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편측성 구순구개열을 가진 청소년기 환자의 상악궁 확장 및 소구치 발치를 동반한 교정치료
임승원,강성자,추현희,오민희,이경민,조진형 대한치과교정학회 2020 대한치과교정학회 임상저널 Vol.10 No.4
This case report describes a successful orthodontic treatment of a 17-year-old adolescent male patient with unilateral cleft lip and palate on the right side. He showed collapsed posterior segment due to severely constricted maxilla of the affected side, missing of right maxillary lateral incisor, and severe crowding in the both maxillary and mandibular arches. The maxillary arch expansion was performed slowly using quad helix to enable the soft tissue to be lengthened. And then, comprehensive orthodontic treatment with first premolar extraction was proceeded. For the upper left quadrant, the canine was extracted instead of the first premolar to prevent gingival recession. After the orthodontic treatment, the congenital missing maxillary lateral incisor was rehabilitated with crown and bridge. The patient achieved improved facial profile with favorable occlusion, which maintained well until 2.5-year retention.
임승원,Jin-Young Choi,Seung-Hak Baek 대한치과교정학회 2019 대한치과교정학회지 Vol.49 No.6
This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.