• 제목/요약/키워드: Overjet

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치조골 소실과 심한 양악전돌을 동반한 성인환자에서의 피질골 절단술과 Compression osteogenesis를 이용한 교정치료 (Severe bimaxillary protrusion with adult periodontitis treated by corticotomy and compression osteogenesis)

  • 김성훈;이계복;정규림;;김태우
    • 대한치과교정학회지
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    • 제39권1호
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    • pp.54-65
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    • 2009
  • 본 증례보고는 성인형 치주염으로 인해 전반적인 치조골 소실을 보이고 양악 전돌을 동반한 II급 부정교합으로 진단된 50세 10개월 된 여자환자의 치료를 소개하고자 한다. 치주 치료를 진행한 후 양악 전돌을 해소하기 위해 양악 제1소구치를 발치하고, 상악 전치부는 피질골 절단술 시행 후 악정형적 견인을, 하악 전치부는 6전치의 전방부 분절골 절단술[Anterior segment osteotomy(ASO)]을 국소마취하에 시행하였다. 총 치료기간은 9개월이 소요되었고 안정적인 교합관계와 안모의 개선이 이루어졌다. 하지만 치료 후에 하악 전치부에 약간의 치근 흡수 소견이 관찰되었다. 치료 27개월 후에도 안정적인 치료결과가 유지되었다.

Accuracy and reliability of measurements performed using two different software programs on digital models generated using laser and computed tomography plaster model scanners

  • Camardella, Leonardo T.;Ongkosuwito, Edwin M.;Penning, E. Willemijn;Kuijpers-Jagtman, Anne Marie;Vilella, Oswaldo V.;Breuning, K. Hero
    • 대한치과교정학회지
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    • 제50권1호
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    • pp.13-25
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    • 2020
  • Objective: The aim of this study was to compare the accuracy and reliability of measurements performed using two different software programs on digital models generated using two types of plaster model scanners (a laser scanner and a computed tomography [CT] scanner). Methods: Thirty plaster models were scanned with a 3Shape laser scanner and with a Flash CT scanner. Two examiners performed measurements on plaster models by using digital calipers and on digital models by using Ortho Analyzer (3Shape) and Digimodel® (OrthoProof) software programs. Forty-two measurements, including tooth diameter, crown height, overjet, overbite, intercanine and intermolar distances, and sagittal relationship, were obtained. Results: Statistically significant differences were not found between the plaster and digital model measurements (ANOVA); however, some discrepancies were clinically relevant. Plaster and digital model measurements made using the two scanning methods showed high intraclass coefficient correlation values and acceptable 95% limits of agreement in the Bland-Altman analysis. The software used did not influence the accuracy of measurements. Conclusions: Digital models generated from plaster casts by using laser and CT scanning and measured using two different software programs are accurate, and the measurements are reliable. Therefore, both fabrication methods and software could be used interchangeably.

구순구개열 환자에서 골신장술을 이용한 전상악골의 재건 (Premaxillary Reconstruction by Distraction Osteogenesis for Cleft Lip/Palate)

  • 김기호;정영수;최진환;이상휘;유형석;손병화;이충국
    • 대한구순구개열학회지
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    • 제9권2호
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    • pp.63-70
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    • 2006
  • Patients with cleft lip and palate usually present midfacial depression and anterior cross-bite. This dentofacial deformity has been believed due to the undergrowth of maxilla and/or the collapse of premaxilla. But, in the case that the collapsed premaxilla exists only, the reconstruction of the premaxilla has to be required for the correction of that deformity. These cases show the surgical treatment of midfacial depression and anterior cross-bite in the cleft lip and palate. After the careful diagnosis for the collapse of premaxilla, the reconstruction using distraction osteogenesis was done successfully. As a result, the anterior overbite / overjet, and facial esthetics were improved remarkably, and the occlusion was also recovered to normal state. In conclusion, the premaxillary reconstruction by distraction osteogenesis in cleft lip and palate patients is a good treatment method based on the pathophysiology.

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Active-treatment effects of the Forsus fatigue resistant device during comprehensive Class II correction in growing patients

  • Cacciatore, Giorgio;Alvetro, Lisa;Defraia, Efisio;Ghislanzoni, Luis Tomas Huanc;Franchi, Lorenzo
    • 대한치과교정학회지
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    • 제44권3호
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    • pp.136-142
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    • 2014
  • Objective: To evaluate the active-treatment effects of the Forsus fatigue resistant device (Forsus) during comprehensive correction of Class II malocclusion in growing patients. Methods: Fifty-four patients (mean age, $12.5{\pm}1.2$ years) with Class II division 1 malocclusion were consecutively treated with fixed app-liances in combination with Forsus. Lateral cephalograms were analyzed at the beginning of the fixed treatment (T1), Forsus insertion (T2), its removal (T3), and end of the comprehensive therapy (T4). Statistical comparisons were carried out by repeated-measures ANOVA with Tukey's post-hoc test (p < 0.05). Results: The overall therapeutic effects were mainly dentoalveolar and occurred mostly during the active treatment with Forsus (T2-T3, mean duration = $0.5{\pm}0.1$ years). The overjet and overbite decreased significantly (-3.5 and -1.5 mm, respectively) and the molar relationship improved by 4.3 mm. These changes were associated with significant retroclination of the maxillary incisors ($-3.1^{\circ}$), proclination and intrusion of the mandibular incisors ($+5.0^{\circ}$ and -1.5 mm, respectively), and mesialization of the mandibular molars (+2.0 mm). Conclusions: Forsus had mainly dentoalveolar effects and contributed largely to the overall therapeutic outcome.

Evaluation of growth changes induced by functional appliances in children with Class II malocclusion: Superimposition of lateral cephalograms on stable structures

  • Oh, Eunhye;Ahn, Sug-Joon;Sonnesen, Liselotte
    • 대한치과교정학회지
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    • 제50권3호
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    • pp.170-180
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    • 2020
  • Objective: To compare short- and long-term dentoalveolar, skeletal, and rotational changes evaluated by Björk's structural method of superimposition between children with Class II malocclusion treated by functional appliances and untreated matched controls. Methods: Seventy-nine prepubertal or pubertal children (mean age, 11.57 ± 1.40 years) with Class II malocclusion were included. Thirty-four children were treated using an activator with a high-pull headgear (Z-activator), while 28 were treated using an activator without a headgear (E-activator). Seventeen untreated children were included as controls. Lateral cephalograms were obtained before treatment (T1), after functional appliance treatment (T2), and after retention in the postpubertal phase (T3). Changes from T1 to T2 and T1 to T3 were compared between the treated groups and control group using multiple linear regression analysis. Results: Relative to the findings in the control group at T2, the sagittal jaw relationship (subspinale-nasion-pogonion, p < 0.001), maxillary prognathism (sella-nasion-subspinale, p < 0.05), and condylar growth (p < 0.001) exhibited significant improvements in the Z- and E-activator groups, which also showed a significantly increased maxillary incisor retraction (p < 0.001) and decreased overjet (p < 0.001). Only the E-activator group exhibited significant backward rotation of the maxilla at T2 (p < 0.01). The improvements in the sagittal jaw relationship (p < 0.01) and dental relationship (p < 0.001) remained significant at T3. Condylar growth and jaw rotations were not significant at T3. Conclusions: Functional appliance treatment in children with Class II malocclusion can significantly improve the sagittal jaw relationship and dental relationships in the long term.

Surgical approach and orthodontic treatment of mandibular condylar osteochondroma

  • Yang, So Jin;Chung, Nam Hyung;Kim, Jong Ghee;Jeon, Young-Mi
    • 대한치과교정학회지
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    • 제50권3호
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    • pp.206-215
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    • 2020
  • Osteochondroma is a common benign tumor of bones, but it is rare in the mandibular condyle. With its outgrowth it manifests clinically as deviation of the mandible limitation of mouth opening, and facial asymmetry. After the tumor is diagnosed on the basis of clinical symptoms and radiographic examination including cone-beam computed tomography (CBCT) analysis, an appropriate surgery and treatment plan should be formulated. Herein, we present the case of a 44-year-old female patient who visited our dental hospital because her chin point had been deviating to the left side slowly but progressively over the last 3 years and she had difficulty masticating. Based on CBCT, she was diagnosed with skeletal Class III malocclusion accompanied by osteochondroma of the right mandibular condyle. Maxillary occlusal cant with the right side down was observed, but it was confirmed to be an extrusion of the molars associated with dental compensation. Therefore, after intrusion of the right molars with the use of temporary anchorage devices, sagittal split ramus osteotomy was used to remove the tumor and perform orthognathic surgery simultaneously. During 6 months after the surgery, continuous bone resorption and remodeling were observed in the condyle of the affected side, which led to a change in occlusion. During the postoperative orthodontic treatment, intrusive force and buccal torque were applied to the molars on the affected side, and a proper buccal overjet was created. After 18 months, CBCT revealed that the rate of bone absorption was continuously reduced, bone corticalization appeared, and good occlusion and a satisfying facial profile were achieved.

External apical root resorption in maxillary incisors in orthodontic patients: associated factors and radiographic evaluation

  • Nanekrungsan, Kamonporn;Patanaporn, Virush;Janhom, Apirum;Korwanich, Narumanus
    • Imaging Science in Dentistry
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    • 제42권3호
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    • pp.147-154
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    • 2012
  • Purpose: This study was performed to evaluate the incidence and degree of external apical root resorption of maxillary incisors after orthodontic treatment and to evaluate particular associated factors related to external apical root resorption. Materials and Methods: The records and maxillary incisor periapical radiographs of 181 patients were investigated. Crown and root lengths were measured and compared on the pre- and post-treatment periapical radiographs. Crown length was measured from the center of the incisal edge to the midpoint of the cemento-enamel junction (CEJ). Root length was measured from the CEJ midpoint to the root apex. A correction factor for the enlargement difference was used to calculate root resorption. Results: The periapical radiographs of 564 teeth showed that the average root resorption was $1.39{\pm}1.27$ ($8.24{\pm}7.22$%) and $1.69{\pm}1.14$ mm ($10.16{\pm}6.78%$) for the maxillary central and lateral incisors, respectively. The results showed that the dilacerated or pointed roots, maxillary premolar extraction cases, and treatment duration were highly significant factors for root resorption (p<0.001). Allergic condition was a significant factor at p<0.01. Age at the start of treatment, large overjet, and history of facial trauma were also factors significantly associated with root resorption (p<0.05). There was no statistically significant difference in root resorption among the factors of gender, overbite, tongue-thrusting habit, types of malocclusion, and types of bracket. Conclusion: These results suggested that orthodontic treatment should be carefully performed in pre-treatment extraction patients who have pointed or dilacerated roots and need long treatment duration.

정상 한국인 성인 남녀에서 협골을 중심으로 한 중안모의 측모 두부방사선 규격사진 분석법 (A LATERAL CEPHALOMETRIC ANALYSIS OF MIDFACE FOCUSING ON ZYGOMATIC BONE IN KOREAN ADULTS)

  • 이의훈;정인교
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제21권4호
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    • pp.353-359
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    • 1999
  • Purpose : A new method of lateral cephalometric analysis for midface, focusing on zygomatic bone, was created in this study, and measured in Korean adults. The purposes of this study are understanding about new approach for midfacial depression, especially zygomatic bone, and using to make adequate diagnosis and treatment plan. Materials and methods : In this study, esthetic Korean adults, 25 males and 25 females who were between $0^{\circ}$ and $4^{\circ}$ in ${\angle}ANB$, and between 62% and 70% in P/A facial height ratio, and had normal overbite and overjet, were used. Orbitale(Or) and Soft tissue orbitale(Or') were used for indicators of anteroposterior position of zygomatic area. And, mean value and standard deviation of linear and angular measurements, and ratio about each linear measurements, were obtained. then, standard deviation diagram - wiggle diagram - was made for visualization of results. Results : Mean values, standard deviations and ranges of 19 measurements were obtained, and among them, 5 linear measurements that had large standard deviation were excluded and the others were used for making standard deviation diagram. In standard deviation diagram, the following results were obtained. 1. If the measurements are located on more left side of mean-value-vertical -line, the potential of midfacial hypoplasia are stronger, especially zygomatic area. 2. If the measurements are located on more right side of mean-value-vertical-line, the potential of midfacial hypoplasia are decreased. Conclusion : This study presented a new method of lateral cephalometric analysis focusing on zygomatic bone in Korean adults. We expect that the results of this study can be used as parameter when clinicians make decisions about diagnosis and treatment plan for rehabilitation of esthetics and function. But, it is necessary to prove its usefulness, and to further evaluate the results.

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Effect of Anterior Guidance Change on the Condylar Path in Skeletal Class I Young Adult Women Using a Splint with Flat or Steep Anterior Guidance

  • Choi, Byung-Taek;Baek, Seung-Hak
    • Journal of Korean Dental Science
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    • 제5권1호
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    • pp.29-36
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    • 2012
  • Purpose: To investigate the effects of anterior guidance (AG) change on the working (WCP) and non-working condylar paths (NWCP), and lower incisor path (LIP) using a splint with flat (FAG) or steep AG (SAG). Materials and Methods: The samples consisted of six young adult women (mean age=$23.5{\pm}3.3$ years). Inclusion criteria were skeletal Class I and normodivergent pattern, normal overbite/overjet, minimal slide from retruded cuspal position to intercuspal position, no temporomandibular disorder signs and symptoms, mutually protected occlusion, and minimal tooth wear. After the values of natural AG (NAG) were obtained as a reference for each patient, two types of splints ($15^{\circ}$ flatter and steeper than NAG) were made. After insertion of the splints with FAG or SAG, the WCP, NWCP, and LIP were recorded five times for each patient using an ultrasonic AQR (SAM, Munich, Germany) and statistical analysis was subsequently performed. Result: NAG exhibited postero-superior movement in the WCP and did not show a noticeable immediate side shift (ISS) or difference between the eccentric (EP) and returning paths (RP) in the NWCP. FAG was associated with an irregular and excessive WCP, an increase in ISS, and a difference between EP and RP in the NWCP. SAG showed minimal WCP movement and a decrease in the extent of difference between EP and RP in the NWCP. LIP showed significant differences in EP and in RP (P<0.001, all; FAG

Twin Block을 이용한 II급 부정교합의 치료증례 (CASE REPORT ON TREATMENT OF CLASS II MALOCCLUSION WITH TWIN BLOCK APPLIANCES)

  • 박수진;장기택;김종철
    • 대한소아치과학회지
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    • 제25권1호
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    • pp.134-143
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    • 1998
  • Twin Blocks are simple bite-blocks that effectively modify the occlusal inclined plane to induce favorably directed occlusal forces by causing a functional mandibular displacement. These devices use upper and lower bite-blocks that engage on occlusal inclined planes. Twin Blocks use the forces of occlusion as the functional mechanism to correct the malocclusion. To get an excellent result in the treatment by using the Twin Block appliances, proper case selection must be needed. Twin Block treatment is performed in two stages. Twin Blocks are used in the active phase to correct the anteroposterior relationship and establish the correct vertical dimension. Once this phase is accomplished, the Twin Blocks are replaced with an upper Hawley type of appliance with an anterior inclined plane, which is then used to support the corrected position as the posterior teeth settle fully into occlusion. The Twin Block is the most comfortable, the most esthetic ane the most efficient of all the functional appliances. Twin Blocks have many advantages compared to other functional appliances. Patients can wear Twin Blocks 24 hours per day and can eat comfortably with the appliances in place. From the moment Twin Blocks are fitted, the appearance is noticeably improved. There is less interference with normal function. Integration with conventional fixed appliances is simpler than with any other functional appliance. Twin Blocks allow independent control of upper and lower arch width. Appliance design is easily modified for transverse and sigittal arch development. The authors treated Class II malocclusion with Twin Blocks. and the results as follows; 1. Rapid profile improvement was achieved in 2-3 months. 2. There was excellent patient cooperation. 3. Severe overjet and overbite were reduced. 4. Class II molar relationship was changed to Class I.

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