CONCLUSION

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- 26 - REFERENCES

1. Azevêdo MS, Machado AW, Barbosa IdS, Esteves LS, Rocha VÁ C, Bittencourt MAV: Evaluation of upper airways after bimaxillary orthognathic surgery in patients with skeletal Class III pattern using cone-beam computed tomography. Dental press journal of orthodontics 21: 34-41, 2016

2. Becker OE, Avelar RL, Göelzer JG, do Nascimento Dolzan A, Júnior OLH, De Oliveira RB: Pharyngeal airway changes in class III patients treated with double jaw orthognathic surgery—maxillary advancement and mandibular setback. Journal of Oral and Maxillofacial Surgery 70: e639-e647, 2012

3. Burkhard JPM, Dietrich AD, Jacobsen C, Roos M, Lübbers H-T, Obwegeser JA:

Cephalometric and three-dimensional assessment of the posterior airway space and imaging software reliability analysis before and after orthognathic surgery. Journal of Cranio-Maxillofacial Surgery 42: 1428-1436, 2014

4. Chen F, Terada K, Hua Y, Saito I: Effects of bimaxillary surgery and mandibular setback surgery on pharyngeal airway measurements in patients with Class III skeletal deformities. American journal of orthodontics and dentofacial orthopedics 131: 372-377, 2007

5. Degerliyurt K, Ueki K, Hashiba Y, Marukawa K, Nakagawa K, Yamamoto E: A comparative CT evaluation of pharyngeal airway changes in class III patients receiving bimaxillary surgery or mandibular setback surgery. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 105: 495-502, 2008 6. DOS Riley RW, DOS Powell NR: Maxillofacial surgery and obstructive sleep apnea

syndrome. Otolaryngologic Clinics of North America 23: 809-826, 1990

- 27 -

7. Enacar A, Aksoy AU, Sencift Y, Haydar B, Aras K: Changes in hypopharyngeal airway space and in tongue and hyoid bone positions following the surgical correction of mandibular prognathism. The International journal of adult orthodontics and orthognathic surgery 9: 285-290, 1994

8. Fernández-Ferrer L, Montiel-Company JM, Pinho T, Almerich-Silla JM, Bellot-Arcis C: Effects of mandibular setback surgery on upper airway dimensions and their influence on obstructive sleep apnoea–A systematic review. Journal of Cranio-Maxillofacial Surgery 43: 248-253, 2015

9. Foltán R, Hoffmannová J, Donev F, Vlk M, Šedý J, Kufa R, Bulik O: The impact of Le Fort I advancement and bilateral sagittal split osteotomy setback on ventilation during sleep. International journal of oral and maxillofacial surgery 38: 1036-1040, 2009

10. Gokce SM, Gorgulu S, Gokce HS, Bengi AO, Karacayli U, Ors F: Evaluation of pharyngeal airway space changes after bimaxillary orthognathic surgery with a 3-dimensional simulation and modeling program. American Journal of Orthodontics and Dentofacial Orthopedics 146: 477-492, 2014

11. Greco JM, Frohberg U, Van Sickels JE: Long-term airway space changes after mandibular setback using bilateral sagittal split osteotomy. International journal of oral and maxillofacial surgery 19: 103-105, 1990

12. Hart PS, McIntyre BP, Kadioglu O, Currier GF, Sullivan SM, Li J, Shay C:

Postsurgical volumetric airway changes in 2-jaw orthognathic surgery patients.

American Journal of Orthodontics and Dentofacial Orthopedics 147: 536-546, 2015

- 28 -

13. Hatab N, Konstantinović V, Mudrak J: Pharyngeal airway changes after mono-and bimaxillary surgery in skeletal class III patients: Cone-beam computed tomography evaluation. Journal of Cranio-Maxillofacial Surgery 43: 491-496, 2015

14. He J, Wang Y, Hu H, Liao Q, Zhang W, Xiang X, Fan X: Impact on the upper airway space of different types of orthognathic surgery for the correction of skeletal class III malocclusion: A systematic review and meta-analysis. Int J Surg 38: 31-40, 2017 15. Hochban W, Conradt R, Brandenburg U, Heitmann J, Peter JH: Surgical

maxillofacial treatment of obstructive sleep apnea. Plastic and reconstructive surgery 99: 619-626; discussion 627, 1997

16. Holmberg H, Linder-Aronson S: Cephalometric radiographs as a means of

evaluating the capacity of the nasal and nasopharyngeal airway. American Journal of Orthodontics 76: 479-490, 1979

17. Hong J-S, Park Y-H, Kim Y-J, Hong S-M, Oh K-M: Three-dimensional changes in pharyngeal airway in skeletal class III patients undergoing orthognathic surgery.

Journal of Oral and Maxillofacial Surgery 69: e401-e408, 2011

18. Jiang Y-Y: Correlation between hyoid bone position and airway dimensions in Chinese adolescents by cone beam computed tomography analysis. International journal of oral and maxillofacial surgery 45: 914-921, 2016

19. Joss CU, Vassalli IM: Stability after bilateral sagittal split osteotomy advancement surgery with rigid internal fixation: a systematic review. Journal of oral and maxillofacial surgery 67: 301-313, 2009

20. Kim M-A, Kim B-R, Youn J-K, Kim Y-JR, Park Y-H: Head posture and pharyngeal airway volume changes after bimaxillary surgery for mandibular prognathism.

Journal of Cranio-Maxillofacial Surgery 42: 531-535, 2014

- 29 -

21. Kim N-R, Kim Y-I, Park S-B, Hwang D-S: Three dimensional cone-beam CT study of upper airway change after mandibular setback surgery for skeletal Class III malocclusion patients. The Korean Journal of Orthodontics 40: 145-155, 2010 22. Kim T, Baek S-H, Choi J-Y: Effect of posterior impaction and setback of the maxilla

on retropalatal airway and velopharyngeal dimensions after two-jaw surgery in skeletal class III patients. The Angle Orthodontist 85: 625-630, 2015

23. Lenza M, Lenza MdO, Dalstra M, Melsen B, Cattaneo P: An analysis of different approaches to the assessment of upper airway morphology: a CBCT study.

Orthodontics & craniofacial research 13: 96-105, 2010

24. Li Y-M, Liu J-L, Zhao J-L, Dai J, Wang L, Chen J-W: Morphological changes in the pharyngeal airway of female skeletal class III patients following bimaxillary surgery:

a cone beam computed tomography evaluation. International journal of oral and maxillofacial surgery 43: 862-867, 2014

25. Liukkonen M, Vähätalo K, Peltomäki T, Tiekso J, Happonen R-P: Effect of

mandibular setback surgery on the posterior airway size. The International journal of adult orthodontics and orthognathic surgery 17: 41-46, 2002

26. Mattos C, Vilani G, Sant’Anna E, Ruellas A, Maia L: Effects of orthognathic surgery on oropharyngeal airway: a meta-analysis. International journal of oral and

maxillofacial surgery 40: 1347-1356, 2011

27. Panou E, Motro M, Ateş M, Acar A, Erverdi N: Dimensional changes of maxillary sinuses and pharyngeal airway in Class III patients undergoing bimaxillary orthognathic surgery. The Angle Orthodontist 83: 824-831, 2013

28. Park S-B, Kim Y-I, Son W-S, Hwang D-S, Cho B-H: Cone-beam computed tomography evaluation of short-and long-term airway change and stability after

- 30 -

orthognathic surgery in patients with Class III skeletal deformities: bimaxillary surgery and mandibular setback surgery. International journal of oral and maxillofacial surgery 41: 87-93, 2012

29. Pereira-Filho VA, Castro-Silva LM, de Moraes M, Gabrielli MFR, Campos JADB, Juergens P: Cephalometric evaluation of pharyngeal airway space changes in class III patients undergoing orthognathic surgery. Journal of oral and maxillofacial surgery 69: e409-e415, 2011

30. Santagata M, Tozzi U, Lamart E, Tartaro G: Effect of orthognathic surgery on the posterior airway space in patients affected by skeletal class III malocclusion. Journal of maxillofacial and oral surgery 14: 682-686, 2015

31. Tselnik M, Pogrel MA: Assessment of the pharyngeal airway space after mandibular setback surgery. Journal of oral and maxillofacial surgery 58: 282-285, 2000

32. Uesugi T, Kobayashi T, Hasebe D, Tanaka R, Ike M, Saito C: Effects of orthognathic surgery on pharyngeal airway and respiratory function during sleep in patients with mandibular prognathism. International journal of oral and maxillofacial surgery 43:

1082-1090, 2014

33. Wenzel A, Williams S, Ritzau M: Changes in head posture and nasopharyngeal airway following surgical correction of mandibular prognathism. The European Journal of Orthodontics 11: 37-42, 1989

- 31 - - 국문요약 -

턱교정 수술 후 상기도 공간의 3 차원적 변화 : 1 년 추적 검사

아주대학교 임상치의학대학원 임상치의학과/구강악안면외과학 전공

강 노 을

(지도교수 : 송 승 일)

목적 : 본 연구의 목적은 편악 BSSRO 하악후퇴술 또는 Le Fort I 절골술을

동반하는 BSSRO 하악후퇴술을 시행한 환자에서 컴퓨터단층화 영상 검사를 통해 1 년동안 추적 검사를 통하여 3 차원적인 상기도 공간의 변화를 알아보는 것이다.

재료 및 방법 : 아주대학교 치과병원에서 골격성 III 급 부정교합을 진단받은 37 명의 환자를 편악 BSSRO 하악후퇴술을 시행한 그룹과 (Group 1, n=23) Le Fort I 절골술을 동반한 BSSRO 하악후퇴술을 시행한 그룹(Group 2, n=14)로 나누었다. 콘빔 컴퓨터단층화 영상을 수술 전(T0), 수술 2 달 후(T1), 수술 6 개월 후(T2), 수술 1 년 후(T3)에 시행하였다. 상기도 공간을 비인두공간, 구강인두공간 및 하인두공간으로 나누고 각각의 부피와 전후방 길이를 Invivo Dental Application version 5 를 통해 측정하였다.

결과 : 그룹 1 에서 구강인두공간 및 하인두공간의 부피는 수술 후(T1)

유의미하게 감소한 후 유지되었다(P<0.05). 그룹 2 에서 비인두공간, 구인두공간