• 대한치과교정학회지
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• 제46권1호
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• pp.55-61
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• 2016

Skeletal anchorage-assisted upper molar distalization has become one of the standard treatment modalities for the correction of Class II malocclusion. The purpose of this study was to analyze maxillary molar movement patterns according to appliance design, with the simultaneous use of buccal fixed orthodontic appliances. The authors devised two distinct types of midpalatal miniscrew-assisted maxillary molar distalizers, a lingual arch type and a pendulum type. Fourteen patients treated with one of the two types of distalizers were enrolled in the study, and the patterns of tooth movement associated with each type were compared. Pre- and post-treatment lateral cephalograms were analyzed. The lingual arch type was associated with relatively bodily upper molar distalization, while the pendulum type was associated with distal tipping with intrusion of the upper molar. Clinicians should be aware of the expected tooth movement associated with each appliance design. Further well designed studies with larger sample sizes are required.

• 대한치과교정학회지
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• 제46권5호
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• pp.290-300
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• 2016

Objective: This study aimed to (1) evaluate the effects of maxillary second and third molar eruption status on the distalization of first molars with a modified palatal anchorage plate (MPAP), and (2) compare the results to the outcomes of the use of a pendulum and that of a headgear using three-dimensional finite element analysis. Methods: Three eruption stages were established: an erupting second molar at the cervical one-third of the first molar root (Stage 1), a fully erupted second molar (Stage 2), and an erupting third molar at the cervical one-third of the second molar root (Stage 3). Retraction forces were applied via three anchorage appliance models: an MPAP with bracket and archwire, a bone-anchored pendulum appliance, and cervical-pull headgear. Results: An MPAP showed greater root movement of the first molar than crown movement, and this was more noticeable in Stages 2 and 3. With the other devices, the first molar showed distal tipping. Transversely, the first molar had mesial-out rotation with headgear and mesial-in rotation with the other devices. Vertically, the first molar was intruded with an MPAP, and extruded with the other appliances. Conclusions: The second molar eruption stage had an effect on molar distalization, but the third molar follicle had no effect. The application of an MPAP may be an effective treatment option for maxillary molar distalization.

• 대한소아치과학회지
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• 제36권3호
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• pp.464-474
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• 2009

상악 대구치의 원심이동이 요구되는 경우, 구외견인, Wilson distalizing arches, 가철식 스프링 장치 그리고 Schwarz plate-type 장치 등을 사용 할 수 있다. 그러나 이러한 전통적인 대구치의 원심이동 장치들로 치료에 성공하기 위해서는 환자의 협조가 필수적이기 때문에 많은 소아치과 의사들은 환자 의존성을 최소화하고 임상가가 통제 할 수 있는 장치들로 전환하고 있다. 이 중 가장 일반적인 것이 pendulum 장치인데, 고정원이 되는 전방치아의 원하지 않는 이동과 고정원 소실, 그리고 구개부 고정원이 좋지 않은 경우 원하는 정도의 구치부 원심이동을 얻기 어렵다는 단점이 있다. 이와 같은 전통적인 pendulum의 단점을 해결하고자, SAS(Skeletal Anchorage System)를 pendulum에 접목하여 골에서 직접 지지를 얻는 변형된 형태의 pendulum, 즉 bone-supported pendulum을 제작하여 장착 시킨 후 주기적인 관찰을 시행하였다. 본 증례는 혼합치열기 환자를 대상으로 bone-supported pendulum을 사용하여 안정된 고정원 유지, 원치 않는 치아이동의 최소화 및 양호한 상악 대구치 원심이동 등을 관찰하였기에 이를 보고하는 바이다.

• 대한치과교정학회지
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• 제45권4호
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• pp.171-179
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• 2015

Objective: To compare dentoalveolar and skeletal changes produced by the pendulum appliance (PA) and the distal screw appliance (DS) in Class II patients. Methods: Forty-three patients (19 men, 24 women) with Class II malocclusion were retrospectively selected for the study. Twenty-four patients (mean age, $12.2{\pm}1.5years$) were treated with the PA, and 19 patients (mean age, $11.3{\pm}1.9years$) were treated with the DS. The mean distalization time was 7 months for the PA group and 9 months for the DS group. Lateral cephalograms were obtained at T1, before treatment, and at T2, the end of distalization. A Mann-Whitney U test was used for statistical comparisons of the two groups between T1 and T2. Results: PA and DS were equally effective in distalizing maxillary molars (4.7 mm and 4.2 mm, respectively) between T1 and T2; however, the maxillary first molars showed less distal tipping in the DS group than in the PA group ($3.2^{\circ}$ vs. $9.0^{\circ}$, respectively). Moreover, significant premolar anchorage loss (2.7 mm) and incisor proclination ($5.0^{\circ}$) were noted in the PA group, whereas premolar distal movement (1.9 mm) and no significant changes at the incisor ($0.1^{\circ}$) were observed in the DS group. No significant sagittal or vertical skeletal changes were detected between the two groups during the distalization phase. Conclusions: PA and DS seem to be equally effective in distalizing maxillary molars; however, greater distal molar tipping and premolar anchorage loss can be expected using PA.

• 대한소아치과학회지
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• 제24권3호
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• pp.543-548
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• 1997

The first permanent molar takes important place in the occlusion. Malposition of the lower first molar is frequently due to mesial migration, which is occurred by early exfoliation of the second deciduous molar or proximal caries of deciduous teeth. Above things happen without any consideration of space maintainer, prompt measures for space regaining have to be started. Especially in the case with early loss of the second deciduous molar, it has been said that there is no suitable appliance for maintaining the space before the eruption of the permanent first molar. In distalizing the upper first molar, headgears have been routinely used, which its result was definitely depended on cooperation of the patients. Nowadays, appliances such as pendulum appliances, K-loop, magnets, which can be used without cooperation of the patients, are introduced. Jones Jig, one of the molar distalizing appliances, was used on the patients who visited department of pediatric dentistry in Seoul National University Dental Hospital complaining of no eruption space for the lower second bicuspid. Either removable splint or lingal arch was used as the anchorage. Jones Jig was favorably used in the lower molar, where vestibule is shallow, and this is a case report on the satisfactory result thereof.

• 대한소아치과학회지
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• 제36권2호
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• pp.281-287
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• 2009

유치열이 혼합치열기를 거쳐 영구치열로 교환되는, 소아 및 청소년기에서는 맹출장애가 흔히 관찰된다. 이로 인해 치아의 맹출시기를 놓치게 되면 심미적 문제 인접치아의 전위 및 치근흡수, 부정교합 등의 많은 문제를 야기한다. 치아 중 제1대구치는 특히 교합 및 발육에 중요하게 관여하며 기능적, 형태적으로 건전한 교합의 발육 및 유지에 필수적인 치아이다. 그러므로 이들 이상증례를 조기에 파악하고 문제점에 대응하는 것은 보다 적절한 교합관리에 중요한 부분이라 할 수 있다. 상악 제1대구치의 맹출장애는 크게 맹출지연, 매복, 일차정체 및 이차정체로 나누어서 생각할 수 있다. 매복의 원인 중 물리적 장애물이 존재할 경우 우선 이를 제거하고 치아발육 상태에 따라 제거 후 관찰, 외과적 노출 또는 교정적 견인 등으로 치료가능하며 이소맹출에 의 한 매복일 경우 brass wire, pendulum applinace, 제2유구치 발치후 공간 유지 및 공간확보 등으로 치료를 할 수 있다. 본 증례들은 혼합치열기의 환아로서 맹출장애를 보이는 상악제1대구치의 진단 및 그에 따른 치료를 통해 양호한 치료결과를 보여 이를 보고하는 바이다.