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인접면 삭제와 변위-기반 접착술로 부착한 수용성 튜브를 이용한 절치 돌출의 교정 치료
노유연(Yu-Yeon Roh),임성훈(Sung-Hoon Lim),정서린(Seo-Rin Jeong) 대한치과의사협회 2017 대한치과의사협회지 Vol.55 No.12
Orthodontic treatment with premolar extraction is usually performed to correct bialveolar protrusion. These methods require the use of stiff rectangular working archwire which requires lengthy alignment and leveling before insertion. In this case report, interproximal reproximation was performed instead of extraction. To establish clearance between the archwire and resin domes fixing the archwire, an archwire was inserted into a water-soluble tube before fabricating resin domes. This tube is solved away by the saliva. During fabrication of resin domes, the archwire was deflected intentionally reflecting the displacement of teeth from their ideal position. This can be called as deflection-based bonding (DBB) technique. DBB is different from conventional method of positioning the brackets on its ideal position and then inserting an archwire to align the brackets. Because the orthodontic force of the archwire comes from its deflection from passive configuration, deflecting an archwire as needed can move the teeth more predictably than just bonding brackets on its ideal position. Also, areas with good alignment before orthodontic treatment can be maintained simply by not deflecting the archwire during bonding in these areas. After initial alignment, interproximal reproximation was performed to create 4.8 ㎜ space in the maxillary arch and 4.2 ㎜ space in the mandibular arch. These spaces were closed using orthodontic mini-implant anchorage thus retracting the maxillary incisors 4 ㎜ posteriorly accompanied with 0.7 ㎜ and 0.3 ㎜ distal movement of right and left molars. By using interproximal reproximation and water-soluble tube with DBB, mild bialveolar protrusion was successfully treated without extraction.
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하악 편악 수술 교정 치료: 술후 하악골의 전상방 회전 재발을 고려한 3차원 수술 시뮬레이션의 활용
김혜민(Hye-Min Kim),임성훈(Sung-Hoon Lim),오지수(Ji-Su Oh),정서린(Seo-Rin Jeong),강신구(Shin-Gu Kang) 대한치과교정학회 2022 대한치과교정학회 임상저널 Vol.12 No.1
Isolated mandibular setback along the occlusal plane inevitably causes the development of the vertical bony step (VBS) between the mesial and distal segments of the mandible due to the angular difference between the occlusal plane and mandibular plane. Because the development of VBS causes postsurgical counterclockwise rotation of the mandible, simulation of this counterclockwise rotation should be incorporated into the simulation of surgery and the determination of surgical occlusion. In this case report, a 27-year-old female was treated to correct mandibular prognathism with asymmetry. During presurgical orthodontic treatment, maxillary molars were intruded to reduce the development of VBS during the isolated mandibular setback surgery. Despite this presurgical molar intrusion, 5.6 mm VBS was still developed at the 3D surgical simulation of single jaw surgery. Ideal jaw position was simulated, reducing this VBS to 2.1 mm, resulting in vertical overlaps of molars. To resolve these vertical overlaps or premature contacts, the distal segment was rotated 3.2° clockwise along the hinge axis. This simulation resulted in a surgical occlusion similar to a Class II open bite. During postsurgical orthodontic treatment, the mandible rotated 5.8° counterclockwise with the center of rotation 13 mm inferior to the hinge axis, resolving the VBS almost completely. This was slightly more than the anticipated amount of postsurgical rotation of the mandible. This case report showed that the isolated mandibular setback surgery can be done more predictably by incorporating the postsurgical counterclockwise rotation of the mandible into the simulation of surgery.
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