• 제목/요약/키워드: Maxillary molar

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성인에서 Hyrax 장치로 완속상악확장하여 폭경부조화를 개선한 증례 (Correction of Transverse Discrepancy with Slowly Maxillary Expansion by Hyrax type expander in Adult Patient)

  • 곽경호;김성식;김용일;박수병;손우성
    • 대한치과의사협회지
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    • 제55권6호
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    • pp.400-410
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    • 2017
  • Approximately 30% of adult patients who want orthodontic treatment have transverse discrepancy with insufficient width of the maxilla. Particularly, in Class III patients requiring orthognathic surgery, the frequency of insufficient width of the maxillary arch related to respiratory problems is high. We report a case of non-surgical maxillary expansion using a Hyrax type expander with an orthognathic surgery, based on the reports that the ratio of non-fused midpalatal suture is not high in adults. A 30 years and 2 months old woman with a long face showed an Angle Class III with a vertical growth pattern. Class III molar and canine relation, anterior edge bite, and mandibular incisor compensatory lingual inclination were observed. The posterior buccal overjet seemed to be appropriate, but I diagnosed that there was a transverse discrepancy, for the following reasons. The inter-canine and inter-molar widths were sufficient but excessive lingual inclination of the mandibular molars was observed when assessing the bucco-lingual inclination based on the center of resistance of the maxillary and mandibular first molar. For this reason, it was expected that intercuspal interference would occur during orthodontic decompensation. Therefore, slow maxillary expansion using Hyrax type expander was performed and 2-jaw rotation surgery was performed to improve aesthetic and occlusion. Adults can also improve width discrepancy by non-surgical methods, which can avoid SARPE requiring additional surgery or segmental surgery lacking stability and predictability.

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건강한 치은과 조기 치은염 환자 부착치은폭경에 관한 연구 (Clinical study on the width of attached gingiva the subjects with healthy gingiva,or eariy stage of gingivitis)

  • 김정숙;문익상;채중규;조규성
    • Journal of Periodontal and Implant Science
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    • 제27권1호
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    • pp.235-248
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    • 1997
  • The purpose of this study was to investigate the width of attached gingiva of 414 subjects with healthy gingiva, or early stage of gingivitis. We compared the differences according to the tooth location, age (Yonger group : $14{\sim}30$, Older group : $31{\sim}67$) and gender. In addition, we compared the width of attached gingiva in the subjects with less than 2 sites of gingival recession($Re{\leq}2$) and the subjects with more than 3 sites of gingival recession($Re{\geq}3$) to study the relationship between the gingival recession and the width of attached gingiva. The results were as follows : 1. The width of keratinized gingiva was widest in maxillary incisors($5.3{\pm}1.4mm$) and narrowest in mandibular right 1st bicuspid and mandibular right and left 2nd molars($3.5{\pm}1.1mm$). 2. The width of attached gingiva was widest in maxillary right central incisor($3.8{\pm}1.5mm$) and narrowest in mandibular right 2nd molar($1.2{\pm}1.0mm$). 3. In the comparison between the age groups, the width of keratinized in older group was significantly (p<0.05) wider than that in younger group in maxillary right and left 1st bicuspids, mandibular right and left 1st and 2nd molars, maxillary right and left cuspids and mandibular right 1st bicuspid. There was no significant difference in the width of attached gingiva between the two groups except for maxillary right and left 1st molars and maxillary left 2nd molar. 4. In the comparison between male group and female group, in maxillary right and and left lateral incisors and cuspids, mandibular right and left cuspids and 1st bicuspids, the width of attached gingiva in female was significantly(p<0.05) wider than that in male group. 5. In the comparison between the Re 3 group and Re 2 group, there was no significant difference except for maxillary right and left 2nd molars and maxillary left 1st molar. 6. The frequency of gingival recession was m the order of mandibular right 1st bicuspid(16.6%), maxillary right 1st bicuspid(13.7%), maxillary and mandibular left 1st bicuspids (13.4%), mandibular left cuspid (10.5%), maxillary left and mandibular right cuspids(10.1%) and maxillary right cuspid(7.9%).

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Posterior superior alveolar nerve block alone in the extraction of upper third molars: a prospective clinical study

  • Swathi Tummalapalli;Ravi Sekhar M;Naga Malleswara Rao Inturi;Venkata Ramana Murthy V;Rama Krishna Suvvari;Lakshmi Prasanna Polamarasetty
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제23권4호
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    • pp.213-220
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    • 2023
  • Background: Third molar extraction is the most commonly performed minor oral surgical procedure in outpatient settings and requires regional anesthesia for pain control. Extraction of the maxillary molars commonly requires both posterior superior alveolar nerve block (PSANB) and greater palatine nerve block (GPNB), depending on the nerve innervations of the subject teeth. We aimed to study the effectiveness of PSANB alone in maxillary third molar (MTM) extraction. Methods: A sample size comprising 100 erupted and semi-erupted MTM was selected and subjected to study for extraction. Under strict aseptic conditions, the patients were subjected to the classical local anesthesia technique of PSANB alone with 2% lignocaine hydrochloride and adrenaline 1:80,000. After a latency period of 10 min, objective assessment of the buccal and palatal mucosa was performed. A numerical rating scale and visual analog scale were used. Results: In the post-latency period of 10 min, the depth of anesthesia obtained in our sample on the buccal side extended from the maxillary tuberosity posteriorly to the mesial of the first premolar (15%), second premolar (41%), and first molar (44%). This inferred that anesthesia was effectively high until the first molars and was less effective further anteriorly due to nerve innervation. The depth of anesthesia on the palatal aspect was up to the first molar (33%), second molar (67%), and lateromedially; 6% of the patients received anesthesia only to the alveolar region, whereas 66% received up to 1.5 cm to the mid-palatal raphe. In 5% of the cases, regional anesthesia was re-administered. An additional 1.8 ml PSANB was required in four patients, and another patient was administered a GPNB in addition to the PSANB during the time of extraction and elevation. Conclusion: The results of our study emphasize that PSANB alone is sufficient for the extraction of MTM in most cases, thereby obviating the need for poorly tolerated palatal injections.

정상인 상악동의 형태에 관한 방사선학적 연구 (A RADIOGRAPHIC STUDY ON THE MORPHOLOGY OF MAXILLARY SINUS IN ADOLESCENTS AND ADULTS.)

  • 고광준;이상래
    • 치과방사선
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    • 제14권1호
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    • pp.17-26
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    • 1984
  • The purpose of this study was radiographic analysis of the morphology of maxillary sinus in adolescents and adults. In order to analize the morphology of maxillary sinus in view point of anteroposterior width of medial wall, vertical distance between antral floor and nasal floor level, anterior extension, distance between antral floor and maxillary 1st molar apex, and types of lower border of maxillary sinus, specialized maxillary projection and periapical view with paralleling technique was taken. The author examined orthopantomograms and intraoral standard views taken from 400 adolescents and adults ranged 15-65 year-old. The obtained results were as follows: 1. The antero-posterior width of medial wall of maxillary sinus was 32.80mm in 15-19 year-old group, 33.86㎜ in 20-24 year-old group, 34.09㎜ in 25-29 year-old group, and 33.67㎜ in 30-65 year-old group, and the left maxillary sinus was somewhat smaller than the right. 2. The vertical distance between antral floor and nasal floor level was 8.49㎜ in 15-19 year-old group, 9.05㎜ in 20-24 year-old group, 8.95㎜ in 25-29 year-old group, and 8.32㎜ in 30-65 year-old group. 3. The order of anterior extension of maxillary sinus were distal half of canine, mesial half of canine, mesial half of 1st premolar, and distal half of 1st premolar. 4. The distance between antral floor and maxillary 1st molar were 4.36㎜ in 15-19 year-old group, 4.77㎜ in 20-24 year-old group, 3.58㎜ in 25-29 year-old group, and 2.33㎜ in 30-65 year-old group. 5. The order of the types of lower border of maxillary sinus were entire downward type, close type, partially downward type, waving type, separating type, and indistinct. In the types of antral floor, there was a tendency to increase the seperating type with age.

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X-선상에 이한 악안면질환의 통계학적 고찰 (A STATISTICAL STUDY OF THE MAXILLOFACIAL DISEASES BY RADIOGRAMS)

  • 정유택
    • 치과방사선
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    • 제4권1호
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    • pp.45-57
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    • 1974
  • This report based on 300 cases of serious diseases in maxillofacial region by radiograms seen at the department of dental radiodontics, infirmary school of dentistry, Kyung Hee University from October 1971 to August 1974. The maxillofacial diseases were analysed upon the following items, such as 1) the frequency of dominant diseases, 2) sex-ratio of male to female, 3) predominant region of diseases, 4) comparison with the age, 5) the incidence of diseases in relative to the individual teeth. The results were obtained as follows. 1) Among the total of 300 cases of the patients, the frequency of dominant diseases of patients were fractures of facial bone (44.3±2.87%), inflammatory diseases (22.7±2.39%), cysts (11.1±1.62%), tumors (10.7±1.77%), maxillary sinusitis (7.9±1.56%), temporomandibular joint disorders(3.3±1.05%) in the order. 2) The ex-ratio of male to female in occurence of jaw fractures were 7.3:1, temporomandibular joint disorders were 2.1:1, inflammatory diseases were 1.8:1, maxillary sinusitis were 1.7:1, but tumors were equal to 1:1, while cysts were 1:1.2 in sex difference. 3) The predominant region of mandibular fractures were symphysis(17.3±3.27%), canine region (15.0±3.09%), and angle region (14.3:±3.04%) in the order. Inflammatory diseases were occured frequently in mandible and it's left side were a little dominant. Odontogenic cysts were observed frequently in maxilla, but regardless of right and left. Carcinomas were involved most frequently in maxilla, while sarcomas and ameloblastomas in mandible. Frequency of the maxillary sinusitis were dominant right side and molar area, also temporomandibular joint disorders were right side. 4) To study comparison with the age jaw fractures showed the highest ratio at the 2nd decade(32.3±4.06%), and 3rd decade (27.8±3.89%), 4th decade (19.6±3.44%), 6th decade (9.0±2.47%), 5th decade(6.0±2.06%), 1st decade (5.3±1.95%) in the order. But 7th decade were not involved entirely. Frequency of the inflammatory diseases were the highest in the age group of 3rd decade (28.0±5.44%), and those of cysts were 5th decade (24.2±7.22%), temporomandibular joint disorders were 3rd decade (60.0±15.49%). Tumors were occured frequently over the 4th decade especially malignint tumors over the 5th decade, but maxillary sinusitis were rearless of age except for 2nd decade. 5) About the incidence of diseases in relative to individual teeth, fractures of facial bone were most frequently involved the maxillary and mandibular anterior teeth, and mandibular 3rd molar region. Cysts were maxillary anterior region inflammatory diseases were mandibular molar region maxillary sinusitis were maxillary 1st molar, region but tumors were regardless of individual teeth.

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Precision TPA로 회전된 편측 구치 치료시 공간변화에 대한 연구 (Spatial changes of the maxillary molar following unilateral derotation with the precision TPA)

  • 김유선;예성필;강대운;전윤식;노준
    • 대한치과교정학회지
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    • 제34권3호
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    • pp.219-227
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    • 2004
  • 본 연구의 목적은 치아의 이동양상을 관찰하기 위해 고안된 Calorific machine system(typodont simulation system)과 precision TPA를 이용하여, 근심 회전된 (mesial-in rotation) 상악 대구치를 회전 (derotation)시킨 후 해당 치아 및 반대측 고정 원의 공간변화를 확인하기 위함이다. 우측 상악 제 1대구치를 고정원으로 사용하였고 좌측 상악 제 1대구치를 근심 회전된 치아로 사용하였으며, TPA에 부여한 회전각은 $20^{\circ},\;40^{\circ},\;60^{\circ}$였다. 먼저 수동형의 precision TPA를 제작한 후, TPA의 왼쪽 삽입부위(tag)를 각각 $20^{\circ},\;40^{\circ},\;60^{\circ}$로 구부려 실험하였다. 각 군별 실험은 동일한 조건에서 5회 반복한 후 ANOVA와 Tucky's Studentized Range (HSD) test로 검정 하였다. 실험 결과, 교합면에서는 precision TPA의 구부리는 각도가 증가할수록 회전된 구치의 원심 설측 교두가 근심 설측 방향으로 움직이는 동안, 근심 협측 교두는 협측으로 더 많이 움직였고(p<0.001) 원심방향으로는 더 적게 움직였다. (p<0.001) 시상면에서 회전 구치의 구개측 치근은 더욱 근심으로 움직였다. (p<0.001) 횡단면에서는 회전된 치아가 약간의 정출을 보였다(p<0.001). 고정원으로 사용된 우측 상악 제1대구치는 세 평면에서 의미 있는 변화를 보이지 않았다.

스켈링 실습실에 내원한 여고생의 구강건강 실태 조사 (A Study of the Actual Conditions of the Dental Health of High School Girls Visiting Scaling Practice Rooms)

  • 장계원;조평규;서은주;이미옥
    • 한국치위생학회지
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    • 제3권1호
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    • pp.13-24
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    • 2003
  • The researcher worked with a total of 158 high school girls visiting the scaling practice room at the department of dental hygiene in Jinju Health college from November 11, 2002 to December 4, 2002, having their teeth scaled, observing their teeth and interviewing them with the aid of questionnaires. The findings can be summarized as follows. 1. The survey on the understanding of dental health and the attitudes of the subjects shows the following results : "I have never learned how to brush teeth" (65.8%: 104 girls); "I brush my teeth twice a day" (57.0%: 90 girls) : "I brush my teeth for 2 minutes"(44.3%: 70 girls): "I brush my teeth vertically and horizontally" (53.2%: 84 girls): "( brush my teeth, gum and tongue" (462%: 73 girls): "I use one brush for two months" (40.5%: 64 girls); "I don't have any floss" (582%: 92 girls): "I have never had my teeth scaled" (84.2%: 133girls) : "Smoking is bad for the teeth" (77.8%: 123 girls): "Drinking is bad for the teeth" (48.7%: 77 girls): "I have ever visited dental clinics" (92.4%: 146 girls). 2. The study on part of the teeth most exposed to caries shows the following results : Mandibular right first molar(79.8%: 126 girls): Mandibular left first molar(77.5%: 124 girls), Mandibular left second molar(70.2%: 111 girls). Mandibular right second molar(65.7%: 104 girls). Maxillary left first molar(59.5%: 94 girls): Maxillary left second molar(59.5%: 94 girls): Maxillary right first molar(58.2%: 92 girls). Maxillary right second molar(50.7%: 80 girls) 3. The statistics on the subjects' caries show the following results: DMF rate: 943%: DMFT rate: 25.61%: DMFT index: 7.17 teeth : DT rate: 4651%: FT rate: 52.25%: MT rate: 124% 4. The survey on dental caries statistics, dental health, dental health behavior, and the subjects' attitudes shows the following results: The worse the subjects' dental health was(r=-327, p<.001), the more they visited dental clinics(r=.195, p<.05), the higher DMT rate, DMFT index were; The more the subjects visited dental clinics(r =.359, p<.001), the higher DT rate was; The worse the subjects teeth went(r=-.197, p<.05), the higher MT rate was. It is necessary that systematic and substantial dental health education for high school students should be carried out in regard to plaque control, fluoride application, diet control, pit & fissure sealant as a part of developing national health policies designed for the dental health of the teenagers.

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Relationship between vertical components of maxillary molar and craniofacial frame in normal occlusion: Cephalometric calibration on the vertical axis of coordinates

  • Han, Ah-Reum;Kim, Jongtae;Yang, Il-Hyung
    • 대한치과교정학회지
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    • 제51권1호
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    • pp.15-22
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    • 2021
  • Objective: The aim of this study was to evaluate the correlation between the vertical position of maxillary first molar and vertical skeletal measurements in lateral cephalograms by using new linear measurements on the vertical axis of coordinates with calibration. Methods: The vertical position of maxillary first molar (U6-SN), and the conventionally used variables (ConV) and the newly derived linear variables (NwLin) for vertical skeletal patterns were measured in the lateral cephalograms of 103 Korean adults with normal occlusions. Pearson correlation analyses and multiple linear regression analyses were performed with and without calibration using the anterior and posterior cranial base (ACB and PCB, respectively) lengths to identify variables related to U6-SN. Results: The PCB-calibrated statistics showed the best power of explanation. ConV indicating skeletal hyperdivergency was significantly correlated with U6-SN. Six NwLin regarding the position of palatal plane were positively correlated with U6-SN. Each multiple linear regression analysis generated a two-variable model: sella and nasion to palatal plane. Among the three models, the PCB-calibrated model yielded highest adjusted R2 value, 0.880. Conclusions: U6-SN could be determined by the vertical position of the maxilla, which could then be used to plan the amount of molar intrusion and estimate its clinical stability. Cephalometric calibration on the vertical axis of coordinates by using PCB for vertical linear measurements could strengthen the analysis itself.

임플랜트 시술을 위한 치조돌기와 상악동 주변 구조물의 형태계측적 연구 (MORPHOMETRICS OF ALVEOLAR PROCESS AND ANATOMICAL STRUCTURES AROUND INFERIOR MAXILLARY SINUS FOR MAXILLARY IMPLANTATION)

  • 박주진;이영수;백두진;박원희;유동엽
    • 대한치과보철학회지
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    • 제45권2호
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    • pp.228-239
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    • 2007
  • Statement of problem: Following tooth loss, the edentulous alveolar process of maxilla is affected by irreversible reabsorption process, with progressive sinus pneumatization leads to leaving inadquate bone height for placement of endosseous implants. Grafting the floor of maxillary sinus by sinus lifting surgery and augmentation of autologous bone or alternative bone material is a method of attaining sufficient bone height for maxillary implants placement and has proven to be a highty successful. Purpose: This study was undertaken to clarify the morphometric characteristics of inferior maxillary sinus and alveolar process for installation of implants. Material and method: Nineteen skulls (37 sinuses, 10M / 9F) obtained from the collection of the department of anatomy and cell biology of Hanyang medical school were studied. The mean age of the deceased was 69.9 years (range 44 to 88 years). The distance between alveolar border and inferior sinus margin at each tooth, the height of alveolar process and the thickness of cortical bone of the outer and inner table of alveolar process and the inferior wall of maxillary sinus were measured. Results and Conclusion: 1. The septum of inferior maxillary sinus were observe 28 sides (76.%) and located at the third molar (52.6%) and the second molar (26.3%). The deepest points of inferior border of maxillary sinus were located the first or second molar. The distance between alveolar margin and the deepest point of inferior maxillary sinus is $9.7{\pm}4.9mm$. 2. The length of the outer table of alveolar process were $4.9\sim28.2mm$ and the shortest point was between the first and the second molors. The thickness of them were $0.9\sim3.2mm$. The length of the inner table of alveolar process were $7.4\sim25.8mm$ and the shortest point was between the first and the second molars. The thickness of the were $0.9\sim4.6mm$. The results of this study are useful anatomical data for installing of maxillary implants.

구개근 절제술을 이용한 상악 제일 대구치의 치료 (Palatal root resection of compromised maxillary first molars)

  • 정성념
    • Journal of Periodontal and Implant Science
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    • 제39권3호
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    • pp.375-381
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    • 2009
  • Purpose: Root resection can be a valuable procedure when the tooth in question has a high strategic value. The prognosis of root resection has been well documented in previous studies, but the results focused on the palatal root resection have not been discussed in depth. I represent here the short term effectiveness of palatal root resection of maxillary first molars. Methods: Palatal root resection was performed on maxillary first molars of three patients. All the palatal roots were floating state on the radiographic finding and showed full probing depth and purulent exudation at initial examination. Reduction of palatal cusp and occlusal table was performed concomitantly. Endodontic therapy was completed after root resection. Results: Compromised maxillary first molars were treated successfully by palatal root resection in 3 cases. The mobility of resected tooth was decreased a little bit. The probing pocket depth of remaining buccal roots was not increased compared to initial depth. All the patients satisfied with comfort and cost effective results and the fact they could save their natural teeth. Conclusions: Within the above results, palatal root resection is an effective procedure treating compromised maxillary first molar showing advanced palatal bone loss to root apex with or without pulp involvement when proper case selection is performed.