악교정수술 및 교정치료를 위한 개별화된 이상적인 교합평면에 관한 연구

황윤정,양상덕,최진영,Hwang, Yun-Jung,Yang, Sang-Duck,Choi, Jin-Young Korean Association of Maxillofacial Plastic and Re 2009 Maxillofacial Plastic Reconstructive Surgery Vol.31 No.2

Introduction: To correct abnormal occlusal plane by orthognathic surgery, we need to have clear criteria for therapeutic occlusal plane. Authors introduced the concept of individualized ideal occlusal plane(Y-plane), which is determined by the size and form of the mandible, and the ideal incisor tip considering upper and lower lip. Authors studied the following to verify if the actual occlusal plane of the patients with optimal jaw relationship corresponds with the individualized ideal occlusal plane. Patients: We reviewed 44 patients who have normal occlusion visitied in the Dept. of orthodontics, Pundang CHA hospital. Methods: We evaluated if there are agreement between individualized ideal occlusal plane(Y plane) and occlusal plane of actual patients. And we confirmed if tested group has a normal face by measuring FABA, FMA, AB-LOP. Results: There were no significant differences of FABA, FMA, AB-LOP, Mo-Y plane between male and female. FABA, FMA and AB-LOP were included in the normal value. Average distance of Mo-Y plane was $0.75{\pm}0.78mm$. Conclusion: Individualized ideal occlusal plane may be applied to orthognathic surgery.

A determination of occlusal plane comparing different levels of the tragus to form ala-tragal line or Camper’s line : a photographic study

Sandeep Kumar,Sandeep Garg,Seema Gupta 대한치과보철학회 2013 The Journal of Advanced Prosthodontics Vol.5 No.1

PURPOSE. The purpose of this study was to determine accurately the part of the tragus to be used to form the Ala-Tragal line or Camper’ line in orthognathic profile patients. MATERIALS AND METHODS. 150 dentate subjects with age of 18-40 years with orthognathic profile were sampled. Life-size lateral digital photographs of the face with fox plane were taken in natural head position. Different angles between Eye-Ear plane and occlusal plane (OT1-OP), Eye-Ear plane and ala-superior border of tragus (OT1-AT1), Eye-Ear plane and ala-middle border of tragus (OT1-AT2) and Eye-Ear plane and ala-inferior border of tragus (OT1-AT3) were calculated using computer software package, AutoCAD 2004. From the three angles formed by the Eye-ear plane (OT1 or FH plane) and the ala-tragal lines, the one closest to the angle formed between Eye-Ear plane (OT1) and occlusal plane (OP) was used to determine the occlusal plane of orientation. The obtained results were subjected to ANOVA F test, Tukey’ Honestly significant difference test, followed by Karl Pearson coefficient of correlation test. P values of less than 0.05 were taken as statistically significant. RESULTS. The mean of base line angle i.e. OT1-OP angle (11.96 ± 4.36) was found to be close to OT1-AT2 angle (13.67 ± 1.93) and OT1-AT3 angle (10.31 ± 2.03), but OT1-OP angle was found to be more closer to OT1-AT3 angle. Comparison of mean angles showed that OT1-OP angle in both males (11.68) and females (12.51) is close to OT1-AT3 angle (males- 11.01, females- 11.95). CONCLUSION. The line joining from ala to the lower border of the tragus was parallel to the occlusal plane in 53.3% of the subjects. There was no influence of the sex on the level of occlusal plane.

Cephalometrically assessing the validity of superior, middle and inferior tragus points on ala - tragus line while establishing the occlusal plane in edentulous patient

Saurabh Chaturvedi,Ram Thombare 대한치과보철학회 2013 The Journal of Advanced Prosthodontics Vol.5 No.1

PURPOSE. The purpose of this study was to decide the most appropriate point on tragus to be used as a reference point at time of marking ala tragus line while establishing occlusal plane. MATERIALS AND METHODS. The data was collected in two groups of subjects: 1) Dentulous 2) Edentulous group having sample size of 30 for each group with equal gender distribution (15 males, 15 females each). Downs analysis was used for base value. Lateral cephalographs were taken for all selected subjects. Three points were marked on tragus as Superior (S), Middle (M), and Inferior (I) and were joined with ala (A) of the nose to form ala-tragus lines. The angle formed by each line (SA plane, MA plane, IA plane) with Frankfort Horizontal (FH) plane was measured by using custom made device and modified protractor in all dentulous and edentulous subjects. Also, in dentulous subjects angle between Frankfort Horizontal plane and natural occlusal plane was measured. The measurements obtained were subjected to the following statistical tests; descriptive analysis, Student’ unpaired t-test and Pearson’ correlation coefficient. RESULTS. The results demonstrated, the mean angle COO (cant of occlusal plane) as 9.76°, inferior point on tragus had given the mean angular value of IFH [Angle between IA plane (plane formed by joining inferior point-I on tragus and ala of nose- A) and FH plane) as 10.40° and 10.56° in dentulous and edentulous subjects respectively which was the closest value to the angle COO and was comparable with the values of angle COO value in Downs analysis. Angulations of ala-tragus line marked from inferior point with occlusal plane in dentulous subject had given the smallest value 2.46° which showed that this ala-tragus line was nearly parallel to occlusal plane. CONCLUSION. The inferior point marked on tragus is the most appropriate point for marking ala-tragus line.

골격성 제III급 부정교합자의 LE FORT I 상악골 절단술후 교합평면의 안정성에 관한 연구

이재휘(Jae Hwy Lee),이호준(Ho Jun Lee) 대한구강악안면외과학회 1996 대한구강악안면외과학회지 Vol.22 No.3

Surgical alteration of occlusal plane in patients with dentofacial deformities is necessary to establish optimal functional and esthetic relationships. In the stability of occlusal plane, clockwise rotation of the maxillomandibular complex in double-jaw surgery is a well-accepted technique in orthognathic surgery, while counterclockwise rotation has not been supported as an acceptable treatment modality. But recently, Wolford et al. Reported the stability of occlusal plane after double-jaw surgery in patient who had an increase or decrease in occlusal plane angulation. And, he concluded that counterclockwise rotation of the maxillomandibular complex is a stable and predictable procedure. The object of this study is to retrospectively evaluate the stability of occlusal plane after Le Fort I maxillary osteotomy using miniplate fixation in patients with skeletal class Ⅲ malocclusion. In this study, eight patients were evalated with preoperative, immediate postoperative, and long-term postoperative lateral cephalometric radiographs. These serial cephalometric radiographs of patients with skeletal class Ⅲmalocclusion, who was selected among the patients performed double-jaw surgery, had superimposed with cephalometric error of SN plane within 1mm. In conclusion, average long-term follow-up changes of occlusal plane angle were -0.9°(1.3° with FH plane and 0.0°(1.2° with SN plane. These results demonstrated that occlusal plane after Le Fort I maxillary osteotomy in patients with skeletal class Ⅲ malocclusion was stable.

성인 Ⅱ급 환자의 안면 수직고경및 교합평면의 특징에 관한 두부방사선학적 연구

남동석,정미향 대한치과교정학회 1998 대한치과교정학회지 Vol.28 No.2

본 연구에서는 Ⅱ급 부정교합자의 교합평면의 형태적 특징을 관찰하고, 안면의 수직고경과 연관지어 정상교합군과 비교하여 교합평면의 발현에 영향을 미치는 골격성, 치성요인의 기여정도를 알아보고자 했다. 성장과 연령군의 변이를 배제하기 위해 성장이 완료된 성인만을 연구대상으로 정하였다. 정상교합자 50명과 서울대학교 치과진료부 교정과에 내원한 50명의 Angle class Ⅱ 환자의 측모 두부방사선 계측사진분석을 통하여 다음의 결과를 얻었다. 1. Ⅱ급 부정교합자군에서 정상군보다 유의하게 크게 관찰된 교합평면의 경사도는 다음과 같다.; SN-FOP, FH-BOP, MP-BOP, AB-BOP, AB-FOP, Facial plane-BOP, FP-FOP 2. Ⅱ급 부정교합자군에서는 정상군에 비해 후안면 고경, 특히 후하안면고경이 유의한 차이를 보였다. 3. 교합평면과 상하악 전치가 이루는 각은 Ⅱ급 부정교합군에서 통계적으로 유의하게 컸고, 대구치와 이루는 각은 상악대구치와 해부학적 교합평면이 이루는 각만이 통계적으로 유의한 차이를 나타냈다. 4. 교합평면의 위치를 결정하는 요소중에서 하악절치에서 하악평면에 이르는 거리만이 Ⅱ급 부정교합군에서 유의하게 컸다. 5. Ⅱ급 부정교합군에서는 수직피개도와 교합평면 경사도의 상관관계가 존재하지만, 정상 교합군에서는 수직피개도와 교합평면 경사도간에 상관관계가 존재하지 않았다. This study was investigated to assess the difference of facial height and occlusal plane inclination between normal occlusion group and class Ⅱ malocclusion group. The subjects consisted of 50 normal occlusion(male 25, female 25) and 50 class Ⅱ(male 25, female 25) malocclusion patients. All subjects are adult. lateral cephalogram was taken with standard method, traced, and digitized for each subjects. The computerized statiscal analysis was carried out with SPSS program. The result were as follows: 1. In class Ⅱ malocclusion group, variables significant different from normal occlusion group were as follows; SN-FOP, FH-BOP, MP-BOP, AB-BOP, AB-FOP, Facial plane-BOP, FP-FOP. 2. In class Ⅱ malocclusion group, the posterior facial height -especially posterior lower facial height-was significantly smaller than normal occlusion group.(P<0.05) 3. In class Ⅱ malocclusion group, the angles between occlusal plane and upper and lower incisor, the angle between upper molar and bisected occlusal plane were significantly larger than those of normal occlusion group.(P<0.05) 4. L1 to Mandibular plane(mm) was a unique factor of occlusal plane position that showed that showed significant difference in class Ⅱ malocclusion group. 5. The correlation between overbite and occlusal plane inclination existed in class Ⅱ malocclusion group, but the correlation didn't exist in normal occlusion group.

하악 제1대구치의 치근 만곡에 영향을 주는 요인

최항문,이원진,허민석,이삼선,김정화,최순철,박태원,Choi Hang-Moon,Yi Won-Jin,Heo Min-Suk,Lee Sam-Sun,Kim Jung-Hwa,Choi Soon-Chul,Park Tae-Won 대한영상치의학회 2006 Imaging Science in Dentistry Vol.36 No.1

Purpose : To find the cause of root curvature by use of panoramic and lateral cephalometric radiograph. Materials and Methods : Twenty six 1st graders whose mandibular 1st molars .just emerged into the mouth were selected. Panoramic and lateral cephalometric radiograph were taken at grade 1 and 6, longitudinally. In cephalometric radio graph, mandibular plane angle, ramus-occlusal plane angle, gonial angle, and gonion-gnathion distance (Go-Gn distance) were measured. In panoramic radio graph, elongated root length and root angle were measured by means of digital subtraction radiography. Occlusal plane-tooth axis angle was measured, too. Pearson correlations were used to evaluate the relationships between root curvature and elongated length and longitudinal variations of all variables. Multiple regression equation using related variables was computed. Results : The Pearson correlation coefficient between curved angle and longitudinal variations of occlusal plane-tooth axis angle and ramus-occlusal plane angle was 0.350 and 0.401, respectively (p<0.05). There was no significant correlation between elongated root length and longitudinal variations of all variables. The resulting regression equation was $Y=10.209+0.208X_1+0.745X_2$ (Y: root angle, $X_1$: variation of occlusal plane-tooth axis angle, $X_2$: variation of ramus-occlusal plane angle). Conclusion : It was suspected that the reasons of root curvature were change of tooth axis caused by contact with 2nd deciduous tooth and amount of mesial and superior movement related to change of occlusal plane.

하악 제1대구치의 치근 만곡에 영향을 주는 요인

최항문,이원진,허민석,이삼선,김정화,최순철,박태원 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.37 No.1

Purpose : To find the cause of root curvature by use of panoramic and lateral cephalometric radiograph. Materials and Methods : Twenty six 1st graders whose mandibular 1st molars just emerged into the mouth were selected. Panoramic and lateral cephalometric radiograph were taken at grade 1 and 6, longitudinally. In cephalometric radio graph, mandibular plane angle, ramus-occlusal plane angle, gonial angle, and gonion-gnathion distance (Go-Gn distance) were measured. In panoramic radio graph, elongated root length and root angle were measured by means of digital subtraction radiography. Occlusal plane-tooth axis angle was measured, too. Pearson correlations were used to evaluate the relationships between root curvature and elongated length and longitudinal variations of all variables. Multiple regression equation using related variables was computed. Results : The Pearson correlation coefficient between curved angle and longitudinal variations of occlusal plane-tooth axis angle and ramus-occlusal plane angle was 0.350 and 0.401, respectively (p<0.05). There was no significant correlation between elongated root length and longitudinal variations of all variables. The resulting regression equation was Y=10.209+0.208X_(1)+0.745X_(2) (Y: root angle, X_(1): variation of occlusal plane-tooth axis angle, X_(2): variation of ramus-occlusal plane angle). Conclusion: It was suspected that the reasons of root curvature were change of tooth axis caused by contact with 2nd deciduous tooth and amount of mesial and superior movement related to change of occlusal plane. (Korean J Oral Maxillofac Radiol 2006; 36 : 55-62)

조립식 교합 평면 인기 장치 POP (PNUD Occlusal Plane) Bow 시스템을 이용한 3D 프린팅 CAD-CAM 의치치료 증례

이설화,정창모,윤미정,허중보,이소현 대한치과보철학회 2023 대한치과보철학회지 Vol.61 No.1

In order to manufacture functional and esthetic prostheses, it is essential to accurately transmit information about the patient’s occlusal plane. In particular, in the case of a completely edentulous patient, the occlusal plane is very important to correctly support the soft tissue, to achieve aesthetic harmony with the facial appearance, and to properly pronounce it, and to form a balanced occlusal relationship for stable mastication. In the conventional method, various facebow systems were used to transmit patient’s information from the clinic to the laboratory, but there were several limitations in the process of transferring them to CAD. To simplify this process, a prefabricated POP (PNUD Occlusal Plane) Bow system was recently developed. In this case, a CAD-CAM (Computer-aided design-computer-aided manufacturing) treatment dentures reflecting the patient’s occlusal plane information was manufactured using the POP Bow system during the treatment of a completely edentulous patient, and aesthetic and functional satisfaction was obtained. (J Korean Acad Prosthodont 2023;61:44-54)

A study on the temporomandibular disorders in dentofacial deformity patients

이충국(Choong Kook Yi),박정현(Jung Hyun Park) 대한구강악안면외과학회 1995 대한구강악안면외과학회지 Vol.21 No.4

악안면기형은 측두하악장애의 발생과 예후에 있어 중요한 기여인자 중의 하나이다. 최근에는 여러 학자들에 의해 교합평면의 변화가 악안면기형환자의 악기형수술을 통한 기능적, 심미적 개선에서 중요한 한 요인임이 보고되었다. 저자는 41명의 악안면기형환자를 대상으로 하여 측두하악장애의 발생율을 조사하고 교합평면 및 하악평면을 중심으로한 두개안면방사선사진 계측을 통해 악교정수술 전후의 측두하악장애의 변화양상을 관찰하고 그 상관관계를 조사하여 다음과 같은 결론을 얻었다. 1. 악안면기형환자의 측두하악장애의 발생율은 46%로 나타났고 악교정수술후 전체환자의 20%로 감소하였다. 2. 측두하악장애의 술전후의 변화양상과 악안면기형의 유형 및 전치부의 피개상태 사이에는 상관관계가 없었다. 3. 측두하악장애의 술전후의 변화양상과 교합평면 및 하악평면의 변화사이에는 상관관계가 높았다. 4. 악안면기형의 교정시에 적절한 저작계의 기능을 얻기 위해서 술후의 교합평면 및 하악평면을 각 개인의 이상적인 교합평면 및 하악평면과 평행하도록 설정하는 것이 바람직할 것으로 사료된다. Dentofacial deformities are important contributing factors in developments and prognosis of temporomandibular disorders. Nowadays, several authors have reported that alteration of occlusal plane is the important factor in functional and esthetic improement of orthognathic surgery of dentofacial defomty patients. The objects of this article are to investigate the incidence and the changes of the symptoms of the temporomandibular disorders through the orthognathic surgery of 41 dentofacial deformity patients and to suggest the interrelation between changes of temporomandibular disorder and occlusal plane and mandibular plane. The result s are as follows ; 1. The incidence of the temporomandibular disorder was 46% and it was decreased to 20% after orthognathic surgery. 2. There were no significant relationships between types of DFDs, types of anterior bite and changes of temporomandibular disorder symptoms. 3. There was a significant relationship between postoperative occlusal and mandibular planes and changes of temporomandibular disorder symptoms. 4. To obtain a optimal function of gnathologic system in correction of dentofacial deformities, it is proposed to achieve the parallelism of postoperative occlusal plane and mandibular plane to its individual ideal occlusal plane and mandibular plane.

骨格型 Ⅲ級 不正咬合者의 垂直不調和에 關한 硏究

申文彰 대한치과교정학회 1990 대한치과교정학회지 Vol.20 No.2

This study was designed to analyse vertical dysplasia such as open bite or deep bite in persons with skeletal Class Ⅲ malocclusion. The subjects consisted of 60 control patients, 40 Class Ⅲ open bite patients and 40 Class Ⅲ deep bite patients. The mean age was 19.8 years in the control group, 17.8 years in the Class Ⅲ open bite group and 16.5 years in the Class Ⅲ deep bite group. The results were as follows: 1. In Class Ⅲ malocclusion patients, the characteristics of the vertical dysplasia are under the palatal plane. 2. In Class Ⅲ malocclusion patients, the items showing the characteristics of the vertical dysplasia are mandibular plane angle, lower gonial angle, lower facial height, dental height & inclination of the upper first molar, interincisal angle, maxillary & mandibular occlusal plane angle. 3. In Class Ⅲ malocclusion patients, LPFH/LAFH ratio shows the highest significance among the facial height ratios. 4. In Class Ⅲ malocclusion patients, open bite group has a upward cant of maxillary occlusal plane & downward cant of mandiblar occlusal plane. And deep bite group has a downward cant of maxillary occlusal plane & upward cant of mandibular occlusal plane. 5. In Class Ⅲ malocclusion patients, the molar teeth of the open bite group are measially inclined and those of the deep bite group are upright.