• 치과방사선
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• 제20권2호
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• pp.201-210
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• 1990

The purpose of this study was to observe the relationship between mandibular asymmetry and Temporomandibular Disorders by means of the cephalometry using the posteroanterior cephalogram and the submentovertex cephalogram which were taken in 35 Temporomandibular Disorder patients and 35 normal persons ranged from 20S to 30S. The results were as follows: 1. The angulation which was formed by the median line with the ANS-Menton line (MAP) was greater in patients group and there was statistically significant difference. 2. The angulation which was formed to the median line with the Menton-Odontoid process tip line (MES), the difference of the distances from the center of the posterior surface of the both condyles to the most anterior point of the chin (DD), the difference of the distances from the center of the both condyles to the horizontal reference line (DE), the difference of the angulations which were formed by the both condyles axes with the horizontal reference line (DCE), the difference of the lengths of the both condyles (CL) and the difference of the widths of the both condyles (DW) were greater in patients group and there were statistically significant differences. There was reversed correlation between MAP and the difference of the distances from the 3. bilateral points of the lateral margin of the both zygomaticofrontal sutures to the at the lateral inferior margin of the both antegonial protuberances in mandible (DH). There was reversed correlation between MES and DD, DE, DCE. 5. There was correlation between MAP and MES.

• 치과방사선
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• 제21권2호
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• pp.235-248
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• 1991

This study was designed to evaluate the diagnostic effect of the simulatneous multifilm individualized lateral tomography in the diagnosis of the temporomandibular disorders. The subjects consisted of 29 patients with symptoms of the temporomandibular disorders. The panoramic view, oblique lateral transcranial radiograph (OLTC) (Hirozontal angulation 0°, Vertical angulation 29°), submentovertex view, and simultaneous multifilm individualized lateral tomographs (SMFI) in centric occlusion (2.5㎜ thickness difference, 5 layers) were taken for the patients. This study compared the findings from each radiographs in the determining of mandibular condylar position with dual linear measurement of the subjective closest posterior and subjective closest anterior interarticular space and in the determining of bony changes on the studied 30 temporomandibular joints (TMJ) with symptoms of the temporomandibular disorders. The results were as follows: 1. The distribution of condylar position of OLTC and 5 layers of SMFI depended on the radiographs (p<0.05). The condylar position and the distribution of condylar position of OLTC were more similar to lateral sections of the SMFI than mesial sections, and in the distribution of the condylar position of SMFI, the more lateral sections of SMFI, the more concentric 2. positions. There were 10 cases in which all layers showed the same condylar position as that of OLTC. There were 3 cases in which no layers showed the same condylar position as that of OLTC. 3. In the SMFI of 30 Temporomandibular joints studied, there is 13 cases in which all five layers represented the same condylar position in the same TMJ and 11 cases in which 4 layers represented the same condylar position in the same TMJ and 6 cases in which 3 layers represented the same condylar position in the same TMJ. So at least 3 layers of SMFI represented same condylar position in the same TMJ. 4. The bony changes were not detected in conventional radiographs on the temporomandibular joint and the bony changes were not detected in simultaneous multifilm individualized lateral tomographs. The bony changes were detected in conventional radiographs on the temporomandibular joint and the bony changes were detected in simultaneous multifilm individualized lateral tomographs. SMFI provided a meams for a three dimensional visualization of the shape, the position and the extent of bony changes of TMJ.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권6호
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• pp.622-627
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• 2008

In orthognathic surgery, precise analysis and diagnosis are essential for successful results. In facial asymmetric patient, traditional 2D image analysis has been used by lateral and P-A Cephalometric view, Skull PA, Panorama, Submentovertex view etc. But clinicians sometimes misdiagnose because they cannot find exact landmark due to superimposition, moreover image can be magnified and distorted by projection technique or patient's skull position, when using these analysis and method. For overcome these defects, analysis by using of 3D CT has been introduced. In this way we can analysis precisely by getting the exact image free of artifact and finding exact landmark with no interruption of superimposition. So we want to review of relationship between various skeletal landmarks of mandible or cranial base and facial asymmetry by predictable analysis using 3D CT. We select the cases of the patients who visited our department for correction of facial asymmetry during 2003-2007 and who were taken image of 3D CT for diagnosis. 3D CT images were reconstructed to 3D image by using V-Work program (Cybermed Inc., Seoul, Korea). And we analysis the relationship between facial asymmetry and various affecting factor of skeletal pattern. The mandibular ramus hight difference between right and left was most affecting factor that express facial asymmetry. And in this research, there was no relationship between cranial base and facial asymmetry. The angulation between facial midline and mandibular ramus divergency has significant relationship with facial asymmetry

• 치과방사선
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• 제18권1호
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• pp.81-136
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• 1988

The aim of this study was to determine whether T.M.J. tomographic examination yielded significant differences in condyle positions among asymptomatic, myalgia, derangement, and arthrosis groups of T.M.J. disorders. The author obtained sagittal linear tomograms of right and left T.M.Js. of 36 asymptomatic, 22 myalgia, 54 derangement, and 31 arthrosis patients taken at serial lateral, central, and medial sections in the intercuspal position after submentovertex radiographs analyzed. With the dual linear measurements of the posterior and anterior interarticular space, condyle positions were mathematically expressed as proportion. All data from these analysis was recorded and processed statistically. The results were obtained as follows. 1. In asymptomatic group, radiographically concentric condyle position was found in 50.0% to 65.4% of subjects, with a substantial range of variability. No significant differences existed between men and women and also between right and left T.M.Js. for condyle position. 2. In women, significant difference for mean condyle position of left lateral section of each diagnostic category existed between derangement and myalgia groups (P<.05). Also that of left central section existed between derangement and myalgia groups, and that of left medial section existed between derangement and myalgia groups (P<.05). 3. In main-symptom side, condyle position in myalgia group was more concentric, and condyle position in derangement group was more posterior. This showed significant differences between derangement and myalgia groups in lateral, central, and medial sections of main- symptom sides, and only between derangement and myalgia groups in central section of contra-lateral sides (P<.05). Condyle position in arthrosis group was broadly distributed among all positions. 4. In contra-lateral side, significant difference for mean condyle position of central section of each symptomatic group existed between derangement and myalgia groups (P<.05). Condyle position in derangement group was more posterior. The distribution of the condyle position of contra-lateral side in patients with unilateral symptoms was similar to that of main-symptom side in each symptomatic group. No significant difference existed between main-symptom and contra-lateral sides. 5. For internal derangement subgroups, condyle position in reducible disc displacement group was more posterior than non-reciprocal and locking groups, but there was no significant difference. 6. From 16 to 25 years, significant difference for mean condyle position of medial section of main-symptom side of each symptomatic group existed between myalgia and derangement groups (P<.05).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권2호
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• pp.108-120
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• 2004

Object : Patients with facial asymmetry accompanying mandibular prognathism have various causes and clinical features. So, it is difficult to find a satisfactory treatment method functionally and esthetically. Every traditional classification and interpretation to find etiopathogenesis and/or to establish ideal surgical modality has many limitations because it can't be applied simply to various conditions of patients with facial asymmetry accompanying mandibular prognathism. Therefore, we employ a new classification to interpret more details of the morphologic change of mandible and the spatial change of mandible and maxilla. Materials and Methods : Using panoramic X-ray films, PA cephalograms and submentovertex films of 126 patients diagnosed with facial asymmetry accompanying mandibular prognathism as resources, the following results were gathered after analyzing each characteristics through distributing the patterns according to the morphological mandibular asymmetry and mandibular and maxillary spatial asymmetry. Results : Almost frequency of morphological mandibular asymmetry was shown. In case of condyle-ramus elongation and body elongation group, it's frequency was the highest. Higher frequency of compensating vertical growth was shown on the side of over growing maxilla in case of vertical length difference between left and right condyle-ramus. On the other hand, higher frequency of no compensating vertical growth difference between left and right side was shown in case of no vertical length difference in condyle-ramus. Spatial mandibular asymmetry generally occurred when there was no morphological mandibular asymmetry. Correlation between condyle length difference and condyle-ramus length difference between left and right side was very high, but correlation between condyle length difference and body length difference, and correlation between condyle length difference and body vertical length difference was low. Conclusion : In case of patients with facial asymmetry accompanying mandibular prognathism, it is suggested that various pattern of facial asymmetry is occurred by the independent growth of each unit rather than dependent growth of other unit by major growth unit abnormality. Due to the untypical pattern and the various asymmetry occurring according to the changes of each mandibular growth unit, it is considered that an appropriate surgical method should be searched based on the accurate recognition of the each pattern for patients with facial asymmetry accompanying mandibular prognathism.

• Journal of Oral Medicine and Pain
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• 제24권1호
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• pp.25-36
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• 1999

저자는 이하두정방사선사진 (願下頭頂放射線寫眞, submentovertex radiographs)을 이용하여 하악과두의 수평각과 측두하악장애와의 연관성을 평가하고자 측두하악장애의 병력 및 증상이 없고, 자연치열로 형성된 정상교합을 가진 성인 34명과 전북대학교병원 구강내과에 내원한 측두하악장애환자 38명을 대상으로, 환자군을 임상검사 및 방사선학적 검사를 통해 편측 정복성 관절원판 전방변위 환자군, 양측 정복성 관절원판 전방변위 환자군 및 편측 비정복성 관절원판 전방변위 혹은 골관절염 환자군으로 세분한 후, 좌우측 외이도의 위치를 확인할 수 있도록 소강구 (小鋼球)가 내재된 장치물을 이용하여 채득한 규격화된 이하두정방사선사진상에서 하악과두의 내측극과 외측극을 이은 선과 양측 외이공에 위치한 소강구를 이은 선으로부터 하악과두의 수평각을 측정하였다. 평가 결과 정상군에서의 좌(평균 25.3도), 우(평균 24.8도)측 하악과두의 수평각 (평균 25.0도)은 유의한 차이를 보이지 않았으며 환자군에서는 이환측 하악과두의 수평각 (평균 28.5도)이 비이환측 하악과두 (평균 26.2도)보다 유의성있게 증가된 수치를 보였다 (p<0.05). 또한 환자군 (평균 27.55도)에서의 하악과두의 수평각이 정상군 (평균 25.0도)에서 보다 유의하게 증가된 수치를 보였다 (p<0.05). 임상적으로 세군으로 구분된 환자군의 경우, 각군의 이환측 또는 비이환측, 각 군을 합한 이환측 또는 비이환측의 경우에 있어서도 정상군에서 보다 하악과두 수평각이 유의성있게 증가된 수치를 보였다 (p<0.05). 세가지로 구분된 환자군 각각의 상호 비교에 있어서는 유의성있는 차이를 나타내지 않았다. 그리고 편측으로 이환된 환자군에서의 이환된 수평각 (평균 29.1도)은 비이환측 (평균 26.2도)보다 유의성있게 증가된 수치를 보였으나 (p<0.05), 양측으로 이환된 환자군에서의 좌우측 수평각은 유의한 차이를 보이지 않았다. 이로써 측두하악장애의 진단 차원에서 측두하악장애를 유발하는 여러 요소 중외 하나로 하악과두 수평각에 대한 평가가 고려되어야 할 것으로 사료된다.