A study on the anterior tooth size discrepancies among orthodontic patients with varying malocclusions

부정교합자의 전치부 치아크기 부조화에 관한 연구

  • Kim, Hyeok-Soo (Department of Orthodontics, School of Dentistry, Seoul National University) ;
  • Shim, Hae-Young (Department of Orthodontics, School of Dentistry, Seoul National University) ;
  • Nahm, Dong-Seok (Department of Orthodontics, School of Dentistry, Seoul National University)
  • 김혁수 (서울대학교 치과대학 교정학교실) ;
  • 심혜영 (서울대학교 치과대학 교정학교실) ;
  • 남동석 (서울대학교 치과대학 교정학교실)
  • Published : 2005.12.31

Abstract

Bolton analysis is widely used to predict tooth size discrepancy. but its accuracy has been challenged. The purpose of this study was to describe true anterior tooth size discrepancies among orthodontic patients and to evaluate the factors that affect true anterior tooth size discrepancies. The subjects consisted of 80 patients with varying malocclusions (Class I. Class II. Class III. and Class III surgery) who were treated orthodontically. Pre-treatment models. set-up models from post-treatment models. and lateral cephalometric radiographs were analyzed The results were as follows. The means. the standard deviations. and ranges of anterior Bolton ratio in the present study were somewhat higher than those of Bolton's samples and Korean normal samples. The number of patients showing maxillary deficiency was larger than that of patients showing maxillary excess in view of true anterior discrepancies. There was a significant difference between anterior Bolton discrepancy from pre-treatment models and true anterior discrepancy from set-up models (p < 0.05) There was no significant difference in true anterior discrepancies among malocclusion groups (p > 0.05). And there was also no significant difference between the male and female groups (p> 0.05). Overbite and the incisal edge thickness of maxillary anterior teeth have little relationship with true anterior discrepancies. Multiple regression analysis showed that true anterior discrepancy was mainly determined by anterior Bolton ratio, upper incisor to occlusal plane angle after treatment. interincisal angle after treatment. and upper right lateral incisor width.

Bolton 분석이 치아크기 부조화를 예측하기 위해 널리 사용되고 있지만 그 정확도에 대해서는 의문이 제기되어왔다. 이에 본 연구는 부정교합자를 대상으로 하여 실제 전치부 부조화가 나타나는 양상을 조사하고. 그것에 영향을 주는 요인에 대해서 평가하고자 하였다.. 연구대상은 다양한 부정교합(Class I. Class II, Class III. Class III surgery)을 가졌으며, 교정치료를 마친 80명의 환자들로 구성되었다. 치료 전 모형, 치료 후 모형으로부터 얻어진 셋업 모형 그리고 치료 전후 측모 두부 X-선 계측사진을 분석하였으며 다음과 같은 결과를 얻었다. 한국인 부정교합자의 전치부 Bolton ratio는 Bolton의 표본 및 한국인 정상교합자 표본과 비교해 보았을 때 평균, 표준편차범위가 다소 크게 나타났다. 실제 전치부 부조화는 상악의 부족(deficiency)을 보이는 경우가 상악의 과잉(excess)을 보이는 경우보다 많았다. 전치부 Bolton ratio로부터 예측한 전치부 부조화는 셋업 모형을 통해서 얻은 실제 전치부 부조화와 비교해 버았을 때 차이를 보였다 (p<0.05). 성별 및 부정교합군은 실제 전치부 부조화에 유의한 차이를 보이지 않았다 (p>005). 수직피개와 상악 치아 절단연 두께는 실제 전치부 부조화와 상관관계가 거의 없는 것으로 나타났다. 다중회귀분석 결과 실제 전치부 부조화에는 치료 전 모형의 전치부 Bolton ratio, 치료 후 상악 전치가 교합평면과 이루는 각, 치료 후 절치간각, 치료 전 상악 우측 측절치 폭경 등의 요인이 기여하는 것으로 나타났다.

Keywords

References

  1. Rudolph DJ, Dominguez PD, Ahn K, Thin T. The use of tooth thickness in predicting intermaxillary tooth-size discrepancies. Angle Orthod 1998;68:133-8
  2. Bolton W A. Disharmony in tooth size and its relation to the analysis and treatment of malocclusion. Angle Orthod 1958;28:113-30
  3. Bolton WA. The clinical application of a tooth-size analysis. Am J Orthod 1962;48:504-29 https://doi.org/10.1016/0002-9416(62)90129-X
  4. Tuverson DL. Anterior interocclusal relations. Am J Orthod 1980;78:361-70 https://doi.org/10.1016/0002-9416(80)90018-4
  5. Moyers RE. Handbook of orthodontics. Chicago: Year Book Medical Publishers, Inc.; 1988
  6. Dahlberg G. Statistical methods for medical and biological students. London: Allen: 1948
  7. 이유현, 장영일. 한국인 정상 교합자의 전치 폭경 비율과 전치부 수직 피개도에 관한 연구, 서울치대논문집; 1998
  8. Crosby DR, Alexander CG. The occurrence of tooth size discrepancies among different malocclusion groups. Am J Orthod Dentofacial Orthop 1989:95:457-61 https://doi.org/10.1016/0889-5406(89)90408-3
  9. Freeman JE, Maskeroni AJ, Lorton L. Frequency of Bolton tooth-size discrepancies among orthodontic patients. Am J Orthod Dentofacial Orthop 1996;110:24-7 https://doi.org/10.1016/S0889-5406(96)70083-5
  10. Santoro M, Ayoub ME, Pardi V A, Cangialosi TJ Mesiodistal crown dimensions and tooth size discrepancy of the permanent dentition of Dominican Americans. Angle Orthod 2000:70:303-7
  11. Smith SS, Buschang PH, Watanabe E. Interarch tooth size relationships of 3 populations: 'Does Bolton's analysis apply?'. Am J Orthod Dentofacial Orthop 2000:117:169-74 https://doi.org/10.1016/S0889-5406(00)70228-9
  12. Fields HW. Orthodontic-restorative treatment for relative mandibular anterior excess tooth-size problems. Am J Orthod 1981:79:176-83 https://doi.org/10.1016/0002-9416(81)90315-8
  13. Halazonetis DJ The Bolton ratio studied with the use of spreadsheets. Am J Orthod Dentofacial Orthop 1996:109:215-9 https://doi.org/10.1016/S0889-5406(96)70181-6
  14. White LW. The clinical use of occlusograms. J Clin Orthod 1982:16: 92-103
  15. Proffit WR. Contemporary orthodontics. St. Louis: Mosby: 1993
  16. Nie Q, Lin J. Comparison of intermaxillary tooth size discrepancies among different malocclusion groups. Am J Orthod Dentofacial Orthop 1999:116:539-44 https://doi.org/10.1016/S0889-5406(99)70186-1
  17. Binder RE, Cohen SM. Clinical evaluation of tooth-size discrepancy. J Clin Orthod 1998:32:544-6
  18. Bennett JC, Mclaughlin RP. Orthodontic management of the dentition with the preadjusted appliance. Oxford: Isis Medical Media: 1997