• 대한치과교정학회지
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• 제53권5호
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• pp.289-297
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• 2023

Objective: To analyze the microimplant (MI) displacement pattern on treatment with a maxillary skeletal expander (MSE) using cone-beam computed tomography (CBCT). Methods: Thirty-nine participants (12 males and 27 females; mean age, 18.2 ± 4.2 years) were treated successfully with the MSE II appliance. Their pre- and post-expansion CBCT data were superimposed. The pre- and post-expansion anterior and posterior inter-MI angles, neck and apical inter-MI distance, plate angle, palatal bone thickness at the MI positions, and suture opening at the MI positions were measured and compared. Results: The jackscrew plate was slightly bent in both anterior and posterior areas. There was no significant difference in the extent of suture opening between the anterior and posterior MIs (P > 0.05). The posterior MI to hemiplate line was greater than that anteriorly (P < 0.05). The apical distance between the posterior MIs was greater than that anteriorly (P < 0.05). The palatal thickness at the anterior MIs was significantly greater than that posteriorly (P > 0.01). Conclusions: In the coronal plane, the angulation between the anterior MIs in relation to the jackscrew plate was greater than that between the posterior MIs owing to the differential palatal bone thickness.

• 대한치과교정학회지
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• 제54권1호
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• pp.59-68
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• 2024

Objective: To investigate the long-term effects of maxillary skeletal expander (MSE) treatment on functional breathing. Methods: Objective measures of breathing, the peak nasal inspiratory flow (PNIF), and peak oral inspiratory flow (POIF), and subjective measures of breathing, the visual analog scale (VAS) and nasal obstruction symptom evaluation (NOSE) survey, were used to investigate the long-term effects of MSE in functional breathing. Seventeen patients, mean age 19.4 ± 3.9 years treated at the UCLA Orthodontics Clinic were assessed on their functional breathing at 3 timepoints: pre-expansion (T0), post-expansion (T1), and post-orthodontic treatment (T2). Results: Immediately after expansion (T1), all the objective functional breathing values were significantly increased in comparison to T0 (P < 0.05). The VAS total, VAS right and VAS left were significantly lower at T1 in comparison to T0 (P < 0.05). At 26.8 ± 3.9 months after MSE expansion (T2), PNIF total, PNIF right, PNIF left, and POIF were significantly higher when compared to T0 (P < 0.05). Also, VAS total, VAS right and VAS left were significantly lower at T2 when compared to T0 (P < 0.05). Additionally, there was a positive correlation between PNIF and the magnitude of expansion at anterior nasal spine and zygomaticomaxillary point (ZMA). There was a positive correlation between total VAS and the magnitude of expansion at the ZMA. There were no significant changes for the NOSE subjective breathing measurement at all time comparisons. Conclusions: Overall, MSE treatment produces an increased objective and subjective airway improvement that continues to remain stable in the long-term post expansion.

• 대한소아치과학회지
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• 제42권2호
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• pp.126-135
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• 2015

본 연구의 목적은 3급 부정교합 환자에서 facemask 치료 시 수직적 골격 양상에 따른 치료 효과를 비교하고, 구내 장치로서 bonded expander의 고정원을 평가하는 것이다. Facemask 치료를 받은 20명의 환자를 대상으로 FMA를 기준으로 두 군으로 분류하였고(HV군; FMA > $27^{\circ}$, AV군; $23^{\circ}$ < FMA < $27^{\circ}$), 치료 전과 후 측모두부방사선사진을 촬영하여 계측치를 비교하였다. 치료 후 두 군 모두 상악의 전방이동 및 하악의 후하방 회전이 관찰되었고, 두 군간에 유의한 차이는 없었다. 두 군 모두 수직적 골격 계측치가 증가하였고, FMA의 증가량은 HV군이 AV군에 비해 유의하게 크게 관찰되었다. 고정원 소실로서 상악구치의 근심이동 및 상악 전치의 전방경사가 관찰되었고, 두 군간에 유의한 차이는 없었다. 결론적으로 수직적 골격 양상에 따라 상악의 전방이동 및 고정원 소실면에서는 유의한 차이가 없었으나, HV군에서 수직적 성장 경향이 더 증가하였다.

• 대한치과교정학회지
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• 제52권5호
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• pp.372-382
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• 2022

Anterior open bite and transverse discrepancy are often accompanied by hyperdivergent skeletal patterns. In addition, degenerative joint disorders and vertical maxillary excess contribute to an unfavorable convex facial profile with a retruded chin. Correction of this complex three-dimensional problem with orthodontic treatment alone is considered challenging owing to anatomical limitations. Moreover, a history of orthodontic treatment with premolar extraction makes retreatment difficult. This case report illustrates the application of a maxillary tissue bone-borne expander and biocreative reverse curve system in a 23-year-old female patient with a severe anterior open bite and transverse discrepancy who underwent orthodontic treatment with four premolar extractions. By setting the treatment target under precise diagnosis and using appropriate appliances, a satisfactory treatment result could be achieved without orthognathic surgery.

• 대한치과교정학회지
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• 제51권3호
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• pp.145-156
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• 2021

Objective: The aim of this retrospective study was to assess the midfacial soft tissue changes following maxillary expansion using micro-implant-supported maxillary skeletal expanders (MSEs) in young adults by cone-beam computerized tomography (CBCT) and to evaluate the correlations between hard and soft tissue changes after MSE usage. Methods: Twenty patients (mean age, 22.4 years; range, 17.6-27.1) with maxillary transverse deficiency treated with MSEs were selected. Mean expansion amount was 6.5 mm. CBCT images taken before and after expansion were superimposed to measure the changes in soft and hard tissue landmarks. Statistical analyses were performed using paired t-test and Pearson's correlation analysis on the basis of the normality of data. Results: Average lateral movement of the cheek points was 1.35 mm (right) and 1.08 mm (left), and that of the alar curvature points was 1.03 mm (right) and 1.02 mm (left). Average forward displacement of the cheek points was 0.59 mm (right) and 0.44 mm (left), and that of the alar curvature points was 0.61 mm (right) and 0.77 mm (left) (p < 0.05). Anterior nasal spine (ANS), posterior nasal spine (PNS), and alveolar bone width showed significant increments (p < 0.05). Changes in the cheek and alar curvature points on both sides significantly correlated with hard tissue changes (p < 0.05). Conclusions: Maxillary expansion using MSEs resulted in significant lateral and forward movements of the soft tissues of cheek and alar curvature points on both sides in young adults and correlated with the maxillary suture opening at the ANS and PNS.

• 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.

• 대한소아치과학회지
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• 제41권4호
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• pp.298-305
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• 2014

본 연구의 목적은 3급 부정교합 환자에서 facemask 치료 시 bonded expander의 치아 피개 정도에 따라 facemask의 치료 효과를 비교하고, 구강 내 장치로서의 고정원 소실 정도를 평가하는 것이다. 초기 혼합치열기에 facemask 치료를 받은 18명의 환자를 대상으로, bonded expander의 피개 범위에 따라 제1군(4개 치아 피개, 9명)과 제2군(3개 치아 피개, 9명)으로 분류하였다. 치료 전과 후 측모두부방사선사진을 촬영하여 계측치를 비교하였다. Facemask 치료 후 두 군 모두 상악 전방이동 및 하악 후하방 회전의 골격적 효과가 관찰되었고, 두 군간에 유의한 차이는 없었다. 고정원 소실로서 두 군 모두 상악 구치의 근심이동이 관찰되었고, 제2군이 제1군에 비해 유의하게 큰 근심이동이 관찰되었다. 결론적으로 bonded expander의 치아 피개 범위에 따라 골격적 치료 효과에는 유의한 차이가 없었으나, 고정원으로서의 소실 정도에는 차이가 있었다.

• 대한소아치과학회지
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• 제42권1호
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• pp.45-52
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• 2015

본 연구의 목적은 3급 부정교합 환자에서 facemask를 이용한 악정형치료 시, 고정원으로 사용하기 위해 장착되는 구내 장치의 종류에 따른 효과를 비교하는 것이다. 3급 부정교합 환자 18명을 대상으로 악정형치료를 평균 12개월 동안 시행하였으며, 이 중 9명은 구내 장치로 bonded expander를, 9명은 Hyrax를 사용하였다. 치료 시작 전, 그리고 치료 직후에 측면 두부방사선사진을 촬영하여 비교 분석하였다. 또한 고정원 소실 정도를 조사하고, 장치에 따른 차이를 비교하였다. 악정형치료 효과에서는 두 군 모두 뚜렷한 개선을 보였고, 군간의 유의한 차이는 없었다. 각 구내 장치 모두 어느 정도의 고정원 소실량은 존재하였지만 군간의 차이는 없었다. Facemask는 성장기 3급 부정교합 환자의 치료에 있어서 효과적인 치료 방법이며, 구내 장치로 사용된 bonded expander와 Hyrax 간에 유의한 차이는 없었다.

• 대한치과교정학회지
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• 제52권6호
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• pp.399-411
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• 2022

Objective: The objective of this randomized clinical trial was to study the skeletal and dental effects of low-level laser therapy (LLLT) along with a miniscrew-assisted expander (Hyrax) after six months of retention. Methods: After sequence generation, concealed allocation, and implementation, 24 female patients were randomly divided (1:1) into two-groups: bone-borne rapid palatal expansion (BBE) without LLLT (n = 12) and BBE with LLLT (n = 12). Eligibility criteria included female patients aged 10-13 years old with bilateral posterior crossbites. Intraoral and extraoral photographs, cone-beam computed tomography images, and digital study models were obtained before expansion and six months after retention. The 7 mm Hyrax appliance was anchored to four palatal mini-screws, which were activated twice daily for 15 days, then locked and kept in place as a retainer. LLLT was performed in the laser group during expansion and retention, according to the guidelines provided. Results: The records of 24 patients were analyzed. According to the post-retention measurements, both groups showed a significant increase in nasal and maxillary widths and total facial height. In the laser group, the Sella-Nasion-Point A and Point A-Nasion-Point B angles and the interpremolar apical distance were significantly increased. Conclusions: Within the limitations of this study, the results suggest that the parameters and protocol of LLLT do not clinically affect the efficiency of BBE in prepubertal and pubertal patients.

• 대한장애인치과학회지
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• 제15권1호
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• pp.84-88
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• 2019

장애인의 교정 치료는 환자에 따라 치료 목표와 방법이 비장애인의 교정 치료와 달라질 수 있다. 교정 치료를 시작하기 전에 환자의 교정 치료의 한계에 대한 보호자와의 충분한 의사소통이 먼저 이루어져야 하고, 교정 치료는 환자가 견딜 수 있으면서 도움이 되는 방향으로 시행되어야 한다. 또한 교정치료 시 보호자들에게 구강위생관리의 중요성을 항상 강조하고 집에서의 구강 위생 관리를 위한 교육을 반드시 시행해야 한다.