대한소아치과학회지 (Journal of the korean academy of Pediatric Dentistry)

  • 제36권3호
  • /
  • Pages.420-426
  • /
  • 2009
  • /
  • 1226-8496(pISSN)
  • /
  • 2288-3819(eISSN)
대한소아치과학회 (Korean Academy of Pediatric Dentistry)
권호 표지

유치열기 3급 부정교합 환아에서 facemask의 효과와 재발 양상

THE EFFECT AND RELAPSE PATTERN OF FACEMASK THERAPY FOR CLASS III MALOCCLUSION CHILDREN

  • 김지연 (성균관대학교 의과대학 삼성서울병원 소아치과) ;
  • 유승은 (성균관대학교 의과대학 삼성서울병원 소아치과) ;
  • 이지현 (성균관대학교 의과대학 삼성서울병원 소아치과) ;
  • 박기태 (성균관대학교 의과대학 삼성서울병원 소아치과)
  • Kim, Ji-Yeon (Department of Pediatric Dentistry, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Yoo, Seung-Eun (Department of Pediatric Dentistry, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Ji-Hyun (Department of Pediatric Dentistry, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ki-Tae, Ki-Tae (Department of Pediatric Dentistry, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 발행 : 2009.08.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 연구의 목적은 유치열기 3급 부정 교합 환아에서 facemask를 이용한 악정형 치료 후 골격적 변화와 치료 후 나타나는 재발 양상을 평가하는 것이다. 유치열기 3급 부정교합 환아 15명을 대상으로 구내장치로 bonded expander, 구외장치로 facemask를 이용한 악정형 치료를 평균 12 개월 동안 시행하였으며, 1년 간의 follow-up 기간 동안 유지 장치는 사용되지 않았다. 치료 시작 전, 치료 직후, 치료 1년 후에 측면두부방사선사진을 촬영하고 전후방 및 수직적 골격관계와 연조직의 변화를 비교분석하였다. 모든 환아에서 치료 직후, 유의할 만한 골격적 전후방 관계의 변화를 보였고 1년 간의 follow-up 기간 동안 재발되는 경향을 보였으나 치료 시작 전과 비교하여 치료 효과는 유지되었다. 수직적 골격적 변화는 치료 직후 증가되었으나 1년 간의 follow-up 기간 동안 다시 감소하여 치료 시작 전과 비교하여 차이를 보이지 않았다. 연조직의 변화는 facial convexity 및 상순의 위치가 치료 직후 개선됨을 보였고 1년 간의 follow-up 기간 동안에도 치료 전과 비교하여 치료효과는 유지되었다. 하순의 위치는 치료 직후에 유의할 만한 변화를 보이지 않았다. Facemask는 유치열기 3급 부정교합에 있어서 효과적인 치료 방법이며, 안정적인 치료 결과를 위해서는 적절한 형태의 유지장치가 고려되는 것이 바람직하다.

The purpose of this study was to evaluate skeletal and soft tissue changes that occur after using a facemask for treatment of skeletal class III malocclusion, and to assess the relapse pattern when no retention appliance was used. Fifteen skeletal class III malocclusion patients were treated with a facemask for an average of 12 months. No retention appliance was used during the 1 year follow-up period. Cephalograms were taken during pretreatment, posttreatment, and the 1 year follow-up. Cephalograms were traced, analyzed, and the results were compared between cephalograms. All patients showed significant sagittal skeletal changes after treatment, but they also showed a significant relapse during the 1 year follow-up period when no retention appliance was used. Despite the relapse, the sagittal skeletal changes that remained were still significant. Vertical skeletal change was also significant after treatment, but the total change was not significant after a 1 year follow-up due to relapse. In soft tissue changes, facial convexity and upper lip position improved after treatment and this change remained significant after the 1 year follow-up period. Facemask therapy is therefore an effective method for treatment of skeletal class III malocclusion, however, retention is imperative to maintain the treatment effect.

키워드

참고문헌

  1. Franchi L, Baccetti T, McNamara JA : Postpubertal assessment of treatment timing for maxillary expansion and protraction therapy followed by fixed appliances. Am J Orthod Dentofacial Orthop, 126:555-568, 2004. https://doi.org/10.1016/j.ajodo.2003.10.036
  2. Ishii H, Morita S, Takeuchi Y, et al. : Treatment effect of combined maxillary protraction and chincap appliance in severe skeletal Class III cases. Am J Orthod Dentofacial Orthop, 92:304-312, 1987. https://doi.org/10.1016/0889-5406(87)90331-3
  3. Sarnas KV, Rune B : Extraoral traction to the maxilla with face mask: a follow-up of 17 consecutively treated patients with and without cleft lip and palate. Cleft Palate J, 24:95-103, 1987.
  4. Wisth PJ, Tritrapunt A, Rygh P, et al. : The effect of maxillary protraction on front occlusion and facial morphology. Acta Odontol Scand, 45:227-237, 1987. https://doi.org/10.3109/00016358709098862
  5. McNamara JA Jr. : An orthopedic approach to the treatment of Class III malocclusion in young patients. J Clin Orthod, 21:598-608, 1987.
  6. Ngan P, Yiu C, Hu A, et al. : Cephalometric and occlusal changes following maxillary expansion and protraction. Eur J Orthod, 20:237-254, 1998. https://doi.org/10.1093/ejo/20.3.237
  7. Turley PK : Orthopedic correction of Class III malocclusion with palatal expansion and custom protraction headgear. J Clin Orthod, 22:314-325, 1988.
  8. Shanker S, Ngan P, Wade D, et al. : Cephalometric A point changes during and after maxillary protraction and expansion. Am J Orthod Dentofacial Orthop, 110:423-430, 1996. https://doi.org/10.1016/S0889-5406(96)70046-X
  9. Baccetti T, Franchi L, McNamara JA Jr. : Cephalometric variables predicting the long-term success or failure of combined rapid maxillary expansion and facial mask therapy. Am J Orthod Dentofacial Orthop, 126:16-22, 2004. https://doi.org/10.1016/j.ajodo.2003.06.010
  10. Baccetti T, Tollaro I : A retrospective comparison of functional appliance treatment of Class III malocclusions in the deciduous and mixed dentitions. Eur J Orthod, 20:309-317, 1998. https://doi.org/10.1093/ejo/20.3.309
  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, 113:204-212, 1998. https://doi.org/10.1016/S0889-5406(98)70141-6
  12. Nakamura S, Okada A, Takeuchi Y : Cephalometric evaluation of surgical orthodontic treatment for the correction of anterior cross-bites. Am J Orthod, 76:178-195, 1979. https://doi.org/10.1016/0002-9416(79)90119-2
  13. Sakamoto T : Effective timing for the application of orthopedic force in the skeletal class III malocclusion. Am J Orthod, 80:411-416, 1981. https://doi.org/10.1016/0002-9416(81)90175-5
  14. 성재현 : III급 부정교합의 치료전략. 대한치과교정학회지, 26:125-139, 1996.
  15. Merwin D, Ngan P, Hagg U, et al. : Timing for effective application of anteriorly directed orthopedic force to the maxilla. Am J Orthod Dentofacial Orthop, 112:292-299, 1997. https://doi.org/10.1016/S0889-5406(97)70259-2
  16. Suda N, Ishii-Suzuki M, Hirose K, et al. : Effective treatment plan for maxillary protraction: is the bone age useful to determine the treatment plan? Am J Orthod Dentofacial Orthop, 118:55-62, 2000. https://doi.org/10.1067/mod.2000.104491
  17. Kama JD, Ozer T, Baran S : Orthodontic and orthopaedic changes associated with treatment in subjects with Class III malocclusions. Eur J Orthod, 28:496-502, 2006. https://doi.org/10.1093/ejo/cjl011
  18. MacDonald KE, Kapust AJ, Turley PK : Cephalometric changes after the correction of class III malocclusion with maxillary expansion/facemask therapy. Am J Orthod Dentofacial Orthop, 116:13-24, 1999. https://doi.org/10.1016/S0889-5406(99)70298-2
  19. Cederquist R : Degree of stability following experimental alteration of midfacial growth with heavy intermittent force (proceedings). Proc Inst Med Chic, 32:50-51, 1978.
  20. Ishii H, Nakamura S, Masaki F, et al. : Experimental study on morphological and histological changes after removal of orthopedic appliance to skeletal Class III with underdeveloped nasomaxillary complex (author's transl). Nippon Kyosei Shika Gakkai Zasshi, 39:53-63, 1980.
  21. Jackson GW, Kokich VG, Shapiro PA : Experimental and postexperimental response to anteriorly directed extraoral force in young Macaca nemestrina. Am J Orthod, 75:318-333, 1979. https://doi.org/10.1016/0002-9416(79)90278-1
  22. Smalley WM, Shapiro PA, Hohl TH, et al. : Osseointegrated titanium implants for maxillofacial protraction in monkeys. Am J Orthod Dentofacial Orthop, 94:285-295, 1988. https://doi.org/10.1016/0889-5406(88)90053-4
  23. Brodie AG : On the growth pattern of human head from the third month to the eight year of life. Am J Anat, 68:209-262, 1941. https://doi.org/10.1002/aja.1000680204
  24. Mitani H : Prepubertal growth of mandibular prognathism. Am J Orthod, 80:546-553, 1981. https://doi.org/10.1016/0002-9416(81)90249-9
  25. Baccetti T, Franchi L, McNamara JA Jr. : Treatment and posttreatment craniofacial changes after rapid maxillary expansion and facemask therapy. Am J Orthod Dentofacial Orthop, 118:404-413, 2000. https://doi.org/10.1067/mod.2000.109840
  26. Baccetti T, McGill JS, Franchi L, et al. : Skeletal effects of early treatment of Class III malocclusion with maxillary expansion and face-mask therapy. Am J Orthod Dentofacial Orthop, 113:333-343, 1998. https://doi.org/10.1016/S0889-5406(98)70306-3
  27. 김태우, 장영일, 남동석 : FACE MASK의 치료 효과에 대한 후향적 고찰. 대한치과교정학회지, 26:547-556, 1996.
  28. Lavergne J, Gasson N : Operational definitions of mandibular morphogenetic and positional rotations. Scand J Dent Res, 85:185-192, 1977.