• Title/Summary/Keyword: 상악 전치

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MITIGATION OF MAXILLARY ANTERIOR TEETH PROTRUSION WITH CEREBRAL PALSY USING REMOVABLE APPLIANCE : A CASE REPORT (뇌성마비환자에서 가철성장치를 이용한 상악 전치부 돌출 완화 : 증례보고)

  • Min, Boram;Lee, Jae-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.9 no.2
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    • pp.122-126
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    • 2013
  • Cerebral palsy is one of the primary handicapping conditions of childhood. The prevalence of malocclusions in patients with cerebral palsy is approximately twice than in general population. Even though these high rates of malocclusions, most clinicians may feel uncomfortable about treating such problems to reduce inclination of anterior teeth because to reduce of protrusion makes to decrease risk of trauma. This is the case report about mitigation of maxillary anterior teeth protrusion in patient with cerebral palsy. A 14 year old boy who had cerebral palsy visited our dental hospital. He had severe protrusive maxillary anterior teeth and narrow arch form. He was experienced at using Castillo morales appliance in early childhood. He had mild mental retardation and was able to learn simple skills. He and his parents had willing to improve his dental problems. A gentle impression taking on maxilla was done. Removable appliance was made including median screw and labial bow. We provide a period of adaption for 3 weeks. After of anterior teeth through activation of labial bow was done once a month by dentist. The treatment carried out for 10 months and we could observe reduced labial inclination of maxillary right central incisor and more wide arch form. Hawley type retainer was set at maxilla for retention. In conclusion, accompanying careful case selection and treatment, patient with cerebral palsy can be treated and should not be ignored their orthodontic needs.

Management of Space Distribution Problem in Upper Dentition (심미성 회복을 위한 상악 전치부 공간 분배 문제의 해결)

  • Hong, Sun-Jae;Song, Byeong-Gi
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.17 no.1
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    • pp.7-14
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    • 2008
  • 치아의 공간 분배 및 배열은 심미적인 수복물의 가장 근본이 되는 중요한 요소이다. 상악 전치부에 과도한 공간으로 심미적으로 부적절한 수복물을 가진 중례에서 기능적으로 그리고 심미적으로 개선시키기 위해 무엇을 고려하고 어떻게 접근하였는지 증례를 통해 반성해보고자 한다.

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Analysis of esthetic factors and evaluation of esthetic perception for maxillary anteriors of dental students (치과대학생의 상악 전치부의 심미적 요소 분석 및 인식도 평가)

  • Kim, Seon-Kyung;Kim, Ok-Su
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.2
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    • pp.118-126
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    • 2019
  • Purpose: This research is to investigate factors that affect dental aesthetics and analyze whether individual perception affects and difference of genders affects the esthetic factors. Materials and methods: Seventy dental students of Chonnam University aged from 25 to 35 years old without periodontal problems were included. Maxillary dental cast for participants were made, and standardized photo was taken with a digital camera. Maximum visual width and the position of gingival zenith of maxillary anterior teeth and maximum height of the maxillary central incisors were measured by a measurement program and the shape of central incisor was categorized. Questionnaire was conducted to evaluate esthetic perception. SPSS program was used to perform statistical analysis. Results: The average visual width ratio of right maxillary anteriors was 1.38:1:0.78 and 1.41:1:0.81 for the left which differ from the golden ratio. The width to height ratio for right and left central incisor was 0.84 and 0.83 respectively. The gingival zenith position was determined to be: mostly, central incisors and canines were located in the distal side, lateral incisors were located in the center. The visual width ratio of right maxillary anterior teeth, ratio of width to height of central incisor, gingival zenith position, crown morphology and amounts of gingival exposure upon smiling were not significantly different between genders, and facial patterns and these dental esthetic factors were not related to aesthetic perception. Conclusion: Even though participants had the visual width ratio of maxillary anteriors or ideal width to ideal height of central incisors that did not agree with the golden ratio, they had high satisfaction for dental esthetics. Esthetic perception depends more on subjective judgements of participants than objective indices.

Three-dimensional finite element analysis of initial tooth displacement according to force application point during maxillary six anterior teeth retraction using skeletal anchorage (골격성 고정원을 이용한 상악 6전치 후방 견인시 힘의 적용점 변화에 따른 치아 이동 양상에 관한 유한 요소법적 분석)

  • Kim, Chan-Nyeon;Sung, Jae-Hyun;Kyung, Hee-Moon
    • The korean journal of orthodontics
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    • v.33 no.5 s.100
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    • pp.339-350
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    • 2003
  • The purpose of this study was to investigate the micro-implant height and anterior hook height to prevent maxillary six anterior teeth from lingual tipping and extruding during space closure. We manufactured maxillary dental arch form, bracket and wire, using the computer aided three-dimensional finite element method. Bracket was $.022'{\times}.028'$ slot size and attached to tooth surface. Wire was $.019'{\times}.025'$ stainless steel and $.032'{\times}.032'$ stainless steel hook was attached to wire between lateral incisor and canine. Length of hook was 8mm and force application points were marked at intervals of In. Four micro-implants were implanted on alveolar bone between second premolar and first molar. The heights of them were 4, 6, 8, 10mm starting from wire. We analyzed initial displacement of teeth by various force application point applying force of 150gm to each micro-implant and anterior hook. The conclusions of 4his study are as the following : 1. When the micro-implant height was 4m and the anterior hook height was 5mm and below, anterior teeth were tipped lingually. When the anterior hook height was 6mm and above, anterior teeth were tipped labially. 2. When the micro-implant height was 6mm and the anterior hook height was 6mm and below, the anterior teeth were tipped lingually. When the anterior hook height was 6m and above, the anterior teeth were tipped labially. But lingual tipping of anterior teeth decreased and labial tipping Increased when the micro-implant height was 6mm, compared with 4mm micro-implant height. 3. When the micro-implant height was 8mm and the anterior hook height was 2mm, the anterior teeth were tipped lingually. When the anterior hook height was 3mm and above, labial tipping movement of the anterior teeth increased proportionally. 4. When the micro-implant height was 10mm and the anterior hook height was 2mm and above, labial tipping of the anterior teeth increased proportionally. 5. As the anterior hook height increased, aterior teeth were tipped more labially. But extrusion occurred on canine and premolar area because of the increase of wire distortion. 6. Movement of the posterior teeth was tipped distally during maxillary six anterior teeth retraction using micro-im plant because of the friction between bracket and were Based on the results of this study, we could predict the pattern of the tooth movement according to position of micro-implant and height of anterior hook. It seems that we can find the force application point for proper tooth movement in consideration of inclination of anterior anterior teeth, periodontal condition, overjet and overbite

A Clinical Report on the Effect of CRS Usage in Degenerative Temporomanibular Joint Disease with Anterior Open Bite Applying Bone Scan (전치부 개교합을 보이는 퇴행성 관절질환에서 골스캔을 이용한 중심위교합장치의 효과 평가에 대한 임상례)

  • 박상배;김병국
    • Journal of Oral Medicine and Pain
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    • v.23 no.3
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    • pp.289-294
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    • 1998
  • 본 증례는 측두하악관절의 퇘행성 변화를 보이는 환자에서 악교정 수술의 시행 전에 중심위교합장치를 통해 측두하악관절의 안정화를 유도하고, 또한 골스캔을 이용하여 장치의 치료효과를 평가한 임상증례이다. 환자는 24세의 여성으로 5년 전부터 전치부 개교합이 발생되기 시작하였고, 고형식 저작시 좌측 전이부에 간헐적인 통증이 발생한다는 주소로 본원에 내원하였다. 임상검사상 촉진시 양측 관절낭 후방부에 압통을 호소하였으며, 각각 50, 45mm의 최대개구량 및 최대무통성 개구량을 보였다. 좌측 악관절부에서 단순 관절 잡음, 우측 악관절부에서 염발음이 청취되었으며, 저항검사 및 부하 검사에서는 특기할 반응을 보이지 않았다. 약 7mm의 전치부 개교합의 소견을 보였으며, 파노라마 사진과 횡두개 방사선 사진 소견상 양측 과두의 크기 및 하악지의 높이가 다소 작은 소견이 관찰되었고 자기공명영상 소견상 양측성 비정복성 관절원판의 전방전위가 관찰되었다. 1997년 10월 27일 첫 번째 골스캔 소견상 양측성 비정복성 관절원판의 전방위가 관찰되엇다. 골스캔의 전방 사진에서 Densitometer를 이용하여 좌, 우측 과두부위와 상악 골부위의 가장 어두운 부분의 흑화도를 측정하였다. 각각 3회씩 구하여 평균을 구하고 좌, 우측 과두 대 상악골의 흑화도의 비율을 계산하였다. 첫번째 골스캔의 평균 흑화도는 우측 과두, 좌측과두, 상악골이 각각 0.88, 0.81, 1.32 였다. 1997년 11월 4일 중심위교합장치를 장착하였고 지속적인 물리치료를 시행하였다. 1997년 12월 10일 두 번째 골 스캔을 평균 흑화도는 우측 과두, 좌측 과두, 상악골이 각각 0.33, 0.37, 088 이었다. 1998년 1월 30일 세 번째 골스캔 소견상 두 번째 골스캔과 비교하여 활성도가 감소된 소견을 보였다. 임상검사시 무통이었다. 1998년 2월 25일 술 전 교정 위해 중심위교합장치의 장작을 중지시켰다. 1998년 6월 5일 네 번째 골스캔 소견상 이전 검사들과 비교시 흡수가 감소된 소견을 보였다. 네 번째 골스캔의 평균 흑화도는 우측 과두, 좌측 과두, 상악골이 각각 0.24, 0.19, 0.85 였다. 현재 지속적인 관찰 중이며 본원 교정과에서 악교정수술 위한 술 전 교장을 시행중이다. 결국 첫 번째 골스캔의 과두 대 상악골의 평균 흑화도의 비율은 우측과 좌측이 각각 0.66, 0.61이었고 두 번째 골스캔에서는 우측과 좌측이 각각 0.37, 0.42였고, 네번째 골스캔에서는 우측과 좌측이 각각 0.28, 0.23 이었다. 각 골스캔의 과두 대 상악골의 평균 흑화도의 비율 사이에 유의한 차이가 있는지 검증하기 위해 Standard t-test 와 ANOVA를 시행하였다. 이상의 결과에서 첫 번째, 두 번째, 네 번째 골스캔으로 갈수록 좌, 우측 과두 대 상악골의 흑화도의 비율이 유의하게 감소했음을 알 수 있었다. 결론적으로 본 증례에서는 전치부 개교합이 발생되어 악교정수술이 필요한 환자에게 측두하악관절의 안정화를 위해 중심위교합장치를 사용함으로써 퇴행성 관절질환의 진행을 억제시킬 수 있고, 퇴행성 관절질환의 활성도에 대한 평가시 골스캔이 유용할 수 있음을 보여주었다고 사료된다.

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Dentoalveolar Compensation according to Skeletal Patterns of Normal Occlusion (정상교합자의 골격형에 따른 치아치조보상)

  • Lee, Shin-Jae;Chang, Young-Il;Ku, Seung-Jun
    • The korean journal of orthodontics
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    • v.32 no.2 s.91
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    • pp.91-105
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    • 2002
  • In general, orthodontists make problem lists and treatment plans based on norms of several cephalometric standards. But consideration of dentoalveolar compensation, which tends to maintain normal dental arch relationship in various skeletal jaw relationships, helps orthodontists make more individualized treatment objectives and plans. The purpose of this study was to classify skeletal patterns of normal occlusion samples by cluster analysis and to investigate the dentoalveolar compensation according to skeletal patterns. The subjects were consisted of 125 subjects who were normal occlusion samples at Seoul National University Dental Hospital, Department of Orthodontics. Lateral cephalograms in centric occlusion were traced and digitized. The skeletal patterns of normal occlusion samples were classified into three horizontal groups and three vertical groups by cluster analysis and ANOVA on the skeletal and dentoalveolar measurements among the groups were carried out. The results were as follows ; 1. Anteroposterior and vertical skeletal relationships of normal occlusion samples were very variable. 2. As the mandibular position was anterior to the maxilla, the maxillary incisors inclined more labially, the mandibular incisors more lingually, and the occlusal plane was flattened due to the anteroposterior dentoalveolar compensation. dentoalveolar height was decreased and upper posterior teeth was uprighted to the palatal plane and lower incisors and lower posterior teeth to the mandibular plane. 4. Lower incisors were more strongly associated with the dentoalveolar compensation than upper incisors according to the anteroposterior and vertical skeletal relationship.