The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Directional forces using skeletal anchorage for treatment of skeletal Class II div. 1 malocclusion

Directional force와 skeletal anchorage를 이용한 골격성 II급 1류 부정교합 환자의 치험례

  • Chae, Jong-Moon (Department of Orthodontics and Daegu Fatima Hospital, The Korean Orthodontic Research Institute Inc.)
  • 채종문 (대구파티마병원 치과교정과, 사단법인 한국치과교정연구회)
  • Published : 2004.04.01
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Abstract

Tweed-Merrifield directional force technology is a very useful concept, especially for the treatment of Glass II malocclusion. It has contributed to treating a favorable counter-clockwise skeletal change and balanced face, while head gear force using high pull J-hook (HPJH) in an appropriate direction is also essential to influence such results. Clinicians have encountered some problems concerning patients' compliance; however skeletal anchorage has been used widely of late because it does not necessitate patients' compliance, yet produces absolute anchorage. In this case, a good facial balance was obtained by Tweed-Merrifield directional force technology using HPJH together with skeletal anchorage, which provided anchorage control in the maxillary posterior area, torque control in the maxillary anterior area, and mandibular response. This indicates 4hat skeletal anchorage can be used to reinforce sagittal and vortical anchorage in the maxillary posterior area during the retraction of anterior teeth. The author used HPJH for torque control, Intrusion, and the bodily movement of maxillary anterior teeth during on masse movement. However, it is thought that such a result nay also be achieved by substituting mini- or microscrews for HPJH. Consequently, Tweed-Merrifield directional force technology using skeletal anchorage for the treatment of Class II malocclusion not only maximiaes the result of treatment but can also minimize patients' compliance.

골격성 II급 부정교합을 치료하는데 있어서, Tweed-Merrifield directional force technology는 시계 반대 방향으로의 양호한 골격적 변화 및 균형 잡힌 안모를 얻는데 기여하고 있다. 이는 적절한 방향으로의 J-hook을 통한 headgear force의 사용이 필수적이다. 따라서 환자의 협조에 대한 의존이 절대적이므로 약간의 문제점이 있는 것 또한 사실이다. 하지만 최근 skeletal anchorage를 이용하여 환자의 협조를 최소화하면서도 보다 효과적으로 고정원 보강을 할 수 있는 방법이 많이 시행되고 있어 이를 보완 할 수 있게 되었다. 저자는 HPJH(high pull J-hook)과 skeletal anchorage를 병용하여 directional force를 적용한 결과 상악 구치부에서의 고정원 보강과 상악 전치부의 토크 조절 및 mandibular response를 얻음으로써 양호한 안모의 균형을 얻을 수가 있었다. 이 치료 결과로 보아 skeletal anchorage는 HPJH을 대신하여 상악 견치 및 전치부 견인시 상악 구치부의 전후적 및 수직적 고정원 보강 역할을 할 수 있을 것으로 생각된다 상악 전치부 견인시 상악 전치부의 토크 조절, 압하 및 치체이동을 위해 HPJH을 사용하였지만, 이 또한 mini 혹은 microscrew로 대체한다면 환자의 협조를 최소화하면서도 양호한 치료결과를 얻을 수 있을 것으로 생각된다.

Keywords

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