The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Assessment of antero-posterior skeletal relationships in adult Korean patients in the natural head position and centric relation

자연 두부 위치 및 안정위에서 한국 성인 환자 골격의 전.후 관계 결정

  • Ahn, Jang-Hoon (Department of Orthodontics, Kangnam Sacred Heart Hospital, Hallym University) ;
  • Bae, Kwang-Hak (Department of Preventive Dentistry, School of Dentistry, Seoul National University) ;
  • Park, Young-Ju (Department of Oral and Maxillofacial Surgery, Kangnam Sacred Heart Hospital, Hallym University) ;
  • Hong, Ryoon-Ki (Department of Orthodontics, Chong-A Dental Hospital) ;
  • Nam, Joeng-Hun (Department of Oral and Maxillofacial Surgery, Kangnam Sacred Heart Hospital, Hallym University) ;
  • Kim, Mi-Ja (Department of Orthodontics, Hangang Sacred Heart Hospital, Hallym University)
  • Received : 2010.02.10
  • Accepted : 2010.06.14
  • Published : 2010.12.31
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Abstract

Objective: This study aimed to verify the intra-individual reproducibility of the natural head position (NHP) in adult Korean patients in the centric relation (CR) position and to prove the inter-individual variability of the Frankfurt horizontal (FH) plane and sella-nasion (SN) line compared to the true horizontal line (THL). In addition, the study aimed to investigate the correlations between linear measurements from A-point and B-point to the nasion true vertical line (NTVL) and angular measurements from A-point and B-point to the SN line. Methods: Two lateral cephalograms were taken of 116 subjects (23 males, 93 females) with CR wax bites in a NHP at a one-week interval. Results: Method errors of three variables and intraclass correlation coefficients of six parameters proved the intra-individual reproducibility of NHP (p < 0.001). The angle of the FH to the THL was not significantly different from $0^{\circ}$ (p > 0.05), but it was clinically variable (SD $3.89^{\circ}$) on the inter-individual level. Conversely, the angle of the SN line to the THL was significantly different from $7^{\circ}$ (p < 0.05). Very low correlation was found between the linear measurements and angular measurements of A-point and B-point (p < 0.01). Conclusions: The NTVL could be a useful reference line for assessing the antero-posterior position of the maxilla and mandible of Korean adult patients in NHP and CR.

SN 기준선과 FH 기준선이 안모의 심미에 종종 맞지 않아서 모든 치열 교정 및 악교정 수술 증례를 이 기준선을 이용하여 반복적으로 정확히 진단하기가 매우 어렵다. 따라서, 이 연구의 목적은 한국 성인 환자를 대상으로 안정위에서 자연 두부 위치의 개인내 재현성을 확인하고 진성 수평선에 대해 SN 기준선과 FH 기준선의 개인간 다양성을 증명하는 것이다. 그러고, 상기 두 연구를 바탕으로 Na 기준 진수선에서 A점 및 B점까지의 거리가 SNA 및 SNB 각도와 상관 관계가 있는지 여부를 조사하는 것이다. 부정교합 및 악골의 부조화를 치료받기 위해 강남성심병원과 한강성심병원 교정과에 내원한 116 명의 환자(남자 23명, 여자 93명)를 조사하였다. 중심위 왁스 바이트는 모든 대상들로부터 채득하였고 1주일 간격으로 자연 두부 위치와 중심위 상태에서 모든 대상자들의 측모두부방사선사진을 2번 촬영하였다. 3개의 변수에서 위치 선정의 방법 오류는 다른 연구에 비해 낮은 수치를 보였다. 그리고 6개의 변수에서 군내 상관계수를 이용하여 자연두부 위치의 개인간 재현성을 증명하였다 (p < 0.001). 각 환자에서 진성 수평선에 대한 FH 기준선간의 각도는 통계적으로 기준치 0도와 다르지 않았다 (p > 0.05). 하지만 임상적으로 다양한 수치를 보였다 (SD: $3.89^{\circ}$). 반면 각 에서 진성 수평선에 대한 SN 기준선간의 각도는 기준치 7도와 매우 다르게 나타났다 (p < 0.05). Na 기준 진수선에서 A점 및 B점까지의 거리와 SNA 및 SNB 각도와의 피어슨 상관 계수에서 유의하지만 매우 낮은 수치를 보였다 (p < 0.01). 이에 자연 두부 위치는 치열 교정 환자 및 악교정 수술 환자의 진단을 위해 재현적이고 믿을 만한 위치이며 자연두부 위치 및 중심위 상태에서 Na 기준 진수선은 SN과 FH기준선을 대신하여 한국인 성인 환자에서 상악쿨과 하악골의 전후 관계를 결정하는데 매우 유용한 기준선으로 이용될 수 있을 것으로 생각한다.

Keywords

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