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한국인 성장기 Ⅲ급 부정교합의 TTBA 치료 후상악골 견인 효과

Maxillary protraction effects of TTBA (Tandem Traction Bow Appliance) therapy in Korean Class III children

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초록

이 논문의 목적은 성장기 골격성 III급 부정교합의 치료를 위하여 새로이 고안된 Tandem Traction Bow Appliance (TTBA)의 상악골 견인 효과를 평가하는 것이다. 이화여자대학교 목동병원 치과 교정과에 내원한 성장기 골격성 III급 부정교합 환자 중 TTBA로 치료받은 88명(소년 42명, 소녀 46명)을 대상으로 하였다. 치료 시작 시 연령은 7세 6개월 ± 1년 6개월이었으며, 평균 치료 기간은 13개월 ± 3개월이었다. 치료 전과 후의 측모두부방사선사진계측이 동일 조사자에 의해 투사 및 중첩되었으며, modified McNamara analysis과 pitchfork analysis로 분석하였다. 치료 전후의 변화를 알아보기 위하여 paired sample t-test를 실시하였으며 다음과 같은 결론을 얻었다. 상악과 상악치열은 전방으로 이동하였다. 하악은 후방으로 이동하였으나, 그 양은 통계학적으로 유의하지 않았다. 하악치열은 전방으로 이동하였다. Net dental changes와 apical base change가 복합되어 나타난 결과, III 급 부정교합 치료에 유리한 방향으로 total molar relationship correction이 일어났다. Total molar relationship correction에 대한 기여 정도는 net dental movement 26%, apical base change 74%였다. 이상의 결과는 TTBA 치료가 상악골 결핍을 가진 성장기 골격성 III급 부정교합에서 유의한 상악골 견인 효과를 가진다는 것을 의미한다.

Abstract

Objective: The purpose of this study was to investigate the maxillary protraction effects of the Tandem Traction Bow Appliance (TTBA), a new appliance devised several years ago for the treatment of growing skeletal Class III patients. Methods: Participants were 88 Korean children (42 boys, 46 girls) with skeletal Class III malocclusion treated with TTBA at the orthodontic clinic of Ewha Womans University Mokdong Hospital. Mean age at the start of treatment was 7.5 years ± 1.5 years. Mean treatment periods were 13 ± 3 months. Pretreatment and posttreatment lateral cephalograms were traced and superimposed by the same investigator and analyzed by modified McNamara analysis and pitchfork analysis. Changes were evaluated with paired t-tests at a significance level of p < 0.05. Results: The maxilla and maxillary dentition moved forward. The mandible moved backward, although not significantly; and the mandibular dentition moved forward. The net dental changes combined with the apical base change resulted in a favorable total molar relationship correction. Net dental movement was 26% and the apical base change 74% of the total molar relationship correction. Conclusion: These results suggest that TTBA has a maxillary protraction effect that can be useful in the treatment of growing skeletal Class III malocclusion with maxillary deficiency. (Korean J Orthod 2007;37(3):231-40)

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