Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
권호 표지

Treatment of Gingival Invagination after Orthodontic Treatment with Extraction

발치 교정치료시 치은 함입에 관한 치은 처치

  • Kim, Yun-Sang (Department of Periodontics, Sanbon Dental Hospital, College of Dentistry, Wonkwang University) ;
  • Cho, Jin-Hyoung (Department of Orthodontics, Sanbon Dental Hospital, College of Dentistry, Wonkwang University) ;
  • Cho, Jin-Woo (Department of General Dentistry, Sanbon Dental Hospital, College of Dentistry, Wonkwang University)
  • 김윤상 (원광대학교 치과대학 산본치과병원 치주과) ;
  • 조진형 (원광대학교 치과대학 산본치과병원 교정과) ;
  • 조진우 (원광대학교 치과대학 산본치과병원 통합진료과)
  • Received : 2012.02.04
  • Accepted : 2012.03.25
  • Published : 2012.03.30
Download PDF
⟨ Previous Next ⟩

Abstract

In most patients with severe crowding or lip protrusion, orthodontic treatment with tooth extraction is done. In these patients, even though space is closed after orthodontic treatment, gingival invagination is observed on the extracted site. Since there are possibilities of space recurrence and regional periodontic problems occurrence, periodontic treatment is necessary on the gingival invagination region. This case was a 16 year old female with a chief complaint of crooked teeth. Since her maxillary premolars were already extracted a few years ago at a local dental clinic, orthodontic treatment was done by extracting mandibular premolars. Unlike maxillary premolar regions, gingival invagination occurred in mandibular premolar regions and gingival flattening was done by excising the gingival invaginated region. Gingival flattening was done once on the left side, twice on the right side and showed stable results. This is a case report of a patient that was prone to gingival invagination after orthodontic treatment with extraction and was treated with gingival flattening.

심한 치열 총생이나 입술이 돌출된 환자들에서 대다수의 경우에 발치 교정치료를 시행한다. 이런 경우 많은 수의 환자들에서 교정치료 완료 후 발치된 공간이 폐쇄되었음에도 해당 발치 공간 부위에 치은이 주름을 형성하는 치은 함입(gingival invagination)이 관찰된다. 이런 경우 폐쇄된 공간의 재발 및 국소적 치주 문제가 발생할 가능성이 있기에 치은 함입부에 대한 치주과적 처치가 필요하다. 본 증례의 환자는 치아가 맞지 않는다고 내원한 16세 여자 환자였으며 몇 년 전에 지역 치과에서 상악 소구치의 발치가 시행되었던 환자였기에 하악 소구치 발치를 동반한 교정치료를 시행하였다. 자연스럽게 폐쇄되었던 상악 소구치부와는 다르게 교정치료 완료 후 하악 소구치부위에서는 치은 함입이 관찰되어 치주과적으로 치은 함입부위를 절제하여 치은 평탄화를 시켰다. 치은 평탄화 작업은 레이저를 이용하여 좌측은 1회, 우측은 2회에 걸쳐서 시행하였으며 안정된 결과를 나타내었다. 이상의 치료를 통하여 발치를 동반한 교정치료 환자에서 발생하기 쉬운 치은 함입부의 치은 평탄화를 이룬 증례를 보고하고자 한다.

Keywords

References

  1. Balenseifen JW, Madonia JV. Study of dental plaque in orthodontic patients. J Dent Res 1970 : 49 : 320-324. https://doi.org/10.1177/00220345700490022101
  2. Zachrisson BU. Cause and prevention of injuries to teeth and supporting structures during orthodontic treatment. Am J Orthod 1976 : 69 : 285-300. https://doi.org/10.1016/0002-9416(76)90077-4
  3. Atack NE, Sandy JR, Addy M. Periodontal and microbiological changes associated with the placement of orthodontic appliances. A Review. J Periodontol 1996;67:78-85. https://doi.org/10.1902/jop.1996.67.2.78
  4. Kang KJ, Son BH. Dental plaque, gingivitis, and decalcification in intraoral fixed orthodontic appliances. Korean J Orthod 1999;29:361-374.
  5. Huser MC, Baehni PC, Lang R. Effects of orthodontic bands on microbiologic and clinical parameters. Am J Orthod Dentofacial Orthop 1990;97:213-218. https://doi.org/10.1016/S0889-5406(05)80054-X
  6. Edwards JG. The prevention of relapse in extraction cases. Am J Orthod. 1971 Aug;60(2):128-144. https://doi.org/10.1016/0002-9416(71)90029-7
  7. Parker GR. Transseptal fibers and relapse following bodily retration of teeth: a histologic study. Am J Orthod. 1972 Apr;61(4):331-344. https://doi.org/10.1016/0002-9416(72)90298-9
  8. Robertson PB, Schultz LD, Levy BM. Occurrence and distribution of interdental gingival clefts following orthodontic movement into bicuspid extraction sites. J Periodontol. 1977 Apr;48(4):232-235. https://doi.org/10.1902/jop.1977.48.4.232
  9. Rivera Circuns AL, Tulloch JF. Gingival invagination in extraction sites of orthodontic patients: their incidence, effects on periodontal health, and orthodontic treatment. Am J Orthod. 1983 Jun;83(6): 469-476. https://doi.org/10.1016/S0002-9416(83)90245-2
  10. Edwards JG. A surgical procedure to eliminate rotational relapse.. Am J Orthod. 1970 Jan;57(1): 35-46. https://doi.org/10.1016/0002-9416(70)90203-4
  11. Ronnerman A, Thilander B, Heyden G. Gingival tissue reactions to orthodontic closure of extraction sites. Histologic and histochemical studies. Am J Orthod. 1980 Jun;77(6):620-625. https://doi.org/10.1016/0002-9416(80)90153-0
  12. Wehrbein H, Fuhrmann R, Andreas A, Diedrich P. The significance of gingival invagination in orthodontic space closure. A clinico-radiological study Fortschr Kieferorthop. 1993 Dec;54(6):231-236. https://doi.org/10.1007/BF02179832
  13. Wehrbein H, Bauer W, Diedrich PR. Gingival invagination area after space closure: a histologic study. Am J Orthod Dentofacial Orthop. 1995 Dec;108(6):593-598. https://doi.org/10.1016/S0889-5406(95)70004-8
  14. Kurol J, Rönnerman A, Heyden G. Long-term gingival conditions after orthodontic closure of extraction sites. Histological and histochemical studies. Eur J Orthod. 1982 May;4(2):87-92. https://doi.org/10.1093/ejo/4.2.87