정중구개부 미니스크류를 이용한 개방교합치료에 대한 연구
A study on the treatment of anterior open bite with midpalatal miniscrews
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본 연구에서는 전치부의 개방교합을 동반한 환자 5명의 증례를 분석하여 (1) 성인에서의 상악 구치 함입을 통한 개방교합의 치료의 가능성과 (2) 이때 고정원으로서의 정중구개부 미니스크류의 유용성 여부와 (3) 치료에 의한 골격성, 치아-치조골의 변화에 대해 알아보고자 하였다. 상악구치부를 스플린트한 후 정중구개부에 두개의 미니스크류를 삽입하고 구개횡선 아치로 상악제일대구치를 연결한 뒤, 탄성재를 이용하여 상악 제일대구치에 함입력을 적용하였다. 측면두개방사선상의 변화에 대한 분석 결과 다음과 같은 결과를 얻었다. 1. 모든 환자에서 상악 제 1대구치의 실질적인 압하가 일어났고, 이때 평균 압하량은 3.4mm (1.5mm~5.0mm)였다. 2. 상악 구치의 압하를 시행하는 동안 임상적으로 정중구개부의 미니스크류의 안정성이 유지되었다. 3. 하악이 반시계방향으로의 회전되었으며, 하악평면각, 교합평면각의 감소가 관찰되었다.
Abstract
Recently several techniques have been reported for the treatment of anterior open bite in adults characterized by molar intrusion with skeletal anchorage. In this study, five adult patients who had anterior open bite malocclusion were selected to undergo upper molar intrusion with midpalatal miniscrew to close the open bite. The aim of this study is (1) to validate true intrusion of molars in adults (2) to test the usefullness of midpalatal miniscrews as anchorage for intruding upper molars (3) to evaluate the skeletal and dental changes of open bite closure. The results are as follows. (1) All had true intrusion of the maxillary molars. Mean amount of molar intrusion was 3.4mm(range 1.5-5mm). (2) No movement of midpalatal miniscrew occurred during their use. (3) Open bite closure was achieved for all 5 patients. The mandible closed and B-point rotated anteriorly and upward. The mandibular plane angle and the occlusal plane angle decreased.
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