• Title/Summary/Keyword: oral appliance therapy

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An Aerodynamic study used aerophone II for snoring patients (코콜이 환자의 sleep splint 착용 전후의 음향학적 및 공기역학적 연구)

  • Jung, Se-Jin;Kim, Hyun-Gi;Shin, Hyo-Keun
    • The Journal of the Korean dental association
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    • v.49 no.4
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    • pp.219-226
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    • 2011
  • Snoring and obstructive sleep apnea (OSA) are common sleep disordered breathing conditions. Habitual snoring is caused by a vibration of soft tissue of upper airway while breath in sleeping, and obstructive sleep apnea is caused by the repeated obstructions of airflow for a sleeping, specially airflow of pharynx. Researchers have shown that snoring is the most important symptom connected with the obstructive sleep apnea syndrome The treatment is directed toward improving the air flow by various surgical and nonsurgical methods. The current surgical procedures used are uvulopalatopharyngoplasty(UPPP), orthognathic surgery, nasal cavity surgery. Among the nonsurgical methods there are nasal continuous positive air pressure(CPAP), pharmacologic therapy. weight loss in obese patient, oral appliance(sleep splint). Sleep splint brings the mandible forward in order to increase upper airway volume and prevents total upper airway collapse during sleep. However, the precise mechanism of action is not yet completely understood, especially aerodynamic factor. The aim of this study evaluated the effect of conservative treatment of snoring and OSAS by sleep splint through measured aerodynamic change by an aerophone II. We measured a airflow, sound pressure level, duration, mean power from overall airflow by aerophone II mask. The results indicated that on a positive correlation between a decrease in maximum airflow rate and a decrease in maximum sound pressure level, on a negative correlation between a decrease in maximum airflow rate and a increase in duration.

Variables Affecting Long-Term Compliance of Oral Appliance for Snoring (코골이 치료용 구강장치의 지속적 사용에 영향을 주는 요인의 분석)

  • Lee, Jun-Youp;Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.305-316
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    • 2008
  • The mandibular advancement device(MAD) has been used to help manage snoring and obstructive sleep apnea. The aims of this study were to specify the demographic and clinical characteristics of the patients receiving long-term treatment with MAD and to quantify the compliance with and side effects of the use of the device. Of 103 patients who were treated with MAD for at least one full year after delivery date, 49 were able to be contacted with telephone and complete follow-up questionnaires were obtainable. They were telephoned to determine whether they were still using the device. If not, they were asked when and why they stopped using it. Patients were also asked how much effectiveness of the MAD in decreasing snoring and how much they and their bed-partners were satisfied with the MAD therapy. The initial respiratory disturbance indices and pre-treatment snoring frequency and intensity were obtained from the medical records of initial visit. All the data were compared between users and nonusers. The results were as follows: 1. Of 49 patients 25 are still using the device, but 24 stopped using it. Among nonusers nobody stopped wearing the device within first 1 month, but 37.5% of nonusers stopped wearing it in the following 6 months, and another 4.2% before the end of the first year. 2. The one-year compliance of the MAD therapy was 79.59%. 3. There were no significant differences in mean age, mean body mass index, and gender distribution between users group and nonusers group. 4. There was no significant difference in mean respiratory disturbance index at initial visit between users group and nonusers group. 5. There was no significant difference in pre-treatment snoring frequency and intensity between users group and nonusers group. 6. The degree of decrease in snoring with use of MAD was significantly higher in the users when compared to nonusers. 7. Patient's overall satisfaction with treatment outcome was significantly higher in the users when compared to nonusers. 8. Bed partner's satisfaction with treatment outcome tended to be higher in the users when compared to nonusers. 9. The most frequent reasons why patients discontinued wearing the MAD were: jaw pain(25%), dental pain(20.83%), broken appliance(20.83%), hassle using(16.67%), lost weight(8.3%), dental work(8.3%), no or little effect(4.17%), sleep disturbance(4.27).

The Relationship between Anterior Disc Displacement without Reduction and Development of Anterior Open Bite (비정복성 관절원판변위와 전치부 개교합 발생간의 관계)

  • Hur, Yun-Kyung;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.32 no.3
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    • pp.293-303
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    • 2007
  • The purpose of this paper is to evaluate if there is a relationship between anterior disc displacement without reduction and development of anterior open bite, and a relation between occurrence of open bite and occlusal appliance therapy. In general, the statistically significant differences were found between the Group 1 and 2 and normal mean group. The variables that represent mandibular size and form, showed a statistical significance in all 3 groups. Also 3 groups patients had a smaller ANB, a larger FMA than normal mean group. When we compared the 3 groups with respect to all cephalometric measurements by One-way analysis of variance (ANOVA), group 1 and 2 patients had a larger FMA, a larger SN to mandibular plane angle, a larger maxillomandibular plane angle, a larger occlusal plane to mandibular plane angle, a smaller total posterior facial height/total anterior facial height(%), and a larger gonial angle than group 3. The statistically significant differences were not found between the Group 1 and 2, and skeletal patterns were similar. Thus, morphologic features of patients with vertical discrepancies may represent a risk factor for the development of anterior open bite with or without occlusal appliance treatment. In case of patients with vertical discrepancy, we may have to be more careful when inducing a change of the vertical dimension.

PRE-ORTHODONTIC TREATMENT WITH MYOFUNCTIONAL APPLIANCE (근기능장치를 이용한 교정 전 치료)

  • Kim, Min-Soo;Yoo, Seung-Hoon;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.620-627
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    • 2005
  • The purposes of early orthodontic intervention are to correct obvious problems, to intercept developing problems and prevent them from becoming worse. Myofunctional influence on facial growth and the dentition change in muscle function and initiate morphologic variation in the normal configuration of the teeth and enhance an already existing malocclusion. Myofunctional therapy has been advocated since 1960's as the treatment for tongue thrust and other oral habits. Pre-orthodontic $TRAINER^{(R)}$ is introduced as functional device usable in children of mixed dentition to correct functional problems concerning soft tissue, tooth and skeleton. The most common cases to treat with Pre-orthodontic $TRAINER^{(R)}$ are lower anterior crowding, anterior open bite, Class II malocclusion and deep bite. Also, it can be used as correction of oral habits. Patients in this cases visited Department of Pediatric Dentistry, School of dentistry, Dankook University for orthodontic treatment. Pre-orthodontic treatment with Pre-orthodontic $TRAINER^{(R)}$ was carried out for correction of the oral habits.

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The Occlusal Evaluation and Treatment Planning for Prosthodontic Full Mouth Rehabilitation (보철학적 교합 재구성을 위한 교합진단과 치료계획)

  • Lee, Seung-Kyu;Lee, Sung-Bok;Choi, Dae-Gyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.16 no.2
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    • pp.149-159
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    • 2000
  • Occlusal disease is comparable to periodontitis in that it is generally not reversible. Occlusal disease, however, like periodontitis, often maintainable. It does itself to treatment and when restorative dentistry is utilized it becomes, in that sense, reversible. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. An integrated treatment plan is first developed on one set of diagnostic casts, properly mounted on a semiadjustable articulator using jaw relationship records. This is accomplished by using wax to make reconstructive modifications to the casts. These modified casts become the blueprint for planned occlusal changes and the fabrication of provisional restorations. The treatment goals are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. This report shows the treatment procedures for a patient whose mandibular position has been altered due to posterior bite collapse. Migration of the maxillary anterior teeth had occurred, and the posterior occlusal contacts showed pathologic interference. Precise diagnosis using mounted casts was executed and prosthodontic reconstruction by the aid of an unconventional orthodontic correction on maxillary flaring was planned. An unconventional orthodontic correction can be accomplished by using preexisting natural teeth, which can be modified for use in active tooth movement or splinted together for orthodontic anchorage. This technique has an advantage over conventional fixed appliance orthodontic therapy because it can accomplish tooth movement concurrently with restorative and periodontal therapy. On occasion, minor tooth movement can be necessary to achieve the optimum occlusal scheme, crown form, and tooth position for the forces of occlusion to be displaced down the long axis of the periodontally compromised teeth. Once the occlusion, periodontal health, and crown contours for the provisional splinted restoration are acceptable, the final splinted restoration can be similarly fabricated, and it becomes an excellent orthodontic retainer.

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A Research on the Basis of Questionnaires about the Dental Patients' Awareness and Understanding of TMDs (측두하악장애에 대한 치과 내원환자의 인지도와 이해도에 관한 설문조사 연구)

  • Kim, Kyung Hee
    • Journal of Oral Medicine and Pain
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    • v.38 no.3
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    • pp.275-289
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    • 2013
  • This study was conducted to investigate and analyze the dental patients' awareness and understanding about TMDs. Among the total number of 243 patients who had visited the department of dentistry of Busan Paik Hospital, Inje University or Hanvit dental hospital in Ulsan metropolitan city and participated in the survey, 195 patients who filled in all parts of the questionnaire were selected as the subjects. The results were as follows. 1. The subjects who were aware of the term, "TMDs" were 17.4%. The group with total education period of 12 years and over was significantly more aware of "TMD"(82.4%, p<0.01) than the other group. The subjects who were aware of the term, "jaw joint disease" were 81.0%. 30 to 49 age group(45.6%, p<0.05) and the group with total education period of 12 years and over(60.1%, p<0.01) were significantly more aware of "jaw joint disease" than other groups. 2. More than half of the subjects chose "overuse of the jaws" as the concept of jaw joint disease(50.6%). 3. TV, radio(41.4%) was the most frequent source of awareness about jaw joint disease followed by family and friends(20.2%), hospitals and health professionals(18.2%), internet(15.7%) and newspapers, magazines(4.5%). Among the respondents who were aware of jaw joint disease through TV, radio, 30 to 49 age group showed significantly higher percentage(52.4%, p<0.05) than other age groups. Among the respondents who were aware of jaw joint disease through internet, 18 to 29 age group showed significantly higher percentage(61.3%, p<0.01) than other age groups. Among the respondents who were aware of jaw joint disease from hospitals and health professionals, the group with total education period of 12 years and over showed significantly higher percentage(75.0%, p<0.05) than the other group. 4. Noise during mouth opening and closing(26.9%), mouth opening difficulty(25.1%) and jaw pain(13.7%) were the most frequently responded sign and symptoms of jaw joint disease. For the causes of jaw joint disease, enjoying hard food chewing(19.5%), occlusal discrepancy(19.0%) and chewing with one side only(18.5%) were responded in sequence. TMJ surgery(28%) was the most frequently responded treatment method for jaw joint disease, followed by occlusal appliance therapy(23.9%) and physical therapy(14.6%). For preventive method of jaw joint disease, avoid eating hard food(21.1%), avoid opening mouth wide(17.0%) and simultaneous using of molar of both side when chewing food(15.4%) were chosen frequently.

A STUDY ON THE EFFECT OF THE CHINCAP BY FINITE ELEMENT ANALYSIS IN JUVENILE SKELETAL CLASS III PATIENTS (유년기 골격성 III급 부정교합자에서 이모장치의 효과에 관한 유한요소분석법적 연구)

  • Choi, Jeong-Ho;Yang, Won-Sik
    • The korean journal of orthodontics
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    • v.28 no.3 s.68
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    • pp.353-370
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    • 1998
  • This study was conducted to investigate the changes in the structural parts of the craniofacial skeleton subsequent to chincap therapy in the juvenile skeletal Class III patients. The subject consisted of 29 Korean children(14 males, 15 females) who had skeletal Class III malocclusion and were undergone chincap therapy from the beginning of the treatment (and an auxilliary upper removable appliance, if necessary). The control group was composed of 21 children(10 males, 11 females) with skeletal Class III malocclusion who had no orthodontic treatment. Cephalometric data at the mean age of 7 and 2 years later were analyized by finite element method, and compared between groups by independent group t-test(p<0.05). The results of the present study were as follows; 1. There were no significant changes in the cranial base, posterior face, upper anterior face, ramus, chin and soft tissues by the chincap therapy. 2. The mandibular body showed significant differences in the minimum extention ratio and the overall shape ratio. This means that the vertical direction of growth was retarded by the chincap therapy. 3. The major direction of the growth in the maxillary basal bone was significantly more horizontal in the experimental group, which suggests that the vertical growth of maxilla was inhibited. 4. There was statistical difference in the major direction of the growth of the anterior face between groups. This may be due to the significant difference in the major direction of growth of the lower anterior face, supposed to be resulted from the mandibular rotation and/or displacement by the chincap therapy. The change in the oral functional space seemed to be caused by the same reason. 5. From the standpoint of these results, the retardation of growth, the changes of the growth direction and the morphological changes could be accepted partly, but the major effect of the chincap seems to be the rotation and the displacement of the mandible.

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