• Title/Summary/Keyword: Skeletal Class III malocclusion

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Evaluation of the stability of maxillary expansion using cone-beam computed tomography after segmental Le Fort I osteotomy in adult patients with skeletal Class III malocclusion

  • Kim, Hoon;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.48 no.1
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    • pp.63-70
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    • 2018
  • Objective: The aim of this study is to quantitatively evaluate the stability of the skeletal and dental widths using cone-beam computed tomography (CBCT) after segmental Le Fort I osteotomy in adult patients with skeletal Class III malocclusion requiring maxillary expansion. Methods: In total, 25 and 36 patients with skeletal Class III malocclusion underwent Le Fort I osteotomy (control group) and segmental Le Fort I osteotomy (experimental group), respectively. Coronal CBCT images were used to measure the dental and skeletal widths before (T1) and after (T2) surgery and at the end of treatment (T3). The correlation between the extent of surgery and the amount of relapse in the experimental group was also determined. Results: In the control group, the dental width exhibited a significant decrease of $0.70{\pm}1.28mm$ between T3 and T2. In the experimental group, dental and skeletal expansion of $1.83{\pm}1.66$ and $2.55{\pm}1.94mm$, respectively, was observed between T2 and T1. The mean changes in the dental and skeletal widths between T3 and T2 were $-1.41{\pm}1.98$ and $-0.67{\pm}0.72mm$, respectively. There was a weak correlation between the amount of skeletal expansion during segmental Le Fort I osteotomy and the amount of postoperative skeletal relapse in the experimental group. Conclusions: Maxillary expansion via segmental Le Fort I osteotomy showed good stability, with a skeletal relapse rate of 26.3% over approximately 12 months. Our results suggest that a greater amount of expansion requires greater efforts for the prevention of relapse.

Comparison of Dental Age and Skeletal Maturity in Korean Children with Skeletal Malocclusion (한국 어린이의 골격적 부정교합에 따른 골 성숙도와 치아의 성숙도 비교)

  • Kim, Jeeyoun;Oh, Sohee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.3
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    • pp.225-232
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    • 2014
  • The purpose of this study was to compare skeletal maturity index and dental developmental stages based on skeletal malocclusion. A total of 192 patients (89 male and 103 female) between 6 to 14 years old were selected for this study and underwent cephalograms, panorama radiographs, and hand-wrist radiographs. Any syndromic cases were excluded. Selected clinical parameters were dichotomised for statistical analysis. Chi-square, logistic regression analysis, and independent t-tests were used for the statistical evaluation. Canine, first molar, and second molar calcification were significantly associated with skeletal maturity in the logistic regression model (p < 0.05). In addition, patients who had higher skeletal maturity index were 11.43 times more likely to be female than those who had lower skeletal maturity index (p < 0.001). The patients with skeletal class II malocclusion displayed significantly higher dental developmental stage in canines, first premolars, first molars, and second molars than the patients with class III malocclusion (p < 0.05). The dental developmental stage of the patients was significantly associated with skeletal maturity. In addition, there was a significant difference between class II and class III malocclusion with some types of tooth calcification.

Maxillomandibular arch width differences at estimated centers of resistance: Comparison between normal occlusion and skeletal Class III malocclusion

  • Koo, Yun-Jin;Choi, Sung-Hwan;Keum, Byeong-Tak;Yu, Hyung-Seog;Hwang, Chung-Ju;Melsen, Birte;Lee, Kee-Joon
    • The korean journal of orthodontics
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    • v.47 no.3
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    • pp.167-175
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    • 2017
  • Objective: To evaluate the differences in maxillomandibular transverse measurements at either the crown or the estimated center of resistance (CR), and to compare values between normal occlusion and Class III malocclusion groups. Methods: Dental casts and computed tomography (CT) data from 30 individuals with normal occlusion and 30 with skeletal Class III malocclusions were evaluated. Using the casts, dental arch widths (DAWs) were measured from the cusp tips, and basal arch widths (BAWs-cast) were measured as the distance between the points at the mucogingival junction adjacent to the respective cusp tips. The BAWs determined from CT (BAWs-CT) images were measured from the estimated CRs of the teeth. Results: None of the DAW measurements or maxillomandibular DAW differences showed statistically significant intergroup differences. In contrast, the maxillary BAWs-CT and BAWs-cast were lesser in the Class III malocclusion group than in the normal occlusion group. The mandibular BAWs-CT were significantly greater in the Class III malocclusion group than in the normal occlusion group. Moreover, the maxillomandibular BAW differences on both CT and cast showed significant intergroup differences in all transverse measurements. Conclusions: The maxillomandibular DAW differences showed no significant intergroup differences. In contrast, the maxillomandibular BAW differences on both CT and cast showed significant intergroup differences in all transverse measurements. The maxillomandibular BAW differences at the estimated CRs, measured using CT or casts, can reveal underlying transverse maxillary basal arch deficiencies in patients with skeletal Class III malocclusions.

Minimum presurgical orthodontic treatment: The influence of the postsurgial occlusal stability on postsurgical mandibular changes in class III malocclusion (임상가를 위한 특집 2 - 최소술전교정: 수술교합의 안정성이 술후 하악골 위치변화에 미치는 영향)

  • Kim, Byoung-Ho
    • The Journal of the Korean dental association
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    • v.50 no.2
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    • pp.64-71
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    • 2012
  • Recently, the presurgical orthodontic duration tends to be shortened by virtue of the advancement of surgical and orthodontic techniques in class III orthognathic surgery cases. But the predictability of the surgical results should be secured by removing several uncertain factors in presurgical orthodontic treatment. The purpose of this study is to investigate the influence of immediate postsurgical occlusal stability on postsurgical mandibular change. The study includes 40 patients who underwent orthognathic surgery to correct skeletal class III malocclusion. The patients were divided into two groups based on the numbers of occlusal contact in surgical setup occlusion: group 1 (stable surgical occlusion, n=24) and group 2(unstable surgical occlusion, n=16). Changes of horizontal and vertical mandibular measurements during postsurgical follow up period(from 1 week postsurgery to 12month after debonding) were compared to examine the differences between two groups. The stability of surgical occlusion is one of the factors influencing postsurgical mandibular changes in class III malocclusion. The various class III malocclusion cases have specific prerequisites for the orthognathic surgery according to the skeletal patterns. The prerequisites should be obtained by minimum presurgical orthodontics to increase the predictability of the surgical results.

The Evaluation of TMJ Status after Orthognathic Surgery for Skeletal Class III Malocclusion (악교정 수술을 받은 골격성 III급 부정교합 환자의 악관절 상태에 관한 연구)

  • Son, Woo-Sung;Jung, Choong-Bo;Kim, Jong-Ryoul
    • Journal of Dental Rehabilitation and Applied Science
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    • v.22 no.4
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    • pp.289-300
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    • 2006
  • This study was performed to investigate the influence of orthognathic surgery on the temporomandibular dysfunction in skeletal class III malocclusion. The temporomandibular joint status in 22 patients(mean age: 23.7 years) who received orthognathic surgery such as mandibular BSSRO(14 patients), maxillary Le Fort I osteotomy with mandibular BSSRO(8 patients) was evaluated by craniomandibular index. All these patients received orthognathic surgery at least 6 months ago. The mean score and standard deviation was obtained and compared with that of 22 normal individuals(mean age: 24.8years) by Student's t-test. In mandibular movement, the score of orthognathic surgery group was higher than that of the normal group. All the items except mandibular movement did not show any differences between the two groups.

SKELETAL MATURITY AND MANDIBULAR THIRD MOLAR DEVELOPMENT IN CLASS III MALOCCLUSION (III급 부정교합 어린이의 수완부 골성숙과 하악 제3대구치 발육에 대한 연구)

  • Kang, Keun-Young;Yang, Kyu-Ho;Choi, Nam-Ki;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.235-242
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    • 2008
  • The purpose of this study was to investigate the relationship of the skeletal maturity of hand-wrist and the development of mandibular third molar in subjects with class I and class III malocclusion. The subjects used in this study were 304 children(149 boys, 155 girls) with class I malocclusions and 308 children( 153 boys, 155 girls) with class III malocclusions, ranged from 8 to 15 years of age. Hand-wrist radiographs and panoramic radiographs were used to evaluate the stage of skeletal maturity and teeth development. Fishman's method for the skeletal maturity stages of the hand-wrist and new six-developmental-stage method for the calcification stages of mandibular third molars were analyzed. The results were as follows : 1. In subjects with class I and class III malocclusion, skeletal maturity of the hand-wrist occured earlier in females than in males(p<0.05), while the calcification stages of mandibular third molars were no significant gender differences. 2. There were no significant differences between the groups, when comparing the skeletal maturity stages of the hand-wrist and the calcification stages of mandibular third molars between subjects with the class I and the class III malocclusion. 3. The correlation coefficients between the calcification stages of mandibular third molars and the skeletal maturity stages of the hand-wrist in subjects with class I and class III malocclusion showed a high interrelationship(p<0.01). 4. The correlation coefficients between the calcification stages of mandibular third molars and chronological age in subjects with class I and class III malocclusion showed a high interrelationship (p<0.01). As a result, there were no significant differences between class I and class III malocclusion group for skeletal maturity of the hand-wrist and third molar development.

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Comparison of changes in the transverse dental axis between patients with skeletal Class III malocclusion and facial asymmetry treated by orthognathic surgery with and without presurgical orthodontic treatment

  • Song, Han-Sol;Choi, Sung-Hwan;Cha, Jung-Yul;Lee, Kee-Joon;Yu, Hyung-Seog
    • The korean journal of orthodontics
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    • v.47 no.4
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    • pp.256-267
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    • 2017
  • Objective: To evaluate transverse skeletal and dental changes, including those in the buccolingual dental axis, between patients with skeletal Class III malocclusion and facial asymmetry after bilateral intraoral vertical ramus osteotomy with and without presurgical orthodontic treatment. Methods: This retrospective study included 29 patients with skeletal Class III malocclusion and facial asymmetry including menton deviation > 4 mm from the midsagittal plane. To evaluate changes in transverse skeletal and dental variables (i.e., buccolingual inclination of the upper and lower canines and first molars), the data for 16 patients who underwent conventional orthognathic surgery (CS) were compared with those for 13 patients who underwent preorthodontic orthognathic surgery (POGS), using three-dimensional computed tomography at initial examination, 1 month before surgery, and at 7 days and 1 year after surgery. Results: The 1-year postsurgical examination revealed no significant changes in the postoperative transverse dental axis in the CS group. In the POGS group, the upper first molar inclined lingually on both sides (deviated side, $-1.8^{\circ}{\pm}2.8^{\circ}$, p = 0.044; nondeviated side, $-3.7^{\circ}{\pm}3.3^{\circ}$, p = 0.001) and the lower canine inclined lingually on the nondeviated side ($4.0^{\circ}{\pm}5.4^{\circ}$, p = 0.022) during postsurgical orthodontic treatment. There were no significant differences in the skeletal and dental variables between the two groups at 1 year after surgery. Conclusions: POGS may be a clinically acceptable alternative to CS as a treatment to achieve stable transverse axes of the dentition in both arches in patients with skeletal Class III malocclusion and facial asymmetry.

AN ELECTROMYOGRAPHIC STUDY OF MUSCLE ACTIVITY IN NORMAL OCCLUSION AND SKELETAL CLASS III MALOCCLUSION IN ADULT (성인에서 골격형 III급 부정교합자와 정상교합자의 근활성도에 관한 연구)

  • Kim, Taik-Soo;Sohn, Byung-Hwa
    • The korean journal of orthodontics
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    • v.22 no.3 s.38
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    • pp.627-646
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    • 1992
  • The purpose of this study was to investigate the relationship among the activity of the craniofacial muscle and craniofacial form and occlusal state. In this study, subjects were consisted of 23 male adults with skeletal Class III malocclusion and 30 male adults with normal occlusion. The measurements in oral exam, lateral ceghalogram, and E.M.G. recordings of anterior temporal, masseter, and upper lip muscles at rest position, clenching in centric occlusion, chewing of gum, swallowing of juice, were analyzed with SPSS system. The results were as follows: 1. At rest position upper lip muscle activity of skeletal Class III group was significantly higher than that of normal group. 2. Both clenching and chewing masseter and temporal muscle activity of normal group were significantly higher than that of skeletal Class III group. 3. During swallowing of juice, upper lip muscle activity of skeletal Class III group were significantly higher than that of normal group. 4. The activities of masseter and anterior temporal muscle during clenching and chewing were significantly correlated with hypodivergent facial form and number of occluded teeth. 5. The activity of upper lip during swallowing had positive correlation with mandibular prognathism.

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Subclassification of Skeletal Class II Malocclusion of Korean Adults Using Cluster Analysis (군집분석을 통한 한국인 성인 골격성 제 II급 부정교합의 아분류)

  • Ahn, Kwang-Seok;Baik, Hyoung-Seon;Kim, Kyung-Ho;Kim, Baek-Il;Lee, Kee-Joon
    • Korean Journal of Cleft Lip And Palate
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    • v.14 no.1_2
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    • pp.1-18
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    • 2011
  • Skeletal malocclusion is the result of abnormal dimension and alignment of each skeletal component. Understanding on these mechanisms may help to elucidate the etiology of skeletal malocclusion and to establish population-oriented treatment plans. Attempts to subdivide the Angle's classification have been performed for Class III malocclusion, while few studies have been conducted for Class II malocclusion despite recent growing interests in Class II malocclusion. 200 adults (88 male, 112 female) with skeletal Class II malocclusion were collected and subdivided using cluster analysis, using the measurements representing the dimension and the alignment of each facial skeletal component. The properties of each cluster was grouped within the subjects and a comparison between the subjects and the control group (38 male, 35 female) with normal occlusion was performed. Six clusters were finally recognized in each male and female groups. The clusters in both genders were mainly characterized by the cranial base alignment, dimension of the posterior cranial base, dimension of the mandibular ramus and the degree of mandibular rotation. The results implicate that active treatment of mandible rather than the nasomaxillary complex may be primarily considered for the correction of Korean Class II skeletal pattern.

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ANALYSIS OF FAMILIAL TENDENCY IN SKELETAL CLASS III MALOCCLUSION (골격성 하악전돌증 환자의 유전적 경향에 대한 분석)

  • Lee, Chang-Hwan;Lee, Sang-Han;Kim, Hyun-Soo;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.6
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    • pp.506-513
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    • 2006
  • The purpose of this study was to examine the familial tendency of the patients with mandibular prognathism in three generations and to define the relationship between the familial tendency and the skeletal class III morphology. The probands of this study were 103 orthognathic surgery patients with skeletal Class III malocclusions who had undergone (48 men, 55 women) mandibular set-back surgery. A questionnaire was given to patients who sought surgical treatment for excessive mandibular length, and all answers were confirmed in interviews. Lateral cephalograms were analyzed in cranial base parameters, mandibular positional parameters and mandibular skeletal parameters. In the examined families, 58.3% had at least one member other than the proband who had mandibular prognathism. The affected ratio of total relatives was 4.5%, and the value was higher in first-degree (13.4%) than second-degree (5.9%) and third-degree relatives (1.7%). The affected ratio was 51.9% in the offsprings who had at least one affected father or mother. The comparison of the groups according to the familial tendency showed no significant craniofacial skeletal measurments. In conclusion, skeletal class III malocclusion showed high familial tendency, suggesting a significant genetic influence in the etiology. However, the patient's familial tendency did not show the special craniofacial patterns compare to the subjects without familial tendency.