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안면비대칭 교정 - 치아교정만으로 치료한 사례

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작성자 연세반트교정치과 댓글 3건 조회 10,471회 작성일 19-11-18 13:25

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인천 구월동 연세반트 교정치과 시경근 원장입니다.

지난 포스팅에서 안면비대칭의 원인과 그에 맞는 치료방법에 대해 알아보았습니다.


오늘은 안면비대칭 비수술 교정치료 사례를 직접 보도록 할게요.

<연세반트 블로그 원문> https://blog.naver.com/vantdental/221722989619

20대 초반 여성분입니다.

얼굴 비대칭이 심하고 어금니가 반대로 물린다는 주소로 내원하셨어요.

얼굴 사진입니다. 아래턱이 좌측으로 틀어져 있고, 입술 라인이 기울어져 보입니다.

안면 비대칭

미소 시 치아 교합 평면도 기울어져 있습니다.

교합평면 기울어짐(canting)

입안 정면 사진이에요.

위, 아래 치아 중심선이 3~4mm 정도 어긋나며, 좌측 어금니 부위에 편측 반대교합(교차교합)이 관찰됩니다.

아래턱이 좌측으로 비대칭 되면서 교합도 어긋나게 되는 양상입니다.

중심선 비대칭과 좌측 어금니 반대교합

교합면 사진입니다. 위쪽 좌측 작은 어금니, 아래 양측 작은 어금니가 하나씩 결손되어 있습니다.

결손치아가 있고, 중심선이 좌측으로 틀어져 있는 것을 고려하여 작은 어금니 4개 발치교정에 준하여 치료 계획을 세웠어요. 따라서 위쪽 우측 작은 어금니와, 아래쪽 우측 영구치 결손으로 오래 남아있던 유구치를 발치하기로 했습니다.

빨간 원- 결손치, 노란 x- 발치 계획

빨간 원- 결손치, 노란 x- 발치 계획

먼저 좌측 어금니 반대교합(교차교합)을 개선하기 위해 악궁을 확장하였어요

위쪽 악궁이 확장되어 좌측 어금니 반대교합이 개선되었습니다.

좌측 어금니 부위 반대교합 개선

반대교합 개선 후 기울어진 교합평면 수정을 위해 위턱 우측 잇몸에 미니스크류(빨간원)를 식립하여 어금니 부위 함입을 진행했습니다.

위쪽 교합평면 개선

위쪽 교합 평면 개선 후 아래쪽 치아의 기울어짐도 미니스크류 고정원을 이용하여 교합을 맞추어 나갔어요.

기울어진 교합 평면이 수정되었어요.

치료 후 입안 사진입니다.

골격 비대칭이 있어 중심선을 완벽히 맞추는 것은 불가능하였지만, 교합에 의한 미끄러짐에 의한 비대칭을 개선하여 1~2mm 정도로 위, 아래 치아 중심선 불일치를 개선하였습니다.

좌측 어금니도 반대교합도 개선되어 정상 범주의 교합으로 개선되었습니다.

치료 전후 변화입니다.

치료 후 얼굴 모습입니다.

약간의 골격 비대칭은 남아있지만, 교합에 의한 비대칭이 개선되었습니다. 그리고 양측 교합을 정상 범주로 만들어 편측 저작 습관도 개선되어 연조직(근육)에 의한 비대칭도 상당량 개선되어 보입니다.

치료 전후 안모 변화입니다.

환자분께서는 수술 없이 교정만으로 이루어진 결과에 만족도가 높으셨습니다.

교정만으로 치료가 어려워 보이는 경우라도 정확한 진단과 원인에 맞는 명확한 치료 계획, 그리고 단계적 치료 접근을 통해 목표를 달성해 간다면 만족스러운 치료 결과를 이뤄낼 수 있다는 것을 보여주는 치료 사례였습니다.

안면비대칭, 어려운 교정도 연세반트교정치과와 함께 하시면 만족스러운 치료 결과를 약속드립니다.^^


 

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