C-activator를 이용한 성장기 II급 부정교합환자의 구치부 원심이동 치험례
C-activator treatment for distalization of maxillary molars in Class II anterior deep bite malocclusion
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초록
혼합 치열기의 교정치료 증례 중에서 경도의 총생을 가진 경우 상악 대구치를 원심 이동함으로서 양호한 치료의 결과를 얻는 경우가 많다. 주로 악외 견인장치를 적용하여 원심이동을 시행하지만 환자의 협조도에 따라 구치의 원심이동이 결정되는 단점을 가지고 있다. 구강내 고정원 사용시 생길 수 있는 반작용을 최소화하기 위해 정에 의해 개발된 C-space regainer는 후방이동 시키고자 하는 치아를 제외한 거의 모든 치아들을 완벽하게 묶음으로서 효과적인 후방이동을 가능케 하는 장치이다. 후속영구치의 맹출 공간 부족으로 매복 치에 의한 인접치의 치근손상이 예상되는 성장기 II급 부정교합 환자에서 악기능 교정장치에 c-space regainer의 개념을 적용한 변형된 C-space regainer, 즉 C-activator가 사용되어 양호한 치료결과를 얻었기에 이에 보고하는 바이다.
Abstract
A modified removable appliance for molar distalization called C-activator was used in a 10-year old male patient with a Class II anterior deep bite malocclusion with upper arch discrepancy. The treatment plan involved correcting the Class II relationship, distalizing both upper first molars, and regaining space for the erupting canines. The C-activator, which was used for 6 months, consisted of a labial framework formed from .036-in stainless steel wire and an acrylic monobloc. Both the closed helices of the labial framework were compressed for reactivation during the C-activator treatment period. C-activator mechanics simultaneously achieved distalization of the upper first molars into their proper positions and repositioning of the mandible. After 21 months of treatment, the correct overbite and overjet was obtained and contributed to an improvement in facial balance. The treatment results were stable 6 months after debonding. Fabrication and placement of the new appliance and clinical procedures are detailed, and the treatment sequence and results of this case are presented as follows.
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