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.

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.

Treatment of anterior open bite with bimaxillary anterior segmental osteotomy and genioplasty

Skeletal anterior open bite is a difficult problem to correct in orthodontic treatment. To treat adult patients who have skeletal anterior open bite, we considered two methods. Combination treatment of orthodontics & surgery and camouflage orthodontic treatment. In adults, treatment of severe skeletal anterior open bite consists mainly of surgically repositioning the maxilla or the mandible. However, camouflage therapy is often the treatment of choice for skeletal open bite patients who have mild to moderate skeletal discrepancies when growth modification is no longer possible. But excellent results generally require careful coordination of the orthodontic and surgical phases of treatment. This is a case report of a skeletal anterior open bite patients who were treated with orthodontic treatment and orthognathic surgery. First case was diagnosed as skeletal class I malocclusion & bimaxillary protrusion with anterior open bite, and finally treatment ended for removal of open bite with orthodontic procedure and bimaxillary anterior segmental osteotomy surgery. Second case was diagnosed as skeletal class II malocclusion with open bite & mandibular retrusion, and was treated with only camouflage orthodontics because she feared to have a surgery. In a regular follow up visit after debonding we proposed to the patient advanced genioplasty, and in her agreement her facial esthetics was improved through the surgery.

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.

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.