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Class III¿¡¼­ Á¦1±â Ä¡·á¸¦ ½ÃÇàÇÑ ÈÄ¿¡ ¼ºÀå±â¸¦ ÅëÇÏ¿© ±³ÇÕÀÌ À¯ÁöµÇ´Â °æ¿ì¿Í ¹Ý´ë±³ÇÕÀÌ Àç¹ßµÇ´Â °æ¿ì°¡ Àִµ¥, ±× ÀÌÀ¯´Â ¹«¾ù ¶§¹®Àΰ¡¿ä?
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Áú¹® 2 :  Class III¿¡¼­ Á¦1±â Ä¡·á¸¦ ½ÃÇàÇÑ ÈÄ¿¡ ¼ºÀå±â¸¦ ÅëÇÏ¿© ±³ÇÕÀÌ À¯ÁöµÇ´Â °æ¿ì¿Í ¹Ý´ë±³ÇÕÀÌ Àç¹ßµÇ´Â °æ¿ì°¡ Àִµ¥, ±× ÀÌÀ¯´Â ¹«¾ù ¶§¹®Àΰ¡¿ä?

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A. Class I°ú ºñ±³ÇÏ¿© Class III¿¡¼­ Æò±ÕÀûÀÎ ¼ºÀå·®Àº Â÷ÀÌ°¡ ¾ø´Âµ¥µµ ºÒ±¸ÇÏ°í Class III¿¡¼­´Â Àç¹ßµÇ´Â ¾ç»óÀÌ ¸¹ÀÌ ¹ß°ßµÈ´Ù. Class IIIÀÇ Àç¹ß±º°ú ¾ÈÁ¤±ºÀ» ºñ±³ÇÑ °á°ú¿¡¼­, ¾ÈÁ¤±º¿¡ ºñ±³ÇÏ¿© Àç¹ß±º¿¡¼­ ÇϾǰñÀÇ Å©±â¿Í ÇüÅ°¡ Å©°í, ÇϾǰñ Àüü±æÀÌ¿Í Àü¾È¸é°í°æÀÇ ÃѼºÀå·®(8¼¼ºÎÅÍ 17¼¼±îÁö)ÀÌ Å©´Ù°í º¸°íµÇ¾ú´Ù4). ¶ÇÇÑ Class IIIÀÇ ÇϾǰñ ¼ºÀå·®ÀÌ Class I¿¡ ºñ±³ÇÏ¿© °³°³ÀÎÀÇ ´Ù¾ç¼ºÀÌ Å©¸ç, Ç¥ÁغÐÆ÷ÀÇ Æò±ÕÄ¡º¸´Ù ¸¹Àº ¼ºÀå·®À» º¸ÀÌ´Â Class III ȯÀÚ¿¡¼­´Â ¹Ý´ë±³ÇÕÀÌ Àç¹ßµÇ±â ½±´Ù. ¶ÇÇÑ Èĵΰ³ÀúÀÇ ÃѼºÀå·®ÀÌ Àç¹ß±ºº¸´Ù ¾ÈÁ¤±º¿¡¼­ ÄÇ´Ù. Mitani´Â Class I¿¡¼­ ÇϾǰñÀÇ ¼ºÀåÀº spheno-occipital synchondrosisÀÇ ¼ºÀå°ú ÇÔ²² ÃøµÎ°ñÀÇ ÇϾǿͰ¡ ÈĹæÀ¸·Î À̵¿Çϸ鼭 º¸»óÀÌ ÀÌ·ç¾îÁø´Ù°í ÇÏ¿´À¸¸ç, À̸¦ µÎ°³Àú ±³ÇÕ º¸»ó ±âÀü(cranial base compensation)À̶ó ÇÏ¿´´Ù. 

B.  µÎ°³Àú ±³ÇÕ º¸»ó±âÀü8)°ú Ä¡¾ÆÄ¡Á¶¼º º¸»ó±âÀüÀÇ ¿ªÇÒ
  ¼ºÀå±â µ¿¾È¿¡ °ñ°ÝÀÌ ¼ºÀåÇÔ¿¡µµ ºÒ±¸ÇÏ°í ±³ÇÕÀ» À¯ÁöÇÏ´Â °Í¿¡´Â µÎ°³Àú ±³ÇÕ º¸»ó±âÀü°ú Ä¡¾ÆÄ¡Á¶¼º º¸»ó±âÀüÀÌ Áß¿äÇÑ ¿ªÇÒÀ» ÇÑ´Ù. µÎ°³Àú ±³ÇÕ º¸»ó±âÀüÀ̶õ, »ó¾Ç°ñÀÇ ¼ºÀå·®º¸´Ù ÇϾǰñÀÇ ¼ºÀå·®ÀÌ ´õ ¸¹À½¿¡µµ ºÒ±¸ÇÏ°í ±³ÇÕÀ» ¾ÈÁ¤ÇÏ°Ô À¯ÁöÇÏ´Â °ÍÀ¸·Î ÇϾǰúµÎ¸¦ Æ÷ÇÔÇÑ ÃøµÎÇϾǿÍ(temporo-mandibular fossa)°¡ spheno-occipital synchondrosisÀÇ ¼ºÀå¿¡ µû¶ó¼­ ÈĹæÀ¸·Î À̵¿Çϸ鼭 ÇϾǰñÀÇ ¼ºÀå·®À» º¸»óÇÏ´Â °ÍÀÌ´Ù. ÀÌ·± ÀÏÂ÷ÀûÀÎ °ñ°ÝÀûÀÎ º¸»ó ÈÄ¿¡ base boneÀ§¿¡ ³õÀÎ Ä¡Á¶°ñÀÇ ¼ºÀåÀ¸·Î ±³ÇÕÀ» À¯ÁöÇÏ´Â º¸»óÀÌ ¼öÁ÷, ¼öÆòÀûÀ¸·Î ÀÌ·ç¾îÁø´Ù. ÀÌ°ÍÀÌ Ä¡¾ÆÄ¡Á¶ º¸»ó±âÀüÀÌ´Ù. µû¶ó¼­ ¹Ý´ë±³ÇÕÀÇ Àç¹ßÀÌ ÀÌ·ç¾îÁö´Â °æ¿ì´Â µÎ°³ÀúÀÇ ±³ÇÕ º¸»ó±âÀüÀÌ ÀÏÂ÷ÀûÀ¸·Î ³ª»Û °æ¿ìÀÌ´Ù. Áï spheno-occipital synchondrosis°¡ ºü¸¥ À¶ÇÕÀ¸·Î ¼ºÀåÀÌ »¡¸® Á¾·áµÇ¾ú°Å³ª, NSBa °¢µµ°¡ À۾Ƽ­ ÇϾÇÀÇ À§Ä¡°¡ Àü¹æÀ¸·Î À§Ä¡ÇÑ °æ¿ì¿¡µµ ¹Ý´ë±³ÇÕÀÌ Àç¹ßµÉ °¡´É¼ºÀÌ ³ô´Ù. ¹°·Ð ÀϹÝÀûÀ¸·Î´Â µÎ°³Àú ±³ÇÕ º¸»ó±âÀüÀÌ Á¶±Ý ºÒ·®ÇÏ´õ¶óµµ Ä¡¾ÆÄ¡Á¶ º¸»ó±âÀü¿¡ ÀÇÇÏ¿© º¸»óµÇ¾îÁö¸é¼­ ±³ÇÕÀ» À¯ÁöÇÒ ¼ö ÀÖÁö¸¸, Ä¡¾ÆÄ¡Á¶ º¸»ó±âÀüÀ¸·Îµµ ȸº¹ÇÒ ¼ö ¾øÀ» Á¤µµ·Î ½ÉÇÑ °æ¿ì¿¡´Â ¹Ý´ë±³ÇÕÀÌ Àç¹ßµÇ°Å³ª °³¹æ±³ÇÕÀÌ ¹ßÇöµÇ´Â µîÀÇ ºÎÁ¤±³ÇÕÀÌ À¯¹ßµÇ±â ½±´Ù. Class III¿¡¼­ »ó¾Ç°ñÀÇ ÀüÄ¡ºÎ°¡ ¼øÃø °æ»çÇÏ°í ÇϾǰñ ÀüÄ¡ºÎ´Â ¼³Ãø °æ»çµÇ´Â ÀÌÀ¯°¡ ÀÌ Ä¡¾ÆÄ¡Á¶ º¸»ó±âÀüÀÇ º¸»ó¿¡ ÀÇÇÑ °ÍÀÌ´Ù.

 1) Mitani H, Sakamoto T. Chin cap force to a growing mandible: long-term clinical reports. Angle Orthod 1984;54:93-122,
 2) Tanner JM, Whitehouse RH.  Assessment of skeletal maturity and prediction of adult height(TW2 method), 2nd edition, London, Academic Press 1983;22-37.
3)  Sugawara J, Asano J, et al.  Seeking a consensus for Class III treatment, Tokyo Clincal Press 2002;202-204.
 4) Choi YH, Sato K, Mitani H. Growth characteristics of prognathic face with relapsed incisor reversed occlusion following chin cap therapy. J Japan Orthod 1999;58: 1-14.
5)  ä¹Ý»ªÞªÁªè¡¢ñ¥Ôöúûò¸.ù»äÉîñÔÍñøªËªªª±ªëÎìïáö½Öûý­ªÎù»äÉð¯3ÓÞÏ¿öÍ ªÎÔÑ÷¾ªËªÄª¤ªÆ¡¢ÔÔÝÁÎìïáöÍò¼ 1993; 104:18-28.
6) ñ¥Ôöúûò¸¡¢ß²ÍÛçÈÜý. äÔØü, ÔéËÏ, ÌòÝ»ªÎð³û¡òõªªªèªÓãóíþªÎà÷íþtimingªË関ª¹ªëæÚϼ, ÔÔÝÁÓÞöÍò¼ 1988;6: 71-79.
 7) ÷øÜâû³Ú¸í­, ίê«ñÞì£, ß²ÍÛçÈÜý. ÞÖõðÑ¢àõà÷íþÑ¢ªËªªª±ªëÑûí­ ÍéÌ«àõù»äÉîñÔÍíºªÎäÉäÔØüÔéËϪÎà÷íþܨûù, ìíÎìöÍò¼, 1996;55:372-386.
 8) ß²ÍÛçÈÜý.  çµÎùöÍÎáùêû¡à÷Ñ¢ªËªªª±ªëÎáùê学ýÌͧûù -öÍ, äÉ, äÔØüªÎà÷íþªòÛÎÌتȪ·ªÆー.¡¡Quintessence õó÷ú,ÔÔÌÈ 1991;95-108.
 9) Kim JY, Kim TW, Nahm DS, Chang YI. Analysis of dentoalveolar compensation and discrimination of skeletal types. Korean J Orthod 2003;33(6): 407-418.
10)  Sim HY, Chang YI. Dentoalveolar compensation according to skeletal discrepancy in normal occlusion. Korean J Orthod 2004;34(5):380-393.