하악 편악 수술 교정 치료: 술후 하악골의 전상방 회전 재발을 고려한 3차원 수술 시뮬레이션의 활용
Orthodontic Treatment with Isolated Mandibular Setback Surgery: Use of 3D Surgical Simulation including Postsurgical Relapse of Mandibular Setback
김혜민, 임성훈, 오지수, 정서린, 강신구,
소속 상세정보
김혜민 ( Kim Hye-Min ) - Chosun University College of Dentistry Department of Orthodontics
임성훈 ( Lim Sung-Hoon ) - Chosun University College of Dentistry Department of Orthodontics
오지수 ( Oh Ji-Su ) - Chosun University College of Dentistry Department of Oral and Maxillofacial Surgery
정서린 ( Jeong Seo-Rin ) - Chosun University College of Dentistry Department of Orthodontics
강신구 ( Kang Shin-Gu ) - Chosun University College of Dentistry Department of Orthodontics
Abstract
Isolated mandibular setback along the occlusal plane inevitably causes the development of the vertical bony step (VBS) between the mesial and distal segments of the mandible due to the angular difference between the occlusal plane and mandibular plane. Because the development of VBS causes postsurgical counterclockwise rotation of the mandible, simulation of this counterclockwise rotation should be incorporated into the simulation of surgery and the determination of surgical occlusion. In this case report, a 27-year-old female was treated to correct mandibular prognathism with asymmetry. During presurgical orthodontic treatment, maxillary molars were intruded to reduce the development of VBS during the isolated mandibular setback surgery. Despite this presurgical molar intrusion, 5.6 mm VBS was still developed at the 3D surgical simulation of single jaw surgery. Ideal jaw position was simulated, reducing this VBS to 2.1 mm, resulting in vertical overlaps of molars. To resolve these vertical overlaps or premature contacts, the distal segment was rotated 3.2° clockwise along the hinge axis. This simulation resulted in a surgical occlusion similar to a Class II open bite. During postsurgical orthodontic treatment, the mandible rotated 5.8° counterclockwise with the center of rotation 13 mm inferior to the hinge axis, resolving the VBS almost completely. This was slightly more than the anticipated amount of postsurgical rotation of the mandible. This case report showed that the isolated mandibular setback surgery can be done more predictably by incorporating the postsurgical counterclockwise rotation of the mandible into the simulation of surgery.
키워드
Mandibular prognathism with asymmetry; Isolated mandibular setback; Vetical bony step; Postsurgical counterclockwise rotation; Surgical simulation
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