구치부 반대교합을 동반한 성인 구순구개열 환자의 MARPE를 사용한 치험례

Jihoon Kim(Jihoon Kim),Ji-Hyun Lee(Ji-Hyun Lee),Chooryung J. Chung(Chooryung J. Chung),Kyung-Ho Kim(Kyung-Ho Kim) 연세대학교 치과대학 두개안면기형연구소 2023 연세임상교정 Vol.30 No.1

목적: 구순구개열로 인해 상악골의 횡적, 전후방적 성장 결핍과 열 부위 치아 결손을 동반한 환자에서 MARPE를 사용하여 악궁 확장을 시행한 증례를 보고하고자 한다. 임상 증례: 본 증례는 21세 남환으로 이가 반대로 물리며 치열을 가지런하게 하고싶다는 주소로 내원하였다. 환자는 구순구개열에 의한 상악의 성장 부전으로 인해 III급 골격 관계를 갖고 있었으며, 열 부위인 상악 좌측 측절치 결손 상태였다. 환자는 유아기 구순구개열 수술과 골 결손부위 2차 치조골 이식술, 성장기 교정 치료를 진행했으며, 성인이 된 후 치아배열 및 2차교정을 위해 본과 내원했다. 본과에서는 구순구개열에 의한 상악 열성장을 해결하기 위해 수술교정을 권하였으나, 환자분의 요구대로 비수술적 치료를 하게 됐고, 따라서 MARPE를 사용한 상악궁 확장과 전후방적 치아 이동을 통한 절충치료를 진행했다. 결론: 구순구개열을 치료하기 위해서는 출생 시부터 성장이 완료될 때까지 여러 과들의 협진을 통해 진행되며, 각 시기에 필요한 치료를 순서대로 진행하여 성인이 된 후 구순구개열을 성공적으로 치료할 수 있다. 특히 교정적 접근은 결손된 치아 및 부정교합의 회복을 위해 필수적이며, 성장기 교정치료와 더불어 악골 성장이 완료되는 시기에 최종적인 교합의 완성을 위한 치료를 진행한다. 대다수의 구순구개열 환자는 악골의 전후방적 부조화 및 횡적 부조화를 보이며, 이에 따라 치료과정이 더 복잡해지기 때문에 치료계획을 수립함에 있어 환자의 교정적 문제점을 파악하는 데 중점을 두어야 한다. 본 증례는 상악골의 횡적, 전후방적 성장 결핍과 열 부위 치아 결손을 동반한 구순구개열 환자에서 악궁의 회복 및 결손 부위의 공간확보를 통해 양호한 교합을 형성하였고 심미와 기능의 개선을 얻을 수 있었다. Purpose: We report the successful treatment of a patient with cleft lip and palate and anterior-posterior and transverse deficiency of the maxilla using MARPE. Clinical Case: A 21-year-old man presented with the chief complaints of multiple teeth in crossbite and crowding. He had cleft lip and palate in the past, skeletal Class III malocclusion due to growth deficiency of the upper jaw, and a missing upper left lateral incisor. For the treatment of cleft lip and palate, the patient underwent lip and palate surgeries in infancy, secondary alveolar bone graft, and phase I orthodontic treatment. We recommended surgical correction to solve the maxillary deficiency due to cleft lip and palate, but nonsurgical treatment was performed as requested by the patient. Orthopedic treatment through maxillary arch expansion using MARPE along with camouflage treatment through anterior and posterior tooth movement was performed. Conclusion: It is necessary to carry out treatment of cleft lip and palate patients in multiple stages from birth to adulthood through collaboration with various medical and dental departments. Orthodontic approach is essential for the recovery of malocclusion. Treatment for the completion of the final occlusion is performed after growth cessation, while orthodontic treatment also takes place during the growth period.

상악 전치부 브릿지 제거 후 양측 측절치를 중절치로 대체한 중년 제 II급 부정교합 치험례

Chaehee Oh(Chaehee Oh),Ji-Hyun Lee(Ji-Hyun Lee),Kyung-Ho Kim(Kyung-Ho Kim),Chooryung J. Chung(Chooryung J. Chung) 연세대학교 치과대학 두개안면기형연구소 2023 연세임상교정 Vol.30 No.2

The effect of cetirizine, a histamine 1 receptor antagonist, on bone remodeling after calvarial suture expansion

Soonshin Hwang,Chooryung J. Chung,Yoon Jeong Choi,Taeyeon Kim,김경호 대한치과교정학회 2020 대한치과교정학회지 Vol.50 No.1

Objective: The objective of this study was to evaluate the effects of cetirizine, a histamine 1 receptor antagonist, on bone remodeling after calvarial suture expansion. Methods: Sixty male Sprague–Dawley rats were divided into 4 groups; the phosphate-buffered saline (PBS)-injected no expansion group, cetirizine-injected no expansion group, PBS-injected expansion group, and cetirizine-injected expansion group, and were observed at 7, 14, and 28 days. Five rats per group were examined at each observation day. Daily injections of cetirizine or PBS were administered to the relevant groups starting 2 weeks prior to expander insertion. A rapid expander was inserted in the calvarial bone to deliver 100 cN of force to the parietal suture. The specimens were prepared for hematoxylin and eosin and tartrate-resistant acid phosphatase (TRAP) staining. Suture opening and bone regeneration were evaluated using microcomputed tomography and bone histomorphometric analysis. Serum blood levels of osteocalcin and carboxy-terminal collagen crosslinks (CTX) were also evaluated. Results: TRAP-positive cell counts and CTX levels decreased while osteocalcin levels increased in the cetirizine-injected expansion group at observation day 28. In the expansion groups, the mineralized area gradually increased throughout the observation period. At day 28, the cetirizine-injected expansion group showed greater bone volume density, greater mineralized area, and narrower average suture width than did the PBS-injected expansion group. Conclusions: Cetirizine injection facilitated bone formation after suture expansion, mostly by suppressing osteoclastic activity. Histamine 1 receptor antagonists may aid in bone formation after calvarial suture expansion in the rat model.

교정 치료 후 교합력, 교합면적의 변화

최윤정,정주령,김경호 대한치과교정학회 2010 대한치과교정학회지 Vol.40 No.3

고정식 교정장치를 이용한 교정치료 후 교합의 기능적 변화를 평가하기 위해, 교합력 및 교합접촉면적을 측정하여 단기적인 변화 양상을 확인하고 소구치 발치 여부에 따른 차이를 파악하였다. 고정식 교정장치로 치료를 종료한 18세에서 40세 사이의 성인을 남자군과 여자군으로 분류하고, 각각의 군을 4개의 소구치를 발치한 군과 비발치로 치료한 군으로 세부 분류하였다(남자발치군 16명, 남자비발치군 18명, 여자발치군 19명, 여자비발치군 21명). Dental prescale system (Fuji Film Corp., Tokyo, Japan)의 pressure sensitive sheet를 5초간 최대교두감합위에서 최대근력으로 교합하도록 한 뒤 CCD camera를 이용해 교합력과 교합면적을 측정하였다. 고정식 교정장치를 제거하고 고정식 유지장치를 붙인 직후, 교정장치 제거 1주일, 1개월, 3개월, 6개월, 1년 뒤에 각각 측정하여 비교하였다. 모든 군에서 교정장치 제거 후 1년간의 유지기간 동안 교합력과 교합면적은 점진적으로 증가하였다 (p < 0.05). 모든 측정 시기에서 남자군은 여자군보다 높은 교합력과 교합면적을 보였으며 (p < 0.05), 남자, 여자군 모두에서 발치군과 비발치군 사이에는 교합력 및 교합면적에서 통계적으로 유의한 차이가 관찰되지 않았다 (p > 0.05). 본 연구를 통해 교정치료 후 1년간의 유지기간 동안 교합이 기능적으로 향상됨을 파악하였고, 소구치 발치로 인한 교합의 기능적 저하는 없을 것이라 추측할 수 있었다. Objective: This study was performed to evaluate functional changes of occlusion after orthodontic treatment by measuring the occlusal force (OcFr) and occlusal contact area (OcAr), and to compare OcFr and OcAr change according to premolar extractions. Methods: Data were obtained from 74 patients who had finished orthodontic treatment using fixed appliance aged between 18 and 40 years. Subjects were divided into groups who had four premolars extractions or non-extraction (Male extraction-16, Male nonextraction-18, Female extraction-19, Female nonextraction-21). All subjects were asked to bite pressure-sensitive sheets into maximum intercuspation with maximum bite force, and OcFr and OcAr were evaluated by measuring the sheet with a CCD camera. Records were taken right after debonding, 1 week, 1 month, 3 months, 6 months and 1 year after debonding. Results: OcFr and OcAr increased gradually in all groups during the 1 year retention period (p < 0.05). Male groups showed higher OcFr and OcAr than female groups throughout the retention periods (p < 0.05). There were no statistically significant differences of OcFr and OcAr between extraction and non-extraction groups in both males and females (p > 0.05). Conclusions: Occlusion was improved functionally throughout the 1 year retention, and premolar extraction did not induce a decline in the functional aspect of occlusion.

The comparison of torque values in two types of miniscrews placed in rabbits

Kyung-Ho Kim,Chooryung Chung,Hyun-Mi Yoo,Dong-Sung Park,In-Sung Jang,Seung-Hyun Kyung 대한치과교정학회 2011 대한치과교정학회지 Vol.41 No.4

Objective: This study compared the stability of cylindrical miniscrews (Cy, 7 mm in length) with that of tapered miniscrews (Ta, 5 mm in length), using torque values to determine if the healing time before loading affects the stability of the miniscrew and if the insertion torque is associated with the removal torque measured after a few weeks of healing. Methods: Ta and Cy with different thread lengths were placed in the tibias of 12 female New Zealand white rabbits (body weight: 3.0 - 3.5 kg), and the maximum insertion torque values (ITV) were measured. No orthodontic forces were applied so as to allow us to determine the pure effects of the different shapes. After 3 different healing periods (2, 4, and 6 weeks), maximum removal torque values (RTV) were measured immediately before the rabbits were sacrificed. Results: No miniscrews were loosened. There were no significant differences in ITV or RTV between the Ta and Cy nor were there any significant differences in the ITV and RTV between the 3 groups, which had different healing periods. There was a correlation between the ITV and RTV. Conclusions: Shorter Ta showed similar stability as Cy, as determined by torque values. This result strongly suggests that the tapered shape is more advantageous than the cylindrical shape. The RTV did not increase significantly over time. It is recommended that a miniscrew be loaded immediately; waiting a few weeks before loading should be avoided. The correlation between the ITV and RTV suggests that the ITV can be used to estimate a screw’s future stability.

The relationship between malocclusion and menarcheal age, and its secular trend for Korean women

Yoon Jeong Choi,Chooryung Chung,Kyung-Ho Kim 대한치과교정학회 2012 대한치과교정학회지 Vol.42 No.1

Objective: This study aimed to evaluate the mean age of menarche, its secular trend in Korean women, and the relationship between malocclusion and the rate of skeletal maturation, as defined by menarcheal age. Methods: We retrospectively collected data on menarcheal age from 931 Korean women born during 1961 - 1997. Subjects were divided by the malocclusion type and birth-year decade into 3 and 4 groups, respectively. The mean menarcheal age for each group was determined, and one-way ANOVA was performed for intergroup comparison (p = 0.05). Two-way ANOVA was also performed to compare all the 12 subgroups (p = 0.05). Results: The mean age of menarche was 12.82 years for Korean women born during 1961 - 1997. A distinct downward secular trend of menarcheal age was noticed (p < 0.05). For the birth-year decade 1961 - 1970, the Class III malocclusion group showed earlier onset of menarche than the other malocclusion groups (p < 0.05), but the other birth-year groups did not show any significant difference in the type of malocclusion (p > 0.05). Conclusions: A positive secular trend towards earlier menarche exists among Korean women. Malocclusion does not show any significant relationship with the rate of skeletal maturation, as defined by menarcheal age.

Observation of an extracted premolar 2.5 years after mineral trioxide aggregate apexification using micro-computed tomography

Lee, Gayeon,Chung, Chooryung,Kim, Sunil,Shin, Su-Jung The Korean Academy of Conservative Dentistry 2020 Restorative Dentistry & Endodontics Vol.45 No.2

Although numerous studies have been conducted on apexification using mineral trioxide aggregate (MTA), direct observation of extracted human teeth after the procedure has been rarely reported. This case report describes a mandibular premolar treated 2.5 years ago and extracted recently for orthodontic treatment. The tubercle of the right mandibular premolar of a 12-year-old boy with dens evaginatus was fractured and the pulp was exposed. The tooth was diagnosed with pulp necrosis and asymptomatic periapical abscess. During the first visit, copious irrigation was performed with 2.5% sodium hypochlorite. Calcium hydroxide paste was placed as an intracanal medicament. The sinus tract had disappeared at the second visit after 3 weeks. MTA was applied on to the bleeding point as a 4-mm-thick layer, followed by a 3-mm-thick gutta-percha filling and resin core build-up. After 2.5 years, the tooth and three other premolars were extracted for orthodontic treatment. The right and left mandibular premolars were scanned with micro-computed tomography to determine the root shape and canal anatomy. Irregular root growth was observed and the root outline of the right mandibular premolar differed from that of the contralateral tooth. Apexification with MTA leads to the formation of roots with irregular morphology, without any pulpal space.

Long-term pharyngeal airway changes after bionator treatment in adolescents with skeletal Class II malocclusions

Seimin Han,Yoon Jeong Choi,Chooryung J. Chung,Ji Young Kim,Kyung-Ho Kim 대한치과교정학회 2014 대한치과교정학회지 Vol.44 No.1

Objective: The aim of this study was to evaluate long-term changes in the pharyngeal airway dimensions after functional appliance treatment in adolescents with skeletal Class II malocclusions. Methods: Pharyngeal airway dimensions were compared between subjects with skeletal Class II malocclusions (n = 24; mean age: 11.6 ± 1.29 years) treated with a Class II bionator and age-matched control subjects with skeletal Class I occlusions (n = 24; mean age: 11.0 ± 1.21 years) using a series of lateral cephalograms obtained at the initial visit (T0), after treatment (T1), and at the completion of growth (T2). Results: The length of the nasopharyngeal region was similar between adolescents with skeletal Class I and Class II malocclusions at all time points, while the lengths of the upper and lower oropharyngeal regions and the pharyngeal airway areas were significantly smaller in the skeletal Class II adolescents before treatment when compared to the control adolescents (p < 0.05). However, following treatment with a functional appliance, the skeletal Class II adolescents had increased pharyngeal airway dimensions, which became similar to those of the control subjects. Conclusions: Functional appliance therapy can increase the pharyngeal airway dimensions in growing adolescents with skeletal Class II malocclusions, and this effect is maintained until the completion of growth.

Long-term survival of retained deciduous mandibular second molars and maxillary canine incorporated into final occlusion

Soonshin Hwang,Yoon Jeong Choi,Chooryung J. Chung,Kyung-Ho Kim 대한치과교정학회 2017 대한치과교정학회지 Vol.47 No.5

Orthodontic treatment of a complex case that involves retained deciduous mandibular second molars with missing permanent successors is challenging. Usually, congenitally missing teeth are manifested with other dental anomalies that further complicate orthodontic treatment, such as retained deciduous teeth, impactions, transpositions and peg-shaped lateral incisors. Even though the long term prognosis of the retained deciduous tooth is not fully predictable, if the teeth are in good condition, the patient and clinician may incline towards a decision to preserve the deciduous teeth as long as possible. This case report demonstrates that deciduous teeth, in this case the mandibular second molars and maxillary canine, can be incorporated into final occlusion with clinically stable long-term results.

Comparison of peri-implant marginal bone level changes between tapered and straight implant designs: 5-year follow-up results

Park, Han,Moon, Ik-Sang,Chung, Chooryung,Shin, Su-Jung,Huh, Jong-Ki,Yun, Jeong-Ho,Lee, Dong-Won Korean Academy of Periodontology 2021 Journal of Periodontal & Implant Science Vol.51 No.-

Purpose: The aim of this study was to compare straight and tapered implant designs in terms of marginal bone loss, the modified plaque index (mPI), and the modified bleeding index (mBI) for 5 years after functional loading. Methods: Twelve patients were recruited. Two types of implants were placed adjacent to each other: 1 straight implant and 1 tapered implant. Marginal bone loss, mPI, and mBI were measured every year for 5 years after loading. Results: The straight implants showed 0.2±0.4 mm of marginal bone loss at 5 years after loading, while the tapered implants showed 0.2±0.3 mm of marginal bone loss; this difference was not statistically significant (P=0.833). Our analysis also showed no statistically significant differences in mPI (straight implants: 0.3±0.3 vs. tapered implants: 0.2±0.3; P=0.414) or in mBI (straight implants: 0.3±0.4 vs. tapered implants: 0.2±0.3; P=0.317) at 5 years after prosthesis delivery. Conclusions: Straight and tapered implants showed no significant differences with respect to marginal bone loss, mPI, and mBI for 5 years after loading.