Changes of mandibular dental arch during surgical-orthodontic treatment in skeletal class III malocclusion individuals

악교정수술을 받은 III급 부정교합자의 치료 전, 후의 하악치열궁 변화

  • Nam, Hyung-Jin (Department of Orthodontics, School of Dentistry, Pusan National University) ;
  • Son, Woo-Sung (Department of Orthodontics, School of Dentistry, Pusan National University) ;
  • Park, Soo-Byung (Department of Orthodontics, School of Dentistry, Pusan National University) ;
  • Kim, Seong-Sik (Department of Orthodontics, School of Dentistry, Pusan National University)
  • 남형진 (부산대학교 치과대학 치과교정학교실) ;
  • 손우성 (부산대학교 치과대학 치과교정학교실) ;
  • 박수병 (부산대학교 치과대학 치과교정학교실) ;
  • 김성식 (부산대학교 치과대학 치과교정학교실)
  • Published : 2008.08.30

Abstract

Objective: The purpose of this study was to investigate changes in the mandibular dental arch from presurgical orthodontic treatment and orthognathic surgery, and to evaluate the relationships between the pretreatment records and changes of mandibular dental arch in skeletal Class III malocclusion individuals. Methods: Lateral cephalometric radiographs and mandibular study models of 31 adults with skeletal class III malocclusion were taken and measured. All measurements were evaluated statistically by ANOVA, Scheffe's Post Hoc, and paired t-test, and correlation coefficients were evaluated. Results: No significant difference in Mn-LMMC, Mn-LIE, Mn-MnOcc was detected between pretreatment and presurgical groups. Statistically significant but low correlations were demonstrated between the initial arch length discrepancy (ALD) and change in ICW, IPW1 (r = 0.492, 0.615) and change in arch length (r = 0.641). No association was seen between the initial depth of curve of Spee and change in mandibular incisor angle and arch width or arch length. Regression analysis showed that the amount of change for arch length and IPW1 could be explained by 64.0% and 75.8% of the pretreatment variables respectively. Conclusions: This study suggests that orthognathic surgery results can be predictable by measuring the pretreatment records.

본 연구는 악교정수술을 받은 골격성 III급 부정교합자의 치료 전, 후의 하악치열궁 변화를 관찰하고, 이들이 초진 시의 측모두부방사선 규격사진 및 석고모형과 어떠한 상관성을 가지고 있는지를 알아보기 위해 골격성 III급 부정교합자로 진단받은 31명(남자 14명, 여자 17명, 평균 $21.8\;{\pm}\;3.3$세)을 대상으로 치료 전, 악교정수술 전, 악교정수술 후 채득한 측모두부방사선 규격사진과 치료 전, 후의 석고모형을 계측하여 상관분석과 회귀분석을 시행하였다. 연구 결과 Mn-LMMC, Mn-LIE, Mn-MnOcc는 술전교정치료에 의한 유의한 차이를 보이지 않았다. 치료 전의 계측치와 치료 후 변화된 계측치와의 상관관계에서는 치열궁공간부족(ALD)은 ICW, IPW1의 변화량과 순상관관계(r = 0.492, 0.615)를 보였으며, 치열궁장경(arch length)의 변화량과도 순상관관계(r = 0.641)를 보였다. 그러나 Spee 만곡은 전치부치축 각도 변화와 치열궁 폭경 및 장경 등 각각의 변화량과는 상관관계를 보이지 않았다. 이를 이용하여 회귀분석을 시행한 결과, 술전교정 후 Arch length, IPW1의 변화량은 치료 전의 계측치로 각각 64.0%, 75.8%를 설명할 수 있었다. 이상의 연구에서 골격성 III급 부정교합자의 치료 전, 후의 변화량과 치료 전 측모두부방사선 규격사진 및 석고모형 간에 관련성이 있었고 악교정수술을 동반한 교정치료 계획을 수립할 때 술전교정치료의 목표 설정과 악교정수술 결과의 예측에 도움이 될 것으로 판단된다.

Keywords

References

  1. Yang SD. Surgical treatment objectives. J Korean Dent Assoc 2007;45:404-13
  2. Tae GC. Pre- and post-surgical orthodontic treatment. J Korean Dent Assoc 2007;45:413-22
  3. Montini RW, McGorray SP, Wheeler TT, Dolce C. Perceptions of orthognathic surgery patient's change in profile. A five-year follow-up. Angle Orthod 2007;77:5-11 https://doi.org/10.2319/061705-206R.1
  4. Worms FW, Isaacson RJ, Speidel TM. Surgical orthodontic treatment planning: profile analysis and mandibular surgery. Angle Orthod 1976;46:1-25
  5. Lee SJ, Hong SJ, Kim YH, Baek SH, Suhr CH. Effect of maxillary premolar extraction on transverse arch dimension in Class III surgical-orthodontic treatment. Korean J Orthod 2005;35:23-34
  6. Proffit WR, White RP, Sarver DM. Contemporary treatment of dentofacial deformity. St Louis: Mosby; 2003. p. 245-67
  7. Wolford LM, Hilliard FW, Dugan DJ. Surgical treatment objective. St Louis: Mosby; 1995. p. 11-74
  8. Steiner CC. Cephalometrics in clinical practice. Angle Orthod 1959;29:8-29
  9. Arnett GW, Jelic JS, Kim J, Cummings DR, Beress A, Worley CM Jr, et al. Soft tissue cephalometric analysis: diagnosis and treatment planning of dentofacial deformity. Am J Orthod Dentofac Orthop 1999;116:239-53 https://doi.org/10.1016/S0889-5406(99)70234-9
  10. Yang WS. Morphology of mandibular symphysis and positioning of lower incisors in the skeletal class III malocclusions. Korean J Orthod 1985;15:149-62
  11. Handelman CS. The anterior alveolus: its importance in limiting orthodontic treatment and its influence on the occurrence of iatrogenic sequelae. Angle Orthod 1996;66:95-109
  12. Wehrbein H, Bauer W, Diedrich P. Mandibular incisors, alveolar bone, and symphysis after orthodontic treatment. A retrospective study. Am J Orthod Dentofac Orthop 1996;110:239-46 https://doi.org/10.1016/S0889-5406(96)80006-0
  13. Hwang CJ, Kwon HJ. A study on the preorthodontic prediction values versus the actual postorthodontic values in class III surgery patients. Korean J Orthod 2003;33:1-9
  14. Kim SJ, Park SY, Woo HH, Park EJ, Kim YH, Lee SJ, et al. A study on the limit of orthodontic treatment. Korean J Orthod 2004;34:165-75
  15. Little RM. The irregularity index: a quantitative score of mandibular anterior alignment. Am J Orthod 1975;68:554-63 https://doi.org/10.1016/0002-9416(75)90086-X
  16. Shannon KR, Nanda RS. Changes in the curve of Spee with treatment and at 2 years posttreatment. Am J Orthod Dentofacial Orthop 2004;125:589-96 https://doi.org/10.1016/j.ajodo.2003.09.027
  17. Bae GS, Son WS. Construction of an ideal set-up model for lingual orthodontic treatment. Korean J Orthod 2005;35:459-74
  18. Dahlberg G. Statistical methods for medical and biological students. New York: Interscience Publishers Inc.; 1940. p. 122-32
  19. Bousaba S, Delatte M, Barbarin V, Faes J, De Clerck H. Preand post-surgical orthodontic objectives and orthodontic preparation. Rev Belge Med Dent 2002;57:37-48
  20. Swinnen K, Politis C, Willems G, De Bruyne I, Fieuws S, Heidbuchel K, et al. Skeletal and dento-alveolar stability after surgical-orthodontic treatment of anterior open bite: a retrospective study. Eur J Orthod 2001;23:547-57 https://doi.org/10.1093/ejo/23.5.547
  21. Lee HK, Son WS. A study on basal and dental arch width in skeletal Class III malocclusion. Korean J Orthod 2002;32:117-27
  22. Ishikawa H, Nakamura S, Iwasaki H, Kitazawa S, Tsukada H, Chu S. Dentoalveolar compensation in negative overjet cases. Angle Orthod 2000;70:145-8
  23. Jeon YJ, Park SB, Son WS. The correlation between dental compensation and craniofacial morphology in skeletal class III maloccusion. Korean J Orthod 1997;27:209-19
  24. Shim HY, Chang YI. Dentoalveolar compensation according to skeletal discrepancy in Normal occlusion. Korean J Orthod 2004;34:380-93
  25. Park SS, Kim HD, Lee DH, Jeon YM, Kim JG. Dentoalveolar characteristics according to facial types of class III malocclusion. Korean J Orthod 2002;32:33-42
  26. Jeong MH, Choi JH, Kim BH, Kim SG, Nahm DS. Soft tissue changes after double jaw rotation surgery in skeletal class III malocclusion. J Korean Assoc Oral Maxillofac Surg 2006;32: 559-65
  27. Baek SH, Yang WS. A soft tissue analysis on facial esthetics of Korean young adults. Korean J Orthod 1991;21:131-70
  28. Robinson SW, Speidel TM, Isaacson RJ, Worms FW. Soft tissue profile change produced by reduction of mandibular prognathism. Angle Orthod 1972;42:227-35
  29. Capelozza Filho L, Martins A, Mazzotini R, da Silva Filho OG. Effects of dental decompensation on the surgical treatment of mandibular prognathism. Int J Adult Orthodon Orthognath Surg 1996;11:165-80
  30. Yang SD. Orthognathic surgery and orthodontic treatment goals. J Korean Found Gnatho-Orthod Res 2003;6:7-34
  31. Lee SJ, Kim TW, Nahm DS. Transverse implications of maxillary premolar extraction in class III presurgical orthodontic treatment. Am J Orthod Dentofacial Orthop 2006;129:740-8 https://doi.org/10.1016/j.ajodo.2006.02.002
  32. Willmot DR, Moss JP. Changes in the axial inclinations of upper and lower incisors after mandibular surgery in class III cases. J Maxillofac Surg 1984;12:163-6 https://doi.org/10.1016/S0301-0503(84)80238-6
  33. AlQabandi AK, Sadowsky C, BeGole EA. A comparison of the effects of rectangular and round arch wires in leveling the curve of Spee. Am J Orthod Dentofacial Orthop 1999;116:522-9 https://doi.org/10.1016/S0889-5406(99)70183-6
  34. Braun S, Hnat WP. Dynamic relationships of the mandibular anterior segment. Am J Orthod Dentofacial Orthop 1997;111: 518-24 https://doi.org/10.1016/S0889-5406(97)70289-0
  35. Hemley S. Bite plates, their application and action. Am J Orthod Oral Surg 1938;24:721-36 https://doi.org/10.1016/S0096-6347(38)90280-7
  36. Strang RHM, Thompson WM. Case analysis. In: Textbook of Orthodontia. 4th ed. Lea and Febiger, Philadelphia; 1958. p. 335-61
  37. Chung TS, Sadowsky PL, Wallace DD, McCutcheon MJ. A three-dimensional analysis of mandibular arch changes following curve of Spee leveling in nonextraction orthodontic treatment. Int J Adult Orthodon Orthognath Surg 1997;12:109-21
  38. Im DH, Park HJ, Park JW, Kim JI, Chang YI. Surgical orthodontic treatment of skeletal class III malocclusion using mini-implant: correction of horizontal and vertical dental compensation. Korean J Orthod 2006;36:388-96
  39. Bailey LJ, Proffit WR, Blakey GH, Sarver DM. Surgical modification of long-face problems. Semin Orthod 2002;8:173-83 https://doi.org/10.1053/sodo.2002.125437