• 대한소아치과학회지
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• 제26권1호
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• pp.32-37
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• 1999

항시 장착이 가능한 reverse twin block 장치에 기능의 장애를 받지 않고도 lip pad의 효과를 첨가하기 위하여 가철식으로 lip pad를 제작하여 III급 부정교합의 치료에 적용해 본 결과 다음과 같은 결론을 얻었다. 1. Reverse twin block 장치는 장착한 상태에서 lip pad의 착탈을 통하여 정상적인 저작, 발음 등의 기능을 할 수 있으며 심미적이므로 III급 부정교합의 치료에 있어 상하악이 분리되어 있지 않은 다른 기능성 장치가 가진 단점을 극복할 수 있었다. 2. 본 증례에서는 저발육된 상악에 대한 효과적인 작용을 하는 lip pad를 가철식으로 제작하여 기능의 장애를 받지 않고도 양호한 치료효과를 얻을 수 있었다.

• 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.

• Journal of Yeungnam Medical Science
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• 제3권1호
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• pp.243-247
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• 1986

1983년 8월부터 1986년 11월 사이에 영남대학교 영남의료원 치과에 교정치료를 받기 위하여 내원한 174명의 환자를 대상으로 부정교합의 양상 및 내원환자의 분포를 조사 연구한 결과 다음과 같은 결론을 얻었다. 1. 매년 교정환자수가 증가하였으며 여자환자가 남자환자의 1.3배를 나타냈다. 2. 총내원환자 중 8~15세 연령군이 74%이며 10~13세군에서 가장 높은 빈도를 나타냈다. 월별 신환수를 보면 방학기간 중에 내원한 환자가 78%로 나타났다. 3. 거주지별 분류를 보면 남구, 수성구에서 내원한 환자가 전체내원환자수의 53%를 차지했다. 4. 내원동기를 보면 치과에서 교정치료를 받을 수 있는 사실을 알고 내원한 환자는 30%였고 그외에는 소개환자가 많았다 5. 부정교합 분류를 보면 Angle씨 I급 부정교합 환자가 63%, II급환자가 17%, III급환자가 20%로 나타났으며 I급 부정교합 중에는 총생(crowding)이 60%를 나타냈다.

• 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.

• 대한치과교정학회지
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• 제48권1호
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• pp.63-70
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• 2018

Objective: The aim of this study is to quantitatively evaluate the stability of the skeletal and dental widths using cone-beam computed tomography (CBCT) after segmental Le Fort I osteotomy in adult patients with skeletal Class III malocclusion requiring maxillary expansion. Methods: In total, 25 and 36 patients with skeletal Class III malocclusion underwent Le Fort I osteotomy (control group) and segmental Le Fort I osteotomy (experimental group), respectively. Coronal CBCT images were used to measure the dental and skeletal widths before (T1) and after (T2) surgery and at the end of treatment (T3). The correlation between the extent of surgery and the amount of relapse in the experimental group was also determined. Results: In the control group, the dental width exhibited a significant decrease of $0.70{\pm}1.28mm$ between T3 and T2. In the experimental group, dental and skeletal expansion of $1.83{\pm}1.66$ and $2.55{\pm}1.94mm$, respectively, was observed between T2 and T1. The mean changes in the dental and skeletal widths between T3 and T2 were $-1.41{\pm}1.98$ and $-0.67{\pm}0.72mm$, respectively. There was a weak correlation between the amount of skeletal expansion during segmental Le Fort I osteotomy and the amount of postoperative skeletal relapse in the experimental group. Conclusions: Maxillary expansion via segmental Le Fort I osteotomy showed good stability, with a skeletal relapse rate of 26.3% over approximately 12 months. Our results suggest that a greater amount of expansion requires greater efforts for the prevention of relapse.

• 대한소아치과학회지
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• 제11권1호
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• pp.121-130
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• 1984

Childrens between the ages of 13 and 15 years, living in Seoul, were examined in order to determine the prevalence and severity of malocclusion in the permanent dentition. This survey encompassed 981 children and an individual chart was prepared for each subject recording an original HMAR score and classification of occlusion according to Angle. Also, subjective evaluation of "treatment needs" was carried out in 581 children. The results were as follows: 1. Of the 981 children in this survey, 12,1 percent showed excellent occlusion. (0 point) 2. The 14 percent of the children who had a score of 24 and above all appeared to belong to the "treatment highly desirable" or "treatment mandatory" category. 3. The incorporation of SAR (Supplementary Assessment Record) into the HMAR can provide more sensitive method for evaluating severity of malocclusion. 4. According to Angle's classification 77.4 percent of all malocclusion belonged to Class I, 1.3 percent to Class II, Division 1, 0.9 percent to Class II, Division 2, and 11.3 percent to Class III. 5. The mean HMAR score for Class I was significantly lower than for either Class II, Division 1 or Class III. (P < 0.05) 6. A close relationship was found between the degree of "treatment needs" and the value obtained by the HMAR scoring. (chi-square test, p < 0.05) The differences between the mean HMAR scores of the various subjectively defined categories were statistically significant. (P < 0.001)

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권3호
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• pp.139-144
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• 2012

This study was performed in order to evaluate the occurrence of temporomandibular joint disorder after surgical correction of skeletal class II malocclusion. Materials and Methods: This study included 21 patients who underwent orthognathic surgery for the correction of dentofacial deformities by a single surgeon at Mokdong Hospital, Ewha Womans University from 2000 to 2010. They underwent bilateral sagittal split ramus osteotomy for the treatment of undesirable mandibular advancement. The temporomandibular disorder (TMD) symptoms prior to surgery were recorded and the radiographic evaluation (panorama, bone scan, and magnetic resonance imaging [MRI]) of the post-surgery temporomandibular joint (TMJ) were assessed in order to evaluate condylar resorption, remodeling and disc displacement. The minimum follow-up period, including orthodontic treatment, was 12 months. Orthognathic procedures included 1-jaw surgery (n=8 patients) and 2-jaw surgery (n=13 patients). The monocortical plate was used for bilateral sagittal split ramus osteotomy fixation. Results: Among class II malocclusion patients with TMD symptom, clicking improved in 29.1%, and maximum mouth opening increased from $34.5{\pm}2.1$ mm to $37.2{\pm}3.5$ mm. The differences were not statistically significant, however. Radiographic changes in bone scan improved slightly based on the report by radiologist but not in TMJ dynamic MRI. Conclusion: No particular improvements were found in patients with joint sound only. Patients with limitation of mouth opening showed an increase in the degree of opening, but the difference was not statistically significant (P>0.05).

• 대한치과교정학회지
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• 제45권3호
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• pp.121-129
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• 2015

Objective: This study aimed to assess three-dimensional changes in the temporomandibular joint positions and mandibular dimensions after correction of dental factors restricting mandibular growth in patients with Class II division 1 or division 2 malocclusion in the pubertal growth period. Methods: This prospective clinical study included 14 patients each with Class II division 1 (group I) and Class II division 2 (group II) malocclusions. The quad-helix was used for maxillary expansion, while utility arches were used for intrusion (group I) or protrusion and intrusion (group II) of the maxillary incisors. After approximately 2 months of treatment, an adequate maxillary arch width and acceptable maxillary incisor inclination were obtained. The patients were followed for an average of 6 months. Intraoral and extraoral photographs, plaster models, and cone-beam computed tomography (CBCT) images were obtained before and after treatment. Lateral cephalometric and temporomandibular joint measurements were made from the CBCT images. Results: The mandibular dimensions increased in both groups, although mandibular positional changes were also found in group II. There were no differences in the condylar position within the mandibular fossa or the condylar dimensions. The mandibular fossa depth and condylar positions were symmetrical at treatment initiation and completion. Conclusions: Class II malocclusion can be partially corrected by achieving an ideal maxillary arch form, particularly in patients with Class II division 2 malocclusion. Restrictions of the mandible in the transverse or sagittal plane do not affect the temporomandibular joint positions in these patients because of the high adaptability of this joint.

• 대한치과교정학회지
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• 제46권3호
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• pp.137-145
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• 2016

Objective: The purpose of this study was to investigate the characteristics of orthodontic patients at Yonsei Dental Hospital from 2008 to 2012. Methods: We evaluated Angle's classification from molar relationships, classification of skeletal malocclusion from the A point-nasion-B point angle, facial asymmetry, and temporomandibular joint disorders (TMDs) from the records of 7,476 patients who received an orthodontic diagnosis. The orthognathic surgery rate, extraction rate, and extraction sites were determined from the records of 4,861 treated patients. Results: The patient number increased until 2010 and gradually decreased thereafter. Most patients were aged 19-39 years, with a gradual increase in patients aged ${\geq}40years$. Angle's Class I, Class II divisions 1 and 2, and Class III malocclusions were observed in 27.7%, 25.6%, 10.6%, and 36.1% patients, respectively, with a gradual decrease in the frequency of Class I malocclusion. The proportion of patients with skeletal Class I, Class II, and Class III malocclusions was 34.3%, 34.3%, and 31.4%, respectively, while the prevalence of facial asymmetry and TMDs was 11.0% and 24.9%, respectively. The orthognathic surgery rate was 18.5%, with 70% surgical patients exhibiting skeletal Class III malocclusion. The overall extraction rate among nonsurgical patients was 35.4%, and the maxillary and mandibular first premolars were the most commonly extracted teeth. Conclusions: The most noticeable changes over time included a decrease in the patient number after 2010, an increase in the average patient age, and a decrease in the frequency of Angle's Class I malocclusion. Our results suggest that periodic characterization is necessary to meet the changing demands of orthodontic patients.