• 제목/요약/키워드: class 2 malocclusion

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골격성 III급 부정교합자에서 상악골 전진술을 동반한 양악 수술 시 중안면 연조직 형태의 변화 (Soft tissue change of the midface in skeletal class III orthognathic surgery patients)

  • 정종현;김성식;손우성;박수병
    • 대한치과교정학회지
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    • 제38권2호
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    • pp.83-94
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    • 2008
  • 본 연구는 중안면 함몰이 있는 골격성 III급 부정교합자의 중안면의 형태를 정상 표본과 비교하고, 악교정수술에 의하여 연조직이 어떤 변화를 보이는 지를 알아보기 위하여 시행하였다. 골격성 III급 부정교합으로 진단 받고 상악 전진술과 하악 후퇴술을 시행 받은 환자 34명(남자:15명, 여자:19명)을 대상으로 수술 전후 측모 두부방사선 계측사진을 분석하였다. 골격성 III급 부정교합자의 중안면의 경조직 계측치 S'-Or, Or${\bot}$NA, S'Or/SN, ${\angle}$SNOr에서 남녀모두에서 정상 교합자와 큰 차이가 있었다. 상악골이 평균 5.03 mm 전방이동 될 때 연조직 Orbitale는 2.26 mm전방으로 이동하였으며 상관계수는 0.599였다 (p<0.05). 상악 평면각의 변화(시계방향으로 회전)와 상악골의 수직이동은 연조직 Orbitale의 전방이동과 유의성있는 상관관계가 없었다. 상악골 전방이동에 대한 연조직 Orbitale와 Subnasale의 전방이동 비율은 각각 43.57%, 81.54%였다. 이상의 결과에서 중안면 함몰이 있는 환자는 상악골 전방이동시 상순과 비부 외에도 연조직 Orbitale를 포함한 중안면 연조직이 전방으로 이동하지만, 상악골의 회전이동 및 수직이동에 대해서는 연조직의 변화량이 적었다는 것을 알 수 있었다. 이는 상악골의 수술에 따른 중안면 함몰의 해소를 예측하는데 도움이 될 것이다.

Posterior dental compensation and occlusal function in adults with different sagittal skeletal malocclusions

  • Hwang, Soonshin;Choi, Yoon Jeong;Jung, Sooin;Kim, Sujin;Chung, Chooryung J.;Kim, Kyung-Ho
    • 대한치과교정학회지
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    • 제50권2호
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    • pp.98-107
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    • 2020
  • Objective: The aim of this study was to compare posterior tooth inclinations, occlusal force, and contact area of adults with different sagittal malocclusions. Methods: Transverse skeletal parameters and posterior tooth inclinations were evaluated using cone beam computed tomography images, and occlusal force as well as contact area were assessed using pressure-sensitive films in 124 normodivergent adults. A linear mixed model was used to cluster posterior teeth into maxillary premolar, maxillary molar, mandibular premolar, and mandibular molar groups. Differences among Class I, II, and III groups were compared using an analysis of variance test and least significant difference post-hoc test. Correlations of posterior dental inclinations to occlusal function were analyzed using Pearson's correlation analysis. Results: In male subjects, maxillary premolars and molars had the smallest inclinations in the Class II group while maxillary molars had the greatest inclinations in the Class III group. In female subjects, maxillary molars had the smallest inclinations in the Class II group, while maxillary premolars and molars had the greatest inclinations in the Class III group. Occlusal force and contact area were not significantly different among Class I, II, and III groups. Conclusions: Premolar and molar inclinations showed compensatory inclinations to overcome anteroposterior skeletal discrepancy in the Class II and III groups; however, their occlusal force and contact area were similar to those of Class I group. In subjects with normodivergent facial patterns, although posterior tooth inclinations may vary, difference in occlusal function may be clinically insignificant in adults with Class I, II, and III malocclusions.

부정교합의 유형과 성별에 따른 자연두부위치의 재현성에 관한 연구 (A study on the reproducibility of the natural head position according to the skeletal malocclusion types and sex)

  • 김하란;이동렬;김광원;윤영주
    • 대한치과교정학회지
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    • 제30권3호
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    • pp.307-315
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    • 2000
  • 교정치료의 진단 및 치료계획의 수립시 이용되는 측모두부방사선 사진을 이용하여 골격성 부정교합의 형태와 성별에 따른 두부위치의 재현성을 파악하고자 성인남녀 90명을 대상으로 자세변수 6항목을 설정하여 연구한 결과 다음과 같은 결과를 얻었다. 1. 자연두부위치의 재현성에 있어서 남,녀 각각의 자세변수는 통계학적인 유의성이 없었다 (P>0.05). 2. 자연두부위치의 재현성에 있어서 각 부정교합군과 전체 표본 각각의 자세변수는 통계학적인 유의성이 없었다(P>0.05). 3. method error를 이용한 자연두부위치의 재현성은 모든군에서 우수하였다. 결론적으로 자연두부위치의 재현성은 골격성 부정교합의 양상과 성별에 관계없이 우수하였는데, 이는 자연두부위치를 이용한 많은 연구에 도움이 될 뿐 아니라 교정적 문제와 관련된 기능과 형태의 관계를 파악하고자 할 때 그 가치를 높이는데 기여할 수 있으리라 생각된다.

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Le Fort I 상악골전진술 후 안정성에 관한 연구 (THE SKELETAL STABILITY OF LE FORT I MAXILLARY ADVANCEMENT)

  • 서민교;구성영;김은주;임대호;신효근;고승오
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권2호
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    • pp.149-153
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    • 2010
  • The purpose of this retrospective study was to evaluate relapse, comparing large and small maxillary advancements with four-plate rigid fixation and without bone grafting. All patients had skeletal class III malocclusion, and underwent bimaxillary surgery. Standardized cephalometric analysis by one examiner was performed on serial radiographs of 14 patients immediately before surgery, and within 1 week and at least 6 months postoperatively (mean 10 months). The group was divided into two subsets to determine whether the magnitude of relapse. In group 1 ($\leq$ 5 mm, n = 8), the average advancement was $4.0{\pm}0.9\;mm$, with a mean relapse of $0.1{\pm}0.5\;mm$. In group 2 (6-8 mm, n = 4), the average advancement was $6.8{\pm}0.9\;mm$, with a mean relapse of $0.7{\pm}0.4\;mm$. There was no statistical difference in the measured relapse among the groups. Maxillary advancement with a 1-piece Le Fort I osteotomy is a relatively stable procedure.

Comparison of treatment effects between four premolar extraction and total arch distalization using the modified C-palatal plate

  • Jo, Sung Youn;Bayome, Mohamed;Park, Justyn;Lim, Hee Jin;Kook, Yoon-Ah;Han, Seong Ho
    • 대한치과교정학회지
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    • 제48권4호
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    • pp.224-235
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    • 2018
  • Objective: The purpose of this study was to compare the skeletal, dental, and soft-tissue treatment effects of nonextraction therapy using the modified C-palatal plate (MCPP) to those of premolar extraction (PE) treatment in adult patients with Class II malocclusion. Methods: Pretreatment and posttreatment lateral cephalographs of 40 adult patients with Class II malocclusion were retrospectively analyzed. The MCPP group comprised 20 patients treated with total arch distalization of the maxillary arch while the PE group comprised 20 patients treated with four PE. Fifty-eight linear and angular measurements were analyzed to assess the changes before and after treatment. Descriptive statistics, paired t-test, and multivariate analysis of variance were performed to evaluate the treatment effects within and between the two groups. Results: The MCPP group presented 3.4 mm of retraction, 1.0 mm of extrusion, and $7.3^{\circ}$ lingual inclination of the maxillary central incisor. In comparison, the PE group displayed greater amount of maxillary central incisor retraction and retroclination, mandibular incisor retraction, and upper lip retraction (5.3 mm, $14.8^{\circ}$, 5.1 mm, and 2.0 mm, respectively; p < 0.001 for all). In addition, the MCPP group showed 4.0 mm of distalization and 1.3 mm of intrusion with $2.9^{\circ}$ distal tipping of the maxillary first molars. Conclusions: These findings suggest the MCPP is an effective distalization appliance in the maxillary arch. The amount of incisor retraction, however, was significantly higher in the PE group. Therefore, four PE may be recommended when greater improvement of incisor position and soft-tissue profile is required.

골격성 제3급 부정교합자의 양악 수술 후 상기도 공간의 변화에 관한 두부 계측 방사선학적 연구 (A RADIOGRAPHIC STUDY OF CHANGES OF UPPER RESPIRATORY AIRWAY SPACE AFTER ORTHOGNATHIC SURGERY OF BOTH JAWS IN PATIENTS WITH SKELETAL CLASS III MALOCCLUSION)

  • 주범기;김진태;조명철;허종기;김형곤;박광호
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제29권2호
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    • pp.148-156
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    • 2007
  • Purpose: The aim of this study is the changes of upper respiratory airway space in patients with mandibular prognathism after 2-jaw orthognathic surgery in patients with skeletal classs III malocclusion. Method: We measured the lines between selected upper airway landmarks on lateral cephalometric x-ray films of skeletal class III 64 persons who had not been operated yet, were 6 months after operation. The test subjects were divided into 3 groups according to maxillary movement, as follows; maxillary advancement (MA) group, maxillary posterior impaction (MPI) group, maxillary posterior impaction and superior repositioning (MPI+MSR) group. Result: In this study, nasopharyngeal airway space in MPI+MSR group was significantly increased after operation (p<0.05). Oropharygeal and hypopharyngeal airway space in MA group and MPI group were significantly decreased after operation (p<0.05). From hyoid bone to anterior mandible point distance in MA group and MPI group were significantly decreased after operation (p<0.05). Conclusion: Oropharygeal and hypopharyngeal airway space were influenced more by mandibular set-back than maxillary movement. Maxillary movement surgery as well as mandibular setback surgery should be taken into consideration in order to minimize symptoms related to obstructive sleep apnea syndrome after operation.

Floating-Harbor 증후군 환자와 쌍둥이 여동생의 치성 및 골격성 특성과 행동 양상 비교 (Dental and Skeletal Characteristics and Behavioral Aspects of the Patient with Floating-Harbor Syndrome Compared with Twin Sister)

  • 임종화;김기민;이제식;남순현;김현정
    • 대한소아치과학회지
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    • 제49권2호
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    • pp.234-240
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    • 2022
  • Floating Harbor 증후군 (FHS)은 드문 유전질환이다. 본 증례는 FHS를 가진 환아에 대해 소개하였다. 환아는 독특한 얼굴 형태, 저성장된 상악과 전돌된 하악을 동반한 심한 골격적 3급 부정교합, 결손치, 왜소치, 상악 치아의 이소맹출을 보였다. 쌍둥이 여동생은 하악 전돌을 동반한 경미한 골격성 3급 부정교합은 보였으나 결손치와 왜소치는 보이지 않았다. 높은 구개궁, 넓은 난형의 하악궁에 비해 좁은 V형의 상악궁, 역의 관계의 상하악 구치간 폭경으로 인한 구치부 반대교합이 환자의 모델 분석을 통해 확인되었다. 이러한 특성은 쌍둥이에서는 나타나지 않았다. 행동면에서 환아는 경미한 정신지체로 인해 치과 치료 중 낮은 협조도를 보였다.

Age, extraction rate and jaw surgery rate in Korean orthodontic clinics and small dental hospitals

  • Jung, Min-Ho
    • 대한치과교정학회지
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    • 제42권2호
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    • pp.80-86
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    • 2012
  • Objective: This study aimed to investigate the current data regarding age, sex, and Angle Classification of Korean orthodontic patients and influence of these factors on the tendency to undergo extraction and orthognathic surgery. Methods: The recent trends of Korean orthodontic patients were assessed using questionnaire survey. The questionnaires were e-mailed to orthodontists who met the study criteria; 58% of the orthodontists opened the e-mails, and 27.7% replied to the e-mails. In all, the medical records of 11,340 patients who underwent orthodontic treatment at private clinics and small dental hospitals in Korea were analyzed. Results: The percentage of female patients in the study sample was 69.6%, and the average age of the patients was 19.87 years. The percentage of patients who were older than 19 years was 50.2%. Class II and Class III malocclusions were noted in 33.6% and 23.6% of patients, respectively. Extraction and orthognathic surgery were performed in 60.4% and 6.9% of patients, respectively. Conclusions: The results showed that there were a high percentage of adult, Class II malocclusion and extraction patients in private practices and small dental hospitals during the study period. Further, a relatively high proportion of adult patients opted to undergo orthognathic surgery.

Angle 1급 부정교합 아동의 안면두개골 형태의 유형적 특징에 관한 연구 (A CEPHALOMETRIC STUDY ON SUB-GROUPINGS IN KOREAN CHILDREN WITH CLASS I MALOCCLUSIONS : A COUNTERPART ANALYSIS)

  • 이정옥;최영철
    • 대한소아치과학회지
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    • 제26권1호
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    • pp.172-184
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    • 1999
  • The present study was performed to identify morphologic sub-groupings in Korean children with Class I malocclusions, and to find out anatomic differences between the sub-groups. Standardized lateral cephalometric radiographs of 152 Korean children, aged between 6 and 12 years, with Class I malocclusions were analyzed by the Counterpart Analysis. A statistical method, Ward's Minimum Variance Cluster Analysis, was employed to divide the sample into sub-groups those with similar morphologic characteristics. The results were as follows; 1. There appeared two facial types, Type I and Type II, in Korean children with Class I malocclusions, 48.7% and 51.3%, respectively. 2. In both sub-groups, there existed strong Class III skeletal patterns due to a counterclockwise rotation of the Middle Cranial Fossa alignment, and strong Class II skeletal patterns due to the long Posterior Maxillary vertical dimension and a clockwise rotation of the Ramus alignment. 3. There were no significant differences in Upper Anterior Facial Height between Type I and Type II, $52.6{\pm}2.92mm\;and\;52.8{\pm}3.23mm$, respectively. 4. The Lower Anterior Facial Height in Type II was longer ($66.0{\pm}4.03mm$) due to the long Posterior Maxillary vertical dimension, the clockwise rotation of the Ramus alignment, and a clockwise rotation of the Mandibular plane alignment than that of Type I ($64.2{\pm}4.15mm$).

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상악골 전방견인 장치의 효과와 안정성에 대한 두부방사선 계측학적 연구 (Clinical Effects and Stability of the Maxillary Protraction Using the Lateral Cephalogram in Korean)

  • 백형선
    • 대한치과교정학회지
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    • 제22권3호
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    • pp.509-529
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    • 1992
  • Skeletal Class III malocclusion is one of the most difficult type to treat and stabilize. For a child with developing skeletal Class III malocclusion, the treatment objective would be to stimulate maxillary growth, particulary one who has markedly deficient maxilla, and to restrain excessive mandibular growth. In order to stimulate the maxillary growth, maxillary protraction appliance is the one of the effective orthopedic appliances in skeletal Class III. The purposes of this study were as follows ; evaluation of the skeletal and dental changes of the maxillary protraction in children with Class III Maxillary deficiency , comparison of the clinical effects between the group with RPE and labiolingual intraoral appliances , comparison of the clinical effects and stability related to the ages of the patients : stability of the maxillary protraction about 1 year after retention. The subjects consisted of 60 children between the ages of 8 and 13.4 who were diagnosed as Class III with maxillary deficiency and were treated with Face Mask (Delaire Type) from the Dept. of Orthodontics Yong Dong Severance Hospital, Yonsei University. 48 children wore the RPE and 12 children wore Labiolingual Appliance. Lateral Cephalograms were taken for each patient at before and after correction of anterior cross-bite in 60 children, and after an observation period of 10 to 14 months in 19 children. X and Y coordinate of 10 landmarks were analyzed using a horizontal line through sella and rotated $6^{\circ}$ down anteriorly as the horizontal reference axis, and a perpendicular verticual line through sella as the vertical reference axis. Each of the 31 measurents (10 verticals, 10 horizontals, 2 angles and 9 others) was statistically analyzed using SPSS/PC statistics. The results are as follows; 1. After maxillary protraction the maxilla and maxillary teeth moved downward and forward, while the mandible and mandibular incisor rotated downward and backward. 2. Maxillary protraction with rapid palatal expansion appliance was more effective than with labiolingual appliance. 3. More downward movement of the posterior palatal plane obserbed with maxillary protraction doing the midpalatal suture opening than with protraction after finishing the palatal expansion 4. The clinical effects of protraction and changes of the retention periods were not statistically significant among the age groups. 5. During the retention period, maxilla and maxillary teeth, and mandible and mandibular teeth moved downward and forward, however the mandibular changes were larger than the maxillary changes.

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