The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Three dimensional analysis of tooth movement using different types of maxillary molar distalization appliances

간접골성 고정원을 이용한 상악 구치부 원심이동 장치 종류에 따른 치아 이동 양상 평가

  • Kim, Su-Jin (Division of Orthodontics, Department of Dentistry, College of Medicine, Ewha Womans University) ;
  • Chun, Youn-Sic (Division of Orthodontics, Department of Dentistry, College of Medicine, Ewha Womans University) ;
  • Jung, Sang-Hyuk (Department of Preventive Medicine, College of Medicine, Ewha Womans University) ;
  • Park, Sun-Hyung (Division of Orthodontics, Department of Dentistry, College of Medicine, Ewha Womans University)
  • 김수진 (이화여자대학교 의과대학 치과학교실) ;
  • 전윤식 (이화여자대학교 의과대학 치과학교실) ;
  • 정상혁 (이화여자대학교 의과대학 예방의학교실) ;
  • 박선형 (이화여자대학교 의과대학 치과학교실)
  • Published : 2008.12.30
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Abstract

Objective: The purpose of this study was to compare the three dimensional changes of tooth movement using four different types of maxillary molar distalization appliances; pendulum appliance (PD), mini-implant supported pendulum appliance (MPD), stainless steel open coil spring (SP) and mini-implant supported stainless steel open coil spring (MSP). Methods: These experiments were performed using the Calorific $machine^{(R)}$ which can simulate dynamic tooth movement. Computed tomography (CT) images of the experimental model were taken before and after tooth movement in 1 mm thicknesses and reconstructed into a three dimensional model using V-works $4.0^{TM}$. These reconstructed images were superimposed using Rapidform $2004^{TM}$ and the direction and amount of tooth movement were measured. Results: The mean reciprocal anchor loss ratio at the first premolar was 17 - 19% for the PD and SP groups. The appliances using mini-implants (MPD or MSP) resulted in less anchorage loss (7 - 8%). On application of a pendulum appliance or MPD, distalization was obtained by tipping rather than by bodily movement. Furthermore, the maxillary second molar tipped distally and bucally. But on application of MSP, distalization was achieved almost by bodily movement. Conclusions: Regarding tooth movement patterns during molar distalization, stainless steel open coil spring with indirect skeletal anchorage was relatively superior to other methods.

본 연구의 목적은 pendulum 장치, 미니임플란트를 동반한 pendulum장치(펜듈럼), 오픈코일 스프링 및 미니임플란트를 동반한 오픈코일 스프링 이용 시 각각의 치아이동 양상을 3차원적으로 분석하는 데 있었다. 상악 좌측 치조골 및 치아 모형을 제작하고, Calorific $machine^{(R)}$을 이용하여 모형상에서 대구치를 3 mm 원심 이동시켰다. 실험은 5회씩 반복 실시하였다. 모델을 전산화 단층 촬영한 후 V-$Works^{TM}$를 이용하여 3차원 모델을 제작하였다. $Rapidform^{TM}$상에서 3차원적으로 이동방향과 이동량을 계측하였고, 각각의 장치에 관한 통계적 유의성을 검정하였다. 교정용 미니임플란트를 간접 골성 고정원으로 이용하여 오픈코일 스프링으로 구치부를 원심으로 이동시켰을 때가 치체이동에 가장 가까운 이동양상을 보였고, 고정원 소실도 적게 나타났다 (p < 0.05). 오픈코일 스프링, 펜듈럼 장치 모두 미니임플란트를 부가적으로 이용했을 때 고정원 소실량이 적었다 (p < 0.05). 미니임플란트를 이용하지 않은 경우에는 두 장치의 고정원 소실량이 비슷하였다. 미니임플란트의 이용 여부와 관계없이 펜듈럼 장치로 상악 구치 원심 이동 시 오픈코일 스프링에 비해 제1대구치가 조절성 경사이동 양상으로 이동되었고 (p < 0.05), 제2대구치는 비조절성 경사이동 양상을 보였으며, 치관의 협측경사이동이 일어났다 (p < 0.05). 이와 같은 결과를 근거로 간접 골성 고정원을 이용한 오픈코일 스프링이 상악 구치의 원심 치체이동에 가장 효과적인 장치였으며, 펜듈럼 장치를 이용한 구치부 원심이동 시에는 추가적인 조절이 필요하다고 할 수 있다.

Keywords

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