The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Correlation between menton deviation and dental compensation in facial asymmetry using cone-beam CT

Cone-beam CT를 이용한 안면비대칭자에서 이부편위에 따른 치성보상의 양상분석

  • Park, Soo-Byung (Department of Orthodontics, School of Dentistry, Pusan National University) ;
  • Park, Jeong-Heuy (Department of Orthodontics, School of Dentistry, Pusan National University) ;
  • Jung, Yun-Hoa (Department of Oral & Maxillofacial Radiology, School of Dentistry, Pusan National University) ;
  • Jo, Bong-Hye (Department of Oral & Maxillofacial Radiology, School of Dentistry, Pusan National University) ;
  • Kim, Yong-Il (Department of Orthodontics, School of Dentistry, Pusan National University)
  • 박수병 (부산대학교 치의학전문대학원 교정학교실) ;
  • 박정희 (부산대학교 치의학전문대학원 교정학교실) ;
  • 정연화 (부산대학교 치의학전문대학원 구강악안면방사선학교실) ;
  • 조봉혜 (부산대학교 치의학전문대학원 구강악안면방사선학교실) ;
  • 김용일 (부산대학교 치의학전문대학원 교정학교실)
  • Received : 2009.04.06
  • Accepted : 2009.08.23
  • Published : 2009.10.30
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Abstract

Objective: The purpose of this study was to evaluate the correlation between menton deviation and dental compensation in facial asymmetry. Methods: Tooth axis and distance of first molar and canine to the reference plane were investigated by cone-beam computerized tomography. The subjects consisted of 50 patients with asymmetric mandibles (male 21, female 29, mean age 24.3 years). Control groups were also assessed (male 11, female 9, mean age 25.6 years). Nine measurements (5 linear measurements and 4 angular measurements) were measured in order to evaluate the correlation between menton deviation and the linear and angular difference of first molar and canine in the deviated and none-deviated sides using the defined MPR images. The differences between deviated and non-deviated side, according to menton deviation, were statistically analyzed using stepwise multiple regression analysis. Results: From the result, Menton deviation was negatively correlated with mandibular first molar's angular measurement (${\Delta\angle}LM6$-Mn plane (dev.-ndev.)) and positively with maxillary fist molar's angular measurement (${\Delta\angle}UM6$-FH plane (dev.-ndev.)) (p < 0.01). Two angular measurements (${\Delta\angle}LM6$-Mn plane (dev.-ndev.), ${\Delta\angle}UM6$-FH plane (dev.-ndev.)) explained the variability in menton deviation with a significant $r^2$ value of 0.589. Conclusions: This study suggests that the tooth axis of upper and lower first molars leans towards the deviated side of Menton when there is mandibular asymmetry with Menton deviation.

본 연구는 Cone-beam CT의 MPR이미지상에서 하악골 평면에 대한 하악 제1대구치와 견치의 편위측과 비편위측의 높이와 각도차이 그리고 FH 평면에 대한 상악 제1대구치와 견치의 편위측과 비편위측의 높이와 각도차이를 계측함으로써 안면비대칭자에서 이부편위에 따른 편위측과 비편위측의 제1대구치와 견치의 높이와 협설측 경사도를 CBCT를 이용하여 분석하고 그 관련성을 알아보는 데 있다. 연구대상은 하악골의 이부편위를 동반한 안면비대칭 환자 50명(여자 29명, 남자 21명, 평균나이 24세 4개월)으로 하였다. 대조군으로 평균나이 25세 7개월인 20명(남자 11명, 여자 9명)을 분석하였다. 결과는 이부편위에 대해 FH 평면에 대한 상악 제1대구치의 편위측과 비편위측의 길이 및 각도 차이(편위측 - 비편위측)는 대조군에 대해 통계적으로 유의한 차이가 존재하였다 (p < 0.01). 비대칭군에서 상악 제1대구치 각도는 편위측이 비편위측보다 평균 $8.62\;{\pm}\;5.95^{\circ}$ 컸다 (p < 0.01). 상악 견치의 경우에도 편위측과 비편위측의 각도차이가 평균 $4.48\;{\pm}\;5.05^{\circ}$로 통계적으로 유의한 차이가 존재하였다 (p < 0.01). 하악골 평면에 대한 하악 제1대구치의 수직 길이와 각도는 편위측과 비편위측에서 통계적으로 유의할 만한 차이가 존재하였다 (p < 0.01). 각도의 차이는 평균 $-11.92\;{\pm}\;5.79^{\circ}$로 나타났다. 이부편위에 대한 상하악 제1대구치와 견치의 수직거리 및 각도의 Pearson 상관분석 및 회귀분석 결과, FH 평면에 대한 상악 제1대구치의 편위측과 비편위측의 각도차이(${\Delta\angle}UM6$-FH plane (dev.-ndev.))는 통계적으로 유의한 양의 상관관계를 나타내었고, 하악골 평면에 대한 하악 제1대구치의 편위측과 비편위측의 각도차이(${\Delta\angle}LM6$-Mn plane (dev.-ndev.))는 통계적으로 유의한 음의 상관관계를 나타내었다. 이상의 결과에서 이부편위를 동반한 하악골 비대칭이 존재하는 경우, 이부가 편위되는 방향으로 상하악 제1대구치의 치아장축의 각도가 변화되는 것으로 나타났다.

Keywords

References

  1. Peck H, Peck S. A concept of facial esthetics. Angle Orthod 1970;40:284-318
  2. Simon PW. Fundamental principles of a systematic diagnosis of dental anomalies. Boston: Stratford; 1926
  3. Grayson B, Cutting C, Bookstein FL, Kim H, McCarthy JG. The three-dimensional cephalogram: theory, technique, and clinical application. Am J Orthod Dentofacial Orthop 1988;94:327-37 https://doi.org/10.1016/0889-5406(88)90058-3
  4. Kusnoto B, Evans CA, BeGole EA. de Rijk W. Assessment of 3-dimensional computer-generated cephalomtric measurements. Am J Orthod Dentofacial Orthop 1999;116:390-9 https://doi.org/10.1016/S0889-5406(99)70223-4
  5. Kim WS, Lee KH, Hwang HS. Comparison of asymmetric degree between maxillofacial hard and soft tissue in facial asymmetric subjects using three-dimensional computed tomography. Korean J Orthod 2005;35:163-73
  6. Kwon TG, Park HS, Ryoo HM, Lee SH. comparison of craniofacial morphology in patients with and without facial asymmetry--a three-dimensional analysis with computed tomography.Int J Oral Maxillofac Surg 2006;35:43-8 https://doi.org/10.1016/j.ijom.2005.04.006
  7. Kim GW, Kim JH, Lee KH, Hwang HS. Reproducibility of asymmetry measurements of the mandible in three-dimensional CT imaging. Korean J Orthod 2008;38:314-27 https://doi.org/10.4041/kjod.2008.38.5.314
  8. Park JW, Kim N, Chang YI. Comparison of landmark position between conventional cephalometric radiography and CT scans projected to midsagittal plane. Korean J Orthod 2008;38:427-36 https://doi.org/10.4041/kjod.2008.38.6.427
  9. Chang HS, Baik HS. A proposal of landmarks for craniofacial analysis using three-dimensional CT imaging. Korean J Orthod 2002;32:313-25
  10. Yoon SJ, Lim HJ, Kang BC, Hwang HS. Three dimensional CT analysis of facial asymmetry. Korean J Oral Maxiillofac Radiol 2007;37:45-51
  11. Hinds EC, Reid LC, Burch RJ. Classification and management of mandibular asymmetry. Am J Surg 1960;100:825-34 https://doi.org/10.1016/0002-9610(60)90513-4
  12. Ahn JS, Hwang HS. Relationship between perception of facial asymmetry and posteroanterior cephalometric measurements. Korean J Orthod 2001;31:489-98
  13. Kim GW, Kim JH, Lee KH, Hwang HS. Reproducibility of asymmetry measurements of the mandible in three-dimensional CT imaging. Korean J Orthod 2008;38:314-27 https://doi.org/10.4041/kjod.2008.38.5.314
  14. Vig PS, Hewitt AB. Asymmetry of the human facial skeleton. Angle Orthod 1975;45:125-9
  15. Grayson BH, McCarthy JG, Bookstein F. Analysis of craniofacial asymmetry by multiplane cephalometry. Am J Orthod 1983;84:217-24 https://doi.org/10.1016/0002-9416(83)90129-X
  16. Fukushima K, Yasui K, Otsuka Y, Matsui S, Hirase N, Takayanagi J, et al. Morphological characteristics of patients with jaw deformity: frontal cephalometric evaluation of facial symmetry. Meikai Univ Dent J 2003;32:118-23
  17. Tani M, Iketani M, Watanabe M, Suda S, Fujimura N, Miyazawa M, et al. Posterior-anterior cephalometric analysis in patients with dentofacial deformities. J Jpn Stomatol Soc 1989;35:1749-59
  18. Youn IS, Lee KH, Hwang HS. Clasification of facial asymmetry by cluster analysis. J Korean Dent Assoc 2001;39:765-73 https://doi.org/10.1016/j.ajodo.2007.01.017
  19. Silva MA, Wolf U, Heinicke F, Bumann A, Visser H, Hirsch E. Cone-beam computed tomography for routine orthodontic treatment planning: a radiation dose evaluation. Am J Orthod Dentofaial Orthop 2008;133:640.e1-5 https://doi.org/10.1016/j.ajodo.2007.11.019
  20. Proffit WR. Concepts of growth and development. In: Proffit WR editor. Contemporary orthodontics. 4th ed. St. Louis:Mosby; 2007. p.27-71
  21. Matteson SR, Bechtold W, Phillips C, Staab EV. A method for three-dimensional image reformation for quantitative cephalometric analysis. J Oral Maxillofac Surg 1989;47:1053-61 https://doi.org/10.1016/0278-2391(89)90180-8
  22. Proffit WR. Retention. In: Proffit WR editor. Contemporary orthodontics. 4th ed. St. Louis: Mosby; 2007. p. 617-31

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