The effect of treatment timing on maxillary protraction treatment response - A comparison of prepubertal and pubertal patients

치료시기에 따른 상악골 전방견인효과 - 사춘기전과 사춘기의 비교

  • Kim, Kyung-Ho (Department of Orthodontics, College of Dentistry, Yonsei University) ;
  • Choy, Kwang-Chul (Department of Orthodontics, College of Dentistry, Yonsei University) ;
  • Baik, Hyoung-Seon (Department of Orthodontics, College of Dentistry, Yonsei University) ;
  • Lee, Ji-Hyun (Department of Orthodontics, College of Dentistry, Yonsei University)
  • 김경호 (연세대학교 치과대학 교정학교실, 두개안면 기형연구소) ;
  • 최광철 (연세대학교 치과대학 교정학교실, 두개안면 기형연구소) ;
  • 백형선 (연세대학교 치과대학 교정학교실, 두개안면 기형연구소) ;
  • 이지현 (연세대학교 치과대학 교정학교실)
  • Published : 2002.10.01

Abstract

Treatment timing is a very important factor to consider in treating skeletal Class III patients by means of maxillary protraction. According to the literature maxillary Protraction should be carried out at an early age before puberty. However, no scientific data were presented to support this statement and recent studies supported by statistical data showed disagreement concerning the optimum treatment time of maxillary protraction. Therefore, there is no agreement about the optimum treatment time of maxillary protraction. In this study hand-wrist X-rays were taken from 119 patients and subjects were grouped into prepubertal and pubertal group according to their skeletal maturity. Pretreatment and posttreatment lateral cephalometric X-rays were taken and treatment effects were compared. The average treatment time was 6.5 months for the prepubertal group and 6.1 months for the pubertal group. The obtained results were as follows ; 1. The amount of maxillary forward movement was the same for Pretreatment and pubertal group. 2. The amount of maxillary downward movement was the same for prepubertal and pubertal group. 3. The amount of mandibular downward and backward rotational movement was the same for prepubertal and pubertal group. 4. Dental effects were the same for prepubertal and pubertal group.

상악골 전방견인 장치를 이용한 골격성 III급 부정교합 환자의 악정형적 치료에서 치료시기는 치료효과에 지대한 영향을 미칠 수 있으며 이상적인 치료시기는 연구자에 따라 다소의 차이는 있으나 다른 형태의 부정교합보다는 다소 이른 사춘기 이전의 어린 나이라는 것이 선학들의 공통된 의견이었다 하지만 통계적 자료들을 바탕으로 한 최근의 논문들은 과거 선학들의 의견을 뒷받침 해주는 논문과 그렇지 않은 논문들로 나뉘고 있어 이상적 치료시기에 대한 정립된 의견이 없는 실정이다. 이에 본 연구에서는 119명의 환자들의 수완부골 방사선 사진을 평가하여 골성숙도에 따라 사춘기전군과 사춘기군으로 분류하고 치료전후 측모두부방사선 사진을 분석하여 상악골 전방견인에 대한 치료효과를 비교하였다. 평균 치료기간은 사춘기전군은 6.5개월, 사춘기군은 6.1개월이었으며 치료전후의 측모두부방사선 사진을 분석한 결과 다음과 같은 결론을 얻었다. 1. 상악골의 전방이동양은 사춘기전군과 사춘기군간에 차이가 없었다. 2. 상악골의 하방이동양은 사춘기전군과 사춘기군간에 차이가 없었다. 3. 하악골의 하방이동양과 후하방회전양은 사춘기전군과 사춘기군간에 차이가 없었다. 4. 치성이동양은 사춘기전군과 사춘기군간에 차이가 없었다. 이상의 결과로 사춘기전 뿐 아니라 사춘기에서도 상악골 전방견인에 의해 상악골 성장촉진과 함께 성공적인 악정형 치료가 가능함을 알 수 있었다.

Keywords

References

  1. Kambara T. Dentofacial changes produced by extraoral forward force in the Marum irus. Am J Orthod 1977: 71 : 249-77 https://doi.org/10.1016/0002-9416(77)90187-7
  2. Nanda R. Protraction of maxilla in rhesus monkey by controlled extra-oral forces. Am J Orthod 1978 : 74 : 121-41 https://doi.org/10.1016/0002-9416(78)90080-5
  3. Jackson GW, Kokich VG, Shapiro PA. Experimental and postexperi-mental response to anteriorly directed extraoral force in young Ma-caca nemestrira. Am J Orthod 1979: 75 : 318-33 https://doi.org/10.1016/0002-9416(79)90278-1
  4. Baik HS. Clinical results of the maxillary protraction in Korean chil-dren. Am J Orthod Dentofac Orthop 1995 : 108 : 583-92 https://doi.org/10.1016/S0889-5406(95)70003-X
  5. Sung SJ, Baik HS. Assessment of skeletal and dental changes by maxillary protraction Am J Orthod Dentofac Orthop 1998: 114 : 492-502 https://doi.org/10.1016/S0889-5406(98)70168-4
  6. 황충주, 경승현, 임중기, 골격성 제III급 부정교합 환자에 대한 상악골 전방견인 장치의 치료효과. 대치교정지 1994 : 24 : 851-60
  7. Irie M, Nakamura S. Orthopedic approach to severe skeletal Class Ill malocclusion. Am J Orthod 1975 : 67 : 377-92 https://doi.org/10.1016/0002-9416(75)90020-2
  8. Mermigos J, Full CA, Andreasen G. Protraction of the maxillofacial complex. Am J Orthod Dentofac Orthop 1990: 98 : 47-55 https://doi.org/10.1016/0889-5406(90)70031-7
  9. Ngan P, Hagg D, Yiu C, Merwin D, Wei SHY. Treatment response to maxillary expansion and protraction. Eur J Orthod 1996 : 18 : 151-68 https://doi.org/10.1093/ejo/18.1.151
  10. Rygh P, Tindlund R. Orthopedic expansion and protraction of the maxilla in cleft palate patients-A new treatment rationale. Cleft Palate J 1982: 19 : 104-12
  11. Samas KV, Rune B. Extraoral traction to maxilla with face mask: A follow-up of 17 consecutively treated patients with and without cleft lip and palate. Cleft Palate J 1987: 24 : 95-103
  12. Delaire J. Considerations sur la croissance faciale (en particulier du maxillaire superieur). Deductions therapeutiques. Rev Stom (Paris) 1971 : 72 : 57-76
  13. Cozzani G. Extraoral traction and Class Ill treatment. Am J Orthod 1981 : 80 : 638-50 https://doi.org/10.1016/0002-9416(81)90266-9
  14. Campbell PM. The dilemma of Class Ill treatment: early or late? Angle Orthod 1983 : 53 : 175-91
  15. Nanda R. Biomechanical and clinical considerations of a modified protraction headgear. Am J Orthod 1980 : 78 : 125-39 https://doi.org/10.1016/0002-9416(80)90055-X
  16. Baccetti T, McGillJS, Franchi L, McNamara JA Jr, Tollaro L Skeletal effects of early treatment of Class Ill malocclusion with maxillary expansion and face-mask therapy. Am J Orthod Dentofac Orthop 1998: 113 : 333-43 https://doi.org/10.1016/S0889-5406(98)70306-3
  17. Merwin D, Ngan P, Hiigg D, Yiu C, Wei SHY. Timing for effective application of anteriorly directed orthopedic force to the rnaxilla. Am J Orthod Dentofac Orthop 1997 : 112 : 292-9 https://doi.org/10.1016/S0889-5406(97)70259-2
  18. Kim JH, Viana MAG, Graber TM, Ornerza FF, BeGole EA. The effec-tiveness of protraction face mask therapy: A meta analysis. Am J Orthod Dentofac Orthop 1999 : 115 : 675-85 https://doi.org/10.1016/S0889-5406(99)70294-5
  19. Fishman LS. Radiographic evaluation of skeletal maturation: A clinically orientated method based on hand-wrist films. Angle Orthod 1982 : 52 : 88-112
  20. Ioondeph DR. Early orthodontic treatment. Am J Orthod Dentofac Orthop 1993 : 104 : 199-200 https://doi.org/10.1016/S0889-5406(05)81011-X
  21. Gianelly AA. One-phase versus two-phase treatment. Am J Orthod Dentofac Orthop 1995 : 108 : 556-9 https://doi.org/10.1016/S0889-5406(95)70057-9
  22. Kapust AJ, Sinclair PM, Turley PK. Cephalometric effects of face mask/expansion therapy in Class Ill children: A comparison of three age groups. Am J Orthod Dentofac Orthop 1998 : 113 : 204-12 https://doi.org/10.1016/S0889-5406(98)70141-6
  23. Saadia M, Torres E. Sagittal changes after maxillary protraction with expansion in Class Ill patients in the primary, mixed, and late mixed dentitions: A longitudinal retrospective study. Am J Orthod Dentofac Orthop 2000 : 117 : 669-80 https://doi.org/10.1016/S0889-5406(00)70176-4
  24. Takada K, Petdachai S, Sakuda M. Changes in dentofacial morphology in skeletal Class Ill children treated by a modified maxillary protrac-tion headgear and a chin cup: a longitudinal cephalometric appraisal. Eur J Orthod 1993 : 15 : 211-21
  25. Bj$\"{o}$rk A, Helm S. Prediction of the age of maximum puberal growth in body height. Angle Orthod 1967 : 37 : 134-43
  26. Kuroda T, Natori H, Kawanobe O. Prediction of the age at maximum puberal growth in body height from ossification of the adductor sesamoid of thumb in Japanese children. 日本橋正誌 1969 : 28 : 68-73
  27. Sato K, Abe M, Shirato Y, Mitani H. Standard growth curve of maxi-lla and mandible applied to the growth prediction based on standards of bone age (Tanner-Whitehouse 2 method) for Japanese females. 日本橋正誌 1996 : 55 : 545-8
  28. Iwata R. The relation of complete fusion time on the distal phalanx of the first digit and mandibular growth. 日本橋正誌, 1994 : 53 : 1-9
  29. Bergersen EO. The male adolescent facial growth spurt: its prediction and relation to skeletal maturation. Angle Orthod 1972 : 42 : 319-38
  30. 김경호, 성상진, 박소연 경추골과 수완부골 방사선 사진을 이용한 골성숙도 평가 대치교정지 1998 : 28 : 285-95
  31. 김경호, 백형선, 손은수. 부정교합 분류에 따른 초경시기와 골성숙도에 관한 연구, 대치교정지 1998: 28 : 581-9
  32. Hagg D, Taranger J. Maturation indicators and the pubertal growth spurt. Am J Orthod 1982 : 82 : 299-309 https://doi.org/10.1016/0002-9416(82)90464-X
  33. Salzmann JA. Orthodontics in daily practice. Philadelphia: Lippincott, 1974 : 556-91
  34. Burstone CJ, James RB, Legan H, Murphy GA, Norton LA. Cephalo-metries for orthognathic surgery. J Oral Surg 1978 : 36 : 269-77
  35. Proffit WR, Phillips C, Dann IV C, Turvey TA. Stability after surgical -orthodontic correction of skeletal Class III malocclusion. I. Mandi-bular setback. Int J Adult Orthod Orthognath Surg, 1991 : 6 : 7-18
  36. 김경호, 최광철, 이지연. 한국 아동의 측모두부 수평기준선에 관한 연구 대치교정지 1999 : 29: 251-265
  37. Ishii H, Morita S, Takeuchi Y, Nakamura S. Treatment effect of com-bined maxillary protraction and chincap appliance in severe skeletal Class Ill cases. Am J Orthod Dentofac Orthop 1987 : 92 : 304-12 https://doi.org/10.1016/0889-5406(87)90331-3
  38. Nartallo- Turley P, Turley P. Effects of palatal expansion and face-mask therapy on Class Ill malocclusion. J Dent Res 1996: 75 : 36 Special issue (lADR Abstracts)
  39. 강흥석 상악 전방견인시 악안면골의 초기반응에 관한 Laser Hologra-phy연구, 대치교정지 1988 : 18 : 367-86
  40. Miyasaka-Hiraga J, Tanne K, Nakamura S. Finite element analysis for stress in the craniofacial sutures produced by maxillary protraction forces applied at the upper canines. Br J Orthod 1994 : 21 : 343-8 https://doi.org/10.1179/bjo.21.4.343
  41. Bishara SE, Staley RN. Maxillary expansion: Clinical implications. Am J Orthod Dentofac Orthop 1987 : 91 : 3-14 https://doi.org/10.1016/0889-5406(87)90202-2
  42. 김태우, 장영일, 남동석 Face Mask의 치료 효과에 대한 후향적 고찰, 대치교정지 1996 : 26 : 547-56
  43. 이영지, 차경석, 이진우. 골격성 III급 부정교합 환자에서 상악골 전방견인시 일어나는 골격 변화 양상에 관한 연구, 대치교정지 1998: 28 : 533-46
  44. Tollaro I, Baccetti T, Franchi L., Mandibular skeletal changes induced by early functional treatment of Class III malocclusion: A superim-position study. Am J Orthod Dentofac Orthop 1995 : 108 : 525-32 https://doi.org/10.1016/S0889-5406(95)70053-6
  45. Tollaro I, Baccetti T, Franchi L. Craniofacial changes induced by early functional treatment of Class III malocclusion. Am J Orthod Dentofac Orthop 1996 : 109 : 310-8 https://doi.org/10.1016/S0889-5406(96)70154-3
  46. Melsen B, Melsen F. The postnatal development of the palatomaxillary region studied on human autopsy material. Am J Orthod 1982 : 82 : 329-42 https://doi.org/10.1016/0002-9416(82)90467-5
  47. Kanekawa M, Shimizu N. Age-related changes on bone regeneration in midpalatal suture during maxillary expansion in the rat. Am J Orthod Dentofac Orthop 1998 : 114 : 646-53 https://doi.org/10.1016/S0889-5406(98)70196-9
  48. Revelo B, Fishman LS. Maturational evaluation of ossification of the midpalatal suture. Am J Orthod Dentofac Orthop 1994 : 105 : 288-92 https://doi.org/10.1016/S0889-5406(94)70123-7