Disparity in opinions on lip protrusiveness in contemporary African American faces / 대한치과교정학회지

OBJECTIVE@#In accordance with the changing demographics in the United States, orthodontists working on various ethnic populations should be more conscious when using the standardized profile analyses for the African American patient. The objective of this study was to examine whether the perception of lip protrusiveness in modern African American faces has changed. For this purpose, we investigated the most favorable African American lip profile using the opinions of 10 experienced and 10 newly trained younger orthodontists.@*METHODS@#Attractiveness was converted to a number on visualized analog scales. Comparative ranks on 16 African American profiles, with focus on lip protrusiveness and thickness, were made among the groups. Mixed-effects linear regression models were fit and group differences were estimated.@*RESULTS@#Younger orthodontists favored a more protrusive lip profile, and the variance in their perceptions was narrower than those of older orthodontists. Measurements related to upper lip protrusion showed the strongest correlation to attractiveness (r = −0.82). The association with attractiveness decreased linearly as the protrusiveness of the upper lip increased. Steiner's E-line was the most influential reference for determining the level of attractiveness for the older orthodontists, whereas upper lip protrusion was the most influential factor for the young orthodontists.@*CONCLUSIONS@#An adequate level of lip protrusiveness and thickness should be essential for maintaining attractive esthetics in African American patients. Yet, a new set of standards for prominent lips in this population is necessary to reflect the current trend in the concept of a beautiful face in the modern world.

Response of masticatory muscles to passive stretch stimulus - from perspectives of functional appliances / 대한치과교정학회지

OBJECTIVE: The aims of this study were to examine whether a passive stretch stimulus by means of a functional appliance induces changes in the fiber composition of masticatory muscles and whether these changes are similar to the changes in stretched limb muscle fibers by using RT-PCR, western blot, and immunohistochemical assays. METHODS: Five male New Zealand White rabbits were fitted with a prefabricated inclined plane on the maxillary central incisors to force the mandible forward (- 2 mm) and downward (- 4 mm). Further, 1 hind limb was extended and constrained with a cast so that the extensor digitorum longus (EDL) was stretched when the animal used the limb. The animals were sacrificed after 1 week and the masseter, lateral pterygoid, and EDL were processed and compared with those from control animals (n = 3). RESULTS: The stretched EDL had a significantly higher percentage of slow fibers, whereas the stretched masticatory muscles did not show changes in the composition of the major contractile proteins after 7 days. CONCLUSIONS: The transition of fiber phenotypes in response to a stretch stimulus may take longer in the masticatory muscles than in the limb muscles.

Morphological characteristics of the upper airway and pressure drop analysis using 3D CFD in OSA patients / 대한치과교정학회지

OBJECTIVE: Obstructive sleep apnea (OSA) is a common disorder which is characterized by a recurrence of entire or partial collapse of the pharyngeal airway during sleep. A given tidal volume must traverse the soft tissue tube structure of the upper airway, so the tendency for airway obstruction is influenced by the geometries of the duct and characteristics of the airflow in respect to fluid dynamics. METHODS: Individualized 3D FEA models were reconstructed from pretreatment computerized tomogram images of three patients with obstructive sleep apnea. 3D computational fluid dynamics analysis was used to observe the effect of airway geometry on the flow velocity, negative pressure and pressure drop in the upper airway at an inspiration flow rate of 170, 200, and 230 ml/s per nostril. RESULTS: In all 3 models, large airflow velocity and negative pressure were observed around the section of minimum area (SMA), the region which narrows around the velopharynx and oropharynx. The bigger the Out-A (outlet area)/ SMA-A (SMA area) ratio, the greater was the change in airflow velocity and negative pressure. CONCLUSIONS: Pressure drop meaning the difference between highest pressure at nostril and lowest pressure at SMA, is a good indicator for upper airway resistance which increased more as the airflow volume was increased.

EMG and cephalometric study on changes in upper airway structures and muscle activities according to the use of mandibular repositioning appliance and body posture in OSA parients / 대한치과교정학회지

Obstructive sleep apnea (OSA) is a disorder characterized by repetitive episode of upper airway collapse during sleep. Recent studies showed that not only the anatomic factors but the physiologic factors of the upper airway also have effects on the occurrence of apnea and that the genioglossus muscle also plays an important role in the maintenance of the upper airway. A variety of therapies were performed to treat OSA, and among them the use of mandibular repositioning appliances showed reasonable results. But there is still a lack of research on the structural and physiological mechanism upon the use of mandibular repositioning appliances. The author selected 26(male 17, female 9) OSA patients that came to the Yonsei University Dental Hospital; Department of Orthodontics, and 20 normal adults (male 10, female 10) and took cephalometric radiographs of them in a supine position before and after the placement of the mandibular repositioning appliance to see the structural changes of the upper airway and compare the therapeutic effects between the two groups. W ~ also studied the waking genioglossus muscle activity in OSA patients and investigated the difference in the electromyo ram of the genioglosssus muscle upon the change in body posture and the use of mandibular repositioning appliance. Following results were obtained. 1. Among the cephalometric measurements of the upper airway structure, the length of the soft palate, maximum thickness of the soft palate and SPAS, MAS, VAL, H-H1, MP-H showed statistically significant differences between the normal and OSA groups, but the lAS and EAS showed no statistically significant differences between the two groups. 2. In both the normal and OSA groups, as the epiglottis moved forward on wearing the mandibular repositioning appliance, the epiglottis level of the upper airway increased and the maximum thickness of the soft palate changed and the hyoid bone also moved forward, but the lAS in both groups showed various results and the effect of the mandibular repositioning appliance on the structure of the upper airway was different in the two groups. 3. Upon changing the position, the electromyogram of the genioglossus muscle showed a increasing tendency but there was no statistically significant differences, and when the mandibular repositioning appliance were worn there was a statistically significant increase in the electromyogram of the genioglossus muscle in both the upright and supine positions. The mandibular repositioning appliances not only have an effect on the anatomical structure of the upper airway but also on the physiology of the upper airway. There are different responses to the use of mandibular repositioning appliance between the normal and OSA groups therefore it could be considered to have the different physiology of the upper airway between the two groups.

A size analysis in obstructive sleep apnea patients / 대한치과교정학회지

The sybmental region in patients with Obstructive Sleep Apnea (OSA) is perceived to be larger than normal. Therefore, neck thickness has become a variable routinely measured during clinical screening of OSA subjects. In general, OSA patients are believed to have a large tongue and a narrow airway. To test if OSA patients have a larger face and tongue than non-alneics, eighty pairs of upright and supine cephalograms were obtained from four groups of subjects subclassified in accirdance with severity. The sum of distances between pairs of landmarks was calculated for each subjects and employed as a pure size variable for the face and tongue. Only tongue size become larger in accordance with apnea severity in both body positions (P<.01). Tongue size reflects apnea seveity, yet it provides only a small fraction of the explanation with regard to apnea severity. We conclude that size may be one factor of many which are significantly related to OSA seberity.