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어린이에서 저속 상악 확장에 따른 골격성, 치아치조성, 기도 변화에 대한 3차원적 평가

Three Dimensional Skeletal, Dentoalveolar and Airway Space Changes after Slow Maxillary Expansion in Children

김재곤|양연미|이대우|김나운
대한소아치과학회 (The Korean Academy Of Pediatric Dentistry)|2023.05|대한소아치과학회지 (Journal of the Korean academy of pediatric dentistry)|제50권 제2호|pp. 155-167

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키워드

CBCTSlow maxillary expansionRapid maxillary expansionBanded hyraxUpper airway volume
주제분류치의학

초록

이 연구의 목적은 상악 확장 속도에 따른 치아치조성, 골격성 효과 및 상기도에 대한 효과를 CBCT를 통해 3차원적으로 분석하여 저속 상악 확장의 효과를 확인하는 것이다. 전북대학교 소아치과에서 Banded hyrax를 이용하여 상악 확장을 시행한 23명(평균 8.93 ± 1.61세)의 환자가 포함되었다. 확장 속도에 따라 저속 상악 확장군과 급속 상악 확장군으로 분류되었다. 치료 전후의 치아치조성, 골격성, 기도 부피 변화를 평가하기 위해 치료전(T0)과 치료 종료 및 유지 후(T1)에 촬영한 CBCT를 사용하였다. 상악 확장 결과 두 군모두에서 치아치조성, 골격성 측정 값 및 상기도 부피의 유의한 증가가 관찰되었다. 또한모든 측정 값에서 저속 상악 확장과 급속 상악 확장 간의 유의한 차이를 보이지 않았다. 이연구는 혼합치열기 어린이에서 저속 상악 확장의 효과에 대해 확인하였다. 저속 상악 확장은 치아치조성, 골격성 측정 값 뿐만 아니라 기도 부피, 상악동 기체 부피에서도 유의한 효과를 보였다. 또한, 급속 상악 확장의 효과와 비교하였을 때 유의한 차이를 보이지 않았다. 따라서 소아치과의사는 성장기 어린이의 치주 조직의 생리적 측면, 불편감에 따른 협조도등을 고려하여 급속 상악 확장과 저속 상악 확장 중 적절한 방법을 선택할 수 있을 것이다.

Abstract

The aim of this study was to investigate the effects of slow maxillary expansion (SME) on the dentoalveolar, skeletal, upper airway, and maxillary sinus using cone-beam computed tomography (CBCT). Twenty-three orthodontic patients (mean age 8.93 ± 1.61 years) who were treated with maxillary expansion using banded hyrax in the Department of Pediatric Dentistry at Jeonbuk National University Dental Hospital were included. According to the expansion speed applied, they were divided into two groups: SME (12 subjects, mean age 8.92 ± 1.45 years) and rapid maxillary expansion (RME, 11 subjects, mean age 8.94 ± 1.84 years). CBCT were obtained before (T0) and after (T1) the treatment and were analyzed with InVivo5 software (Anatomage, San Jose, CA, USA). Descriptive statistics showed no significant differences between the two groups in age, sex, or skeletal maturity. There were significant increases in maxillary width at the dentoalveolar and skeletal levels for both groups. Upper airway volume revealed a significant increase of 38.59% in the SME group and 28.72% in the RME group. However, there was no significant difference between SME group and RME group in all measurements. This study suggested the efficacy of SME in growing patients. SME was effective in increasing not only dentoalveolar and skeletal measurements but also airway volume. Therefore, pediatric dentists should select an appropriate expansion method considering the physiological aspects of periodontal tissues and discomfort in growing children.

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