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심한 총생 : 비발치로 가능한가?

Severe crowding : Is nonextraction treatment possible?

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초록

Extraction treatment has been used for a long time to treat crowding or lip protrusion patients and still extraction decision is the most difficult and important decision during diagnosis and treatment planning. If the amount of crowidng is severe, premolar extraction is often considered. Because of their location, premolar extractions would seem to allow for the most straightforward relief of crowding and the improvement of soft tissue profile. But patients and their parents often prefer nonextraction approach if possible and such a preference gives us serious question about the boundary of nonextraction treatment. Because Orthodontic Mini-Implant (OMI) become popular these days, distalization of posterior teeth can be obtained easily without patient's compliance. For this reason, many orthodontists are trying to treat crowding patient with nonextraction than before. But sometime, unexpected side effects are observed including unesthetic profile, impaction of second molar and long treatment time. All the tools for space gaining – extraction, arch expansion, molar distalization and interproximal enamel reduction - have their limitations and indications. Possible side effects and limitations should be carefully considered during the treatment planning. Although Korean patients usually require extraction more often than US or European patients, more knowledge about the tools for space gaining would help us to decrease the rate of extraction and the problems during treatment of crowding patients.

Abstract

Extraction treatment has been used for a long time to treat crowding or lip protrusion patients and still extraction decision is the most difficult and important decision during diagnosis and treatment planning. If the amount of crowidng is severe, premolar extraction is often considered. Because of their location, premolar extractions would seem to allow for the most straightforward relief of crowding and the improvement of soft tissue profile. But patients and their parents often prefer nonextraction approach if possible and such a preference gives us serious question about the boundary of nonextraction treatment. Because Orthodontic Mini-Implant (OMI) become popular these days, distalization of posterior teeth can be obtained easily without patient's compliance. For this reason, many orthodontists are trying to treat crowding patient with nonextraction than before. But sometime, unexpected side effects are observed including unesthetic profile, impaction of second molar and long treatment time. All the tools for space gaining – extraction, arch expansion, molar distalization and interproximal enamel reduction - have their limitations and indications. Possible side effects and limitations should be carefully considered during the treatment planning. Although Korean patients usually require extraction more often than US or European patients, more knowledge about the tools for space gaining would help us to decrease the rate of extraction and the problems during treatment of crowding patients.

참고문헌 (12)

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  7. Johner AM, "Quantitative comparison of 3 enamel-stripping devices in vitro: How precisely can we strip teeth?", Am J Orthod Dentofac Orthop, 143, pp.s168~s172 (2013)
  8. Ferro F, "Mandibular lip bumper treatment and second molar eruption disturbances", Am J Orthod Dentofac Orthop, 139, pp.622~627 (2011)
  9. Rubin RL, "Mandibular second molar eruption difficulties related to the maintenance of arch perimeter in the mixed dentition", Am J Orthod Dentofac Orthop, 141, pp.146~152 (2012)
  10. Hudson AL, "A study of the effects of mesiodistal reduction of mandibular anterior teeth", Am J Orthod, 42, pp.615~624 (1956)
  11. Stroud JL, "Enamel thickness of the posterior dentition : its implications for nonextraction treatment", Angle Orthod, 68, pp.141~146 (1998)
  12. Jung MH, "A comparison of second premolar extraction and miniimplant total arch distalization with interproximal stripping", Angle Orthod, 83, pp.680~685 (2013)

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