대한치과교정학회지 (The korean journal of orthodontics)

  • 제39권6호
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  • Pages.402-419
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  • 2009
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  • 2234-7518(pISSN)
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  • 2005-372X(eISSN)
대한치과교정학회 (The Korean Association Of Orthodontists)
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성인 환자에서 구치부 압하를 통한 개방교합의 치료와 유지

Non-surgical treatment and retention of open bite in adult patients with orthodontic mini-implants

  • 투고 : 2008.12.01
  • 심사 : 2009.09.16
  • 발행 : 2009.12.30
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초록

성장이 종료된 치성 또는 골격성 개방교합 환자를 치료하는 것은 매우 어려운 일이다. 전치부 개방교합 환자는 증가된 전안면고경, 상악 구치부의 과도한 수직성장, 큰 하악각 등의 특징을 지닌다. 이러한 증례에서 구치의 압하를 통한 개방교합의 해소는 좋은 치료전략이다. 본 연구는 교정용 미니임플란트를 이용하여 개방교합을 치료하고 성공적인 유지를 얻은 두 명의 환자에 대한 보고이다. 적절한 진단이 시행되고 교정용 미니임플란트 등의 장치를 이용한 치료기법을 적용하면 수술치료 없이 교정치료만으로 개방교합의 치료가 가능하며, 하악구치부에 posterior bite block을 추가한 가철식 유지장치 및 SFR이 개교환자를 위한 유지장치 또는 보조유지장치로 유용하게 사용될 수 있다는 결론을 얻었다.

Successful treatment of the non-growing patient with an open bite of either dental skeletal pattern often presents a difficult challenge. The morphologic pattern in anterior open bite is characterized by longer vertical dimensions, an increase in development of the maxillary posterior dento-alveolar structure and a steep mandibular plane. In such cases, molar intrusion would be a good remedy for treatment. This article reports the successful treatment and retention of two anterior open-bite cases. We used orthodontic mini-implants for treatment and a circumferential retainer with posterior bite block or skeletal fixed retainer for retention. The diagnostic criteria and mechanics for appropriate treatment are discussed. Our results suggest that open bite can be reduced successfully with intrusion of molars using orthodontic mini-implants (OMI) without orthognathic surgery, and that circumferential retainer with posterior bite block and skeletal fixed retainer are effective for retention.

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참고문헌

  1. Epker BN, Fish L. Surgical-orthodontic collection of open-bite deformity. Am J Orthod 1977;71:278-99 https://doi.org/10.1016/0002-9416(77)90188-9
  2. Proffit WR, Phillips C, Dann C 4th. Who seeks surgical- orthodontic treatment? Int J Adult Orthodon Orthognath Surg 1990;5:153-60
  3. Proffit WR, Fields HW Jr. Contemporary Orthodontics. 2nd ed. St Louis: Mosby-Year Book Inc; 1993. p. 464-506
  4. Isaacson JR, Isaacson RJ, Speidel TM, Worms FW. Extreme variation in vertical facial growth and associated variation in skeletal and dental relations. Angle Orthod 1971;41:219-29
  5. Sassouni V. A classification of skeletal facial types. Am J Orthod 1969;55:109-23 https://doi.org/10.1016/0002-9416(69)90122-5
  6. Schudy FF. The rotation of the mandible resulting from growth: its implications in orthodontic treatment. Angle Orthod 1965;35:36-50
  7. Chae JM, Chang NY, Cho JH, Kang KH, Kim SC. Treatment of skeletal Class II adult patient with vertical and transverse problems caused by nasal airway obstruction using microimplant anchorage. Korean J Orthod 2009;39:257-72 https://doi.org/10.4041/kjod.2009.39.4.257
  8. Freudenthaler JW, Haas R, Bantleon HP. Bicortical titanium screws for critical orthodontic anchorage in the mandible: a preliminary report on clinical applications. Clin Oral Implants Res 2001:12:358-63 https://doi.org/10.1034/j.1600-0501.2001.012004358.x
  9. Bernhart T, Vollgruber A, Gahleitner A, D$\"{o}$rtbudak O, Haas R. Alternative to median region of the palate for placement of an orthodontic implant. Clin Oral Implants Res 2000;11:595-601 https://doi.org/10.1034/j.1600-0501.2000.011006595.x
  10. Tosun T, Keles A, Erverdi N. Method for the placement of palatal implants. Int J Oral Maxillofac Implants 2002;17:95-100
  11. Kim SJ, Lim SH. Anatomic study of the incisive canal in relation to midpalatal placement of mini-implant. Korean J Orthod 2009;39:146-58 https://doi.org/10.4041/kjod.2009.39.3.146
  12. Higuchi KW, Slack JM. The use of titanium fixtures for intraoral anchorage to facilitate orthodontic tooth movement. Int J Oral Maxillofac Implants 1991;6:338-44
  13. Kuroda S, Katayama A, Takano-Yamamoto T. Severe anterior open-bite case treated using titanium screw anchorage. Angle Orthod 2004;74:558-67
  14. Lee YS, Kim JC. A cephalometric study on the airway size according to the types of the malocclusion. Korean J Orthod1995;25:19-29
  15. Kim JH, Lee KS. Relations between posture and size of the tongue and dentoalveolar pattern. Korean J Orthod 1986;8:305-18
  16. Subtenly JD, Sakuda M. Open bite: diagnosis and treatment. Am J Orthod 1964:50:337-58 https://doi.org/10.1016/0002-9416(64)90175-7
  17. Proffit WR, Fields HW, Nixon WL. Occlusal forces in normaland long-face adults. J Dent Res 1983;62:566-70 https://doi.org/10.1177/00220345830620051201
  18. Chun YS, Row J. Cephalometric analysis in Children and Adolescent. Seoul: JeeSeung Publishing Co; 1999. p. 163-6
  19. Kim YH. Anterior open bite and its treatment with multiloop edgewise archwire. Angle Orthod 1987;57:290-321
  20. Proffit WR, Fields HW Jr, Sarver DM. Contemporary Orthodontics. 4th ed. St Louis: Mosby; 2007. p. 695-9
  21. Umemori M, Sugawara J, Mitani H, Nagasaka H, Kawamura H. Skeletal anchorage system for open-bite correction. Am J Orthod Dentofacial Orthop 1999;115:166-74 https://doi.org/10.1016/S0889-5406(99)70345-8
  22. Moon CH. Clinical use and failure of skeletal anchorage system. J Korean Dental Assoc 2002;40:68-74
  23. Janson G, Valarelli FP, Henriques JF, de Freitas MR, Cançado RH. Stability of anterior open bite nonextraction treatment in the permanent dentition. Am J Orthod Dentofacial Orthop 2003; 124:265-76 https://doi.org/10.1016/S0889-5406(03)00449-9
  24. de Freitas MR, Beltr$\~{a}$o RT, Janson G, Henriques JF, Can$\c{c}$ado RH. Long-term stability of anterior open bite extraction treatment in the permanent dentition. Am J Orthod Dentofacial Orthop 2004;125:78-87 https://doi.org/10.1016/j.ajodo.2003.01.006
  25. Sugawara J, Baik UB, Umemori M, Takahashi I, Nagasaka H, Kawamura H, et al. Treatment and posttreatment dentoalveolar changes following intrusion of mandibular molars with application of a skeletal anchorage system (SAS) for open bite correction. Int J Adult Orthodon Orthognath Surg 2002;17:243-53
  26. Kuroda S, Sakai Y, Tamamura N, Deguchi T, Takano- Yamamoto T. Treatment of severe anterior open bite with skeletal anchorage in adults: comparison with orthognathic surgery outcomes. Am J Orthod Dentofacial Orthop 2007;132:599-605 https://doi.org/10.1016/j.ajodo.2005.11.046
  27. Lee HA, Park YC. Treatment and posttreatment changes following intrusion of maxillary posterior teeth with miniscrew implants for open bite correction. Korean J Orthod 2008;38:31-40 https://doi.org/10.4041/kjod.2008.38.1.31

피인용 문헌

  1. Severe bidentoalveolar protrusion treated with lingual Biocreative therapy using palatal miniplate vol.40, pp.4, 2010, https://doi.org/10.4041/kjod.2010.40.4.276
  2. Three-dimensional finite element analysis for determining the stress distribution after loading the bone surface with two-component mini-implants of varying length vol.41, pp.6, 2011, https://doi.org/10.4041/kjod.2011.41.6.423
  3. En-masse retraction dependent on a temporary skeletal anchorage device without posterior bonding or banding in an adult with severe bidentoalveolar protrusion: Seven years posttreatment vol.141, pp.4, 2012, https://doi.org/10.1016/j.ajodo.2010.06.028