The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Treatment effect of face mask therapy for Class III malocclusion patients according to low facial morphology

성장기 골격성 III급 부정교합 환자의 상악골 전방 견인 시 하안모 형태에 따른 치료 효과 비교

  • Cha, Kyung-Suk (Department of Orthodonitcs, School of Dentistry, Dankook University)
  • 차경석 (단국대학교 치과대학 교정학교실)
  • Published : 2007.08.30
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Abstract

Improvements in jaw relationship through clockwise rotation of the mandible may be desirable in some Class III patients with short low facial height. The aim of this study was to examine the treatment effect of face mask for Class III malocclusion patients according to their low facial morphology. Methods: Class III patients in their pubertal growth period were divided into two groups (Group 1, high LFH; Group 2, low LFH) according to lower facial height (LFH) by Ricketts (norm, 47). treatment changes between groups after face mask treatment was compared not only for hard tissue but also for soft tissue. Results: There were no significant differences between the two groups for the skeletal and soft tissues of the maxilla. There were no significant differences between the two groups for the skeletal posterior movement of the mandible, but posterior movement of the mandibular soft tissues in group 2 was larger than group 1. There were no significant differences between the two groups for the vertical hard tissue proportion changes of the mandible, but the vertical soft tissue proportion changes of the mandible in group 2 was larger than group 1. There was a significant correlation between the sagittal hard tissue and soft tissue changes of the maxilla and mandible, but there was no significant difference in the vertical changes. Conclusion: The clockwise rotation of the mandible occurred from use of the face mask, and posterior movement of soft tissues of the mandible was higher in Cl III patients with low LFH than with high LFH.

성장기 아동의 상악골 전방 견인을 이용한 치료 효과 중 하악골의 후하방 회전은 III급 골격관계를 개선시키지만 하안모의 길이가 길어져 face mask가 장안모 환자에게는 비적응증 이라는 것이 선학들의 일반적 견해였다. 그러나 실제로 하안모의 길이를 분류 기준으로 삼아 이에 따른 치료 효과를 비교한 연구는 부족한 실정이며 경조직 변화에 따른 연조직 변화의 연구 또한 미비하였다. 본 연구에서는 상악골 열성장을 보이는 성장기 골격성 III급 부정교합 환자 44명을 Ricketts의 lower facial height (LFH)기준에 따라 LFH가 정상 수치 이상인 군(1군)과 미만인 군(2군)으로 분류하여, 상악골 전방 견인 시 두 군간의 경조직, 연조직 치료 효과를 비교하고 경조직과 연조직의 상호 관계를 비교 분석하여 다음과 같은 결론을 얻었다. 상악의 경조직, 연조직 전방 이동량은 두 군간에 유의한 차이가 없었다. 하악의 경조직 후방이동량은 두 군간에 유의한 차이가 없었으나 연조직 후방이동량은 2군에서 더 크게 나타났다. 하안면의 경조직 수직 비율 변화는 두 군간에 유의한 차이가 없었으나 연조직 수직 비율 변화는 2군에서 더 크게 나타났다. 상악과 하악의 전후방적 경조직, 연조직 변화는 유의한 상관관계를 갖는 반면 수직적 하안면 비율 변화는 유의한 상관관계를 갖지 않았다. 위의 결과들을 고려해 볼 때 Face mask 사용 결과 상악골의 전방 이동과 하악골의 후하방회전이 일어났으며 하악의 연조직 후방 이동량은 단안모에서 더 크게 나타났다.

Keywords

References

  1. Delaire J. La croissance maxillarire; deductions therapeutiques. Trans Eur Orthod Soc 1971;81-102
  2. Dellinger EL. A preliminary study of anterior maxillary displacement. Am J Orthod 1973;63:509-16 https://doi.org/10.1016/0002-9416(73)90163-2
  3. Kambara T. Dentofacial changes produced by extraoral forward force in the Macaca irus. Am J Orthod 1977;71:249-77 https://doi.org/10.1016/0002-9416(77)90187-7
  4. Jackson GW, Kokich VG, Shapiro PA. Experimental and postexperimental response to anteriorly directed extraoral force in young Macaca nemestrina. Am J Orthod 1979;75:318-33 https://doi.org/10.1016/0002-9416(79)90278-1
  5. Nanda R. Protraction of maxilla in rhesus monkey by controlled extraoral forces. Am J Orthod 1978;74:121-41 https://doi.org/10.1016/0002-9416(78)90080-5
  6. Nanda R. Differential response of midfacial sutures and bones to anterioly directed extraoral forces in monkeys. J Dent Res 1978; 57:362
  7. Bishara SE, Staley RN. Maxillary expansion: clinical implications. Am J Orthod Dentofacial Orthop 1987;91:3-14 https://doi.org/10.1016/0889-5406(87)90202-2
  8. Graber TM, Vanarsdall RL. Orthodontics: current principles and technique. second edition, St Louis: Mosby, 1994. p. 534
  9. Takada K, Petdachai S, Sakuda M. Changes in dentofacial morphology in skeletal Class III children treated by a modified maxillary protraction headgear and a chin cup: a longitudinal cephalometric appraisal. Eur J Orthod 1993;15:211-21 https://doi.org/10.1093/ejo/15.3.211
  10. Sung SJ, Baik HS. Assessment of skeletal and dental changes by maxillary protraction. Am J orthod Dentofacial Orthop 1998;114:492-502 https://doi.org/10.1016/S0889-5406(98)70168-4
  11. Kapust AJ, Sinclair PM, Turley PK. Cephalometric effects of face mask/expansion therapy in Class III children: a comparison of three age groups. Am J Orthod Dentofacial Orthop 1998;113:204-12 https://doi.org/10.1016/S0889-5406(98)70141-6
  12. Kim TW, Chang YI, Nahm DS. Retrospective study of face mask therapy. Korea J Orthod 1996;26:547-56
  13. Lee YJ, Cha KS, Lee JW. A study on the skeletal changes in maxillary protraction of the skeletal Cl III malocclusion patients. Korea J Orthod 1998;28:533-46
  14. Ricketts RM. Perspectives in the clinical application of cephalometries. The first fifty years. Angle orthod 1981;51:115-50
  15. Fishman LS. Radiographic evaluation of skeletal maturation. A clinically oriented method based on hand-wrist films. Angle Orthod 1982;52:88-112
  16. Legan HL, Burstone CJ. Soft tissue cephalometric analysis for orthognathic surgery. J Oral Surg 1980;38:744-51
  17. Sperry TP, Speidel TM, Isaacson RJ, Worms FW. The role of dental compensations in the orthodontic treatment of mandibular prognathism. Angle Orthod 1977;47:293-9
  18. Graber LW. Chin cup therapy for mandibular prognathism. Am J Orthod 1977;72:23-41 https://doi.org/10.1016/0002-9416(77)90122-1
  19. Sanborn RT. Differences between the facial skeletal patterns of Class III malocclusion and normal occlusion. Angle Orthod 1955;25:208-22
  20. Bell RA, LeCompte EJ. The effects of maxillary expansion using a quad helix appliance during the deciduous and mixed dentitions. Am J Orthod 1981;79:152-61 https://doi.org/10.1016/0002-9416(81)90313-4
  21. Jacobson A, Evans WG, Preston CB, Sadowsky PL. Mandibular prognathism. Am J Orthod. 1974;66:140-71 https://doi.org/10.1016/0002-9416(74)90233-4
  22. Oppenheim A. A possibility for physiologic orthodontic movement. Am J Orthod 1944;30:277-328
  23. Rune B, Sarnas KV, Selvik G, Jacobsson S. Posteroanterior traction in maxillonasal dysplasia (Binder syndrome). A roentgen stereometric study with the aid of metallic implants. Am J Orthod 1982;81:65-70 https://doi.org/10.1016/0002-9416(82)90290-1
  24. Baik HS. Clinical Effects and Stability of the Maxillary Protraction Using the Lateral Cephalogram in Korean. Korea J Orthod 1992;22:509-29
  25. Burstone CJ, James RB, Legan H, Murphy GA. Norton LA. Cephalometries for orthognathic surgery. J Oral Surg 1978;36:269-77
  26. Proffit WR, Phillips C, Dann C 4th, Turvey TA. Stability after surgical-orthodontic correction of skeletal Class III malocclusion. I. Mandibular setback. Int J Adult Orthodon Orthognath Surg 1991;6:7-18
  27. Baik HS. Clinical results of the maxillary protraction in Korean children. Am J Orthod Dentofacial Orthop 1995;108:583-92 https://doi.org/10.1016/S0889-5406(95)70003-X
  28. Campbell PM. The dilemma of Class III treatment. Early or late? Angle Orthod 1983;53:175-91
  29. Deguchi T, Kanomi R, Ashizawa Y, Rosenstein SW. Very early face mask therapy in Class III children. 1999;69:349-55
  30. Hata S, Itoh T, Nakagawa M, Kamogashira K, Ichikawa K, Matsumoto M, Chaconas SJ. Biomechanical effects of maxillary protraction on the craniofacial complex. Am J Orthod Dentofacial Orthop 1987;91:305-11 https://doi.org/10.1016/0889-5406(87)90171-5
  31. Irie M, Nakamura S. Orthopedic approach to severe skeletal Class III malocclusion. Am J Orthod 1975;67:377-92 https://doi.org/10.1016/0002-9416(75)90020-2
  32. Ishii H, Morita S, Takeuchi Y, Nakamura S. Treatment effect of combined maxillary protraction and chincap appliance in severe skeletal class III cases. Am J Orthod Dentofacial Orthop 1987;92:304-12 https://doi.org/10.1016/0889-5406(87)90331-3
  33. Pelton WJ, Elsasser WA. Studies of dentofacial morphology. III. The role of dental caries in the etiology of malocclusion. Angle Orthod 1953;46:648-57
  34. Subtenly JD. A longitudinal study of soft tissue facial structures and their profile characteristic defined in relation to underlying skeletal structures. Am J Orthod 1959;45:481-507 https://doi.org/10.1016/0002-9416(59)90014-4
  35. Bowker WD, Meredith HV. A metric analysis of facial profile. Angle Orthod 1959;29:149-60
  36. Mauchamp O, Sassouni V. Growth and prediction of the skeletal and soft-tissue profiles. Am J Orthod 1973;64:83-94 https://doi.org/10.1016/0002-9416(73)90282-0
  37. Hershey HG, Smith LH. Soft-tissue profile change associated with surgical correction of the prognathic mandible. Am J Orthod 1974;65:483-502 https://doi.org/10.1016/0002-9416(74)90031-1
  38. Robinson SW, Speidel TM, Isaacson RJ, Worms FW. Soft tissue profile change produced by reduction of Mandibular prognathism. Angle Orthod 1972;42:227-35