The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
권호 표지

A comparative study of initial lateral cephalometric characteristics: mandibular setback surgery only versus mandibular setback surgery with advancement genioplasty

하악 후퇴술과 전진 이부성형술이 시행된 III급 부정교합자의 초진 시 측모 두부 방사선사진 특성에 관한 연구

  • Kim, Jae-Sik (Department of Orthodontics, School of Dentistry, Kyunghee University) ;
  • Kim, Jung-Il (Kooalldam Dental Hospital) ;
  • Kang, Seung-Goo (Department of Orthodontics, School of Dentistry, Kyunghee University)
  • 김재식 (경희대학교 치의학전문대학원 교정학교실) ;
  • 김정일 (구올담치과병원) ;
  • 강승구 (경희대학교 치의학전문대학원 교정학교실)
  • Published : 2008.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: The aim of this study was to compare the initial lateral cephalometric characteristics in two groups of patients: those that had mandibular setback surgery only and those that had mandibular setback surgery with advancement genioplasty. Methods: The lateral cephalograms of thirty-one patients were studied. Twenty-one Class III patients (group A) had only madibular setback surgery Twelve Class III patients (group B) had mandibular setback surgery with advancement genioplasty. Results: Differences between two groups were found in N-Me, ANS-Me, Occlusal Plane angle, Palatal Plane to U1, Mandibular Plane to L1, Mandibular Plane to L6, SN to U1, Sn-Stms, and Pog' projection. Compared to group A, group B showed more linguoversion and extrusion of upper incisors, more extrusion of lower incisors and lower first molar, and more steepness of the occlusal plane. N-Me, ANS-Me, and Sn-Stms were also longer in group B. But Pog' projection was shorter than group A. Conclusion: We conclude that certain initial lateral cephalometric characteristics may help indicate the inclusion of advancement genioplasty when mandibular setback surgery is planned in skeletal Class III patients.

III급 부정교합의 악교정수술을 통한 치료 시 하악 후퇴술만을 시행하는 경우와 하악 후퇴술에 전진 이부성형술이 추가로 시행되는 경우에 있어 초진 시 측모 두부 방사선사진상의 특성차이에 대하여 알아보고자 하였다. 구올담치 과병원 구강외과에서 III급 부정교합을 하악후퇴술을 통하여 치료한 33명을 대상으로 하여 하악 후퇴술만을 시행한 21명과 하악 후퇴술과 전진 이부성형술을 시행한 12명으로 나누어 초진 측모 두부 방사선사진상의 차이를 알아보았다. 그 결과 B군에서 N-Me, ANS-Me이 더 길었으며 교합평면의 각도가 더 컸다. 구개평면에서 상악중절치까지의 거리, 하악평면에서 하악 절치 및 제1대구치까지의 거리가 B군에서 더 길었으며, 상악 중절치는 더 설측경사를 보였다. B군에서 Sn-Stms는 더 길고 연조직 Pog은 덜 돌출되어 있었다. 본 연구의 결과에 따라 III급 부정교합 환자에서 하악 후퇴술과 더불어 전진 이부성형술이 시행될지 여부를 예측하는데 초진 측모 두부 방사선사진상의 위 계측항목을 이용할 수 있을 것이다. 수술전 발치교정을 시행한 경우가 있다는 것과 외과의의 심미안, 해부학적 구조등이 이부성형술에 영향을 미쳤을 수 있다는 것은 본 연구의 한계로 생각된다.

Keywords

References

  1. Korean Council of Orthodontic Professors. Orthodontics 2nd Ed. Seoul: Narae Publishing; 2006. p.115
  2. Sugawara J, Mitani H. Facial growth of skeletal Class III malocclusion and the effects, limitations, and long-term dentofacial adaptations to chincap therapy. Semin Orthod 1997;3:244-54 https://doi.org/10.1016/S1073-8746(97)80057-6
  3. Nanda R. Biomechanical and clinical considerations of a modified protraction headgear. Am J Orthod 1980;78:125- 39 https://doi.org/10.1016/0002-9416(80)90055-X
  4. Ishikawa H, Nakamura S, Iwasaki H, Kitazawa S, Tsukada H, Chu S. Dentoalveolar compensation in negative overjet cases. Angle Orthod 2000;70:145-8
  5. Trauner R., Obwegeser H. The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. 1. Surgical procedures to correct mandibular prognathism and reshaping of the chin. Oral Surg Oral Med Oral Pathol 1957;10:677-89 https://doi.org/10.1016/S0030-4220(57)80063-2
  6. Dal Pont G. Retromolar osteotomy for the correction of prognathism. J Oral Surg Anecth Hosp Dent Serv 1961;19:42-7
  7. Epker BN. Modifications of the sagittal osteotomy of the mandible. J Oral Surg 1977;35:157-9
  8. Proffit WR, White RP, Saver DM. Contemporary treatment of dentofacial deformity. St Louis: Mosby; 2003
  9. Guyer EC, Ellis EE, McNamara JA, Behrents RG. Components of Class III malocclusion in juveniles and adolescents. Angle Orthod 1986;56:7-30
  10. Lew KKK, Foong WC. Horizontal skeletal typing in an ethnic clinese popluation with true class III malocclusion. Br J Orthod 1993;20:19-23 https://doi.org/10.1179/bjo.20.1.19
  11. Kim JS. Esthetic orthognathic surgery for mandibular prognahtism. Seoul: Jisung Publishing; 1999. p.11,71
  12. Burch RJ, Bowden GW, Woodward HW. Intraoral one-stage ostectomy for correction of mandibular prognathism: report of case. J Oral Surg 1961;19:72-6
  13. Hofer O. Operation der prognatic und mikrogenie. Dtsch Zahn Mund Kieferheilkd 1942;9:81-8
  14. Bell WH, Gallagher DM. The versatility of genioplasty using a broad pedicle. J Oral Maxillofac Surg 1983;41:763-9 https://doi.org/10.1016/S0278-2391(83)80041-X
  15. Wolfe S. Chin advancement as an aid in correction of deformities of the mental and submental regions. Plast Reconstr Surg 1981;67:624-9 https://doi.org/10.1097/00006534-198105000-00008
  16. Rosen HM. Aesthetic guidelines in genioplasty. the role facial disproportion. Plast Reconstr Surg 1995;95:470-2 https://doi.org/10.1097/00006534-199503000-00005
  17. Arnett GW, McLaughlin RP. Facial and dental planning for orthodontist and oral surgeons. St Louis: Mosby; 2004. p.246
  18. 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
  19. Haskell BS. The human chin and its relationship to mandibular morphology. Angle Orthod 1979;49:153-66
  20. Cha BK, Suhr CH. A study on the morphology of chin in relation to vertical sydplasia of craniofacial complex. Korean J Orthod 1990;20:135-55
  21. Ricketts RM. The keystone triad II. Growth treatment, and clinical significance. Am J Orthod 1964;50:728-50 https://doi.org/10.1016/0002-9416(64)90079-X
  22. Aki T, Nanda RS, Currier GF, Nanda SK. Assessment of symphysis morphology as a predictor of the direction of mandibular growth. Am J Orthod Dentofacial Orthop 1995;106:60-9 https://doi.org/10.1016/S0889-5406(94)70022-2
  23. Kim SJ, Son WS. A study on the relationship of the mandibular symphysis and aneterior alveolar and skeletal morphology according to the rotational growth pattern of mandible in skeletal Class III malocclusion. Korean J Orthod 1999;29:303-15
  24. Kim SD, Kwon OW, Sung JH. The relationship between the morphology of mandibular symphysis and the craniofacial morphology in Class III malocclusion. Korean J Orthod 1996;26:509-22
  25. Wolford LM, Chemello PD, Hilliard F. Occlusal plane alteration in orthognathic surgery-part 1: Effects on function and esthetics. Am J Orthod Dentofacial Orthop 1994;106:304-16 https://doi.org/10.1016/S0889-5406(94)70051-6