하악 후퇴술과 전진 이부성형술이 시행된Ⅲ급 부정교합자의 초진 시 측모 두부 방사선사진특성에 관한 연구
A comparative study of initial lateral cephalometric characteristics: mandibular setback surgery only versus mandibular setback surgery with advancement advancement genioplasty
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III급 부정교합의 악교정수술을 통한 치료 시 하악 후퇴술만을 시행하는 경우와 하악 후퇴술에 전진 이부성형술이 추가로 시행되는 경우에 있어 초진 시 측모 두부 방사선사진상의 특성차이에 대하여 알아보고자 하였다. 구올담치과병원 구강외과에서 III급 부정교합을 하악후퇴술을 통하여 치료한 33명을 대상으로 하여 하악 후퇴술만을 시행한 21명과 하악 후퇴술과 전진 이부성형술을 시행한 12명으로 나누어 초진 측모 두부 방사선사진상의 차이를 알아보았다. 그 결과 B군에서 N-Me, ANS-Me이 더 길었으며 교합평면의 각도가 더 컸다. 구개평면에서 상악중절치까지의 거리, 하악평면에서 하악 절치 및 제1대구치까지의 거리가 B군에서 더 길었으며, 상악 중절치는 더 설측경사를 보였다. B군에서 Sn-Stms는 더 길고 연조직 Pog은 덜 돌출되어 있었다. 본 연구의 결과에 따라 III급 부정교합 환자에서 하악 후퇴술과 더불어 전진 이부성형술이 시행될지 여부를 예측하는데 초진 측모 두부 방사선사진상의 위 계측항목을 이용할 수 있을 것이다. 수술전 발치교정을 시행한 경우가 있다는 것과 외과의의 심미안, 해부학적 구조등이 이부성형술에 영향을 미쳤을 수 있다는 것은 본 연구의 한계로 생각된다.
Abstract
Objective: The aim of this study was to compare the initial lateral cephalometric characteristics in two groups of patients: those that had mandibular setback surgery only and those that had mandibular setback surgery with advancement genioplasty. Methods: The lateral cephalograms of thirty-one patients were studied. Twenty-one Class III patients (group A) had only madibular setback surgery. Twelve Class III patients (group B) had mandibular setback surgery with advancement genioplasty. Results: Differences between two groups were found in N-Me, ANS-Me, Occlusal Plane angle, Palatal Plane to U1, Mandibular Plane to L1, Mandibular Plane to L6, SN to U1, Sn-Stms, and Pog' projection. Compared to group A, group B showed more linguoversion and extrusion of upper incisors, more extrusion of lower incisors and lower first molar, and more steepness of the occlusal plane. N-Me, ANS-Me, and Sn-Stms were also longer in group B. But Pog' projection was shorter than group A. Conclusion: We conclude that certain initial lateral cephalometric characteristics may help indicate the inclusion of advancement genioplasty when mandibular setback surgery is planned in skeletal Class III patients.
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