• Title/Summary/Keyword: 하악 전치부

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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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Oral Hygiene Management and Factor Analysis of the Community People (일부지역 주민들의 구강환경관리 및 요인분석)

  • Park, Hyang-Sook;Kim, Jin-Soo;Kim, Jin-Mi;Kim, Yoon-Sin
    • Journal of dental hygiene science
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    • v.10 no.1
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    • pp.11-16
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    • 2010
  • The subjects of this study were patients at scaling practice, the total number of the subjects was 249 of 138 men and 111 women. The results were analyzed using SPSS 12.0. 1. In oral health care, among tooth brushing methods, scrub method was found to be 65.9%(164 patients), and 83.9%(209 patients) did not use oral care aids. 2. Mean calculus index was $0.57{\pm}0.22$. 3. For calculus index per tooth brushing method, there was statistically significant difference in all of the upper jaw, the lower jaw, the anterior portion, and the posterior portion(p < 0.05). 4. For calculus index per frequency of tooth brushing, there was statistically significant difference in the upper jaw, the lower jaw, and the posterior portion(p < 0.05). 5. For calculus index per time of tooth brushing and per use of oral care aids, there was statistically significant difference in all of the upper jaw, the lower jaw, the anterior portion, and the posterior portion(p < 0.05). 6. For factors influencing calculus index, as a result of applying stepwise method based on 0.05 of significance level, age, use of oral care aids, sex, and time of tooth brushing were found to influence calculus index. Final regression model was calculus index = $0.362^*age+0.216^*$use of oral care aids - $0.161*sex-0.127^*$time of tooth brushing, and explanatory power of the model was 23.4%. $0.362^*age+0.216^*$use of oral care aids - $0.161^*sex-0.127^*$time of tooth brushing, and explanatory power of the model was 23.4%.

Re-establishment of occlusion after unilateral condylar fracture (편측성 하악 과두 골절 후의 교합 관계 회복)

  • Kim, Yoo-Kyung;Park, Sung-Ho;Roh, Byoung-Duck
    • Restorative Dentistry and Endodontics
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    • v.37 no.2
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    • pp.110-113
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    • 2012
  • Complications resulting from condylar fracture include occlusal disturbance due to loss of leverage from temporomandibular joint (TMJ). In general, closed reduction with active physical training has been performed, and under favorable circumstances, adaptation occurs in attempt to restore the articulation. The patient in this case report had unilateral condylar fracture accompanied with multiple teeth injuries, but he was left without any dental treatment for 1 mon which led to unrestorable occlusal collapse. Fortunately, delayed surgical repositioning of dislocated maxillary anterior teeth followed by consistent long-term physical training has been proved successful. Normal occlusion and satisfactory remodeling of condyle were obtained on 10 mon follow-up.

Zirconia removable prosthesis using a milled bar in patient with mandible anterior edentulous area with severe alveolar bone resorption: a case report (치조골 흡수가 심한 하악 전치부 부분 무치악 환자에서 Milled-bar를 이용한 지르코니아 가철성 보철물 수복 증례)

  • Jin-Young Park;Chang-Mo Jeong;Mi-Jung Yun;Jung-Bo Huh;So-Hyoun Lee;Dae-Sung Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.3
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    • pp.193-200
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    • 2024
  • In patients with severe alveolar bone resorption on mandibular anterior edentulous areas, it can be difficult to place implants in the location for crowns, and to create the fixed prosthesis having an adequate emergence profile or embrasure, which makes maintenance difficult. Fabricating a removable zirconia prosthesis with a milled bar on poorly positioned implants can be a good option because of easy maintenance. In this case, the patient had severe bone resorption on mandibular anterior region, and large vertical space. We report on the aesthetical and easy-to-maintain results by placing two implants and fabricating a zirconia prosthesis using milled bar.

TRANSITIONAL TREATMENT OF AMLEOGENESIS IMPERFECTA IN MIXED DENTITION: A CASE REPORT (혼합치열기에 있는 법랑질형성부전증 환아의 이행적 치료)

  • Hwang, Ji-Young;Choi, Yeong-Chul;Kim, Kwang-Chul;Park, Jae-Hong;Choi, Sung-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.601-606
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    • 2009
  • Amelogenesis Imperfecta (AI) is a genetic disorder which retards the development of enamel and it can be classified into three types: hypoplastic, hypomaturation, hypocalcified type. This can occur both in deciduous and permanent dentition. A 8 year 8 month old patient with a chief complaints of delayed eruption on upper anteriors, calculus deposit on lower anteriors and anterior openbite visited the clinic. Anteriors had thin layer of enamel and were very narrow. Especially lower anteriors had rough surface and were in bad shape. Teeth were very hypersensitive to thermal changes. Upper and lower first molars showed severe attrition on the occlusal surface. Radiographs also verified hypoplastic enamel in the whole dentition including the teeth in the tooth bud. The patient was diagnosed as hypoplastic AI, and is being treated at the pediathc and prosthodontic department of the Kyunghee dental university hospital. To improve the function, esthetics, hypersensitivity of the AI patients, restorations on the posteriors and the anteriors with oral hygiene instruction are necessary, Constant follow-up check is needed until full growth and after full growth, cooperative care with the other department is needed.

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Morphological difference of symphysis according to various skeletal types using cone-beam computed tomography (안면골격 유형에 따른 하악 전치 치조골의 형태 차이: Cone-beam CT를 이용한 정량적 평가)

  • Kwon, Hyun-Jin;Chun, Youn-Sic;Kim, Min-Ji
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.3
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    • pp.215-222
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    • 2014
  • Purpose: The aim of this study was to investigate differences between the morphology of the mandibular symphysis and four facial skeletal types. Materials and Methods: 40 cone-beam computed tomographies were selected and classified in to 4 groups according to their vertical and anterior-posterior skeletal patterns. The bone volume ($mm^3$) of the symphysis, the cross sectional area corresponding to the 4 mandibular incisors' axis: the cross sectional area of total bone ($mm^2$), the area of the cancellous bone ($mm^2$) and the thickness (mm) of labial and lingual alveolar bone at 2 mm, 3 mm under the cemento-enamel junction (CEJ) were measured. General linear model (GLM), Kruskal-Wallis test and Tukey honestly significant difference (HSD) test were subsequently used for statistical analysis. Results: The lingual cortical bone thickness of the lateral incisors at 2, 3 mm under CEJ was greater in the Class I low angle group than the other 3 groups (P < 0.05). There were no statistically significant differences in the volume of the mandibular incisor bony support, cross-sectional area of total bone and cancellous bone at the mandibular incisor' axis. Conclusion: Patients in Class I, low angle group have a thicker lingual mandibular symphysis than Class I, high angle patients.

CLINICAL APPLICATION OF MODIFIED FR-4 (Modified FR-4의 임상적용례)

  • Song, Jae-Hyuk;Lee, Keung-Ho;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.2
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    • pp.323-328
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    • 2001
  • Anterior open bite is one in which the teeth in the anterior portion of the maxilla and mandible are vertically apart and lack the overlapping necessary for the incisive function when the mandible is in closed position. Anterior open bite is a result of the interaction of many different etiologic factors including thumb and finger sucking, lip and tongue habits, airway obstruction, skeletal growth abnormalities and its tendency may appear with any type of skeletal patterns, such as Class I, II or III malocclusion types. Though the treatment methods for anterior open bite are various, the conventional FR-4, designed by Rolf Fr$\"{a}$nkel, is known to be effective in treating open bite cases with Class I or II skeletal patterns. It is due to that an incidence of skeletal Class II is high in the Occidentals, and open bite is accompanied by these malocclusion type in many cases. However, an incidence of skeletal Class III is high in the Orientals, and open bite is sometimes accompanied by skeletal Class III in many cases. Although the use of the conventional FR-4 was effective in the treatment of open bite, skeletal Class III would be worsened. So, a modified FR-4(placing the labial bow in the lower, the labial pads in the upper) was designed for the treatment of patients showing skeletal Class III and open bite.

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