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.

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.

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.

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.

Three-dimensional evaluation of dentofacial transverse widths of adults with various vertical facial patterns

Hwang, Soonshin,Jeong, Seokjin,Choi, Yoon Jeong,Chung, Chooryung J.,Lee, Hye Sun,Kim, Kyung-Ho Elsevier 2018 American journal of orthodontics and dentofacial o Vol.153 No.5

<P><B>Introduction</B></P> <P>The purpose of this study was to investigate maxillomandibular transverse widths and molar inclinations of adults with hypodivergent, normodivergent, and hyperdivergent facial patterns using cone-beam computed tomography.</P> <P><B>Methods</B></P> <P>We evaluated Class I subjects (55 men, 66 women) who were divided into hypodivergent (<27°), normodivergent (28°-37°), and hyperdivergent (>38°) groups by their mandibular plane angles. Frontal and coronal views of the images were analyzed. Sex differences, vertical facial pattern differences, and related factors were assessed with independent 2-sample <I>t</I> tests, 1-way analysis of variance followed by post hoc Tukey tests, and Pearson correlation analysis.</P> <P><B>Results</B></P> <P>The hypodivergent group had greater maxillary alveolar widths 7 mm apically from the alveolar crest. The intermolar widths and molar inclinations showed no significant differences among the groups. As the mandibular plane angles increased, interjugular widths, transverse mandibular widths, and buccolingual maxillary alveolar widths at the midroot level decreased, whereas the maxillomandibular width differences and palatal heights increased im both sexes.</P> <P><B>Conclusions</B></P> <P>An increase in the mandibular plane angle is associated with tendencies of narrow mandibular arches, thinner maxillary alveolar bones at the midroot level, and higher palatal arches in both sexes. Intermolar widths and molar inclinations were not significantly affected by vertical facial patterns.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Maxillomandibular transverse width and molar inclinations were assessed in adults. </LI> <LI> Subjects were grouped by hypodivergent, normodivergent, and hyperdivergent facial pattern. </LI> <LI> Intermolar widths and molar inclinations were not significantly affected by facial pattern. </LI> <LI> Increased mandibular plane angle was associated with narrow mandibular arches. </LI> <LI> It was also associated with thinner maxillary alveolar bones midroot and high palatal arches. </LI> </UL> </P>

Camouflage Extraction Treatment of Unilateral Cleft Lip and Palate Patient: 4-year Follow-up

Woowon Jang,Jueon Song,Soonshin Hwang,Chooryung J. Chung,Kyung-Ho Kim 대한구순구개열학회 2019 대한구순구개열학회지 Vol.22 No.1

Cleft lip and palate is one of the most common congenital abnormalities in the dentofacial region. Orthodontic treatment for adult patients with cleft lip and palate is difficult because of several factors such as dental anomalies, limitations in tooth movement around the cleft region, and retention. Here we report a case involving a 20-year-old woman with unilateral cleft lip and palate who successfully underwent camouflage orthodontic treatment for skeletal Class II malocclusion accompanied by absence of the maxillary left lateral incisor (#22) and second premolar (#25). After a 4-year retention phase, the facial profile and occlusion remained stable, without skeletal or occlusal changes. The findings from this case suggest that an appropriate orthodontic treatment plan and close monitoring during the retention phase can facilitate functional occlusion and esthetic improvement of the facial profile in adult patients with cleft lip and palate.

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Sanghee Lee,Woowon Jang,Yoon Jeong Choi,Chooryung J Chung,Kyung-Ho Kim,Soonshin Hwang 대한치과교정학회 2019 대한치과교정학회지 Vol.49 No.2

Treatment satisfaction and its influencing factors among adult orthodontic patients

Lee, Rami,Hwang, Soonshin,Lim, Hyunsun,Cha, Jung-Yul,Kim, Kyung-Ho,Chung, Chooryung J. Elsevier 2018 American journal of orthodontics and dentofacial o Vol.153 No.6

<P><B>Introduction</B></P> <P>The aim of this study was to investigate the level of satisfaction for orthodontic treatment among adult patients. In addition, the influencing host factors were monitored for their associations with satisfaction.</P> <P><B>Methods</B></P> <P>A questionnaire was designed to measure the level of satisfaction in 10 items; overall satisfaction, tooth alignment, facial appearance, eating and chewing, confident smile and self-image, retention state, treatment duration, treatment costs, intention to recommend, and relief of previous concerns, using a 5-point Likert scale. Total satisfaction was calculated by averaging the Likert scores from the 10 items. The survey was conducted, and the results from 298 adults were evaluated.</P> <P><B>Results</B></P> <P>For the overall satisfaction item, 45.0% were very satisfied, and 39.9% were satisfied, resulting in a satisfaction ratio of 84.9%. Total satisfaction score was 3.9. The level of satisfaction for tooth alignment and confident smile and self-image were significantly higher than facial appearance and eating and chewing (<I>P</I> <0.001). Patients aged 50 and above were more satisfied than the younger ones, and men were more satisfied than women (<I>P</I> <0.05).</P> <P><B>Conclusions</B></P> <P>Overall, adult patients were highly satisfied with orthodontic treatment. Age, sex, motivation, expected concern, and discomfort influenced the level of satisfaction.</P> <P><B>Highlights</B></P> <P> <UL> <LI> A questionnaire was developed to measure treatment satisfaction among adults. </LI> <LI> In general, adult patients were highly satisfied with orthodontic treatment. </LI> <LI> Adults age 50 and above were more satisfied than younger age groups. </LI> <LI> Sex, motivation, concerns, and discomfort influenced the level of satisfaction. </LI> </UL> </P>