• 대한치과교정학회지
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• 제21권2호
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• pp.325-340
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• 1991

There are evidences that occlusal splint therapy is critical to diagnose hidden akeleto-occlusal disharmonies in malocclusion patients and capable of enhancing stability after orthodontic treatment. In addition, evidences have implicated occlusal splint therapy in condylar positional changes during TMJ disorder treatment. In view of these evidences, this study was performed to investigate the effect of occlusal splint therapy on condylar positional changes in malocclusion patients and the possible clinical application of the occlusal splint as an additional orthodontic tool. For this study, 8 Angle's Class I malocclusion patients, who had centric occlusion-centric relation discrepancy within 1.0 mm and had no clinical symptoms of TMJ disorder, were selected as control group. And 22 malocclusion patients who had centric occlusion-centric relation discrepancy over 1.0 mm were selected and subdivided as Class I Malocclusion group, Class II div. 1 malocclusion group, Class II div. 2 malocclusion group, Open bite group, and Mandibular asymmetry group. For each subject the occlusal splint with mutually protected type of occlusal scheme was applied for 3 months. Condylar positions in centric relation and centric occlusion were measured using Panadent articulators and Panadent condylar position indicator (CPI) before and after occlusal splint therapy. On the basis of this study, the following conclusions might be drawn: 1, In control group, Class II div. 2 malocclusion group, and mandibular assymetry group, there were no significant differences in condylar positions before and after occlusal splint therapy. 2. In Class I malocclusion group, condyles were moved $0.27{\pm}0.45mm$ forward (p < 0.05) and $0.98{\pm}0.25mm$ upward (p < 0.01) after occlusal splint therapy. 3. In Class I malocclusion group, condyles were moved $0.24{\pm}0.21mm$ backward (p < 0.05) and $1.01{\pm}0.33mm$ upward (p < 0.01) after occlusal splint therapy. 4. In open bite group, condyles were moved $1.24{\pm}0.30mm$ upward (p < 0.01) after occlusal splint therapy. 5. In both control and experimental groups, there were no significant differences in lateral condylar positions before and after occlusal splint therapy.

• 치과방사선
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• 제19권1호
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• pp.105-121
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• 1989

The author analysed tomograms and submento-vertex radiograms of 90 temporomandibular joints from 45 asymptomatic young adults. 15 had Angle class Ⅰ malocclusion, 15 classⅡ and 15 class Ⅲ. Corrected lateral tomograms were obtained in three condylar positions; centric occlusion, centric relation and 1 inch mouth opening. The condylar angulation, depth of cut, joint spaces were analysed in each radiogram. The obtained results were as follows; 1. The mean condylar angulation in Angle class Ⅰ, Ⅱ, Ⅲ group was 17.55±5.51° 13.33±8.85° 16.25±6.60° respectively, and there was no significant difference in each group. The mean condylar angulation of right side (16.62±7.23°) was larger than left side (14.80±7.33°). 2. The mean depth of cut in Angle class Ⅰ, Ⅱ, Ⅲ group was 8.13±1.61㎝, 3.05±3.80㎝, 7.75±2.19㎝, respectively. Angle class Ⅰ and class Ⅱ group revealed significant difference in measurement (p<0.0l). 3. The mean height of articular fossa in Angle class Ⅰ, Ⅱ, Ⅲ group was 8.67±3.06㎜, 9.61±2.57㎜, 8.93±2.83㎜, respectively. And the mean width of articular fossa was 19.90±2.80㎜, 19.48±3.83㎜, 20.36±4.82㎜, respectively. 4. The mean height and width of condylar head was 5.11±1.16㎜, 11.20±2.26㎜, respectively. 5. In centric occlusion, the superior joint space was the largest (3.42±1.42㎜), followed by anterior joint space (2.94±1.95㎜) and the posterior joint space (2.64±1.19㎜. In centric relation, the anterior joint space was the largest (3.86±2.17㎜), followed by the superior joint space (3.64±3.68㎜) and the posterior joint space (1.18±0.77㎜). 6. The displaced measurement from centric relation to centric occlusion was 1.10±1.04㎜ anteriorly and 0.24±0.97㎜ inferiorly. In 1 inch mouth opening state, the condylar head displaced posteroinferiorly (2.49±2.49㎜ posteriorly, 1.17±1.34㎜ inferiorly) from the apex of articular eminence. And Angle class Ⅰ and Ⅱ group, Angle class Ⅱ and Ⅲ group revealed significant difference in posterior measurement, respectively (p<0.01).

• 대한치과교정학회지
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• 제19권2호
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• pp.109-120
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• 1989

We tend to consider only static occlusion such as molar relationship, canine key, and interdigitation at finishing stage. Of course, this static occlusion is important for post-orthodontic stability. But we should remember that mandible is always on the move during its various functions. If no pressure or too much pressure is put on during its functions, untoward tooth movement could occur. And tooth mobility, periodontitis, wear facet, bruxism, and far worse temporomandibular disorder could occur. After many studies have been done on what is a desirable occlusal scheme to strengthen post-orthodontic stability, today, "mutually protective occlusion" is recommended. If an orthodontist does not have understanding about this occlusal scheme during orthodontic treatment, the following conditions will be resulted after orthodontic treatment. I. Centric discrepancy 1. centric prematurity 2. sunday bite 3. molar fulcrum II. Eccentric discrepancy 1. posterior interference 2. anterior interference If we have deep understanding about these discrepancies that can happen after orthodontic treatment and their causes, corrections, and especially preventions against them, post-orthodontic stability could be strengthened and further temporomandibular disorder could be prevented.

• 구강회복응용과학지
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• 제30권3호
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• pp.238-245
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• 2014

무치악 환자에서 기능적으로 우수하고 심미적으로 만족스러운 의치 제작을 위해서는 상, 하악 교합관계, 즉 교합수직 고경과 중심위를 정확하게 결정해야 한다. 수직관계를 결정할 때에는 근육, 상, 하악 치열궁간 거리와 상, 하악 치조제의 평행도 등 여러 요소들이 고려되어야 한다. 또한, 중심위는 모든 하악 운동이 시작되는 재현 가능한 위치로서 기록하는 과정 역시 의치 제작에 매우 중요하다. 만일 이러한 악간관계 채득시 오차가 생기면 결과적으로 제작한 의치가 불편하게 된다. Gothic arch tracer와 같은 트레이싱을 이용하는 방법은 술자가 쉽게 교합수직고경과 중심위를 찾아내고 기록할 수 있는 좋은 방법으로 안정적인 교합수직고경에서 하악의 운동위를 얻기에 유리하다.

• The Journal of Advanced Prosthodontics
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• 제9권1호
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• pp.45-51
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• 2017

PURPOSE. This study aims to investigate the effects of four different lateral occlusion schemes and different excursions on peri-implant strains of a maxillary canine implant. MATERIALS AND METHODS. Four metal crowns with different occlusion schemes were attached to an implant in the maxillary canine region of a resin model. The included schemes were canine-guided (CG) occlusion, group function (GF) occlusion, long centric (LC) occlusion, and implant-protected (IP) occlusion. Each crown was loaded in three sites that correspond to maximal intercuspation (MI), 1 mm excursion, and 2 mm excursion. A load of 140 N was applied on each site and was repeated 10 times. The peri-implant strain was recorded by a rosette strain gauge that was attached on the resin model buccal to the implant. For each loading condition, the maximum shear strain value was calculated. RESULTS. The different schemes and excursive positions had impact on the peri-implant strains. At MI and 1 mm positions, the GF had the least strains, followed by IP, CG, and LC. At 2 mm, the least strains were associated with GF, followed by CG, LC, and IP. However, regardless of the occlusion scheme, as the excursion increases, a linear increase of peri-implant strains was detected. CONCLUSION. The peri-implant strain is susceptible to occlusal factors. The eccentric location appears to be more influential on peri-implant strains than the occlusion scheme. Therefore, adopting an occlusion scheme that can reduce the occurrence of occlusal contacts laterally may be beneficial in reducing peri-implant strains.

• 대한치과교정학회지
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• 제22권4호
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• pp.837-853
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• 1992

The purpose of this study was to investigate the positional changes of the mandibular condyles after orthognathic surgery In patients with severe skeletal Class III malocclusion. This study was based on 21 patients who had received bilateral sagittal split osteotomy for mandibular setback. Among them 14 were fixated non - rigidly (W group), and 7 were fixated rigidly (R group). After submental vertex view analysis, each subject was given the T.M.J. Tomogram in both centric occlusion and centric relation immediate before, $4\~6$ weeks after and more than 6 months after surgery. The anteroposterior and vertical changes between each time interval were measured and analyzed statistically. Following results were obtained. 1. There was no significant difference between right and left condyles in their anteroposterior and vertical changes of the condylar position. 2. In anteroposterior changes of condylar position of the wire fixation group, the condyles were moved anteriorly 4-6 weeks after surgery, and then the pattern of reestablishment to their preoperative position was observed more than 6 months after surgery. In the rigid fixation group, there was no significant difference in any observation periods of centric occlusion and centric relation. 3. In vertical changes of condylar position of the wire fixation group. the condyles were moved inferiorly 4-6 weeks after surgery, and then the pattern of reestablishment to their preoperative position was observed more than 6 months after surgery. In the rigid fixation group, the condyles were moved inferiorly 4-6 weeks after surgery, and then the pattern of reestablishment to their preoperative position was observed more than 6 months after surgery in centric occlusion only.

• Journal of Oral Medicine and Pain
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• 제13권1호
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• pp.43-52
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• 1988

The author studied masticatory muscle activity and bite force in normal persons without Temporomandibular Disorders(TMD) signs and symptoms, The number of subjects was 15, and the age of them was from 22 to 25 years. Electromyography was used to record the muscle activity in tapping and clenching movement with or without occlusal splint. 3 splints were made from 3 different mandibular position, that if, centric occlusion position, Rocabado's mandibular rest position, Dawson's centric relation position. The thickness of splint was 3.0-3.5㎜ at molar region. The muscle examined were Masseter and Anterior Temporalis attached with surface electrodes and the device used to measure the EMG level was Bioelectric processor Model EM2. After recording the EMG, the author measured the bite force level in clenching movement with bite force meter Model MPM-3000 in the dame position used in the EMG experiment. The obtained results were as follow : 1. With occlusal splints insetion, the amount of decreased muscle activity in Anterior Temporalis was more than those in Masseter. 2. In the three maxillomandibular relationships with occlusal splints, Masseter showed slightly increased level of muscle in centric occlusion but Ant. Temporalis showed decreased level of muscle activity reversely in that position. 3. Muscle activities between Rocabado's rest position and Dawson's centric relation position were generally similar whatever the muscles or the movements the author examined. 4. Bite force in clenching movement increased with splints insertion, especially with the splint registered in centric occlusion position.

• 구강회복응용과학지
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• 제25권4호
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• pp.337-347
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• 2009

심하게 마모된 치열의 경우 마모로 인해 교합평면의 이상과 보철물을 제작할 공간이 없는 경우가 많다. 이 경우 대개 reverse curve를 보이는 교합평면을 바로잡고 보철물을 제작하기 위해 고합교경을 높여주는 과정이 필요하다. 교합고경이란 상하악 치아가 최대 폐구위에서 감합하고 있을때 상악에 대한 하악의 수직적 위치를 나타낸다. McAndrew는 고경이 변한다해도 중심위에서 전체치궁의 균일한 접촉이 이루어 진다면 치조골내에서 일어나는 remodeling 에의한 고경의 변화에도 불구하고 수정된 교합개선상태는 유지된다고 하였다. 중심위는 치료를 위한 하악위치의 참고점으로 널리 사용되어 왔다. 중심위란 하악이 해부학, 생리학적으로 안정을 이룬 상태에서 반복재현 가능한 위치이다. 본 증례에서는 심하게 마모된 치열을 지녀 보철수복을 위한 공간을 상실한 환자에서 교합고경을 증가시켜 중심위를 이용하여 처치한 치험예를 문헌고찰과 함께 보고하고자 한다.

• 치과방사선
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• 제8권1호
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• pp.43-47
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• 1978

The purpose of this study was to investigate the normal range of condylar movement of normal adults. The author has observed roentgenographic images of four serial positions of condylar head taken by modified transcranail lateral oblique projection. The serial positions are centric occlusion, rest position, 1 inch open position and maximal open position. The results were obtained as follow; 1. Inter-incisal distance was 46.85㎜ in maximal open position. 2. The length between the deepest point of glenoid fossa and summit of condylar head in rest position was wider than that in centric occlusion by 0.8㎜. 3. In 1 inch open position, condylar head moved forward from the standard line in 12.64㎜ of horizontal direction and moved downwards from the standard line in 1.84㎜ of vertical direction. 4. In maximal open position, condylar head moved forward from the standard line in 19.06㎜ of horizontal direction and moved downwards from thestanard line in 0.4㎜ of vertical direction. 5. In centric occlusion, the width between glenoid fossa and margin of condylar head was greater in the posterior portion than in the anterior portion by 0.4㎜. 6. Except for the estimated figures of 1 inch open position, all of the estimated figures was greater in male than in female.

• 치과방사선
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• 제9권1호
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• pp.13-18
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• 1979

The purpose of this study was to investigate the radiographic images of Temporomandibular joint trouble patients. This study included 186 patients with the chief complaints of TMJ pain and dysfunction. Their age ranged from 17 to 68 years. All patients were identified in the department of Dental mary of College of Dentistry, Seoul National University, Apr. 1978 to Jun. 1979. The author has observed the radiographic variations of two positions of condylar head taken by modified transcranial oblique-lateral projection, which are one in centric occlusion and the other in 1 inch(2.54㎝) mouth open. The results were obtained as follows; 1. In centric occlusion, the distances and positional relationship between the summit of condylar head and the deepest point of articular fossa revealed more or less large variations; Normal range is of 37.9%, anterior displacement of 37.3% and posterior displacement of 22.6%. 2. In the horizontal movement of condylar heads when on 1 inch mouth open, it was revealed that normalrange was of 46.5%, anterior displacement of 12.3%, posterior displacement of 41. 1 %. 3. In the positional interrelationship of both condylar heads when on 1 inch mouth open, it was revealed that symmetry(71. 5%) occurred approximately 2.5 times as many as asymmetry. 4. In both centric occlusion and 1 inch mouth open, it was showed that almost all estimated figures were greater in male than in female, and in the horizontal movement of condylar head when on 1 inch open, it was showed that hypermobility was dominant in male and hypomobility in female.