Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of Facemask Therapy for Class III Malocclusions in Patients with Different Vertical Skeletal Patterns

3급 부정교합 환자의 수직적 골격 양상에 따른 facemask 치료 효과 비교

  • Lee, Eunha (Department of Pediatric Dentistry, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Kitae (Department of Pediatric Dentistry, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 이은하 (성균관대학교 의과대학 삼성서울병원 치과진료부 소아치과) ;
  • 박기태 (성균관대학교 의과대학 삼성서울병원 치과진료부 소아치과)
  • Received : 2014.10.17
  • Accepted : 2014.12.02
  • Published : 2015.05.31
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study was to evaluate the skeletal and dentoalveolar effects of facemask therapy and to compare the anchorage of a bonded expander in patients with Class III malocclusion and different vertical skeletal patterns. Twenty subjects with Class III malocclusion were included in this study and were treated with a facemask and bonded expander. Based on the FMA, subjects were divided into two groups of 10 patients each: a high vertical group (HV; mean FMA $33.56^{\circ}$) and an average vertical group (AV; mean FMA $24.88^{\circ}$). Lateral cephalograms were taken and evaluated before and after treatment. In both groups, forward movement of the maxilla and backward rotation of the mandible were observed after treatment, with no statistical differences between the groups. Vertical skeletal variables increased in both groups, but the increase of FMA was significantly larger in the HV group than the AV group. Mesial movement of maxillary molars and proclination of maxillary incisors which indicate anchorage loss of bonded expander were observed in both groups, with no significant differences between the groups. In conclusion, facemask therapy resulted in effective maxillary protraction in both HV and AV groups. However, the open bite tendency was increased more in the HV group.

본 연구의 목적은 3급 부정교합 환자에서 facemask 치료 시 수직적 골격 양상에 따른 치료 효과를 비교하고, 구내 장치로서 bonded expander의 고정원을 평가하는 것이다. Facemask 치료를 받은 20명의 환자를 대상으로 FMA를 기준으로 두 군으로 분류하였고(HV군; FMA > $27^{\circ}$, AV군; $23^{\circ}$ < FMA < $27^{\circ}$), 치료 전과 후 측모두부방사선사진을 촬영하여 계측치를 비교하였다. 치료 후 두 군 모두 상악의 전방이동 및 하악의 후하방 회전이 관찰되었고, 두 군간에 유의한 차이는 없었다. 두 군 모두 수직적 골격 계측치가 증가하였고, FMA의 증가량은 HV군이 AV군에 비해 유의하게 크게 관찰되었다. 고정원 소실로서 상악구치의 근심이동 및 상악 전치의 전방경사가 관찰되었고, 두 군간에 유의한 차이는 없었다. 결론적으로 수직적 골격 양상에 따라 상악의 전방이동 및 고정원 소실면에서는 유의한 차이가 없었으나, HV군에서 수직적 성장 경향이 더 증가하였다.

Keywords

References

  1. Deguchi T, Kuroda T, Minoshima Y, et al. : Craniofacial features of patients with Class III abnormalities: growth-related changes and effects of short-term and long-term chincup therapy. Am J Orthod Dentofacial Orthop, 121:84-92, 2002. https://doi.org/10.1067/mod.2002.120359
  2. Saadia M, Torres E : Sagittal changes after maxillary protraction with expansion in class III patients in the primary, mixed, and late mixed dentitions: a longitudinal retrospective study. Am J Orthod Dentofacial Orthop, 117:669-680, 2000. https://doi.org/10.1016/S0889-5406(00)70176-4
  3. Tollaro I, Baccetti T, Franchi L : Mandibular skeletal changes induced by early functional treatment of Class III malocclusion: a superimposition study. Am J Orthod Dentofacial Orthop, 108:525-532, 1995. https://doi.org/10.1016/S0889-5406(95)70053-6
  4. Ellis E, 3rd, McNamara JA, Jr. : Components of adult Class III malocclusion. J Oral Maxillofac Surg, 42:295-305, 1984. https://doi.org/10.1016/0278-2391(84)90109-5
  5. Guyer EC, Ellis EE, 3rd, McNamara JA, Jr., et al. : Components of class III malocclusion in juveniles and adolescents. Angle Orthod, 56:7-30, 1986.
  6. Sar C, Arman-Ozcirpici A, Uckan S, et al. : Comparative evaluation of maxillary protraction with or without skeletal anchorage. Am J Orthod Dentofacial Orthop, 139:636-649, 2011. https://doi.org/10.1016/j.ajodo.2009.06.039
  7. Baccetti T, McGill JS, Franchi L, et al. : Skeletal effects of early treatment of Class III malocclusion with maxillary expansion and face-mask therapy. Am J Orthod Dentofacial Orthop, 113:333-343, 1998. https://doi.org/10.1016/S0889-5406(98)70306-3
  8. Macdonald KE, Kapust AJ, Turley PK : Cephalometric changes after the correction of class III malocclusion with maxillary expansion/facemask therapy. Am J Orthod Dentofacial Orthop, 116:13-24, 1999. https://doi.org/10.1016/S0889-5406(99)70298-2
  9. Lee C, Kim J, Kwon S : Face mask therapy in early mixed dentition. J Korean Acad Pediatr Dent, 28: 643-648, 2001.
  10. Kim S, Yang K : Case reports on treatment of skeletal Class III malocclusion with RME and facemask. J Korean Acad Pediatr Dent, 25:604-612, 1998.
  11. Yoshida I, Shoji T, Mizoguchi I : Effects of treatment with a combined maxillary protraction and chincap appliance in skeletal Class III patients with different vertical skeletal morphologies. Eur J Orthod, 29: 126-133, 2007. https://doi.org/10.1093/ejo/cjl087
  12. Koh SD, Chung DH : Comparison of skeletal anchored facemask and tooth-borne facemask according to vertical skeletal pattern and growth stage. Angle Orthod, 84: 628-633, 2014. https://doi.org/10.2319/060313-421.1
  13. Sassouni V : A classification of skeletal facial types. Am J Orthod, 55:109-123, 1969. https://doi.org/10.1016/0002-9416(69)90122-5
  14. Geron S, Shpack N, Kandos S, et al. : Anchorage loss-a multifactorial response. Angle Orthod, 73: 730-737, 2003.
  15. Moon YM, Ahn SJ, Chang YI : Cephalometric predictors of long-term stability in the early treatment of Class III malocclusion. Angle Orthod, 75:747-753, 2005.
  16. Tahmina K, Tanaka E, Tanne K : Craniofacial morphology in orthodontically treated patients of class III malocclusion with stable and unstable treatment outcomes. Am J Orthod Dentofacial Orthop, 117: 681-690, 2000. https://doi.org/10.1016/S0889-5406(00)70177-6
  17. Merwin D, Ngan P, Hagg U, et al. : Timing for effective application of anteriorly directed orthopedic force to the maxilla. Am J Orthod Dentofacial Orthop, 112:292-299, 1997. https://doi.org/10.1016/S0889-5406(97)70259-2
  18. Ngan P, Yiu C, Hu A, et al. : Cephalometric and occlusal changes following maxillary expansion and protraction. Eur J Orthod, 20:237-254, 1998. https://doi.org/10.1093/ejo/20.3.237
  19. Tanne K, Miyasaka J, Yamagata Y, et al. : Three-dimensional model of the human craniofacial skeleton: method and preliminary results using finite element analysis. J Biomed Eng, 10:246-252, 1988. https://doi.org/10.1016/0141-5425(88)90006-4
  20. Hirato R : An experimental study on the center of resistance of the nasomaxillary complex. 2-dimensional analysis of the coronal plane in the dry skull. Shikwa Gakuho, 84:1225-1262, 1984.
  21. Tanne K, Hiraga J, Sakuda M : Effects of directions of maxillary protraction forces on biomechanical changes in craniofacial complex. Eur J Orthod, 11: 382-391, 1989. https://doi.org/10.1093/oxfordjournals.ejo.a036010