• Title/Summary/Keyword: 교합 조정

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교합과 저작근 활동

  • Kim, Jung-Su
    • The Journal of the Korean dental association
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    • v.25 no.10 s.221
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    • pp.913-916
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    • 1987
  • 저작운동을 중추신경계와 말초조직의 작용에의해 일생동안 학습과 적응의 가정을 통해 이루어진다. 저작의 양상은 유치가 구강내에 맹출되면서 이루어지며, 상하악 치아의 접촉, 점막과 혀 및 치아상호간에 일어나는 접촉과 치근막의 고유수용기와 악관절 수용기등에 의해 조정되어 최종적으로 에너지소비가 적고 동통이나 불편함이 없이 최대의 효율을 나타내는 양상으로 된다. 그러나 원활한 저작과 하악은동을 이룩하기 위해서는 저작근, 악관절, 상하악 치아의 교합등이 서로 조화를 이루어야 한다. 만일 외상에 의해 악관절의 기능장애가 오면 저작근활동이 변화하고 이에따라 교합장애를 야기한다. 또한 치아를 상실하거나 대합치아간의 조기접촉이 있으면 교합장애가 원인이 되어 근육활동이 변화와 악관절 기능장애를 초래한다. 그리고 때로는 지나친 근육의 활동(이갈이, 지속적 긴장성 수축)에 의해 지나친 치아의 마모로인한 교합장애나 악관절장애를 일으킬 수 있다. 따라서 하악의 기능을 충분히 이해하기 위해서는 교합의 형태학적 관계와 더불어 저작계의 기능적인 면도 고려하여 그 상호관계를 검토하여야 하며 본문에서는 교합에 관련된 저작근의 작용과 이에 영향을 주는 요인 및 교합장애와 근육활동장애의 연관성에 관해 고찰코자 한다.

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Rehabilitation with orthognathic surgery and orthodontic treatment in patient with severe occlusal disharmony: A case report (심한 교합 부조화를 보이는 환자에서 악교정수술 및 교정치료를 동반한 구강회복: 증례 보고)

  • Jung-Jin Lee;Kwang-Yeob Song;Seung-Geun Ahn;Ju-Mi Park;Jae-Min Seo
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.3
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    • pp.204-214
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    • 2023
  • The occlusal treatment including prosthetic treatment should be considered when the pathologic symptom was observed with the excessive discrepancy between the centric relation occlusion (CRO) and the maximum intercuspal position (MIP). Through careful diagnosis, the malocclusion and interarch relationship can be analyzed, and occlusal adjustment, restorative treatment, orthodontic therapy, or orthognathic surgery can be performed depending on the degree of disharmony. The patient in this case report complained the unstable occlusion and loss of masticatory function that had been occurring for several years. At the time of the visit, the patient showed severe occlusal disharmony, with only the upper right second molar contacting the lower jaw at the maximum intercuspal position. Based on the analysis of the occlusion, it was difficult to solve the problem with just occlusal adjustment or restorative treatment. In addition, the patient had the skeletal class II malocclusion between the upper and lower jaws. Therefore, for resolving the severe skeletal class II malocclusion, pre- and post-orthodontic treatment, bilateral sagittal split ramus osteotomy (BSSRO) was performed. After that, the occlusal adjustment was performed for stable occlusion, and the missing teeth area was restored with dental implants. During the follow-up period, a periodic follow-up visits and additional occlusal adjustments were performed to achieve a stable centric occlusion and harmonious anterior and lateral guidance. As a result, the final prosthodontic treatment was completed, and the patient's masticatory function was restored.

Initial Placement of Removable Partial Dentures (가철성 국소의치의 장착)

  • Shin, Soo-Yeon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.3
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    • pp.299-307
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    • 2013
  • The overall objective of fitting removable partial dentures at initial placement is to ensure that the patient is given the best possible start with the new prostheses. This may be achieved by checking that: (1) final inspection of the prosthesis, (2) seating of the RPD framework, (3) evaluation of denture base adaptation, (4) assessment of denture base peripheral extensions, (5) occlusal adjustment, (6) remounting the prosthesis, and (7) instructions to the patient.

Occlusal rehabilitation of post-traumatic malocclusion patient after reduction of panfacial fracture, using selective occlusal adjustment and implant prostheses on centric relation: a case report (다발성 안면 골절의 정복 후 발생한 부정교합 상태의 환자를 중심위에서 선택적 교합 조정 및 임플란트 보철수복으로 교합관계를 회복시킨 증례)

  • Dae-Kyun Kim;So-Young Park;Jung-Jin Lee;Yeon-Hee Park;Kyoung-A Kim;Jae-Min Seo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.204-213
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    • 2023
  • Invasive or non-invasive reduction of fractures could be conducted as treatments of traumatic maxillofacial bone fractures. But when suboptimal reduction or malunion of maxillofacial bone fracture occurs, malocclusion could occur as a result of the lost relationship of the mandible and midface. This malocclusion is called post-traumatic malocclusion and orthognathic surgery, orthodontic treatment, selective grinding and prosthetic reconstruction are suggested as treatments for post-traumatic malocclusion after securement of stable TMJ. Stable TMJ is essential for occlusal rehabilitation to prevent occlusal change and relapse of malocclusion. Centric relation and adapted centric posture are suggested as start points of occlusal rehabilitation because they are most stable TMJ position. This case report presents a case in which post-traumatic malocclusion occurred after reduction of panfacial fracture. To rehabilitate full mouth occlusion, selective grinding and prosthetic reconstruction of implant supported fixed prostheses were conducted in centric relation and showed satisfying results in functional and occlusal aspects.

A Literature Review on Trauma from Occlusion (교합성 외상에 관한 논쟁의 고찰)

  • Park, Go-Woon;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.4
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    • pp.423-436
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    • 2011
  • Trauma from occlusion (TFO) is a pathologic alterations which develop in the periodontium as a result of undue masticatory force. The purpose of this article is to review the controversies about TFO. There are evidences that TFO is a risk factor in the progression of periodontitis. Tooth mobility should be reduced by selective occlusal adjustment. TFO can be developed dependent on the masticatory pattern, occlusion and anterior overbite in sound periodontal conditions. Secondary TFO may aggravate unstable occlusion. If "loss of posterior support" was occur, the problems were worsen. Extrusion, migration, rotation and pathologic deviation can be resulted. Opposite contention is the "shortened dental arch" concept. However, these two concepts persue the occlusal stability together. To treat TFO adequately, exact diagnosis and multi-disciplinary treatment should be needed.