and retained their position throughout an 8 weeks force (200g) application. The mucosal condition around the screws was healthy in cases in which miniserews were inserted in the alveolar bone between the roots and the head of the screws emerged into the attached gingiva. When the force application was terminated, radiographic analysis revealed neither rent resorption not periodontal pathology around the miniscrews that remained stable during the entire treatment period. This study suggests that if titanium miniscrews with adequate length are properly used depending on the location, they provide sufficient stability for orthodontic anchorage.