• 구강회복응용과학지
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• 제25권3호
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• pp.201-210
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• 2009

중심위는 교합적, 교정적, 보존적 관점에서 진단과 치료에 중요한 요소이며, 중심위에 대한 정의와 채득방법에 대하여서는 학자들마다 다양하게 주장하고 있다. 중심위를 채득하는 방법에는 여러 가지가 있고 임상적으로 가장 중요한 부분 중 하나가 재현성과 정확성을 확보하는 것이다. 이에 저자는 중심위 채득시 하악 과두의 운동접번축(kinematic axis)을 인식하는 Arcus $Digma^{(R)}$의 EPA test를 이용하여 중심위 채득 방법에 따른 재현성을 비교하였다. 구강 악안면계의 기능이상이 없으며 교합이 정상이고 치아의 교모 및 마모가 심하지 않은 성인 10명를 대상으로 5가지 중심위 채득 방법 (Self-guided method, Bimanual manipulation, Chin-point guidance, Leaf gauge method, Gothic arch tracer)에 따른 중심위의 재현성을 Arcus $Digma^{(R)}$를 이용하여 비교 연구한 결과 다음과 같은 결론을 얻었다. 첫째, 중심위 채득 방법에 따라 하악과두의 위치는 상이한 양상을 나타냈다. 둘째, 재현성은 bimanual manipulation이 가장 높게 나타났으며 다음으로 chin point guidance, Gothic arch tracer, leaf gauge를 이용한 방법 그리고 unguided method 순이었다. 셋째, 임상에서 양손조작법이나 chin-point guidance이 재현성면에서 비교적 매우 훌륭한 방법이라는 것을 미루어 알 수 있다.

• 구강회복응용과학지
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• 제33권3호
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• pp.207-215
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• 2017

총의치 치료에서는 지지, 유지, 안정, 교합, 심미 등 고려할 요소가 많으나 치조골 흡수가 심한 경우, 해당 요인을 갖추기 어렵다. 해부학적 치아를 사용할 경우 좋은 저작효율과 심미성을 기대할 수 있으나, 흡수된 치조골에서는 안정이 저하될 수 있으며 비해부학적 치아는 이와 반대의 효과를 나타낸다. 이에 치아를 혼용하는 설측 교두 교합이 제시되었다. 설측 교두 교합에서 상, 하악 협측 교두는 중심위, 측방위에서 접촉되지 않고 교합접촉위치가 설측화 또는 중심화되어 의치의 안정성이 증대될 수 있다. 본 증례는 상하 치조제의 흡수가 진행되어, 상악에서 편평한 치조제를 보이는 경우로, 설측 교두 교합을 이용한 총의치를 이용하여 치료함으로써 의치의 안정성과 환자의 만족도를 높였기에 이를 보고하는 바이다.

• Archives of Plastic Surgery
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• 제44권1호
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• pp.19-25
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• 2017

Background Numerous condylar repositioning methods have been reported. However, most of them are 2-dimensional or are complex procedures that require a longer operation time and a highly trained surgeon. This study aims to introduce a new technique using a condylar repositioning plate and a centric relation splint to achieve a centric relationship. Methods We evaluated 387 patients who had undergone surgery for skeletal jaw deformities. During the operation, a centric relation splint, intermediate splint, final centric occlusion splint, and condylar repositioning plate along with an L-type mini-plate for LeFort I osteotomy or a bicortical screw for bilateral sagittal split ramus osteotomy were utilized for rigid fixation. The evaluation included: a physical examination to detect preoperative and postoperative temporomandibular joint dysfunction, 3-dimensional computed tomography and oblique transcranial temporomandibular joint radiography to measure 3-dimensional condylar head movement, and posteroanterior and lateral cephalometric radiography to measure the preoperative and postoperative movement of the bony segment and relapse rate. Results A 0.3% relapse rate was observed in the coronal plane, and a 2.8% relapse rate in the sagittal plane, which is indistinguishable from the dental relapse rate in orthodontic treatment. The condylar repositioning plate could not fully prevent movement of the condylar head, but the relapse rate was minimal, implying that the movement of the condylar head was within tolerable limits. Conclusions Our condylar repositioning method using a centric relation splint and miniplate in orthognathic surgery was found to be simple and effective for patients suffering from skeletal jaw deformities.

• The Journal of Advanced Prosthodontics
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• 제4권3호
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• pp.170-173
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• 2012

Correct occlusal relationships are part of the successful prosthetic treatment for edentulous patients. Fabrication of complete dentures comprises of clinical and laboratory procedures that should be executed accurately for achieving success with fabricated dentures. Errors occurring during the clinical and laboratory procedures of a denture may subsequently lead to the occlusal errors in the final prosthesis. These occlusal errors can be corrected in two ways: i) in patient's mouth ii) by recording new centric relation and remounting dentures on an articulator. The latter method is more feasible because the mobility of denture base on the mucosa in oral cavity does not permit the identification of premature contacts in centric occlusion and tooth guided eccentric excursions. This article describes a modest and effective clinical chair-side remount procedure using customized mounting platforms.

• 치과방사선
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• 제14권1호
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• pp.141-152
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• 1984

The author analysed the bone changes, the positional relationships between condylar head and articular fossa, and the interrelationship between the bone changes and the abnormal position of condylar head, from 1,036 radiographs of 259 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral transcranial projection and orthopantomograms. The results were as follows: 1. Among the radiographic bone changes of the temporomandibular joint arthrosis, deformity was 36.90%(217 case), sclerosis 34.18% (20 cases), errosive chang 25.85% (152 cases) and marginal proliferation 3.06% (18 cases) respectively. 2. In the positional changes between condylar head and articular fossa, the downward positioning of condylar head in centric occlusion was most frequent(36.90%), of which frequency was signifiantly higher than forward positioning (11.22%) and backward positioning(4.76%) in same condition. Also, radiographs showed that the enlargement of articular space showed higher frequency than its narrowing. In the opening position of mouth, the restricted movement of condylar head within articular fossa was most frequent(35.03%). The forward positioning and the downward positioning was 15.65% and 9.52% respectively. Also, radiographs revealed that the incomplete movement or no positional change of condylar head was most frequent. 3. In the interrelationship between bone changes and abnormal position of condylar head, deformity was 42.79% in the cases of downward positioning of condylar head in centric occlusion and 37.50% in those of normal positioning of condylar head in same condition. This revealed that deformity was most frequent bone change in above condylar positionings. However, erossive change was 34.62% in the cases of downward positioning of condylar head in centric occlusion and 33.33% in those of forward positioning. In opening position of condylar head, and deformity in the cases of normal positioning, forward positioning and downward positioning of condylar head was 38.38%, 36.96% and 44.64% respectively. 4. Bone changes of condylar head was 47.11%, articular eminence 41.50% and articular fossa 11.39% respectively. This revealed that the frequencies of bone changes. were higher in the projected portion of bony structures of temporomandibular joint than their depressed portions. On the otherhand, in the bone changes of condylar head, deformity was 59.57% which was the most frequent. In the bone changes of articular eminence and articular fossa, however, sclersis was 41.39% and 65.67% respectively, which was the most frequent in those portions.

• 대한치과의사협회지
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• 제50권1호
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• pp.13-21
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• 2012

In an edentulous situation, the dentist must make several determinations when constructing artificial teeth. These include vertical and horizontal relationships of mandible with respect to the maxilla, occlusal form and position, vertical dimension, occlusal relationships during both centric closure and eccentric excursive movements. Artificial teeth are attached to a movable base resting on movable and displaceable living tissue subject to damage. They act as a unit; therefore, they must be arranged to function as a unit. Bilateral balanced occlusion is that stability of the denture is attained when bilateral contacts ex ist throughout all dynamic and static states of the denture during function. Lateral excursion in a balanced scheme implies simultaneous working side and nonworking side contact, while occlusal contacts are maintained on both anterior and posterior teeth as the mandible moves anteriorly into protrusion.

• 대한치과교정학회지
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• 제22권3호
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• pp.627-646
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• 1992

The purpose of this study was to investigate the relationship among the activity of the craniofacial muscle and craniofacial form and occlusal state. In this study, subjects were consisted of 23 male adults with skeletal Class III malocclusion and 30 male adults with normal occlusion. The measurements in oral exam, lateral ceghalogram, and E.M.G. recordings of anterior temporal, masseter, and upper lip muscles at rest position, clenching in centric occlusion, chewing of gum, swallowing of juice, were analyzed with SPSS system. The results were as follows: 1. At rest position upper lip muscle activity of skeletal Class III group was significantly higher than that of normal group. 2. Both clenching and chewing masseter and temporal muscle activity of normal group were significantly higher than that of skeletal Class III group. 3. During swallowing of juice, upper lip muscle activity of skeletal Class III group were significantly higher than that of normal group. 4. The activities of masseter and anterior temporal muscle during clenching and chewing were significantly correlated with hypodivergent facial form and number of occluded teeth. 5. The activity of upper lip during swallowing had positive correlation with mandibular prognathism.

• 치과방사선
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• 제7권1호
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• pp.19-26
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• 1977

The purpose of this study was to obtain the cephalometric maxillofacial soft tissue measurements, and to define the differences that exist between males and females on the soft tissue profile who had normal occlusion in mixed dentitions. For the object of this study, cephalometric radiographs were obtained from the centric occlusion with the relaxed lip position. Copper filter was designed to obtain both hard and soft tissue structure on the same film. The subjects consist of 100 males and 100 females from 8 to 12.4 years with the normal occlusion and acceptable profiles. The author measured facial depth, vertical height from the tissue profiles in the mixed dentitions. The significant test compare males with females. The following results were obtained from the study 1. In facial convexity, much more larger females than that of males. 2. Inclination of the lip posture were more larger in maxilla (male) and in females more larger in the mandible. 3. The thickness of soft tissue were thicker in males, the height of nose were more prominent in females. 4. There were no significant differences in both sexes.

• 대한치과교정학회지
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• 제25권6호
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• pp.675-688
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• 1995

The purposes of this study were:1) to determine the normal range of CR-CO discrepancy in normal occlusion group ; 2) to evaluate the changes of condylar position and craniofacial morphology between centric relation and centric occlusion before and after stabilization splint therapy in malocclusion group outside the normal range of CR-CO discrepancy. The normal occlusion group consisted of 80 subjects who had well-balanced faces and good occlusions with acceptable Class I molar relationship. They had not been treated orthodontically and had no signs or symptoms of temporomandibular joint dysfunction. 71 malocclusion patients enrolled for orthodontic treatment at the Department of Orthodontics, College of Dentistry, Chosun University comprised the malocclusion group, little variation of growth factor by the second molar eruption. They had CR-CO discrepancy beyond normal range and were subdivided into anterior-posteriorly -[25 Class I (0$\geq$4), and 24 Class III (ANB$\leq$0)] : vertically - [20 Normodivergentscy (30$\geq$34), and 18 Hypodivergency (SNGoMe$\leq$30)] ; and sexually - [26 Male and 45 Female]. For malocclusion group, stabilization splint with mutually protected type of occlusal scheme was applied for three months. Panadent articulators, Panadent condylar position indicator (CPI), and lateral headfilm were used to investigate the influence of stabilization splint on condylar position and craniofacial morphology. The results of this study were as follows. 1. The amounts of CR-CO discrepancy in normal occlusion were that the antero-Posterior component (${\bigtriangledown}X$) was $0.56\pm0.46mm$ (Male:$0.63\pm0.42mm$, Female:$0.49\pm0.50mm$) ; the supero-inferior component (${\bigtriangledown}Y$) was $-0.75\pm0.48mm$ (Male:$-0.76\pm0.52mm$, Female:-$0.73\pm0.43mm$) : and the transverse component (${\bigtriangledown}Z$) was $-0.33\pm0.28mm$ (Male : $-0.38\pm0.29mm$, Female:$-0.31\pm0.27mm$). 2. The condylar position was in normal range after stabilization splint therapy. 3. The mandible was always rotated infero-posteriorly after stabilization splint therapy. 4. Antero-posteriorly, Class III malocclusion responded very well to the stabilization splint therapy. 5. Vertically, Hyperdivergency responded very well to the stabilization splint therapy 6. Sexually, Male responded very well to the stabilization splint therapy.

• Journal of Oral Medicine and Pain
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• 제11권1호
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• pp.57-66
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• 1986

A study of occlusal relationship and TMJ dysfunction, parafunctional relationship and TMJ dysfunction using PRI was investigated in 23 dental students without history of being treated, ranging from 19 to 24 years old. The author used Denar Pantronic and D5-A articulator to study above. The obtained results were as follows : 1. Distribution of PRI in experimental subjects was as follows. None 13%, Slight 43%, Moderate 40%, Severe 4% Prevalance of TMJ Dysfunction was 87% 2. PRI scores of occlusal group Aoi (less than 5 in Helkimo occlusion/articulation index) was $11.72\pm2.32$ , those of occlusal group Boi (more than 5 in Helkimo occlusion/articulation index) 23.0 $\pm$ 8.06. There was a significant difference between group Aoi and group Boi(P<0.01) 3. PRI scores of occlusal group Ald (no eccentric interference, less than 0.5mm in lateral shift of slide in centric) was 12.0 $\pm$ 2.49, those of occlusal group Bld(no eccentric interference, less than 0.5mm in lateral shift of slide in centric) 24.5$\pm$5.33 There was a significant difference between group Ald and group Bld(P<0.05) 4. Prevalance of parafunction subjects(%) was 65.2%. 5. PRI scores of parafunction group was 21.6 $\pm$ 9.48, those of nonparafunctional group 18.7 $\pm$ 9.06. There was not significant difference between parafunctional group and nonparafunctional group(P>0.1)