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Orthodontic Treatment Combined with Occlusal Splint in Regressive Condyle Resorption Patients (퇴행성 과두 흡수 환자에서 교합 안정장치 병용 교정치료)

  • Tae, Ki-Chul
    • Journal of Dental Rehabilitation and Applied Science
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    • v.23 no.1
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    • pp.1-10
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    • 2007
  • 악관절 잡음과 동통,과두 흡수를 동반한 퇴행성 측두하악장애는 교합 불안정과 개구장애 를 동반하기도 한다. 진단을 위해 CT나 MRI를 이용해 과두 형태 및 디스크 위치를 파악하 는 것이 유용한 접근법이다. 퇴행성 측두하악관절 환자는 CT나 MRI를 이용하여 진단하고, 과두-원판 재위치와 근 기능 개선을 위해 장기간 교합 안정장치 사용이 필요하므로 교정치료 기간에 변형된 교합 안정장치의 병용이 필요하다. 이에 본 연구에서 교합 안정장치를 병용하여 교합 재구성 증례를 CT나 MRI로 고찰해 보고자 한다.

EVALUATION OF CONDYLAR POSITION USING COMPUTED TOMOGRAPH FOLLOWING BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY (전산화단층촬영법을 이용한 하악 전돌증 환자의 하악지 시상 골절단술후 하악과두 위치변화 분석)

  • Chol, Kang-Young;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.570-593
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    • 1996
  • This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after BSSRO in 20 patients(males 9, females 11) using computed tomogram that were taken in centric occlusion before, immediate, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period intermaxillary fixation, 24hour after removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.45{\pm}4.01mm$ and horizontal long axis of condylar angle was $11.89{\pm}5.19^{\circ}$on right, $11.65{\pm}2.09^{\circ}$on left side and condylar lateral poles were located about 12mm and medial poles about 7mm from reference line(AA') on the axial tomograph. Mean intercondylar distance was $84.43{\pm}3.96mm$ and vertical axis angle of condylar angle was $78.72{\pm}3.43^{\circ}$on right, $78.09{\pm}6.12^{\circ}$on left. 2. No statistical significance was found on the condylar change(T2C-T1C) but it had definitive increasing tendency. There was significant decreasing of the distance between both condylar pole and the AA'(p<0.05) during the long term(TLC-T2C). 3. On the lateral cephalogram, no statistical significance was found between immediate after surgery and 24 hours after the removing of intermaxillary fixation but only the lower incisor tip moved forward about 0.33mm(p<0.05). Considering individual relapse rate, mean relapse rate was 1.2% on L1, 5.0% on B, 2.0% on Pog, 9.1% on Gn, 10.3% on Me(p<0.05). 4. There was statistical significance on the influence of the mandibular set-back to the total mandibular relapse(p<0.05). 5. There was no statistical significance on the influence of the mandibular set-back(T2-T1) to the condylar change(T2C-T1C), the condylar change(T2C-T1C, TLC-T2C) to the mandibular total relapse, the pre-operative condylar position to the condylar change(T2C-T1C, TLC-T2C), the pre-operative mandibular posture to the condylar change(T2C-T1C, TLC-T2C)(p>0.05). 6. The result of multiple regression analysis on the influence of the pre-operative condylar position to the total mandibular relapse revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condyalr head long axis angle, the more increasing of mandibular horizontal relapse(L1,B,Pog,Gn,Me) on the right side condyle. The same result was founded in the case of horizontal relapse(L1,Me) on the left side condyle.(p<0.05). 7. The result of multiple regression analysis on the influence of the pre-operative condylar position to the pre-operative mandibular posture revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condylar head long axis angle, the more increasing of mandibular vertical length on the right side condyle. and increasing of vertical lengh & prognathism on the left side condyle(p<0.05). 8. The result of simple regression analysis on the influence of the pre-operative mandibular posture to the mandibular total relapse revealed that the more increasing of prognathism, the more increasing of mandibular total relapse in B and the more increasing of over-jet the more increasing of mandibular total relapse(p<0.05). Consequently, surgical mandibular repositioning was not significantly influenced to the change of condylar position with condylar reposition method.

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FUNCTIONAL TREATMENT OF PEDIATRIC CONDYLAR FRACTURES : A CASE REPORT (Activator를 이용한 소아의 하악과두골절의 치험례)

  • Lee, Jung-Ha;Park, Heon-Dong;Lee, Sang-Ho;Lee, Nan-Young
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.3
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    • pp.477-482
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    • 2003
  • The pediatric condylar fracture occurs very frequently in the mandible, but this injury is occasionally ignored due to difficulty of diagnosis and no cooperation of patient. The adequate initial diagnosis and active treatment must be performed because delayed and improper treatment lead to possible severe complication such as TMJ ankylosis and reta rdation of mandibular development. Most pediatric condylar fracture is mainly performed by the conservative or functional treatment, but it may be required open reduction according to cases. In this study, activator is applied for functional treatment of pediatric condylar fracture and fair recovery of jaw function is acquired.

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A STUDY OF CONDYLAR POSITIONAL CHANCES BEFORE & AFTER STABILIZATION SPLINT THERAPY (교합안정장치 사용 전, 후의 하악과두 위치 변화에 관한 연구)

  • Lee, Suk-Kyung;Yoon, Young-Jooh;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.28 no.1 s.66
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    • pp.113-122
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    • 1998
  • Stabilization splint therapy Precedes orthodontic intervention to enable the operator to find a 'true' centric(which is stable and comfortable), to test the patient's response to a change in the occlusion, prior to embarking upon a complex course of occlusal therapy : and finally, to see if the centric relation position can be stabilized. For this study, 47 malocclusion Patients enrolled for orthodontic treatment at the Department of Orthodontics, College of Dentistry, Chosun University comprised the malocclusion group, little variation of growth factor by the second molar eruption. They had Cr-Co discrepancy beyond normal range. For each patients the stabilization splint with mutually protected type of occlusal scheme was applied for 3 months. Condylar positions in CR and CO were measured using Penadent articulators, Panadent condylar position indicator(CPI), and transcranial projection before & after stabilization splint therapy. On the basis of this study, the results of this study were as follows 1. In all samples using CPI, there were statistical significances in CR-CO discrepancy(p<0.001) both before 8t after stabilization splint therapy. 2. In Rt and Lt+Rt/2 of superior joint space using transcranial projection, there were statistical significances in CR-CO discrepancy({<0.05) before & after stabilization splint therapy. 3. In supero-inferior components using CPI, there were statistical significances in CR-CO discrepancy(p<0.01) before & after stabilization splint therapy. 4. In all components except Rt using transcranial projection, there were no statistical significances in CR-CO discrepancy(p>0.05) before & after stabilization splint therapy. To sum up, CPI might be more effective than transcranial projection to reveal the changes between CR-CO discrepancies and stabilization splint might be more useful appliance for displaying the vertical changes, than the antero-posterior changes, of condylar position.

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SURGICAL CORRECTION OF SEVERE MANDIBULAR PROGNATHISM BY OBWEGESER II AND RIGID INTERNAL FLXATION (심한 하악골 전돌증 환자의 외과적 치험례)

  • Lee, Geon-Ho;Kwon, Dae-Geon;Jang, Do-Geon;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.1
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    • pp.33-42
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    • 1994
  • Obwegeser II method and Rigid fixation conserving the condylar position has been performed on 5 patients with severe mandibular prognathism, and we obtained the result after the follow up study follows. 1. Obwegeser II method is considered to move the distal segment passively when surgical correction of severe open bite correction and large amount of set back above 15mm is needed. 2. In one case that has more change of condylar position after operation, documented immediate post-operative relapse have been occurred 3. In the others that have adequate control of condylar position, passive set back and firm skeletal fixation, more functional and esthetic improvement and more post-operative stability has been achieved

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CONSERVING THE CENTRIC RELATION POSITION OF CONDYLAR HEAD WITH MINI-HOFFMANN SETS IN VERTICAL RAMUS OSTEOTOMY (하악골 수직골절단술시 MINI-HOFFMANN SETS을 이용한 하악 과두의 중심위의 보존)

  • Jeong, Inn-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.95-99
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    • 1991
  • Several authors have proposed techniques and devices by which the correct position of the proximal segment can be maintained both during fixation and postoperatively. Schendel, Epker, Lake, Worms, Ive and Poulton have been discussed the problem of condylar distration in mandibular orthognathic surgery. This study described have showed the some advantages forward repositioning of the condyle head in vertical ramus osteotomy which used with the Mini-Hoffmann sets in external skeletal pin fixation extraorally in 19 cases.

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Clinical Assessment, Panoramic and MRI Findings and Cephalometric Characteristics of Patients with Condylar Resorption (과두흡수환자의 자기공명영상 사진 평가 및 악안면 골격형태에 대한 연구)

  • Jang, Heon-Su;Hur, Yun-Kyung;Kim, Kyun-Yo;Ko, Yu-Jeong;Chae, Jong-Moon;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.409-420
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    • 2009
  • The aim of this study was to investigate clinical assessment, panorama & MRI findings and cephalometric characteristics in 42 patients with condylar resorption, who visited in the Department of Oral Medicine Kyungpook National University Hospital at 2006. The results were as follows; 1. Clinical assessment 1) Female was 34 and male was 8, females were predominant. Distribution of age showed as follows; 10s was 14, 20s was 13, 30s was 7, 40s was 3, 50s was 4 and 60s was 1 patient. 10s and 20s were predominant. 2) Most of the patients had parafunctional habit. 2. Findings of panorama & MRI 1) Most of the patients had degree of Grade II condylar resorption by panorama taking. 2) Most of the patients had disc dislocation and belonged to the degree of stage IV by MRI taking. 3. Cephalometric Characteristics 1) SN, SAr and saddle angle in female patients were significantly smaller and SN in male patients showed only significantly smaller than normal group. 2) SNA showed no difference from the normal group in both patients. SNB was smaller and ANB was lager in female patients than normal group. 3) SN-GoMe and FMA increased in patients. 4) Total posterior facial height & ramus height were significantly smaller. 5) Mandibular body length did not show any significant difference.

A POSITIONAL ANALYSIS OF MANDIBULAR CONDYLE ON THE SUBMENTOVERTEX RADIOGRAPH FOR DIAGNOSIS OF TEMPOROMANDIBULAR JOINT DYSFUNCTION (악관절기능장애 진단을 위한 두부축방향 방사선사진에서의 하악과두의 위치분석)

  • Kim Seok-Ho;Choi Soon-Chul;Byun Jong-Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.21 no.1
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    • pp.73-81
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    • 1991
  • The purpose of this study was to analyze the position of mandibular condyle on the submentovertex radiograph, thereafter to evaluate the usefulness of submentovertex radiograph in diagnosis of temporomandibular joint dysfunction, and to check the best method of tomographic techniques. Submentovertex radiographs which were taken in 75 temporomandibular joint dysfunction patients and 75 normal persons were used as the sample for this study. The obtained results were as follows: The submentovertex radiograph was a improper method in diagnosis of temporomandibular joint dysfunction and discrimination of affected side. The selective tomography was a better method than any other tomographic techniques in diagnosis of temporomandibular joint dysfunction.

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EVALUATION OF ARTIFICIAL OSTEOPHYTE II\i l\iiANDIBUlAR CONDYLES USlhlG PANORAMIC RADIOGRAPHY (파노라마를 이용한 하악과두에 인위적으로 형성한 골증식체의 평가)

  • Park Myung Hee;Choi Soon Chul
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.22 no.1
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    • pp.77-84
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    • 1992
  • The purpose of this study was to evaluate the diagnostic value of panoramic radiography for diagnosis of temporomandibular joint. Five dry skulls were selected for this study and artificial osteophyte was attached to four different areas of the mandibular condylar head. And then, the author had taken panoramic radiographs with the head in conventional position, 25㎜ forward position and reverse position in mouth opening state. Three dental radiologists evaluated the radiographic images of osteophyte in 60 panoramic radiographs. The results were as follows: In conventional position, osteophyte on the anterolateral and anterocentral area of the condylar head was best seen (p<0.01). In 25㎜ forward position, osteophyte on the anterocentral and anteromedial area was best seen (p<0.05). In reverse position, osteophyte on the anterocentral area was best seen (p<0.05). Osteophyte on anteromedial area was better seen in 25㎜ forward position than in conventional position (p<0.05).

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THE POSTOPERATIVE CONDYLAR POSITION RELATED TO TEMPOROMANDIBULAR DISCOMFORT IN SAGITTAL SPLIT RAMUS OSTEOTOMY (하악지 시상 분할술에 있어 술후 하악과두의 위치와 측두 하악관절장애)

  • You, Jun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.2
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    • pp.130-134
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    • 1997
  • The sagittal split ramus osteotomy(SSRO) of the mandible has used one of the most popula methods for the correction of various dentofacial deformities, especially mandibular prognathism. In SSRO, there are produced bony gap following mandible setback because of mandibular flaring. For this reason, the condylar axis may be changed due to bony approximation both segment in three dimension more mesio-laterally. According to change of condylar position, the condition of TMJ structure are changed and change of TMJ symptoms are suggested theoretically, and the correction of malocclusion by SSRO may improve the TMJ symptoms by improvement of feeding difficulties. The pupose of this study was to determine relationship between expected alterations in condylar position and suggested TMJ symptoms produced by change of condylar position. TMJ symptoms of 15patients who had operated SSRO are checked at about postoperative 6 month ranging $5{\sim}11$ month. Anterior-posterior position of condyle which was comparison preoperative with postoperative position, was classified 5 groups. The author tried to identify relationship between positional change of condyle and TMJ discomfort.

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