Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
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MAXILLARY MOLAR DISTALIZATION WITH THE BONE-SUPPORTED PENDULUM

Bone-supported pendulum을 이용한 상악대구치 원심이동

  • Jang, Yong-Gul (Department of pediatric dentistry, College of dentistry, Kangnung-Wonju national university) ;
  • Park, Ho-Won (Department of pediatric dentistry, College of dentistry, Kangnung-Wonju national university) ;
  • Lee, Ju-Hyun (Department of pediatric dentistry, College of dentistry, Kangnung-Wonju national university) ;
  • Seo, Hyun-Woo (Department of pediatric dentistry, College of dentistry, Kangnung-Wonju national university)
  • 장용걸 (강릉.원주 대학교 치과대학 소아치과학교실) ;
  • 박호원 (강릉.원주 대학교 치과대학 소아치과학교실) ;
  • 이주현 (강릉.원주 대학교 치과대학 소아치과학교실) ;
  • 서현우 (강릉.원주 대학교 치과대학 소아치과학교실)
  • Published : 2009.08.31
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Abstract

To distalize the maxillary molars, the traditional techniques such as extra-oral traction, Wilson distalizing arches, removable spring appliances and Schwarz plate-type appliances have been used. But, these need considerable patient cooperation. For minimal patient compliance, many practitioners use the pendulum appliances. Several clinical studies demonstrated pendulum is effective molar distalization appliance in the growing patient(using the premolars and the palate as anchorage). But unfortunately, maxillary anterior teeth also shift mesially as the molar moves distally. As a result anchorage loss is occurred. To overcome these disadvantages, we used bone-supported pendulum, combined the conventional pendulum with Skeletal Anchorage System(SAS). The miniscrew was implanted in the anterior paramedian region of the median palatal suture, which has comparatively sufficient bone thickness and is low risk to damage on the dental follicles. We report three cases, using bone-supported pendulum for the maxillary molar distalization in children. After treatment, we find out anchorage stability, minimal unfavorable anterior tooth movement and sufficient molar distalization.

상악 대구치의 원심이동이 요구되는 경우, 구외견인, Wilson distalizing arches, 가철식 스프링 장치 그리고 Schwarz plate-type 장치 등을 사용 할 수 있다. 그러나 이러한 전통적인 대구치의 원심이동 장치들로 치료에 성공하기 위해서는 환자의 협조가 필수적이기 때문에 많은 소아치과 의사들은 환자 의존성을 최소화하고 임상가가 통제 할 수 있는 장치들로 전환하고 있다. 이 중 가장 일반적인 것이 pendulum 장치인데, 고정원이 되는 전방치아의 원하지 않는 이동과 고정원 소실, 그리고 구개부 고정원이 좋지 않은 경우 원하는 정도의 구치부 원심이동을 얻기 어렵다는 단점이 있다. 이와 같은 전통적인 pendulum의 단점을 해결하고자, SAS(Skeletal Anchorage System)를 pendulum에 접목하여 골에서 직접 지지를 얻는 변형된 형태의 pendulum, 즉 bone-supported pendulum을 제작하여 장착 시킨 후 주기적인 관찰을 시행하였다. 본 증례는 혼합치열기 환자를 대상으로 bone-supported pendulum을 사용하여 안정된 고정원 유지, 원치 않는 치아이동의 최소화 및 양호한 상악 대구치 원심이동 등을 관찰하였기에 이를 보고하는 바이다.

Keywords

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