The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Camouflage treatment in adult skeletal Class III cases by extraction of two lower premolars

성인 골격성 III급 부정교합환자의 하악 소구치 발치를 통한 보상치료

  • Ning, Fang (Department of Orthodontics, School of Stomatology, The Fourth Military Medical University) ;
  • Duan, Yinzhong (Department of Orthodontics, School of Stomatology, The Fourth Military Medical University)
  • Received : 2010.02.03
  • Accepted : 2010.03.23
  • Published : 2010.10.30
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Abstract

Objective: The purpose of this study was to evaluate the dentoskeletal and soft tissue profile changes after extraction of two lower first or second premolars in "borderline" adult skeletal Class III cases. Methods: Twenty-eight patients with "borderline" skeletal Class III malocclusion were studied. All of them were treated by extraction of two lower first or second premolars. Lateral cephalometric radiographs taken at the start and end of treatment were analysed. Twenty-five cephalometric variables were calculated and paired $t$-tests were performed. Results: After treatment, no significant changes were noted in the skeletal parameters ($p{\geq}0.05$). Regarding the dental parameters, the L1-MP angle decreased by $8.1^{\circ}$, the U1-L1 angle increased by $7.7^{\circ}$ ($p$ < 0.01), the overjet distance increased by 5.7 mm ($p$ < 0.01), the L1-NB angle decreased by $7.3^{\circ}$ and the L1-NB distance decreased by 4.8 mm ($p$ < 0.01). The soft tissue parameters of Li-E, Li-H and Li-RL2 distance decreased by 3.2 mm, 3.4 mm and 4.1 mm respectively ($p$ < 0.01). Conclusions: Orthodontic camouflage treatment by extraction of two lower first or second premolars provides a viable treatment alternative for "borderline" skeletal Class III cases to achieve a good occlusal relationship.

이번 연구의 목적은 성인 골격성 III급 부정교합환자의 하악 제1소구치 또는 제2소구치 발치 후에 치조골격성 변화와 연조직 변화를 평가하는 데 있다. 28명의 경계선상에 있는 골격성 III급 부정교합환자들이 연구되었다. 모든 환자는 하악 제1소구치 또는 제2소구치를 발치한 후 치료되었으며 치료 전과 치료 후 측모두부방사선사진을 촬영하여 paired t-test를 통해 분석하였다. 치료 후에 골격적으로 유의성 있는 변화는 관찰되지 않았다. 치성변화에 대해 하악 전치각도가 8.1도 정도 감소하였으며 interincisal angle은 7.7도 정도 증가하였다 ($p$ < 0.01). 수평 피개는 5.7 mm로 증가하였으며 ($p$ < 0.01), L1-NB 각은 7.3도 감소하였고 L1-NB 거리는 4.8 mm 감소하였다 ($p$ < 0.01). 연조직 변화에 있어 Li-E, Li-H과 LiRL2 거리는 각각 3.2 mm, 3.4 mm, 4.1 mm 감소하였다 ($p$ < 0.01). 심하지 않은 골격성 III급 부정교합 환자에 대한 하악 소구치 발치를 통한 교정적인 보상치료는 우수한 교합관계를 달성할 수 있으며 예측이 가능한 치료 대안이 될 수 있다.

Keywords

References

  1. Lin J, Gu Y. Preliminary investigation of nonsurgical treatment of severe skeletal Class III malocclusion in the permanent dentition. Angle Orthod 2003;73:401-10.
  2. Guyer EC, Ellis EE 3rd, McNamara JA Jr, Behrents RG. Components of Class III malocclusion in juveniles and adolescents. Angle Orthod 1986;56:7-30.
  3. Dietrich UC. Morphological variability of skeletal Class 3 relationships as revealed by cephalometric analysis. Rep Congr Eur Orthod Soc 1970;131-43.
  4. Duan YZ, Yang ZH, Leng J. Effects of face mask/Class III elastic therapy on severe skeletal crossbite. J Modern Stomatol 2003;17:251-2.
  5. Gu Y, Rabie AB, Hagg U. Treatment effects of simple fixed appliance and reverse headgear in correction of anterior crossbites. Am J Orthod Dentofacial Orthop 2000;117:691-9. https://doi.org/10.1016/S0889-5406(00)70178-8
  6. Uner O, Yuksel S, Ucuncu N. Long-term evaluation after chincap treatment. Eur J Orthod 1995;17:135-41. https://doi.org/10.1093/ejo/17.2.135
  7. Cha KS. Skeletal changes of maxillary protraction in patients exhibiting skeletal class III malocclusion: a comparison of three skeletal maturation groups. Angle Orthod 2003;73:26-35.
  8. Tollaro I, Baccetti T, Franchi L. Craniofacial changes induced by early functional treatment of Class III malocclusion. Am J Orthod Dentofacial Orthop 1996;109:310-8. https://doi.org/10.1016/S0889-5406(96)70154-3
  9. Lin J, Gu Y. Lower second molar extraction in correction of severe skeletal Class III malocclusion. Angle Orthod 2006;76:217-25.
  10. Sato S. Case report: developmental characterization of skeletal Class III malocclusion. Angle Orthod 1994;64:105-11.
  11. Lew KK. Soft tissue profile changes following orthodontic treatment of Chinese adults with Class III malocclusion. Int J Adult Orthodon Orthognath Surg 1990;5:59-65.
  12. Demir A, Uysal T, Sari Z, Basciftci FA. Effects of camouflage treatment on dentofacial structures in Class II division 1 mandibular retrognathic patients. Eur J Orthod 2005;27:524-31. https://doi.org/10.1093/ejo/cji046
  13. Nalbantgil D, Arun T, Sayinsu K, Fulya I. Skeletal, dental and soft-tissue changes induced by the Jasper Jumper appliance in late adolescence. Angle Orthod 2005;75:426-36.
  14. Ning F, Duan Y, Huo N. Camouflage treatment in skeletal Class III cases combined with severe crowding by extraction of four premolars. Orthod Waves 2009;68:80-7. https://doi.org/10.1016/j.odw.2009.01.004
  15. Rabie AB, Wong RW, Min GU. Treatment in borderline Class III malocclusion: orthodontic camouflage (extraction) versus orthognathic surgery. Open Dent J 2008;2:38-48. https://doi.org/10.2174/1874210600802010038
  16. Cassidy DW Jr, Herbosa EG, Rotskoff KS, Johnston LE Jr. A comparison of surgery and orthodontics in "borderline" adults with Class II, division 1 malocclusions. Am J Orthod Dentofacial Orthop 1993;104:455-70. https://doi.org/10.1016/0889-5406(93)70072-V
  17. Kerr WJ, Miller S, Dawber JE. Class III malocclusion: surgery or orthodontics? Br J Orthod 1992;19:21-4. https://doi.org/10.1179/bjo.19.1.21
  18. Zeng XL, Lin JX, Huang JF. Skeletal crossbite: surgery or orthodontics? West China Journal of Stomatology 1985;3:233-7.
  19. Stellzig-Eisenhauer A, Lux CJ, Schuster G. Treatment decision in adult patients with Class III malocclusion: orthodontic therapy or orthognathic surgery? Am J Orthod Dentofacial Orthop 2002;122:27-37. https://doi.org/10.1067/mod.2002.123632
  20. Pellegrino G. Italian board of orthodontics: case N. 2 adult malocclusion. Prog Orthod 2005;6:102-12.
  21. Fukui T, Tsuruta M. Invisible treatment of a Class III female adult patient with severe crowding and cross-bite. J Orthod 2002;29:267-75. https://doi.org/10.1093/ortho/29.4.267

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