Analysis of dentoalveolar compensation and discrimination of skeletal types

골격형에 따른 치아치조성 보상기전의 분석 및 골격형 판별

  • Kim, Ji-Young (Department of Orthodontics, College of Dentistry, Seoul National University) ;
  • Kim, Tae-Woo (Department of Orthodontics, College of Dentistry, Seoul National University) ;
  • Nahm, Dong-Seok (Department of Orthodontics, College of Dentistry, Seoul National University) ;
  • Chang, Young-Il (Department of Orthodontics, College of Dentistry, Seoul National University)
  • Published : 2003.12.01

Abstract

The purpose of this study is to analyze dentoalveolar compensation in normal occlusion samples previously classified into 9 skeletal types, and to provide clinically applicable diagnostic criteria for individual malocclusion patients. Cephalometric measurements of the 294 normal occlusion samples previously divided into 9 types were analyzed. The descriptive features of dentoalveolar variables were compared for the 9 types using analysis of variance, followed by post hoc multiple comparisons. In addition, the correlation between skeletal and dentoalveolar variables were analyzed. Discriminant analysis with a stepwise entry of variables was designed to find out several potential variables for use in skeletal typing. The dentoalveolar compensation pattern of the skeletal types varied, especially with regards to the variables that indicated the inclination of incisors and the occlusal plane. Stepwise variable selection identified four variables: AB-MP, SN-AB, PMA and ANB. Discriminant analysis assigned a classification accuracy of $87.8\%$ to the predictive model. On the basis of these results, this study could provide rudimentary information for the development of diagnostic criteria and treatment guidelines for individual skeletal types.

본 연구의 목적은 전후방 및 수직적 골격형에 따라 선험적으로 9 개의 유형 (type)으로 분류된 정상교합자의 치아치조부 보상기전의 양상을 분석하고 이를 임상적으로 개별 부정교합자에게 적용이 가능한 신뢰성 있고 간편한 골격 유형의 감별기준을 도출하고자 한 것이었다. 이를 위하여 정상교합자 294명의 측모두부방사선계측치 중 치아치조부 계측 항목의 기술 통계량을 구하고 각 유형간의 특징을 비교하기 위하여 분산 분석과 다중 비교를 시행하였으며, 골격 계측 항목과 치아치조부 계측 항목간의 상관관계를 분석하였다. 또한 이러한 유형을 부정교합자의 개별 골격형에 적용할 수 있도록 판별 분석을 시행하여 골격형 감별의 효율성과 정확성을 가늠하였다. 그 결과 갈 골격 유형별로 특징적인 치아치조부 보상기전을 확인할 수 있었으며, 상/하악 전치의 위치 및 교합 평면을 나타내는 변수에서 높은 상관관계가 관찰되었다. 판별 분석 결과 9개의 골격 유형을 분류할 수 있는 4개의 변수(AB-MP, SN-AB, PMA)를 구할 수 있었으며, 이들 4개의 변수로 이루어진 판별 계수로 전체 표본의 $87.8\%$를 정확하게 분류할 수 있었다. 결론적으로, 이러한 연구 결과를 통해 개별 부정교합자의 개별화된 진단 및 치료 지침 수립시 기초적 정보를 제공할 수 있을 것으로 예견되었다.

Keywords

References

  1. Kim JY, Kim TW, Nahm DS, Chang YI. Classification of the skeletal variation in the normal occlusion. Korea J Orthod 2003 : 33 : 141-50
  2. Ku SJ, Lee SJ, Chang YI. Dentoalveolar compensation according to skeletal patterns of normal occlusion. Korea J Orthod 2002 : 32 : 91-105
  3. Casko JS, Sheperd WB. Dental and skeletal variation within the range of normal. Angle Orthod 1984:54:5-17
  4. Solow B, The dentoalveolar compensatory mechanism: background and clinical implications. Br J Orthod 1980 : 7 : 145-61
  5. Beckmann SH, KUltert RB, Prahl-Andersen B, Segner D,The RPS, Tuinzing DB, Alveolar and skeletal dimensions associated with lower face height Am J Orthod Dentofac Orthop 1998: 113: 498-506
  6. Fishman LS. Individualized evaluation of facial form. Am J Orthod Dentofac Orthop 1997 : 111 : 510-7
  7. Janson GPR, Metaxas A, Woodside DG.Variation in maxillary and mandibular molar and incisor vertical demension in 12-year-old subjects with excess, normal, and short lower anterior face height Am J Orthod Dentofac Orthop 1994 : 106: 409-18
  8. Oh CK, Yoon YJ, Kim KW. The compensatory adaptation of anterior teeth according to the skeletal relation. Kor J Orthod 2000 : 30 : 175-83
  9. Norusis MJ. Advanced statistics SPSS/PC+. Chicago: SPSS Inc. 1986 : 1-39
  10. Klecka WR. Discriminant analysis. Newbury Park: Sage Publications Inc. 1980 : 54-60
  11. Steiner CC. Cephalometries in clinical practice. Angel Orthod 1959: 29 : 8-29
  12. Bibby RE. Incisor relationships in different skeletal patterns, Angle Orthod 1980 : 50 : 41-4
  13. Goldsman S. The variations in skeletal and denture patterns in excellent adult facial types. Angle Orthod 1959 : 29 : 63-92
  14. Nasby JA, Worms FW, Speidel TM. Orthodontic extractions and facial skeletal pattern. Angle Orthod 1972 : 42: 116-22
  15. Bjork A, Skieller V. Facial development and tooth eruption. Am J Orthod 1972 : 62: 339-82
  16. Chang YI, Moon SC. Cephalometric evaluation of the anterior open bite treatment. Am J Orthod Dentofac Orthop 1999 : 115 : 29-38
  17. Enlow DH. Intrinsic craniofacial compensation. Angle Orthod 1971 : 41 : 271-85
  18. Simons ME. Change in overbite: a ten year postretention study. Am J Orthod 1973 : 64 : 349-67
  19. Jacobson A. The 'Wits' appraisal of jawdisharmony. Am J Orthod 1975: 67: 125-38
  20. Moorreess CFA. Normal variation and its bearing on the use of cephalometric radiographs in orthodontic diagnosis. Am J Orthod 1953 : 39: 942-50
  21. Tweed CH. The Frankfort mandibular plane angle in orthodontic diagnosis classification, treatment planning and prognosis. Am J Orthod 1946 : 32 : 175-230