• 제목/요약/키워드: Open bite

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전치개교에 관한 임상적 연구 (CLINICAL INVESTIGATION ON ANTERIOR OPEN-BITE)

  • 장영일
    • 대한치과교정학회지
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    • 제16권1호
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    • pp.35-49
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    • 1986
  • 전치개교에 관한 원인과 여러가지 치료법의 장단점을 논의했고 전치개교본태를 객관적으로 이해하는데 강조했다. 진단의 주관적인 해석은 부정교합을 잘못 기술해서 위험한 결과를 흔히 유도하게 된다. 해부학, 생리학, 조직학과 교정기계요법의 역학에 관한 길은 지식을 가진다면 대부분 전치개교치료는 외과적중재 없이 높은 성공율과 안정을 기할 수 있다. 이러한 점에서 지난 20여년동안 임상적으로 정립된 Kim의 MEAW 시술을 설명했으며 전치개교치료증례들이 이 MEAW요법을 입증하는데 제시되었다.

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Early treatment of anterior open bite: Comparison of the vertical and horizontal morphological changes induced by magnetic bite-blocks and adjusted rapid molar intruders

  • Albogha, Mhd Hassan;Takahashi, Ichiro;Sawan, Mhd Naser
    • 대한치과교정학회지
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    • 제45권1호
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    • pp.38-46
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    • 2015
  • Objective: This prospective clinical study aims to determine the differences between two treatment modalities for anterior open bite in growing patients. The treatment modalities involved the use of magnetic bite-blocks (MBBs) or rapid molar intruders (RMIs) applied with posterior bite-blocks. Methods: Fifteen consecutive patients with a mean age of 11.2 (standard deviation [SD] = 1.6) years and a mean open bite of -3.9 mm were treated with MBBs. Another 15 consecutive patients with a mean age of 10.9 (SD = 1.8) years and a mean open bite of -3.8 mm were treated with RMIs applied on bite-blocks. Cephalometric radiographs were obtained before (T1) and immediately after appliance removal (T2). The treatments lasted four months, during which the appliances were cemented to the teeth. The morphological changes were measured in each group and compared using logistic regression analysis. Results: The MBB group exhibited significantly greater decreases in SNA angle, ANB angle, overjet, and maxillary incisor angle (p < 0.05). The MBBs induced greater effects on the maxilla and maxillary dentition. The MBBs restrained maxillary forward growth and retracted the maxillary incisors more effectively than did the RMIs. Consequently, changes in the intermaxillary relationships and overjets were more distinct in the MBB group. Conclusions: The anteroposterior differences between the appliances suggest that MBBs should be preferred for the treatment of patients with Class II open bites and maxillary incisor protrusions.

Evaluation of hyoid bone movements in subjects with open bite: a study with real-time balanced turbo field echo cine-magnetic resonance imaging

  • Karacay, Seniz;Gokce, Sila;Yildirim, Ersin
    • 대한치과교정학회지
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    • 제42권6호
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    • pp.318-328
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    • 2012
  • Objective: To assess the position and movements of the hyoid bone during deglutition in patients with open bite. Methods: Thirty-six subjects were divided into 2 groups according to the presence of anterior open bite. The open bite group (OBG) and control group each comprised 18 patients with a mean overbite of $-4.9{\pm}1.9$ mm and $1.9{\pm}0.7$ mm. The position of the hyoid bone during the 4 stages of deglutition was evaluated by measuring vertical and horizontal movement of the bone. Results: Interactions of group and stage showed no significant effect on the measurements (p > 0.05). However, when group and stage were evaluated individually, they showed significant effects on the measurements (p < 0.001). In OBG, the hyoid bone was more inferiorly and posteriorly positioned, and this position continued during the deglutition stages. Conclusions: The hyoid bone reaches the maximum anterior position at the oral stage and maximum superior position at the pharyngeal stage during deglutition. Open bite does not change the displacement pattern of the bone during deglutition. The hyoid bone is positioned more inferiorly and posteriorly in patients with open bite because of released tension on the suprahyoid muscles.

Anterior Open Bite with Temporomandibular Joint Osteoarthritis Treated with Skeletal Anchorage Device: A Case Report

  • Seo-Rin Jeong;So-Yoon Lee;Sung-Hoon Lim;Hye-Min Kim;Shin-Gu Kang;Hyun-Jeong Park
    • Journal of Oral Medicine and Pain
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    • 제48권3호
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    • pp.123-130
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    • 2023
  • This case report describes the orthodontic treatment of a patient with severe anterior open bite and skeletal class II malocclusion with temporomandibular joint (TMJ) osteoarthritis (OA) of the left condyle. The 21-year-old male patient had open-bite malocclusion, mild crowding, and protrusion of the anterior teeth. Mild erosive changes were detected in the anterior part of the left mandibular condyle on cone-beam computed tomography; however, because no clinical symptoms were present, orthodontic treatment was performed. It is imperative to consider the potential implications of orthodontic treatment on the stability of the TMJ throughout the duration of treatment, as any instability can exacerbate TMJ OA. Hence, it is crucial to opt for the least invasive treatment modality available. In this regard, orthodontic treatment using a skeletal anchorage system as an alternative to conventional orthognathic surgery for patients with open bite holds great promise, as it not only ensures mandibular stability but also significantly ameliorates the open-bite condition.

Quantitative evaluation of palatal bone thickness in patients with normal and open vertical skeletal configurations using cone-beam computed tomography

  • Suteerapongpun, Piyoros;Wattanachai, Tanapan;Janhom, Apirum;Tripuwabhrut, Polbhat;Jotikasthira, Dhirawat
    • Imaging Science in Dentistry
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    • 제48권1호
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    • pp.51-57
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    • 2018
  • Purpose: To perform a comparative analysis of the palatal bone thickness in Thai patients exhibiting class I malocclusion according to whether they exhibited a normal or open vertical skeletal configuration using cone-beam computed tomography (CBCT). Materials and Methods: Thirty CBCT images of Thai orthodontic patients (15-30 years of age) exhibiting class I malocclusion with a normal or open vertical skeletal configuration were selected. Palatal bone thickness was measured in a 3.0-mm grid pattern on both the right and left sides. The palatal bone thickness of the normal-bite and open-bite groups was compared using the independent t-test. The level of significance was established at P<.05. Results: The palatal bone thickness in the normal-bite group ranged from $2.2{\pm}1.0mm$ to $12.6{\pm}4.1mm$. The palatal bone thickness in the open-bite group ranged from $1.9{\pm}1.1mm$ to $13.2{\pm}2.3mm$. The palatal bone thickness was lower at almost all sites in patients with open bite than in those with normal bite. Significant differences were found at almost all anteroposterior sites along the 3 most medial sections (3.0, 6.0, and 9.0 mm lateral to the midsagittal plane)(P<.05). Conclusion: Class I malocclusion with open vertical skeletal configuration may affect palatal bone thickness, so the placement of temporary anchorage devices or miniscrew implants in the palatal area in such patients should be performed with caution.

성인 환자에서 구치부 압하를 통한 개방교합의 치료와 유지 (Non-surgical treatment and retention of open bite in adult patients with orthodontic mini-implants)

  • 문철현;이주신;이현선;최진휴
    • 대한치과교정학회지
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    • 제39권6호
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    • pp.402-419
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    • 2009
  • 성장이 종료된 치성 또는 골격성 개방교합 환자를 치료하는 것은 매우 어려운 일이다. 전치부 개방교합 환자는 증가된 전안면고경, 상악 구치부의 과도한 수직성장, 큰 하악각 등의 특징을 지닌다. 이러한 증례에서 구치의 압하를 통한 개방교합의 해소는 좋은 치료전략이다. 본 연구는 교정용 미니임플란트를 이용하여 개방교합을 치료하고 성공적인 유지를 얻은 두 명의 환자에 대한 보고이다. 적절한 진단이 시행되고 교정용 미니임플란트 등의 장치를 이용한 치료기법을 적용하면 수술치료 없이 교정치료만으로 개방교합의 치료가 가능하며, 하악구치부에 posterior bite block을 추가한 가철식 유지장치 및 SFR이 개교환자를 위한 유지장치 또는 보조유지장치로 유용하게 사용될 수 있다는 결론을 얻었다.

정중구개부 미니스크류를 이용한 개방교합치료에 대한 연구 (A study on the treatment of anterior open bite with midpalatal miniscrews)

  • 경승현
    • 대한치과교정학회지
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    • 제34권1호
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    • pp.13-21
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    • 2004
  • 본 연구에서는 전치부의 개방교합을 동반한 환자 5명의 증례를 분석하여 (1) 성인에서의 상악 구치 함입을 통한 개방교합의 치료의 가능성과 (2) 이때 고정원으로서의 정중구개부 미니스크류의 유용성 여부와 (3) 치료에 의한 골격성, 치아-치조골의 변화에 대해 알아보고자 하였다. 상악구치부를 스플린트한 후 정중구개부에 두개의 미니스크류를 삽입하고 구개횡선 아치로 상악제 일대구치를 연결한 뒤, 탄성 재를 이용하여 상악 제일대구치에 함입력을 적용하였다. 측면 두개방사선상의 변화에 대한 분석 결과 다음과 같은 결과를 얻었다. 1. 모든 환자에서 상악 제1대구치의 실질적인 압하가 일어났고, 이때 평균 압하량은 $3.4mm(1.5mm\~5.0mm)$였다. 2. 상악 구치의 압하를 시행하는 동안 임상적으로 정중구개부의 미니스크류의 안정성이 유지되었다. 3. 하악이 반시계방향으로의 회전되었으며, 하악평면각, 교합평면각의 감소가 관찰되었다.

CEPHALOMETRIC CHARACTERISTICS OF OPEN-BITE CASES WITH DEGENERATIVE JOINT DISEASE(DJD) OF TMJ

  • Kim, Tae-Woo
    • 대한치과교정학회지
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    • 제25권6호
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    • pp.665-674
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    • 1995
  • The purpose of this study is to investigate the cephalometric characteristics of the open-bite patients with DJD of TMJ. The DJD open-bite cases were compared with normal samples and Class II open-bite cases with normal TMJ respectively. Twenty three open-bite patients with bilateral DJD of TMJ($13.9\~35.3$ yens old, Group I) were selected from the Department of Orthodontics, SNUDH. Group ll consisted of thirteen Class II open-bite cases($13.2\~27.4$ years old) with no TMD signs/symtoms and good condylar shapes. Group III samples were the forty eight healthy dental students who have Class I molar relationships with no history of orthodontic treatment, good facial balance and no TMD symptoms($20.0\~26.8$ years old). First, sixty measurements in the lateral cephalometric radiographs and analysis of variance(P<0.05, Scheffe) were used to compare these three groups. The seven measurements showed significant difference(p<0.05) between Group I and Group II. After analysis of variance, six of them were used for the discriminant analysis(Wilks' stepwise analysis) and the discrminant function for Group I/Group II was obtained. The results and conclusions were as follows : In most of the measurments, Group I and Group II showed the same skeletal and dental characteristics. But seven of the sixty measurements(FH-PP angle, SNB, FH-ArGo angle, articulare angle, genial angle, upper gonial angle and Ar-Go length) were significantly different(p<0.05) between Group I and Group II. These differences may be explained by the fact that in DJD cases the mandible rotated backward due to the shortening of the ramus following the degenerative destruction of condylar head and its surrounding structures. The resulting discriminant function was : $D={-0.120X}_1+{0.066X}_2+{0.144X}_3-{0.058X}_4+2000,\;where\;X_1=ArGo\;length(mm),\;X_2=SArGo\;angle(degree),\;X_3=FH-PP\;angle(degree),\;X_4=Gonial\;angle(degree)$. Mean of the group centroids was -0.555 and percent of the 'grouped' cases correctly classified was $88.89\%$.

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수직두개계측법에 의한 과개교합 및 개교에 관한 연구 (A STUDY 01 OEEP ()VER81TE AND OPEN BITE BY VERTICAL CEPHALOMETRIC ANALYSIS)

  • 전윤식;유영규
    • 대한치과교정학회지
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    • 제11권2호
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    • pp.109-123
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    • 1981
  • The author studied and analyzed statistically 112 adults female ranging in age from 18 to 20 years with normal occlusion, 56 adults female ranging in age from 18 to 24 years with deep overbite and 53 adults female ranging in age from 18 to 28 years with open bite by vertical cephalometric analysis. The results were as follows; 1. In comparing normal occlusion with deep overbite and open bite, skeletal linear measurements were more significant than dentoalveolar linear measurements. SN-MP angle, SN-OP angle, PP-OP angle and Xi angle (ANS-Xi-Pog) were significant in anglular measurements. 2. Upper posterior facial height (SE-PNS), upper anterior alveolar height, lower posterior alveolar height, lower posterior alveolar height/lower anterior alveolar height and SN-PP angle were non significant between deep overbite and open bite. 3 The most significant items between deep overbite and open bite were lower anterior facial height (ANS-ME) and SN-MP angle. 4. Correlation coefficients of angular measurements were higher in deep overbite, while that of linear measurement total anterior facial height (N-ME) was higher in open bite. 5. In the multiple regression equation, significant variables were total anterior facial height (N-ME), lower anterior alveolar height, upper anterior alveolar height, upper posterior alveolar height, Xi angle (ANS-Xi-Pog) and ramus height (AR-Go) in deep overbite, and total anterior facial height (N-Me), lower anterior alveolar height, ramus height (AR-Go), lower posterior alveolar height, PP-MP angle and upper posterior facial height (SE-PNS) in open bite.

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하악전돌증 및 개교합 환자에 있어 Obwegeser Ⅱ method의 안정성 (STABILITY OF OBWEGESER II METHOD IN MANDIBULAR PROGNATHIC OR ANTERIOR OPEN BITE PATIENTS)

  • 정창욱;남정훈;이상한;권대근
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권1호
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    • pp.25-33
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    • 2004
  • The purpose of this study was to evaluate the postoperative stability of the severe open bite or mandibular prognathic patients after mandibular set back surgery by Obwegeser II method. There were 19 patients who had been undergone Obwegeser II method. The horizontal and vertical position of the cephalometric points were measured preoperation and immediate postoperation, postoperative 1 month, postoperative 6 months ; were analyzed by linear measurement to evaluate changes in skeletal landmark and the relapse was compared between open bite group and prognathism group. By the operation, horizontal change of B was $6.84{\pm}4.35mm$ and vertical change of B was $6.28{\pm}3.25mm$ in open bite group and horizontal change of B was $14.20{\pm}4.81mm$ and vertical change of B was $1.99{\pm}2.66mm$ in prognathism group, horizontal change of Pog was $3.82{\pm}5.71mm$ and vertical change of Pog was $5.38{\pm}2.11mm$ in open bite group and horizontal change of Pog was $13.24{\pm}5.99mm$ and vertical change of Pog was $1.91{\pm}0.94mm$ in prognathism group. Between immediate postoperation and postoperative 1 month, all skeletal landmarks change was no statistical difference (p>0.05) and there were no statistical difference between open bite group and prognathism group except x-Me landmark (p>0.05). Between postoperative 1 month and 6 months, horizontal change of B was $0.12{\pm}1.35mm$ and vertical change of B was $1.47{\pm}1.48mm$ in open bite group and horizontal change of B was $1.43{\pm}1.35mm$ and vertical change of B was $0.82{\pm}1.99mm$ in prognathism group, horizontal change of Pog was $0.13{\pm}1.40mm$ and vertical change of Pog was $0.88{\pm}1.71mm$ in open bite group and horizontal change of Pog was $1.08{\pm}1.74mm$ and vertical change of Pog was $0.47{\pm}1.57mm$ in prognathism group (p>0.05) and there were no statistical difference between open bite group and prognathism group (p>0.05). Between immediate postoperation and postoperative 6months, horizontal change of B was $0.24{\pm}1.17mm$ and vertical change of B was $1.87{\pm}1.63mm$ in open bite group and horizontal change of B was $1.54{\pm}1.55mm$ and vertical change of B was $1.04{\pm}1.96mm$ in prognathism group, horizontal change of Pog was $0.91{\pm}1.46mm$ and vertical change of Pog was $1.18{\pm}2.05mm$ in open bite group and horizontal change of Pog was $0.96{\pm}1.62mm$ and vertical change of Pog was $1.23{\pm}2.35mm$ in prognathism group (p>0.05) and there were statistical difference between open bite group and prognathism group in x-B, x-Pog, x-Gn, x-Me (p<0.05). Obwegeser II method is considered as one of the best operation when surgical correction of severe open bite or severe mandibular prognathism is needed.