• Journal of Oral Medicine and Pain
• /
• 제17권2호
• /
• pp.27-35
• /
• 1992

The purpose of this study was to evaluate the size of the temporomandibular joint space by the increase of the occlusal force on the working side and the non-working side during unilateral biting. For the study, 22 normal adults, age from 23 to 25, who had normal or class I molar relationship and had no symptoms on TMJ area and masticatory muscles were selected. Transcranial TMJ radiograph was taken during unilateral biting with the sensor of occlusal load measuring device (MPM-3000 ; Nihon Kohden Kogyo Co. Ltd., Japan) on 1st molar teeth of right and left side given to force of 0kg, 10kg, 20kg and 30kg respectively with Accurad-200(Denar Corperation's product). The radiographs were traced on the screen, with enlaged as 5 times. The size of temporomandibular joint space at anterior, superior and posterior compartment were measured with Dumas's method (reference line between squamotympanic fissure and the lowest point of articular eminence). The following results were obtained by this study. 1. The size of anterior TMJ space showed a tendency to decrease on the working side and increase on the non-working side by the increase of the occlusal force, but had no statistical significancy (P>0.05). 2. The size of superior TMJ space showed a tendency to increase on the working side and decrease on the non-working side by the increase of the occlusal force (P<0.05). 3. The size of posterior TMJ space showed a tendency to decrease on both working and nonworking side, but had no statistical significancy (P>0.05)

• 대한치과보철학회지
• /
• 제36권2호
• /
• pp.389-423
• /
• 1998

This investigation was designed to determine the effectiveness of the posterior occlusal schemes on masticatory activity during mastication in complete denture. Twelve edentulous subjects were selected for this study. All subjects had no past history and no functional abnormality on masticatory system and TMjoint. And, they had residual ridge of favorable morphology, firm mucosa and Class I skeletal jaw relationship, Twelve experimental denture with interchangeable occlusions(0-degree teeth, 30-degree teeth, Levin teeth and S-A teeth) were constructed for this study. The masticatory performance was analyzed by means of standard sieve(10, 16, 20, 30sieve), and the electrical activity from selected muscles(Temporalis and Masseter muscle) was recorded simultaneously with electromyography (Bio-Pak system) as the subject masticated test foods (rice, peanut and gum) with four different occlusal schemes. Mandibular movement was, also, measured with Sirognathography(Bio-Pak system). These recordings were performed in immediately, after 1 week and after 2 weeks of insertion of complete denture. The results were as fellows; 1. The average masticatory performance of 0-degree artificial teeth was higher than any other artificial teeth. 2. Masticatory performance in denture wearer was affected preferentially by food and artificial occlusal schemes. 3. During chewing, there was a statistical difference of EMG activity between masseter and temporal muscle(p<0.01). Especially, EMG activity of working masticatory muscle was highly affected by food rather than by artificial occlusal schemes. 4. In denture wearer, the velocity of opening was not affected by food, whereas, the velocity of closing was faster in soft food chewing than in hard food chewing, and the amount of vertical displacement was grater in chewing of soft and large bolus than in chewing of hard and small bolus. However, the amount of lateral displacement showed conversely(p<0.05). 5. It was considered that masticatory performance in denture wearer is not affected by the condition of residual ridge. the history of denture wear, the preference, the adaptation to artificial teeth and the total mesiodistal length of artificial posterior teeth.

• 대한치과기공학회지
• /
• 제11권1호
• /
• pp.115-120
• /
• 1989

Many attempts for the compfrt, esthetics and improvement of Masticatory function of the patients with removable prosthesis have been made for several decades. The search for the ideal denture occlusion has been going on in an effort to find the tooth form which provides maximum denture stability and masticatory efficiency without damaging the health of the underlying bone. For the purpose, the basic concept of lingualized occlusion were suggested by payne(1941) and pound(1973) discussed a similar occlusal concept and used term " lingualized occlusion." The purpose of this literature study is to clarify and amplify a method to achieve bilateral balanced occlusion with the occlusal arrangement termed " lingualized occlusion." Lingualized occlusion can be achieved by use of anatomic teeth for the mandibular denture. Lingualized occlusion can be used in most denture combination. It is particulary helpful when the patient places high priority on esthetics but a nonanatomic occlusal scheme is indicated by oral conditions such a severe alveolar resorption, a class II jaw relationship or displaceable supporting tissue. Advantages of lingualized occlusion are summarized as follows : 1) Most of the advantages attributed to both the anatomic and nonanatomic forms are retained. 2) Cusp form is more natural in appearance compare to nonanatomic tooth form. 3) Good pnetration of the food bolus is possible. 4) Bilateral mechanical balanced occlusion is readily obtained for a region around arotric relation. 5) Bertical forces are centralized on the mandibular teeth. Lingualized occlusion provides a useful combination of several occlusal concept. Many. advantages of anatomic and nonanatomic occlusions are accomplished but the lingualized occlusal concept is not is not a panacea, and all other procedures still must be carefully excuted.

• 대한치과보철학회지
• /
• 제34권3호
• /
• pp.539-573
• /
• 1996

This investigation was designed to determine the effectiveness of the posterior occlusal schemes on masticatory activity during mastication in complete denture. Twelve edentulous subjects were selected for this study. All subjects had no past history and no functional abnormality on masticatory system and TMjoint. And, they had residual ridge of favorable morphology, firm mucosa and Class I skeletal jaw relationship, Twelve experimental denture with interchangeable occlusions(0-degree teeth, 30-degree teeth, Levin teeth and S-A teeth) were constructed for this study. The masticatory performance was analyzed by means of standard sieve(10, 16, 20, 30sieve), and the electrical activity from selected muscles(Temporalis and Masseter muscle) was recorded simultaneously with electromyography(Bio-Pak system) as the subject masticated test foods (rice, peanut and gum) with four different occlusal schemes. Mandibular movement was, also, measured with Sirognathography(Bio-Pak system). These recordings were performed in immediately, after 1 week and after 2 weeks of insertion of complete denture. The results were as follows; 1. The average masticatory performance of 0-degree artificial teeth was higher than any other artificial teeth. 2. Masticatory performance in denture wearer was affected preferentially by food and artificial occlusal schemes. 3. During chewing, there was a statistical difference of EMG activity between masseter and temporal muscle(p<0.01). Especially, EMG activity of working masticatory muscle was highly affected by food rather than by artificial occlusal schemes. 4. In denture wearer, the velocity of opening was not affected by food, whereas, the velocity of closing was faster in soft food chewing than in hard food chewing, and the amount of vertical displacement was grater in chewing of soft and large bolus than in chewing of hard and small bolus. However, the amount of lateral displacement showed conversely (p<0.05). 5. It was considered that masticatory performance in denture wearer is not affected by the condition of residual ridge, the history of denture wear, the preference, the adaptation to artificial teeth and the total mesiodistal length of artificial posterior teeth.

• 구강회복응용과학지
• /
• 제37권3호
• /
• pp.157-170
• /
• 2021

구치부 지지 상실과 같은 치아 결손은 불안정한 교합 관계를 야기하고 중심위나 습관적 폐구위에서 하악의 전방 활주 시 전치부에 과도한 하중을 초래하기 쉬워 교합평면이 붕괴되며 교합수직고경의 감소와 악관절 기능 장애까지 나타날 수 있다. 치열궁 크기의 부조화는 전치부와 구치부에서 수직수평적인 관계의 부조화를 유발하며 이로써 나타나는 전치부의 과개교합과 구치부의 가위교합은 불안정한 교합접촉과 충분하지 못한 교합접촉면적을 야기한다. 본 증례는 이와 같은 문제들이 복합적으로 나타나는 환자로 임시보철물을 이용하여 교합수직고경 증가 및 새롭게 설정한 교합평면에 대한 적응을 평가하였고, 교차 모형부착을 이용하여 최종보철물에 반영하여 수복하였다. 그 결과 안정적인 교합과 조화로운 수직수평피개 및 교합평면을 형성하여 기능적, 심미적으로 만족스러운 결과를 얻어 이를 보고하고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제27권4호
• /
• pp.350-359
• /
• 2005

Sagittal split ramus osteotomy(SSRO) has been commonly performed in the mandibular prognathism. The previous studies of the mandibular anatomy for SSRO have mostly been used in dry skull without consideration of age, sex or jaw relationship of patients. This study was performed to evaluate the location of mandibular canal and the anatomy of ramus, such as the location of mandibular lingula and the ramal bone marrow, which were associated with SSRO procedures, in the patients with mandibular prognathism and normal young adults by using computerized tomographs(CT) and 3D images. The young adults at their twenties, who were considered to complete their skeletal growth, and seen in the Department of Orthodontics and Oral and Maxillofacial Surgery in Chonnam National University Hospital between March 2000 and May 2003, were selected. This study was performed in 30 patients (15men, 15women) who were diagnosed as skeletal class I normal relationship, and another 30 patients (15men, 15women) who were diagnosed as skeletal class III relationship upon clinical examination and lateral cephalometric radiographs. The patients were divided into 2 groups : Class I group, the patients who had skeletal class Ⅰ normal relationship(n=30, 15men, 15women), and Class III group, the patients who had skeletal class III relationship(n=30, 15men, 15women). Facial CT was taken in all patients, and pure 3D mandibular model was constructed by V-works version 4.0. The occlusal plane was designed by three points, such as the mesiobuccal cusp of both mandibular 1st molar and the incisal edge of the right mandibular central incisor, and used as a reference plane. Distances between the tip of mandibular lingula and the occlusal plane, the sigmoid notch, the anterior and the posterior borders of ramus were measured. The height of ramal bone marrow from the occlusal plane and the distance between mid-point of mandibular canal and the buccal or lingual cortex of the mandible in the 1st and 2nd molars were measured by V-works version 4.0. Distance(Li-OP) between the occlusal plane and the tip of mandibular lingula of Class III Group was longer than that of Class I Group in men(p<0.01), but there was no significant difference in women between both groups. Distance(Li-SN) between the sigmoid notch and the tip of mandibular ligula of Class III group was longer than that of Class I Group in men(p<0.05), but there was no significant difference in women between both groups. Distance(Li-RA) between the anterior border of ramus and the tip of mandibular lingula of Class III Group was shorter than that of Class I Group in men and women(p<0.01). Distance(Li-RP) between the posterior border of ramus and the tip of mandibular lingula of Class III Group was slightly shorter than that of Class I Group in men(p<0.05), but there was no significant difference in women between both groups. Distance(RA-RP) between the anterior and the posterior borders of ramus of Class III Group was shorter than that of Class I Group in men and women(p<0.01). Longer the distance(SN-AN) between the sigmoid notch and the antegonial notch was, longer the vertical ramal length above occlusal plane, higher the location of mandibular lingula, and shorter the antero-posterior ramal length were observed(p<0.01). Height of ramal bone marrow of Class III Group was higher than that of Class I Group in men and women(p<0.01). Distance between mandibular canal and buccal cortex of Class III Group in 1st and 2nd lower molars was shorter than that of Class I Group in men and women (p<0.05 in 1st lower molar in men, p<0.01 in others). These results indicate that there are some anatomical differences between the normal occlusal patients and the mandibular prognathic patients, such as the anterior-posterior length of ramus, the height of ramal bone marrow, and the location of mandibular canal.

• 대한치과교정학회지
• /
• 제41권3호
• /
• pp.154-163
• /
• 2011

본 연구는 교합 상태를 객관적이고 정량적으로 평가하기 위해 개발된 American Board of Orthodontics objective grading system (ABO-OGS)을 이용하여 교정치료 후 나타나는 재발 경향을 평가하고 이에 영향을 줄 수 있는 요소들과의 상관관계를 알아보고자 시행되었다. 부산대학교, 경희대학교와 단국대학교 치과병원 교정과에서 포괄적 교정치료를 받은 환자 중 치료종료 후 2년 이상의 유지기간을 갖는 80명의 환자를 대상으로 초진 시(T1)의 peer assessment rating (PAR) index, 치료 후(T2)와 유지 후(T3) 시기의 ABO-OGS를 측정하여 T2와 T3 간의 변화 양상을 각 항목별로 측정하였고, 나이, 성별, Angle 분류, 발치 여부, 유지기간, 초진 시의 상태와의 상관관계를 조사하기 위해 다중 회귀분석을 시행하여 다음과 같은 결과를 얻었다. T2 시기와 비교하여 T3 시기에 ABO-OGS의 7개 항목 중 치아 배열(alignment)은 악화되었으며, 교합 접촉(occlusal contact)과 치간 접촉(interproximal contact)은 개선되었고, 나머지 4개의 항목에서는 유의한 차이가 없었다. 다중 회귀분석을 시행한 결과, 유의한 회귀모형은 치아 배열(alignment), 교합 관계(occlusal relationship), 수평피개(overjet), 치간 접촉(interproximal contact) 항목이었으나, 회귀 모형들의 설명력이 낮았으며, 연령, 성별, Angle 분류, 발치 여부, 유지기간, 초진시의 상태(initial PAR index, T1)는 T2 시기와 T3 시기의 ABO-OGS 변화량을 설명하는 데 큰 영향을 미치지는 않는 것으로 보인다.

• 대한치과보철학회지
• /
• 제54권2호
• /
• pp.132-139
• /
• 2016

교합의 점진적인 마모는 연령이 증가함에 따라 진행되는 정상적인 과정이다. 하지만 교합면의 마모가 과도하게 진행되어 수직 교합 고경이 감소하고 교합 평면이 붕괴된 경우에는 병적인 치수 상태, 교합 부조화, 기능적 장애 및 심미적인 문제가 나타날 수 있다. 치아를 수복할 공간이 부족하거나 교합 관계를 수정하기 위해서는 수직 교합 고경의 변경이 필요하다. 수직 고경을 변화시킬 경우, 수복 치료를 시작하기 전에 신중한 진단이 필수적이며 1 - 3개월 간 임시 수복물을 이용하여 근 신경계의 적응 범위를 벗어나지 않는지 평가를 한 후 최종 수복을 하여야 한다. 본 증례의 환자는 다수 치아들의 심한 마모가 있는 78세 남성 환자로서 수직 교합 고경의 평가 후 상악 전치부의 심미적인 외형 확보 및 교합관계, 교합평면의 개선을 위하여 최소한의 수직교합고경의 거상을 통하여 임시치아를 제작, 약 12주간의 적응기간 후 최종수복물을 제작하였다. 최종 수복물 장착 후 1년여의 경과 관찰 결과 새로 형성한 교합이 안정적으로 유지되었으며 특이할만한 합병증은 없었다. 이러한 일련의 치료과정을 통해 심미적, 기능적으로 만족할 만한 결과를 얻었기에 이를 보고하는 바이다.

• 대한소아치과학회지
• /
• 제29권4호
• /
• pp.586-591
• /
• 2002

이갈이(bruxism)는 일반적으로 주간의 이악물기(clenching)와 야간의 이갈이(grinding)를 포함하는데 이악물기는 상하악의 정적인 관계에서 대합하는 치열이 힘있게 다물어지는 것을 의미하고 이갈이는 하악의 편심운동시에 상하악이 동적인 관계에서 힘 있게 다물어지는 것을 의미한다. 이갈이의 원인은 아직까지 정확하게 밝혀진 것은 없지만 가장 큰 요인으로 정서적 스트레스를 들 수 있고, 수면장애나 약물, 중추신경장애 등을 원인으로 볼 수 있다. 이갈이의 치료는 근본적인 치료법은 아직까지 없으나 정서적 스트레스를 감소시키고, 교합조정이나 교합안정장치, 약물요법, 물리치료 등을 통해서 이갈이의 증상 및 징후를 치료하는 것이 치료의 목표가 된다. 본 증례는 이갈이를 주소로 내원한 환자에서 교합안정장치를 통하여 이갈이가 감소하는 결과를 얻었기에 보고하는 바이다.

• 대한치과보철학회지
• /
• 제54권1호
• /
• pp.65-71
• /
• 2016

치아 교합면의 점진적인 마모는 나이가 들면서 진행되는 정상적인 과정이다. 그러나 과도한 마모는 병적인 치수 상태, 교합 부조화, 기능 장애 및 심미적인 문제를 가져온다. 치아 수복을 위한 공간 확보, 심미성 증진, 또는 교합관계를 수정하기 위해서는 수직고경 변경을 고려하여야 하는데 환자의 심미적 요구와 술자의 기능적 목표를 최소침습적으로 달성하는 것을 충족시키는 범위 내에서 수직고경을 결정하고 새로운 수직고경에 대한 적응 평가를 함께 이루어야 한다. 그리고 과피개 교합 문제는 단순히 피개 교합의 정도에 국한된 문제라기 보다는 전후방적인 교합 문제를 복합적으로 지니고 있는 경우가 많다. 이러한 고려사항을 생각해 보았을 때 근본적인 문제 해결을 위해서는 악골 및 치아의 전후방적인 관계 개선과 더불어 결손부의 적절한 수복이 뒤따라야 한다. 본 증례는 67세 남자 환자로 다수 치아 마모와 구치부 상실된 환자로 수직고경의 증가를 동반하여 하악 무치악 부위는 가철성 국소의치, 상하악 유치악 부위는 고정성 보철물로 수복을 하였으며, 이에 기능적, 심미적으로 만족스러운 결과를 얻었기에 증례를 보고하고자 한다.