The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
권호 표지

The stability in the adolescent Class III malocclusion treated by fixed appliances

성장기 III급 부정교합의 고정식 교정 치료 후의 안정성

  • Lim, Yong-Kyu (Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University) ;
  • Lee, Joo-Na (Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University) ;
  • Kim, Joeng-Il (Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University) ;
  • Lee, Dong-Yul (Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University)
  • 임용규 (고려대학교 임상치의학대학원 교정학교실) ;
  • 이주나 (고려대학교 임상치의학대학원 교정학교실) ;
  • 김정일 (고려대학교 임상치의학대학원 교정학교실) ;
  • 이동렬 (고려대학교 임상치의학대학원 교정학교실)
  • Published : 2004.08.01
Download PDF
⟨ Previous Next ⟩

Abstract

The Purpose of this study was to investigate the predictors of relapse in orthodontic treatment of skeletal Class III malocclusion in growing patients. A total of 55 patients were studied and all subjects were divided into two groups according to their stability in the post-treatment stage. Of the sample, 33 patients were included in the stable group and the remaining 22 were assigned to the relapse group. Cephalometric data of the pre-treatment stage was taken and compared between the stable and relapse group. The following results were obtained through t-test: 1. This study presented statistical evidence to show that the major skeletal determinant of prognosis in Class III orthodontic treatment was not anteroposterior discrepancy .but vertical discrepancy, especially within the AB-maxillo mandibular triangle. Vertical angular measurements that showed statistically significant differences were AB-MP and ODI(P<0.01) and the vortical ratio measurements were MP-P/AL and PP-P/AL(P<0.05). 2. Relapse tendency increased with the steep occlusal Plane, especially the steep lower occlusal plane. As to occlusal plane, there were statistically significant differences in OP(L)-PP, OP-PP, AB-OP(L) and Wits appraisal(P<0.05). This study claimed that anteroposterior discrepancy was not necessarily the proper criteria to predict relapse. Vertical discrepancy had a significant effect on post-treatment stability.

본 연구에서는 성장기 골격성 III급 부정 교합 한자의 치료 전 측모 두부방사선 계측사진에서 얻을 수 있는 골격성, 치성 분석을 통하여 안정군과 재발군을 구별하여 주는 요소를 찾아보아 III급 부절 교합의 치료시 안정성을 고려한 치료 선택에 도움을 주고자 하였다 고정식 교정 장치를 통한 전치부 반대 교합 혹은 절단 교합의 골격성 III급 부정 교합 치료 후 최소 1년 동안 안정된 결과를 보인 안정군 33명과 관찰 기간 동안 절단 교합 이하의 수평 피개를 보인 재발군 22명을 연구 대상으로 하여 비교하였으며 t-test를 시행하여 다음과 같은 결론을 얻었다. 1. 건후방적 골격 형태보다는 수직적 형태, 특히 AB-maxillo-mandibular triangle내의 수직적 형태가 III급 부정 교합치료의 예후에 주요한 결정 인자로 나타났다. 수직 각도 계측 항목에 의한 안정군과 재발군간의 비교에서 유의성 있는 차이를 보인 항목은 AB-MP, ODI로 나타났다(P<0.01). 수직 비율 계측 항목에서도 MP-P/AL, PP-P/AL항목이 유의성 있는 차이를 보였다(P<0.05). 2. 재발의 경향은 교합 평면 특히. 하악 교합 평면이 전하방으로 급경사를 이룰수록 증가했다. 친합 평면 경사도와 관련된 계측 항목에 의한 안정군과 재발군간의 비교에서 OP(L)-PP, OP-PP, AB-OP(L), Wits appraisal항목이 유의성 있는 차이를 보였다(P<0.05). 본 연구는 전후방 부조화가 아닌 골격성, 치성 수직 부조화가 재발을 예측하는 적절한 기준이 됨을 시사하였다.

Keywords

References

  1. Battagel JM. Class Ill malocclusion: the post-retention findings following a non-extraction treatment approach. Eur J Orthod 1993;15:45-55 https://doi.org/10.1093/ejo/15.1.45
  2. Skieller V, Bjork A, Lind-Hancen T. Prediction of mandibular growth rotation evaluated from a longitudinal implant sample. Am J Orthod 1984;86:359-70 https://doi.org/10.1016/S0002-9416(84)90028-9
  3. Mi yajima K, McNamara Jr JA, Sana M, Murata S. An estimation of craniofacial growth in the untreated Class Ill female with anterior crossbite. Am J Orthod Dentofacial Orthop 1997;112:425-34 https://doi.org/10.1016/S0889-5406(97)70051-9
  4. Ishikawa H, Nakamura S, Iwasaki H, Kitazawa S, Tsukda H, Sato Y. Dentoalveolar compensation related to variations in saggital jaw relationships. Angle Orthod 1999;69:534-8
  5. Bibby RE. Incisor relationships in different skeletofacial patterns. Angle Orthod 1980;50:41-4
  6. Battagel SM. Predictors of relapse in orthodontically treated Class Ill malocclusions. Br J Orthod 1994:21:1-13
  7. 성재현, 권오원, 김상두. III급 부정 교합의 치료 후 예후에 관한 후향적 고찰 대치교정지 1998;28:175-87
  8. Tahmina K, Tanaka E, Tanne K. Craniofacial morphology in orthodontically treated patients of Class Ill malocclusion with stable and unstable treatment outcomes. Am J Orthod Dentofacial Orthop 2000;117:681-90 https://doi.org/10.1016/S0889-5406(00)70177-6
  9. Zentner A, Doll GM, Peylo SM. Morphological parameters as predictors of successful correction of Class Ill malocclusion. Eur J Orthod 2001;23:383-92 https://doi.org/10.1093/ejo/23.4.383
  10. Franchi L, Baccetti T, Tollaro L. Predictive variables for the outcome of early functional treatment of Class Ill malocclusion. Am J Orthod Dentofacial Orthop 1997;112:80-6 https://doi.org/10.1016/S0889-5406(97)70277-4
  11. Battagel JM. Identification of the relapsing class Ill face: Chernoff faces in orthodontics. Br J Orthod 1993;20:193-202 https://doi.org/10.1179/bjo.20.3.193
  12. Kerr WJS, Orth D, Miller S. Class Ill malocclusion: Surgery or Orthodontics? Br J Orthod 1992;19:21-4 https://doi.org/10.1179/bjo.19.1.21
  13. Nanda RS, Merrill RM. Cephalometric assessment of sagittal relationship between maxilla and mandible. Am J Orthod Dentofacial Orthop 1994;105:328-44 https://doi.org/10.1016/S0889-5406(94)70127-X
  14. Lishikawa H, Nakamura S, Iwasaki H, Kitazawa S. Seven parameters describing anteroposterior jaw relationships: Postpubertal prediction accuracy and interchangeability. Am J Orthod Dentofacial Orthop 2000;117:714-20 https://doi.org/10.1016/S0889-5406(00)70181-8
  15. Millett D, Gravely JF. The assessment of antero-posterior dental base relationship. Br J Orthod 1991;18:285-97 https://doi.org/10.1179/bjo.18.4.285
  16. Han UK, KimYH. Determination of Class II and Class III skeletal patterns: Receiver operating characteristic (ROC) analysis on various cephalometric measurements. Am J Orthod Dentofacial Orthop 1998;113:538-45 https://doi.org/10.1016/S0889-5406(98)70265-3
  17. Kim YH, Vietas JJ, Anteroposterior dysplasia indicator: An adjunct to cephalometric differential diagnosis. Am J Orthod 1978;73:619-33 https://doi.org/10.1016/0002-9416(78)90223-3
  18. Kim YH. Overbite depth indicator with particular reference to anterior open-bite. Am J Orthod 1974;65:586-611 https://doi.org/10.1016/0002-9416(74)90255-3
  19. Johnston LE. A statistical evaluation of cephalometric prediction. Angle Orthod 1968;38:284-304