DOI QR코드

DOI QR Code

Intrusion of the extruded maxillary central incisor using skeletal anchorage system and unilateral segmental intrusion arch

골성 고정원과 편측 분절호선을 이용한 정출된 상악 중절치의 압하 치료

  • Kwon, Eun-Young (Dental Clinic Center, Pusan National University Hospital) ;
  • Baek, Young-Jae (Dental Clinic Center, Pusan National University Hospital) ;
  • Park, Soo-Byung (Department of Orthodontics, School of Dentistry, Pusan National University) ;
  • Kim, Seong-sik (Department of Orthodontics, School of Dentistry, Pusan National University) ;
  • Kim, Yong-il (Department of Orthodontics, School of Dentistry, Pusan National University) ;
  • Choi, Youn-kyung (Dental Clinic Center, Pusan National University Hospital)
  • 권은영 (부산대학교병원 치과진료센터) ;
  • 백영재 (부산대학교병원 치과진료센터) ;
  • 박수병 (부산대학교 치의학전문대학원 치과교정과) ;
  • 김성식 (부산대학교 치의학전문대학원 치과교정과) ;
  • 김용일 (부산대학교 치의학전문대학원 치과교정과) ;
  • 최윤경 (부산대학교병원 치과진료센터)
  • Received : 2019.05.27
  • Accepted : 2019.07.16
  • Published : 2019.09.30

Abstract

Patients who have a moderate periodontitis with pathologic tooth migration of maxillary incisors, it is necessary not only periodontal treatment for reduce periodontal inflammation, but also orthodontic treatment to teeth repositioning. For orthodontic treatment, it is necessary to apply less force and careful considerations of the center of resistance of the tooth and optimal force of tooth movement. At this time, the segmental arch applied only to the target teeth, is more effective and predictable, because applied force and direction can be controlled. In addition, to design the orthodontic appliance that can prevent the unwanted tooth movement that used as an anchorage is important. In recent years, various types of skeletal anchorage system have been used for preventing loss of the anchorage. We reported the patient who had extruded maxillary central incisor due to pathologic tooth migration, treated by a successful periodontal-orthodontic multidisciplinary treatment using an orthodontic appliance designed to apply less traumatic force and reduce an anchorage loss.

병적 치아 이동된 상악 전치를 가진 중등도 치주염 환자에서는 치태 관리를 통한 치주 염증의 해소뿐만 아니라 치아를 재위치 시키기 위한 교정치료가 함께 필요하다. 이 때의 교정치료는 더 적은 힘의 적용과 치아의 저항중심, 최적의 힘 등을 세심하게 고려해야 하는데, 이동하고자 하는 치아에만 적용되는 분절호선은 이동의 예측성을 높여주고, 힘을 조절할 수 있어 보다 효율적이다. 또한 교정치료 시, 고정원으로 사용되는 치아의 원치 않는 움직임을 차단하여 구치 교합 상태를 유지할 수 있는 장치 설계가 필요하며, 이를 위해 다양한 종류의 골성 고정원이 사용될 수 있다. 본 증례에서는 정출되고 변위된 상악 전치를 가진 환자에서, 철저한 치주 치료와 적절한 힘과 역학이 설계된 교정 장치로, 양호한 치료 결과를 얻을 수 있었으므로, 소개하고자 한다.

Keywords

References

  1. Disease Statistics. Healthcare Bigdata Hub. Wonju: Healthcare Insurance Review & Assessment Service. Available from: http://opendata.hira.or.kr/op/opc/olapHifrqSickInfo.do (updated 2019 May 24).
  2. Melsen B. Adult Orthodontics: Aetiology. 3rd ed. West Sussex; Wiley-Blackwell; 2012. p. 48-50.
  3. Proffit WR, Field HW, Sarver DM. Contemporary Orthodontics. 4th ed. New York; Elsevier; 2007. p.142-4.
  4. Towfighi PP, Brunsvold MA, Storey AT, Arnold RM, Willman DE, McMaham CA. Pathologic migration of anterior teeth in patients with moderate to severe periodontitis. J Periodontol 1997;68:967-72. https://doi.org/10.1902/jop.1997.68.10.967
  5. Artun J, Urbye KS. The effect of orthodontic treatment on periodontal bone support in patients with advanced loss of marginal periodontium. Am J Orthod Dentofac Orthop 1988;93:143-8. https://doi.org/10.1016/0889-5406(88)90292-2
  6. Melsen B, Agerbaek N, Erikson J, Terp S. New attachment through periodontal treatment and orthodontic intrusion. Am J Orthod Dentofac Orthop 1988;94:104-16. https://doi.org/10.1016/0889-5406(88)90358-7
  7. Erkan M, Pikdoken L, Usumez S. Gingival response to mandibular incisor intrusion. Am J Orthod Dentofacial Orthop 2007;132:143.e9-13. https://doi.org/10.1016/j.ajodo.2006.10.015
  8. Ericsson I, Thilander B, Lindhe J, Okamoto H. The effect of orthodontic tilting movements on the periodontal tissures of infected and non-infected dentitions in dogs. J Clin Periodontol 1977;4:278-93. https://doi.org/10.1111/j.1600-051X.1977.tb01900.x
  9. Melsen B, Agerbaek N, Markenstam G. Intrusion of incisors in adult patients with marginal bone loss. Am J Orthod Dentofacial Orthop 1989;96:232-41. https://doi.org/10.1016/0889-5406(89)90460-5
  10. Ryph P. Ultrastructural vascular changes in pressure zones of rat molar periodontium incident to orthodontic movement. Scand J Dent Res 1972;80:307-21.
  11. Weltman B, Vig KW, Fields HW, Shanker S, Kaizar EE. Root resorption associated with orthodontic tooth movement: a systematic review. Am J Orthod Dentofacial Orthop 2010;137:462-76. https://doi.org/10.1016/j.ajodo.2009.06.021
  12. Mostafa YA, Iskander KG, El-Mangoury NH. Iatrogenic pulpal reactions to orthodontic extrusion. Am J Orthod Dentofac Orthop 1991;99:30-4. https://doi.org/10.1016/S0889-5406(05)81677-4
  13. Steigman S, Michaeli Y. Experimental intrusion of rat incisors with continuous loads of varying magnitude. Am J Orthod 1981;80:429-36. https://doi.org/10.1016/0002-9416(81)90177-9
  14. Thilander B. Orthodontic tooth movement in peri-Intrusion of the extruded maxillary central incisor using skeletal anchorage system and unilateral segmental intrusion arch odontal therapy. In: Textbook of Clinical Periodontology. Copenhagen; Munksgaard; 1989. p. 450-500.
  15. Alstad S, Zachrisson BU. Longitudinal study of periodontal condition associated with orthodontic treatment in adolescents. Am J Orthod 1979;76:277-86. https://doi.org/10.1016/0002-9416(79)90024-1
  16. Re S, Corrente G, Abundo R, Cardaropoli D. Orthodontic treatment in periodontally compromised patients: 12-year report. Int J Periodontics Restorative Dent 2000;20:31-9.
  17. Burstone CJ, Goldberg AJ. Maximum forces and deflections from orthodontic appliances. Am J Orthod 1983;84:95-103. https://doi.org/10.1016/0002-9416(83)90173-2
  18. Burstone CR. Deep overbite correction by intrusion. Am J Orthod 1977;72:1-22. https://doi.org/10.1016/0002-9416(77)90121-X
  19. Reitan K. Tissue rearrangement during retention of orthodontically rotated teeth. Angle Orthod 1959;29:105-13.
  20. Ericsson I, Thilander B. Orthodontic relapse in dentitions with reduced periodontal support: an experimental study in dogs. Eur J Orthod 1980;2:51-7. https://doi.org/10.1093/ejo/2.1.51