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상악 골절단 및 급속구개확장(SARME)을 이용한 술전 치성보상의 해소와 악교정 치험 2례 : REPORT OF 2 CASES
강상원,김명래,김기환,김한석,김채두 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.4
This is to review the surgically assisted rapid maxillary expansion followed by orthodontic treatment for malocclusion with maxillary narrow-arch. Two patients who presented with narrow-arch maloccluson and transverse maxillary deficiency underwent a Lefort I osteotomy extending to the zygomatico-maxillary but-trees and splitting of the midpalates. Orthopedic expansion was initiated with one complete rotation 0.8㎜ of the expansion screw on the day, and followed by two quarter-turn 0.4㎜ each day thereafter untill the arch expanded to preplanned level. Changes of the mid-incisal gap space. intermolar width. incisal inclination, TMJ symptoms and reapse tendency were examined periodically. After the surgico-orthodontic leveling and alignment. pre-planned orthognathic surgeries (maxillary & mandibular osteotomies) were rendered to correct the maxillofacial deformites. Results:Intermolar width (IMW) was increased to 13㎜ within 20 days and the gap between to cen-tral incisors was declined to5-7^。. There were neither complaints nor signs of TMJ disorders during treatment. The amount of relapse was less than 0.5㎜ in a year. Therefore, the surgically assisted rapid palatal expansion(SARME) can be a pre-orthodontic option to gain the interdental space in narrow-arch malocclusion with crowding and to reduce the labial inclination of upper incisors without extraction of premolars.
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