IVRO를 이용한 하악골 전돌증 환자의 수술전훈 악관절 증상 변화에 대한 임상적 평가
A CLINICAL STUDY ON THE CHANGE OF TMJ SYMPTOMS FOLLOWING IVRO IN THE MANDIBULAR PROGNATHISM
소속 상세정보
김진권/Jin-Kwon Kim
박광호/김형곤/김상수/김기영/허종기/Kwang-Ho Park/Hyung-Gon Kim/Sang-Soo Kim/Ki-Young Kim/Jong-Ki Huh
KMID : 0360119970190010001
Abstract
결론
1. 악관절 증상을 보인 환자는 술전 40%에서 술후 20%로 감소함을 보였다.
2. 주된 악관절 증상은 동통과 관절잡음이었으며 술후 전체 환자의 67%정도가 해소되었
다고 술전 증상이 없었으나 술후 야기된 환자는 2명, 6%였다.
3. 안면 비대칭을 동반한 하악골 전돌증 환자중 60%가 악관절 증상을 보였으며 안면 비
대 칭이 심할수록 악관절 증상의 빈도가 높았다.
4. 여러 요소 중 교합평면각과 하악평면각의 변화는 악관절 증상에 변화를 일으킬 수 있
는 한 요소로 작용하나, 그 변화량과는 유의성이 적으며 하악지 수직고경의 증감이 변화를
야기할 수 있다.
5. IVRO를 선택 사용한 상하악 동시이동술의 전증례에서 하악운동의 제한은 없었으며 술
후 악관절증상으로 부가적 치료를 요하는 환자가 없다는 것을 볼 때 악관절 증상의 해소에
치료 효과가 있다고 볼 수 있다.
#초록#
Preoperative and postoperative TMJ symptoms were observed in mandibular
prognathism of 30 patients operated on by Le Fort I osteotomy and intraoral vertical
ramus osteotomy. The alterations of TMJ symptoms were investigated and the
relationship between changes of TMJ symptoms and some cephalometric values
including occlusal plane angle, mandibular plane angle, posteior ramal height and a
degree of deviation of mandibular incisor midline to facial midline were observed. The
results are as follows.
The incidence of patient with TMJ symptoms before orthognathic surgery was 40%
and after orthognathic surgery was 20%. The most frequetly encountered symptoms in
orthognathic TMJ dysfunction patients were TMJ pain and/or clicking. After surgery
66% of the preoperative symptomatic patients reported improvement TMJ symptoms. On
the other hand 2 patients (6%) of the preoperative asymptomatic patients developed TMJ
symptoms after surgery. Preoperatively, 60% of the facial asymptomatic patients with
mandibular prognathism had TMJ symptoms. The more severe facial asymmetry was,
the higher incidence of TMJ symptoms was. The alteration of occlusal plane angle and
mandibular plane angle seems to be one of the contributing factors which make to
change TMJ symptoms in orthognathic patients. But its amount seems to be low
significance. Increase or decrease of posterior ramal height have influence on the change
of TMJ symptoms.
키워드
TMJ symptoms; IVRO;
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