• 대한소아치과학회지
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• 제32권3호
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• pp.525-530
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• 2005

정중이개란 상악 중절치 사이의 치간이개를 말한다. 이는 혼합 치열기에서 ugly ducking stage에 흔히 관찰할 수 있으며 일반적으로 견치가 맹출하면서 자연적으로 소실되므로 꼭 치료가 필요한 것은 아니다. 그러나 견치 맹출 후에도 정중이개가 2mm이하로 계속 존재하거나 견치 맹출 전이라도 3mm이상의 정중이개가 존재하는 경우에서는 치료의 적응증이 될 수 있다. 특히 후자의 경우 심미적인 면에서 뿐만 아니라, 이로 인해 측절치와 견치의 맹출공간이 부족해지는 문제가 발생하므로 교정치료가 권장된다. 정중이개 치료시 사용되는 장치물은 finger spring 등을 이용한 가철성 장치물과, 교정용 band, tube, bracket 등을 부착시켜 rubber elastics이나 coil spring 등을 사용하는 고정성 장치물로 나뉘어진다. 그러나 정중이개의 치료를 위해 rubber band를 band, tube, bracket 등과 같은 적절한 부가장치 없이 사용하면 rubber band가 치근은 따라 치은 하방으로 이동하게 되고 치주 인대를 파괴하며 치근단 부위에 이르러 치아동요, 치아정출 및 탈락 등 치아에 치명적인 손상을 입힐 수 있다. 본 증례는 정중이개의 치료를 위해 부적절하게 rubber band를 사용하여 외상을 받은 치아를 관찰하여 다소의 지견을 얻었기에 이를 보고하는 바이다.

• 대한치과교정학회지
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• 제48권4호
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• pp.236-244
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• 2018

Objective: The aim of this study is to compare the adaptation of a straight wire between brackets positioned at the mid-lingual surface and those placed gingivally by using a three-dimensional simulation software. Methods: This cross-sectional study was performed using OrthoAid, an in-house software. The subjects were 36 adolescents with normal Class I occlusion. For each dental cast, two bracket positioning approaches, namely the middle and gingival, were examined. In the middle group, the reference points were placed on the mid-lingual surface of each tooth, while in the gingival group, the reference points were positioned lingually on the anterior teeth. A 4th degree polynomial was adopted, and the in-plane and off-plane root mean squares (RMSs) of the distances between the reference points and the fitted polynomial curve were calculated using the software. Statistical analysis was performed using the paired-samples t-test (${\alpha}=0.05$). Results: The mean in-plane RMS of the polynomial curve to the bracket distance in the gingival group was significantly lower than that in the middle group (p < 0.001). The off-plane RMS was higher in the gingivally positioned brackets in the maxilla than in the middle group (p < 0.001). However, the off-plane RMS in mandible was not statistically significantly different between the two groups (p = 0.274). Conclusions: The results demonstrated that the gingival placement of lingual brackets on the anterior teeth could decrease the distance between a tooth and the straight wire.

• 대한치과교정학회지
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• 제45권2호
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• pp.74-81
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• 2015

Objective: The purposes of this study were 1) to classify lingual dental arch form types based on the lingual bracket points and 2) to provide a new lingual arch form template based on this classification for clinical application through the analysis of three-dimensional virtual models of normal occlusion sample. Methods: Maxillary and mandibular casts of 115 young adults with normal occlusion were scanned in their occluded positions and lingual bracket points were digitized on the virtual models by using Rapidform 2006 software. Sixty-eight cases (dataset 1) were used in K-means cluster analysis to classify arch forms with intercanine, interpremolar and intermolar widths and width/depth ratios as determinants. The best-fit curves of the mean arch forms were generated. The remaining cases (dataset 2) were mapped into the obtained clusters and a multivariate test was performed to assess the differences between the clusters. Results: Four-cluster classification demonstrated maximum inter-cluster distance. Wide, narrow, tapering, and ovoid types were described according to the intercanine and intermolar widths and their best-fit curves were depicted. No significant differences in arch depths existed among the clusters. Strong to moderate correlations were found between maxillary and mandibular arch widths. Conclusions: Lingual arch forms have been classified into 4 types based on their anterior and posterior dimensions. A template of the 4 arch forms has been depicted. Three-dimensional analysis of the lingual bracket points provides more accurate identification of arch form and, consequently, archwire selection.

• 대한치과교정학회지
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• 제22권2호
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• pp.289-296
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• 1992

The purpose of this study was to evaluate and compare the shear bond strengths and failure sites of metal brackets bonded with chemically cured adhesive and light-cured adhesive. 10 brackets were bonded on prepared enamel surfaces with $Transbond^{circledR}$ (Unitek/3M; U.S.A.) light-cured orthodontic adhesive and another 10 brackets were bonded with $Ortho-one^{\circledR}$ (Bisco:U.S.A.) chemically cured orthodontic adhesive. 24 hours after bonding, the Instron universal testing machine was used to measure the shear bond strengths. The failure sites were examined under streoscopic microscope. The results were as follows: 1 . The mean shear bond strength of metal brackets bonded with light-cured adhesive was lower than that of metal brackets bonded with chemically cured adhesive, but the difference was not statistically significant (p < 0.05). 2. Regardless of the type of adhesives, the brackets were failed primarily at the bracket base-adhesive interface. 3. Bonding of metal brackets with light-cured adhesive is considered to be clinically acceptable.

• 대한치과교정학회지
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• 제43권3호
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• pp.141-146
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• 2013

Objective: Bonding forces of brackets to enamel surfaces may be affected by the procedures used for bleaching and enamel etching. The aim of this study was to investigate the bonding strength of orthodontic brackets to laser-etched surfaces of bleached teeth. Methods: In a nonbleached control group, acid etching (group A) or Er:YAG laser application (group B) was performed prior to bracket bonding (n = 13 in each group). Similar surface treatments were performed at 1 day (groups C and D; n = 13 in each subgroup) or at 3 weeks (groups E and F; n = 13 in each subgroup) after 38% hydrogen peroxide bleaching in another set of teeth. The specimens were debonded after thermocycling. Results: Laser etching of bleached teeth resulted in clinically unacceptable low bonding strength. In the case of acid-etched teeth, waiting for 3 weeks before attachment of brackets to the bleached surfaces resulted in similar, but not identical, bond strength values as those obtained with nonbleached surfaces. However, in the laser-etched groups, the bonding strength after 3 weeks was the same as that for the nonbleached group. Conclusions: When teeth bleached with 38% hydrogen peroxide are meant to be bonded immediately, acid etching is preferable.

• 대한소아치과학회지
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• 제24권4호
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• pp.758-762
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• 1997

There are various types of localized tooth malpositions in the mixed dentition, such as abnormal tooth axis, anterior crossbite of some incisors, impaction, midline diastema, ectopic eruption, and so forth. We, Pediatric Dentists, have usually used removable appliances for these instances. But, removable orthodontic appliances, as is known, have marked limitations in some situations, for example, severe rotation, intrusion and extrusion, root torque, closure of large diastema, traction of impacted tooth, etc. In such cases, Whip spring, combined with fixed or removable appliance, can increase utilities of removable orthodontic appliances. The authors have applied whip springs to some cases showing localized positional and arrangement problems, and have witnessed the results as follows; 1. The refined and elaborate control of direction and magnitude of force by the operator, and accurate compliance of the patients were requisite for the treatment with it. 2. It showed special effectiveness for de rotation of incisors. Although it yields some benefit for root movement, the special consideration for incomplete roots in this age bracket was required. 3. In the localized malalignment cases in mixed dentition, uncurable with traditional removable appliances but practically unrealistic with fixed appliance therapy, the whip spring was thought to be a good alternative.

• 대한치과교정학회지
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• 제49권2호
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• pp.116-123
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• 2019

As an alternative to the conventional fixed appliance that uses orthodontic brackets, a simple round tube without a bonding base can be bonded to the tooth surface by covering the tube with flowable resin. In this technique, bent wires cannot be inserted into the simple tubes; therefore, repositioning of the simple tubes is often required for adjustments. To reduce repositioning of simple tubes, a dome-shaped resin covering of the simple tube can be designed with a customized in-and-out compensation, using three-dimensional computer-aided design software based on digital simulation of orthodontic tooth movement. In the present case, the use of simple tubes bonded with customized resin coverings in a Class I nonextraction case is described in a 17-year-old male, in whom moderate crowding of the anterior teeth was treated over an 8-month period. This case shows that simple tubes can be used as an alternative to brackets in some Class I nonextraction cases, with the potential benefit of reducing decalcification.

• 대한치과교정학회지
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• 제27권5호
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• pp.839-852
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• 1997

Crystal growth 용액인 황화이온을 함유한 폴리아크릴산 용액에 의한 법랑질 표면처리는 법랑질 표면에 crystal growth를 유도함으로써 통상적인 산부식법을 대체하여 교정용 브라켓을 접착하기 위한 법랑질 전처치의 방법으로 사용될 수 있음이 제안된 바 있다. 이 연구는 crystal growth후 교정용 브라켓 접착제로 브라켓을 접착하는 방법의 임상적용 가능성을 구명하기 위하여 시행되었다. 발거된 사람소구치의 법랑질 표면을 $25\%$ 폴리아크릴산과 0.3M 황산을 함유한 기본 crystal growth 용액, 각각 0.3M lithium sulfate, 0.3M magnesium sulfate, 0.3M potassium sulfate를 첨가한 crystal growth 용액, $37\%$ 인산용액, 퍼미스로 각각 처리한 후, 교정용 광중합형 글래스아이오노머 시멘트와 교정용 레진접착제로 금속브라켓을 접착하였다. $37^{\circ}C$의 증류수에 24시간 침지시킨 후, 브라켓 전단결합강도를 측정하고 접착 파절양태를 관찰하였으며 표면처리된 법랑질 표면과 브라켓 제거후의 법랑질 표면을 주사전자현미경으로 관찰하여 다음과 같은 결과를 얻었다. Crystal growth후 광중합형 글래스아이오노머 시멘트로 브라켓 접착시 0.3M magnesium sulfate를 함유한 군의 브라켓 전단결합강도가 가장 높았다(p<0.01). Crystal growth후 광중합형 글래스아이오노머 시멘트로 접착한 군의 브라켓 전단결합강도는 crystal growth 후 레진접착제로 접착한 군보다 높았다(p<0.001). Magnesium sulfate, 또는 potassium sulfate를 함유한 crystal growth 용액으로 법랑질 표면을 처리한 후 글래스아이오노머시멘트로 접착한 군의 브라켓 전단결합강도는 산부식 후 레진 접착제로 접착한 군과 유의한 차이를 보이지 않았다. 브라켓 제거시 잔류접착제의 양은 글래스아이오노머 시멘트로 접착한 것이 가장 적었다. 이상의 결과는 magnesium sulfate나 potassium sulfate를 함유한 crystal growth 용액으로 법랑질 표면처리 후 교정용 광중합형 글래스 아이오노머 시멘트로 브라켓을 접착하는 방법이 통상적으로 사용되는 산부식 후 교정용 레진접착제에 의한 브라켓 접착법을 대체할 수 있음을 시사한다.

• 대한치과교정학회지
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• 제26권1호
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• pp.17-32
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• 1996

여러가지 교정장치 중에서 고정성 장치는 개개치아의 이동에 있어 가장 효과적으로 사용되는 장치이므로 그 작용기전과 역학적 관계를 이해하는 것이 중요하다. 고정성 장치의 탄선형태는 크게 continuous arch, segmented arch, sectional arch로 나누어 볼수있는데, segmented arch나 sectional arch는 힘의 작용점이 단순하고 interbracket distance도 길어 술자 임의대로 force system 조절이 가능한 반면 continuous arch에 서는 bracket geometry가 다양하고, interbracket distance가 좁아 force system의 조절이나 그 역학적 분석이 어려운게 사실이다. 저자는 공학에서의 3 dimensional elastic beam이 continuous arch의 형태와 유사한 점에 착안하여 continuous arch 의 force system을 분석하고자 하였으며, 이를 위해 다양한 형상을 갖는 3개의 bracket geometry를 표본형상으로 설정하고 기울기, 변위 및 interbracket distance에 따른 힘과 moment의 변화양상을 분석하고, 저자가 임의로 제작한 불규칙한 치아배열을 갖는 3차원 모형을 일례로하여 0.016 NiTi archwire를 bracket내에 삽입했을 때 발생되는 초기 힘과 moment를 분석 비교해본 결과 다음과 같은 결론을 얻었다. 1. Bracket의 변위 또는 기울기에 따라 나타나는 힘의 양상이 선형 대칭적인 비례관계를 보였다. 2. Interbracket distance에 따라 나타나는 힘의 양상은 비선형 대칭적인 반비례관계를 보였다. 3. 3차원 모형에서 bracket 형상이 비교적 단순한 부위에서는 표본형상과 비교분석이 가능했지만 인접치의 형상이 복잡한 부위에서는 표본형상의 예측량보다 힘이 크게 발생 되었다.나타나지 않았다. 하악의 arch length discrepancy는 하악 절치의 MD/FL index와, 상악의 arch length discrepancy는 측절치의 MD/FL index에서 상관관계를 나타내었다. 4. 정상군과 밀집군의 각 계측항목의 t-검정 결과 하악의 arch length discrepancy, overbite에서만 유의차를 나타내었다. 검사에서 Plaque Index(p<0.01)와 Gingival Index(p<0.001)가 상당히 낮은것으로 나타났다. 겔형 불화주석군에서 한 증례는 미미한 치관착색을, 두 증례는 보통정도의 치관착색을 보였다. 치아탈회 연구에서는 겔형 불화주석군과 불화나트륨 양치액군이 치료후 치아탈회값에서 치료전 치아탈회값을 뺀 치아탈회값이 대조군에 비해 구강전체및 제1대구치에서 현저하게 낮은 값(p<0.05)을 보였다. 비록 겔형 불화주석군이 불화나트륨 양치액군보다 일관되게 낮은 치아탈회값을 보였을지라도 통계적으로 그 차이는 단지 유의성을 보이는 정도였다.는 골기질의 주성분인 type I 교원질의 합성을 선택적으로 억제하는 기능과 alkaline phosphatase의 활성을 크게 증가시키지 못한 점 등으로 미루어 볼 때, 골개조를 억제하는 방향으로 작용한다고 볼 수 있으며, 교정치료 과정중 골개조를 억제하는 부위에서 사용을 시도해 볼 수 있겠다.>신뢰구간은 상악에서 정상교합군은 $79.5-81.0\%$, 비발치군은 $81.6-84.9\%$, 발치군은 $70.1-72.2\%$로 나타났으며, 하악에서 정상교합군은 $79.8-82.2\%$, 비발치군은 $82.1-85.5\%$, 발치군은 $73.1-75.1\%$로 나타났다. 7. 최대치아근원심폭경합, 기저악궁폭경, 기저악궁장경, 최대치아근원심폭경 합에 대한

• 대한치과교정학회지
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• 제41권2호
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• pp.138-146
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• 2011

The purpose of this article is to introduce a new virtual orthodontic treatment (VOT) system, which can be used to construct three-dimensional (3D) virtual models, establish a 3D virtual setup, enable the placement of the virtual brackets at the predetermined position, and fabricate the transfer jig with a customized bracket base for indirect bonding (IDB) using the stereolithographic technique. A 26-year-old woman presented with anterior openbite, crowding in the upper and lower arches, and narrow and tapered upper arch, despite having an acceptable profile and balanced facial proportion. The treatment plan was rapid palatal expansion (RPE) without extraction. After 10 days of RPE, sufficient space was obtained for decrowding. After a 10-week retention period, accurate pretreatment plaster models were obtained using silicone rubber impression. IDB was performed according to the protocol of the VOT system. Crowding of the upper and lower arches was effectively resolved, and anterior openbite was corrected to normal overbite. Superimposition of the 3D virtual setup models (3D-VSM) and post-treatment 3D virtual models showed that the latter deviated only slightly from the former. Thus, the use of the VOT system helped obtain an acceptable outcome in this case of mild crowding treated without extraction. More cases should be treated using this system, and the pre- and post-treatment virtual models should be compared to obtain feedback regarding the procedure; this will support doctors and dental laboratory technicians during the learning curve.