안면 비대칭 환자에서 삼차원 컴퓨터단층촬영 계측법의 신뢰성

김영석,박병윤,유대현,권순만 대한두개안면성형외과학회 2006 Archives of Craniofacial Surgery Vol.7 No.1

3-dimensional computed tomography(3D-CT) imaging has been used in the diagnosis and surgical treatment planning of patients with craniofacial deformities, but its measurements were not commonly accepted contrary to the measurements in cephalometric analysis which was accepted as the best way to evaluate the facial profile on craniofacial & orthognathic fields. The purpose of this study was to compare the measurements from cephalometric analysis and 3D-CT analysis in facial asymmetric patients in order to show the reliability of the latter. 10 facial asymmetry patients had taken both cephalometry x-ray & 3D-CT. The 8 measurements were obtained from cephalometric analysis and 3D-CT analysis on each patient. The cephalometric analysis was based on the manual tracing of PA cephalometry x-ray film and the 3D-CT analysis was performed using the 'measuring tools' of Medical PACS system. The measurements included the maxillar & mandibular height, mandiblular body length, and vertical & horizontal deviation degree of maxilla and mandible. The paired t-test was used to compare differences between measurements from two methods. And also the ratio(affected side/unaffected side) in 3 measurements was calculated and compared using paired t-test to show the reliability. There were no statistically significant differences between measurements from cephalometric analysis and 3D-CT analysis(P>0.05) except mandibular body length. Also no statistically significant differences were noted between the ratio of 3 measurements on cephalometric analysis and 3D-CT analysis(P>0.05). 3D-CT analysis of facial asymmetry presents reliable data as much as cephalometric analysis. Moreover, it is very easy and simple method to use. The 3D-CT analysis as described herein is a practical method of evaluation the morphology of facial asymmetry and can replace the cephalometric analysis.

측모 두부방사선계측사진 분석과 측모 사진 분석의 비교

김광원,임성훈,조주영,최갑림 대한치과교정학회 2006 대한치과교정학회지 Vol.36 No.1

오래 전부터 교정진단 및 치료계획 수립 시 골격 및 치열 관계와 안모를 분석하기 위한 필수적인 진단 자료로 측모 두부방사선계측사진을 이용하였다. 하지만 최근 들어 심미적인 측면이 강조되면서 좀 더 정량화된 연조직 분석법이 필요하게 되었고 좀 더 사실적인 연조직 측모를 얻기 위해서는 측모 두부방사선계측사진보다는 측모 사진이 더 유용할 것이다. 아직까지 측모 사진을 계측, 분석하는 경우는 드물었기 때문에 이 연구에서는 측모 사진의 계측 분석을 측모 두부방사선계측사진 분석과 비교해 봄으로써 연조직과 경조직 분석이 서로 상관관계를 갖는지를 알아보고 그 대체 가능성을 시험 평가해 보고자 하였다. 교정과에 내원한 환자들 중 측모 두부방사선계측사진의 계측치인 ANB를 기준으로 Ⅰ급 부정교합(0˚~4°) 32명, Ⅱ급 부정교합(4°≤) 32명, Ⅲ급 부정교합(5°~0°) 31명을 선정하였다. 각 피험자들의 측모 두부방사선계측사진과 측모 사진을 각각 촬영하여 수평적, 수직적 계측 항목을 설정한 후 각 계측치들의 평균과 표준편차를 구하였고 통계적 유의성을 알아보기 위해 표준화 변수 Z를 이용한 t-test와 상관분석을 이용하였다. 분석 결과 측모 두부방사선계측사진 분석에서 세 그룹 간에 뚜렷한 차이를 보이는 계측치들이 측모 사진에서도 유사한 차이를 보이는 것을 확인할 수 있었다. 본 연구결과 측모사진은 Sn-N'-Pg'은 측모 두부방사선계측사진에서 상,하악골의 전후방적인 관계를 나타내는 ANB를 대신하여 사용될 수 있으며, 측모 사진의 N'-Sn/Sn-Pg'은 측모 두부방사선계측사진의 NA/APg (ficial convexity)을, 그리고 측모 사진의 N'-Tra-Me'는 측모 두부방사선계측사진의 FH-MP (mandibular plane)을 대신하여 사용될 수 있을 것으로 보인다. Alalysis of lateral cephalometric radiograph (cephalogram) has been used routinely to evaluate skeletal and dental relationships, but alalysis of the lateral facial photograph has not been used frequently for evaluation of skeletal relationships. As concerns about harm of X-ray irradiation increases, this study was planned to evaluate the possibility of substituting analysis of the lateral cephalogram with analysis of the lateral facial photograph by comparing these two analysis. According to the ANB values from cephalometric analysis, subjects were divided into three group: ClassⅠmalocclusion group (n = 32). Class Ⅱ malocclusion group (n = 32), and Class Ⅲ malocclusion group (n = 31). After measurements of angles indicating horizontal and vertical relationships of the maxilla and mandible on the lateral cephalograms and photographs, differences between ClassⅠ,Ⅱ and Ⅲ groups were evaluated. To evaluate the similarity between two similar values in the cephalograms and photographs, t-test using standardized variable Z and correlation analysis were performed in the Class Ⅰmalocclusion group. The results show that 1) SnN'Pg' on the photograph can be used to evaluate the antero-posterior relationship of the maxilla and mandible (ANB), 2) N'-Sn/Sn-Pg' on the photograph can be used to evaluate facial convexity (NA/APg), 3) Sn-Tra-Me' on the photograph can be used as a measurement similar to FMA, In conclusion, partly substituting lateral cephalogram analysis with lateral facial photograph analysis was possible in the evaluation of the maxilla and mandible.

Mandibular shape prediction using cephalometric analysis: applications in craniofacial analysis, forensic anthropology and archaeological reconstruction

Omran, Ahmed,Wertheim, David,Smith, Kathryn,Liu, Ching Yiu Jessica,Naini, Farhad B. Korean Association of Maxillofacial Plastic and Re 2020 Maxillofacial Plastic Reconstructive Surgery Vol.42 No.-

Background: The human mandible is variable in shape, size and position and any deviation from normal can affect the facial appearance and dental occlusion. Objectives: The objectives of this study were to determine whether the Sassouni cephalometric analysis could help predict two-dimensional mandibular shape in humans using cephalometric planes and landmarks. Materials and methods: A retrospective computerised analysis of 100 lateral cephalometric radiographs taken at Kingston Hospital Orthodontic Department was carried out. Results: Results showed that the Euclidean straight-line mean difference between the estimated position of gonion and traced position of gonion was 7.89 mm and the Euclidean straight-line mean difference between the estimated position of pogonion and the traced position of pogonion was 11.15 mm. The length of the anterior cranial base as measured by sella-nasion was positively correlated with the length of the mandibular body gonion-menton, r = 0.381 and regression analysis showed the length of the anterior cranial base sella-nasion could be predictive of the length of the mandibular body gonion-menton by the equation 22.65 + 0.5426x, where x = length of the anterior cranial base (SN). There was a significant association with convex shaped palates and oblique shaped mandibles, p = 0.0004. Conclusions: The method described in this study can be used to help estimate the position of cephalometric points gonion and pogonion and thereby sagittal mandibular length. This method is more accurate in skeletal class I cases and therefore has potential applications in craniofacial anthropology and the 'missing mandible' problem in forensic and archaeological reconstruction.

성장기 3급 부정교합 환자에서 악안면 형태에 대한 측모두부계측방사선학적 연구

손우일,장익준,송재철,진병로 영남대학교 기초/임상의학연구소 2001 Yeungnam University Journal of Medicine Vol.18 No.2

When we make treatment plan of class III malocclusion children, it is difficult to determine whether we treat it with orthognathic surgery or without orthognathic surgery. To determine that, we must consider many factors, such as cephalometric analysis, growth pattern, family history, and skeletal age. A Harvold cephalometric analysis is useful in determining the amount of discrepancy by comparing the maxillary unit length with mandibular unit length. We tried this study to help the decision of treatment planning in class III malocclusion children by comparison in class III malocclusion and normal occlusion children using a Harvold analysis. Materials and Methods: The materials for this study consisted of 20 class III malocclusion children. Cephalometric tracing and measurements were performed by one investigator. The control group consisted of 18 normal occlusion children and lateral cephalograms were obtained from 8.5 to 14.5 years old children biannually. The relationships between class III malocclusion group and normal occlusion group were evaluated statistically. Results: The lower anterior facial heights between two groups were not significantly different, although the lower anterior facial heights of class III malocclusion group was higher than those of normal occlusion group in all age groups. The Maxillary-mandibular unit length differences of class III malocclusion group were significantly higher than those of normal occlusion group(p <0.05). Conclusion: A Harvold analysis was useful to make treatment planning for class III malocclusion children.

Changes in longitudinal craniofacial growth in subjects with normal occlusions using the Ricketts analysis

Eun-ju Bae,Hye-jin Kwon,Oh-won Kwon 대한치과교정학회 2014 대한치과교정학회지 Vol.44 No.2

Objectives: This study was designed to define the Korean norm values for the Ricketts analysis. Methods: In this longitudinal study, lateral cephalograms of 31 subjects with normal occlusion were taken biennially from ages 9?19 years. Cephalometric measurements were performed. Parameters for which the 10-year change did not exceed one standard deviation were defined as unchanged. The means and standard deviations for the measured parameters were determined for each age group. Results: No significant changes in growth were observed in the molar relationship, incisor overjet, incisor overbite, mandibular incisor extrusion, interincisor angle, lower incisor tip (B1) to A point-Pogonion (A-PO) plane, upper incisor tip (A1) to A-PO plane, B1 inclination to A-PO, A1 inclination to A-PO, B1 inclination to Frankfurt plane (FH), convexity, lower facial height, facial axis, maxillary depth, maxillary height, palatal plane to FH, cranial deflection, ramus Xi position, or porion location. Continual changes over the 10 years of growth were observed in the maxillary first molar distal position to pterygoid true vertical plane, facial depth, mandibular plane to FH, anterior cranial length, mandibular arc, and corpus length. Conclusions: Clinicians can apply the Korean norms at age 9 as determined in this study when using the Ricketts analysis. The patient’s age at the beginning of treatment and their sex should be taken into consideration when drawing visual treatment objectives.

유치열기 정상교합아동의 측모두부방사선 계측연구

김지연,권장혁,김경호,박기태 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.4

본 연구의 목적은 유치열기 부정교합의 진단자료로 사용할 수 있는 정상 계측치를 알아보는 것이다. 4세에서 6세 사이 유치열기 정상교합아동 32명의 측모두부방사선 계측사진 및 안모사진을 이용하여 악골 및 연조직의 전후방적, 수직적 관계를 분석하였다. 수평적인 골격성 계측항목 중 SNA는 83°,SNB는 78.72°,ANB는 5.28°를 나타내어 하악골이 상악골에 비해 후방에 위치하고 있었으며 수직적인 골격성 계측항목 중 Gonial angle은 127°를 나타내어 성인에 비하여 High angle pattern을 보였다. 연조직 분석에서는 성인에 비해 convex한 soft tissue profile이 관찰되었다. 치성 계측항목 중 U1 to SN은 91.04°, IMPA는 86.57°를 나타내어 성인에 비해 reteroclination된 상하악 유중절치가 관찰되었다. 정상교합아동의 골격성분석에서 여자가 남자에 비하여 평균 나이가 많음에도 불구하고 linear measurement는 전제적으로 남자가 여자보다 큰 수치를 보였다. The present study was designed to formulate cephalometric norms of normal occlusion for usage in orthodontic diagnosis of malocclusion in Korean children. Thirty two children, aged 4 to 6. with normal occlusion were chosen for this study. Sagittal and vertical relations were analyzed using lateral cephapogram and clinical photos and the measurements were compared with those of adults. On skeletal sagittal analysis, the mean values of the SNA and SNB angles were 83°and 78.72°. It showed that the mandible was retrognathic and retropositioned in comparison to those angle pattern in children and reduction of gonial angle due to counterclockwise rotation of the mandible. On dental analysis. the mean values of the U1 to SN and IMPA were 91.04° and 86.57°, This showed retroclined upper and lower deciduous teeth in comparison to adults. For values. the linear values were generally greater in males than females.

코골이와 폐쇄성 수면무호흡증 환자의 두부규격방사선사진 상의 특징 및 호흡장애지수와의 상관관계

최재갑,최정미,안형준,Choi, Jae-Kap,Choi, Jung-Mi,Ahn, Hyoung-Joon 대한안면통증구강내과학회 2001 Journal of Oral Medicine and Pain Vol.26 No.4

Objectives : The purposes of the study was to evaluate cephalometric characteristics in snorers and patients with obstructive sleep apnea (OSA) and to see any relationships between the cephalometric measurements and respiratory disturbance indices (RDI). Materials and Methods : Twelve snoring patients, 11 patients with OSA, and 10 normal subjects were included for the study. After taking a screening sleep study for a night to obtain RDI, $SaO_2$, and snoring index, a detailed cephalometric analysis was conducted to obtain SNA, SNB, SN-MP, IAS, MAS, SPAS, SAAS, Mn-H, and PNS-P. All the data were compared between groups. For a group including 12 snoring patients and 11 OSA patients, correlation coefficients were calculated between respiratory disturbance index and each item of cephalometric measurements. Results : The mandible and the maxilla are retropositioned. The oropharyngeal and hypopharyngeal airway is reduced in area and is a factor that could produce or enhance OSA symptoms. The hyoid bone is displaced inferiorly. The soft palate is significantly elongated. Conclusions : These data suggest that cephalometric evaluation could be useful to evaluate snoring and OSA patients, and to assist with the planning treatment for improvement of upper airway patency.

디지털 측방두부규격방사선사진과 MDCT의 3차원 재구성 영상을 이용한 합성측방두부규격방사선사진의 계측치 비교 및 머리 위치가 미치는 효과

김미자,최보람,허경회,이원진,허민석,이삼선,최순철 대한구강악안면방사선학회 2009 Imaging Science in Dentistry Vol.39 No.3

Purpose : To investigate the reproducibilities and compare the measurements in digital and MDCT-synthesized cephalometric radiograph, and to investigate the effect of head position on the measurement during imaging with MDCT. Materials and Methods : Twenty-two dry skulls (combined with mandible) were used in this study. Conventional digital cephalometric radiograph was taken in standard position, and MDCT was taken in standard position and two rotated position (10°left rotation and 10°right tilting). MDCT data were imported in OnDemand?? and lateral cephalometric radiograph were synthesized from 3D virtual models. Two types of rotated MDCT data were synthesized with default mode and with corrected mode using both ear rods. For all six images, sixteen angular and eleven linear measurements were made in V-Ceph?? three times. Reproducibility of measurements was assessed using repeated measures ANOVA and ICC. Linear and angular measurements were compared between digital and five MDCTsynthesized images by Student t-test. Results : All measurements in six types of cephalometric radiograph were not statistically different under ICC examination. Measurements were not different between digital and MDCT-synthesized images (P> .05). Measurements in MDCT-synthesized image in 10°left rotation or 10°right tilting position showed possibility of difference from digital image in some measurements, and possibility of improvement via realignment of head position using both ear rods. Conclusion : MDCT-synthesized cephalometric radiograph can substitute conventional cephalometric radiograph. The error on head position during imaging with MDCT have possibility that can produce measurement errors with MDCT-synthesized image, and these position error can be corrected by realignment of the head position using both ear rods. (Korean J Oral Maxillofac Radiol 2009; 39 : 133-47)

Influence of heritability on craniofacial soft tissue characteristics of monozygotic twins, dizygotic twins, and their siblings using Falconer’s method and principal components analysis

Jeongmin Song,Hwa Sung Chae,Jeong Won Shin,Joohon Sung,Yun-Mi Song,Seung-Hak Baek,Young Ho Kim 대한치과교정학회 2019 대한치과교정학회지 Vol.49 No.1

Objective: The purpose of this study was to investigate the influence of heritability on the craniofacial soft tissue cephalometric characteristics of monozygotic (MZ) twins, dizygotic (DZ) twins, and their siblings (SIB). Methods: The samples comprised Korean adult twins and their siblings (mean age, 39.8 years; MZ group, n = 36 pairs; DZ group, n = 13 pairs of the same gender; and SIB group, n = 26 pairs of the same gender). Thirty cephalometric variables were measured to characterize facial profile, facial height, soft-tissue thickness, and projection of nose and lip. Falconer’s method was used to calculate heritability (low heritability, h2 < 0.2; high heritability, h2 > 0.9). After principal components analysis (PCA) was performed to extract the models, we calculated the intraclass correlation coefficient (ICC) value and heritability of each component. Results: The MZ group exhibited higher ICC values for all cephalometric variables than DZ and SIB groups. Among cephalometric variables, the highest h2 (MZ-DZ) and h2 (MZ-SIB) values were observed for the nasolabial angle (NLA, 1.544 and 2.036), chin angle (1.342 and 1.112), soft tissue chin thickness (2.872 and 1.226), and upper lip thickness ratio (1.592 and 1.026). PCA derived eight components with 84.5% of a cumulative explanation. The components that exhibited higher values of h2 (MZ-DZ) and h2 (MZ-SIB) were PCA2, which includes facial convexity, NLA, and nose projection (1.026 and 0.972), and PCA7, which includes chin angle and soft tissue chin thickness (2.107 and 1.169). Conclusions: The nose and soft tissue chin were more influenced by genetic factors than other soft tissues.

정상 한국인 성인 남녀에서 협골을 중심으로 한 중안모의 측모 두부방사선 규격사진 분석법

정인교,이의훈 大韓顎顔面成形再建外科學會 1999 Maxillofacial Plastic Reconstructive Surgery Vol.21 No.4

Purpose : A new method of lateral cephalometric analy sis for midface, focusing on zygomatic bone, was created in this study, and measured in Korean adults. The purposes of this study are understanding about new approach for midfacial depression, especially zygomatic bone, and using to make adequate diagnosis and treatment plan. Materials and methods : In this study, esthetic Korean adults, 25 males and 25 females who were between 0˚and 4˚in ∠ANB, and between 62% and 70% in P/A facial height ratio, and had normal overbite and overjet, were used. Orbitale(Or) and Soft tissue orbitale(Or') were used for indicators of anteroposterior position of zygomatic area. And, mean value and standard deviation of linear and angular meansurements, and ratio about each linear measurements, were obtained. then, standard deviation diagram - wiggle diagram- was made for visualization of results. Results : Mean values, standard deviations and ranges of 19 meansurements were obtained, and among them, 5 linear meansurements that had large standard deviation were excluded and the others were used for making standard deviation diagram. In standard deviation diagram, the following results were obtained. 1. If the measurements are located on more left side of mean-value- vertical-line, the potential of midfacial hypoplasia are stronger, especially zygomatic area. 2. If the measurements are located on more right side ofmean-value-vertical-line, the potential of midfacial hypoplasia are decreased. Conclusion : This study presented a new method of lateral cephalometric analysis focusing on zygomatic bone in Korean adults. We expect that the results of this study can be used as parameter when clinicians make decisions about diagnosis and treatment plan for rehabilitation of esthetics and function. But, it is necessary to prove its usefulness, and to further evaluate the results.