INTERNAL VS. RIGID EXTERNAL DISTRACTION DEVICE FOR THE MAXILLARY HYPOPLASIA OF CLEFT PATIENTS

Distraction osteogenesis for the advancement of hypoplastic maxilla of cleft patients has shown successful results. In this report, rigid external distraction(RED) system and internal distraction device were used for maxillary advancement. Each system has its advantages and disadvantages. Larger amount of advancement can be achieved with RED system. But complex external device may give patients psychological stress. Internal device is invisible. However its distraction amount have limitation for the advancement (< 20mm) and the vector cannot be changed freely during distraction. The authors treated five cleft patients with maxillary hypoplasia(three with RED system and two with internal distractor). Their results were clinically satisfactory. We present the pros and cons of RED and internal system for maxillary distraction osteogenesis

Association between MSX1 SNPs and Nonsyndromic Cleft Lip with or without Cleft Palate in the Korean Population

The purpose of this study was to investigate the contribution of MSX1 gene to the risk of nonsyndromic cleft lip with or without cleft palate (NS-CL +/- P) in the Korean population. The samples consisted of 142 NS-CL +/- P families (9 with cleft lip, 26 with cleft lip and alveolus, and 107 with cleft lip and palate; 76 trios and 66 dyads). Three single nucleotide polymorphisms (SNPs: rs3821949, rs12532, and rs4464513) were tested for association with NS-CL +/- P case-parent trios using transmission disequilibrium test (TDT) and conditional logistic regression models (CLRMs). Minor allele frequency, heterozygosity, chi(2) test for Hardy-Weinberg equilibrium, and pairwise linkage disequilibrium (LD) at each SNP were computed. The family- and haplotype-based association test programs were used to perform allelic and genotypic TDTs for individual SNPs and to fabricate sliding windows of haplotypes. Genotypic odds ratios (GORs) were obtained from CLRMs using R software. Although the family-based TDT indicated a meaningful association for rs3821949 (P = 0.028), the haplotype analysis did not reveal any significant association with rs3821949, rs12532, or rs4464513. The A allele at rs3821949 had a significant increased risk of NS-CL +/- P (GOR, 1.64; 95% confidence interval, 1.03-2.63; P = 0.038, additive model). A positive association is suggested between MSX1 rs3821949 and NS-CL +/- P in the Korean population.OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000004298/4SEQ:4PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000004298ADJUST_YN:YEMP_ID:A072100DEPT_CD:852CITE_RATE:1.249FILENAME:kimny-cleft-msx1-manuscript-jkms-final.pdfDEPT_NM:치의과학과SCOPUS_YN:YCONFIRM:

Maxillary incisor inclination of skeletal Class III patients treated with extraction of the upper first premolars and two-jaw surgery: Conventional orthognathic surgery vs surgery-first approach.

Objective: To investigate the differences in the amount and pattern of the maxillary incisor (MXI) inclination change in skeletal Class III patients treated with extraction of the maxillary first premolars (MXP1) and two-jaw surgery (TJS) between conventional orthognathic surgery (COS) and surgery-first approach (SFA). Materials and Methods: The study included 60 skeletal Class III patients who had normal maxillary position, prognathic mandible, and mild crowding in the maxillary arch (#4 mm). The patients were divided into group 1 (COS, n 5 36) and group 2 (SFA, n 5 24). Lateral cephalograms were taken before treatment (T0), 1 month before surgery (T1), within 1 month after surgery (T2), and after debonding (T3) for COS patients and at T0, T2, and T3 for SFA patients. After measurement of the skeletodental variables, statistical analyses were performed. Results: During T0–T2, the amount of MXI inclination change (DU1-SN) in group 1 was significantly larger than that in group 2 (212.8u vs 24.4u; P , .001). During T2–T3, DU1-SN in groups 1 and 2 occurred in opposite directions (3.8u vs 25.9u; P , .001). However, the total amount of DU1-SN during T0–T3 was not different between groups 1 and 2 (29.0u vs 210.3u). At T3 the U1-SN values for groups 1 and 2, respectively, moved closer to normal according to the values of the normal range rate (all 83%), relative percentage ratio (102.4% and 100.1%), and achievement ratio (77.7% and 97.8%). Conclusions: The results of this study might provide basic data for predicting the amount and pattern of MXI inclination change in SFA for skeletal Class III TJS patients.OAIID:oai:osos.snu.ac.kr:snu2014-01/102/0000004298/4SEQ:4PERF_CD:SNU2014-01EVAL_ITEM_CD:102USER_ID:0000004298ADJUST_YN:NEMP_ID:A072100DEPT_CD:852CITE_RATE:1.184FILENAME:parkhm-sfa-mxi-ao-2014.pdfDEPT_NM:치의과학과SCOPUS_YN:YCONFIRM:

Orthodontic treatment of gummy smile by maxillary total intrusion with a midpalatal absolute anchorage system

This article describes the orthodontic treatment of a 31-year-old Korean female patient with gummy smile and crowding. The patient showed excessive gingival display in both the anterior and posterior areas and a large difference in gingival heights between the anterior and posterior teeth in the maxilla. To correct the gummy smile, we elected to intrude the entire maxillary dentition instead of focusing only on the maxillary anterior teeth. Alignment and leveling were performed, and a midpalatal absolute anchorage system as well as a modified lingual arch was designed to achieve posterosuperior movement of the entire upper dentition. The active treatment period was 18 months. The gummy smile and crowding were corrected, and the results were stable at 21 months post-treatment.OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000004298/7SEQ:7PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000004298ADJUST_YN:YEMP_ID:A072100DEPT_CD:852CITE_RATE:.537FILENAME:hongyk-maas-gummy0smile-kjo-2013.pdfDEPT_NM:치의과학과SCOPUS_YN:YCONFIRM:

Associations between the risk of tooth agenesis and single-nucleotide polymorphisms of MSX1 and PAX9 genes in nonsyndromic cleft patients

Objective: To investigate the association between the risk of tooth agenesis and single-nucleotide polymorphisms (SNPs) of MSX1 and PAX9 genes in nonsyndromic cleft patients. Materials and Methods: The subjects were 126 Korean nonsyndromic cleft patients. Tooth agenesis type (TAT) was classified as none (0); cleft area (1); cleft area + other area (2); and other area (3) based on agenesis of the maxillary lateral incisor (MXLI) and another tooth within or outside the cleft area. TAT was further grouped into two subcategories (0 and 1) and four subcategories (0, 1, 2, and 3). Three SNPs of MSX1 and 10 SNPs of PAX9 were investigated using Fisher's exact test and logistic regression analysis. Results: Although the association between genotype distribution of PAX9-rs7142363 and TAT was significant (P < .05 in four subcategories#, genotypic odds ratios #GORs# of SNPs in each TAT were not meaningful. However, for MSX1-rs12532 and PAX9-rs2073247, associations between genotypic distribution and TAT were significant #P < .01 in four subcategories and P < .05 in two subcategories; P < .01 in two subcategories, respectively#. In cleft area, GORs of MXLI agenesis in genotypes GA of MSX1-rs12532 and CT of PAX9-rs2073247 were increased by 3.14-fold and 4.15-fold compared with genotype GG of MSX1-rs12532 and CC of PAX9-rs2073247, respectively #P <. 01; P < .05#. In cleft area + other area, the GOR of agenesis of MXLI and another tooth in genotype AA of MSX1-rs12532 was increased by fivefold compared with genotype GG #P < .05). Conclusion: Genetic disturbances of MSX1 and PAX9 genes are associated with tooth agenesis within and outside the cleft area.OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000004298/13SEQ:13PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000004298ADJUST_YN:YEMP_ID:A072100DEPT_CD:852CITE_RATE:1.184FILENAME:seoyj-msx1-pax9-missing-ao-2013.pdfDEPT_NM:치의과학과SCOPUS_YN:YCONFIRM:

일측성 구순열 환자에서 3차원 수치사진측량 스캔과 직접계측 방법의 비교

Background: In cleft lip patients, the necessity of a thorough preoperative analysis of facial deformities before reconstruction is unquestioned. The surgical plan of cleft lip patient is based on the information gained from our preoperative anthropometric evaluation. A variety of commercially available three-dimensional (3D) surface imaging systems are currently introduced to us in plastic surgery for these use. However, few studies have been published on the soft tissue morphology of unrepaired cleft infants described by these 3D surface imaging systems.Methods: The purpose of this study is to determine the accuracy of facial anthropometric measurements obtained through digital 3D photogrammetry and to compare with direct anthropometry for measurement in unilateral cleft lip patients. We compared our patients with three measurements of dimension made on both sides: heminasal width, labial height, and transverse lip length.Results: The preoperative measurements were not significantly different in both side of labial height and left side of heminasal width. Statistically significant differences were found on both side of transverse lip length and right side of heminasal width. Although the half of preoperative measurements were significantly different, trends of results showed average results were comparable.Conclusion: This is the first study in Korea to simultaneously compare digital 3D photogrammetry with traditional direct anthropometry in unilateral cleft lip patients. We desire this study could contribute the methodological choice of the many researchers for proper surgical planning in cleft lip reconstruction field.OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000004298/10SEQ:10PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000004298ADJUST_YN:YEMP_ID:A072100DEPT_CD:852FILENAME:김석화-3d-nose-2013.pdfDEPT_NM:치의과학과SCOPUS_YN:NCONFIRM:

Effects of insertion angle and implant thread type on the fracture properties of orthodontic mini-implants during insertion

Objective: To determine the effects of insertion angle (IA) and thread type on the fracture properties of orthodontic mini-implants (OMIs) during insertion. Materials and Methods: A total of 100 OMIs (self-drilling cylindrical; 11 mm in length) were allocated into 10 groups according to thread type (dual or single) and IA (0 degrees, 8 degrees, 13 degrees, 18 degrees, and 23 degrees) (n = 10 per group). The OMIs were placed into artificial materials simulating human tissues: two-layer bone blocks (Sawbones), root (polymethylmethacrylate stick), and periodontal ligament (Imprint-II Garant light-body). Maximum insertion torque (MIT), total insertion energy (TIE), and peak time (PT) were measured and analyzed statistically. Results: There were significant differences in MIT, TIE, and PT among the different IAs and threads (all P<.001). When IA increased, MIT increased in both thread groups. However, TIE and PT did not show significant differences among 0 degrees, 8 degrees, and 13 degrees IAs in the dual-thread group or 8 degrees, 13 degrees, and 18 degrees IAs in the single-thread group. The dual-thread groups showed higher MIT at all IAs, higher TIE at 0 degrees and 23 degrees IAs, and longer PT at a 23 degrees IA than the single-thread groups. In the 0 degrees, 8 degrees, and 13 degrees IA groups, none of the OMIs fractured or became deformed. However, in the 18 degrees IA group, all the OMIs were fractured or deformed. Dual-thread OMIs showed more fracturing than deformation compared to single-thread OMIs (P < .01). In the 23 degrees IA group, all OMIs penetrated the artificial root without fracturing and deformation. Conclusions: When OMIs contact artificial root at a critical contact angle, the deformation or fracture of OMIs can occur at lower MIT values than those of penetration.OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000004298/8SEQ:8PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000004298ADJUST_YN:YEMP_ID:A072100DEPT_CD:852CITE_RATE:1.184FILENAME:조일식-백승학.pdfDEPT_NM:치의과학과SCOPUS_YN:YCONFIRM:

Segregation analysis of mandibular prognathism in Korean orthognathic surgery patients and their families

Objective: To investigate the existence of genetic influences on the incidence of mandibular prognathism (MP) in Korean Class Ill patients. Materials and Methods: The probands consisted of 100 Class Ill patients with MP (51 men and 49 women; mean age, 22.1 +/- 5.2 years; SNA, 81.2 degrees +/- 3.2 degrees; SNB, 84.1 degrees +/- 3.9 degrees) who underwent orthognathic surgery. Using three-generation pedigree charts, questionnaires, and clinical examinations, general information and information regarding MP for a total of 3777 relatives of the probands (1911 men and 1866 women) was ascertained. Familial correlations of MP between possible pairs in the pedigree were estimated. Heritability (h(2)) of MP under various models was estimated. Segregation analysis was conducted under the assumption of the nonpolygenic multivariate logistic model and finite polygenic mixed model. One-, two-, and three-susceptibility-type models were evaluated. Results: Among 3777 relatives, 199 (97 men and 102 women) were affected with MP (5.3%). Correlation coefficients of MP incidence in full siblings and in parent-offspring were .2003 and .2036, respectively (all P < .001). The h(2) of MP was estimated as 21.5% after adjusting for sex and founder effects. Two- and three susceptibility-type models showed that the general model fit better than the other models. MP incidence did not have a major gene transmission model and was influenced by numerous minor effect genes and their additive effects. Conclusion: These results suggest that the inherited susceptibility to MP in Korean Class Ill patients might be due to the summation of minor effects from a variety of different genes and/or influence of environmental factors, rather than Mendelian transmission of major genes.OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000004298/12SEQ:12PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000004298ADJUST_YN:YEMP_ID:A072100DEPT_CD:852CITE_RATE:1.184FILENAME:segregation-ao-2013-final.pdfDEPT_NM:치의과학과SCOPUS_YN:YCONFIRM:

Effect of frequent laser irradiation on orthodontic pain A single-blind randomized clinical trial

Objective: To analyze the effect of low-level laser therapy (LLLT) on perception of pain after separator placement and compare it with perceptions of control and placebo groups using a frequent irradiation protocol. Materials and Methods: Eighty-eight patients were randomly allocated to a laser group, a light-emitting diode (LED) placebo group, or a control group. Elastomeric separators were placed on the first molars. In the laser and LED groups, first molars were irradiated for 30 seconds every 12 hours for 1 week using a portable device. Pain was marked on a visual analog scale at predetermined intervals. Repeated measure analysis of variance was performed for statistical analysis. Results: The pain scores of the laser group were significantly lower than those of the control group up to 1 day. The pain scores in the LED group were not significantly different from those of the laser group during the first 6 hours. After that point, the pain scores of the LED group were not significantly different from those of the control. Conclusions: Frequent LLLT decreased the perception of pain to a nonsignificant level throughout the week after separator placement, compared with pain perception in the placebo and control groups. Therefore, LLLT might be an effective method of reducing orthodontic pain.OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000004298/6SEQ:6PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000004298ADJUST_YN:YEMP_ID:A072100DEPT_CD:852CITE_RATE:1.184FILENAME:ao_july,_laser.pdfDEPT_NM:치의과학과SCOPUS_YN:YCONFIRM:

Maxillary Protraction in the Cleft Patients Using the Orthopedic Appliances

Cleft lip and palate patients often develop maxillary retrusion due to the combined effects of the congenital deformity and the scar tissue after surgical repairs. Maxillary protraction in the cleft patients using orthopedic appliances (i.e. face mask) or distraction osteogenesis during early childhood helps to achieve more balanced skeletal harmony and favorable occlusion for future growth to occur. Kinds, indication, protocol for use of the traditional orthopedic appliances will be discussed. Also the facemask with miniplate system recently developed will be introduced