• 대한치과교정학회지
• /
• 제25권4호
• /
• pp.375-401
• /
• 1995

성장기 골격성 제III급 부정교합의 원인은 상악 열성장, 하악 과성장과 두 양상의 조합형태로 나뉠 수 있다. 이중 상악 열성장을 동반한 성장기 골격성 제III급 부정교합의 경우, 상악골 전방견인 장치의 사용이 추천되고 있는데, 이러한 장치의 치료효과는 상악골의 전하방 이동과 하악골의 후하방 회전으로 알려져 있다. 국내외 선학들에 의해 상악골 전방견인 장치의 치료효과에 대한 많은 동물실험과 임상실험 결과가 발표되었으나, 연조직 측모 변화에 대한 연구는 미비한 상태이고, 또한 치료를 받은 환자간의 치료효과에 대한 비교도 부족한 상태이다. 이에 저자는 상악골 열성장으로 인한 성장기 골격성 제III급 부정교합으로 진단받고, 상악골 전방견인 장치로 치료 받은 93명의 환자를 성별, 치료개시 나이별, 구개봉합 opening여부(구강내 장치), 안모성장 형태에 따라 분류하여, 각 유형에 따라 어떠한 경조직과 연조직 측모의 변화가 관찰되는지 여부와, Angle씨 제 I 급 부정교합의 정상군 20명과 상악골 전방견인 장치로 치료받은 환자 사이에 경조직과 연조직에 있어서 성장량과 치료량에 어떠한 관계가 있는지 비교하여 다음의 결론을 얻었다. 1. 상악골 전방견인 장치 사용시 골격적 계측항목과 치아와 연조직 계측항목에서 성장량보다 많은 치료에 의한 변화량을 관찰할 수 있었다. 2. 남녀별 치료개시 나이에 따른 상악골 전방이동량과 하악골의 후하방 회전량에는 유의차가 없었다. 3. R.P.E.에서 La-Li보다 유의성 있는 상악골(A point)의 전방이동을 보였으며, 상악 전치의 순측 돌출이 La-Li를 사용하였을때 보다 감소되었다. 4. 안모성장 형태에 따라서는 상악골 전방이동량에는 유의차가 없었으나, 하악골의 후하방 회전을 나타내는 계측치에서 counterclockwise군이 clockwise군보다 많은 변화를 나타냈다. 5. 상순과 하순의 후경변화는 하부 골조직과 상하악 치아의 위치변화와 높은 상관관계를 보였으며, 상순의 고경과 nasolabial angle이 증가하고, mentolabial angle이 감소되었다.

• 대한치과교정학회지
• /
• 제42권3호
• /
• pp.100-109
• /
• 2012

Objective: A national survey was conducted to assess orthodontic residents' current concepts and knowledge of cleft lip and palate (CLP) management in Korea. Methods: A questionnaire consisting of 7 categories and 36 question items was distributed to 16 senior chief residents of orthodontic department at 11 dental university hospitals and 5 medical university hospitals in Korea. All respondents completed the questionnaires and returned them. Results: All of the respondents reported that they belonged to an interdisciplinary team. Nineteen percent indicated that they use presurgical infant orthopedic (PSIO) appliances. The percentage of respondents who reported they were 'unsure' about the methods about for cleft repair operation method was relatively high. Eighty-six percent reported that the orthodontic treatment was started at the deciduous or mixed dentition. Various answers were given regarding the amount of maxillary expansion for alveolar bone graft and the estimates of spontaneous or forced eruption of the upper canine. Sixty-seven percent reported use of a rapid maxillary expansion appliance as an anchorage device for maxillary protraction with a facemask. There was consensus among respondents regarding daily wearing time, duration of treatment, and amount of orthopedic force. Various estimates were given for the relapse percentage after maxillary advancement distraction osteogenesis (MADO). Most respondents did not have sufficient experience with MADO. Conclusions: These findings suggest that education about the concepts and methods of PSIO and surgical repair, consensus regarding orthodontic management protocols, and additional MADO experience are needed in order to improve the quality of CLP management in Korean orthodontic residents.

• 대한치과의사협회지
• /
• 제46권2호통권465호
• /
• pp.88-99
• /
• 2008

In growing patients with Class III malocclusion and midfacial deficiency, the treatment protocol calls for orthopedic maxillary protraction and clinicians choose the facemask therapy generally. But facemask is not esthetic or comfortable to patients because it should be worn extraorally. Consequently it is difficult to obtain patients cooperation, and this often influences the treatment effects negatively. MTA (modified tandem appliance), that is a small intraoral appliance, is carried conveniently and esthetic relatively. So it seemed more patient-friendly than a facemask. While the treatment effect of this is similar to that of a facemask. This report presents skeletal Class III malocclusion two cases treated by MTA with good results.

• 대한치과교정학회지
• /
• 제15권2호
• /
• pp.353-368
• /
• 1985

This present paper describes 3 clinical cases which were treated with Bioprogressive mechanism. Each patient has shown a deficient maxilla combined with prognathic and steep mandible. The purpose of treatment was planned to obtain the forward growth of maxilla and redirectioning of mandibular growth. The most noteworthy approach in the treatment was the application of Cl III intermaxillary elastics with upper protraction utility arch immediately after rapid maxillary expansion. In the analysis of the data obtained from pre- and post treatment lateral cephalogram, the result achieved by this method is very favolable to the correction of anteroposterior relationship of maxilla and mandible.

• 대한치과교정학회지
• /
• 제44권6호
• /
• pp.281-293
• /
• 2014

Objective: Esthetic improvements during orthodontic treatment are achieved by changes in positions of the lips and surrounding soft tissues. Facial soft-tissue movement has already been two-dimensionally evaluated by cephalometry. In this study, we aimed to three-dimensionally assess positional changes of the adult upper lip according to simulated maxillary anterior tooth movements by white light scanning. Methods: We measured changes in three-dimensional coordinates of labial landmarks in relation to maxillary incisor movements of normal adults simulated with films of varying thickness by using a white light scanner. Results: With increasing protraction, the upper lip moved forward and significantly upward. Labial movement was limited by the surrounding soft tissues. The extent of movement above the vermilion border was slightly less than half that of the teeth, showing strong correlation. Most changes were concentrated in the depression above the upper vermilion border. Labial movement toward the nose was reduced significantly. Conclusions: After adequately controlling several variables and using white light scanning with high reproducibility and accuracy, the coefficient of determination showed moderate values (0.40-0.77) and significant changes could be determined. This method would be useful to predict soft-tissue positional changes according to tooth movements.

• Imaging Science in Dentistry
• /
• 제43권4호
• /
• pp.261-266
• /
• 2013

Purpose: This study was performed to investigate the bone thickness of the infrazygomatic crest area by computed tomography (CT) for placement of a miniplate as skeletal anchorage for maxillary protraction in skeletal Class III children. Materials and Methods: CT images of skeletal Class III children (7 boys, 9 girls, mean age: 11.4 years) were taken parallel to the Frankfurt horizontal plane. The bone thickness of the infrazygomatic crest area was measured at 35 locations on the right and left sides, perpendicular to the bone surface. Results: The bone was thickest (5.0 mm) in the upper zygomatic bone and thinnest (1.1 mm) in the anterior wall of the maxillary sinus. Generally, there was a tendency for the bone to be thicker at the superior and lateral area of the zygomatic process of the maxilla. There was no clinically significant difference in bone thickness between the right and left sides; however, it was thicker in male than in female subjects. Conclusion: In the infrazygomatic crest area, the superior and lateral area of the zygomatic process of the maxilla had the most appropriate thickness for placement of a miniplate in growing skeletal Class III children with a retruded maxilla.

• 대한소아치과학회지
• /
• 제42권2호
• /
• pp.126-135
• /
• 2015

본 연구의 목적은 3급 부정교합 환자에서 facemask 치료 시 수직적 골격 양상에 따른 치료 효과를 비교하고, 구내 장치로서 bonded expander의 고정원을 평가하는 것이다. Facemask 치료를 받은 20명의 환자를 대상으로 FMA를 기준으로 두 군으로 분류하였고(HV군; FMA > $27^{\circ}$, AV군; $23^{\circ}$ < FMA < $27^{\circ}$), 치료 전과 후 측모두부방사선사진을 촬영하여 계측치를 비교하였다. 치료 후 두 군 모두 상악의 전방이동 및 하악의 후하방 회전이 관찰되었고, 두 군간에 유의한 차이는 없었다. 두 군 모두 수직적 골격 계측치가 증가하였고, FMA의 증가량은 HV군이 AV군에 비해 유의하게 크게 관찰되었다. 고정원 소실로서 상악구치의 근심이동 및 상악 전치의 전방경사가 관찰되었고, 두 군간에 유의한 차이는 없었다. 결론적으로 수직적 골격 양상에 따라 상악의 전방이동 및 고정원 소실면에서는 유의한 차이가 없었으나, HV군에서 수직적 성장 경향이 더 증가하였다.

• 대한치과교정학회지
• /
• 제13권2호
• /
• pp.193-199
• /
• 1983

The purpose of orthodontic treatment is to produce functional occlusion and to create or maintain facial esthetic harmony. The soft-tissue covering of the face also plays an important role in facial esthetics, speech and other physiologic functions. The study of the soft-tissue profile is important for the planning of orthodontic treatment. The author studied cephalometric X-ray films on 49 patients (23boys, 26 girls) with Angle's class II division 1 malocclusion, ranged from 9 to 13 years of age. Roentgenocephalmetric X-ray films were taken pre and post orthodontic care. Tracings were made in usual manner. The obtained results were as follow. 1. There was no significant sexual difference on mean changes. 2. In the comparison of the soft-tissue thickness changes, Ls-Ls' and Si-Si' in male subjects were remarkable. 9. There were significant correlations between osseous (Ss') change and soft-tissue (Ss) chang, of maxilla in male and female subjects subsequent to orthodontic treatment. 4. The ratios between the protraction of the Ss' and that of the Ss were 1:1.5 in all sexes, the ratios between the Si' and that of the Si were 1:1.4 in male and 1:1.2 in female. 5. There were significant correlations between maxillary central incise. angulation change $({\angle}A)$ and upper lip inclination change $({\angle}B)$ in all sexes. 6. There were little correlations between change in distance difference of Is and Ii and change in distance difference of Ls and Li in all sexes in all sexes.

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

• 대한구순구개열학회지
• /
• 제5권1호
• /
• pp.43-58
• /
• 2002

A General survey on the cleft lip and/or palate patients in Pusan National University Hospital was done. The conclusions were as follow. 1. In gender ratio, male was higher than female. 2. In the cleft type, unilateral cleft lip and palate, cleft lip and alveolus, and bilateral cleft lip and palate in higher ratio order. Left unilateral cleft lip and palate was higher than right in ratio. 3. In first hospital visiting age for dental treatment, the group from 6 years old to 12 years old was most and in that the age group for attending elementary school (about 7-8 years old) showed especially higher ratio. The large majority of patient were born in 1980's and lived in Pusan metropolitan city, KyungSangNamDo. Especially, most of them lived in the neighboring Held of Pusan National University Hospital. 4. Class III skeletal pattern and Angle's Class III molar relationship was most prevalent. Angle's Class II molar relationship showed relative higher ratio because tooth loss and malposition. 5. Primary lip closure in 3 months, secondary lip closure in 6-7 years old, palatal closure in 12-16 months and bone graft in 8-10 years old were operated mostly. Rhinoplasty and scar revision were operated in too early age so the need of infantile orthopedics must be considered. 6. Maxillary expansion and protraction were operated mostly in 8-11 years old but operating in primary dentition must be considered. 7. Tooth alignment were started mostly in mixed dentition and consideration about prosthodontic treatment and retention will be need. 8. In tooth anomaly, tooth malformation and missing were most prevalent.