치아교정용 호선의 굽힘 영향 예측

이기준(Kee-Joon Lee),조영수(Young-Soo Cho),김시범(Si-Pom Kim),이권희(Kwon-Hee Lee) 한국기계가공학회 2010 한국기계가공학회지 Vol.9 No.6

For orthodontic treatment, most commonly, an archwire is inserted into orthodontic brackets that can be made from stainless steel. Then, the archwires interact with the brackets to move teeth into the desired positions. However, the activation of an archwire may induce undesirable rotation of a tooth due to the moment application. An appropriate magnitude of the gable bends of an archwires prevents its rotation. However, it is not easy to predict the relationship between the rotation and the gable bend. This study presents the numerical approach to predict the rotation of a tooth with respect to the gable bend in the activation of an archwire. To predict the rotation of a tooth, the kriging interpolation method is introduced.

상악궁 확장을 통한 폐쇄성 수면무호흡 치료

이기준(Kee-Joon Lee),최윤정(Yoon Jeong Choi) 대한치과의사협회 2021 대한치과의사협회지 Vol.59 No.8

Patients having obstructive sleep apnea frequently present malocclusion such as maxillary constriction, posterior crossbite, and long face. Maxillary expansion has been addressed to correct the malocclusion and to improve obstructive sleep apnea. In growing patients, rapid palatal expander (RPE) can separate the midpalatal suture and expand the maxilla, which results in increase of volume in the nasal cavity and nasopharynx as well as increase of the cross-sectional area. In non-growing patients, miniscrew-assisted rapid palatal expander can be used for the same effect. Maxillary expansion can be used for correction of obstructive sleep apnea in case of maxillary constriction.

안면비대칭을 동반한 골격성 III급 부정교합의 비수술 설측교정 치험례

서희주(Hui Joo Seo),이기준(Kee-Joon Lee) 연세대학교 치과대학 두개안면기형연구소 2017 연세임상교정 Vol.24 No.1

설측교정은 접근성과 공간의 제약으로 다양한 매카닉의 구사가 어려우나, 여러 가지 재료가 개발되고, 해결 방법이 논의되면서 그 적용범위가 점점 더 넓어지고 있다. 따라서 과거에 설측교정의 금기증으로 여겨졌던 심한 총생, 토크 조절이 필요한 발치 증례에서도 적용이 가능해졌다.2-4 본 증례는 짧은 설측 치관길이와 심한 총생이 있는 치열에서 전략적인 셋업 및 자가결찰 브라켓을 이용하여 양호한 치료 결과를 얻었기에 이를 소개하고자 한다. It is difficult to use a variety of mechanics because of the limited accessibility and space in lingual orthodontics. However, development of materials and solutions widened the coverage of lingual orthodontics. Treatment with lingual appliances is now available even for a severe crowding case or extraction case which needs strict anterior torque control which were considered to be contraindicated for a lingual appliance.2-4 This case report introduces the successful treatment of short lingual crown length and severe crowding with strategic setup and self-ligating lingual brackets.

교정용 미니스크류를 이용한 연속호선과 분절호선의 유한요소분석

이언화(Eon-Hwa Lee),유형석(Hyung-Seog Yu),이기준(Kee-Joon Lee),송진욱(Jin Wook Song),박영철(Young-Chel Park) 대한치과교정학회 2011 대한치과교정학회지 Vol.41 No.4

설측의 연속호선과 분절호선의 3차원 유한요소 모델에서 레버암의 길이와 미니스크류의 위치를 달리하여 전치부 후방 견인 시의 변위 양상을 비교하였다. 구개 경사면 견인 시, 두 호선 공히 레버암이 짧을수록 전치부의 설측 경사 이동을, 20 mm인 경우 중절치의 치체 이동 및 견치의 치근 이동 양상을 나타냈다. 정중구개봉합부 견인 시의 변위 양상은 구개 경사면의 경우와 유사하였으나, 레버암이 20 mm인 두 호선에서 절치의 치체 이동 및 연속호선에서 전치부의 함입 소견을 보였다. 호선 종류에 관계없이 레버암이 길어질수록 절치의 정출은 감소하였고, 구개 경사면에서의 견인인 경우와 함께 견치의 협측 변위가 증가하였으며, 분절호선에서 변위량이 많았다. 연속호선상의 제2소구치는 근심 경사 이동 및 함입 소견을, 대구치는 레버암이 길수록 원심 이동 및 협측 변위를 나타낸 반면, 분절호선상의 구치부도 3차원적 이동 양상을 나타냈으나 변위량은 미미하였다. 전치부 후방 견인 시 레버암 작용에 의해 절치의 경사 이동과 견치의 측방 이동 경향이 있었으며, 치체 이동을 위해서는 약 20 mm의 레버암을 추천할 수 있다. 또한 호선의 종류가 치열 변위 양상 및 변위량에 차이를 나타냈다. Objective: The purpose of this study was to compare the displacement patterns shown by finite element analysis when the maxillary anterior segment was retracted from different orthodontic miniscrew positions and different lengths of lever arms in lingual continuous and segmented arch techniques. Methods: A three dimensional model was produced, the translation of teeth in both models was measured and individual displacement was calculated. Results: When traction was carried out from miniscrews in the palatal slope, lingual tipping of crowns and extrusion of the maxillary anterior segment were found in both continuous and segmented arches as the lever arms were made shorter. With miniscrews in the midpalatal suture area, the displacement patterns were similar to the palatal slope, but bodily movement of the upper incisors was observed in both continuous and segmented arches with the lever arm at 20 mm. When lever arms were longer, there was less extrusion of the incisors and more buccal displacement of the canines. Such displacement was shown less in the continuous arch than the segmented arch. The second premolar showed crown mesial tipping and intrusion, and the molars showed distal tipping in the continuous arch. The posterior segment was displaced three dimensionally in the segmented arch, but the amount of displacement was less than the continuous arch. Conclusions: It is recommended that lever arms of 20 mm in length be used for bodily movement of the anterior segment. Use of continuous or segmented arches affect the displacement patterns and induce differences in the amount of displacement.

브라켓의 접착 전후 입술 주위 연조직의 3차원적 변화

이원제(Won-Je Lee),이기준(Kee-Joon Lee),유형석(Hyung-Seog Yu),백형선(Hyoung-Seon Baik) 대한치과교정학회 2011 대한치과교정학회지 Vol.41 No.6

브라켓의 접착에 의한 입술 주위 연조직의 변화를 평가하기 위하여 심한 골격적 부조화가 존재하지 않는 18세 이상, 29세 미만의 성인 환자 중 포괄적 교정 치료를 위하여 상, 하악 치아의 순측에 브라켓을 접착한 45명을 대상으로 3차원 레이저 스캐너를 이용하여 브라켓의 접착 직전과 직후의 3차원 입체 영상을 획득하였다. 브라켓의 접착 전후 입술 및 입술 주위 연조직의 변화를 3차원 좌표계 상에서 분석하였다. 3차원 변화량(distance: 동일 계측점 간의 변화에 대한 최단 거리)에서 유의성을 보인 모든 계측점에서 전방 변화량이 가장 크게 나타났으며, 측면 계측점들은 측방으로 유의성 있는 변화가 나타났다. 상순의 계측점들은 상방으로, 하순의 계측점들과 B"는 하방으로 유의성 있는 변화가 나타났다. 하순의 Li (labrale inferius)에서 1.39 mm로 가장 큰 변화가 나타났고 (p < 0.01), Li Rt (labrale inferius right), Li Lt (labrale inferius left)에서 1.15 mm, 1.09 mm의 변화가 나타났다 (p < 0.01). 상순의 양측 ULP (upper lip point), Ls (labrale superius), Ls Rt (labrale superius right), Ls Lt (labrale superius left)에서 0.81 mm, 0.85 mm, 0.82 mm, 0.97 mm, 0.92 mm의 변화를 보여 (p < 0.01), 하순에 비하여 상순의 변화가 작게 나타났다. 양측 Ch(cheilion)과 Stm (stomion)에서 1.17 mm, 1.16 mm, 1.02 mm (p < 0.01), Sn (subnasale)와 B" (soft tissue B point)에서 0.46 mm, 0.63 mm (p < 0.01, p < 0.05)의 변화가 나타났다. 브라켓의 종류에 따른 연조직 변화량은 차이가 나타나지 않았다. 이상의 결과는 성인 교정 환자에서 브라켓의 접착에 의한 입술 및 입술 주위 연조직 변화의 예측에 참고 자료가 될 것이다. (대치교정지 2011;41(6):411-422) Objective: The aim of this study was to evaluate the lip and perioral soft tissue changes after bracket bonding. Methods: The soft tissue changes in 45 adult patients (age greater than 18 years and less than 29 years) without severe skeletal discrepancy were evaluated using three-dimensional images acquired with a laser scanner before and after bracket bonding was performed using 4 types of labial orthodontic brackets. Results: Among the statistically significant changes in distance observed for the landmarks, the biggest change was observed in forward movement. The landmarks on the lateral sides also showed significant changes. While the landmarks on the upper lip showed significant upward movement, those on the lower lip showed significant downward movement. However, the changes were smaller for the landmarks on the upper lip (average, 0.87 mm) than for the landmarks on the lower lip (average, 1.21 mm). The type of bracket used did not significantly affect the soft tissue changes. Conclusions: These findings will help predict soft tissue changes after bracket bonding for orthodontic treatment. (Korean J Orthod 2011;41(6):411-422)

구조적 대응체 분석법에 의한 한국인 골격성 III급 부정교합의 특징

손병화(Byung-Wha Sohn),이기준(Kee-Joon Lee),모성서(Sung-Seo Mo) 대한치과교정학회 2002 대한치과교정학회지 Vol.32 No.3

Enlow s counterpart analysis reflects the characteristics of each individual sample to find out the cause of the malocclusion and further applying them to the clinic. Enlow s counterpart analysis was performed on 100 Korean samples (50 male, 50 female) with normal occlusion and 100 skeletal class III patients (50 male, 50 female) scheduled for orthognathic surgery. The following conclusions were obtained. 1. The cause of malocclusion in skeletal class III patients were complex and interrelated ; backward upward rotation of the cranial base, forward inclination of the ramus, increase in the mandibular body length, and posteriorly located maxilla. 2. Seen on R2 (male-1.68mm, female-2.33mm), in skeletal class III, the maxilla is more posteriorly located than the normal group. 3. The cause of malocclusion in skeletal class III patients, consists of retrognathic maxilla(A1) male 22%, female 26%, prognathic mandible(B1) male 44%, female 34%, and combination of an retrognathic maxilla and prognathic mandible were male 28%, female 38%. 4. There was no significant difference in the anterior-posterior length of the maxilla(A4) between skeletal class III males with the normal group, while in the female subjects, the skeletal class III group showed a smaller maxilla(A4) compared to the normal group. 5. In skeletal class III patients the proganthic mandible was primarily caused by the inclination of the ramus(R3, R4) and mandibular body length(B4, B6) rather than ramus width(B3).

구조적 대응체 분석법에 의한 한국인 골격성 Ⅲ급 부정교합의 특징

손병화(Byung-Wha Sohn),이기준(Kee-Joon Lee),모성서(Sung-Seo Mo) 대한치과교정학회 2002 대한치과교정학회지 Vol.32 No.3

사춘기전 I, II급 부정교합 아동의 기도 면적, 혀의 위치와 안면 형태에 관한 연구

황용인(Yong-In Hwang),이규홍(Kyu-Hong Lee),이기준(Kee-Joon Lee),김상철(Sang-Cheol Kim),조형준(Hyung-Jun Cho),천세환(Se-Hwan Cheon),박양호(Yang-Ho Park) 대한치과교정학회 2008 대한치과교정학회지 Vol.38 No.2

다수의 매복치 및 과잉치를 동반한 쇄골두개이형성증 환자에서 골내고정원 및 악간견인을 이용한 교정치료

김하림(Harim Kim),천주희(Joo-He Chun),조웅기(Ung Ki Cho),이기준(Kee-Joon Lee) 대한구순구개열학회 2022 대한구순구개열학회지 Vol.25 No.1

Cleidocranial dysplasia (CCD) is a genetic skeletal condition with autosomal dominant inheritance. It is characterized by various skeletal and dental abnormalities, such as missing clavicles, hypoplastic maxilla, retained deciduous teeth, and supernumerary and impacted permanent teeth. In such patients forced eruption of impacted teeth tends to be challenging due to the limited osteogenesis. The present case illustrates the orthodontic and surgical management of a 15-year-old female patient with CCD accompanied by multiple supernumerary and impacted teeth using intermaxillary traction and bone-borne anchorage. After the surgical opening of the impacted teeth, a miniscrew-assisted rapid palatal expander (MARPE) was delivered in combination with a facemask for anteroposterior and transverse development of the maxilla. Following the maxillary expansion, a fixed appliance was bonded sequentially, first in the maxilla and then in the mandible for space regaining and eruption of the impacted teeth. Supernumerary teeth were removed successively during the treatment. The treatment was completed after 31 months with successful eruption and alignment of the impacted teeth, and the 3-year-follow-up showed satisfactory posttreatment stability. As shown in the present case, early diagnosis and timely orthodontic and surgical interventions are crucial to avoid further skeletal and dental complications and to facilitate aesthetic and functional rehabilitation in patients with CCD.

성인 편측성 구순구개열 환자에서 비수술적 상악 확장후 순측 호선에 의한 장기간 폭경 유지 증례

전지윤(Ji Yoon Jeon),성의향(Eui-Hyang Sung),최태현(Tae-Hyun Choi),이기준(Kee-Joon Lee) 대한구순구개열학회 2020 대한구순구개열학회지 Vol.23 No.2

Purpose: We report a case of an adult patient with skeletal Class II hyperdivergent and complete unilateral cleft lip and palate (UCLP, left side), whose severe transverse discrepancy was successfully resolved via nonsurgical maxillary expansion followed by unintentional long-term maintenance with buccal archwire. Case: A 26-year-old female patient with skeletal Class II hyperdivergent and complete UCLP showed maxillary constriction with bilateral posterior crossbite. To solve transverse discrepancy mainly in the posterior area, nonsurgical rapid palatal expansion was attempted twice. During comprehensive orthodontic treatment, treatment was discontinued for 10 years and 1 month in total due to inadvertent absence of the patient. Meanwhile, buccal archwire was retained without bone graft. After extraction of the maxillary right first premolar and the mandibular both first premolars, space closure was conducted to complete the treatment at Class I molar relation. After orthodontic treatment, the intermolar width between the maxillary first right and left molars was increased by 10.5 mm and acceptable transverse relationship was achieved. Conclusion: Nonsurgical maxillary expansion with long-term transverse control may be effective for severe maxillary constriction in an adult patient with UCLP. Bone graft does not appear to be essential for the stability.