교합안정장치 사용후 하악과두의 위치변화에 관한 연구

Abstract

[한글]

저작계 기능이상의 증상이 없는 11명의 정상군과 기능이상의 증상을 갖고 연세대학교 치과병원 교합과에 내원한 18명의 환자군을 대상으로 교합안정장치 장착 전후의 중심위 교합 기록을 채득하고 상하악 모형을 교합기에 옮긴 후 Vericheck를 이용하여 하악골이 중심위에 있을 때 시상면에서의 하악과두 위치를 측정하여 다음과 같은 결론을 얻었다.

1. 정상군의 경우 교합안정장치 장착 전자 2주간의 장착후에 나타나는 중심위에서의 하악과두 위치 재현도는 유의차가 없었다.

2. 환자군의 경우 치료후에 나타나는 하악과두 위치의 재현도는 치료전에 비하여 향상되었으나 (p＜0.01 ), 정상군보다는 뒤떨어졌다. (p＜0.01 )

3. 정상군에서 장착 2주후에 나타나는 하악과두 위치의 평균이동 거리는 0. 38±0.22mm 였다.

4. 환자군에서 치료후 하악과두 위치의 평군이동 거리는 1. 36 ±0.70mm로써 정상군보다 매우 컸다. (p＜0.01 )

5. 환자군에서는 치료후 하악과두 위치의 이동방향이 주로 전상방으로 변하였고 특히 상방으로의 변화가 뚜렷하였다.

[영문]

The establishment of an optimal and functional condylar position (centric relation) as the therapeutic and diagnostic reference position during occlusal treatment for patients with temporomandibular joint and muscle pain dysfunction has long been an important subject in dentistry.

The objective of this study was to compare the reproducibility and the changes of condylar position in normal group to those in patient group after use of the occlusal biteplane splint.

For this study, 11 normal adults who had no symptoms of masticatory dysfunction and 18patients who had visited at the department of occlusion in dental infirmary of Yonsei University were selected. For each subject three centric relation records

were recorded before treatment, after 2 weeks and after symptoms were improved. And the condylar positions in centric relation were measured using articulators and a Vericheck.

On the basis of this study, the following results were obtained.

1. In normal group, there was no significant difference of reproducibility in condylar position before and after the use of the occlusal biteplane splint for 2 weeks.

2. In patient group there was significant improvement in the reproducibility of condylar position after treatment (P < 0.71). The reproducibility in patient group, however, was less than normal group.(P < 0.01)

3. The mean distance of condylar movements was 0.38 ± 0.22 mm after 2 weeks in normal group.

4. In patient group, condylar movements were 1.36 ± 0.70 mm (P < 0.01), significantly different from normal group. (P < 0.01)

5. In patient group, the main direction of condylar movements after treatment was toward anterior and superior, preponderance being at superior direction.