The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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The structural change in the hyoid bone and upper airway after orthognathic surgery for skeletal class III anterior open bite patients using 3-dimensional computed tomography

3D-CT를 이용한 골격성 III급 개방교합자의 악교정 수술 전, 후 설골 및 상기도의 변화

  • Lee, Yoon-Seob (Department of Orthodonitcs, College of Dentistry, Yonsei University) ;
  • Baik, Hyoung-Seon (Department of Orthodontics, College of Dentistry, Oral Science Research Center, The Institute of Cranio-facial Deformity, Yonsei University) ;
  • Lee, Kee-Joon (Department of Orthodontics, College of Dentistry, Oral Science Research Center, The Institute of Cranio-facial Deformity, Yonsei University) ;
  • Yu, Hyung-Seog (Department of Orthodontics, College of Dentistry, Oral Science Research Center, The Institute of Cranio-facial Deformity, Yonsei University)
  • 이윤섭 (연세대학교 치과대학 교정학교실) ;
  • 백형선 (연세대학교 구강과학연구소, 치과대학 교정학교실, 두개안면기형 연구소) ;
  • 이기준 (연세대학교 구강과학연구소, 치과대학 교정학교실, 두개안면기형 연구소) ;
  • 유형석 (연세대학교 구강과학연구소, 치과대학 교정학교실, 두개안면기형 연구소)
  • Published : 2009.04.30
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Abstract

Objective: The purpose of this study was to investigate the structural changes of the hyoid bone and upper airway after orthognathic surgery for skeletal class III anterior open bite patients, and make comparisons with normal occlusion. Methods: Pre- and post-operative computed tomography (CT) examinations were performed on 12 skeletal class III anterior open bite patients who were treated with mandibular setback osteotomy. Using the V-works $4.0^{TM}$ program, 3-dimensional images of the total skull, mandible, hyoid bone, and upper airway were evaluated. Results: In the Class III open bite group, the hyoid bone were all positioned anteriorly, compared to the Normal group (p < 0.05). The angle between the hyoid plane and mandibular plane in the Class III openbite group before surgery was greater than in the Normal group (p < 0.05), and the difference increased after surgery (p < 0.01). In the Class III openbite group, the volume of the upper airway decreased after surgery (p < 0.001) and the volume of the upper airway was smaller than the Normal group before and after surgery (p < 0.001). Conclusions: The narrow upper airway space in skeletal Class III openbite patients decreased after mandibular setback osteotomy. This may affect the post-surgical stability.

본 연구는 골격성 III급 개방교합자의 악교정 수술 전, 후 설골과 상기도의 변화를 3D-CT를 이용하여 관찰하고 이를 정상교합자와 비교하기 위하여 시행하였다. 전치부 개방교합을 동반한 골격성 III급 부정교합으로 진단되어 악교정 수술을 받은 환자 중 12명을 선정 후, 3D-CT를 통해 설골과 상기도의 3차원 입체영상을 분석하여, 악교정 수술 전, 후의 설골의 위치 변화 및 상기도의 부피 변화를 살펴보고, 이의 결과를 정상교합자 10명과 비교하였다. 설골은 골격성 III급 개방교합군에서 악교정 수술 전에 정상교합군의 설골에 비해 전방에 위치하고 있었고 악교정 수술 후 설골은 후, 상방으로 변화하였으나 유의성은 관찰되지 않았다. Hyoid plane과 mandibular plane이 이루는 각은 악교정 수술전의 골격성 III급 개방교합군이 정상교합군보다 큰 값을 나타내었고, 악교정 수술 후에는 그 차이가 더욱 증가하였다. 골격성 III급 개방교합군의 상기도 부피는 정상교합자보다 작으며 이는, 악교정수술 후에 더욱 감소하였다. 3차원 영상 분석 결과, 골격성 III급 개방교합자의 상기도는 정상교합자에 비해 좁으며, 하악골 후퇴술 이후 더욱 감소하기 때문에 이는 수술적 개선의 안정성에 영향을 줄 수 있음을 알 수 있었다.

Keywords

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