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수직적 골격 패턴에 따른 가철식 투명 교정 장치 치료 결과

Other Titles
 The effect of vertical skeletal pattern on clear orthodontic appliance treatment 
Authors
 정인성 
College
 College of Dentistry (치과대학) 
Degree
석사
Issue Date
2019
Abstract
치아 전체를 감싸는 투명 교정 장치는 형태적 특성으로 인해 장치 자체가 posterior bite–block으로 작용하여 환자의 교합력에 따라 수직적으로 영향을 받게 된다. 교합력은 환자 개인의 수직적 골격패턴과 밀접한 상호연관성이 있으며, 수직적인 안모를 가진 환자일수록 교합력은 작아진다. 본 연구는 성인 환자의 치료 전 수직적 골격패턴에 따라 가철식 투명 교정 장치의 치료 후 결과가 유의하게 달라지는지를 측모두부방사선사진 비교를 통해 알아보았다. 경도의 총생 해소를 위해 비발치로 가철식 투명 교정 장치 (InvisalignⓇ, Align Technology, Santa Clara, Calif, USA)로 치료를 진행한 환자를 대상으로 mandibular plane angle (to SN)에 따라 low angle군 (남성 8명, 여성 21명, 평균 26.2 ± 3.8세)과 high angle군 (남성 9명, 여성 26명, 평균 28.6 ± 4.7세)으로 나누어 두 군의 측모두부방사선사진을 통해 치료 전 (T1), 치료 후 (T2) 골격적, 치성 계측치를 비교하여 다음과 같은 결과를 얻었다. 1. 골격적 계측 항목에서는 low angle군과 high angle군 공통적으로 전안면고경이 감소하였고 (low angle, P<0.001; high angle, P<0.05), low angle군에서 더 많은 양 감소하여 두 군 간 유의한 차이를 나타냈다 (P<0.001). 후안면고경은 low angle군에서만 유의하게 감소하여 (P<0.001), 두 군 간 유의한 차이를 나타냈다 (P<0.001). 2. 구치부 계측 항목에서는 두 군에서 공통적으로 상하악 제2대구치가 유의하게 압하 되었으나 (low angle, P<0.001; high angle, P<0.05), 상하악 제1대구치는 low angle군에서만 유의하게 압하 되었고 (P<0.01), 압하량은 low angle군에서 high angle군보다 유의하게 컸다 (P<0.05). 3. 전치부 계측 항목에서는 두 군에서 공통적으로 수직 피개가 유의하게 증가하였으나 (low angle, P<0.001; high angle, P<0.05), 증가량은 low angle군이 high angle군보다 더 컸다 (P<0.05). 수평 기준선에서 하악 전치까지의 거리는 low angle군에서만 유의하게 감소하여 (P<0.001), 두 군 간 유의한 차이가 있었다 (P<0.001). 위 결과로 가철식 투명 교정 장치를 이용한 비발치 치료를 시행할 때, low angle의 환자는 high angle의 환자보다 구치부가 압하되어 수직 안면고경이 감소하는 경향이 높다는 점을 고려하여야 할 것이다. Due to its morphological characteristics, removable clear orthodontic appliance that wraps the entire tooth, acts as a posterior bite-block and is vertically influenced by the occlusal force of the patients. As vertical skeletal pattern and occlusal force are closely related to each other, patients with vertical growth pattern have smaller occlusal forces. The purpose of this study was to compare whether the post-treatment results of the removable clear orthodontic appliance will change significantly according to the pre-treatment vertical skeletal pattern of adult patients by using lateral cephalograms. In this study, I have analyzed patients who have mild crowding and have been treated by removable clear orthodontic treatment (InvisalignⓇ, Align Technology, Santa Clara, Calif, USA) by non-extraction. Subjects are divided into two groups according to the mandibular plane angle (to SN), which corresponds to the low angle group (8 males and 21 females, mean age of 26.2 ± 3.8 years) and the high angle group (9 males and 26 females; mean age, 28.6 ± 4.7 years). Comparing the skeletal and dental measurements of both pre- (T1) and post-treatment (T2) using lateral cephalograms, we have come to some results as below. 1. In skeletal measurement, both low angle group and high angle group showed decrease of anterior facial height (low angle, P<0.001; high angle, P<0.05), but low angle group showed more decrease than high angle group (P<0.001). Posterior facial height was significantly decreased only in low angle group (P<0.001), the difference in the amount of change was significant in two groups (P<0.001) 2. In posterior part of dental measurement, both groups showed intrusion of maxillary and mandibular second molars (low angle, P<0.001; high angle, P<0.05), but maxillary and mandibular first molars were only intruded in low angle group(P<0.01). The amounts of intrusion were greater in low angle group than high angle group (P<0.05). 3. In anterior part of dental measurement, both groups showed increase of overbite (low angle, P<0.001; high angle, P<0.05), but low angle group showed more increase than high angle group (P<0.05). Distance from tip of mandibular incisor to horizontal reference line was significantly decreased only in low angle group (P<0.001), the difference in the amount of change was significant in two groups (P<0.001) Clinician should consider about the results that low angle patient, who received a non-extraction treatment using removable clear orthodontic appliance, were likely to experience more intrusion in the molars and consequently have decreased vertical facial height than high angle patient.
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Appears in Collections:
2. College of Dentistry (치과대학) > Others (기타) > 5. Others
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/178268
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