Osteochondroma in the Rib: A Case Report Reviewing Magnetic Resonance Imaging Findings

Osteochondroma is a benign bone tumor that is most commonly found in the extremities and is prevalent in adolescents, with a peak incidence before the age of 20 years. Herein, we present a rare case of a 33-year-old man with an asymptomatic tumor on the right anterior rib that was pathologically confirmed to be a rib osteochondroma after surgical excision. We describe the computed tomography and magnetic resonance imaging (MRI) procedures and highlight the importance of MRI as a critical diagnostic tool for osteochondroma.

Three dimensional analysis of the upper airway and facial morphology in children with Class II malocclusion using cone-beam computed tomography / 대한치과교정학회지

OBJECTIVE: The aim of this study was to evaluate the volumes and areas of the upper airways in children with Class II malocclusion, using three dimensional cone-beam computed tomography (CBCT) and to compare the volumetric and cross-sectional measurements and cephalometric variables to investigate possible relationships between the upper airway and facial morphology. METHODS: CBCT scans were obtained from 37 subjects (17 boys and 20 girls; average age, 11.02 years). The upper airway volumes and areas were measured, and compared with cephalometric variables. RESULTS: The area of the PNS-posterior plane (SPP) was significantly smaller in the Class II malocclusion group (p 0.05). The Class II malocclusion group showed significantly smaller values of PFH, mandibular body length, pog to N perp and showed larger values of FMA, ANB, and facial convexity than the Class I malocclusion group. The volume of the upper airway in front of PNS point (WN) showed negative correlation with ANB (p < 0.05). CONCLUSIONS: The Class II malocclusion group had a narrower upper airway associated with a decreased posterior facial height and a divergent growth pattern than the Class I malocclusion group.

The relationship between upper airway width and facial growth changes in orthodontic treatment of growing children / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to evaluate how airway changes influence facial growth during puberty in Korean children. METHODS: Thirty-six patients aged 9 to 11 (mean age: 10.7 years) were selected. Cephalograms and hand-wrist x-rays were taken at pre-treatment (T1) and post-treatment (T2). The sample was divided into narrow (5.2 - 8.6 mm, AW-Narrow), medium (8.9 - 11.5 mm, AW-Medium), and wide (11.7 - 16.0 mm, AW-Wide) groups according to the airway width at T1. Cephalometric measurements at T1, T2 and growth from T1 to T2 were compared between groups. RESULTS: The degree of increase in airway size in each group was 4.55 mm, 3.84 mm and 1.94 mm in the AW-Narrow, AW-Medium, and AW-Wide groups, respectively. Moreover, the differences were statistically significant. The significant smallest posterior facial height was found in the AW-Narrow group at T1. For the growth values from T1 to T2, the AW-Narrow group showed significantly larger values of PFH/AFH, facial axis, ANS (T1 - T2), and Gn (T1 - T2) than the AW-Medium group. CONCLUSIONS: The compensational changes in the airway width and facial growth were found in the narrow group. Surgical approach of the airway to prevent unfavorable facial growth in these years of age should be carried out, but with careful deliberation because these problems may be improved naturally.

Effect of airway and tongue in facial morphology of prepubertal Class I, II children / 대한치과교정학회지

OBJECTIVE: This study examined the craniofacial morphology of young patients in their prepubertal stage showing class I, II malocclusion, by analyzing lateral cephalograms, and analyzed its relationship with tongue position, tongue space, and airway space in order to ascertain the effects of nasopharyngeal airway and tongue morphology on the form of the malocclusion. METHODS: Seventy-six patients aging from 9 to 11 were divided into two groups depending on the ANB difference on the lateral cephalogram: Experimental group (Cl II malocclusion group) showing 0 ANB difference < or = < 4.0; Control group (Cl I malocclusion group) showing 0 < ANB difference < 4.0. The tongue space, space between palate and tongue, nasopharyngeal airway space and craniofacial morphology were compared between the two groups. RESULTS: Tongue space, palate-tongue space, nasopharyngeal airway space showed no significant differences between class I and class II malocclusion groups. Hyperdivergent faces were associated with smaller nasopharyngeal airway space. Longer anterior facial height and posterior facial height were associated with larger tongue space, and greater anterior facial height were associated with lower tongue position. Smaller nasopharyngeal airway space showed smaller tongue space. CONCLUSIONS: Tongue space and nasopharyngeal airway space showed no significant differences between class I malocclusion group and class II malocclusion group. Only anterior facial height and posterior facial height had an influence on tongue space and nasopharyngeal airway space.

Treatment of transverse deficiency with surgically assisted rapid palatal expansion in an open bite patient showing pseudomacroglossia

Anterior open bite is a condition in which maxillary and mandibular incisors do not occlude at central occlusion. It is a vertical discrepancy of the jaws and dental arches that has many etiologic factors making it difficult in diagnosis, treatment and prediction of prognosis. One of the causes of open bite is abnormal size and shape of the tongue. Macroglossia, a condition in which tongue is oversized, is caused by several factors which are not clearly identifiable, and it may be a major factor of anterior and posterior open bite. Macroglossia is subdivided into true, functional and pseudomacroglossia depending on its relative size in the oral cavity. In this case report, a patient was diagnosed as skeletal Class II with pseudomacroglossia, and was treated with SARPE in order to expand the narrowed maxillary arch and quad helix for the mandibular arch. As a result the transverse deficiency was treated. In the adult patients where no skeletal growth is expected, SARPE has shown to be effective in treating maxillomandibular transverse discrepancies in which macroglossia was accompanied as in this case.

Treatment of transverse deficiency of maxilla with sarpe in cleft palate

Patients who have repaired cleft lip and palate generally undergo restriction of maxillary growth. Concave facial profile is often exhibited with relatively normalized mandible. Horizontal and sagittal deficiency of the maxilla could cause anterior and posterior crossbites. In growing patients, orthodontic and orthopedic treatment is acceptable with maxillary expansion and protraction. However, surgical approach has to be accompanied with orthodontic treatment in skeletally matured patients. We used SARPE and BSSRO to expand the constricted maxilla and retract the mandible in a patient who had cleft palate repaired in infancy. Through SARPE, orthodontic treatment and BSSRO, we sufficiently expanded the maxillla and improved facial profile.

Treatment of transverse deficiency of maxilla with sarpe in cleft palate

Patients who have repaired cleft lip and palate generally undergo restriction of maxillary growth. Concave facial profile is often exhibited with relatively normalized mandible. Horizontal and sagittal deficiency of the maxilla could cause anterior and posterior crossbites. In growing patients, orthodontic and orthopedic treatment is acceptable with maxillary expansion and protraction. However, surgical approach has to be accompanied with orthodontic treatment in skeletally matured patients. We used SARPE and BSSRO to expand the constricted maxilla and retract the mandible in a patient who had cleft palate repaired in infancy. Through SARPE, orthodontic treatment and BSSRO, we sufficiently expanded the maxillla and improved facial profile.

Skeletal maturation associated with the fourth cervical vertebra and menarcheal timing / 대한치과교정학회지

OBJECTIVE: This study analyzed the morphologic changes of the fourth cervical vertebra body to determine the skeletal age of orthodntic patients during growth. METHODS: Eighty-one female patients aged from 11 to 14 who had cephalograms taken on the same day were examined. The subjects were divided into three groups depending on the depth of the concavity of the lower border of the fourth cervical vertebra (Group A: less than 1.05 mm, Group B: 1.05 - 2.07 mm, Group C: greater than 2.07 mm). Menarcheal timing, SMI stage, length, width and ratio of length and width of the fourth cervical vertebra body were analyzed and the following results were obtained. RESULTS: The average SMI stage of group A,B and C were 5.67 +/- 2.57, 8.73 +/- 2.41, and 10.00 +/- 1.47, respectively. Length, width, ratio of length and width, and SMI stage were greater in group B than group A and in group C than group B. Mean menarcheal timing was 11.64 +/- 0.92 years. Concavity depth, length, width, ratio of length and width showed a significant positive correlation with SMI stage, especially with the concavity depth. CONCLUSION: The results of this study propose a simple method for determining the timing of orthopedic treatment by measuring the concavity depth of the fourth cervical vertebra on the cephalogram.

Changes in Condylar Shape and Gonial Angle according to Loss of Teeth in Elderly Population

As the aged population is steadily increasing, oral health has been an important issue. Purpose of this study is to evaluate theeffects of aging and subsequent loss of teeth on the morphologic change of mandibular condyle and angle. Fifty dentulous patients aged from 20 to 24(Group 1) and forty-six posterior edentulous patients aged from 65 to 69(Group 2) were examined. Cortical thickness of antegonial notch and gonial angle on panoramic radiographs were measured in order to compare and analyze the mandibular morphology. In addition, bone height from the superior border of the mandibular canal in molar area was measured, and distribution of 3 condylar types in each group was analyzed. The posterior edentulous group had lower values in bone height from the superior border of the mandibular canal and cortical thickness of the antegonial notch compared to completely dentulous group. In condylar type1 subgroup of the dentulous group, a negative correlation was shown between cortical thickness of the antegonial notch and gonial angle. In the posterior edentulous group, a positive correlation was shown between age and gonial angle. The completely dentulous group showed a high incidence of type 2 and type 3 subgroup compared to the posterior edentulous group.

Changes in Tongue Position, Airway Width, Gonial Angle, Lower Facial Height after Bilateral Sagittal Split Ramus Osteotomy in Mandibular Prognathic Patients

INTRODUCTION: In patients with mandibular prognathism, Bilateral Sagittal Split Ramus Osteotomy(BSSRO) combined with orthodontic treatment reduces oral volume and influences tongue and other surrounding tissues. Purpose of this study was to analyze post-operative tongue position and airway dimension, as well as mandibular changes in vertical, horizontal, and angular dimensions. MATERIALS AND METHODS: Height of dorsum of tongue, width of airway, gonial angle and lower facial height of mandibular prognathic patients who visited Kangdong Sacred Heart Hospital from Jan. 2001 to Dec. 2006 were anaylzed via pre-operative and post-operative cephalograms. T-test was used to compare pre-operative and post-operative measurements. Also, correlations among pre-operative measurements of the patients were analyzed. RESULTS AND CONCLUSION: A significant correlation was shown between ANS-Xi-PM area and location of dorsum of tongue in pre-operative patients. A significant superior movement of tongue and decrease of airway width was observed in post-operative patients. Also the upper gonial angle decreased significantly.