The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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The relationship between condyle position, morphology and chin deviation in skeletal Class III patients with facial asymmetry using cone-beam CT

안면비대칭을 동반한 골격성 III급 부정교합자에서 하악 과두의, 위치 형태와 이부 편위의 관계: cone-beam CT를 이용한 연구

  • Lee, Bo-Ram (Department of Orthodontics, School of Dentistry, Pusan National University) ;
  • Kang, Dae-Keun (Department of Orthodontics, School of Dentistry, Pusan National University) ;
  • Son, Woo-Sung (Department of Orthodontics, School of Dentistry, Pusan National University) ;
  • Park, Soo-Byung (Department of Orthodontics, School of Dentistry, Pusan National University) ;
  • Kim, Seong-Sik (Department of Orthodontics, School of Dentistry, Pusan National University) ;
  • Kim, Yong-Il (Department of Orthodontics, School of Dentistry, Pusan National University) ;
  • Lee, Kyung-Min (Department of Orthodontics, School of Dentistry, Pusan National University)
  • 이보람 (부산대학교 치의학전문대학원 치과교정학교실) ;
  • 강대근 (부산대학교 치의학전문대학원 치과교정학교실) ;
  • 손우성 (부산대학교 치의학전문대학원 치과교정학교실) ;
  • 박수병 (부산대학교 치의학전문대학원 치과교정학교실) ;
  • 김성식 (부산대학교 치의학전문대학원 치과교정학교실) ;
  • 김용일 (부산대학교 치의학전문대학원 치과교정학교실) ;
  • 이경민 (부산대학교 치의학전문대학원 치과교정학교실)
  • Received : 2011.01.17
  • Accepted : 2011.03.04
  • Published : 2011.04.30
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Abstract

Objective: Facial asymmetry is usually evaluated from the difference in length and angulation of the maxilla and mandible. However, asymmetric position or shape of the condyle can also affect the expression of asymmetry. The purpose of this study was to evaluate the correlation between condylar asymmetry and chin point deviation in facial asymmetry. Methods: Cone-beam CT images of fifty adult skeletal Class III patients were studied. Thirty patients who had more than 4 mm menton deviation were categorized in the asymmetric group. Twenty patients with less than 4 mm menton deviation were assigned to the symmetric group. Anteroposterior and transverse condyle positions were evaluated from the cranial base. The greatest mediolateral diameter (GMD) of the condyle in the axial plane and angulation to the coronal plane were measured. The height and volume of the condyles were evaluated. Results: The symmetric group had no statistical difference between both condyles in position, angulation, GMD, height and volume. In the asymmetric group, the non-deviated side condyle was larger in GMD, height and volume than the deviated side. There was no statistical difference in condyle position and angulation. The GMD, height difference and condylar volume ratio (non-deviated/deviated) were positively correlated with chin deviation. From the linear regression analysis, condylar volume ratio was a significant factor affecting chin deviation. Conclusions: These findings suggests that the non-deviated side condyle is larger than the deviated side. In addition, condylar asymmetry can affect the expression of facial asymmetry.

안면비대칭의 원인은 다양하며, 비대칭적 성장은 상악골과 하악골의 길이나 각도로 평가되어지곤 한다. 하지만 하악 과두의 비대칭적인 위치나 형태 또한 비대칭의 표현에 영향을 줄 것으로 생각된다. 따라서 본 연구는 하악 과두가 안면비대칭의 표현형인 이부 편위에 영향을 주는지에 대해 알아보고자 하였다. 50명의 골격성 III급 부정교합자 중 4 mm 이상의 menton point deviation을 보이는 비대칭군 30명, 4 mm 이하의 menton point deviation을 보이며 뚜렷한 안면비대칭이 없는 20명을 대칭군으로 하여, 두개저에 대한 좌우 하악 과두의 근원심적, 전후방적 위치를 평가하고, axial 평면에서 장축을 설정해 하악 과두의 최대 크기와 coronal plane에 대한 각도를 평가하였으며, sigmoid notch 상방 하악 과두의 길이와 부피를 측정하였다. 대칭군은 좌우 하악 과두의 위치, 각도, 크기, 길이, 부피에 있어 통계적인 차이가 없었다. 비대칭군은 이부 편위측과 비편위측으로 나누어볼 때, 이부 편위에 따른 좌우 하악 과두의 위치와 angulation 에서 통계적 차이는 없었으나, 하악 과두의 크기, 길이 및 부피에서는 비편위측 값이 컸고, 이부 편위량이 클수록 좌우 크기, 길이의 차이 및 편위측에 대한 비편위측 하악 과두의 부피비가 컸다. 또한 편위측에 대한 비편위측 하악 과두의 부피비가 이부 편위의 정도를 가장 잘 설명해주는 특성이었다. 이상의 결과를 통해 하악 과두의 비대칭이 안면비대칭의 발현에 영향을 주며, 비편위측 하악 과두가 편위측에 비해 크고 길다는 것을 알 수 있었다.

Keywords

References

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