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성장기 아동의 single tooth scissors bite의 교정 치료: 증례 보고

ORTHODONTIC TREATMENT OF SINGLE TOOTH SCISSORS BITE IN GROWING CHILDREN: CASE REPORTS

  • 김지인 (서울대학교 치의학대학원 소아치과학교실) ;
  • 현홍근 (서울대학교 치의학대학원 소아치과학교실) ;
  • 김영재 (서울대학교 치의학대학원 소아치과학교실) ;
  • 김정욱 (서울대학교 치의학대학원 소아치과학교실) ;
  • 장기택 (서울대학교 치의학대학원 소아치과학교실) ;
  • 이상훈 (서울대학교 치의학대학원 소아치과학교실) ;
  • 한세현 (서울대학교 치의학대학원 소아치과학교실) ;
  • 김종철 (서울대학교 치의학대학원 소아치과학교실)
  • Kim, Ji-In (Department of Pediatric Dentistry, School of Dentistry, Seoul National University) ;
  • Hyun, Hong-Keun (Department of Pediatric Dentistry, School of Dentistry, Seoul National University) ;
  • Kim, Young-Jae (Department of Pediatric Dentistry, School of Dentistry, Seoul National University) ;
  • Kim, Jung-Wook (Department of Pediatric Dentistry, School of Dentistry, Seoul National University) ;
  • Jang, Ki-Taeg (Department of Pediatric Dentistry, School of Dentistry, Seoul National University) ;
  • Lee, Sang-Hoon (Department of Pediatric Dentistry, School of Dentistry, Seoul National University) ;
  • Hahn, Se-Hyun (Department of Pediatric Dentistry, School of Dentistry, Seoul National University) ;
  • Kim, Chong-Chul (Department of Pediatric Dentistry, School of Dentistry, Seoul National University)
  • 투고 : 2011.08.27
  • 심사 : 2011.11.15
  • 발행 : 2011.11.30

초록

중심교합위의 상태에서 편측 혹은 양측으로 상악 구치부의 치아가 하악 구치부의 협측으로 위치한 경우를 scissors bite라고 한다. 이는 상악의 폭경이 크거나 하악의 폭경이 좁은 경우 발생한다. Scissors bite의 경우 방치하게 되면 하악의 성장이 방해받게 되고 그 결과, 악궁 폭경의 부조화가 심해져 저작 장애를 일으킬 수 있으므로 조기 차단 교정이 반드시 필요하다. 실제 임상에서는 여러 치아의 scissors bite보다 최후방 구치 혹은 그 외 하나의 구치만의 single tooth scissors bite(STSB)을 보이는 경우가 많다. 이러한 STSB의 경우도 방치하게 되면 저작력으로 인하여 구치의 각도가 더욱 악화되므로 즉각적인 치료가 필요하다. 본 증례에서는 STSB를 보이는 7세, 14세, 12세, 16세의 환자에게 각각 criss-cross elastic, 고정성 장치, 가철성 장치, miniscrew를 사용하여 치료한 증례를 보고하였다. 각 환자의 증례에 적합한 장치를 잘 선택하여 사용한다면 치아를 정출시키는 등의 부작용을 야기하지 않고 양호한 결과를 얻을 수 있을 것이다.

A scissors bite in the posterior teeth occurs when the upper teeth are positioned totally buccal to the lower teeth in centric occlusion, either unilaterally or bilaterally. This malocclusion can result from either excessive width of the maxilla or deficient width of the mandible, or sometimes combination of the both. Scissors bite, when left untreated without a proper dental intervention, interferes with the normal mandibular growth leading to a state where consequent disharmony in dental arch width evokes occlusal disturbances. Therefore, early preventive orthodontic treatment is necessary in patients with scissors bite. Scissors bite rarely involves anterior and posterior sites concuttently across the dental arch but usually affect single tooth. Even in the single tooth scissors bite cases, more likely to be met in the clinical fields, immediate dental intervention is indicated because continuous occlusal forces that exacerbate the already adverse axis of the posterior teeth. In this case study, patients with single tooth scissors bite, each 7, 14, 12, and 16 years old, were each treated with criss-cross elastic, fixed appliance, removable appliance, and miniscrews. With the proper selection of appliances appropriate to each specific cases, good treatment outcome can be achieved without resulting any side effects.

키워드

참고문헌

  1. Yun SW, Lim WH, Chong DR, Chun YS : Scissors-bite correction on second molar with a dragon helix appliance. Am J Orthod Dentofacial Orthop, 132:842-847, 2007. https://doi.org/10.1016/j.ajodo.2006.03.029
  2. 문성권, 김정욱, 이상훈 등 : 유치열에서 scissors bite의 치료에 대한 증례보고. 대한소아치과학회지, 33:311-316, 2006.
  3. Valencia RM : Treatment of unilateral buccal cross-bites in the primary, early mixed, and permanent dentitions: case reports. J Clin Pediatr Dent, 31:214-218, 2007.
  4. Gellin ME : Treatment and retention of a mandibular arch telescoped within the maxillary arch: case report. Pediatr Dent, 13:167-169, 1991.
  5. van der Linden FP, Boersma H : Diagnosis and treatment planning in dentofacial orthopedics. Quintessence publishing co., London, UK, 265-267, 1987.
  6. Ogihara K, Nakahara R, Koyanagi S, Suda M : Treatment of a Brodie bite by lower lateral expansion: a case report and fourth year follow-up. J Clin Pediatr Dent, 23:17-21, 1998.
  7. King JW, Wallace JC : Unilateral Brodie bite treated with distraction osteogenesis. Am J Orthod Dentofacial Orthop, 125:500-509, 2004. https://doi.org/10.1016/j.ajodo.2003.07.005
  8. Harper DL : A case report of a Brodie bite. Am J Orthod Dentofacial Orthop, 108:201-206, 1995. https://doi.org/10.1016/S0889-5406(95)70084-6
  9. 김종철, 황현식, 김광원 등 : 부정교합의 진단과 치료계획, 군자출판사, 서울, 240-241, 1995.
  10. Dolce C : Correction of posterior crossbite. N Y State Dent J, 62:50-52, 1996.
  11. Nakamura S, Miyajima K, Nagahara K, Yokoi Y : Correction of single-tooth crossbite. J Clin Orthod, 29:257-262, 1995.
  12. Proffit WR : Contemporary orthodontics, fourth edition. Mosby. St Louis, 660-661, 2008.
  13. Quinn GW : Extraction of four second molars. Angle Orthod, 55:58-69, 1985.
  14. Moffitt AH : Eruption and function of maxillary third molars after extraction of second molars. Angle Orthod, 68:147-152, 1998.
  15. Bishara SE, Orthod D, Burkey PS : Second molar extractions : a review. Am J Orthod, 89:415-424, 1986. https://doi.org/10.1016/0002-9416(86)90073-4
  16. Orton-Gibbs S, Crow V, Orton HS : Eruption of third permanent molars after the extraction of second permanent molars. Part 1 : Assessment of third molar position and size. Am J Orthod Dentofacial Orthop, 119:226-238, 2001. https://doi.org/10.1067/mod.2001.111556
  17. Kucher G, Weiland FJ : Goal-oriented positioning of upper second molars using the palatal intrusion technique. Am J Orthod Dentofacial Orthop, 110:466-468, 1996. https://doi.org/10.1016/S0889-5406(96)70051-3
  18. Hwang HS, Lee KH : Intrusion of overerupted molars by corticotomy and magnets. Am J Orthod Dentofacial Orthop, 120:209-216, 2001. https://doi.org/10.1067/mod.2001.115149
  19. 박효상 : Micro-implant를 이용한 교정치료. 대한나래출판사, 서울, 122-127, 2006.
  20. Tamamura N, Kuroda S, Sugawara Y, et al. : Use of palatal miniscrew anchorage and lingual multi-bracket appliances to enhance efficiency of molar scissors-bite correction. Angle Orthod, 79:577-584, 2009. https://doi.org/10.2319/031708-152.1
  21. Lim KF : Correction of posterior single-tooth cross-bite. J Clin Orthod, 30:276, 1996.
  22. 김상민, 박호원, 이주현, 서현우 : 성장기 아동에서 miniscrew를 고정원으로 이용한 치아이동. 대한소아치과학회지, 37:537-544, 2010.