• 제목/요약/키워드: Anterior open bite

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Three-dimensional evaluation of the pharyngeal airway space in patients with anterior open bite

  • Seong-Sik Kim;Yong-Il Kim;Soo-Byung Park;Sung-Hun Kim
    • 대한치과교정학회지
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    • 제53권6호
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    • pp.358-364
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    • 2023
  • Objective: This study aimed to three-dimensionally evaluate the pharyngeal airway space (PAS) of patients with anterior open bite (AOB) by using cone-beam computed tomography (CBCT) and compare the findings with those obtained in individuals with normal occlusion. Methods: The open bite group (OBG, n = 25) consisted of patients with an anterior overbite of -3 mm or less, while the control group (n = 25) consisted of age- and sex-matched individuals with an anterior overbite of 1-3 mm, Angle Class I malocclusion (1° ≤ point A-nasion-point B angle ≤ 4°), and a normodivergent profile (22° ≤ Frankfort mandibular plane angle ≤ 28°). After the CBCT data were reconstructed into a three-dimensional image, the PAS was segmented into four parts, and the volume of each part was measured. Pharyngeal airway length (PAL) and the area and transverse width of the part showing minimal constriction were also measured. Pearson's correlation analysis was used to evaluate the correlation between changes in the PAS and the amount of anterior overbite. Results: The OBG showed a significantly narrower airway space in the nasopharyngeal, hypopharyngeal, and total airway volumes. The OBG also showed a significantly smaller area and transverse width of the part with minimal constriction. The OBG showed a significantly longer PAL, but there was no correlation between the amount of anterior overbite and the changes in PAS. Conclusions: The PAS was associated with AOB. Patients with AOB had a narrower PAS and a smaller part showing minimal constriction.

심한 퇴행성 악관절 질환 환자에서 보철성 과두를 이용한 하악과두 재건술의 치험례 (A CLINICAL CASE OF ALLOPLASTIC CONDYLE REPLACEMENT WITH CONDYLAR PROSTHESIS IN SEVERE DEGENERATIVE JOINT DISEASE)

  • 전용민;김창현;차정섭;민경기;권종진
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권2호
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    • pp.162-167
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    • 2010
  • This is a case report about patient who had suffered from degenerative joint disease and treated by TMJ reconstruction with condylar prosthesis. The patient visited Korea University An-am hospital on 2007 complaining symptom about both TMJ pain, mouth opening limitation and open bite. From CT view there was severe resorption of both condylar head, therefore condylar prosthesis reconstruction was planned. After 3D RP model analysis for preparation, the patient was operated under general anesthesia for condylar prosthesis reconstruction and the symptom was alleviated. (increased mouth opening, reduced anterior open bite, full mouth occlusal contact achieved) Follow up was carried out monthly, but after this, patient refused follow up. After 26 months from the operation, the patient revisited for anterior open bite. In clinical evaluation, occlusal contact was remained, but anterior open bite was relapsed. From cephalometry analysis, severe resorption of glenoid fossa was found. Therefore, Autogenous disc reconstruction with alloplastic material was planned on August 2009. After another surgery, condylar prosthesis was regained its normal position in glenoid fossa, and occlusion was recovered properly.

상대적 거대설을 보이는 전치부 개방교합 환자의 외과적 급속 구개확장술을 통한 횡적 부조화의 치험례 (TREATMENT OF TRANSVERSE DEFICIENCY WITH SURGICALLY ASSISTED RAPID PALATAL EXPANSION IN AN OPEN BITE PATIENT SHOWING PSEUDOMACROGLOSSIA)

  • 김윤지;이규홍;박준우;이건주;조형준;박양호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권3호
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    • pp.376-382
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    • 2008
  • Anterior open bite is a condition in which maxillary and mandibular incisors do not occlude at central occlusion. It is a vertical discrepancy of the jaws and dental arches that has many etiologic factors making it difficult in diagnosis, treatment and prediction of prognosis. One of the causes of open bite is abnormal size and shape of the tongue. Macroglossia, a condition in which tongue is oversized, is caused by several factors which are not clearly identifiable, and it may be a major factor of anterior and posterior open bite. Macroglossia is subdivided into true, functional and pseudomacroglossia depending on its relative size in the oral cavity. In this case report, a patient was diagnosed as skeletal Class II with pseudomacroglossia, and was treated with SARPE in order to expand the narrowed maxillary arch and Quad helix for the mandibular arch. As a result the transverse deficiency was treated. In the adult patients where no skeletal growth is expected, SARPE has shown to be effective in treating maxillomandibular transverse discrepancies in which macroglossia was accompanied as in this case.

Long Face(open-bite) 환자의 수술 교정 치료 (ORTHOPEDIC AND SURGICO-ORTHODONTIC TREATMENT IN THE LONG FACE)

  • 백형선
    • 대한치과교정학회지
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    • 제19권3호
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    • pp.147-160
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    • 1989
  • Long face patients are characterized by excessive anterior facial height, lip incompetence at rest, anterior open bite, and gummy smile. A major problem is an inferior rotation of the posterior maxilla and upper molars. Long face patients have been the most difficult for orthodontist to treat successfully. In growing patients, the methods for impeding excessive vertical growth have been used high pull head gear, functional appliance, and combined type of two. One significant improvement comes from using a full arch splint to deliver force to the maxilla more vertically. In adult patients, orthodontic camouflage treatment is biomechanically difficult and doesn't work when the problem is primarilly vertical. Surgical maxillary impaction provides a means for successfully treating most of problems. Also, superior reposition of the chin via a mandibular inferior border osteotomy is effective in decrease of lower anterior facial height and correction of the poor chin-lip balance. Post-surgical stability and the physiologic response are good. The coordinated orthodontic and surgical treatment is necessary for solution the difficult skeletal deformity.

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관절원판전위와 갑작스런 교합변화가 발생한 환자의 임상증례 및 원인에 관한 보고 (Occlusal Change as a Sequela of Anterior Disc Displacement without Reduction of Temporomandibular Joint: Case Reports)

  • 허윤경;정재광;최재갑
    • Journal of Oral Medicine and Pain
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    • 제36권2호
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    • pp.107-115
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    • 2011
  • 교합이 완성된 성인에서 비정복성 관절원판전위가 있는 경우에 과두흡수가 없는 상태에서도 갑작스런 교합의 변화 즉 전치부 개교합이 발생한 환자 2명과 측방으로 중심위와 중심교합위 간 활주가 발생한 환자 1명과 그리고 전후방으로 중심위와 중심교합위 간의 차이가 발생한 1명의 환자를 관찰하였기에 증례 보고하는 바이며, 비정복성 관절원판전위와 연관되어 교합의 변화가 발생하는 원인을 분석하고자 한다.

전치부 개방교합을 보이는 법랑질형성부전증 환자의 CAD/CAM system을 이용한 전악 수복 증례 (Full-mouth rehabilitation in an amelogenesis imperfecta patient with anterior open bite using CAD/CAM system)

  • 이상훈;이양진;조득원
    • 대한치과보철학회지
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    • 제55권4호
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    • pp.410-418
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    • 2017
  • 법랑질 형성 부전증은 유전적인 결함으로 인해 구조적으로 약한 법랑질이 형성되는 질환이다. 이들 환자들은 이른 나이부터 진행되는 법랑질 마모에 의한 시린 증상과 비심미적인 치아를 주소로 치과에 내원하게 되며, 성장기 이후에는 전악 보철 수복을 통해 치아의 기능성과 심미성을 회복해 주게 된다. 법랑질 형성 부전증 환자에서 보여지는 전치부 개방 교합은, 구치의 교합면 마모 및 보상성 맹출에 의한 수직적 수복 공간 문제와 결부되어 보철 치료를 어렵게 하는 요인이 된다. 따라서 전치 길이의 결정 및 교합 고경의 거상 여부, 전방유도의 설정은 신중히 결정되어야 한다. 근래에는 Computer aided design-computer aided manufacturing (CAD/CAM) 기술을 이용하여 진단 및 최종 수복으로의 이행이 용이해 졌다. 본 증례에서는 전치부 개방교합을 가지고 있는 법랑질 형성 부전증 환자에서, CAD/CAM을 이용한 전악 수복을 시행한 후, 양호한 경과를 보이고 있기에 이를 보고하고자 한다.

전치부 개방교합을 동반한 골격성 제3급 부정교합 환자에 대한 양측 하악지 시상분할 골절단술후 안정성에 관한 임상적 분석 (CLINCAL ANALYSIS OF SKELETAL STABILITY AFTER BSSRO FOR CORRECTION OF SKELETAL CLASS III MALOCCLUSION PATIENTS WITH ANTERIR OPEN BITE)

  • 김현수;권대근;이상한;김진수;강동화;장현중
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제33권2호
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    • pp.152-161
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    • 2007
  • This study was conducted to patients visited oral maxillo-facial surgery, KNUH and the purpose of the study was to assess skeletal and dento-alveolar stability after surgical-orthodontic correction treated by skeletal Class III malocclusion patients with open bite versus non-open bite. This retrospective study was based on the examination of 40 patient, 19 males and 21 females, with a mean age 22.3 years. The patients were divided into two groups based on open bite and non-open bite skeletal Class III malocclusion patients. The cephalometric records of 40 skeletal Class III malocclusion patients (open bite: n = 18, non-open bite: n = 22) were examined at different time point, i.e. before surgery(T1), immediately after surgery(T2), one year after surgery(T3). Bilateral sagittal split ramus osteotomy was performed in 40 patients. Rigid internal fixation was standard method used in all patient. Through analysis and evaluation of the cephalometric records, we were able to achieve following results of post-surgical stability and relapse. 1. There was no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in maxillary occlusal plane angle of pre-operative stage(p>0.05). 2. Mean vertical relapses of skeletal Class III malocclusion patients with open bite were $0.02{\pm}1.43mm$ at B point and $0.42{\pm}1.56mm$ at Pogonion point. In skeletal Class III malocclusion patients with non-open bite, $0.12{\pm}1.55mm$ at B point and $0.08{\pm}1.57mm$ at Pogonion point. There was no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in vertical relapse(p>0.05). 3. Mean horizontal relapses of skeletal Class III malocclusion patients with open bite were $1.22{\pm}2.21mm$ at B point and $0.74{\pm}2.25mm$ at Pogonion point. In skeletal Class III malocclusion patients with non-open bite, $0.92{\pm}1.81mm$ at B point and $0.83{\pm}2.11mm$ at Pogonion point. There was no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in horizontal relapse(p>0.05). 4. There were no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in post-surgical mandibular stability(p>0.05). and we believe this is due to minimized mandibular condylar positional change using mandibular condylar positioning system and also rigid fixation using miniplate 5. Although there was no significant relapse tendency observed at chin points, according to the Pearson correlation analysis, the mandibular relapse was influenced by the amount of vertical and horizontal movement of mandibular set-back(p=0.05, r>0.304).

전치부 Open-bite의 치험일례 (A CASE REPORT OF ANTERIOR OPEN-BITE)

  • 장상헌;이미대;남동석;양원식;조희원
    • 대한치과의사협회지
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    • 제13권9호
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    • pp.823-828
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    • 1975
  • We have effectually treated 22 years girl who had complained of an aterior open-bite. Treatment was based on non-extracted and multibanded technigue at the use of horizontal loop with 0.016 inch green Elgiloy wire. Anteior cross elastics, C1Ⅲ intermaxillary elastics, occasicnally C1.Ⅱ elastics were used. when vertical discrepancy was corrected, we changed the arch wire making use of 0.018 ×0.022 inch rectangular wire with 1st. and 2nd. order bend. After 12mons. the ideal arch wire with tie back loop was placed for stabilizing arch. Nearly after 20 months bands were removed and placed retainer.

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급성 비정복성 관절원판 변위에 따른 급성 교합변화의 증례 (Acute Occlusal Change Following Acute Anterior Disc Displacement without Reduction: A Case Report)

  • 정재광;허윤경;최재갑
    • Journal of Oral Medicine and Pain
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    • 제37권4호
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    • pp.205-211
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    • 2012
  • 35세 여자환자가 갑작스런 개구장애와 함께 발생한 급성 교합변화를 주소로 내원하였다. 환자는 이전 수년 동안의 관절잡음의 병력을 가지고 있었으며 관절잡음의 소실과 동시에 개구제한이 발생하였음을 보고하였다. 환자는 개구제한과 함께 개구시 우측 악관절의 통증을 호소하였으며 구강내 교합 검사 시 전치부의 개교합과 함께 하악이 우측으로 전위된 양상이 관찰되었다. 또한 좌측으로의 측방운동량 또한 감소된 것으로 관찰되었다. 자기공명영상에서 우측 악관절에서 비정복성 관절 원판 전방 변위가 관찰되었으며 후방 관절강의 협착이 관찰되었다. 이 환자는 우측 악관절의 비정복성 관절원판 전방변위로 진단되었으며, 급성 교합변화는 변위된 관절원판에 의해 야기된 과두위치의 변화로 초래된 것으로 추정하였다. 처음 3개월간의 물리치료와 약물치료와 병행된 안정교합장치요법에서는 만족할 만한 치료결과를 얻지 못하였으나, 그 다음 약 8개월간 사용된 악간견인장치 치료를 통해서 통증 및 교합변화가 해소되었으며 정상적인 개구량으로 회복되었다. 술후 촬영된 자기공명영상에서 우측 과두가 재형성된 양상을 관찰할 수 있었다.