The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Analysis of occlusal contact and guidance pattern during maximal intercuspal position and protrusive movement

최대교두감합위 및 하악 전방운동 시의 교합접촉 및 교합유도 양상에 관한 분석

  • Kim, Jiyeon (Department of Prosthodontics, School of Dentistry, Kyung Hee University) ;
  • Kim, Kang-Hyun (Department of Prosthodontics, School of Dentistry, Kyung Hee University) ;
  • Noh, Kwantae (Department of Prosthodontics, School of Dentistry, Kyung Hee University) ;
  • Kim, Hyeong-Seob (Department of Prosthodontics, School of Dentistry, Kyung Hee University) ;
  • Woo, Yi-Hyung (Department of Prosthodontics, School of Dentistry, Kyung Hee University) ;
  • Pae, Ahran (Department of Prosthodontics, School of Dentistry, Kyung Hee University)
  • 김지연 (경희대학교 치의학전문대학원 치의학과 치과보철학교실) ;
  • 김강현 (경희대학교 치의학전문대학원 치의학과 치과보철학교실) ;
  • 노관태 (경희대학교 치의학전문대학원 치의학과 치과보철학교실) ;
  • 김형섭 (경희대학교 치의학전문대학원 치의학과 치과보철학교실) ;
  • 우이형 (경희대학교 치의학전문대학원 치의학과 치과보철학교실) ;
  • 배아란 (경희대학교 치의학전문대학원 치의학과 치과보철학교실)
  • Received : 2013.06.18
  • Accepted : 2013.07.15
  • Published : 2013.07.31
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Abstract

Purpose: The importance of occlusal contacts of the natural dentition for durability of teeth, mandibular stabilization, and restorative dentistry is well known. The purpose of this study is to analyze the occlusal contact and guidance pattern of Koreans by evaluating the static occlusion on maximal intercuspal position and measuring dynamic occlusion during straight protrusion. Materials and methods: The occlusal contacts at maximal interincisal position and the occlusal guidance pattern during straight protrusion of 29 subjects were recorded with shimstock foil (Whaledent, Langenau, Germany), T-Scan III (Tekscan Inc., Boston, MA, USA), polyvinylsiloxane registration material (Genie Bite, Sultan Healthcare, Hackensack, NJ, USA) and compared. Occlusal registration procedures were repeated 3 times. The position was fixed to an upright position and the head position was fixed with the Frankfurt horizontal plane paralleling the horizontal plane. Fisher's Exact Test (R-General Public License, ver. 2.14.1) and Pearson's Test were used to assess the significance level of the differences between the experimental groups (${\alpha}=.05$). Results: When using shimstock foil, T-Scan III system, and polyvinylsiloxane registration material, most of the patients showed contact on anterior, premolar, and molar teeth during maximal intercuspal position. Approximately 51% of maximal intercuspal position showed anterior contact using shimstock foil. When examining the protrusive movement using shimstock foil and T-Scan III system, guidance pattern with the central incisor was the most common. Conclusion: During maximal intercuspal position, there were cases in which not all of the teeth showed occlusal contact. During mandibular protrusive movements, one or more maxillary central incisors frequently joined in straight protrusion and the posterior teeth were disoccluded. Therefore, the anterior teeth protect the posterior teeth, and vice versa. Thus, mutually protected occlusion should be applied when reconstructing occlusion.

연구 목적: 저작 및 하악 운동시 발생되는 치아접촉은 치열의 보존, 하악의 안정과 보철 수복과정에 있어서 중요하다. 이에 한국인의 20-30대 성인을 대상으로 최대교두감합위에서의 치아접촉점의 위치 및 교합유도양상과 교합유도치의 분포를 분석하여 알아보고자 한다. 연구 대상 및 방법: 29명의 성인을 대상으로 하악의 최대교두감합위에서의 치아접촉점의 위치와 분포 및 전방운동시 교합접촉양상을 shimstock foil (Whaledent, Langenau, Germany), T-Scan III (Tekscan Inc., Boston, MA, USA), polyvinylsiloxane registration material (Genie Bite, Sultan Healthcare, Hackensack, NJ, USA)을 이용하여 측정하였다. 측정시 자세는 직립위로 Frankfurt horizontal plane과 지면이 수평이 되도록 앉게 하였으며 접촉이 재현될 때까지 수 차례 반복한 후 3회씩 측정하였다. 최대교두감합위에서 세가지 방법 간의 통계적 유의성을 비교하기 Fisher's Exact Test (R-General Public License, ver. 2.14.1)를 이용하였고, 전방 운동시 Pearson's Test를 통해 통계 검증하였다(${\alpha}=.05$). 결과: 최대교두감합위에서의 치아 접촉 양상을 shimstock foil, T-Scan III, polyvinylsiloxane registration material로 측정시 전치부, 소구치부, 구치부 모두에서 접촉하는 경우가 대부분이었으며, shimstock 사용시 약51%의 최대교두감합위는 전치부 접촉에서 일어났다. Shimstock foil과 T-Scan III를 사용하여 전방운동 측정시 중절치의 접촉이 가장 많이 일어났다. 결론: 최대교두감합위에서 실제 모든 치아의 접촉이 이루어지지 않는 경우가 있었으며 따라서 구치부에서 전치부를 보호해 주고 있음을 확인할 수 있었다. 또한, 전방운동 시 전치부의 치아접촉은 과도한 구치부의 치아접촉을 방지해 전치부가 구치부를 보호해 주고 있었다. 따라서 교합 재구성 시에는 이러한 상호 보호 교합에 대한 고려가 필요하다.

Keywords

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