Cone-beam CT를 이용한 제II급 부정교합 아동의 상기도 형태에 관한 3차원적 연구
Three dimensional analysis of the upper airway and facial morphology in children with Class II malocclusion using cone-beam computed tomography
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
성장기 아동의 상기도 협착은 두개안면 성장에 영향을 미칠 수 있다. 본 연구는 3차원 cone-beam computed tomography (CBCT)를 이용하여 제II급 부정교합 아동의 상기도 부피 및 단면적 계측치와 측모두부계측치를 비교하여 상기도와 안면 형태와의 연관성을 알아보고자 하였다. 37명의 아동(남자 17명, 여자 20명, 평균 연령 11.02세)의 CBCT를 촬영하였다. 연구 결과, 상기도의 PNS-posterior plane에서의 단면적(SPP)은 제II급 부정교합군에서 유의하게 작았다 (p < 0.05). 상기도 부피 계측치는 제II급 부정교합군에서 제I급 부정교합군보다 작았으나, 두 군 간 통계적으로 유의한 차이는 없었다. 제II급 부정교합군은 후안모고경(PFH), mandibular body length (p < 0.05), Pog to N perp (p < 0.01)에서 제I급 부정교합군보다 유의하게 작은 값을 보였고, FMA (p < 0.05), ANB, facial convexity (p < 0.01)는 유의하게 큰 값을 보였다. 제II급 부정교합군의 PNS 전방의 상기도 부피(WN)는 ANB difference 각도와 음의 상관관계를 보였다 (p < 0.05). 제II급 부정교합 아동은 상대적으로 좁은 상기도 부피를 가지며 이에 따른 감소된 후안모고경(PFH)과 하악골의 divergent한 안면 성장 양상을 보였다. (대치교정지 2010;40(3):134-144)
Abstract
Objective: The aim of this study was to evaluate the volumes and areas of the upper airways in children with Class II malocclusion, using three dimensional cone-beam computed tomography (CBCT) and to compare the volumetric and cross-sectional measurements and cephalometric variables to investigate possible relationships between the upper airway and facial morphology. Methods: CBCT scans were obtained from 37 subjects (17 boys and 20 girls; average age, 11.02 years). The upper airway volumes and areas were measured, and compared with cephalometric variables. Results: The area of the PNS-posterior plane (SPP) was significantly smaller in the Class II malocclusion group (p < 0.05). Also, the volumetric and cross-sectional measurements were lower in Class II than in Class I malocclusion groups, although the differences were not significant between the two groups (p > 0.05). The Class II malocclusion group showed significantly smaller values of PFH, mandibular body length, pog to N perp and showed larger values of FMA, ANB, and facial convexity than the Class I malocclusion group. The volume of the upper airway in front of PNS point (WN) showed negative correlation with ANB (p < 0.05). Conclusions: The Class II malocclusion group had a narrower upper airway associated with a decreased posterior facial height and a divergent growth pattern than the Class I malocclusion group. (Korean J Orthod 2010;40(3):134-144)
참고문헌 (30)
- Ceylan I, "A study on the pharyngeal size in different skeletal patterns", Am J Orthod Dentofacial Orthop, 108, pp.69~75 (1995)
- Holmberg H, "Cephalometric radiographs as a means of evaluating the capacity of the nasal and nasopharyngeal airway", Am J Orthod, 76, pp.479~90 (1979)
- Joseph AA, "cephalometric comparative study of the soft tissue airway dimensions in persons with hyperdivergent and normodivergent facial patterns", J Oral Maxillofac Surg, 56, pp.135~9 (1998)
- Ricketts RM, "Respiratory obstruction syndrome", Am J Orthod, 54, pp.495~507 (1968)
- Lopatiene K, "Malocclusion and upper airway obstruction", Medicina (Kaunas), 38, pp.277~83 (2002)
- Angle E, "Treatment of malocclusion of the teeth. 7th ed", pp.45~ (1907), SS White Manufacturing Company
- Linder-Aronson S, "Their effect on mode of breathing and nasal airflow and their relationship to characteristics of the facial skeleton and the denition. A biometric, rhino-manometric and cephalometro-radiographic study on children with and without adenoids", Acta Otolaryngol, 265, pp.1~132 (1970)
- Moore A, "Observations on mouth breathing", Bull N Z Soc Periodontol, 33, pp.9~11 (1972)
- Hwang CJ, "A longitudinal study of nasopharynx and adenoid growth of Korean children", Korean J Orthod, 15, pp.93~104 (1985)
- Lee YS, "A cephalometric study on the airway size according to the types of the malocclusion", Korean J Orthod, 25, pp.19~29 (1995)
- 이윤섭, "3D-CT를 이용한 골격성 III급 개방교합자의 악교정 수술 전, 후 설골 및 상기도의 변화", 대한치과교정학회지, 39(2), pp.72~82 (2009), 대한치과교정학회
- Alves PV, "Three-dimensional cephalometric study of upper airway space in skeletal class II and III healthy patients", J Craniofac Surg, 19, pp.1497~507 (2008)
- 장혜숙, "3차원 CT 영상을 이용한두개악안면 분석을 위한 계측점의 제안", 대한치과교정학회지, 32(5), pp.313~325 (2002), 대한치과교정학회
- Iwasaki T, "Oropharyngeal airway in children with Class III malocclusion evaluated by cone-beam computed tomography", Am J Orthod Dentofacial Orthop, 136, pp.318~9 (2009)
- 김용일, "Cone beam CT를 이용한 안면골격형태에 따른 상기도 공간 분석", 대한치과교정학회지, 39(3), pp.136~145 (2009), 대한치과교정학회
- Dahlberg G, "Statistical methods for medical and biological students", pp.1~140 (1940), G. Allen & Unwin Ltd
- Lagravère MO, "Three-dimensional accuracy of measurements made with software on cone-beam computed tomography images", Am J Orthod Dentofacial Orthop, 134, pp.112~6 (2008)
- Major MP, "Assessment of lateral cephalometric diagnosis of adenoid hypertrophy and posterior upper airway obstruction: a systematic review", Am J Orthod Dentofacial Orthop, 130, pp.700~8 (2006)
- Abramson ZR, "Three-dimensional computed tomographic analysis of airway anatomy", J Oral Maxillofac Surg, 68, pp.363~71 (2010)
- Fouke JM, "Effect of position and lung volume on upper airway geometry", J Appl Physiol, 63, pp.375~80 (1987)
- Pae EK, "A cephalometric and electromyographic study of upper airway structures in the upright and supine positions", Am J Orthod Dentofacial Orthop, 106, pp.52~9 (1994)
- Proffit WR, "Concepts of growth and development. In Contemporary orthodontics. 4th ed", pp.27~9 (2007), Mosby
- 황용인, "사춘기전 I, II급 부정교합 아동의 기도 면적,혀의 위치와 안면 형태에 관한 연구", 대한치과교정학회지, 38(2), pp.74~82 (2008), 대한치과교정학회
- McNamara JA, "Influence of respiratory pattern on craniofacial growth", Angle Orthod, 51, pp.269~300 (1981)
- Subtelny JD, "The significance of adenoid tissue in velopharyngeal function", Plast Reconstr Surg, 17, pp.235~50 (1956)
- Mergen DC, "The size of nasopharynx associated with normal occlusion and Class II malocclusion", Angle Orthod, 40, pp.342~6 (1970)
- 김윤지, "교정치료에 따른 사춘기 성장 아동의 상기도 폭경과 안면 성장 변화와의 관계 연구", 대한치과교정학회지, 39(3), pp.168~176 (2009), 대한치과교정학회
- Behlfelt K, "Cranio-facial morphology in children with and without enlarged tonsils", Eur J Orthod, 12, pp.233~43 (1990)
- Solow B, "Airway adequacy, head posture, and craniofacial morphology", Am J Orthod, 86, pp.214~23 (1984)
- Sosa FA, "Postpharyngeal lymphoid tissue in Angle Class I and Class II malocclusions", Am J Orthod, 81, pp.299~309 (1982)
