• 대한심미치과학회지
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• 제29권2호
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• pp.84-91
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• 2020

치주질환으로 손상된 치간유두의 재생은 아주 도전적인 과제이다. 지금까지 많은 치과의사들이 훌륭한 수술적인 방법을 고안하여 소개하였다. 지금까지 소개된 술식들을 순서대로 비교해보고 장단점을 비교해 치간유두를 재생을 위한 최적의 방법을 고안해보았다. 치주수술만으로 해결하기 어려운 좁은 치간유두 사이의 공간을 부분교정치료를 통하여 공간을 일시적으로 만들어 주는 것이 치은이식을 위해 큰 도움이 되었다. 치은이식은 마이크로 블레이드를 이용하여 박리를 시행하고 치은경계부에서 떨어진 수직절개를 하나만 시행해 여기를 통해 추가적인 박리와 이식편을 넣어서 치은이식을 시행하였다. 이렇게 교정치료를 동반하여 좁은 치간유두 사이의 폭을 벌려서 치은이식이 더 용이한 상태로 만들어 치은이식을 진행하고, 치은이 성숙한 뒤 교정력으로 다시 치아사이를 모아주는 술식(ELSA technique)을 통해 치간유두 재생을 할 수 있었다.

• 대한치과교정학회지
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• 제31권3호
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• pp.369-379
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• 2001

본 연구는 수직적 골결손부에 골이식을 시행한 후 교정력 적용시기에 따른 치주조직의 반응을 알아보고자 시행하였다. 체중 15 kg내외의 성견 9마리에서 상악 좌우측 제 3절치의 원심 치근면에 수직적 골결손을 형성하고 치주질환을 유발시킨 2주 후 치주판막술을 시행하고 골결손 기저부 수준의 치근면에 기준 홈을 형성하였다. 골이식 후 치유기간에 따라 2주군, 4주군, 6주군으로 각각 3마리씩 분류하고 우측 제 3절치는 치주판막술만 하는 비이식측으로, 좌측 제 3절치는 치주판막술과 골이식을 병용한 이식측으로 설정하여 양측 모두 술후 2주, 4주, 또는 6주부터 120 gm의 교정력을 적용하여 8주 동안 치체이동 시킨 후 2주간 보정하였다. 이후 동물을 희생시키고 조직표본을 만든 후 치주조직의 반응을 비교 관찰하여 다음과 같은 결과를 얻었다. 1. 모든 실험동물에서 비이식측에 비해 이식측의 골재생양이 많이 나타났다. 2. 6주군에서는 홈에서 백악-법랑 경계부까지 거리의 1/2이상 치조골과 백악질이 재생되었고 상피의 하방증식없이 결합조직대가 치근면과 부착을 이루었다. 3. 4주군에서는 5주군과 유사한 치주조직 재생소견을 보였으나 그 양은 더 적게 나타났다. 4. 2주군의 경우 골재생이 양측 모두 홈에 한정되어 나타났으며 상피의 하방증식이 홈의 기저부까지 연장되고 백악질과 결합조직의 재생은 관찰되지 않았다. 이상의 결과는 치주질환에 의한 수직적 골결손 환자에서 치주판막술과 골이식을 시행하고 교정적 치아이동을 할 경우 교정력 적용시기에 따른 치주조직의 반응이 차이가 있음을 시사하였다.

• 대한치과교정학회지
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• 제28권3호
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• pp.441-452
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• 1998

이 연구의 목적은 말초조직에 유해 자극을 가하였을 때 중추 신경계내 이차 신경 세포체내에 발현되어 neuronal marker로 사용되고 있는 c-fos를 사용한 면역 조직화학법으로 치아이동시 동반되는 동통의 투사경로의 이해에 도움을 주고자하는 것이다. 생후 9주령의 210gm내외의 Sprague-Dawley계 웅성 백서 21마리를 교정력을 가하지않고 마취만을 시행한 정상 대조군과 교정력 적용 시간 경과에 따라 1시간, 3시간, 6시간, 12시간, 1일, 3일군으로 나누어 각 해당 시간동안 상악 우측 제1 대구치와 상악 우측 측절치사이에 Ni-Ti coil spring를 결찰하여 30gm내외의 지속적인 교정력을 가한 후 희생시켰다. 희생시킨 백서의 뇌간을 적출하여 토끼의 항체를 이용하여 면역화학 염색을 시행하였다. 삼차신경 감각핵군내 부위에 따른 c-fos 면역 반응 세포를 측정하여 교정력 적용 시간 경과에 따른 변화를 관찰하였다. $\cdot$c-fos면역 반응 세포의 배측에서의 분포는 자극측 중위핵과 미측핵의 이행부위에서 시작하여 제1경추 척수 후각에 까지 이어졌는데 가장 많은 분포를 보인 곳은 미측핵의 문측 부위였다. 그리고 주로 I층 과 II층에서 관찰되었다. $\cdot$복측에서의 c-fos면역 반응 세포의 분포는 자극측 중위핵의 미측 부위에서 시작하여 미측핵의 중간부위에 까지 이어졌다. $\cdot$교정력 적용3, 6시간군에서 c-fos면역 반응 세포가 가장 많이 관찰 되었으며 12시간군에서 감소되기 시작하여 1일, 3일군에서는 현저히 감소 하였다. 위로 미루어 볼때 지속적인 교정력에 의한 동통은 중위핵과 미측핵의 이행부위, 미측핵, 제 1경추 척수후각에서 매개되는 것으로 생각된다.

• 대한치과교정학회지
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• 제42권3호
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• pp.118-128
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• 2012

Objective: The aim of this study was to investigate and compare the in vivo effects of prostaglandin E2 (PGE2) administered by different methods on orthodontic tooth movement and bone metabolism macroscopically, histopatologically, and biochemically. Methods: Forty-five young adult New Zealand rabbits were randomly divided into 3 experimental groups (n = 10/group), 1 positive control group (n = 10), and 1 negative control group (n = 5). The experimental rabbits were fitted with springs exerting 20-g reciprocal force on the maxillary incisors and PGE2 (10 ${\mu}g/mL$) was administered by the intravenous, submucosal, or intra ligamentous route aft er appliance insertion and on days 1, 3, 7, and 14 thereafter. All rabbits were sacrificed on day 21 and their premaxillae were resected for histologic evaluation. Results: Tooth movement was observed in the experimental and positive control groups, but the intraligamentous PGE2 group had the highest values of all analyzed parameters, including serum calcium and phosphorus levels and osteoclastic and osteoblastic populations (p < 0.001). Conclusions: Sub mucosal and intraligamentous PGE2 administration significantly increases orthodontic tooth movement and bone metabolism, but the intraligamentous route seems to be more effective.

• 대한소아치과학회지
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• 제24권4호
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• pp.758-762
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• 1997

There are various types of localized tooth malpositions in the mixed dentition, such as abnormal tooth axis, anterior crossbite of some incisors, impaction, midline diastema, ectopic eruption, and so forth. We, Pediatric Dentists, have usually used removable appliances for these instances. But, removable orthodontic appliances, as is known, have marked limitations in some situations, for example, severe rotation, intrusion and extrusion, root torque, closure of large diastema, traction of impacted tooth, etc. In such cases, Whip spring, combined with fixed or removable appliance, can increase utilities of removable orthodontic appliances. The authors have applied whip springs to some cases showing localized positional and arrangement problems, and have witnessed the results as follows; 1. The refined and elaborate control of direction and magnitude of force by the operator, and accurate compliance of the patients were requisite for the treatment with it. 2. It showed special effectiveness for de rotation of incisors. Although it yields some benefit for root movement, the special consideration for incomplete roots in this age bracket was required. 3. In the localized malalignment cases in mixed dentition, uncurable with traditional removable appliances but practically unrealistic with fixed appliance therapy, the whip spring was thought to be a good alternative.

• 대한치과교정학회지
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• 제51권4호
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• pp.293-300
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• 2021

In this report, we demonstrate the effectiveness of the Invisalign^® system in the treatment of severe gingival recession and bone dehiscence through torque, translation, and intrusion movements in a young woman. Cone-beam computed tomography was used to assess bone parameters and check the teeth during treatment. The root of the mandibular right central incisor, which was buccally positioned and exhibited bone dehiscence of 9.4 mm, was moved toward the center of the alveolar process by using the Invisalign^® system and SmartForce^® features. The patient was monitored by a periodontist throughout the orthodontic treatment period. Her gingival recession reduced, while the bone dehiscence reduced from 9.40 mm to 3.14 mm. Thus, movement of the root into the alveolus promoted bone neoformation and treated the gingival recession. The findings from this case suggest that orthodontic treatment using the Invisalign^® system, along with periodontal monitoring, can aid in the treatment of gingival recession and alveolar defects.

• 대한치과교정학회지
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• 제19권2호
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• pp.57-73
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• 1989

The purpose of this study was to investigate the tissue response of the rat molar periodontium incident to intermittent orthodontic force. The author intended to observe the healing process of injured periodontium and the response of injured tissue to the resumed force. Oxytetracyclin 50mg/Kg was given to each rat intraperitonially. 5 days later, maxillary 1st molars were moved mesially from the incisors with closed coil spring of 100gram. 7 days later, the appliances were removed and 20mg/Kg of calcein were given intraperitonially to each rat. At the same time, maxillary left 1st molars of 15 rats were moved by the same method, but force was lowered to 20 gram. After 1 day, maxillary left 1st molars of another 15 rats were moved by the same method and 50mg/Kg of oxytetracycline was given intraperitonially. After 4 days, another 15 rats were treated as above. After 7 days, another 15 rats were treated as above. 1,4,7,10 and 14 days after change of force, 3 rats were sacrificed in each group respectively. 2 rats were decalcified, embedded in paraffin, and stained with hematoxylin-eosin stain and with Masson's trichrome stain. Another rat was embedded in polyester resin and undecalcified specimen were made. Microradiograms were taken with the undecalcified sections. Observations were made with light and fluorescence microscope. Following conclusions were made. 1. Connective tissue cells and vessels were infiltrated into the hyalinized tissue from the bony cleft and along the border of the hyalinized tissue with bone and root surface. At the same time, elimination of hyalinized tissue, bone and root resorption occurred. 2. Bone and root were resorbed directly and indirectly. 3. Hyalinized tissue was removed within 5 days after force removal. 4. Hyalinized zone was less extensive and easily removed as the rest period prolonged. 5. Hyalinized tissue developed more rapidly and extensively and lasted over 10 days as the force resumed on the already formed hyalinized tissue.

• Journal of Korean Dental Science
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• 제16권1호
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• pp.23-34
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• 2023

Purpose: This study aims to investigate the force delivery profile of thermoformed aligners (TFA) compared with direct-printed aligners (DPA) and to explore the effect of different activation amounts on forces and moments of respective groups. A secondary objective is to observe the amount of stress relaxation that occurs over the 7~14 days when aligners are maintained in a simulated intraoral environment. Materials and Methods: An in vitro setup was created to quantify forces and moments. It consisted of a three dimensional-printed base plate and segmented maxillary teeth, placed in a semi-enclosed chamber to maintain a temperature of 37℃. Ninety clear aligners were divided into nine groups of ten aligners each based on material types (Zendura, ATMOS, TC-85) and activation amounts. Aligners were created with 0.00, 0.25- and 0.50-mm activations for lingual bodily movement of the upper left central incisor and kept on models in the "stressed" position in a 37℃ water bath. Three force components acting on the upper left lateral incisor, upper left central incisor, and upper right central incisor were measured for each time point, beginning from the initial baseline measurement, 8 hours, 16 hours, 24 hours, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, and lastly, 14 days. Result: TC-85 aligners in every activation group showed less force on teeth than Zendura and ATMOS. Significant force levels from 0.0 mm activation were present and stayed consistent over the course of 14 days. Comparisons made for baseline measurements to 7-days and 14-days showed statistically significant change from the baseline force level. Conclusion: TC-85 aligners demonstrated lower, more consistent forces with fewer side effects. Aligners can generate forces even when no activation is programmed. No major decreases in force levels over time were observed; the intra-oral clinical simulated environment and length of observation time could contribute to this.

• 대한치과교정학회지
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• 제43권5호
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• pp.235-241
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• 2013

Objective: The purpose of this study was to investigate whether extension of the custom base is necessary for enhancement of bond strength, by comparing the debonding forces and residual adhesives of 3 different lingual bracket systems. Methods: A total of 42 extracted upper premolars were randomly divided into 3 groups of 14 each for bonding with brackets having (1) a conventional limited resin custom base; (2) an extended gold alloy custom base: Incognito${TM}$; and (3) an extended resin custom base: KommonBase${TM}$. The bonding area was measured by scanning the bracket bases with a 3-dimensional digital scanner. The debonding force was measured with an Instron universal testing machine, which applied an occlusogingival shear force. Results: The mean debonding forces were 60.83 N (standard deviation [SD] 10.12), 69.29 N (SD 9.59), and 104.35 N (SD17.84) for the limited resin custom base, extended gold alloy custom base, and extended resin custom base, respectively. The debonding force observed with the extended resin custom base was significantly different from that observed with the other bases. In addition, the adhesive remnant index was significantly higher with the extended gold alloy custom base. Conclusions: All 3 custom-base lingual brackets can withstand occlusal and orthodontic forces. We conclude that effective bonding of lingual brackets can be obtained without extension of the custom base.

• 대한치과교정학회지
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• 제21권3호
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• pp.543-560
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• 1991

Practitioners are aware of the presence of friction between bracket system and archwire during sliding movement of teeth. Clinically a mesiodistally applied force must exceed the frictional force to produce a tooth movement. The objective of this study were to determine, on a dry condition, changes in magnitude of friction with respect to load, 3rd order inclination (Torque), archwire materials and ligature type. Three wire alloys (Stainless Steel, TMA, NiTi) in two wire sizes (.016, .016x, .022 inch) were examined respect to two bracket system (Straight, Standard), and two ligature type (Metal, Plastic ligature) at three levels of load (100g, 150g, 200g). The results were as follows; 1. Frictional resistance was found to increase with increasing load for S.S., TMA, NiTi. 2. The straight bracket system was exhibited more frictional force than standard bracket system for .016x, .022 S.S. tightly ligated metal ligature. But, torque difference did not increase friction for loose metal ligature & plastic ligature. 3. Regardless of the ligature type, torque and load, stainless steel wire sliding against stainless steel exhibited the lowest friction, and TMA sliding against stainless steel exhibited the highest friction. 4. The loose stainless steel ligature generated lower frictional resistance than plastic ligature in all experimental groups. 5. The following factors affected friction in decreasing order; wire material ligature type, and load.