• 제목/요약/키워드: surgically assisted orthodontics

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Does surgically assisted maxillary protraction with skeletal anchorage and Class III elastics affect the pharyngeal airway? A retrospective, long-term study

  • Elvan Onem Ozbilen;Petros Papaefthymiou;Hanife Nuray Yilmaz;Nazan Kucukkeles
    • 대한치과교정학회지
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    • 제53권1호
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    • pp.35-44
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    • 2023
  • Objective: Surgically assisted maxillary protraction is an alternative protocol in severe Class III cases or after the adolescent growth spurt involving increased maxillary advancement. Correction of the maxillary deficiency has been suggested to improve pharyngeal airway dimensions. Therefore, this retrospective study aimed to analyze the airway changes cephalometrically following surgically assisted maxillary protraction with skeletal anchorage and Class III elastics. Methods: The study population consisted of 15 Class III patients treated with surgically assisted maxillary protraction combined with skeletal anchorage and Class III elastics (mean age: 12.9 ± 1.2 years). Growth changes were initially assessed for a mean of 5.5 ± 1.6 months prior to treatment. Airway and skeletal changes in the control (T0), pre-protraction (T1), post-protraction (T2), and follow-up (T3) periods were monitored and compared using lateral cephalometric radiographs. Statistical significance was set at p < 0.05. Results: The skeletal or airway parameters showed no statistically significant changes during the control period. Sella to nasion angle, N perpendicular to A, Point A to Point B angle, and Frankfort plane to mandibular plane angle increased significantly during the maxillary protraction period (p < 0.05), but no significant changes were observed in airway parameters (p > 0.05). No statistically significant changes were observed in the airway parameters in the follow-up period either. However, Sella to Gonion distance increased significantly (p < 0.05) during the follow-up period. Conclusions: No significant changes in pharyngeal airway parameters were found during the control, maxillary protraction, and follow-up periods. Moreover, the significant increases in the skeletal parameters during maxillary protraction were maintained in the long-term.

임상가를 위한 특집 2 - 하악골의 외과적 확장 (Mandibular Symphysis Transverse Widening)

  • 오승환
    • 대한치과의사협회지
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    • 제51권6호
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    • pp.313-321
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    • 2013
  • The most common orthodontic methods of treating mandibular transverse deficiencies is extractions, interdental stripping, and other dento-alveolar compensation but it can not addressesd about skeletal problem This study assessed the treatment outcomes after surgically assisted rapid tooth orthodontics using the symphysis osteotomy and dentoalveolar distraction osteogenesis technique. The applications of distraction osteogenesis in mandibular widening, by symphysis osteotomy, has emerged as a definitive, predictable and better stability. The most important factors in mandibular widening is performed with simple surgical technique and devices. As a results, these techniques are very useful and effective in cases of difficult tooth movement in adult orthodontics transverse problems There were few intraoperative or postoperative complications and were not clinically significant.

Surgically-assisted orthodontics

  • 김재수;김현숙;이형돈;정혜승;태기출;김상철
    • 대한치과교정학회:학술대회논문집
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    • 대한치과교정학회 2001년도 제34회 학술대회
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    • pp.79.2-79.2
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    • 2001
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Surgically assisted rapid palatal expansion with tent screws and a custom-made palatal expander: a case report

  • Park, Kang-Nam;Lee, Chang Youn;Park, In Young;Kim, Jwa Young;Yang, Byoungeun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제37권
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    • pp.11.1-11.5
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    • 2015
  • Rapid palatal expansion(RPE) with the tooth-born appliance is not sufficient to apply to the patients with periodontal problem or insufficient tooth anchorage, and it leads to tipping of the anchorage teeth and increasing teeth mobility and root resorption. To avoid these disadvantages, we present the case using palatal screws and custommade palatal expander. A 23-year-old patient underwent surgically assisted rapid maxillary expansion with the Hyrax expansion using 4 tent screws. The study models were used to measure the pre-/-post surgical width of the anterior and posterior dental arches with a digital sliding caliper. In the result, the custom-made palatal expander with 4 tent screws is suitable for delivering a force to the mid-palatal suture expansion. And it is low cost, small sized and simply applied. The results indicated that maxillary expansion with the custom-made palatal anchorage device is predictable and stable technique without significant complications in patients.

비강기도 협소에 의한 수직 및 횡적 문제를 가진 골격성 II급 성인환자에서의 마이크로임플란트를 이용한 증례보고 (Treatment of skeletal Class II adult patient with vertical and transverse problems caused by nasal airway obstruction using microimplant anchorage)

  • 채종문;장나영;조진형;강경화;김상철
    • 대한치과교정학회지
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    • 제39권4호
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    • pp.257-272
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    • 2009
  • 본 증례보고는 I급 견치 및 구치 관계를 보이나, 비강기도 협소에 따른 하안면 고경의 과도한 증가와 양 악궁의 폭경 감소 뿐만 아니라, 하악골의 후방위치 및 현저한 입술의 돌출로 인해 돌출된 안모를 지닌 성인 환자의 치료를 소개하고자 한다. 협착된 양 악궁은 수술을 동반한 급속 구개확장과 슈발츠 장치로써 확장되었으며, 마이크로임플란트를 이용한 directional force technology를 적용하여 상하악 구치부에서의 고정원 보강과 상악 전치부의 토크 조절 및 시계 반대 방향으로의 양호한 mandibular response를 얻음으로써 양호한 안모의 균형을 얻을 수가 있었다. 총 치료기간은 29개월 소요되었고, 장치 제거 후 13개월 유지 후에도 양호한 결과가 유지되었다.

유착된 상악 절치의 외과적 처치를 동반한 교정 치료 (Surgically assisted orthodontic treatment of ankylosed maxillary incisor)

  • 손우성;정인교;신상훈
    • 대한치과교정학회지
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    • 제32권4호
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    • pp.257-264
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    • 2002
  • 유착된 치아는 교정력으로 이동되지 않으므로 대부분 발치를 하였지만 어린나이에 치아를 발거하면 치아의 결손과 이에 수반되는 치조골의 소실 때문에 심미적으로 매우 불량해진다. 저자들은 임상적, 방사선 소견으로 유착된 것이 확인된 상악 중절치와 측절치를 각각 의도적인 탈구와 단일치아 골절단술을 시행한 후 약하고 지속적인 힘을 가하여 비교적 양호한 결과를 얻어 이에 대해 보고하고자 한다.

상대적 거대설을 보이는 전치부 개방교합 환자의 외과적 급속 구개확장술을 통한 횡적 부조화의 치험례 (TREATMENT OF TRANSVERSE DEFICIENCY WITH SURGICALLY ASSISTED RAPID PALATAL EXPANSION IN AN OPEN BITE PATIENT SHOWING PSEUDOMACROGLOSSIA)

  • 김윤지;이규홍;박준우;이건주;조형준;박양호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권3호
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    • pp.376-382
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    • 2008
  • Anterior open bite is a condition in which maxillary and mandibular incisors do not occlude at central occlusion. It is a vertical discrepancy of the jaws and dental arches that has many etiologic factors making it difficult in diagnosis, treatment and prediction of prognosis. One of the causes of open bite is abnormal size and shape of the tongue. Macroglossia, a condition in which tongue is oversized, is caused by several factors which are not clearly identifiable, and it may be a major factor of anterior and posterior open bite. Macroglossia is subdivided into true, functional and pseudomacroglossia depending on its relative size in the oral cavity. In this case report, a patient was diagnosed as skeletal Class II with pseudomacroglossia, and was treated with SARPE in order to expand the narrowed maxillary arch and Quad helix for the mandibular arch. As a result the transverse deficiency was treated. In the adult patients where no skeletal growth is expected, SARPE has shown to be effective in treating maxillomandibular transverse discrepancies in which macroglossia was accompanied as in this case.

하악 이부 확장술 시 나타나는 합병증의 치험례 (A CASE REPORT OF COMPLICATIONS DURING MANDIBULAR TRANSVERSE SYMPHYSIS WIDENING)

  • 서충환;강경화;최문기
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제30권5호
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    • pp.480-488
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    • 2008
  • Orthodontists often treat cases which are difficult to treat with conventional orthodontics. In such cases, it could be treated with surgical procedures with the help of an oral surgeon. Especially, transverse deficiency of the mandible can be corrected by widening the transverse width of mandibular symphysis, using distraction osteogenesis. Transverse widening of mandibular sympysis is known as a safe treatment but still complications could occur during the treatment. We are reporting some complications of cases that mandibular symphysis transverse widening were applied. Some cases showed complications because of the inappropriate osteotomy line. Since straight vertical osteotomy line was inclined to the left, only the left bony segment was likely to expand. According to bio-mechanical considerations, it will be better to perform a step osteotomy, cutting the eccentric area of the alveolar crest and the centric area of the basal symphyseal area. Complications could also occur by the failure of the distraction device. The tooth borne distraction device was attached on the lingual side of the tooth with composite resin. During the distraction period, it was impossible to obtain appropriate distraction speed and rhythm because of frequent fall off of the distraction device. Therefore, distraction device should be attached firmly with orthodontic band or bone screw, etc. Tooth mobility increasement could also occur as a complication. 'Walking teeth phenomenon' was observed during the distraction period, showing severe teeth mobility and pain during mastication. These symptoms fade out during the consolidation period. Since the patient could feel insecure and uncomfortable, it should be notified to the patient before the procedure. Finally, alveolar crestal bone loss could occur. Alveolar crestal bone loss occurred because of lack of distraction device firmness and teeth trauma caused by lower lip biting habit. Therefore, adequate firmness of the distraction device and habit control will be needed.

Salvage rapid maxillary expansion for the relapse of maxillary transverse expansion after Le Fort I with parasagittal osteotomy

  • Lee, Hyun-Woo;Kim, Su-Jung;Kwon, Yong-Dae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권2호
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    • pp.97-101
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    • 2015
  • Maxillary transverse deficiency is one of the most common deformities among occlusal discrepancies. Typical surgical methods are segmental Le Fort I osteotomy and surgically-assisted rapid maxillary expansion (SARME). This patient underwent a parasagittal split with a Le Fort I osteotomy to correct transverse maxillary deficiency. During follow-up, early transverse relapse occurred and rapid maxillary expansion (RME) application with removal of the fixative plate on the constricted side was able to regain the dimension again. RME application may be appropriate salvage therapy for such a case.