• 치위생과학회지
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• 제7권4호
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• pp.275-279
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• 2007

본 연구는 하악 제3대구치의 맹출 양상이 치관주위염의 발생에 미치는 영향을 조사하고자 양산시에 소재한 N치과병원에 하악 제3대구치 발거를 주소로 내원한 환자 200명을 대상으로 조사연구를 실시하였다. 하악 제3대구치의 좌 우측 분포도, 경사도, 매복정도, 하악지 전연에서의 위치, 하악 제2대구치와 제3대구치 사이의 거리는 $X^2$-test, 치관주위염 유 무와 제 변수와의 상관성은 Pearson 상관관계를 실시하여 다음과 같은 결론을 얻었다. 1. 하악 제3대구치에 대한 치관주위염의 발생은 연령과 상관관계가 있는 것으로 나타났다. 2. 하악 제3대구치의 경사도에 있어서 치관주위염이 가장 호발된 군은 근심경사군이었다. 3. 하악 제3대구치의 매복정도와 치관주위염의 발생은 Level a, Level c, Level b순으로 나타났다. 4. 하악 제3대구치의 하악지 전연에서의 위치는 Class II, I, III의 순으로 치관주위염이 호발하였다. 5. 하악 제2대구치의 원심 백악법랑경계에서 하악 제3대구치의 근심 백악법랑경계까지의 거리가 좁을수록 치관주위염이 호발하였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권5호
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• pp.375-379
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• 2010

Introduction: In the management of dentofacial deformities, variable movement of the maxilla can be made possible by a Le Fort I osteotomy. Posterior impaction of the maxilla necessary for rotation of the maxillomandibular complex enhances the functions and esthetic results. In cases of posterior impaction of the maxilla, an increase in the figure of the occlusal plane angle and incisor inclination can occur. This study reports the relationship between the amount of posterior impaction and the change in the occlusal plane angle and incisor inclination in a Le Fort I osteotomy by preoperative and postoperative lateral cephalograms. Materials and Methods: Twenty patients who had undergone orthognathic surgery in Dong-A University Medical Center participated in this study. Lateral cephalometrics, within 3 weeks prior to surgery and 3 days after surgery, were used for analysis. Pre and postoperative measurements of the occlusal plane angle and incisal inclination based on the Frankfort horizontal (FH) plane were performed. X and Y were defined as the amount of vertical change in the upper incisor tip and the amount of vertical change in the upper first molar mesial cup tip through the operation. The amount of final posterior maxillary impaction was determined by subtracting Y from X, which is the difference in vertical height. According to the amount of posterior maxillary impaction, the change in the occlusal plane angle and incisal inclination was measured. Results: The average posterior maxillary impaction was 2.91 mm and the average change in the occlusal plane angle and incisal inclination was $6.54^{\circ}$after surgery. As a result, each mm of posterior maxillary impaction changed the occlusal plane angle and incisal inclination by $2.25^{\circ}$. Statistically, there was high significance. Two cases were observed: one with the same amount of posterior maxillary impaction performed on both the right and left showing $2.20^{\circ}$, and the other with a different amount of posterior maxillary impaction performed showing $2.35^{\circ}$. In this case, there was no significance difference between the two cases. Conclusion: Each mm of posterior maxillary impaction changes the occlusal plane angle and incisal inclination by an average of $2.25^{\circ}$. In posterior maxillary impaction, there was no significant difference in the amount of change in the occlusal plane angle and incisal inclination regardless of whether there was an equal amount of posterior maxillary impaction on both sides. This study is expected to help in the presurgical orthodontic preparation and presurgical treatment planning.

• 대한치과교정학회지
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• 제23권2호
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• pp.165-177
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• 1993

Upper canine is important because it protects and maintains the stability of the dental arch and also, joins the anterior with the posterior teeth. The incidence of impaction of upper canine is the second most frequent next to the third molar because it takes a long period of time to develop, and has a complicated path of eruption, and erupts lately. After the age of 10, clinical and radioglaphic examination can be used in revealing the possibility of impaction and efforts should be put to reduce the side effects. To prevent impaction, selective extraction of primary canine at the age of 8 to 9 could be considered and prolonged retention of primary canine in oral cavity should be avoided at this time. Once the impaction is iden, the first stage of the treatment is to lcocalize the lesion by radiographic examination and According to the severity, orthodontic traction or autotransplantation should be considered and comprehensive diagnosis and treatment plan of malocclusion should be established. Generally, labial impaction is due to arch length discrepancy and palatal impaction is due to malposition or morphologic pathosis of lateral incisors rather than arch length discrepancy. In surgical procedure, peridontal problems should be considered and the minimum amount of bone and soft tissue should be reduced and direct bonding method of many attachment methods should be recommended. Especially in traction of labially impacted canine, it should be guided to erupt through the keratinized zone and proper forced magnitude should be applied. The importance of periodontal condition should always be in mind following the patient education to mintain the good oral hygiene at each stage of treatment. Properly managed impacted canine can provide function and esthetic by proper diagnosis and treatment if extraction of canine is not indicated.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권6호
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• pp.530-535
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• 2004

Objectives. The purpose of this study was to evaluate mandibular third molars as risk factors for angle fracture in a patient sample with fractured mandible. Materials and methods. The medical records and panoramic radiographs of 107 patients with mandibular fractures were examined. The presence and absence and degree of impaction of the lower third molar were assessed for each patient and related to the occurrence of fracture of the mandibular angle. Data were also collected for age, sex and mechanism of injury. Data were analyzed by a chisquare statistics and Student t test. Result. The incidence of mandibular angle fracture was found to be significantly greater when a lower third molar was present(p <0.05) especially at class III state.(p < 0.05)(by Pell & Gregory system) Of the 78 patients with a lower third molar, 46(58.97%) had angle fractures. Of the 29 without a lower third molar, 24(82.76%) had not angle fractures. Conclusion. The result of this study showed that the mandibular angle that have a lower third molar is more susceptible to fracture when exposed to an impact than an angle without an lower third molar.

• 대한소아치과학회지
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• 제24권4호
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• pp.771-775
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• 1997

Ectopic eruption is defined as abnormal eruption and results in malpositioned teeth and abnormal root resorption of adjacent teeth. Ectopic eruption, first reported by Chapman, occurs in 3% of the population and that mostly in the maxilla. Etiologic factors include narrow maxilla, large maxillary teeth, retarded calcification of the first molar, inclined eruption path of the first molar and retruded position of the maxilla. Impaction of the second molar is rare and occurs mostly in the mandible. Major causes are large teeth and insufficient arch length. Halterman has devised a method of distalizing a ectopically erupting first molar by cementing a band on the second deciduous molar with a hook soldered and a button bonded to the occlusal surface of the first permanent molar. Ectopically erupted posterior teeth should be treated early to maintain normal development of the dentition, harmony of facial growth and occlusal support, a failure to do so could result in severe malocclusion, periodontal damage and continued root resorption of the adjacent teeth. Early detection and treatment is thus vital. The author is submitting this report as he has obtained favorable results in treating a patient who came to the SNUDH Dept. of Pediatric Dentistry complaining of the first molar by using a modified Halterman appliance.

• 대한소아치과학회지
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• 제31권1호
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• pp.41-45
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• 2004

정상적인 하악 성장에서, 하악 제1대구치 후방의 치배는 근심경사되어 있다. 보통 이러한 근심경사는 자발적으로 해소되나, 항상 그런 것만은 아니다. 첫 번째 증례는 14세 여아로서 가족이 모두 하악 제2대구치가 매복된 병력을 가지고 있었다. 환아 역시 양측 모두 매복되어 분절호전과 개방용 코일 스프링으로 치료하였다. 두 번째 증례는 14세 남아 환자로 Halterman 장치를 이용하여 매복된 하악 우측 제2대구치를 치료하였다. 세 번째 증례는 11세 남아로서 고정성 교정 치료 중 하악 양측 제2대구치가 매복되었다. 분절호선과 개방용 코일 스프링, 구리선으로 치료하였다.

• Imaging Science in Dentistry
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• 제43권4호
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• pp.219-225
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• 2013

Purpose: The purpose of this study was to determine the prevalence of missing and impacted third molars in people aged 25 years and above. Materials and Methods: The study sample of 3,799 patients was chosen randomly from patients who visited Pusan National University Dental Hospital and had panoramic radiographs taken. The data collected included presence and impaction state, angulation, and depth of impaction of third molars, and radiographically detected lesions of third molars and adjacent second molars. Results: A greater percentage of men than women retained at least one third molar. The incidence of third molars decreased with increasing age. The incidence of partially impacted third molars greatly declined after the age of 30. Vertically impacted maxillary third molars and horizontally impacted mandibular third molars were most frequent in all age groups. Among the maxillary third molars, those impacted below the cervical line of the second molar were most frequent in all age groups, and among the mandibular third molars, deeply impacted third molars were most frequent in those aged over 40. Dental caries was the most common radiographic lesion of the third molars. Mesioangularly impacted third molars showed radiographic lesions in 13 (9.5%) adjacent maxillary second molars and 117 (27.4%) mandibular second molars. Conclusion: The number of remaining third molars decreased and the percentage of Class C depth increased with age. Caries was the most frequent lesion in third molars. Partially impacted mesioangular third molars showed a high incidence of caries or periodontal bone loss of the adjacent second molar. Regular oral examination will be essential to keep asymptomatic third molars in good health.

• 대한소아치과학회지
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• 제37권1호
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• pp.136-142
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• 2010

이소맹출은 치아가 비정상적인 위치나 방향으로 맹출하는 것으로 정의되며 구치부에서는 근심측으로 맹출하여 인접치아의 치근 흡수나 조기 탈락을 야기하여 공간 상실을 일으킬 수 있고, 부분 맹출된 경우 치은 하방의 치아우식 위험성이 증가하고 농양을 형성할 수도 있다. 구치부의 이소맹출 가운데 66% 정도는 가역적인 경우로 특별한 치료 없이 자연적으로 정상적인 맹출이 일어나며, 비가역적인 이소맹출의 경우에는 치아의 맹출 상태, 인접치에 의해 매복된 양, 인접치의 동요도, 통증이나 감염 여부 등의 여러 요인을 고려하여 본격적인 치료가 필요하다. 본 논문에서는 비가역적으로 이소맹출된 상악 제1대구치와 하악 제2대구치를 치간이개 고무줄, modified Halterman appliance 그리고 외과적 노출 후 modified Halterman appliance를 이용한 방법 등으로 정상적인 맹출을 유도한 증례를 보고 하는 바이다.

• 대한소아치과학회지
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• 제37권1호
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• pp.102-108
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• 2010

매복이란 맹출로 상에 물리적 장애물이 있거나, 치아의 비정상적 위치, 또는 공간 부족 등으로 인해 맹출이 정지되는 경우이다. 이는 과잉치, 치성 종양, 또는 낭성 병소의 존재와 연관되어 나타나기도 하는데, 법랑모세포섬유종은 이러한 매복을 일으킬 수 있는 치성 종양의 한 종류이다. 법랑모세포섬유종은 많은 경우 미맹출 치아나 매복치와 연관되어 나타나며, 병소의 크기 및 양상, 그리고 환자의 연령을 고려하여 보존적 절제술(conservative resection) 또는 완전 절제술(block resection)을 시행한다. 본 증례는 하악 좌측 제1대구치의 맹출 장애를 주소로 내원한 환아에서 외과적 노출술 및 변형된 halterman 장치를 사용한 교정적 견인을 통하여 양호한 결과를 얻었기에 보고하는 바이다. 매복의 원인이었던 법랑모세포섬유종의 비교적 높은 재발률 및 악성 전환 가능성을 고려하여 추후 장기적인 추적검사가 필요할 것으로 사료된다.

• 대한소아치과학회지
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• 제24권4호
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• pp.776-780
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• 1997

Patient with alveolar abscess due to dental caries with severe alveolar bone loss, severe tooth mobility, root resorption need extraction of tooth because it is impossible to carry out pulp treatment and restoration by using conventional method. Early loss of primary molar might cause masticatory interference, extrusion of opposing tooth, problem in maintaining space and interference on eruption of permanent tooth. Especially, early loss of primary second molar before the eruption of permanent first molar might cause space closure by mesially erupted permanent first molar and impaction of second premolar. In such a case, distal shoe space maintainer and removable space regaining appliance was the first choice of treatment. But, distal shoe space maintainer need precise adaptation and might cause chronic inflammation if the oral hygiene is poor. In a case using removable space regaining appliance, patient's cooperation is most important. If the distal root of primary second molar is comparably sound and alveolar abscess with alveolar bone loss is localized at mesial root, hemisection should be carried out for precise guide to eruption of the permanent first molar, restoration of masticatory fuction and solution to the discomfort of the patient