Activator 사용전후 부정교합 유형에 따른 각 근육 활성도의 변화에 관한 연구

이진우,차경석 대한치과교정학회 1996 대한치과교정학회지 Vol.26 No.1

본 연구는 Ⅱ급 및 Ⅲ급 부정교합자를 대상으로 activator사용에 따른 각 근육의 적응 및 변화양상을 알아보고자 시행되었다. 본 연구의 대상은 성장 발육기에 있는 아동중 Ⅱ급 부정교합자 15명과 Ⅲ급 부정교합자 17명으로 기능적 요인을 갖고있는 자로 선정하였고, 연구방법은 전측두근(T.A), 교근(M.M.), 후측두근(T.P.), 악이복근 전복(D>A.)의 활성도를 알아보고자 Biopak program 과 쌍극표면전극을 이용하여 activator 치료 시작시기와 사용후 6-12개월 사이의 두 차례에 걸쳐 안정위, 연하시, clenching등 세가지 조건에서 근활성도를 측정하여 비교해본 결과 다음과 같은 결론을 얻었다. Ⅱ급 및 Ⅲ급 부정교합자와 정상교합자의 근활성도를 비교한 결과 언정위시와 연하시 유의한 차이를 보이지 않았으나 clenching시 교근과 후측두근에서는 차이를 나타내었다. 치료전 근활성도가 정상보다 작은 군은 유의성 있는 증가를, 큰 군은 유의성 있는 감소를 보이는 등 대부분의 근육이 일정한 경향을 나타내었고, 이러한 경향은 Ⅲ급 부정교합군에서 전측두근(연하시), 후측두근(clenching시), 악이복근 전복(연하시, clenching시)을 제외하고 모두에서 보였으며 Ⅱ급 부정교합군에서는 전측두근(연하시), 교근(안정위, 연하시), 후측두근(clenching시)에서만 관찰되었다. 그러나 이러한 경향은 clenching시에서 감소되었다. Ⅱ급 부정교합군과 Ⅲ급 부정교합군과의 근활성도 비교에서 안정위시는 Ⅲ급 부정교합군의 근활성도 증가율이 Ⅱ급 부정교합군보다 우세했고, 연하시에는 교근을 제외하고 Ⅱ급 부정교합군이, clenching시에는 역시 Ⅱ급 부정교합군이 악이복근 전복을 제외하고 우세하게 나타났다. This study was carried out to study the changing patterns in muscle activities in Angle's ClassⅡ and ClassⅢ malocclusion patients following activator therapy. To study the activities of anterior temporal(T.A.), masseter(M.M.), posterior temporal(T.P.), and anterior belly of digastric(D.A.) muscles, surface electrodes were placed on 15 Angle's ClassⅡ abd 17 Angle's ClassⅢ malocclusion patients and following conclusions were obtained after electromyographic recordings were taken at prior to the activator therapy and at some time between 6-12 month after the start of activator therapy. 1. ClassⅡand ClassⅢ malocclusion groups, when compared to normal occlusion group, showed no significant differences during resting and swallowing. But significant differences were observed in masseter and posterior temporal muscles during clenching. 2. Most of the muscles studied showed a certain pattern, that is those groups whose pre-treatment E.M.G. were lower than the normal value showed significant increase after activator therapy, whereas those groups whose pre-treatment E.M.G. were higher than the normal value showed significant decrease after activator therapy. This pattern was observed in all of the muscle groups studied except T.A.(swallowing), T.P.(clenching) and D.A.(swallowing, clenching) in Angle's ClassⅢ malocclusion group and in Angle's ClassⅡ malocclusion group, above tendency were observed only in T.A.(swallowing), M.M.(resting, swallowing) and T.P.(clenching). This pattern was less obvious during clenching. 3. When E.M.G. activity after activator therapy between Angle's ClassⅡand ClassⅢmalocclusion group was compared, Class Ⅲ malocclusion group showed more increase during resting, and ClassⅡ malocclusion group showed more increase during swallowing and clenching excepting M.M. and D.A. respectively.

한국인 2급 1류 부정교합자의 FHI (Facial Height Index)에 영향을 미치는 요소에 관한 두부방사선 계측학적 연구

박영일,이진우,차경석 대한치과교정학회 1996 대한치과교정학회지 Vol.26 No.4

안모의 수직적 부조화는 안면의 전방 고경 요소와 후방 고경 요소 사이의 상관 관계에 따라 결정되는 것이므로, 전하안면 고경에 대한 후하안면 고경의 비인 FHI에 따라 수직적 control이 치료 성공의 관건인2급 1류 부정 교합을 분류하고 FHI에 영항을 미치는 요소를 파악하여 치료의 지침으로 삼고자 본 연구를 시행하였다. 단국대학교 치과대학 교정과에 내원한 혼합치열기의 2급 1류 부정 교합자를 대조군의 FHI(평균 0.6999)의 1 S.D(0.25)를 기준으로 수직적으로 분류하였다. 임상적으로 수직적 부조화에 영향을 미칠 것으로 사료되었던 상악 제 1 재 구치 치조 교경, 구치간 각도, 구개평면 기울기, 하악지 기울기 등의 영향을 검증하고, 만약 영향을 미치지 않는다면 어느 요소가 FHI에 영향을 미치는가 알아보고자 하였으며, 각 군간에 골격적 양상을 알아보고자 하여 다음의 결론을 얻었다. 2급 1류 부정 교합자의 FHI에 주로 기여하는 요소로 구개 평면과 하악 평면 사이의 경사도이고, RH, ID의 순으로 나타났으며, 구개 및 하악 평면의 독립적인 경사도 보다는 상호 경사도가 중요하게 나타났다. 2급 1류 부정 교합의 양상은 FHI에 따라보면, Low group은 상악이 전돌되고 하악지의 발육이 아주 강하고 하악체의 길이 및 전후방 위치는 정상이다. Normo group은 상악은 약간 전돌되고 하악지의 발육이 정상보다 약하고 하악이 다소 후방에 위치하고, High group은 상악은 정상위치이고 하악지 및 하악체의 발육이 제일 약하며 하악이 후방에 위치하는 것으로 나타났다. 2급 1류 부정 교합자의 각 군간 FHI를 결정짓는 요소를 보면 Low group은 MP-PP각이 아주 작고, ID는 정상군과 유사하나 RH가 아주 커서 FHI가 크게된다. Normo-group은 PP-MP각이 정상이고, ID는 정상군보다 약간 작고 RH가 정상군보다 작아 FHI가 정상비를 유지하였다. High group은 PP-MP각이 아주 크고 ID는 정상군과 유사하나 RH가 정상군보다 작아 FHI가 작았던 것으로 나타났다. Facial vertical dyscrepancies is decided on the relationship between the anterior vertical facial height and posterior vertical facial height. Thus this study was conducted to determine the factors that affect the FHI, and classify the Class II div.1, malocclusion, which success is dependent on the vertical control according to the FHI, which is the ratio of antero-inferior facial height, posterio-inferior facial height ratio, and to use this as a guideline for treatment. Angle between palatal plane and Mandibular plane were in the order of RH, ID. Thus showing that interrelated angle was more important than the independent angle of both, palatal plane and Mandibular plane. The tendency of Cl II div.1. Malocclusion according to FHI, showed the Low group to have Mx. protrusion, prominent development of Mn. ramus, and the Mn. body length and ant. post. position was normal. The Normo group showed slight protrusion of the Maxilla,. The development of the ramus was less than normal and the Mn. was in a slight retruded position. The High group showed the Mx. in a normal position, the development of the Mn. ramus and body was the lowest, and the Mn. was in a Posterior position. In observation of the factors affecting the FHI between each groups of Cl II div.1. malocclusion; In the Low group the MP-PP angle was very small, the ID was smililar to the normal group, but the RH was very large thus the FHI was increased. In the Normo group, the PP-MP angle was normal, ID was slightly smaller than the normal group and the RH was slightly smaller than the normal group, thus maintaining a normal FHI ratio. In the High group the PP-MP angle was very large, the ID was similar to the normal group, but the RH was smaller than the normal group thus the FHI was small.

물리적 외력이 배양중인 치주인대세포에 미치는 영향

김현영,차경석 대한치과교정학회 1994 대한치과교정학회지 Vol.24 No.2

The movement of teeth during orthodontic treatment requires bone remodeling process in periodontal tissue. To find out changes occuring in the cell itself, mechanical force was applied to the cultured periodontal ligament cells. Following results were obtained from measuring the changes in cyclic AMP and PGE₂,³H-thymidine incorporation amount in time lapse after application of mechanical force. 1. When mechanical force was applied to cultured PDL cells, the amount of cAMP in cells were increased significantly after 15 min. of force application, but were decreased gradually as time lapsed. 2. When mechanical force was applied to cultured PDL cells, the amount of PGE2 were increased at 20,40,60 min. and was significantly increased at 20 min. 3. When mechanical force was applied to cultured PDL cells, the amount of ³H- thymidine incorporation was some increased, increased, but not statistically significant.

骨格型 Ⅲ級 不正咬合者의 第2 大臼齒 石灰化過程에 關한 硏究

車敬石 대한치과교정학회 1981 대한치과교정학회지 Vol.11 No.2

This investigation was designed to compare the calcification degree of maxillary second permanent molar to mandibular second permanent molar in skeletal Class Ⅲ Malocclusion. The material selected for this study consisted in standand lateral cephalogram study model and orthopantomogram of two hundred fifty seven Korean Children, one hundred twenty one boys and one hundred twenty four girls, aged 6 through 12 years, having skeletal Class Ⅲ Malocclusion. On the basis of findigs of this study, the following results were obtained 1. In the stage of completion of crown, there was no significant difference in calcification degree between maxillary second molar and mandibular second molar of both boys and girls in skeletal Class Ⅲ Malocclusion. 2. From 8 years of age at the stage of beginning root formation to 12 years of age, the calcification degree of mandibular second molar was more advanced than Maxillary second molar of both boys and girls in skeletal Class Ⅲ Malocclusion.

기능성 Ⅲ급 부정교합자에서 편도 절제술 전 후의 Pharyngeal airway, hyoid bone, head posture에 관한 연구

박원서,이진우,차경석 대한치과교정학회 1997 대한치과교정학회지 Vol.27 No.2

본 연구는 거대 편도를 가진 기능성 III급 부정 교합자의 구개 편도 절제술 전후의 인두강, 설골, 두부 위치의 변화 양상에 대해 알아보기 위해 단국 대학교 부속 치과 병원 교정과에 내원한 남녀 환자 42명을 대상으로 연구하여 다음과 같은 결론을 얻었다. 1. Enlarged tonsil을 보이는 기능성 3급 부정교합자는 1급 부정교합자보다 혀는 전방에 위치하고 설골은 하방에 위치한다. 2. Tonsillectomy 후에 편도 절제술전과 비교하여 혀는 후방에 위치하고, nasopharynx은 증가 양상을 보이며, 설골은 상, 후방에 위치하며 counterclockwise rotation 양상을 보인다. 3. Tonsillectomy 후에 nasopharynx depth 변화와 하악 전치 경사도, 혀의 수직적 변화와 cranial base에 대한 hyoid axis, hyoid의 수직적, 수평적 변화와 두경부 경사도, 두경부 경사와 하악 전치간에 95% 유의수준으로 상관성을 보인다. 4. Tonsillectomy 후에 설골 장축의 counterclockwise rotation시 hya-NL의 감소와 nasopharyx의 증가를 보이고, 혀의 거상시 hya-NL의 감소를 보이며, 혀의 후방위치시 h-hl의 증가와 hya-ba-n의 감소를 보인다. This study was carried out in order to find out the changes of the pharyngeal airway, hyoid bone and head posture before and after tonsillectomy in functional class III malocclusion patients. For this study, 21 Angle`s class I patients and 21 Angle`s class III patients, totally 42 subjects were chosen. The results were as follows; 1. In comparison to Class I group, tongue was more anteriorly and hyoid bone was more inferiorly positioned in functional Class III group. 2. In comparison to pre-tonsillectomy, tongue was more posteriorly positioned and larger nasopharynx depth was shown in post-tonsillectomy. In post tonsillectomy, the hyoid bone was displaced posteriorly and superiorly and counterclockwise rotation was shown, 3. The level of significance for the correlations shown was 5 percent (p<0.05) indicating that: The change of nasopharyx depth was correlated to the inclination of lower incisors. Vertical change of tongue posture was correlated to the hyoid axis change. Vertical change of hyoid bone was correlated to the horizontal change of hyoid bone, craniocervical inclination. The change of craniocervical inclination was correlated to the inclination of lower incisors. 4. After the tonsillectomy, counterclockwise rotation of hyoid axis was associated with decrease of hya-NL and large nasopharyngeal airway. High posture of the tongue was associated with decrease of hya-NL. Posterior posture of the tongue was associated with increase of h-hl, and decrease of hya-ba-n.

前齒部 開放咬合者의 顎顔面 骨格 特性에 關한 硏究

金美卿,車卿石 대한치과교정학회 1991 대한치과교정학회지 Vol.21 No.3

This study was performed to verify the craniofacial skeletal characteristics in anterior open bite group, incontrast to normal occlusion group, and also to find out, vertical factors which shows, correlate to the amount of anterior openbite. 21 individuals, including 10 males and 11 females, without orthodontic treatment history and anterior- posterior skeletal malrelationships, were selected and analyzed basic morphology and vertical factors, using standard lateral cephalogram. The obtained results as follows: 1.Comparison of anterior open-bite group with normal occlusion group using Moyers analysis. a)In basis morphologic analysis, Ba-SE-ME was lesser and Ba-SE-Mn.P.and Mn.P/A-B were greater in both sexes of anterior openbite group than in normal occlusion group. b)In angle measurements of vertical analysis, PMV/pal.P.was lesser in male anterior openbite group and PMV/Occ.P.and PMV/Mn.P.were greater in both sexes of anterior openbite group than in normal occlusion group. c)In height ratio of vertical analysis, ATFH/PTFH and ALFH/ATFH were greater in both sexes of anterior openbite group than on normal occlusion group. 2.The amount of anterior openbite was correlated with PMV/Occ.P.and PMV/Mn.p.

Dental Age측정에 관한 硏究

박순서,차경석 대한치과교정학회 1991 대한치과교정학회지 Vol.21 No.2

Dental maturity is one of the index of physiological maturity indicators. To investigate the relationship between dental maturity and chronological age, the author took the orthopantomograms of 984 students, aged 7 through 17 years, having normal occlusion. The orthopantomograms were examined and calcification degree of each tooth on the left side was rated according to the method described by Demirjian. On the basis of findings of this study, the following results were obtained. 1.The root completion periods of mandibular permanent teeth were as follows: Central Incisor M 8.32±1.03 years F 7.96±1.04 years Lateral Incisor M 9.40±1.30 years F 9.01±0.90 years Canine M 12.81±1.24 years F 11.42±0.94 years 1st Premolar M 12.76±1.74 years F 12.19±1.33 years 2nd Premolar M 13.31±1.88 years F 12.88±1.49 years 1st Molar M 9.60±1.69 years F 9.30±1.16 years 2nd Molar M 14.38±1.73 years F 13.96±1.63 years 2.Sexual differences in same age group at given calcification stage were not significant statistically. 3.The developmental order in mandibular permanent teeth was as follows; a)central incisor, b)lateral incisor, c)1st molar, d)canine and 1st premolar, e)2nd premolar, f)2nd molar.

전치부 개방교합의 치료 한계

차경석 대한치과의사협회 1995 대한치과의사협회지 Vol.33 No.9

3급 부정교합 환자에서의 치료후 골격변화 양상에 관한 연구

정동화,차경석 대한치과교정학회 1996 대한치과교정학회지 Vol.26 No.3

교정치료는 치료 후의 분석이 이루어져야 그 성공여부를 평가받을 수 있다. 왜냐하면 교정치료는 환자자신의 고유한 균형을 변화시켜 또 다른 균형을 설정해가는 과정이기 때문이다. 그러나 1급이나 2급 부정교합에 비해 3급 부정교합 환자에 대한 연구는 미비하였다. 이 연구는 일반적인 교정치료시와 보정기간 중에는 어떠한 변화과정을 겪으며, 이들 중 재발양상을 나타내는 요소에 대하여 치료 전의 골격형태와 치료기간 중 변화량과의 상관관계를 알아보고자 시행하였다. 초진시의 Helleman dental age가 ⅢB이상이며 1년 6개월이상의 보정기간이 경과한 24명을 대상으로 하여 치료기간과 보정기간 중에 각항목의 변화량을 비교하고 이중 복귀현상을 나타낸 항목에 대한 상관관계를 분석하여 다음과 같은 결론을 얻었다. 1. FH plane에 대한 교합평면의 각과 하악평면의 각, 그리고 하악평면에 대한 하악 전치의 각은 치료기간중의 변화가 보정기간 중에 치료전의 상태로의 복귀현상을 나타내었으며 이중 교합평면각과 하악 전치의 치축항목은 치료기간중의 변화량과 역상관 관계를 나타내었다. 2. 치료 종료시 교합평면의 상방변위가 보정기간 중에 원래의 형태로 복귀하려는 경향을 보였으며 이는 치료기간 중에 변위량과 비례하여 나타났으나 기저골에 대한 상하악 대구치의 경사는 치료기간중의 변화량이 보정기간에 일정하게 유지되었다. 3. 보정기간 중의 하악평면각의 치료기간 중의 하악의 후하방 회전량이 클수록 감소하였다. This study was investigated the changes during treatment and retention period in the ClassⅢ malocclusion patients and explored the correlationship between factors that showed relapse tendencies and pre-treatment skeletal pattern and the changes during treatment period. Numbers of total sample were 24 and their Hellman's dental age at the start of treatment was over ⅢB and were retained at least over 1 year 5 months. The following conclusion were obtained by comparing the differences between treatment period and retention period, and after analysing the correlationship of factors that manifested relapse tendencies. 1. The angles formed by FH plane and occlusal plane, FH plane and mandibular plane, and mandibular incisor and mandibular plane changes showed rebound effect during retention period and among them occlusal plane angle and IMPA show reverse correlationship. 2. Upward displacement of the occlusal plane at the end of treatment has returning tendency, is proportional to the displacement during treatment period, but the angle between maxillary and mandibular 1st molar to its basal bone have been constantlsy maintained during the retention period. 3. Mandibular plane decrease during retention period and downward backward rotation during treatment period show correlationship.

Soft-tissue thickness of South Korean adults with normal facial profiles

차경석 대한치과교정학회 2013 대한치과교정학회지 Vol.43 No.4

Objective: To standardize the facial soft-tissue characteristics of South Korean adults according to gender by measuring the soft-tissue thickness of young men and women with normal facial profiles by using three-dimensional (3D) reconstructed models. Methods: Computed tomographic images of 22 men aged 20 - 27 years and 18 women aged 20 - 26 years with normal facial profiles were obtained. The hard and soft tissues were three-dimensionally reconstructed by using Mimics software. The soft-tissue thickness was measured from the underlying bony surface at bilateral (frontal eminence, supraorbital, suborbital, inferior malar, lateral orbit, zygomatic arch, supraglenoid, gonion, supraM2, occlusal line, and subM2) and midline (supraglabella, glabella, nasion, rhinion, mid-philtrum, supradentale, infradentale, supramentale, mental eminence, and menton) landmarks. Results: The men showed significantly thicker soft tissue at the supraglabella, nasion, rhinion, mid-philtrum, supradentale, and supraglenoid points. In the women, the soft tissue was significantly thicker at the lateral orbit, inferior malar, and gonion points. Conclusions: The soft-tissue thickness in different facial areas varies according to gender. Orthodontists should use a different therapeutic approach for each gender.