Objective: To investigate skeletal and dental changes after application of a mandibular setback surgery-first orthodontic treatment approach in cases of skeletal Class III malocclusion. Methods: A retrospective study of 34 patients (23 men, 11 women; mean age, $26.2{\pm}6.6years$) with sk...
Objective: To investigate skeletal and dental changes after application of a mandibular setback surgery-first orthodontic treatment approach in cases of skeletal Class III malocclusion. Methods: A retrospective study of 34 patients (23 men, 11 women; mean age, $26.2{\pm}6.6years$) with skeletal Class III deformities, who underwent surgery-first orthodontic treatment, was conducted. Skeletal landmarks in the maxilla and mandible at three time points, pre-treatment (T0), immediate-postoperative (T1), and post-treatment (T2), were analyzed using cone-beam computed tomography (CBCT)-generated half-cephalograms. Results: The significant T0 to T1 mandibular changes occurred $-9.24{\pm}3.97mm$ horizontally. From T1 to T2, the mandible tended to move forward $1.22{\pm}2.02mm$, while the condylar position (Cd to Po-perpendicular plane) shifted backward, and the coronoid process (Cp to FH plane) moved vertically. Between T1 and T2, the vertical dimension changed significantly (p < 0.05). Changes in the vertical dimension were significantly correlated to T1 to T2 changes in the Cd to Po-perpendicular plane (r = -0.671, p = 0.034), and in the Cp to FH plane (r = 0.733, p = 0.016), as well as to T0 to T1 changes in the Cp to Po-perpendicular plane (r = 0.758, p = 0.011). Conclusions: Greater alterations in the vertical dimension caused larger post-treatment (T2) stage skeletal changes. Studying the mandibular position in relation to the post-surgical vertical dimension emphasized the integral importance of vertical dimension control and proximal segment management to the success of surgery-first orthodontic treatment.
Objective: To investigate skeletal and dental changes after application of a mandibular setback surgery-first orthodontic treatment approach in cases of skeletal Class III malocclusion. Methods: A retrospective study of 34 patients (23 men, 11 women; mean age, $26.2{\pm}6.6years$) with skeletal Class III deformities, who underwent surgery-first orthodontic treatment, was conducted. Skeletal landmarks in the maxilla and mandible at three time points, pre-treatment (T0), immediate-postoperative (T1), and post-treatment (T2), were analyzed using cone-beam computed tomography (CBCT)-generated half-cephalograms. Results: The significant T0 to T1 mandibular changes occurred $-9.24{\pm}3.97mm$ horizontally. From T1 to T2, the mandible tended to move forward $1.22{\pm}2.02mm$, while the condylar position (Cd to Po-perpendicular plane) shifted backward, and the coronoid process (Cp to FH plane) moved vertically. Between T1 and T2, the vertical dimension changed significantly (p < 0.05). Changes in the vertical dimension were significantly correlated to T1 to T2 changes in the Cd to Po-perpendicular plane (r = -0.671, p = 0.034), and in the Cp to FH plane (r = 0.733, p = 0.016), as well as to T0 to T1 changes in the Cp to Po-perpendicular plane (r = 0.758, p = 0.011). Conclusions: Greater alterations in the vertical dimension caused larger post-treatment (T2) stage skeletal changes. Studying the mandibular position in relation to the post-surgical vertical dimension emphasized the integral importance of vertical dimension control and proximal segment management to the success of surgery-first orthodontic treatment.
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제안 방법
The aim of the present study was to investigate post-surgery-first-treatment skeletal and dental changes in skeletal Class III malocclusion, by superimposition of CBCT volumes representing the pre-treatment (T0), immediate-postoperative (T1), and post-treatment (T2) stages. Likewise, an additive correlation analysis of skeletal and dental changes was performed. The operative hypothesis was the existence of a correlation between vertical dimension changes and skeletal changes after surgery-first orthodontic treatment.
, Hwaseong, Korea). The Half-Cephalograms were obtained by reformatting the CBCT raw data to three-dimensional (3D) images using 3D imaging software (OnDemand 3D; Cybermed Co., Seoul, Korea). After superimposing the CBCT data on the anterior cranial base according to the maximization of mutual information theory, ray-cast images and MIP images were acquired from right side of the CBCT data (Figure 1).
The aim of the present study was to investigate post-surgery-first-treatment skeletal and dental changes in skeletal Class III malocclusion, by superimposition of CBCT volumes representing the pre-treatment (T0), immediate-postoperative (T1), and post-treatment (T2) stages. Likewise, an additive correlation analysis of skeletal and dental changes was performed.
To evaluate statistically significant differences, all of the measurements were analyzed at three time points on CBCT-generated Half-Cephalograms (DCT pro; Vatech Co., Hwaseong, Korea). The Half-Cephalograms were obtained by reformatting the CBCT raw data to three-dimensional (3D) images using 3D imaging software (OnDemand 3D; Cybermed Co.
대상 데이터
To test the proposed hypothesis, a retrospective study was conducted using data from 34 patients (23 men, 11 women; mean age: 26.2 ± 6.6 years) that presented to the Department of Orthodontics, Pusan National University Dental Hospital (Yangsan, Korea)between January 2010 and July 2012.
데이터처리
*Repeated-measures analysis of variance test and Bonferroni’s multiple correction comparison test were conducted.
Repeated-measures analysis of variance was used to determine the skeletal and dental changes at T0, T1, and T2, and multiple comparisons were performed with the Bonferroni’s test.
Repeated-measures analysis of variance was used to determine the skeletal and dental changes at T0, T1, and T2, and multiple comparisons were performed with the Bonferroni’s test. Spearman correlation coefficients were calculated to assess the relationship between the vertical dimension and skeletal changes after the surgery-first orthodontic treatment.
0; SPSS, Chicago, IL, USA). The same investigator repeated all of the measurements two weeks after initial data collection, and the mean of the two values was used in the statistical analysis. The systematic intra-examiner error between the two measurements was determined by a paired t-test, and the magnitude of the corresponding error was assessed using the intraclass correlation coefficient (ICC).
The same investigator repeated all of the measurements two weeks after initial data collection, and the mean of the two values was used in the statistical analysis. The systematic intra-examiner error between the two measurements was determined by a paired t-test, and the magnitude of the corresponding error was assessed using the intraclass correlation coefficient (ICC). Repeated-measures analysis of variance was used to determine the skeletal and dental changes at T0, T1, and T2, and multiple comparisons were performed with the Bonferroni’s test.
성능/효과
Analysis of the systematic intra-examiner error revealed no statistically significant differences, and the ICC indicated robust reproducibility (ICC range:0.945−0.989).
We initially hypothesized that a correlation existed between vertical dimension and skeletal changes. Consequently, the study results revealed statistically significant correlations between T1 to T2 vertical dimension changes and T1 to T2 Cd to Po-perpendicular plane changes, T1 to T2 Cp to FH plane changes, and T0 to T1 Cp to Po-perpendicular plane changes.
The dental changes in the vertical dimension were statistically significant (p < 0.05), and included the upward movement of the lower 1st molar, and a 1.62 ± 1.35 mm reduction from L6 to FH (Table 3 and 4).
참고문헌 (14)
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