• 대한소아치과학회지
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• 제29권1호
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• pp.100-106
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• 2002

III급 부정교합은 서양인에서 약 5%의 발생빈도를 보이며, 일본인과 한국인에서 교정환자중 50%정도로 증가하는 추세이다. 이런 III급 부정교합자의 63%가량이 상악골의 열성장 또는 상악골의 열성장과 하악골의 과성장에 의한 것이라고 알려져 있다. 일반적으로 환자의 나이가 많을수록 악정형력보다는 치열에서의 변화량이 크므로 치료는 조기에 시행하는 것이 바람직하다고 하였다. 조기치료시 성장조절, 환자의 협조도, 치료의 관리와 같은 결정요소들을 잘 판단하여 시행함으로써 상악골의 더 많은 전방이동이 가능하며 정상 성장을 도모하고 교합관계가 증진되며 안모의 개선으로 인해 정상적인 사회 심리적 발육이 이루어질 수 있다. 본 증례는 반대교합을 주소로 원광의료원 치과병원 소아치과에 내원한 유치열기 환아에게 facemask를 이용한 조기 치료로 양호한 결과를 얻었기에 보고하는 바이다.

• 대한치과교정학회지
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• 제37권4호
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• pp.272-282
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• 2007

본 연구의 목적은 구순이 이완되도록 개구한 상태(relaxed lip position)에서 촬영한 측모 두부방사선사진과 일반적으로 채득하는 중심교합위에서 입술을 다문 상태(closed lip position)의 측모 두부방사선 사진에서 비순각의 변화 양상을 비교하여 안모 분석 시 relaxed lip position의 중요성을 검토하는 것이다. 전치부 반대교합을 보이는 골격성 III급 부정교합 성인환자(평균 23.3세) 60명(남자 35명, 여자 25명)을 연구대상으로 선정하였다. 구순이 이완되도록 개구한 상태에서와 중심교합 상태에서의 비순각 차이를 비교한 결과 유의성 있는 차이가 있었으며, 비순각의 변화량 사이의 유사성을 기준으로 좀 더 객관적으로 분류하여 분석하고자 군집분석을 통해 제1군(27명, 45%, 구순 이완시 비순각이 감소하는 군), 제2군(30명, 50%, 구순 이완 시 비순각이 증가하는 군), 제3군(3명, 5%, 구순 이완 시 비순각이 예외적으로 크게 증가하는 군)으로 분류하였다. 제1군에서는 상순이 전체적으로 후방 이동되며 비순각은 변화가 없거나 오히려 감소하였으며, 제2군에서는 상순이 후하방 회전되며 비순각이 증가하였다. 제3군에서는 상순이 하순과 하악전치에 의해 상방으로 압박되었다가(compression)이완되며 비순각이 크게 증가하였다. 이상의 연구 결과에서 골격성 III급 부정교합자에서 구순이 이완된 상태에 대해 중심 교합 시의 비순각의 변화가 다양한 것을 알 수 있었다. 따라서 정확한 안모분석과 수술-교정 치료 후의 연조직 심미성의 예측을 위해 기록 채득과 분석 시 이완된 구순 위치에 대한 고려가 필요하며 이러한 자세로 진단용 방사선 사진을 촬영하는 것이 필요하다고 생각되었다.

• 대한치과교정학회지
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• 제24권3호
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• pp.695-707
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• 1994

This study investigates the effects of third molar on the occlusal plane in Angle's class El malocclusion with possibilities of posterior crowding and the interrelationships of occlusal plane inclinations to other skeletal patterns. Above investigations might showed that considerations should be given to third molars with possibilities of posterior crowding in establishing diagnosis and treatment plans for Angle's class III malocclusion patients. The following conclusions were obtained 1. In events of third molars causing possible posterior crowding, maxillary third molars showed more mesial inclinations than second molars, and compared to those with third molar missing cases, first molars were more mesially inclined and displaced more inferiorly from the palatal plane and OP-MP was increase , thus the occlusal plane was less steep. 2. In events of third molars causing possible posterior crowding, the anglulation between AB line and mandibular plane was decreased and ANB showed negative values. Thus chin points were more protruded, ramus were more anteriorly displaced, and increase in lower facial height, genial angle, effective mandibular length and mandibular plane angle were observed. This in all caused more vertical opening and more severe skeletal disturbance. 3. OP-MP was increased as the maxillary first molars were more inferiorly displaced from the palatal plane. As this angle was increased mandibular planes were more inferiorly inclined and LFH, genial angle, effective mandibular length were more increased and mandibular ramus was more anteriorly placed. 4. As the maxillary first molars were more inferiorly placed from the palatal plane, more increased OP-MP/PP-MP ratio made the occlusal plane less steep. As OP-MP/PP-MP was increased, mandibular ramus was more anteriorly placed and made longer, and facial angle and effective mandibular length were increased.

• Imaging Science in Dentistry
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• 제50권1호
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• pp.9-14
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• 2020

Purpose: The purpose of this study was to evaluate vertical bone loss and alveolar bone thickness in the maxillary and mandibular incisors of patients with skeletal class III malocclusion. This study also aimed to evaluate the periodontal condition of class III malocclusion patients who had not undergone orthodontic treatment. Materials and Methods: The sample included cone-beam computed tomography scans of 24 Korean subjects (3 male and 21 female). Alveolar bone thickness (ABT), alveolar bone area (ABA), alveolar bone loss (ABL), and fenestration of the maxillary and mandibular incisors were measured using 3-dimensional imaging software. Results: All incisors displayed an ABT of less than 1.0 mm from the labial surface to root level 7 (70% of the root length). A statistically significant difference was observed between the mandibular labial and lingual ABAs and between the maxillary labial and mandibular labial ABAs. The lingual ABA of the mandibular lateral incisors was larger than that of the mandibular central incisors. ABL was severe on the labial surface. A statistically significant difference was observed between the maxillary and mandibular labial ABL values(21.8% and 34.4%, respectively). Mandibular lingual ABL (27.6%) was significantly more severe than maxillary lingual ABL (18.3%) (P<0.05). Eighty-two fenestrations were found on the labial surfaces of the incisors, while only 2 fenestrations were observed on the lingual surfaces. Fenestrations were most commonly observed at root level 6. Conclusion: Careful evaluation is needed before orthodontic treatment to avoid iatrogenic damage of periodontal support when treating patients with class III malocclusion.

• 대한소아치과학회지
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• 제42권1호
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• pp.45-52
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• 2015

본 연구의 목적은 3급 부정교합 환자에서 facemask를 이용한 악정형치료 시, 고정원으로 사용하기 위해 장착되는 구내 장치의 종류에 따른 효과를 비교하는 것이다. 3급 부정교합 환자 18명을 대상으로 악정형치료를 평균 12개월 동안 시행하였으며, 이 중 9명은 구내 장치로 bonded expander를, 9명은 Hyrax를 사용하였다. 치료 시작 전, 그리고 치료 직후에 측면 두부방사선사진을 촬영하여 비교 분석하였다. 또한 고정원 소실 정도를 조사하고, 장치에 따른 차이를 비교하였다. 악정형치료 효과에서는 두 군 모두 뚜렷한 개선을 보였고, 군간의 유의한 차이는 없었다. 각 구내 장치 모두 어느 정도의 고정원 소실량은 존재하였지만 군간의 차이는 없었다. Facemask는 성장기 3급 부정교합 환자의 치료에 있어서 효과적인 치료 방법이며, 구내 장치로 사용된 bonded expander와 Hyrax 간에 유의한 차이는 없었다.

• 대한치과교정학회지
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• 제47권4호
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• pp.256-267
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• 2017

Objective: To evaluate transverse skeletal and dental changes, including those in the buccolingual dental axis, between patients with skeletal Class III malocclusion and facial asymmetry after bilateral intraoral vertical ramus osteotomy with and without presurgical orthodontic treatment. Methods: This retrospective study included 29 patients with skeletal Class III malocclusion and facial asymmetry including menton deviation > 4 mm from the midsagittal plane. To evaluate changes in transverse skeletal and dental variables (i.e., buccolingual inclination of the upper and lower canines and first molars), the data for 16 patients who underwent conventional orthognathic surgery (CS) were compared with those for 13 patients who underwent preorthodontic orthognathic surgery (POGS), using three-dimensional computed tomography at initial examination, 1 month before surgery, and at 7 days and 1 year after surgery. Results: The 1-year postsurgical examination revealed no significant changes in the postoperative transverse dental axis in the CS group. In the POGS group, the upper first molar inclined lingually on both sides (deviated side, $-1.8^{\circ}{\pm}2.8^{\circ}$, p = 0.044; nondeviated side, $-3.7^{\circ}{\pm}3.3^{\circ}$, p = 0.001) and the lower canine inclined lingually on the nondeviated side ($4.0^{\circ}{\pm}5.4^{\circ}$, p = 0.022) during postsurgical orthodontic treatment. There were no significant differences in the skeletal and dental variables between the two groups at 1 year after surgery. Conclusions: POGS may be a clinically acceptable alternative to CS as a treatment to achieve stable transverse axes of the dentition in both arches in patients with skeletal Class III malocclusion and facial asymmetry.

• 대한소아치과학회지
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• 제24권1호
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• pp.95-111
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• 1997

The human speech organ consists of respiration system (lung, larynx), phonation system (vocal cord), articulation system (esophagus, pharynx, uvula, teeth, gingiva, palate, tongue, lip) and resonating system(oral cavity, nasal cavity, paranasal sinus). Because teeth are components of the articulation system, it has been reported that the persons with abnormally positioned teeth generally have abnormal occlusion and pronunciation. In this study, using /ㅅ(s)/, the most commonly mispronunced consonant in children with malocclusion, and the seven single vowels, /사(sa), 서($s\delta$), 소(so), 수(su), 스($s\omega$), 시(si), 세(se)/ and / ㅏ(a), ㅓ($\delta$), ㅗ(o), ㅜ(u), ㅡ($\omega$), 1(i), ㅔ(e)/ were recorded and analyzed using speech analysis program on computer by measuring formants and compared them for investigating the differences in pronunciation in children with Angle's class I occlusions and those with Angle's class II div.1 malocclusion. The result were as follows: 1. In the Angle's Class II div.1 group, there were no significant differences in F1 of all recorded sounds as compared with Angle's Class I group(p>0.05). 2. In the consonants, there were significant differences in F2 of /스($s\omega$)/ and F2/F1 ratio of /사(sa), 서($s\delta$), 시(si)/ between the two group(p<0.05). 3. In the vowels, there were significant differences F2/F1 ratio of /ㅓ($\delta$)/(p<0.05) and no significant differences in F2/F1 ratio between two group(p>0.05). 4. In the consonants, there were significant differences in F2 and F2/F1 ratio when succeeding vowels were high or low, and F2/F1 ratio when front in accordance with tongue position (p<0.05). 5. In the vowels, there were no significant differences in formant in accordance with tongue position(p>0.05)

• 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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• 제52권2호
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• pp.85-101
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• 2022

Objective: To classify facial asymmetry (FA) phenotypes in adult patients with skeletal Class III (C-III) malocclusion. Methods: A total of 120 C-III patients who underwent orthognathic surgery (OGS) and whose three-dimensional computed tomography images were taken one month prior to OGS were evaluated. Thirty hard tissue landmarks were identified. After measurement of 22 variables, including cant (°, mm), shift (mm), and yaw (°) of the maxilla, maxillary dentition (Max-dent), mandibular dentition, mandible, and mandibular border (Man-border) and differences in the frontal ramus angle (FRA, °) and ramus height (RH, mm), K-means cluster analysis was conducted using three variables (cant in the Max-dent [mm] and shift [mm] and yaw [°] in the Manborder). Statistical analyses were conducted to characterize the differences in the FA variables among the clusters. Results: The FA phenotypes were classified into five types: 1) non-asymmetry type (35.8%); 2) maxillary-cant type (14.2%; severe cant of the Max-dent, mild shift of the Man-border); 3) mandibular-shift and yaw type (16.7%; moderate shift and yaw of the Man-border, mild RH-difference); 4) complex type (9.2%; severe cant of the Max-dent, moderate cant, severe shift, and severe yaw of the Man-border, moderate differences in FRA and RH); and 5) maxillary reverse-cant type (24.2%; reverse-cant of the Max-dent). Strategic decompensation by pre-surgical orthodontic treatment and considerations for OGS planning were proposed according to the FA phenotypes. Conclusions: This FA phenotype classification may be an effective tool for differential diagnosis and surgical planning for Class III patients with FA.

• 대한치과교정학회:학술대회논문집
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• 대한치과교정학회 2004년도 제37회 학술대회
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• pp.38.1-38.1
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• 2004