대한치과교정학회지 (The korean journal of orthodontics)

  • 제35권2호
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  • Pages.91-105
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  • 2005
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  • 2234-7518(pISSN)
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  • 2005-372X(eISSN)
대한치과교정학회 (The Korean Association Of Orthodontists)
권호 표지

안면비대칭 진단을 위한 하악골 3차원영상 계측기준치에 관한 연구

A study on the 3-D standard value of mandible for the diagnosis of facial asymmetry

  • 안정순 (전남대학교 치과대학 교정학교실) ;
  • 이기헌 (전남대학교 치의학연구소, 치과대학 교정학교실) ;
  • 황현식 (전남대학교 치의학연구소, 치과대학 교정학교실)
  • Ahn, Jeong-Soon (Department of Orthodontics, School of Dentistry, Chonnam National University) ;
  • Lee, Ki-Heon (Department of Orthodontics, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Hwang, Hyeon-Shik (Department of Orthodontics, School of Dentistry, Dental Science Research Institute, Chonnam National University)
  • 발행 : 2005.04.01
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초록

기존의 2차원적 진단자료는 상의 확대 및 왜곡으로 인해 형태나 크기의 정량적 평가시 부적절한 결과를 야기할 수 있어 안면비대칭의 정확한 진단과 치료계획 수립을 위해서는 3차원영상 진단의 도입이 필요하다. 본 연구는 안면비대칭 진단시 3차원적 분석에 도움이 되는 기준자료를 얻고자 정상교합자를 대상으로 하악골 3차원 영상 계측항목의 평균값과 좌우차이의 정상범주를 알아보기 위하여 시행되었다 뚜렷한 안면비대칭을 보이지 않는 성인 정상교합자 남녀 30명씩 총 80명을 대상으로 두경부 전산화단층사진을 촬영한 후 컴퓨터프로그램을 이용한 각각의 단면 촬영영상 정보를 이용하여 3차원 입체영상을 재구성한 다음, 하악골 비대칭시 좌우차이를 보일 수 있는 계측항목으로 ramus length를 나타내는 5개 condylar neck length를 나타내는 1개, mandibular body length를 나타내는 8개 등 15개의 거리 계측항목과, gonial angle을 나타내는 4개. frontal ramal inclination을 나타내는 2개. lateral ramal inclination을 나타내는 2개 등 8개의 각도계측항목, 총 23개의 계측항목을 설정한 후, 좌측과 우측을 구분하여 컴퓨터 상에서 3차원계측치를 구하고 좌우차이값을 산출하였다. 본 연구결과 얻어진 정상교합자의 하악골 3차원영상 계측항목의 좌우차이값은 안면비대칭 환자의 진단 기준치로 유용하게 사용될 수 있을 것이다.

For af accurate diagnosis and treatment planning of facial asymmetry, the use of 3-dimensional (3-D) image is indispensable. The purpose of this study was to get standard data for the 3-D analysis of facial asymmetry Computerized tomography (CT) was taken in the 60 normal occlusion individuals (30 male. 30 female) who did not have any apparent facial asymmetry. The acquired 2D CT DICOM data were input on a computer, and the reformatted 3-D images were created using a 3-D image software. Twenty three measurements were established in order to evaluate asymmetry; 15 ;omear measurements (6 for ramus length. 1 for condylar neck length, and 8 for mandibular body length) and 8 angular measurements (4 for gonial angle. 2 for frontal ramal inclination. and 2 for lateral ramal inclination) The right aid left difference of each measurement was calculated and analyzed. It is suggested that the right and left differences of the measurements obtained from the study could be used as references for the diagnosis of facial asymmetric patients.

키워드

참고문헌

  1. Farkas LG, Cheung G. Facial asymmetry in healthy North American Caucasians. An anthropometrical study. Angle Orthod 1981;51:70-7
  2. Vazquez F, Grostic JD, Fonder AC, DeBoer KF. Eccentricity of the skull. Correlation with dental malocclusion. Angle Orthod 1982;52:144-58
  3. Sutton PH, Lateral facial asymmetry - Methods of assessment. Angle Orthod 1968;38:82-92
  4. Arnett GW, Bergman RT. Facial keys to orthodontic diagnosis and treatment planning. Part I. Am J Orthod Dentofacial Orthop 1993;103:299-312 https://doi.org/10.1016/0889-5406(93)70010-L
  5. Bishara SE, Jorgensen GJ, Jakobsen JR. Changes in facial dimensions assessed from lateral and frontal photographs. Part I - Methodology. Am J Orthod Dentofacial Orthop 1995;108:389-93 https://doi.org/10.1016/S0889-5406(95)70036-6
  6. Bishara SE, Jorgensen GJ, Jakobsen JR. Changes in facial dimensions assessed from lateral and frontal photographs. Part II Results and conclusions. Am J Orthod Dentofacial Orthop 1995;108:489-99 https://doi.org/10.1016/S0889-5406(95)70049-8
  7. 이계형, 조홍규, 황현식, 김종철. 얼굴 비대칭 인지도와 정면 머리방사선 사진 계측항목간의 관련성 연구. 체질인류학회지 1998;11:41-8
  8. Fisher B. Asymmetries of the dentofacial complex. Angle Orthod 1954;24:179-92
  9. Letzer GM, Kronman JH. A posteroanterior cepha]omettic evaluation of craniofacial asymmetry. Angle Orthod 1967;37:205-11
  10. Hewitt AB. A radiographic study of facial asymmetry. Br J Orthod 1975;2:37-40 https://doi.org/10.1179/bjo.2.1.37
  11. Vig PS, Hewitt AB. Asymmetry of the human facial skeleton. Angle Orthod 1975;45:125-9
  12. Grummons DC, Kappeyne van de Coppello MA. A frontal asymmetry analysis. J Clin Orthod 1987;21:448-65
  13. Peck S, Peck L, Kataja M. Skeletal asymmetry in esthetically pleasing faces. Angle Orthod 1991;61:43-8
  14. Athanasiou AE, Droschl H, Bosch C. Data and patterns of transverse dentofacial structure of 6- to 15-year-old children: A posteroanterior cephalometric study. Am J Orthod Dentofacial Orthop 1992;101:465-71 https://doi.org/10.1016/0889-5406(92)70121-P
  15. Bishara SE, Burkey PS, Kharouf JG. Dental and facial asymmetries: a review. Angle Orthod 1994;64:89-98
  16. Grayson BH, McCarthy JG, Bookstein F. Analysis of craniofacial asymmetry by multiplane cephalometry. Am J Orthod 1983;84:217-24 https://doi.org/10.1016/0002-9416(83)90129-X
  17. Bawmind S, Moffitt FH, Curry S. Three-dimensional x-ray stenometry from paired coplanar images: a progress report. Am J Orthod 1983;84:292-312 https://doi.org/10.1016/S0002-9416(83)90346-9
  18. Baumrind S, Moffitt FH, Curry S. The geometry of three-dimensional measurement from paired coplanar x-ray images. Am J Orthod 1983;84:313-22 https://doi.org/10.1016/S0002-9416(83)90347-0
  19. Moss JP, Linney AD, Grindrod SR, Arridge SR, Clifton JS. Three-dimensional visualization of the face and skull using computerized tomography and laser scanning techniques. Eur J Orthod 1987;9:247-53 https://doi.org/10.1093/ejo/9.1.247
  20. Grayson B, Cutting C, Bookstein FL, Kim H, McCarthy JG. The three-dimensional cephalogram: theory, technique, and clinical application. Am J Orthod Dentofacial Orthop 1988;94:327-37 https://doi.org/10.1016/0889-5406(88)90058-3
  21. Bookstcin FL, Grayson B, Cutting CD, Kim HC, MacCarthy JG. Landmarks in three dimension: reconstruction from cephalograms versus direct observation. Am J Orthod Dentofacial Orthop 1991;100:133-40 https://doi.org/10.1016/S0889-5406(05)81520-3
  22. Ferrario VF, Sforza C, Poggio CE, Tartaglia G. Distance from symmetry: a three-dimensional evaluation of facial asymmetry. J Oral Maxillofac Surg 1994;52:1126-32 https://doi.org/10.1016/0278-2391(94)90528-2
  23. Ferrario VF, Sforza C, Puleo A, Poggio CE, Schmitz JH. Three-dimensional facial morphometry and conventional cephalometries: a correlation study. Int J Adult Orthod Orthognath Surg 1996;11:329-38
  24. Kusnoto B, Evans CA, BeGole EA, de Rijk W. Assessment of 3-dimensional computer-generated cephalometric measurements. Am J Orthod Dentofacial Orthop 1999;116:390-9 https://doi.org/10.1016/S0889-5406(99)70223-4
  25. Carls FR, Schuknecht B, Sailer HF. Value of three-dimensional computed tomography in crarllomaxillofacial surgery. J Crarllofac Surg 1994;5:282-8 https://doi.org/10.1097/00001665-199411000-00003
  26. Santler G, Karcher H, Ruda C. Indications and limitations of three-dimensional models in cranio-maxillofacial surgery. J Cranio-Maxillofac Surg 1998;26:11-6 https://doi.org/10.1016/S1010-5182(98)80029-2
  27. Peck H, Peck S. A concept of facial esthetics. Angle Orthod 1970;40:284-318
  28. 황현식, 이기현, 박지영, 강병철, 박재우, 이종석. 안면비대칭 진단을 위한 새로운 정모 두부 방사선 규격사진 분석시스템 개발. 대치협회지 2004;42:219-31
  29. 김은희, 황현식. 정모 두부 방사선 사진 촬영시 Head Posture Aligner의 유용성에 관한 연구. 대치교정지 2000;30:543-52
  30. 김관모, 이기헌, 김왕식, 황현사. 정모 두부방사선규격사진 분석 시 기준선 설정 방법에 관한 비교 연구. 대치협회지 2001;39:676-83
  31. 김고운. 전산화단층사진을 이용한 하악골 3차원 영상에서 비대칭진단 계측항목의 재현도에 관한 연구. 석사학위논문 전남대학교 대학원, 광주;2003
  32. 안정순, 황현식. 안면비대칭에 대한 주관적 인지도와 정모두부방사선사진 분석치의 연관성. 대치교정지 2001;31:489-98
  33. Shah SM, Joshi MR. An assessment of asymmetry in the normal craniofacial complex. Angle Orthod 1978:48:141-8
  34. Bergersen EO. Enlargement and distortion in cephalometric radiography: compensation tables for linear measurements. Angle Orthod 1980;50;23044
  35. Tsao DH, Kazanoglu A, McCasland JP. Measurability of radiographic images. Am J Orthod 1983:84:212-6 https://doi.org/10.1016/0002-9416(83)90128-8
  36. Jarvinen S. A study of the factors causing differences in the relative variability of linear radiographic cephalometric measurements. Am J Orthod Dentofacial Orthop 1987;92:17-23 https://doi.org/10.1016/0889-5406(87)90291-5
  37. 구본찬. 두부방사선규격사진과 광학사진의 중첩적합도에 관한 측면 합성영상과 정면 합성영상의 비교. 박사학위논문, 연세대학교 대학원, 서울; 2003
  38. Vannier MW, Marsh JL, Warren JO. Three dimensional CT reconstruction images for craniofacial surgical planning and evaluation. Radiology 1984;150:179-84 https://doi.org/10.1148/radiology.150.1.6689758
  39. Darling CF, Byrd SE, Allen ED, Radkowski MA, Wilczynski MA. Three-dimensional computed tomography imaging in the evaluation of craniofacial abnormalities. J Natl Med Assoc 1994;86:676-80
  40. Fuhrmann RA, Schnappauf A, Diedrich PH. Three-dimensional imaging of craniomaxillofacial structures with a standard personal computer. Dentomaxillofac Radiol 1995;24:260-3 https://doi.org/10.1259/dmfr.24.4.9161172
  41. Quintero JC, Trosien A, Hatcher D, Kapila S. Craniofacial imaging in orthodontics: historical perspective, current status, and future devclopments. Angle Orthod 1999;69:491-506
  42. Kalender WA, Polacin A, SUss C. A comparison of conventional and spiral CT an experimental study on the detection of spherical lesions. J Comput Assist Tomogr 1994:18:167-76 https://doi.org/10.1097/00004728-199403000-00001
  43. Stoler A. Helical CT scanning for CAD/CAM subperiosteal implant constmction. J Oral Implantol 1996;22:247-57
  44. Vannier MW, Hildebolt CF, Conover G, Knapp RH, Yokoyama-Crothers N, Wang G. Three-dimensional dental imaging by spiral CT A progress report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997:84:561-70 https://doi.org/10.1016/S1079-2104(97)90274-2
  45. Kobayashi F, Ito J, Hayashi T, Maeda T. A study of volumetric visualization and quantitative evaluation of bone trabeculae in helical CT. Dentomaxillofac Radiol 2003;32:181-5 https://doi.org/10.1259/dmfr/28959099
  46. Ericson S, Kurol J. CT diagnosis of ectopically erupting maxillary canines - a case report. Eur J Orthod 1988;10:115-120 https://doi.org/10.1093/ejo/10.1.115
  47. Freisfeld M, Dahl IA, Jager A, Drescher D, Schuller H. X -ray diagnosis of impacted upper canines in panoramic radiographs and computed tomographs. J Orofac Orthop 1999;60:177-84 https://doi.org/10.1007/BF01365264
  48. Fuhrmann R, Feifel H, Schnappauf A, Diedrich P. Integration of three-dimensional cephalometry and 3D-skull models in combined orthodontic/surgical treatment planning. J Orofac Orthop 1996;57:32-45 https://doi.org/10.1007/BF02189047
  49. 윤일선, 이기헌, 황현식. 군집분석법에 의한 안면비대챙의 분류. 대치협회지 2001;39:765-73
  50. Epker BN, Stella JP, Fish LC. Diagnosis and treatment planning for correction of asymmetric dentofacial deformities. In: Dentofacial deformities. Integrated orthodontics and surgical correction. St. Louis: Mosby; 1999;1855-71
  51. Snodell SF, Nanda RS, Currier GF. A longitudinal cephalometric study of transverse and vertical craniofacial growth. Am J Orthod Dentofacial Orthop 1993;104:471-83 https://doi.org/10.1016/0889-5406(93)70073-W
  52. Ferrario VF, Sforza C, Miani A, Tartaglia G. Craniofacial morphometry by photographic evaluations. Am J Orthod Dentofacial Orthop 1993;103:327-37 https://doi.org/10.1016/0889-5406(93)70013-E