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BACKGROUND Skeletal mandibular protrusion would influence to the muscle fatigue of the masticatory muscles. Establishing a diagnostic procedures combining physiological and biochemical information is necessary for quantitative evaluation of masticatory muscle fatigue. OBJECTIVE The transverse relaxation time (T2 time) of muscle functional magnetic resonance imaging (mfMRI), and 31 P-magnetic resonance spectroscopy (MRS) were used to investigate the reliability as parameters for measuring the masseter muscle in patients with skeletal mandibular prognathism. METHOD The subjects were 19 patients diagnosed as skeletal mandibular protrusions and 19 healthy subjects as a control group. Transverse relaxation time (T2 value) determined by mfMRI along with creatine phosphate (PCr) and inorganic phosphorus (Pi) determined by 31 P-MRS before, during, and after clenching were used for molecular imaging of muscle fatigue. RESULTS The average T2 value of the patient group was significantly higher than that of the healthy control group at rest. Furthermore, the average T2 value transiently increased in both groups during experimental clenching. The PCr and Pi showed a tendency toward a transient decrease and increases, respectively. The pH in the masseter muscle showed a transient decrease in both groups prior to and following experimental clenching. The pH in the masseter muscle of the patient group was significantly lower than that in the healthy control group at rest and recovery. CONCLUSION We showed mfMRI and 31 P-MRS are useful for evaluating masseter fatigue during clenching, and the masseter muscle in the prognathic patients showed more severe fatigue than the healthy controls.

Objectives: The objective of this study is to test the hypothesis that there is a difference in the morphology of the lips of Class II div 1 and Class III malocclusion, before and after orthodontic treatment. Methods: The sample subjects included 20 adult female patients with Angle Class II div 1 malocclusion and 30 adult female patients with dento-skeletal Class III malocclusion. Frontal photographs were taken both before and after orthodontic and/or orthognathic treatment. Thirty-five landmarks were placed on each tracing made from the photograph. Thereafter, landmarks were digitized into an x and y coordinates system with the subnasal point as the origin. The Class II pretreatment and posttreatment groups of rest and smile conditions were compared with the Class III group respectively, using t-tests. Results: In the Class II pretreatment group, upper and lower lips positioned downward than that in the Class III group. When smiling, there was no statistically significant difference between the two groups before treatment, whereas after orthodontic treatment both Class II and Class III groups showed the significant difference at rest and on smiling conditions. On smiling condition Class III group showed more upwards and lateral movement of the mouth corners than Class II group. Conclusion: Orthodontic treatment induced larger amount in movement of lips at smiling in both Class II and III patients, which may reflect the emotional changes in the patients after treatment. DOI: http://dx.doi.org/10.3329/bjodfo.v1i1.15971 Ban J Orthod & Dentofac Orthop, October 2010; Vol-1, No.1, 5-12

Objective: To evaluate the morphological changes in the lips and to determine the degree of improvement in the smile after orthodontic treatment for Class II division 1 malocclusion.Materials and Methods: The sample subjects were divided into two groups: a group that consisted of 20 adult female patients with Angle Class II division 1 malocclusion and a control group that consisted of 28 adult female volunteers with normal occlusion. Frontal photographs were taken before and after orthodontic treatment, and 35 landmarks were placed on each tracing made from the photograph. Thereafter, landmarks were digitized into an x- and y-coordinate system with the subnasal point as the origin. The comparisons between pretreatment and posttreatment at rest and on smiling, and the comparisons between Class II division 1 and control group were made using Student's t-test.Results: Both the upper and lower lips in the smile of patients in the Class II division 1 pretreatment group were positioned downward, and the upward movement of the upper lip and mouth corners was smaller in comparison with the control group. These characteristics of the Class II smile improved after orthodontic treatment, but the differences with the control group remained unchanged immediately after treatment.Conclusion: The soft tissue morphology shows a relative improvement after orthodontic treatment.

This article presents orthognathic treatment in successful collaboration with autotransplantation of the maxillary third molar. The case report describes a 24-year-old man with severe mandibular protrusion and severe crowding in both dentitions. Overbite was 0 mm, overjet, −15 mm. Maxillary second molars and mandibular third molars were extracted, and presurgical multibracket treatment was begun. Maxillary third molars were impacted completely at 18 months in terms of presurgical tooth alignment. Autotransplantation of the teeth was achieved to substitute for extracted maxillary second molars. At 6 months after autotransplantation, the maxilla was advanced 4 mm on both sides through a Le Fort I procedure; left and right sides of the mandible were set back 15 and 18 mm, respectively, via sagittal split ramus osteotomy to improve mandibular protrusion. The total treatment period lasted 37 months. Autotransplantation treatment is an effective modality for tooth replacement when a donor tooth is available. Fully impacted maxillary third molars are potentially reliable candidates for autotransplantation.

Objective: To investigate the most reliable stress or strain parameters in subject-specific finite element (FE) models to predict success or failure of orthodontic mini-implants (OMIs). Materials and Methods: Subject-specific FE analysis was applied to 28 OMIs used for anchorage. Each model was developed using two computed tomography data sets, the first taken before OMI placement and the second taken immediately after placement. Of the 28 OMIs, 6 failed during the first 5 months, and 22 were successful. The bone compartment was divided into four zones in the FE models, and peak stress and strain parameters were calculated for each. Logistic regression of the failure (vs success) of OMIs on the stress and strain parameters in the models was conducted to verify the ability of these parameters to predict OMI failure. Results: Failure was significantly dependent on principal strain parameters rather than stress parameters. Peak maximum principal strain in the bone 0.5 to 1 mm from the OMI surface was the best predictor of failure (R2 = 0.8151). Conclusions: We propose the use of the maximum principal strain as a criterion for predicting OMI failure in FE models.

Lateral cephalometric radiographs of 35 Japanese male patients suffering from Duchenne muscular dystrophy (DMD) were taken longitudinally from 10 to 20 years of age. Eighteen landmarks were placed and 15 angles and four linear distances calculated. Profile diagrams (profilograms) were produced to analyse changes in craniofacial morphological growth in the DMD subjects. The measurements were then compared with Japanese standards. In young patients with DMD, compared with the controls, the following were observed: a large gonial angle; clockwise rotation of the mandible; short sagittal length of the cranial base and protrusion of the upper incisors. In adult patients, the maxillary alveolus and the upper incisors were protruded, compared with the controls. Overbite in DMD subjects also showed a tendency to decrease. In the controls, mandibular growth direction tended to be straight down and forward, while in patients with DMD, the growth direction was down until approximately 16 years of age and, after that, a forward vector of growth was apparent. As a result, the tendency towards a clockwise rotation of the mandible in the adults was less than in the young patients. These findings showed that DMD significantly affects craniofacial morphology.

The purpose of this study was to evaluate the effects of orthodontic treatment, involving the extraction of four premolars, on vermilion height and lip area. Twenty-eight female patients (mean 21.9 ± 3.1 years) who were diagnosed with bimaxillary protrusion were selected for this study to be treated by extraction of four premolars. The control group consisted of 28 female volunteers (mean 25.0 ± 3.0 years) with Angle Class I normal occlusion. Frontal photographs of the patients were taken both before and after the orthodontic treatment in resting position. Thirty-five landmarks on the upper and lower lips were identified for the measurements of vermilion height and lip area. Lateral cephalograms were taken before and after active orthodontic treatment, and linear and angular measurements were performed. The mean pre-treatment values of vermilion height and lip area were significantly greater in the treatment group than those of the control group and decreased significantly after the orthodontic treatment towards the values in the control group. There were no significant differences in the vermilion height and lip area between the post-treatment and the control groups, except for lower lip area values. Significant correlations found between the changes in incisor position and the changes in vermilion height were few in number for the upper lip but greater in number for the lower lip. Thus, the results of this study show that bimaxillary protrusion cases can be treated by the extraction of four premolars to produce an aesthetic improvement in frontal facial features.

OBJECTIVES: To test the hypothesis that there is no difference in the morphology of the lips and to determine the degree of improvement in the smile after orthognathic surgery for Class III malocclusion. MATERIALS AND METHODS: The sample subjects included 30 adult female patients with dento-skeletal Class III malocclusion and 28 adult female volunteers with normal occlusion. Frontal facial photographs were taken before and after treatment, and 35 landmarks were placed on each tracing made from the frontal facial photograph. Thereafter, the landmarks were digitized into an x and y coordinate system with the subnasal point as the origin. The pretreatment rest and smile conditions were compared with the posttreatment conditions, respectively, using paired t-tests. In addition, two sample t-tests were used to test for differences between groups. RESULTS: Both the upper and lower lips in the smiles of the Class III pretreatment group were positioned downward, and the upward movement of the upper lip and commissure points were smaller compared with the control group. When smiling, the horizontal direction of the mouth corners was statistically significantly different between the pretreatment and posttreatment conditions, whereas these were wider in the posttreatment than in the pretreatment conditions. These characteristics of the Class III smile improved after orthognathic treatment, but the differences with the control group remained unchanged immediately after treatment. CONCLUSION: The hypothesis is rejected. The soft tissue morphology of patients with dento-skeletal Class III malocclusion shows a significant improvement after orthognathic surgery.

To evaluate the morphological changes in the lips and to determine the degree of improvement in the smile after orthodontic treatment for Class II division 1 malocclusion.The sample subjects were divided into two groups: a group that consisted of 20 adult female patients with Angle Class II division 1 malocclusion and a control group that consisted of 28 adult female volunteers with normal occlusion. Frontal photographs were taken before and after orthodontic treatment, and 35 landmarks were placed on each tracing made from the photograph. Thereafter, landmarks were digitized into an x- and y-coordinate system with the subnasal point as the origin. The comparisons between pretreatment and posttreatment at rest and on smiling, and the comparisons between Class II division 1 and control group were made using Student's t-test.Both the upper and lower lips in the smile of patients in the Class II division 1 pretreatment group were positioned downward, and the upward movement of the upper lip and mouth corners was smaller in comparison with the control group. These characteristics of the Class II smile improved after orthodontic treatment, but the differences with the control group remained unchanged immediately after treatment.The soft tissue morphology shows a relative improvement after orthodontic treatment.

Objective: To test the hypothesis that there is no difference in the stability of the hard and soft tissue changes following a surgical mandibular setback using a sagittal split ramus osteotomy or an intraoral vertical ramus osteotomy. Materials and Methods: The samples consisted of 45 female patients with mandibular prognathism, who were divided into two groups. Twenty-three underwent a sagittal split ramus osteotomy (SSRO) with rigid fixation by titanium mini-screws and maxillomandibular fixation (MMF) for 14.0 ± 0.7 days. Twenty-two underwent intraoral vertical ramus osteotomy (IVRO) without rigid fixation, and MMF was released 21.5 ± 3.3 days after surgery. Data were collected from standardized cephalometric radiographs taken at the start of preoperative orthodontic treatment (T1), immediately after surgery (MMF, T2), and the completion of postoperative treatment (T3). Angular measurements were compared on each of T1, T2, and T3. Results: There were no significant differences in the pretreatment hard and soft tissue morphology between the SSRO and IVRO. However, when fixation was released, the mandible was posteriorly positioned in the IVRO group. In the soft tissue profile, the mental region was located backward in the IVRO group at postoperative stage (T3). Conclusions: The hypothesis is rejected. The soft tissue profile of the IVRO group especially showed a retromandibular position after postoperative treatment in comparison with the SSRO group. This tendency of the IVRO group would contribute to the database for treatment planning and prediction.

SUMMARY The purpose of the present study was to obtain quantitative values for human skull structures in a cross-sectional analysis of offspring and their parents. The offspring were classified into three groups according to age. For each of 11 maxillo-facial and nine dento-alveolar structural angular measurements, the mean and SD were calculated for each set of paternal, maternal, midparent and offspring. The standard deviation unit (SDU) values were calculated from the disparity between the measured value in a given individual, i.e. father, mother, midparent, offspring, and their corresponding group mean value. Three disparity values (D.v.), expressed by the difference between the SDU values in each pair (father-offspring, mother-offspr ing and midparent-offspring), were developed to evaluate the degree of familial resemblance for each of 20 morphometric measurements, and the differences among these values in three age groups were then investigated. The similarity ratio (S.r.), expressing the degree of correlation to the father and mother, was derived by processing the D.v. The relationship between the maxillo-facial S.r. and the dento-alveolar S.r. was analysed in each age group. There were significant differences between the D.v. in families and those in unrelated control groups. Consistency between the S.r. for maxillo-facial and that for dento-alveolar measurements was found in the older age groups. It is concluded that individual growth of skull morphology might be more predictable using the present method.