The buccolingual inclination of posterior teeth in skeletal Class III patients with or without asymmetry was evaluated by CBCT scans and compared with that in skeletal Class I patients. Also, the relationship between asymmetry and buccolingual inclination of posterior teeth was assessed. The findings are as followings,
1. The maxillary teeth had a tendency to be buccally inclined and the mandibular teeth to be lingually inclined from premolars through molars in all groups.
2. Group S showed more buccal inclination of maxillary premolars and molars, and more lingual inclination of mandibular first premolar and second molar compared to those of group I (p<0.05).
3. Group AS had significant difference in buccolingual inclination of posterior teeth between on the deviated side and non-deviated side (p<0.001). On the deviated side, maxillary teeth were more buccally inclined and mandibular teeth were more lingually inclined than the non-deviated side.
4. In Group AS, all teeth on the deviated side showed more buccally inclined maxillary teeth and lingually inclined mandibular teeth than those in other groups (p<0.05). On the non-deviated side, maxillary teeth had no significant difference
with group I (p>0.05) and only mandibular first molar was more buccally inclined than that of group I (p<0.05).
5. In group AS, Me deviation had negative correlation with the buccolingual inclination of all mandibular teeth on the deviated side (p<0.05), and canting of maxilla had negative correlation with only buccolingual inclination of maxillary second premolar on the non-deviated side (p<0.05).
There was transverse dental compensation in skeletal Class III patients with asymmetry, especially on the deviated side, and Me deviation had correlation with the dental compensation of mandibular teeth on the deviated side.
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국문 요약
비대칭 유무에 따른 골격성 III급 부정교합 환자의 구치부 협설측 치축 분석
연세대학교 대학원 치의학과 (지도교수 김 경 호)
안 재 찬
본 연구에서는 CBCT 분석을 통해 비대칭 유무에 따른 골격성 III급 부정교합 환자의 구치부의 협설측 치축을 골격성 I급 환자와 비교하였으며, 비대칭과 구치부 협설측 치축간의 연관성을 평가하였다.
총 63명의 골격성 III급 부정교합 환자 (남 : 32명, 여 : 31명)가 선정 되었으며 연구 대상의 평균 나이는 22.4 ± 4.00세 였다. 대상자는 이부 변 위량에 따라 두 그룹으로 나누었으며 이부변위는 정중시상면에서 이부까지 의 거리로 측정되었다. 이부 변위 2mm 미만인 환자를 비대칭이 없는 골 격성 III급 군, 이부 변위 4mm 초과인 환자를 비대칭을 동반한 골격성 III 급 군으로 정하였고 이부 변위가 2mm 이상 4mm 이하인 자는 제외하였 다. 대조군은 골격성 I급이며 경미한 총생을 보이는 총 25명의 정상교합자 (남 : 11명, 여 : 14명)로 이루어졌으며 평균 나이는 22.7 ± 5.31세 였다.
CBCT 영상에서 상악은 FH plane, 하악은 하악골 하연을 기준평면으 로 소구치와 대구치의 협설측 치축이 측정되었다. 각 군간의 협설측 치축 을 비교하여 치성보상을 평가하였고, 비대칭이 구치부의 협설측 치축에 미 치는 영향을 조사하여 다음과 같은 결과를 얻었다.
1. 골격성 I급과 골격성 III급 군 모두에서 협설측 치축은 제 1 소구치부터 제 2 대구치까지 후방으로 갈수록 상악 치아는 더욱 협측 경사 되었고, 하악 치아는 더욱 설측 경사되는 양상을 나타냈다.
2. 비대칭이 없는 골격성 III급 군에서 골격성 I급 군에 비해 상악의 모든 소구치와 대구치는 협측 경사되었고 하악 제 1 소구치와 제 2 대구치는 설측 경사되었다 (p<0.05).
3. 비대칭을 동반한 골격성 III급 군에서 이환측과 비이환측 간의 협설측 치축 차이는 통계적으로 유의할만한 차이가 있었다 (p<0.001). 상악은 이환측 치아가 더 협측 경사된 치축을, 하악은 이환측 치아가 더 설측 경사된 치축을 나타냈다.
4. 비대칭을 동반한 골격성 III급 군에서 골격성 I급, 비대칭이 없는 골격성 III급 군과 비교 시 모든 이환측 치아들이 상악은 협측 경사, 하악은 설 측 경사를 보였다 (p<0.05). 비이환측은 골격성 I급 군과 비교 시 상악
은 차이가 없었으며 (p>0.05), 하악은 제 1 대구치만이 협측 경사를 보 였다 (p<0.05).
5. 비대칭을 동반한 골격성 III급 군에서 하악 이부의 변위는 하악 치아의 모든 이환측 치아의 협설측 치축과 음의 상관성을 가졌으며 (p<0.05), 상악의 기울기는 단지 비이환측 상악 제 2 소구치의 협설측 치축과 음 의 상관관계를 가졌다 (p<0.05).
비대칭을 동반한 골격성 III급 부정교합 환자의 이환측 치아에서 횡적 인 치성보상이 주로 일어났으며, 하악 이부의 변위가 하악 이환측 치아의 치성보상과 상관관계를 보였다.
핵심 되는 말: 협설측 치축, CBCT, 골격성 III급 부정교합, 비대칭