대한치과교정학회임상저널 Volume VIII Number 2 April May June 2018 Kao.or.kr/cjkao 대한치과교정학회
대한치과교정학회임상저널 2018 년 4 5 6 월호 CASE REPORT 전치부개방교합환자의교정적절충치료및유지에대한고찰 윤달선ㆍ최동순ㆍ장인산ㆍ차봉근 강릉원주대학교치과대학치과교정학교실 2 9 치료후유지장치 후퇴된중안면부와부족한상악전치노출도를가지는골격성 III급부정교합환자의선수술치험례경효정ㆍ김현수ㆍ강지인ㆍ박기호경희대학교치의학전문대학원치과교정학교실 13 19 술전및술후중첩 하악제 1 대구치의유착을동반한성장기부정교합환자의치험례 이영준ㆍ장나영ㆍ채종문원광대학교치과대학치과교정학교실 22 24 초진시 CBCT 골격성개방교합을보이는 II급장안모환자에서피질골절제술 (Corticotomy) 을이용한교정치료치험례정현주ㆍ안효원경희대학교치의학전문대학원치과교정학교실 31 투고안내 42 34 협측-구개측함입시작시구내사진 2 가위교합의치료증례 *.
CASE REPORT 전치부개방교합환자의교정적절충치료및유지에대한고찰 윤달선ㆍ최동순ㆍ장인산ㆍ차봉근강릉원주대학교치과대학치과교정학교실 서론..,. 1 (gingival smile line), (smile arc),,..,. Dr. 윤달선 Dr. 최동순 Dr. 장인산 Dr. 차봉근 윤달선 / 대학원생, 최동순 / 교수, 장인산 / 부교수, 차봉근 / 교수강릉원주대학교치과대학치과교정학교실교신저자 : 최동순강원도강릉시죽헌길 7, 강릉원주대학교치과대학병원치과교정과 Tel: 033-640-3152, E-mail: dschoi@gwnu.ac.kr 2 CASE REPORT 1
윤달선ㆍ최동순ㆍ장인산ㆍ차봉근,. 2-4,,,. Lopez-Gavito 5 35%. Dension 6 21%. Lee Park 7 11 17.4, 10.36% ( 2.22 mm, 0.23 mm ), 18.10%., Baek 8 9 1, 3, 3 22.80%, 17.00%. 1.,. 그림 1. 치료전구외및구내사진 (15 세 8 개월 ). 대한치과교정학회임상저널 3
전치부개방교합환자의교정적절충치료및유지에대한고찰 증례진단 15 8.,. (open lock). (0mm),, reverse smile arc., ( 1). 2-plane. I,.. SNA 81.5º, SNB 78.6º, ANB 2.9º, (GoMe to FH) 35.3º, (ANS-Me) 77.5mm ( 2, 1). ODI 62.6º. 1 9 2.0mm, 1.1mm, 1 2.5mm, 0.6mm -3.7mm. BioEMG(BioPAK system, Bio-Research, Inc., Milwaukee, USA) (temporalis anterior; TA) (masseter muscle; MM) (electromyography; EMG), clenching (T/M ratio, T/M ratio = [ TA + TA] / [ MM + MM]) 2.9 ( 2).,,, I. 그림 2. 치료전파노라마및측면두부계측방사선사진 (15 세 8 개월 ). 4 CASE REPORT 1
윤달선ㆍ최동순ㆍ장인산ㆍ차봉근 표 1. 치료전, 치료후, 유지기간 1 년후측면두부계측방사선사진분석 Norm Pretreatment (15Y 8M) Posttreatment (17Y 5M) Retention (18Y 5M) SNA ( ) 82.0 81.5 82.1 81.7 SNB ( ) 80.0 78.6 78.3 78.2 ANB ( ) 2.0 2.9 3.9 3.5 FMA (Go-Me to FH) ( ) 23.8 35.3 34.7 35.1 ODI ( ) 71.9 62.6 65.3 66.3 ANS-Me (mm) 62.5 77.5 76.8 76.9 Overbite (mm) 2.3-3.7 1.4 0.4 Overjet (mm) 3.2 3.1 3.8 2.7 U1 to FH ( ) 111.0 113.8 108.4 108.2 L1 to MP ( ) 90.0 85.7 89.0 90.8 U1 to PP (mm) 28.5 30.5 32.9 32.4 U6 to PP (mm) 23.9 25.0 23.5 23.5 L1 to MP (mm) 42.4 43.0 45.0 44.5 L6 to MP (mm) 33.5 36.0 38.0 38.0 FH, Frankfort horizontal plane; PP, palatal plane; MP, mandibular plane. 표 2. 치료전, 치료후, 유지기간 1 년후의최대교합시, 측두근과교근의근전도비교 EMG activity (μv) Pretreatment (15Y 8M) Posttreatment (17Y 5M) Retention (18Y 5M) TA Right 123.7 159.3 127.1 TA Left 124.2 79.4 165.1 MM Right 48.0 33.9 68.4 MM Left 36.1 39.4 77.7 Balance T/M ratio 2.9 3.3 2.0 TA, temporalis anterior; MM, masseter muscle. T/M ratio = (TA right + TA left) / (MM right + MM left). 치료목표및계획 (1), (2), (3), (4),.. 대한치과교정학회임상저널 5
전치부개방교합환자의교정적절충치료및유지에대한고찰,.,,,.,. (TPA) 2mm. 1.5mm. (1) lingual spur, (2) (muscle exercise), (3). 치료경과및결과 0.022-inch slot, MBT prescription 그림 3. 교정치료과정 ; 치료시작 ( 상 ), 치료 5 개월째상악구치압하 ( 중 ), 치료 1 년 3 개월째수직피개가증가됨 ( 하 ). 6 CASE REPORT 1
윤달선ㆍ최동순ㆍ장인산ㆍ차봉근 (Victory Series, 3M Unitek, Monrovia, USA) ( 3), 0.016-, 0.018 0.025-inch NiTi, 0.019 0.025-inch stainless steel, 2mm. 5 1 2 ( 1.6mm, 8mm, Jeil Medical, Seoul, Korea),. 9 1 roping. 1 roping 1 7. (mechanotherapy) 2, 9 lingual spur. 5 ( 30 [clenching] 30 5 [1 ] 1 4 ). 4. 그림 4. 치료후구외및구내사진 (17 세 5 개월 ). 대한치과교정학회임상저널 7
전치부개방교합환자의교정적절충치료및유지에대한고찰, smile arc..,., ( 5). 35.3º 34.7º, 77.5mm 76.8mm, -3.7mm +1.4mm ( 5, 1).,. 그림 5. 치료후파노라마및측면두부계측방사선사진과중첩사진 (17 세 5 개월 ); 빨간선은치료전 (15 세 8 개월 ), 파란선은치료후 (17 세 5 개월 ). 8 CASE REPORT 1
윤달선ㆍ최동순ㆍ장인산ㆍ차봉근 lingual spur,. 1 button ( 6). 3, 9. 1, 1.4mm 0.4mm ( 7, 1)., 0.5mm. 그림 6. 유지장치 : 상하악견치간고정식유지장치, 하악중절치설측에 lingual spur 부착, 설측버튼을부착한투명교정장치와미니스크루임플랜트를고무줄로연결하여야간에착용. 그림 7. 치료후와유지 1 년후의측면두부계측방사선사진중첩 ; 빨간선은치료직후 (17 세 5 개월 ), 파란선은유지 1 년후 (18 세 5 개월 ). 대한치과교정학회임상저널 9
전치부개방교합환자의교정적절충치료및유지에대한고찰 2,, 1. 48.0μV 36.1μV 33.9μV 39.4μV, 1 68.4μV 77.7μV. (T/M ratio) 2.0. 고찰,. 10,,.,. -3.7mm +1.4mm +5.1mm(100%),, 2.4mm(47.1%), 2.0mm(39.2%) 86.3%, 0.7mm 13.7%.. Kim 1, 4mm. 0mm, 2.4mm,. 2,,..,. 5-8,11 Baek 8 9 3. 3 0.45mm, 1.20mm, 1 0.40mm, 0.99mm,. 1 1.0mm 19.6%., Baek 8,,. 1, 2. Sugawara 11 10 CASE REPORT 1
윤달선ㆍ최동순ㆍ장인산ㆍ차봉근 (overcorrection),. 0.5mm, Reitan Rygh. 12,, 6.,.. 13,14 Lowe 15, Bakke Michler 16. Lindsey English 17 (clenching),., 1,,. Huang 18, tongue spur. tongue spur., tongue spur, 1..,..,,. 결론,.,. 대한치과교정학회임상저널 11
전치부개방교합환자의교정적절충치료및유지에대한고찰 참고문헌 1. Kim YH. Anterior openbite and its treatment with multiloop edgewise archwire. Angle Orthod 1987;57:290-321. 2. Kuroda S, Katayama A, Takano-Yamamoto T. Severe anterior open-bite case treated using titanium screw anchorage. Angle Orthod 2004;74:558-567. 3. Park HS, Kwon OW, Sung JH. Nonextraction treatment of an open bite with microscrew implant anchorage. Am J Orthod Dentofacial Orthop 2006;130:391-402. 4. Fukui T, Kano H, Saito I. Nonsurgical treatment of an adult with an open bite and large lower anterior facial height with edgewise appliances and temporary anchorage devices. Am J Orthod Dentofacial Orthop 2016;149:889-898. 5. Lopez-Gavito G, Wallen TR, Little RM, Joondeph DR. Anterior open-bite malocclusion: a longitudinal 10-year postretention evaluation of orthodontically treated patients. Am J Orthod 1985;87:175-186. 6. Denison TF, Kokich VG, Shapiro PA. Stability of maxillary surgery in openbite versus nonopenbite malocclusions. Angle Orthod 1989;59:5-10. 7. Lee HA, Park YC. Treatment and posttreatment changes following intrusion of maxillary posterior teeth with miniscrew implants for open bite correction. Korean J Orthod 2008;38:31-40. 8. Baek MS, Choi YJ, Yu HS, Lee KJ, Kwak J, Park YC. Long-term stability of anterior open-bite treatment by intrusion of maxillary posterior teeth. Am J Orthod Dentofacial Orthop 2010;138:396 e1-9. 9. Sung JH, Kwon OW, Kyung HM, Park KD. Longitudinal data of craniofacial growth from lateral cephlometrics in Koreans with normal occlusion. Seoul: Jung-Won; 2001. 10. Ellis E, 3rd, McNamara JA, Jr., Lawrence TM. Components of adult Class II open-bite malocclusion. J Oral Maxillofac Surg 1985;43:92-105. 11. Sugawara J, Baik UB, Umemori M, Takahashi I, Nagasaka H, Kawamura H et al. Treatment and posttreatment dentoalveolar changes following intrusion of mandibular molars with application of a skeletal anchorage system (SAS) for open bite correction. Int J Adult Orthodon Orthognath Surg 2002;17:243-253. 12. Reitan K, Rygh P. Biomechanical principles and reactions. St Louis: Mosby; 1994. 13. Ringqvist M. Isometric bite force and its relation to dimensions of the facial skeleton. Acta Odontol Scand 1973;31:35-42. 14. Kiliaridis S. Masticatory muscle influence on craniofacial growth. Acta Odontol Scand 1995;53:196-202. 15. Lowe AA. Correlations between orofacial muscle activity and craniofacial morphology in a sample of control and anterior open-bite subjects. Am J Orthod 1980;78:89-98. 16. Bakke M, Michler L. Temporalis and masseter muscle activity in patients with anterior open bite and craniomandibular disorders. Scand J Dent Res 1991;99:219-228. 17. Lindsey CA, English JD. Orthodontic treatment and masticatory muscle exercises to correct a Class I open bite in an adult patient. Am J Orthod Dentofacial Orthop 2003;124:91-98. 18. Huang GJ, Justus R, Kennedy DB, Kokich VG. Stability of anterior openbite treated with crib therapy. Angle Orthod 1990;60:17-24. 12 CASE REPORT 1
CASE REPORT 후퇴된중안면부와부족한상악전치노출도를가지는골격성 III급부정교합환자의선수술치험례 경효정ㆍ김현수ㆍ강지인ㆍ박기호경희대학교치의학전문대학원치과교정학교실 서론.. 1,.,,.. 2,3 Dr. 경효정 Dr. 김현수 Dr. 강지인 Dr. 박기호 경효정 / 전공의, 김현수 / 개원의, 강지인 / 개원의, 박기호 / 교수교신저자 : 박기호서울시동대문구경희대로 23, 경희대학교치의학전문대학원치과교정학교실 e-mail : pkhmate@khu.ac.kr 대한치과교정학회임상저널 13
후퇴된중안면부와부족한상악전치노출도를가지는골격성 III 급부정교합환자의선수술치험례 4 RAP(regional acceleratory phenomenon). 5. 6,. III., III. 증례진단 36.. 11~14,, III,,. 2 ( 1).,.,. 그림 1. 초진시안모및구내사진. 14 CASE REPORT 2
경효정ㆍ김현수ㆍ강지인ㆍ박기호 ( 1)., (SNA 82.1, N perp-pt.a 5.9mm, SNB 87.9, N perp-pog 2.6mm, ANB -5.7 ) III. (PFH/ AFH 78.7%, FMA 17.0 ) (OP-FH 3.3 ). (U1-FH) 119.7, (IMPA) 100. 3 ( 2, 1). 측면두부계측방사선사진정면두부계측방사선사진파노라마방사선사진 그림 2. 초진시방사선사진. 표 1. 치료전, 후측면두부계측방사선사진계측치 Mean Initial Final SNA ( ) 81.3 82.1 86.7 SNB ( ) 79.2 87.9 86.5 ANB ( ) 1.5-5.7 0.2 N perp-pta (mm) 1.0-5.9-0.3 N perp-pog (mm) 0.5 2.6-0.5 Sum ( ) 391.8 379.7 378.5 FMA ( ) 23.5 17.0 23.2 PFH/AFH (%) 70.0 78.7 73.6 OP-FH ( ) 4.6 3.3 6.9 U1-FH ( ) 116.6 119.7 118.0 IMPA ( ) 89.7 100.5 84.0 Interincisal angle ( ) 124.1 123.0 134.7 대한치과교정학회임상저널 15
후퇴된중안면부와부족한상악전치노출도를가지는골격성 III 급부정교합환자의선수술치험례 치료계획.,.,,., (intercuspation). 7, A point 3mm 3mm (STO).,,. 치료과정 composite resin passive wiring. Le Fort I A point 3mm 3mm, (BSSRO) 4mm, 1mm,. 6 (Empower, Roth, 그림 3. 술후 6 주안모및구내사진. 16 CASE REPORT 2
경효정ㆍ김현수ㆍ강지인ㆍ박기호 022 slot) 0.014 NiTi(Sentalloy) wire, (1/4, 2oz) ( 3). 1. 3 0.016 0.025 stainless steel wire (chain elastic). 1 2 open coil spring, 1 2 (JinE, Φ1.6 6.0mm) ( 4). 5, 2., 6, clear retainer, Hawley retainer ( 5). 치료결과. ( 5).,. ( 6). 2,.. 1 2 그림 4. 술후 1 년구내사진. 대한치과교정학회임상저널 17
후퇴된중안면부와부족한상악전치노출도를가지는골격성 III 급부정교합환자의선수술치험례, ( 7~10). 고찰 그림 5. 치료종료시안모및구내사진. 측면두부계측방사선사진정면두부계측방사선사진파노라마방사선사진 그림 6. 치료종료시방사선사진. 18 CASE REPORT 2
경효정ㆍ김현수ㆍ강지인ㆍ박기호 그림 7. 치료후 1 년유지시안모및구내사진. 그림 8. 술전및술후중첩. 그림 9. 수술후및치료종료후중첩. 그림 10. 치료시작및치료종료후중첩. 대한치과교정학회임상저널 19
후퇴된중안면부와부족한상악전치노출도를가지는골격성 III 급부정교합환자의선수술치험례.,.,,,. 1,. 5 1 6~9, 6~12. 8,9 2,, protraction., 2 3,,. 6. model setup 6,. 11 1, 1. 12 III, 20% 2~4mm, 50~100%. 13-15 2.. 10 1~2mm 20~55%, (BSSRO) (pterygomasseteric sling). 16,17. 18. 19 III., 6mm. 20,. 20, Le Fort I bony gap (block bone graft) bony contact, 20,21 III. 20 20 CASE REPORT 2
경효정ㆍ김현수ㆍ강지인ㆍ박기호. 참고문헌 1. Juggins KJ, Nixon F, Cunningham SJ. Patient- and clinician perceived need for orthognathic surgery. Am J Orthod Dentofacial Orthop 2005;128:697-702. 2. Nagasaka H, Sugawara J, Kawamura H, Nanda R. Surgery First" Skeletal Class III Correction Using the Skeletal Anchorage System. J Clin Orthod 2009;43:97-105. 3. Peiró-Guijarro MA, Guijarro-Martínez R, Hernández- Alfaro F. Surgery first in orthognathic surgery: A systematic review of the literature. Am J Orthod Dentofacial Orthop 2016;149:448-462. 4. Sharma VK, Yadav K, Tandon P. An overview of surgeryfirst approach: recent advances in orthognathic surgery. J Orthod Sci 2015;4:9-12. 5. Liou EJ, Chen PH, Wang YC, Yu CC, Huang CS, Chen YR. Surgery-first accelerated orthognathic surgery: Postoperative rapid orthodontic tooth movement. J Oral Maxillofac Surg 2011;69:781-785. 6. Baek SH, Ahn HW, Kwon YH, Choi JY. Surgery-first approach in skeletal class III malocclusion treated with 2-jaw surgery: Evaluation of surgical movement and postoperative orthodontic treatment. J Craniofac Surg 2010;21:332-338. 7. Khamashta-Ledezma L, Naini FB. Prospective assessment of maxillary advancement effects: Maxillary incisor exposure, and upper lip and nasal changes. Am J Orthod Dentofacial Orthop 2015;147:454-464. 8. Dowling PA, Espeland L, Sandvik L, Mobarak KA, Hogevold HE LeFort I maxillary advancement: 3-year stability and risk factors for relapse. Am J Orthod Dentofacial Orthop 2005;128:560-567. 9. Trento Gdos S, Bernabé FB, da Costa DJ, Rebellato NL, Klüppel LE, Scariot R Clinical and radiographic evaluation of maxillary central incisors exposure in patients undergoing maxillary advancement. Dental Press J Orthod 2015;20:52-59. 10. Proffit WR, Turvey TA, Phillips C. The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: an update and extension. Head Face Med 2007:30;3:21. 11. Son HB, Oh CW. FOS (Functional orthognatic surgery). Korean J Clin Ortho 2002;1:7-19 12. Hwang DS. Evaluation of skeletal stability following twojaw surgery via surgery first orthodontic treatment in class III malocclusion. J Korean Assoc Maxillofac Plast Reconst Surg;33:407-412 13. Proffit WR, Phillips C, Prewitt JW, Turvey TA Stability after surgical-orthodontic correction of skeletal Class III malocclusion. 2. Maxillary advancement. Int J Adult Orthodon Orthognath Surg 1991;6:71-80. 14. Convens JM, Kiekens RM, Kuijpers-Jagtman AM, Fudalej PS. Stability of Le Fort I maxillary inferior repositioning surgery with rigid internal fixation: a systematic review. Int J Oral Maxillofac Surg 2015;44:609-614. 15. Hedemark A, Freihofer HP Jr. The behaviour of the maxilla in vertical movements after Le Fort I osteotomy J Maxillofac Surg 1978;6:244-249. 16. Franco JE, Van Sickels JE, Thrash WJ. Factors contributing to relapse in rigidly fixed mandibular setbacks J Oral Maxillofac Surg. 1989;47:451-456. 17. Ayoub AF, Millett DT, Hasan S. Evaluation of skeletal stability following surgical correction of mandibular prognathism Br J Oral Maxillofac Surg. 2000;38:305-311. 18. Politi M, Costa F, Cian R, Polini F, Robiony M. Stability of skeletal class III malocclusion after combined maxillary and mandibular procedures: rigid internal fixation versus wire osteosynthesis of the mandible. J Oral Maxillofac Surg 2004;62:169-81. 19. Lee JH, Kim SO, Jeon JH. The assessment of the stability in mandibular setback surgery related to spatial factors under rotational control of the proximal segment. Oral Surg Oral Med Oral Pathol Oral Radiol 2014;117:560-566. 20. Park YH, Seo JH, Yang IH, Choi JY, Lee JH, Kim MJ, Baek SH. What Are the Contributing Factors for Postsurgical Relapse After Two-Jaw Surgery in Patients With Cleft Lip and Palate. J Craniofac Surg 2017;28:1071-1077 21. Jeong WS, Jeong HH, Kwon SM, Koh KS, Choi JW. Cleft-Related Orthognathic Surgery Based on Maxillary Vertical Lengthening of the Anterior Facial Height. Plast Reconstr Surg 2018;141:736-746. 대한치과교정학회임상저널 21
CASE REPORT 하악제 1 대구치의유착을동반한성장기부정교합환자의치험례 이영준ㆍ장나영ㆍ채종문원광대학교치과대학치과교정학교실 서론. 1. 1 2. 증례 14,. Dr. 이영준 Dr. 장나영 Dr. 채종문 이영준 / 전공의, 장나영 / 부교수, 채종문 / 교수원광대학교치과대학치과교정학교실교신저자 : 장나영대전광역시서구둔산로 77 번지원광대학교치과대학대전치과병원치과교정과 Tel: 042-366-1192, e-mail: esther0705@hanmail.net 22 CASE REPORT 1
이영준ㆍ장나영ㆍ채종문. II, 1, gold inlay., 1. 1, 2 ( 1). 1 2. Cone beam computed tomography(cbct), CBCT 1 ( 2). I, Frankfort horizontal line (U1-FH) 107.65, (IMPA) 85.47 ( 3, 1). 그림 1. 초진시안모및구내사진. 대한치과교정학회임상저널 23
하악제 1 대구치의유착을동반한성장기부정교합환자의치험례 그림 2. 초진시파노라마방사선사진및 CBCT. 표 1. 치료전측면두부계측방사선사진계측값 그림 3. 초진시측면두부계측방사선사진. Measurements Mean Pre-treatment SNA( ) 81.0 86.92 SNB( ) 78.0 83.03 ANB( ) 3.0 3.89 APDI 82.0 81.26 Bjork SUM( ) 395.8 392.83 U1 to FH( ) 116.0 107.65 IMPA( ) 95.00 85.47 치료목표와계획 1 1), 2), 3), 4)..,,. 2,3,.,, 1. 1. 2 1 1 24 CASE REPORT 3
이영준ㆍ장나영ㆍ채종문 1 (spacing). 치료과정 2 2 open coil spring 2 ( 4). 5 2, 1 ( 5). 그림 4. 치료시작시구내사진. 그림 5. 치료시작 7 개월후구내사진. 대한치과교정학회임상저널 25
하악제 1 대구치의유착을동반한성장기부정교합환자의치험례 8 1, ( 6). 5, 1, 0.014-inch NiTi box elastic ( 7)., 1, corticotomy, ( 8). 1 3. I,. 1, ( 9, 10)., CBCT 1 그림 6. 외과적재이식후파노라마방사선사진. 그림 7. 치료시작 12 개월후구내사진. 26 CASE REPORT 3
이영준ㆍ장나영ㆍ채종문 그림 8. ( 상 ) 치료 22 개월후 corticotomy 를시행한모습 ( 하 ) 상악좌측구치부를전방견인하는모습. 그림 9. 치료종료시안모및구내사진. 대한치과교정학회임상저널 27
하악제 1 대구치의유착을동반한성장기부정교합환자의치험례 ( 11)., ( 12, 2). 3 1,. ( 13). 표 2. 치료전후측면두부방사선사진계측값의비교 Measurements Pretreatment Posttreatment SNA( ) 86.92 86.68 SNB( ) 83.03 84.33 ANB( ) 3.89 2.35 APDI 81.26 85.08 Bjork SUM( ) 392.83 392.12 U1 to FH( ) 107.65 109.82 IMPA( ) 85.47 81.74 그림 10. 치료종료시파노라마및하악제 1 대구치치근단방사선사진. 그림 11. 치료종료시 CBCT 사진. 그림 12. 치료전후측면두부계측방사선사진중첩. 28 CASE REPORT 3
이영준ㆍ장나영ㆍ채종문 그림 13. 치료종료 3 년후의구내사진및치근단방사선사진. 고찰,.. 1,,. 3,,,,,,. 1 1,., 20%..,., 2, CBCT slice thickness,. 4,. 3, 대한치과교정학회임상저널 29
하악제 1 대구치의유착을동반한성장기부정교합환자의치험례., decoronation,,,,. 3,. Andreasen 80~90%, 5 2~3. 1) conventional transplantation, 2) intra-alveolar transplantation, and 3) intentional replantation. intraalveolar transplantation.,,,,.,. 6,7 corticotomy,. bone filling 3. 결론 1. 3. 1,.. 참고문헌 1. Pithon MM, Bernardes LA. Treatment of ankylosis of the mandibular first molar with orthodontic traction immediately after surgical luxation. Am J Orthod Dentofacial Orthop 2011;140:396-403. 2. You KH, Min YS, Baik HS. Treatment of ankylosed maxillary central incisors by segmental osteotomy with autogenous bone graft. Am J Orthod Dentofacial Orthop 2012;141:495-503. 3. Chae JM, Paeng JY. Orthodontic treatment of an ankylosed maxillary central incisor through single-tooth osteotomy by using interdental space regained from microimplant anchorage. Am J Orthod Dentofacial Orthop 2012;141:e39-51. 4. Hirabayashi S, Umamoto N, TachiM, Sugawara Y, Sakurai A, Harii K. Optimized 3-D CT scan protocol for longitudinalmorphological estimation in craniofacial surgery. J Craniofac Surg 2001;12:136-40. 5. Andreasen JO, Kristerson L, Andreasen FM. Damage of thehertwig s epithelial root sheath: effect upon root growth after autotransplantation of teeth in monkeys. Endod Dent Traumatol 1988;4:145-51. 6. Tsukiboshi M. Autotransplantation of teeth: requirements for predictable success. Dent Traumatol 2002;18:157-80. 7. Kravitz ND, Yanosky M, Cope JB, Silloway K, Favagehi M. Surgical Uprighting of Lower Second Molars. J Clin Orthod 2016;50:33-40. 30 CASE REPORT 3
CASE REPORT 골격성개방교합을보이는 II급장안모환자에서피질골절제술 (Corticotomy) 을이용한교정치료치험례 정현주ㆍ안효원경희대학교치의학전문대학원치과교정학교실 서론,. 1. 2.. (corticotomy). 3,, 4-6. 7. 정현주 / 전공의, 안효원 / 교수교신저자 : 안효원서울시동대문구경희대로 23 경희대학교치의학전문대학원치과교정학교실 02-958-9390 e-mail : hyowon@khu.ac.kr Dr. 정현주 Dr. 안효원 대한치과교정학회임상저널 31
골격성개방교합을보이는 II 급장안모환자에서피질골절제술 (Corticotomy) 을이용한교정치료치험례 증례보고진단 19 4.. 7, bone scan uptake.,,., 2mm. 4mm,,,,, 2mm ( 1). 방사선사진소견 II (SNA; 80.5, SNB; 73, ANB; 7.5 ) (Björk Sum; 411, FMA, Frankfort mandibular plane angle; 37.5 ). (U1 to FH; 111 ), (L1 to mandibular plane, IMPA; 94.5 ). (U1 to Stomion; -1.5 mm), 그림 1. 치료전구외및구내사진. 32 CASE REPORT 4
정현주ㆍ안효원 a b 치료전측면두부계측방사선사진 그림 2. 치료전방사선사진. 치료전파노라마방사선사진. 1 29mm, 8 25mm ( 2.a, 1)., 3, ( 2.b). 치료계획 1),, 3 total distalization,. 2), ASO,,, (genioplasty) II. 3) 표 1. 치료전후측면두부계측방사선사진계측치 Mean Initial Final Divergency SUM ( ) 395.7 411 405 PFH/AFH(%) 70 56.7 56 OP-FH ( ) 5.9 9 12.5 MP-FH ( ) 25.4 36.5 35.4 Maxilla-Mandible Relation ANB ( ) 2.8 7.5 7.0 APDI ( ) 85.8 73.5 73.6 Maxilla SNA ( ) 81.7 80.5 81 N perp-pt.a (mm) 2-2.5-4.5 Mandible SNB ( ) 79 73 74 N perp-pog (mm) -0.3-19.5-13 Denture Interincisal angle ( ) 128.3 117.5 124 U1-FH ( ) 116.6 111 108 IMPA ( ) 90.1 94.5 92 U6-PP (mm) 25 30.3 26.5 U1 exposure (mm) 4-1.5 0 L1-Apog ( ) 23.3 31 27 L1-Apog (mm) 4.5 6.7 5.5 대한치과교정학회임상저널 33
골격성개방교합을보이는 II 급장안모환자에서피질골절제술 (Corticotomy) 을이용한교정치료치험례, autorotation,.,. 치료과정 0.022 preadjusted 0.014, 0.018, 0.014 0.025 NiTi, 0.016, 0.018, 0.014 0.025 NiTi stop 1,2. 4, 0.016 0.025 NiTi, 0.017 0.025 SS. midazolam 5mg 1.,,. 2, 1 2 2 1, 2 1 long type C-tube C-plate. 2 1-1,2 ( 3), 6 1,2 ( 4). 1,2. 11 ( 5). 그림 3. 협측 - 구개측함입시작시구내사진 (2 차피질골절제술 1 주일후 ). 34 CASE REPORT 4
정현주ㆍ안효원 그림 4. 함입 6 주경과시구내사진. 그림 5. 양의값의수직피개가달성된시점 ( 함입 11 주 ) 의구내사진. 11, ( 6). 6mm 2., 3 6. C-plate, 1,2.. total distalization ( 대한치과교정학회임상저널 35
골격성개방교합을보이는 II 급장안모환자에서피질골절제술 (Corticotomy) 을이용한교정치료치험례 7)., 3 total distalization,., 24. 2 ( 8,9, 1). a b 중간평가시측면두부계측방사선사진 중간평가시파노라마방사선사진 c 치료전과중간평가시기의측면두부계측방사선사진중첩도 그림 6. 양의값의수직피개가달성된시점의방사선사진 ( 중간평가 ). 36 CASE REPORT 4
정현주ㆍ안효원 그림 7. Total distalization 시작시의구내사진. 그림 8. 치료종료시구외및구내사진. 대한치과교정학회임상저널 37
골격성개방교합을보이는 II 급장안모환자에서피질골절제술 (Corticotomy) 을이용한교정치료치험례 a b 치료후측면두부계측방사선사진 치료후파노라마방사선사진 C 치료전후측면두부계측방사선사진중첩도 그림 9. 치료후방사선사진및중첩도. 치료결과 11 ( 6.c), 1 2mm autorotation. 2mm.,. ( 8). ( 9.c) 38 CASE REPORT 4
정현주ㆍ안효원 그림 10. 치료후 3 년유지시구내사진.,., C-tube 2, C-tube. 3, ( 10). 고찰,,.,,,,. 9 Regional Acceleratory Phenomenon(RAP), Frost 9,10 RAP,,,,,,. 1 hyaline (RAP), 1 22-25 2, 1 2, 2 4 11. 11 Systematic review, 1.5 4. 12, 대한치과교정학회임상저널 39
골격성개방교합을보이는 II 급장안모환자에서피질골절제술 (Corticotomy) 을이용한교정치료치험례. 1, -. 1.9%, 13., safe zone. autorotation center. condylion, 14 1 1 5.4mm, 4.8mm 1:0.88. 15 II,, autorotation,.,. 3. Baek 16, 2.4mm 23% 80% 1,,.. 17 참고문헌 1. Xun C, Zeng X, Wang X. Microscrew anchorage in skeletal anterior open-bite treatment Angle Orthod 2007;77:47-56. 2. Kanno T, Mitsugi M, Furuki Y, Kozato S, Ayasaka N, Mori H. Corticotomy and compression osteogenesis in the posterior maxilla for treating severe anterior open bite. Int J Oral Maxillofac Surg 2007;36:354-7. 3. Aboul-Ela SM, El-Beialy AR, El-Sayed KM, Selim EM, El-Mangoury NH, Mostafa YA. Miniscrew implantsupported maxillary canine retraction with and without corticotomy-facilitated orthodontics. Am J Orthod Dentofacial Orthop 2011;139:252-9. 4. Oliveira TF, Nakao CY, Gonçalves JR, Santos-Pinto A. Maxillary molar intrusion with zygomatic anchorage in open bite treatment: lateral and oblique cephalometric evaluation. Oral Maxillofac Surg 2015;19:71-7. 5. Erverdi N, Usumez S, Solak A. New generation openbite treatment with zygomatic anchorage. Angle Orthod 2006;76:519-26. 6. Park HS, Kwon OW, Sung JH. Nonextraction treatment of an open bite with microscrew implant anchorage. Am J Orthod Dentofacial Orthop 2006;130:391-402. 7. Akay MC, Aras A, Günbay T, Akyalçin S, Koyuncue BO. Enhanced effect of combined treatment with corticotomy and skeletal anchorage in open bite correction. J Oral Maxillofac Surg 2009;67:563-9. 8.,..,, 2001. 9. Frost HM. The biology of fracture healing. An overview for clinicians. Part I. Clin Orthop Relat Res 1989;248:283-93. 10. Frost HM. The biology of fracture healing. An overview for clinicians. Part II. Clin Orthop Relat Res1989;248:294-309. 11. Mathews DP, Kokich VG. Accelerating tooth movement: the case against corticotomy-induced orthodontics. Am J Orthod Dentofacial Orthop 2013;144:5-13. 40 CASE REPORT 4
정현주ㆍ안효원 12. Fernández-Ferrer L, Montiel-Company JM, Candel- Martí E, Almerich-Silla JM, Peñarrocha-Diago M, Bellot- Arcís C. Corticotomies and orthodontic tooth movement: A systematic review. Med Oral Patol Oral Cir Bucal 2016;21:e703-e712. 13. Chen YJ, Chang HH, Huang CY, Hung HC, Lai EH, Yao CC. A retrospective analysis of the failure rate of three different orthodontic skeletal anchorage systems. Clin Oral Implants Res 2007;18:768-75. 14. Kim K, Choy K, Park YC, Han SY, Jung H, Choi YJ. Prediction of mandibular movement and its center of rotation for nonsurgical correction of anterior open bite via maxillary molar intrusion. Angle Orthod 2018:88 in press. 15. Wang YC, Ko EW, Huang CS, Chen YR. The interrelationship between mandibular autorotation and maxillary LeFort I impaction osteotomies. J Craniofac Surg 2006;17:898-904. 16. Baek MS, Choi YJ, Yu HS, Lee KJ, Kwak J, Park YC. Long-term stability of anterior open-bite treatment by intrusion of maxillary posterior teeth. Am J Orthod Dentofacial Orthop 2010;138:396.e1-9. 17. Hassan AH, Al-Fraidi AA, Al-Saeed SH. Corticotomyassisted orthodontic treatment: review. Open Dent J 2010;4:159-64. 대한치과교정학회임상저널 41
투고안내 인터넷판한글임상잡지 대한치과교정학회임상저널 투고안내 2011 5-6 (Clinical Journal of Korean Association of Orthodontists). 7-8.. (kao.or.kr). pdf.. clinical tip (kao.or.kr/cjkao). Ask an Expert Ask an Expert. < 대한치과교정학회임상저널 투고규정 > 1.,. 2.,,, 1. ( ),,. 3... 4.,.. 5..,. 6.,,. 7., kao100@chol.com.
대한치과교정학회임상저널 인쇄 / 2018 년 6 월 30 일발행 / 2018 년 6 월 30 일 제 8 권 2 호 2018 년발행인 / 국윤아편집인 / 채종문편집위원회 / 배기선, 최동순, 홍미희, 안효원, 이상민, 김성식, 임원희, 최성환, 장나영, 이미영, 이경민, 이승엽, 임성훈발행처 / 대한치과교정학회 주소 / 서울시서초구서초동 1327 서초트라팰리스 II 603 호 E-mail : kao100@chol.com http: //www.kao.or.kr 전화 / 02-464-9153 팩스 / 02-464-9154..
KOREAN ASSOCIATION OF ORTHODONTISTS