• 제목/요약/키워드: Skeletal anchorage

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골성 고정원과 편측 분절호선을 이용한 정출된 상악 중절치의 압하 치료 (Intrusion of the extruded maxillary central incisor using skeletal anchorage system and unilateral segmental intrusion arch)

  • 권은영;백영재;박수병;김성식;김용일;최윤경
    • 구강회복응용과학지
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    • 제35권3호
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    • pp.180-190
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    • 2019
  • 병적 치아 이동된 상악 전치를 가진 중등도 치주염 환자에서는 치태 관리를 통한 치주 염증의 해소뿐만 아니라 치아를 재위치 시키기 위한 교정치료가 함께 필요하다. 이 때의 교정치료는 더 적은 힘의 적용과 치아의 저항중심, 최적의 힘 등을 세심하게 고려해야 하는데, 이동하고자 하는 치아에만 적용되는 분절호선은 이동의 예측성을 높여주고, 힘을 조절할 수 있어 보다 효율적이다. 또한 교정치료 시, 고정원으로 사용되는 치아의 원치 않는 움직임을 차단하여 구치 교합 상태를 유지할 수 있는 장치 설계가 필요하며, 이를 위해 다양한 종류의 골성 고정원이 사용될 수 있다. 본 증례에서는 정출되고 변위된 상악 전치를 가진 환자에서, 철저한 치주 치료와 적절한 힘과 역학이 설계된 교정 장치로, 양호한 치료 결과를 얻을 수 있었으므로, 소개하고자 한다.

교정용 미니스크류 임플랜트의 제거회전력 및 골형성에 관한 연굴 (REMOVAL TORQUE AND BONE FORMATION OF ORTHODONTIC MINISCREW IMPLANT)

  • 윤영국;류재준;서규원
    • 대한치과보철학회지
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    • 제45권4호
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    • pp.492-505
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    • 2007
  • Statement of problem: An orthodontic miniscrew implant has been used as a skeletal anchorage for orthodontic treatment. However, any relation among the influence of the cortical bone, morphologic differences of orthodontic miniscrew implants and new bone formation hasn't been made clear yet. Purpose: The purpose of this study was to evaluate whether the orthodontic miniscrew implant could work as an intraoral skeletal anchorage immediately and stably for orthodontic treatment after insertion of it. Material and methods: Two types of orthodontic miniscrew implants were used in this experiment; tapered type and straight type. One hundred and sixty eight orthodontic miniscrew implants were inserted into the tibiae of 21 rabbits and sacrificed on 3, 7, 11, 14, 21 and 28days later after insertion of them to study removal torque values and histologic and histomorphometric analyses. Results: The results were as follows. 1. The removal torque values of the tapered type were higher than those of the straight type in all groups(p<0.05). 2. There wasn't any distinguishing differences between the tapered type and the straight type about the new bone formation percentage. 3. The removal torque values for both the tapered type and the straight type were gradually decreased at early stages of the test but started to increase at the 7 days group of the straight type and the 11 days group of the tapered type. 4. New bone formation percentage was increased gradually for both the tapered and the straight types as time passed(p<0.05). 5. It was found that the tapered type showed lower values in the cortical bone about both the maximum equilibratory stress distribution and the maximum principal stress distribution than the straight type in linear finite elements analysis. Conclusion: According to the research, the removal torque values were decreased at 7 days group of the tapered type and 11 days group of the straight type after the insertion of the orthodontic miniscrew implants in tibiae of rabbits. Considering the human bone activity, it is better to apply the orthodontic force $3{\sim}4$ weeks later than to apply it immediately after the insertion of orthodontic miniscrew implants. Considering that general orthodontic force is about $250{\sim}500$ grams, the tapered type can be worked as a stable skeletal anchor age in an orthodontic treatment even if the orthodontic force is applied on it immediately after the insertion of it.

상악 전방견인치료의 새로운 두 가지 기법: Intentional Ankylosis와 Distraction Osteogenesis (Two New Modalities for maxillary Protraction Therapy: Intentional Ankylosis and Distraction Osteogenesis)

  • 차봉근;박영욱;이남기;이연희
    • 대한치과의사협회지
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    • 제38권11호통권378호
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    • pp.997-1007
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    • 2000
  • Maxillary protraction is the treatment of choice for growing patients with skeletal Class 3 malocclusion due to midfacial retrusion. Its treatment goal is to achieve skeletal movement of maxilla without dentoalveolar movement. To avoid dentoalveolar movement, it is necessary to enhance anchorage of maxillary dentition or to reduce resistance of maxilla protraction. The purpose of this report is to introduce two cases applying adjunctive surgical approach as intentional ankylosis and distraction osteogenesis respectively.

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Mini-implant를 이용한 III급 부정교합의 수술교정치료: 수평, 수직적 치성 보상의 조절 (Surgical orthodontic treatment of skeletal Class III malocclusion using mini-implant: correction of horizontal and vertical dental compensation)

  • 임동혁;박현정;박재우;김정일;장영일
    • 대한치과교정학회지
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    • 제36권5호
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    • pp.388-396
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    • 2006
  • 전치부 치성 보상기전과 장안모를 보이는 하악전돌증례에서 악교정 수술전 교정치료과정과 치료결과를 보이고자한다. 악교정 수술전 교정치료로 장안모의 해결을 위해 구개 정중부에 mini-implant를 식립하여 상악 구치부를 압하하였고, 하악전치부 치성보상을 해결하기 위해 하악 좌우측 견치와 제1소구치 사이에 mini-implant를 식립하여 하악전치의 순측경사를 유도하였다. 그 결과 하악골 후퇴술만 시행하였음에도 수평, 수직적으로 조화로운 안모를 얻을 수 있었다. 치료기간은 11개월이 소요되었으며, 치료 후 18개월 후에도 안정적인 교합이 유지되었다.

Bonded expander 형태에 따른 facemask의 치료 효과 비교연구 (A Comparative Study of Facemask Therapy with Two Types of Bonded Expander)

  • 이은하;박기태
    • 대한소아치과학회지
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    • 제41권4호
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    • pp.298-305
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    • 2014
  • 본 연구의 목적은 3급 부정교합 환자에서 facemask 치료 시 bonded expander의 치아 피개 정도에 따라 facemask의 치료 효과를 비교하고, 구강 내 장치로서의 고정원 소실 정도를 평가하는 것이다. 초기 혼합치열기에 facemask 치료를 받은 18명의 환자를 대상으로, bonded expander의 피개 범위에 따라 제1군(4개 치아 피개, 9명)과 제2군(3개 치아 피개, 9명)으로 분류하였다. 치료 전과 후 측모두부방사선사진을 촬영하여 계측치를 비교하였다. Facemask 치료 후 두 군 모두 상악 전방이동 및 하악 후하방 회전의 골격적 효과가 관찰되었고, 두 군간에 유의한 차이는 없었다. 고정원 소실로서 두 군 모두 상악 구치의 근심이동이 관찰되었고, 제2군이 제1군에 비해 유의하게 큰 근심이동이 관찰되었다. 결론적으로 bonded expander의 치아 피개 범위에 따라 골격적 치료 효과에는 유의한 차이가 없었으나, 고정원으로서의 소실 정도에는 차이가 있었다.

Effect of extraction treatment on upper airway dimensions in patients with bimaxillary skeletal protrusion relative to their vertical skeletal pattern

  • Cho, Ha-Nul;Yoon, Hyun Joo;Park, Jae Hyun;Park, Young-Guk;Kim, Su-Jung
    • 대한치과교정학회지
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    • 제51권3호
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    • pp.166-178
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    • 2021
  • Objective: To investigate dimensional changes in regional pharyngeal airway spaces after premolar extraction in bimaxillary skeletal protrusion (BSP) patients according to vertical skeletal pattern, and to further identify dentoskeletal risk factors to predict posttreatment pharyngeal changes. Methods: Fifty-five adults showing BSP treated with microimplant anchorage after four premolar extractions were included in this retrospective study. The subjects were divided into two groups according to the mandibular plane steepness: hyperdivergent (Frankfort horizontal plane to mandibular plane [FH-MP] ≥ 30) and nonhyperdivergent groups (FH-MP < 30). The control group consisted of 20 untreated adults with skeletal Class I normodivergent pattern and favorable profile. Treatment changes in cephalometric variables were evaluated and compared. The association between posttreatment changes in the dentoskeletal and upper airway variables were analyzed using linear regression analysis. Results: The BSP patients showed no significant decrease in the pharyngeal dimensions to the lower level in comparison with controls, except for middle airway space (MAS, p < 0.01). The upper airway variable representing greater decrease in the hyperdivergent group than in the nonhyperdivergent group was the MAS (p < 0.01). Posttreatment changes in FH-MP had negative correlation with changes in MAS (β = -0.42, p < 0.01) and inferior airway space (β = -0.52, p < 0.01) as a result of multivariable regression analysis adjusted for sagittal skeletal relationship. Conclusions: Decreased pharyngeal dimensions after treatment in BSP patients showed no significant difference from the normal range of pharyngeal dimensions. However, the glossopharyngeal airway space may be susceptible to treatment when vertical dimension increased in hyperdivergent BSP patients.

유한 요소법을 이용한 설측 치아교정시 전치부 후방 견인에 관한 연구 (Study on the Retraction of Anterior Teeth in the Lingual Orthodontics with the Three-Dimensional Finite Element Method)

  • 송정한;허훈;박현상
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2004년도 춘계학술대회
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    • pp.198-203
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    • 2004
  • In these days, the orthodontic surgery including lingual orthodontics has attracted a person' attention due to its functional and esthetic appreciation. The delivery of the optimal orthodontic treatment is greatly influenced by clinician' ability to predict and control the tooth movement by applying force system to dentition. The skeletal anchorage system with the miniscrew has been used recently in the lingual orthodontics to assist the anchorage control. Precise understanding of the force system produced from the various orthodontic appliances is necessary. However, the qualitative and quantitative effect of the miniscrew has not been identified well. In this paper, three dimensional finite element analysis is introduced on the lingual orthodontics to investigate the effect of anterior retraction force on the miniscrew and transpalatal arch wire. The purpose of this study is to determine the location of the miniscrew and the point of force application of the anchorage system in the lingual orthodontics. The analysis results indicate the efficient position of the miniscrew and the transpalatal arch wire in the lingual orthodontics.

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악정형력 적용을 위한 골내 고정원으로서 미니플레이트 형상의 영향: 3차원 유한요소법적 연구 (INFLUENCE OF MINIPLATE SHAPES AS SKELETAL ANCHORAGE FOR APPLICATION OF ORTHOPEDIC FORCE: A THREE-DIMENSIONAL FINITE ELEMENT ANALYSIS)

  • 이남기;백승학;최동순;박영욱;김지혁;차봉근
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제30권4호
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    • pp.345-352
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    • 2008
  • Purpose: This study was performed to evaluate the stress distribution in the bone and the displacement distribution of the miniscrew under orthopedic force with two different types of miniplate design as skeletal anchorage for orthopedic treatment. Materials and methods: Finite element models were made for 6-hole miniplate (0.8mm in thickness), which were designed in two different shapes-one is curvilinear shaped (C plate, Jeil Medical Co., Korea) and another, Y shaped (Y plate), fixed with 3 pieces of miniscrew 2mm-diameter and 6mm-long respectively. A traction force of 4 N was applied in $0^{\circ}$, $30^{\circ}$ and $60^{\circ}$ to imaginary axis connecting two unfixed distalmost holes of the miniplate. Results: The maximum von Mises stress in the bone was much greater in the cortical portion rather than in the cancellous portion. C plate showed greater maximum von Mises stress in the cortical bone than Y plate. The maximum displacement of the miniscrew was greater in C plate than Y plate. The more increased the angle of the applied orthopedic force, the greater maximum von Mises stress in the bone and maximum displacement of the miniscrew. It was observed that in C plate, the von Mises stress in the bone and displacement of the miniscrew were distributed around the distalmost screw-fixed area. Conclusions: The results suggest that Y plate should have the advantage over C plate and in the placement of the miniplate, its imaginary axis should be placed as parallel as possible to the direction of orthopedic force to obtain its primary stability.

정중구개부 미니스크류를 이용한 개방교합치료에 대한 연구 (A study on the treatment of anterior open bite with midpalatal miniscrews)

  • 경승현
    • 대한치과교정학회지
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    • 제34권1호
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    • pp.13-21
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    • 2004
  • 본 연구에서는 전치부의 개방교합을 동반한 환자 5명의 증례를 분석하여 (1) 성인에서의 상악 구치 함입을 통한 개방교합의 치료의 가능성과 (2) 이때 고정원으로서의 정중구개부 미니스크류의 유용성 여부와 (3) 치료에 의한 골격성, 치아-치조골의 변화에 대해 알아보고자 하였다. 상악구치부를 스플린트한 후 정중구개부에 두개의 미니스크류를 삽입하고 구개횡선 아치로 상악제 일대구치를 연결한 뒤, 탄성 재를 이용하여 상악 제일대구치에 함입력을 적용하였다. 측면 두개방사선상의 변화에 대한 분석 결과 다음과 같은 결과를 얻었다. 1. 모든 환자에서 상악 제1대구치의 실질적인 압하가 일어났고, 이때 평균 압하량은 $3.4mm(1.5mm\~5.0mm)$였다. 2. 상악 구치의 압하를 시행하는 동안 임상적으로 정중구개부의 미니스크류의 안정성이 유지되었다. 3. 하악이 반시계방향으로의 회전되었으며, 하악평면각, 교합평면각의 감소가 관찰되었다.