• 구강회복응용과학지
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• 제39권3호
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• pp.133-145
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• 2023

하악전돌 양상을 보이는 3급 부정교합은 골격성 3급과 치아변위에 의한 가성 3급으로 나눌 수 있다. 골격성 부정교합은 수복공간 확보 및 심미적, 기능적 결과를 얻기 위해 적절한 수직 및 수평 악간관계를 설정하면 양호한 치료결과를 얻을 수 있다. 본 증례는 하악 전돌과 전치부 마모 및 교합수직고경의 감소를 보이는 환자에서 임플란트와 고정성 보철물을 이용하여 완전구강회복을 시행하였다. 모형 분석과 디지털 진단을 시행 후 수직고경을 거상한 임시수복물을 제작하여 구치부 지지를 확보하고 안정적인 중심교합을 평가하였고, 이를 반영한 최종보철물로 양호한 기능과 심미를 회복할 수 있었기에 이를 보고하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권1호
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• pp.99-107
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• 2008

Objective : The objective of this review was to provide reliable comparative results regarding the effectiveness of any interventions either open or closed that can be used in the management of fractured mandibular condyle Patients and Methods : Research of studies from MEDLINE and Cochrane since 1990 was done. Controlled vocabulary terms were used. MeSH Terms were "Mandibular condyle" AND "Fractures, bone". Only comparative study were considered in this review using the "limit" function. According to the criteria, two review authors independently assessed the abstracts of studies resulting from the searches. The studies were divided according to some criteria, and following were measured: Ramus height, condyle sagittal displacement, condyle Towns's image displacement, Maximum open length, Protrusion & Lateral excursion, TMJ pain, Malocclusion, and TMJ disorder. Results : Many studies were analyzed to review the post-operative result of the two methods of treatment. Ramus height decreased more in when treated by closed reduction as opposed to open reduction. Sagittal condyle displacement was shown to be greater in closed reduction. Condyle Town's image condyle displacement had greater values in closed reduction. Maximum open length showed lower values in closed reduction. In protrusive and lateral movement, closed reduction was less than ORIF. Closed reduction showed greater occurrence of malocclusion than ORIF. However, post-operative pain and discomfort was greater in ORIF. Conclusion : In almost all categories, ORIF showed better results than CRIF. However, the use of the open reduction method should be considered due to the potential surgical morbidity and increased hospitalization time and cost. To these days, Endoscopic surgical techniques for ORIF (EORIF) are now in their infancy with the specific aims of eliminating concern for damage to the facial nerve and of reducing or eliminating facial scars. Before performing any types of treatment, patients must be understood of both of the treatment methods, and the best treatment method should be taken on permission.

• 치과방사선
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• 제16권1호
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• pp.69-79
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• 1986

The purpose of this investigation was to know correlation of mean values between centric occlusion and centric relation by the cephalogram in Angle's Class Ⅰ and Ⅲ malocclusion subjects. 22 adults with Angle's Class Ⅰ malocclusion (17 men and 5 women, 21 to 27 years of age) and 14 adults with Angle's Class Ⅲ malocclusion (10 men and 4 women, 21 to 27 years of age) were selected from the dental students in Yonsei University. Each subject was given two lateral cephalometric radiographies and cephalometric analysis was performed. All data from these analyses was recorded and statistically processed with CYBER computer system. 1. The results were obtained as follows: There was a strong positive correlation between centric occlusion and centric relation in all subjects with Angle's Class Ⅰ and Ⅲ malocclusion. 2. In Angle's Class Ⅰ malocclusion, measurements in lower facial height revealed significant difference between centric occlusion and centric relation (P<0.05). In Angle's Class Ⅲmalocclusion, measurements in facial axis angle, mandibular plane angle, convexity of A point, lower incisor protrusion, lower facial height revealed significant difference between centric occlusion and centric relation (P<0.05). 3. When the mandible was moved from centric occlusion to centric relation, the mean distance of mandibular movement was 1.27㎜ (0.2-2.8㎜) in Angle's Class Ⅰ malocclusion, 1.70㎜ (0.55-4.15㎜) in Angle's Class Ⅲ malocclusion, and 1.44㎜ (0.2-4.15㎜) in all subjects.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권5호
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• pp.331-335
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• 2017

Clinical limitations following closed reduction of an intracapsular condylar fracture include a decrease in maximum mouth opening, reduced range of mandibular movements such as protrusion/lateral excursion, and reduced occlusal stability. Anteromedial and inferior displacement of the medial condyle fragment by traction of the lateral pterygoid muscle can induce bone overgrowth due to distraction osteogenesis between the medial and lateral condylar fragments, causing structural changes in the condyle. In addition, when conventional maxillomandibular fixation (MMF) is performed, persistent interdental contact sustains masticatory muscle hyperactivity, leading to a decreased vertical dimension and premature contact of the posterior teeth. To resolve the functional problems of conventional closed reduction, we designed a novel method for closed reduction through protrusive MMF for two weeks. Two patients diagnosed with intracapsular condylar fracture had favorable occlusion after protrusive MMF without premature contact of the posterior teeth. This particular method has two main advantages. First, in the protrusive position, the lateral condylar fragment is moved in the anterior-inferior direction closer to the medial fragment, minimizing bone formation between the two fragments and preventing structural changes. Second, in the protrusive position, posterior disclusion occurs, preventing masticatory muscle hyperactivity and the subsequent gradual decrease in ramus height.

• Journal of Oral Medicine and Pain
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• 제12권1호
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• pp.85-93
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• 1987

The author studied on the effect of TMJ sounds to the patterns and ranges of mandibular border movements in horizontal plane with Pantograph (Denar Corp.). For study, 19 patients with TMJ sounds only and 16 students with no TM disorder were selected and classified as experimental group and control group, respectively. The subject performed right lateral movement, left lateral movement, and forward movement. Each movement were performed 3 times and the movement trajectory obtained with mechanical pantograph were observed for accordance of centric relation position, reproducibility and/or restriction of lateral movement paths, deviation of protrusive path in anterior table, restriction of protrusive condylar movement path in posterior horizontal table, presence of Fisher angle in posterior vertical table. And pantographic reproducibility Index (PRI) were obtained with pantronic by the same movement method as in the mechanical pantograph record. The obtained results were as follows : 1. In experimental group, PRI scores in those who show accordance of centric relation position were 14.4, and were 26.53 in those who did not show accordance of centric relation position. However, the PRI scores of the two subgroups show no statistically significant difference in control group. Therefore, in experimental group, the capability of accordance of centric relation position affected largely the PRI scores than in control group. 2. Deviation of protrusive path was opposite to the affected side in experimental group, and was left side in control group. 3. Restriction side of condylar movement in protrusion was ipsilateral to the deviation side in experimental group, but in control group, restriction side was not related to the deviation side. 4. PRI scores in experimental group were 23.2 (moderate dysfunction category), and in control group, were 17.8 (slight dysfunction category). The PRI scores in control group, however, implies that the evaluation of temporomandibular disorders by the PRI scores only may be unreasonable.

• 대한치과교정학회지
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• 제23권4호
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• pp.707-724
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• 1993

The purpose of the study is to estimate hard and soft tissue changes after orthognathic surgery for the correction of the mandibular prognathism and to describe interrelationship and ratios of soft and hard tissue changes. The presurgical and postsurgical lateral cephalograms of 31 treated patients(17 males and 14 females) was used ; these patients had received combined orthodontic-surgical treatment by means of a bilateral sagittal split ramus osteotomy. Their ages ranged from 16 to 31 years and mean age was 21.4 years. A computerized cephalometric appraisal was developed and used to analyse linear and angular changes of skeletal and soft tissue profile. The statistical elaboration of the data was made by means of $SPSS/PC^+$. The results of the study were as follows : 1. The correlations of soft and hard tissue horizontal changes were significantly high and the ratios were $97\%$ at LI, $107\%$ at ILS, and $93\%$ at Pog'. 2. The correlations of vertical changes at Stm, LI and horizontal changes at Pog were high$(26\%)$ and at the other areas were not statistically high. 3. The correlations of soft ad hard tissue vertical changes were not significantly high in all areas except Gn' $(30\%)$ and Me' $(56\%)$. 4. The soft tissue thickness was significantly decreased in upper lip and increased in lower lip, and the amount of changes after surgery was reversely correlated with initial thickness. 5. The facial convexity was increased and relative protrusion of upper lip was increased and that of lower lip was decreased. 6. The upper to lower facial height(Gl-Sn/Sn-Me') was increased and upper to lower jaw height(Sn-Stms/Stmi-Me') was increased.

• 대한치과교정학회지
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• 제34권6호
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• pp.544-554
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• 2004

진단용 셋업 모형 제작시 전치의 치축을 조절하기 위하여 incisor inclination indicator란 장치가 소개되었다. 이것은 상하악 전치의 후방 견인시 토오크 조절을 위하여 사용된다. 본 논문에서는 incisor inclination indicator를 사용하여 전치부 설측 브라켓에 적절한 토오크를 처방하는 방법을 묘사하고 이렇게 적절한 토오크가 처방된 전치부 설측 브라켓으로 치료한 양악 전돌증 환자의 치료결과를 평가한다. 후방 견인시 상하악 전치는 토오크가 적절하게 조절되었다. 설측교정치료에 있어서 incisor inclination indicator는 기공 과정에서 부가적으로 사용되어 전치부의 후방 견인시 효과적으로 토오크 조절을 할 수 있는 것으로 생각된다.

• 대한치과교정학회지
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• 제50권2호
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• pp.120-128
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• 2020

Objective: The aims of the present study were to evaluate the changes in the maximum lip-closing force (MLF) after orthodontic treatment with or without premolar extractions and verify the correlation of these changes with dentoskeletal changes. Methods: In total, 17 women who underwent nonextraction orthodontic treatment and 15 women who underwent orthodontic treatment with extraction of all four first premolars were included in this retrospective study. For all patients, lateral cephalograms and dental models were measured before (T0) and after (T1) treatment. In addition, MLF was measured at both time points using the Lip De Cum LDC-110R^® device. Statistical analyses were performed to evaluate changes in clinical variables and MLF and their correlations. Results: Both groups showed similar skeletal patterns, although the extraction group showed greater proclination of the maxillary and mandibular incisors and lip protrusion compared to the nonextraction group at T0. MLF at T0 was comparable between the two groups. The reduction in the arch width and depth and incisor retroclination from T0 to T1 were more pronounced in the extraction group than in the nonextraction group. MLF in the extraction group significantly increased during the treatment period, and this increase was significantly greater than that in the nonextraction group. The increase in MLF was found to be correlated with the increase in the interincisal angle and decrease in the intermolar width, arch depth, and incisor-mandibular plane angle. Conclusions: This study suggests that MLF increases to a greater extent during extraction orthodontic treatment than during nonextraction orthodontic treatment.

• 구강회복응용과학지
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• 제28권1호
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• pp.79-86
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• 2012

심한 치열 총생이나 입술이 돌출된 환자들에서 대다수의 경우에 발치 교정치료를 시행한다. 이런 경우 많은 수의 환자들에서 교정치료 완료 후 발치된 공간이 폐쇄되었음에도 해당 발치 공간 부위에 치은이 주름을 형성하는 치은 함입(gingival invagination)이 관찰된다. 이런 경우 폐쇄된 공간의 재발 및 국소적 치주 문제가 발생할 가능성이 있기에 치은 함입부에 대한 치주과적 처치가 필요하다. 본 증례의 환자는 치아가 맞지 않는다고 내원한 16세 여자 환자였으며 몇 년 전에 지역 치과에서 상악 소구치의 발치가 시행되었던 환자였기에 하악 소구치 발치를 동반한 교정치료를 시행하였다. 자연스럽게 폐쇄되었던 상악 소구치부와는 다르게 교정치료 완료 후 하악 소구치부위에서는 치은 함입이 관찰되어 치주과적으로 치은 함입부위를 절제하여 치은 평탄화를 시켰다. 치은 평탄화 작업은 레이저를 이용하여 좌측은 1회, 우측은 2회에 걸쳐서 시행하였으며 안정된 결과를 나타내었다. 이상의 치료를 통하여 발치를 동반한 교정치료 환자에서 발생하기 쉬운 치은 함입부의 치은 평탄화를 이룬 증례를 보고하고자 한다.

• 대한치과교정학회지
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• 제20권3호
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• pp.519-539
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• 1990

It is the aim of this study to observe the distribution of various facial types in class III malocclusion and to characterize the craniofacial features of the very facial types. Cephalometric headptates of a hundred and ten persons showing bilateral class III malocclusion whose mean age was 12.51 years and sixty nine persons of normal occlusion whose mean age was 12.23 years were measured and statistically analyzed. The following summary and conclusions were drawn. 1. Affording the bases for SNA and SNB, $35.45\%$ of sample showed normally positioned maxilla and protruded mandible, $30.00\%$ for retruded maxilla and normally positioned mandible, $15.45\%$ for retruded maxilla and protruded mandible, $10.90\%$ for both maxilla and mandible within normal range and $8.20\%$ for miscellaneous types were arranged in class III malocclusion. 2. $52.72\%$ of sample showed neutrodiveigent, $35.45\%$ for hyperdivergent and $11.81\%$ manifested hypodivergent mandible in class III malocclusion. 3. Providing the bases for facial and mandibular planes, $33.63\%$ of sample showed prognathic and neutrodivergent, $20.90\%$ for mesognathic and hyperdivergent, $17.27\%$ for prognathic and hyperdivergent and $15.45\%$ for mesognathic and neutrodivergent were arranged in class III malocclusion. 4. The class III malocclusion brought out shorter cranial base, smaller saddle angle, and larger articular and genial angle. It showed retropositioned maxilla and forward positioned mandible in spite of no significant differences in linear measurements of mandible. Anterior lower facial height was significantly larger in class III malocclusion, while posterior total facial and anterior total facial heights exhibited no significant differences. 5. It is suggested class III malocclusion was attributed to shorter cranial base, smaller saddle angle, maxillary deficiency and/or retrusion, mandibular excess and/or protrusion, excessive vertical growth of the anterior lower face, and their complex as well.