• 대한치과교정학회지
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• 제25권3호
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• pp.355-373
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• 1995

두개악안면 영역은 많은 해부학적 구조를 포함하는 근골격구조(musculodentos keletal system)로 두부골격의 구조, 악궁상태, 저작근의 형성 및 기능은 서로 밀접한 연관성을 가지고 있다. 두개악안면 영역의 성장과 발육은 유전적인 요인이외에 환경적인 요인들 즉, 두개안면부의 근육을 포함한 주위조직의 영향을 받는 것으로 이미 알려져 있다. 그러나 반대로 두개안면부의 골격구조가 변화되는 경우 이에 대응하여 두개안면근육의 기능 또한 변화, 적응되는지에 대해서는 체계적인 연구결과가 미흡한 상태이다. 저자는 골격형 제 III급 부정교합자의 악교정수술 전, 후의 근활성도의 변화에 대한 비교연구를 통해 두부 골격구조와 교합상태에 따른 저작근 기능의 상호관계 및 변화 양상에 대해 알아보고자 정상교합을 가진 성인남자 15명과 술전 및 술후 골격형 제 III급 부정교합자 각각 15명을 대상으로 측모두부 방사선사진과 저작효율검사 및 rest, clenching, chewing, swallowing시의 전측두근, 교근, 상순의 근활성도 검사를 시행하여 다음과 같은 결과를 얻었다. 1. 하악의 안정위(rest)에서 술전 부정교합군에서 술후군보다 전측두근, 교근, 상순에서 높은 활성도를 보였으며, 술후군에서는 상순에서만 정상대조군보다 의미있는 높은 근활성도를 보였다. 2. 최대교합(clenching)시는 술후군에서 술전 부정교합군보다 전측두근, 교근, 상순에서 높은 근활성도를 보였다. 3. 저작(chewing)시는 술후군이 술전 부정교합군보다 전측두근 및 교근에서 높은 활성을 보인 반면 상순에서는 감소된 근활성도를 보였다. 4. 연하(swallowing)시 술후군에서 상순은 술전 부정교합군보다 감소되었으나 정상대조군보다 증가된 근활성도를 나타냈으며, 각 군간에 전측두근 및 교근에서는 유의차가 없었다. 5. 저작효율은 술전부정교합군에서 정상대조군보다 낮았으며, 술후군에서 술전 부정교합군보다 증가되었으나 두군 모두 정상대조군과 유의차를 보였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권6호
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• pp.628-635
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• 2000

The purpose of this study was to evaluate the result after 2-phase surgical-orthodontic treatment without preoperative orthodontic treatment for the skeletal Cl III malocclusion patient and to obtain an adequate protocol on the bases of this result. This retrospective study of ten patients who underwent 2-phase treatment were done to evaluate 1) the surgical stability and relapse pattern 2) the facial esthetics 3) the TMJ problem 4) the total time of the treatment. Results were followed : 1) The horizontal relapse of the mandible was 26.8% and didn't show significant differences compared to the conventional 3-phase treatment. But, it was considered that this amount of relapse was the sum of true relapse and autoratation of mandible due to decreased vertical dimension during orthodontic treatment. 2) It was estimated that there's no difference on the ratio of anterior facial height between the subjects and the normal patients. On the horizontal analysis, the mandible of the subjects was located more anteriorly than that of the normal patients. This result showed that there was a need for the accurate preoperative esthetic evaluation and the additional methods for reducing the relapse due to the occlusal interference. 3) Wide variation was noted on the TMJ symptoms of the subjects, however, it was estimated that there's no significant differencees of symptoms compared to that of the conventional 3-phase treatment on literatures. 4) The average of the overall period of treatment was 20.8 months and we obtained reduction of the treatment time compaired to 3-phase treatment on many literatures. Most of the results of this study were similar to the findings of the 3-phase treatment(preoperative orthodontic-orthognathic surgery-postoperative orthodontic), but total time of the treatment was shorter in patients with 2-phase treatment than in those with the conventional 3-phase treatment. With 2-phase treatment, we experienced many advantages compared to the conventional method considering that it was favarable conditions for the teeth, it had the flexibility for the treatment, and it could be the adequate treatment approach for the stomatognathic system. Although this retrospective pilot study had some limitations, due to small samples, the authors would hope that it could serve as a guide for the future researches, and the clinical applications.