Precision TPA로 회전된 편측 구치 치료시 공간변화에 대한 연구
Spatial changes of the maxillary molar following unilateral derotation with the precision TPA
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초록
본 연구의 목적은 치아의 이동양상을 관찰하기 위해 고안된 Calorific machine system(typodont simulation system)과 precision TPA를 이용하여, 근심 회전된(mesial-in rotation) 상악 대구치를 회전(derotation)시킨 후 해당 치아 및 반대측 고정원의 공간변화를 확인하기 위함이다. 우측 상악 제1대구치를 고정원으로 사용하였고 좌측 상악 제1대구치를 근심 회전된 치아로 사용하였으며, TPA에 부여한 회전각은 20°, 40°, 60° 였다. 먼저 수동형의 precision TPA를 제작한 후, TPA의 왼쪽 삽입부위(tag)를 각각 20°, 40°, 60°로 구부려 실험하였다. 각 군별 실험은 동일한 조건에서 5회 반복한 후 ANOVA 와 Tucky's Studentized Range(HSD) test로 검정 하였다. 실험 결과, 교합면에서는 precision TPA의 구부리는 각도가 증가할수록 회전된 구치의 원심 설측 교두가 근심 설측 방향으로 움직이는 동안, 근심 협측 교두는 협측으로 더 많이 움직였고(p<0.001) 원심방향으로는 더 적게 움직였다.(p<0.001) 시상면에서 회전 구치의 구개측 치근은 더욱 근심으로 움직였다.(p<0.001) 횡단면에서는 회전된 치아가 약간의 정출을 보였다(p<0.001). 고정원으로 사용된 우측 상악 제1대구치는 세 평면에서 의미 있는 변화를 보이지 않았다.
Abstract
The purpose of this study was to evaluate the spatial changes of mesial-in rotated maxillary molar and opposite anchor tooth during derotation by the precision transpalatal arch (TPA) with the use of a new typodont simulation system, the Calorific machine system, which was designed to observe the whole process of tooth movement. The maxillary right first molar was used for the anchor tooth and the maxillary left first molar was used for the mesial-in rotated tooth, and the angle of rotation was increased to 20, 40, and 60. A passive precision TPA was fabricated and then activated by bending the left arm to 20, 40, and 60. Each experiment was repeated five times under the same conditions and analyzed by ANOVA and Tucky's Studentized Range (HSD) test. In the occlusal plane, when the bending angle of precision TPA was increased, the mesiobuccal cusp of the rotated molar moved more buccally (p<0.001) and less distally (p<0.001) while the distolingual cusp moved in the mesiopalatal direction. In the sagittal plane, the palatal roots of the derotated molar moved mesially (p<0.001). In the traverse plane, the derotated molar showed slight extrusion (p<0.001). The upper right first molar, which was used as an anchor tooth, showed clinically insignificant movement across all three planes.
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