장안모를 보이는 치주 질환자에서 하악 전치의 압하를 통한 과개 교합 치료 : 8년 경과 관찰
Orthodontic intrusion treatment of mandibular anterior teeth in a periodontal patient with hyperdivergent skeletal pattern : 8-year follow-up
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치아의 병적 이동으로 전치가 정출되고 수직 피개가 깊은 치주염 환자에서는 치주 염증 치료와 더불어 정출된 전치의 위치 개선이 필요하다. 그러나 깊은 수직 피개로 교정 장치 부착이 어렵고, 역학적으로 전치 압하보다 구치 정출이 더욱 쉽게 발생하는 문제점이 있다. 특히 골격적 장안모를 보이는 환자에서 구치 정출을 통한 상대적 전치 압하는 안모의 악화를 야기하므로, 치료 계획에서부터 이를 차단하기 위한 설계가 필요하다. 본 증례에서는 전치가 정출되어 과개 교합을 보이는 치주염 환자에서, 철저한 치주 치료와 하악 전치에 부착한 cute bracket과 골성 고정원을 이용한 고정원 보강으로하악 전치의 양호한 압하 치료 결과를 얻을 수 있었으며, 8년간 경과 관찰하여 이를 보고하고자 한다.
Abstract
Patients who have extruded anterior teeth and deep bite with pathologic tooth migration, it is necessary not only periodontal treatment for reduce inflammation, but also orthodontic treatment for intrusion of anterior teeth. However, it is difficult to place the orthodontic brackets due to the deep bite, and there is a problem that the extrusion of the posterior teeth occurs more easily than the intrusion of the anterior teeth biomechanically. In particular, in patients with long face, relative intrusion of the anterior teeth by extrusion of the posterior teeth causes the clockwise rotation of the mandible and makes the facial profile worse. Therefore the biomechanical consideration and appliance design that can block these problems are required from the treatment plan. This is a patient who had a deep overbite with extruded anterior teeth, treated by periodontal treatment and intrusion of mandibular anterior teeth using cute brackes and miniscrews, and resulted in favorable maintenance during 8-year retention.
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