• 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.

• 대한치과교정학회지
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• 제44권3호
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• pp.143-153
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• 2014

An 8-years old boy with facial asymmetry and unilateral posterior crossbite on the left side received orthopedic and orthodontic treatment. During the first phase of treatment, the narrow maxillary arch was expanded using an acrylic plate. Then, the acrylic plate was used as a bite block with occlusal indentations from the construction bite that was obtained with the incisors in a coincident dental midline. After the position of the mandible was stabilized, the second phase of orthodontic treatment was initiated using fixed appliances for detailing of the occlusion. Skeletal symmetry, ideal occlusion, and coincident dental midlines were thus achieved. Functionally, occlusal force balance and masticatory muscle activity were improved, and the chewing patterns were normalized.

• 대한소아치과학회지
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• 제25권1호
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• pp.134-143
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• 1998

Twin Blocks are simple bite-blocks that effectively modify the occlusal inclined plane to induce favorably directed occlusal forces by causing a functional mandibular displacement. These devices use upper and lower bite-blocks that engage on occlusal inclined planes. Twin Blocks use the forces of occlusion as the functional mechanism to correct the malocclusion. To get an excellent result in the treatment by using the Twin Block appliances, proper case selection must be needed. Twin Block treatment is performed in two stages. Twin Blocks are used in the active phase to correct the anteroposterior relationship and establish the correct vertical dimension. Once this phase is accomplished, the Twin Blocks are replaced with an upper Hawley type of appliance with an anterior inclined plane, which is then used to support the corrected position as the posterior teeth settle fully into occlusion. The Twin Block is the most comfortable, the most esthetic ane the most efficient of all the functional appliances. Twin Blocks have many advantages compared to other functional appliances. Patients can wear Twin Blocks 24 hours per day and can eat comfortably with the appliances in place. From the moment Twin Blocks are fitted, the appearance is noticeably improved. There is less interference with normal function. Integration with conventional fixed appliances is simpler than with any other functional appliance. Twin Blocks allow independent control of upper and lower arch width. Appliance design is easily modified for transverse and sigittal arch development. The authors treated Class II malocclusion with Twin Blocks. and the results as follows; 1. Rapid profile improvement was achieved in 2-3 months. 2. There was excellent patient cooperation. 3. Severe overjet and overbite were reduced. 4. Class II molar relationship was changed to Class I.

• 대한장애인치과학회지
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• 제10권2호
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• pp.93-96
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• 2014

본 증례를 통하여 뇌병변 장애 1급 환아에 자해성 구강손상이 발생한 경우 치료에 대해 고려할 점은 다음과 같다. 뇌병변 장애 1급을 포함하는 의식 저하 환자에서는 혀, 입술 씹기 등의 자해성 구강손상 발생 빈도가 높다. 연성 구강보호장치의 용이성으로 우선적으로 고려될 수 있으나, 연성 구강 보호 장치로 병소가 개선되지 않을 경우, 교합 거상판을 포함한 아크릴릭 레진 가철성 장치를 고려할 수 있다. 교합 거상판을 포함하는 아크릴릭 레진 가철성 장치 장착이후 구강 위생 관리 및 치료 부위 유지를 위해 주기적인 치과 검진이 필요하다.

• 대한치과보철학회지
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• 제40권6호
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• pp.560-571
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• 2002

Jaw relations and the recording methods have been controversial aspects of dentistry. The purpose of this study was to quantify the relative muscle activity of the masseter and temporal muscles in relation to different intermaxillary relations recorded by intra-oral tracer during maximal clenching and to decide the optimal mandibular position. Ten volunteers with healthy TMJ were studied. Intra-oral tracer was assembled and bite block was fabricated in the articulator. Intra-oral tracer was placed in the mouth, and four mandibular positions were recorded. EMG activity was recorded on a BIO-PAK system (Bio-Research Associates, Inc. USA.) in masseter and temporal muscle and compared in each mandibular positions. The results were as follows: 1. In comparison with maximum intercuspation, the chewing position was the most similar followed by tapping position, myocentric position and posterior border position. However the differences were not statistically significant. 2. In comparison of bilateral symmetry of masseter muscle, tapping position was the most symmetrical followed by chewing position and maximum intercuspation. Myocentric position and posterior border position were not symmetrical. (P<.05). 3. In comparison of bilateral symmetry of anterior temporal muscle, chewing position was the most symmetrical followed by posterior border position, maximum intercuspation, myocentric position and tapping position. However the differences were not statistically significant. 4. In comparison of proportionality of anterior temporal muscle to masseter muscle activity on left side, posterior border position was the greatest followed by myocentric position, taping position, chewing position and maximum intercuspation. And the proportionality of posterior border position was greater than that of maximum intercuspation. (P<.05). 5. In comparison of proportionality of anterior temporal muscle to masseter muscle activity on right side, myocentric position was the greatest followed by posterior border position, tapping position, maximum intercuspation and chewing position. However the differences were not statistically significant.

• 대한치과의사협회지
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• 제48권11호
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• pp.819-828
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• 2010

Activator is a removable functional appliance used for correcting the skeletal Class II malocclusion in children with the mandibular deficiency. Berlin standard activator modified from Andresen activator has following characters; do not cover the palatal surface for tongue space, relief on lingual surface of mandibular incisors and resin capping 1/3-1/2 of crown height on mandibular incisors for preventing labioversion of mandibular incisors, L-hook between maxillary lateral incisor and canine for anterior high pull headgear, relief on mandibular posterior bite block for differential eruption of posterior teeth. Two cases presented here had a mandibular deficiency and slight maxillary protrusion. First case (an 11-year-old girl) treated with Berlin standard activator and anterior high pull headgear for 13 months followed by fixed orthodontic appliance for another 29 months. Second case (a 12-year-old boy) treated with Berlin standard activator for 6 months followed by fixed appliance for another 24 months. Treatment results showed a significant improvement in sagittal skeletal and occlusal relationship without premolar extraction. Mandibular condyles were concentric in TMJ [ossa, and masticatory muscle activities were normalized after treatment. In the retention period facial harmony and occlusal stability was maintained.

• 대한장애인치과학회지
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• 제10권2호
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• pp.89-92
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• 2014

상악 전치부 완전탈구를 주소로 내원한 지적 장애를 동반한 뇌병변 장애를 가진 25세 환자에서 재식 후 구치부 bite block을 추가한 vacuum-formed splint을 이용한 교합 안정술을 통하여, 외상 치아의 동요도 감소 및 교합안정을 이루는데 도움이 될 것으로 사료 된다.

• 구강회복응용과학지
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• 제37권1호
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• pp.48-60
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• 2021

치아의 병적 이동으로 전치가 정출되고 수직 피개가 깊은 치주염 환자에서는 치주 염증 치료와 더불어 정출된 전치의 위치 개선이 필요하다. 그러나 깊은 수직 피개로 교정 장치 부착이 어렵고, 역학적으로 전치 압하보다 구치 정출이 더욱 쉽게 발생하는 문제점이 있다. 특히 골격적 장안모를 보이는 환자에서 구치 정출을 통한 상대적 전치 압하는 안모의 악화를 야기하므로, 치료 계획에서부터 이를 차단하기 위한 설계가 필요하다. 본 증례에서는 전치가 정출되어 과개 교합을 보이는 치주염 환자에서, 철저한 치주 치료와 하악 전치에 부착한 cute bracket과 골성 고정원을 이용한 고정원 보강으로 하악 전치의 양호한 압하 치료 결과를 얻을 수 있었으며, 8년간 경과 관찰하여 이를 보고하고자 한다.

• 대한치과교정학회지
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• 제25권4호
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• pp.403-414
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• 1995

본 연구는 영구치열이 완성된 원숭이 2마리를 실험 동물로 선정하여 전치간 수직 고무와 연속 호선에 의한 개교 치료 기전으로 수직피개도가 증가하였을 때, 하악 치주 조직의 조직학적 변화를 고찰하였다. 상악에 구치부 교합거상판을 장착시켜 일시적인 전치부 개교 상태를 유발하면서 상악을 고정원으로 안정화하였고, 하악에는 양측 제2대구치를 발거한 후 나머지 모든 치아에 주조금관을 제작하였다. 각 주조금관에 018inch 표준 브라켓을 납착하여 구내 고정하고, 대조동물에는 $016{\times}022$inch의 ideal archwire를, 실험동물에는 같은 크기의 MEAW(multiloop edgewise archwire)를 삽입하였다. 2주 동안 전치간 수직 고무를 적용하고 희생하였으며, 하악 치주 조직 표본을 관찰한 결과, 다음과 같은 결론을 얻었다. 1. 2주간의 실험 기간 동안 수직피개도는 대조동물에서 0.3mm, 실험동물에서 1.3mm 증가되었다. 2. 대조동물과 실험동물 모두 중절치로부터 제1소구치까지는 정출력을 받고, 제2소구치와 제1대구치는 압하력을 받은 것으로 나타났다. 3. 실험동물의 정출된 하악 절치부 치주인대는 대조군에 비하여 견인 방향에 따른 섬유 구조의 재배열이 두드러지고, 치근단과 치조정부 및 치근 측면 치조골에서 신생골 형성이 현저하였다. 4. 실험동물의 정출된 하악 절치부 치주인대의 견인력이 분포한 영역에서 과도한 치근 흡수나 초자양 변성은 관찰되지 않았다. 5. 전치부와 구치부의 치조골면에서의 골개조 현상이 대조동물에 비해서 실험동물에서 더 뚜렷하였다.

• Journal of Periodontal and Implant Science
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• 제36권2호
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• pp.555-565
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• 2006

The purpose of the present study is to evaluate the biological stability of the zirconia/alumina composite abutment by histologic and radiographic examination in clinical cases. 17 partially edentulous patients (5 men and 12 women, mean age 47) were treated with 37 implants. The implants were placed following the standard two-stage protocol. After a healing period of 3 to 6 months, zirconia/alumina composite abutments were connected. All radiographs were taken using paralleling technique with individually fabricated impression bite block, following insertion of the prosthesis and at the 3-, 6-, 12 month re-examinations. After processing the obtained images, the osseous level was calculated using the digital image in the mesial and distal aspect in each implant. An ANOVA and t-test were used to test for difference between the baseline and 3-, 6-, 12 months re-examinations, and for difference between maxilla and mandible. Differences at P <0.05 were considered statistically significant. For histologic examination, sample was obtained from the palatal gingiva which implant functioned for 12 months. Sections were examined under a light microscope under various magnifications. Clinically, no abutment fracture or crack as well as periimplantitis was observed during the period of study. The mean bone level reduction(${\pm}standard$ deviation) was 0.34 rom(${\pm}\;0.26$) at 3-months, 0.4 2mm(${\pm}\;0.30$) at 6-months, 0.62 mm(${\pm}\;0.28$) at 12-months respectively. No statistically significant difference was found between baseline and 3-, 6-, 12-months re-examinations (p > 0.05). The mean bone level reduction in maxilla was 0.33(${\pm}0.25$) at 3-months, 0.36(${\pm}0.33$) at 6-months, 0.56(${\pm}0.26$) at 12-months. And the mean bone level reduction in mandible was 0.35(${\pm}0.27$) at 3-months, 0,49(${\pm}0.27$) at 6-months, 0.68(${\pm}0.30$) at 12-months. No statistical difference in bone level reduction between implants placed in the maxilla and mandible. Histologically, the height of the junctional epithelium was about 2.09 mm. And the width was about 0.51 mm. Scattered fibroblasts and inflammatory cells, and dense collagen network with few vascular structures characterized the portion of connective tissue. The inflammatory cell infiltration was observed just beneath the apical end of junctional epithelium and the area of direct in contact with zirconia/alumina abutment. These results suggest the zirconia/alumina composite abutment can be used in variable intraoral condition, in posterior segment as well as anterior segment without adverse effects.