• 제목/요약/키워드: Adult orthodontics

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백서 하악골의 후방 이동이 과두에 미치는 영향에 관한 실험적 연구 (AN EXPERIMENTAL STUDY ON THE EFFECT OF POSTERIOR DISPLACEMENT OF THE MANDIBLE ON THE TEMPOROMANDIBULAR JOINT IN RATS)

  • 박경진
    • 대한치과교정학회지
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    • 제10권1호
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    • pp.29-36
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    • 1980
  • Inclined plane, one of frequently used orthodontic appliances, may cause posterior displacement of mandible and injure the normal growth of temporomandibular joint. So author carried out the mandibular posterior displacement experimentally induced by inserting inclined plane in the rat incisors in order to investigate the histological reactions occuring in the temporomandibular joint of experimental animals. Following results were obtained. 1. The posterior displacement of condyle resulted in the widening of anterior synovial space with anterior condylar hyperplasia and posterior condylar atrophy. In addition, tissue changes were more severe in young rats than in adult rats. 2. The tissue reactions were localized only to condylar head ana there were no evidence of traumatic features in young rats. In adult rats, hemorrhage was an additional finding 1 week after experiment. 3. The remodelling processes were accompanied by the increasing or reduction of fibrous layer and subsequent replacement by cartilage layer occured massively and abruptly in young rats, it occured slightly and slowly in adult rats. 4. The remodelling process of injured condyle occured from 1 week to 4 weeks after experiment and completed between 8 weeks after experiment.

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개방교합성 골격헝태를 갖는 부정교합자의 기도크기 (Airway size in malocclusions with hyperdivergent skeletal pattern)

  • 곽소영;김효영;전영미;김정기
    • 대한치과교정학회지
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    • 제33권4호
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    • pp.293-305
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    • 2003
  • 인두는 호흡과 연하를 수행하는 기관의 일부를 구성하며 이의 기능 및 형태는 두개악안면구조의 형태와 밀접한 관련성을 가지는 것으로 알려져 있다. 본 연구의 목적은 정상과 개방교합성 골격형태에서 인두와 연구개, 혀 그리고 설골을 포함하는 기도크기를 비교하고 또한 각 군에서 연령에 따른 차이를 평가하는 것이다. 본 연구의 대상은 51명의 정상골격군(정상군)과 52명의 개방교합성 골격군(개방골격군)으로 구성되고 각각은 연령에 따라 아동군(9-12세)과 성인군(18세 이상)으로 나누었다. 측모두부 규격 방사선 사진이 촬영하였고 안면 골격과 인두, 연구개, 혀 그리고 설골의 거리, 각, 비율을 계측하고 통계적으로 분석하여 다음과 같은 결론을 얻었다. 1. 정상군과 개방골격군 모두 SN-Mn angle, FMA와 Pal-Mn angle은 아동군에서 성인군보다 컸으며, facial height ratio(FHR)는 성인군보다 아동군에서 작았다. Occl-Mn angle은 개방골격군과 정상군에 따라서는 유의한 차이가 있었으나 아동군과 성인군 사이에 유의한 차이는 관찰되지 않았다. 2. SN-Mn angle, FMA, Palatal-Mn angle, lower anterior facial height(LAFH), FHR 등은 정상군보다 개방골격군에서 기도크기와 높은 상관관계를 보였고 성인군보다 아동군에서 높은 상관관계를 보였다. 개방골격 아동에서 SN-Mn angle, FMA, Palatal-Mn angle은 비인두의 골격적 전후방 크기와 비인두강의 전후방 깊이와 높은 역상관관계를 보이나 이는 성인이 되면 사라졌다. LAFH는 기도의 수직적인 계측치와 높은 순상관관계를 보였다. 3. 수직적 골격 형태에 따라서 기도 크기에서는 유의한 차이를 보이지 않았다. 4. 인두의 연조직 두께는 성인군에서 아동군보다 작았으며 비인두강의 깊이는 성인군에서 더 큰 값을 보였고, 아동군과 성인군에서의 구인두강의 깊이는 유의한 차이가 없었다. 5. 설골의 전후방적인 위치는 아동군과 성인군에서 차이를 보이지 않았으나 수직적으로는 성인군에서 아동군보다 더 하방에 위치하였다.

Construction reproducibility of a composite tooth model composed of an intraoral-scanned crown and a cone-beam computed tomography-scanned root

  • Lim, Seung-Weon;Moon, Ryu-Jin;Kim, Min-Seok;Oh, Min-Hee;Lee, Kyung-Min;Hwang, Hyeon-Shik;Kim, Tae-Woo;Baek, Seung-Hak;Cho, Jin-Hyoung
    • 대한치과교정학회지
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    • 제50권4호
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    • pp.229-237
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    • 2020
  • Objective: To evaluate the construction reproducibility of a composite tooth model (CTM) composed of an intraoral-scanned crown and a cone-beam computed tomography (CBCT)-scanned root. Methods: The study assessed 240 teeth (30 central incisors, 30 canines, 30 second premolars, and 30 first molars in the maxillary and mandibular arches) from 15 young adult patients whose pre-treatment intraoral scan and CBCT were available. Examiner-Reference (3 years' experience in CTM construction) and Examiners-A and Examiner-B (no experience) constructed the individual CTMs independently by performing the following steps: image acquisition and processing into a three-dimensional model, integration of intraoral-scanned crowns and CBCT-scanned teeth, and replacement of the CBCT-scanned crown with the intraoral-scanned crown. The tooth axis angle in terms of mesiodistal angulation and buccolingual inclination of the CTMs constructed by the three examiners were measured. To assess the construction reproducibility of CTMs, intraclass correlation coefficient (ICC) assessments were performed. Results: The ICC values of mesiodistal angulation and buccolingual inclination among the 3 examiners showed excellent agreement (0.950-0.992 and 0.965-0.993; 0.976-0.994 and 0.973-0.995 in the maxillary and mandibular arches, respectively). Conclusions: The CTM showed excellent construction reproducibility in mesiodistal angulation and buccolingual inclination regardless of the construction skill and experience levels of the examiners.

Displacement pattern of the anterior segment using antero-posterior lingual retractor combined with a palatal plate

  • Seo, Kyung-Won;Kwon, Soon-Yong;Kim, Kyung A;Park, Ki-Ho;Kim, Seong-Hun;Ahn, Hyo-Won;Nelson, Gerald
    • 대한치과교정학회지
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    • 제45권6호
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    • pp.289-298
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    • 2015
  • Objective: To evaluate and compare the effects of two appliances on the en masse retraction of the anterior teeth anchored by temporary skeletal anchorage devices (TSADs). Methods: The sample comprised 46 nongrowing hyperdivergent adult patients who planned to undergo upper first premolar extraction using lingual retractors. They were divided into three groups, based on the lingual appliance used: the C-lingual retractor (CLR) group (group 1, n = 16) and two antero-posterior lingual retractor (APLR) groups (n = 30, groups 2 and 3). The APLR group was divided by the posterior tube angulation; posterior tube parallel to the occlusal plane (group 2, n = 15) and distally tipped tube (group 3, n = 15). A retrospective clinical investigation of the skeletal, dental, and soft tissue relationships was performed using lateral cephalometric radiographs obtained pretreatment and post en masse retraction of the anterior teeth. Results: All groups achieved significant incisor and canine retraction. The upper posterior teeth did not drift significantly during the retraction period. The APLR group had less angulation change in the anterior dentition, compared to the CLR group. By changing the tube angulation in the APLR, the intrusive force significantly increased in the distally tipped tube of group 3 patients and remarkably reduced the occlusal plane angle. Conclusions: Compared to the CLR, the APLR provides better anterior torque control and canine tipping while achieving bodily translation. Furthermore, changing the tube angulation will affect the amount of incisor intrusion, even in patients with similar palatal vault depth, without the need for additional TSADs.

Evaluation of buccolingual molar inclinations among different vertical facial types

  • Eraydin, Feyza;Cakan, Derya Germec;Tozlu, Murat;Ozdemir, Fulya
    • 대한치과교정학회지
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    • 제48권5호
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    • pp.333-338
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    • 2018
  • Objective: The aim of this study was to compare the buccolingual inclination of maxillary and mandibular molars in adults with different vertical facial types. Methods: Cone-beam computed tomography images of 135 adult patients (age, 20-45 years) with skeletal Class I maxillomandibular relationships were assigned to normodivergent (n = 46), hypodivergent (n = 49), and hyperdivergent groups (n = 40) according to linear and angular sella-nasion/gonion-menton measurements. The normodivergent group consisted of 24 females and 22 males, hypodivergent group of 26 females and 23 males, and hyperdivergent group of 24 females and 16 males. Buccolingual inclination of the maxillary and mandibular first and second molars was measured relative to the occlusal plane. One-way analysis of variance was used for intergroup comparison. Gender differences were evaluated using independent t-tests. Results: Buccolingual molar inclinations did not differ significantly between females and males (p > 0.05). There were no statistically significant differences among the buccolingual inclinations of the first and second maxillary and mandibular molars of the groups (p > 0.05). Conclusions: Buccolingual inclinations of maxillary and mandibular molars are similar in normodivergent, hyperdivergent, and hypodivergent adults with Class I sagittal relationships.

Camouflage treatment by backward rotation of the mandible for a severe skeletal Class III malocclusion with aplastic anemia: A case report

  • Choi, Dong-Soon;Lee, Dong-Hyun;Jang, Insan;Cha, Bong-Kuen
    • 대한치과교정학회지
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    • 제52권5호
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    • pp.362-371
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    • 2022
  • Orthognathic surgery is the primary treatment option for severe skeletal discrepancy. However, orthodontic camouflage should be considered as an alternative treatment option, considering the risks of surgery. A 19.5-yearold man presented with a severe prognathic mandible with a Class III molar relationship and an anterior crossbite. Orthognathic surgery could be considered because of his severe skeletal discrepancy and mandibular prognathism. However, the anesthetist for orthognathic surgery did not recommend surgery under general anesthesia because of risk factors associated with the patient's aplastic anemia, including bleeding and infections. Thus, a camouflage treatment to promote backward rotation of the mandible via orthodontic extrusion of the posterior teeth was planned. An anterior bite plate, intermaxillary elastics, and fixed orthodontic appliances were used to extrude the posterior teeth and to align the dentition. After 17 months of nonsurgical orthodontic treatment, normal occlusion was achieved, and the facial profile was dramatically improved. This case report describes the dentoskeletal and soft-tissue effects of mandibular rotation and its long-term stability.

Part I. What drives Korean adults to seek orthodontic treatment: Reliability and validity of a measurement instrument for the perception of orthodontic treatment

  • Oh, Min-Hee;Kim, Eun-A;Park, Ae-Hyun;Kim, MinSoo;Cho, Jin-Hyoung
    • 대한치과교정학회지
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    • 제50권6호
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    • pp.363-372
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    • 2020
  • Objective: To develop a standardized instrument to measure the level of cognition for orthodontic treatment in adults, and verify its reliability and validity for assessing perceptions of orthodontic treatment in adults. Methods: A total of 406 adults aged 19-64 years were surveyed by an internet research system. A tool was developed through the instrument development and verification stages. The data were analyzed by correlation analysis, exploratory factor analysis, confirmatory factor analysis, and Cronbach's α test. Results: The instrument consisted of 11 items covering four factors related to orthodontic treatment. Three items were related to general perception, four described the perception of the treatment for adults, two related to the treatment effects, and two related to the retention of orthodontic treatment. In the reliability test, Cronbach's α was 0.845 for the 11 items. In assessments for individual components, Cronbach's α was 0.764 for the general perception of orthodontic treatment, 0.705 for the perception of this treatment for adults, 0.707 for the effects of the treatment, and 0.701 for the retention of orthodontic treatment. Finally, a measurement instrument for the perception of orthodontic treatment in adults was designed to assess the 11 items on a four-point Likert scale. Conclusions: This study developed a standard measurement instrument for assessing the perception of orthodontic treatment in adults. The proposed instrument will enable additional studies on the influence of an adult's perception of orthodontic treatment on the decision to undergo treatment.

Cephalometric predictors of treatment outcome with mandibular advancement devices in adult patients with obstructive sleep apnea: a systematic review

  • Alessandri-Bonetti, Giulio;Ippolito, Daniela Rita;Bartolucci, Maria Lavinia;D'Anto, Vincenzo;Incerti-Parenti, Serena
    • 대한치과교정학회지
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    • 제45권6호
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    • pp.308-321
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    • 2015
  • Objective: The efficacy of mandibular advancement devices (MADs) in the treatment of obstructive sleep apnea (OSA) ranges between 42% and 65%. However, it is still unclear which predictive factors can be used to select suitable patients for MAD treatment. This study aimed to systematically review the literature on the predictive value of cephalometric analysis for MAD treatment outcomes in adult OSA patients. Methods: The MEDLINE, Google Scholar, Scopus, and Cochrane Library databases were searched through December 2014. Reference lists from the retrieved publications were also examined. English language studies published in international peer-reviewed journals concerning the predictive value of cephalometric analysis for MAD treatment outcome were considered for inclusion. Two review authors independently assessed eligibility, extracted data, and ascertained the quality of the studies. Results: Fifteen eligible studies were identified. Most of the skeletal, dental, and soft tissue cephalometric measurements examined were widely recognized as not prognostic for MAD treatment outcome; however, controversial and limited data were found on the predictive role of certain cephalometric measurements including cranial base angle, mandibular plane angle, hyoid to mandibular plane distance, posterior nasal spine to soft-palate tip distance, anterior nasal spine to epiglottis base distance, and tongue/oral cross sectional area ratio thus justifying additional studies on these parameters. Conclusions: Currently available evidence is inadequate for identification of cephalometric parameters capable of reliably discriminating between poor and good responders to MAD treatment. To guide further research, methodological weaknesses of the currently available studies were highlighted and possible reasons for their discordant results were analyzed.

Differences in dentoskeletal and soft tissue changes due to rapid maxillary expansion using a tooth-borne expander between adolescents and adults: A retrospective observational study

  • An, Jung-Sub;Seo, Bo-Yeon;Ahn, Sug-Joon
    • 대한치과교정학회지
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    • 제52권2호
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    • pp.131-141
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    • 2022
  • Objective: The purpose of this study was to compare the differences in dentoskeletal and soft tissue changes following conventional tooth-borne rapid maxillary expansion (RME) between adolescents and adults. Methods: Dentoskeletal and soft tissue variables of 17 adolescents and 17 adults were analyzed on posteroanterior and lateral cephalograms and frontal photographs at pretreatment (T1) and after conventional RME using tooth-borne expanders (T2). Changes in variables within each group between T1 and T2 were analyzed using Wilcoxon signed-rank test. Mann-Whitney U test was used to determine the differences in the pretreatment age, expansion and post-expansion durations, and dentoskeletal and soft tissue changes after RME between the groups. Spearman's correlation between pretreatment age and transverse dentoskeletal changes in the adolescent group was calculated. Results: Despite similar amounts of expansion at the crown level in both groups, the adult group underwent less skeletal expansion with less intermolar root expansion after RME than the adolescent group. The skeletal vertical dimension increased significantly in both groups without significant intergroup difference. The anteroposterior position of the maxilla was maintained in both groups, while a greater backward displacement of the mandible was evident in the adult group than that in the adolescent group after RME. The soft tissue alar width increased in both groups without a significant intergroup difference. In the adolescent group, pretreatment age was not significantly correlated with transverse dentoskeletal changes. Conclusions: Conventional RME may induce similar soft tissue changes but different dentoskeletal changes between adolescents and adults.

Characterization of facial asymmetry phenotypes in adult patients with skeletal Class III malocclusion using three-dimensional computed tomography and cluster analysis

  • Ha, Sang-Woon;Kim, Su-Jung;Choi, Jin-Young;Baek, Seung-Hak
    • 대한치과교정학회지
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    • 제52권2호
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    • pp.85-101
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    • 2022
  • Objective: To classify facial asymmetry (FA) phenotypes in adult patients with skeletal Class III (C-III) malocclusion. Methods: A total of 120 C-III patients who underwent orthognathic surgery (OGS) and whose three-dimensional computed tomography images were taken one month prior to OGS were evaluated. Thirty hard tissue landmarks were identified. After measurement of 22 variables, including cant (°, mm), shift (mm), and yaw (°) of the maxilla, maxillary dentition (Max-dent), mandibular dentition, mandible, and mandibular border (Man-border) and differences in the frontal ramus angle (FRA, °) and ramus height (RH, mm), K-means cluster analysis was conducted using three variables (cant in the Max-dent [mm] and shift [mm] and yaw [°] in the Manborder). Statistical analyses were conducted to characterize the differences in the FA variables among the clusters. Results: The FA phenotypes were classified into five types: 1) non-asymmetry type (35.8%); 2) maxillary-cant type (14.2%; severe cant of the Max-dent, mild shift of the Man-border); 3) mandibular-shift and yaw type (16.7%; moderate shift and yaw of the Man-border, mild RH-difference); 4) complex type (9.2%; severe cant of the Max-dent, moderate cant, severe shift, and severe yaw of the Man-border, moderate differences in FRA and RH); and 5) maxillary reverse-cant type (24.2%; reverse-cant of the Max-dent). Strategic decompensation by pre-surgical orthodontic treatment and considerations for OGS planning were proposed according to the FA phenotypes. Conclusions: This FA phenotype classification may be an effective tool for differential diagnosis and surgical planning for Class III patients with FA.