발치 및 비발치 치료 전후 악궁 폭경의 변화
Change in arch width in extraction vs nonextraction treatment
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초록
일반적으로 네 개의 소구치 발치를 동반한 교정치료는 비발치 치료에 비하여 치열궁 폭경을 더 좁게 만들어, 미소 시 구각 부위에 어두운 구강 내 공간, 소위 buccal corridor를 형성함으로써 비심미적인 결과를 낳는다는 견해가 있다. 한편 발치 치료는 오히려 하악의 견치간 폭경을 증가시키며, 비발치 치료와 비교하여 악궁 폭경의 변화에 있어 유의한 차이를 보이지 않는다는 상반된 연구결과가 존재한다. 이 연구는 발치 치료와 비발치 치료 시 악궁 폭경의 변화를 관찰하여 실제적으로 발치 치료가 미소 시 협측 분절에 미치는 영향을 규명하고자 시행되었다. 경희대학교 치과병원 교정과에서 치료받은 환자 중 전악에 고정식 장치를 사용하여 네 개의 제1소구치 발치 치료를 받은 30명과 비발치로 치료한 30명의 치료 전후 연구 모형을 비교 분석한 결과 악궁 폭경의 변화는 다음과 같다. 네 개의 제1소구치 발치 치료 시 비발치 치료와 비교하여 상악의 견치간 폭경 변화는 유의한 차이가 없었으나, 하악의 견치간 폭경은 유의하게 더 많이 증가하였다. 구치간 폭경 변화는 상악과 하악 치열궁 모두에서 두 군 간에 유의한 차이가 나타났는데, 발치군에서 구치간 폭경이 감소한 반면에 비발치군에서는 구치간 폭경이 증가하였다. 미소 시 노출되는 악궁 폭경은 비발치군보다 발치군에서 더 크게 나타났으며, 이는 치열궁 폭경의 축소가 발치 치료 시 당연히 예상되는 결과가 아님을 시사한다. (대치교정지 2007;37(1):65-72)
Abstract
Objective: This study was performed to investigate the influences of extraction and nonextraction treatment on smile esthetics by measuring dental arch width changes. Methods: Pretreatment and posttreatment study models of 30 first premolar extraction cases and 30 nonextraction cases were randomly selected to determine whether extraction treatment results in narrow dental arches, and a consequent unaesthetic smile. Arch widths were measured from the cusp tips of the canines and the first molars. Posterior arch widths were also measured at a constant arch depth derived by averaging randomly chosen nonextraction models. Results: The intercanine widths increased significantly in the extraction sample, whereas the intermolar widths decreased significantly. The arch width at a standardized arch depth was significantly wider in the extraction subjects. Conclusion: These results elucidate that constriction in arch width is not a materialized consequence of extraction treatment. It leads to postulate that an esthetically compromising effect from narrow dental arches on smile is hardly anticipated with extraction treatment. (원 저 대치교정지 2006;36(3):178-7 ORIGINAL ARTICLE Korean J Orthod 2007;37(1):66-72)
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